Excess weight and obesity have become epidemic in the United States. Today, about two-thirds of the adult population is overweight and upwards of 40% is obese (A BMI greater than or equal to 25 and 30 respectively). Excess weight costs society immeasurable amounts of money, but more importantly, brings with it a cascade of detrimental effects including reduced productivity, increased sick days, impairment of enjoyment and lifestyle and sadly, early death. Unfortunately, losing weight is not as easy as the advertisements may make it seem. Excess weight is much more than excess calories coming in versus those we burn. Diet and exercise DO play a large role in managing excess weight, but there are other reasons behind obesity, including psychological factors as well as a hormonal component. Unfortunately, many of the weight loss options that we try year in, and year out only address a few of the many complex issues that belie the problem.
Whether we need to lose just a few pounds or dozens, virtually everyone turns to diet and exercise. In fairness, it is the front line of fat elimination and rightly so. However, research has shown that upwards of 95% of people suffering from obesity fail at their diet and exercise program. In fact, a significant number of these patients tend to regain the weight and sometimes put on even more weight over the long term. There are many reasons for this, not least of which is the fact that our bodies have a certain “set point.” This is a new normal weight that our brains have determined is appropriate and balanced. Years and decades of overeating and under exercising may create a setpoint higher than what would be considered a safe and healthy body weight. The result? When we try to diet and exercise, our brain resists, thinking that we should be at the higher weight. Unfortunately, excessive and fad dieting only makes the bounce-back worse. And while these programs may address two very important parts of weight loss, they do not address the psychological or hormonal components that often plague those suffering from obesity.
Commercial, structured diet programs are a cornerstone of the weight loss progression. And many of these programs do indeed work. However, they only work if the patient subscribes and continues following the program. Unfortunately, this is where many falter. As we distance ourselves from the support system that allowed us to lose weight, we tend to begin regaining that weight. Further, the cost of the subscription can be prohibitive for some. However, structured programs do have a distinct advantage over exercise and dieting on one’s own. The support system that they offer is a critical part of success. These programs can even be used for patients who are trying to maintain their weight whether they have had bariatric surgery or not. Consequently relatively more people tend to keep their weight off in a structured weight loss program.
Meal delivery programs have increased in popularity over the past decade. Today, one could choose from dozens of meal delivery options. Some target busy professionals, giving them a quicker option to prepare a meal. Others help novices become better cooks. There are also meal delivery programs specifically for weight loss. To be sure, a pre-prepared meal is a great way to control calories and save time. However, meal delivery programs can be unsustainably expensive for some. They can also be problematic when patients are away. If they have not learned the principles of better eating, they risk going back to former habits very quickly.
Weight loss supplements have gained in popularity over the years, but it was very clear early on that many were ineffective, and some were downright unsafe. Certain weight loss supplements such as green tea extract can be detrimental if taken improperly. This is of particular concern because the Federal Drug Administration or FDA does not regulate supplements and vitamins, allowing for lax oversight and a higher risk of a dangerous or ineffective products.
A vitamin or mineral imbalance may be part of an inability to lose weight. While balancing vitamins and mineral levels with supplementation may allow for some weight loss, it is rarely the only cause of excess weight gain.
As with any nutritional supplements, we only suggest taking these products under the supervision and guidance of a qualified medical professional.
Prescription medication for weight loss has been around for many decades with varying levels of success. Even today, there are prescription medications created specifically for weight loss. However, the most important thing to remember about prescription medication for weight loss is that it does not last. Meaning, once you stop taking the medication, it is very likely that you will regain some or all the weight that you lost. If the medication is well tolerated and you see excellent results, medication can be a very useful as a tool after, for example weight loss surgery, when the patient moves into the maintenance phase of their long-term postoperative plan.
On the flipside, some prescription medications may promote significant weight gain. Therefore, if you notice serious weight gain after starting a new prescription drug, speak to your doctor to see if this may be one of the side effects. There may be alternative medications to treat the condition.
The effectiveness and safety of hormone therapy for menopausal women has been debated strongly. To be sure, women experience significant hormonal changes during menopause. For example, a reduction in estrogen can lead to additional abdominal fat and muscle loss. Some studies have shown that hormone therapy can prevent weight gain when applied at specific times during menopause. Hormone therapy may also prevent insulin resistance and generally help improve metabolic health. However, hormone therapy, like other non-surgical treatments, is only effective while it is being used.
Surgical weight loss, also known as weight loss surgery or bariatric surgery is the most effective long-term weight loss solution for patients suffering from obesity. Not only does it combine a physical restriction of calories, but some procedures also offer a hormonal benefit that helps patients eat less and lose weight rapidly, safely and predictably. Of course, as with any weight loss procedure, surgical weight loss does require focus and dedication to the patient’s long-term lifestyle change including improved diet and exercise. However, data shows that gastric sleeve, gastric bypass, and duodenal switch patients experience exceptional long-term weight loss.