Obesity (Weight Loss) (cont.)
Choosing a safe and successful weight-loss program
Scientists have made tremendous strides in understanding obesity and in improving the medication treatment of this important disease. In time, better, safer, and more effective obesity medications will be available. But currently there is still no "magic cure" for obesity. The best and safest way to lose fat and keep it off is through a commitment to a life-long process of proper diet and regular exercise. Medications should be considered helpful adjuncts to diet and exercise for patients whose health risk from obesity clearly outweigh the potential side effects of the medications. Medications should be prescribed by doctors familiar with the patients' conditions and with the use of the medications. Medication(s) and other "herbal" preparations with unproven effectiveness and safety should be avoided.
Almost any of the commercial weight-loss programs can work, but only if they
motivate you sufficiently to decrease the amount of calories you eat or increase
the amount of calories you burn each day (or both). What elements of a
weight-loss program should a consumer look for in judging its potential for safe
and successful weight loss? A responsible and safe weight-loss program should be
able to document for you the five following features:
- The diet should be safe. It should include all of the recommended daily
allowances (RDAs) for vitamins, minerals, and protein. The weight-loss diet
should be low in calories (energy) only, not in essential foodstuffs.
- The weight-loss program should be directed toward a slow, steady weight loss
unless your doctor feels your health condition would benefit from more rapid
weight loss. Expect to lose only about a pound a week after the first week or
two. With many calorie-restricted diets there is an initial rapid weight loss
during the first one to two weeks, but this loss is largely fluid.
- If you plan to lose more than 15 to 20 pounds, have any health problems,
or take medication on a regular basis, you should be evaluated by your doctor
before beginning your weight-loss program. A doctor can assess your general
health and any medical conditions that might be affected by dieting and weight
loss. Also, a physician should be able to advise you on the need for weight
loss, the appropriateness of the weight-loss program, and a sensible goal of
weight loss for you. If you plan to use a very low-calorie diet (a special
liquid formula diet that replaces all food intake for one to four months), you should
do so under the close supervision of a health care practitioner.
- Your program should include plans for weight maintenance after the weight
loss phase is over. It is of little benefit to lose a large amount of weight
only to regain it. Weight maintenance is the most difficult part of controlling
weight and is not consistently implemented in weight-loss programs. The program
you select should include help in permanently changing your dietary habits and
level of physical activity, and to alter a lifestyle that may have contributed
to weight gain in the past. Your program should provide behavior modification
help, including education in healthy eating habits and long-term plans to deal
with weight problems. One of the most important factors in maintaining weight
loss appears to be increasing daily physical activity. Try to be more active
throughout the day and incorporate some simple calorie-burners into your
everyday routine. Even the most basic activities (such as taking an after-dinner
walk, using the stairs at the mall or office instead of taking an escalator or
elevator, park your car farther away so you have a longer walk) can get you
prepared for more regular exercise like walking or jogging. You may choose to
incorporate an individually tailored exercise program into your schedule.
- A commercial weight-loss program should provide a detailed statement of
fees and costs of additional items such as dietary supplements.
Obesity is a chronic condition. Too often it is viewed as a temporary problem
that can be treated for a few months with a strenuous diet. However, as most
overweight people know, weight control must be considered a life-long effort. To
be safe and effective, any weight-loss program must address the long-term
approach or else the program is largely a waste of time, money, and energy.
Conclusion
Maintaining your ideal body weight is a balancing act between food
consumption and calories needed by the body for energy. You are what you eat.
The kinds and amounts of food you eat affect your ability to maintain your ideal
weight and to lose weight.
Medical science has established that eating proper foods can influence health
for all age groups. The U.S. Department of Agriculture's current dietary
guidelines state:
- Eat a variety of foods.
- Balance the food you eat with physical
activity--maintain or improve your weight.
- Choose a diet with plenty of grain
products, vegetables, and fruits.
- Choose a diet low in fat, saturated fat, and
cholesterol.
- Choose a diet moderate in sugars.
- Choose a diet moderate in salt
and sodium.
- If you drink alcoholic beverages, do so in moderation.
Obesity At A Glance
- Obesity means having excess body fat. For adults 35 and older, having a BMI greater
than 30 is considered obese.
- Obesity is not just a cosmetic consideration. It is a chronic medical
disease that can lead to diabetes, high blood pressure, heart disease,
gallstones, and other chronic illnesses.
- Obesity is difficult to treat and has a high relapse rate. Greater than
95% of those who lose weight regain the weight within five years.
- Even though medications and diets can help, the treatment of obesity
cannot be a short-term "fix" but has to be a life-long commitment to
proper diet habits, increased physical activity, and regular exercise.
- The goal of treatment should be to achieve and maintain a "healthier
weight", not necessarily an ideal weight.
- Even a modest weight loss of 5% to 10% of initial weight and the long-term
maintenance of that weight loss can bring significant health benefits by
lowering blood pressure and lowering the risks of diabetes and heart disease.
- Chances of long-term successful weight loss are enhanced if the doctor
works with a team of professionals including dietitians, psychologists, and
exercise professionals.
References:
National Institutes of Health (NIH); "Classification of
Overweight and Obesity by BMI, Waist Circumference, and Associated Disease
Risks." "Body Mass Index Table."
Manson JE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR, Speizer FE, Hennekens CH.; "A prospective study of obesity and risk of coronary heart disease in women." N Engl J Med. 1990 Mar 29;322(13):882-9.
W. B. Droyvold, T. I. Lund Nilsen, S. Lydersen, K. Midthjel, P. M. Nilsson, J.-Å. Nilsson, J. Holmen; "Weight change and mortality: the Nord-Trondelag Health Study."
Journal of Internal Medicine. Volume 257 Issue 4, Pages 338 - 345
National Center for Health Statistics; "National Health and
Nutrition Examination Survey." http://www.cdc.gov/nchs/nhanes.htm.
World Health Organization; "Global Database on Body Mass
Index."
Life Measurements, Inc. (www.bodpod.com)
United States National Library of Medicine, National
Institutes of Health; "Bioelectric Impedance Analysis in Body Composition Measurement."
Lars Sjöström, M.D., Ph.D., Anna-Karin Lindroos, Ph.D., Markku Peltonen, Ph.D., Jarl Torgerson, M.D., Ph.D., Claude Bouchard, Ph.D., Björn Carlsson, M.D., Ph.D., Sven Dahlgren, M.D., Ph.D., Bo Larsson, M.D., Ph.D., Kristina Narbro, Ph.D., Carl David Sjöström, M.D., Ph.D., Marianne Sullivan, Ph.D., Hans Wedel, Ph.D.. "Lifestyle, Diabetes, and Cardiovascular Risk FActors 10 Years after Bariatric Surgery." New England Journal of Medicine.
Volume 351:2683-2693, December 23, 2004.
U.S. Department of Health and Human Services, U.S.
Department of Agriculture; "Dietary Guidelines for Americans."
Last Editorial Review: 12/1/2008
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