Weight Loss Options
Weight loss is big business. And if you’ve ever looked for a program to join, there are plenty out there – not to mention lots of confusion and conflicting information as well. While not every diet or exercise program is ideal for everyone, these structured programs do represent a first step toward taking control of your life and health. In fact, to qualify for insurance coverage of weight loss surgery, many insurers now require patients to have a history (sometimes up to 6 months) of medically-supervised weight loss efforts.
Structured, non-surgical weight loss programs are based on lifestyle change through diet and exercise. However, for over 90% of us (according to the NIH), diet and exercise alone does not contribute to long-term and sustained weight loss. While many lose a significant amount of weight, it is rarely sustainable and significant weight regain is common. Often, the end result is frustration and the beginning of years of yo-yo dieting with no measurable success. Ultimately, we must understand that obesity is not a straightforward disease. There are multiple, complex factors that both cause the weight problems and prevent us from eliminating them.
The risks of obesity however are very clear and affect an ever greater percentage of the population. Whether it be type 2 diabetes, sleep apnea, high cholesterol or hypertension, obesity creates a recipe for lower quality of life and a shortened lifespan.
Weight Loss Surgery
Weight loss surgery, also known as bariatric surgery, is a major surgical procedure. The number of patients turning to bariatric surgery has increased dramatically over the years as new procedures and devices offer greater benefit with less risk. New surgical techniques have made weight loss surgery as safe as it has ever been. Some of the reasons behind the growing popularity of bariatric surgery include:
- Our current knowledge of the health risks of morbid obesity
- The relatively lower risk of the procedures versus leaving obesity unchecked
- The ineffectiveness of current non-surgical approaches to sustained weight loss
With all the above being said, it is important to remember that weight loss surgery is meant to treat the conditions associated with obesity first and foremost – weight loss is actually just a pleasant side effect. It should not, by any means, be considered as a cosmetic procedure. Indeed, the FDA and our practice, have developed and adhere to strict guidelines to help ensure that patients are truly qualified for surgery. Typically those with a BMI of 40 or over or those with a BMI of 35-39.9 with one or more obesity related diseases may qualify for surgery.
As a patient, however, you must commit to your renewed health by attending support groups and following the diet and exercise plan prescribed to you by our office. Of course, you’re not alone. Our practice will be there with you every step of the way.
Diet & Behavior Modification
It is rare to find someone for whom a conventional diet has worked in perpetuity – that’s an unfortunate reality for many dieters. Most of us join a never ending cycle of weight loss and weight regain, which stresses the mind and body. In fact, not only can failed dieting cause frustration and even depression, but it can affect the heart, liver and kidneys too.
You may have had more success with a physician supervised weight loss program. These programs are tailored to the patient with the goal of balancing low calorie intake with proper nutrition. Generally, there are two types of calorie restriction plans employed at a non-surgical physician supervised weight loss program:
- Low calorie diets require a patient consume up to 1000 fewer daily calories than what their body burns
- Very Low Calorie diets restrict calories even further. Some diets allow as few as 400 calories to be consumed daily. These are often liquid diets emphasizing protein meal replacement
While most patients will lose a significant amount of weight on a Very Low Calorie diet, the problem is sustainability. Unfortunately, most regain all their weight, and sometimes more, over the course of two years.
Exercise as a Weight Loss Option
Exercise is a proven weight loss technique and is a critical part of every health and wellness program, no matter what tool is being used to facilitate the weight loss. However, it can be hard for someone who has lived with obesity to start a comprehensive exercise program. After all, no matter the benefits you may derive from exercise, it may be hard just to walk to your car or tie your shoes.
A National Institutes of Health survey of 13 studies concludes that physical activity:
- Results in modest weight loss in overweight and obese individuals
- Increases cardiovascular fitness, even when there is no weight loss
- Can help maintain weight loss
There has been plenty of time devoted to the study of how the body reacts to diet and exercise. Broad consensus has been formed around the body’s “set point” – a pre-programmed weight that your body believes is appropriate. Over the longer-term, this set point can change, however dieting alone is very difficult as the body adapts to retain its current set point. For example, reduced caloric intake may cause a slowing of the metabolism, making it harder to lose weight. Exercise boosts the metabolism, counteracting the tendency for a slower metabolism during dieting.
Exercise programs have to get started somewhere. Here are a few ways you can get your daily exercise with a relatively lower risk of injury:
- Park further from the store so you walk a little more through the parking lot
- Take the stairs when it does not pose a risk (I.e. don’t risk dizziness and falling)
- Cut down on television and do housework instead
- Swim or take a low-impact water aerobics class
- Ride an exercise bike
Just remember to start slowly and don’t overexert yourself. Risking injury is not worth it. Rather, work on your exercise program gradually, in conjunction with your diet and other weight loss tools. Inspire family members and friends to join your exercise program and bring health to those around you as well.
Over-the-Counter & Prescription Drugs
As the ravages of obesity continue to affect a significant portion of the US population, new drugs are coming to market promising to make it easier to lose weight. While some patients do respond well to medication, most patients on drug therapy lose only 10% of their excess body weight and tend to regain that weight after they stop taking the medication. Further, drugs can come with serious side effects. With that being said, medications should not be ruled out as a treatment option for those suffering from excess weight and obesity.
“Since many people cannot lose much weight no matter how hard they try, and promptly regain whatever they do lose, the vast amount of money spent on diet clubs, special foods and over-the-counter remedies, estimated to be on the order of $30 billion to $50 billion yearly, is wasted.” New England Journal of Medicine.