Overweight/Weight Loss Treatment in Del Mar, CA

There are numerous weight-loss methods available but many are ineffective and short-term, especially for those who are morbidly obese. Amongst the morbidly obese, less than 5 percent succeed in losing a considerable amount of weight and maintaining the weight loss with non-surgical programs-- generally a combination of dieting, behavior modification therapy and exercise.

Individuals do lose weight without surgery, however, especially when they work with a licensed healthcare professional to develop an effective and risk-free weight-loss program. The majority of health insurance providers do not cover weight-loss surgery unless you first make a major effort to lose weight using non-surgical methods.

Many individuals participate in a combination of the following therapies:

Dietary Modification

A lot of us have tried a variety of diets and have been stuck in a cycle of weight gain and loss-- "yo-yo" dieting-- that can lead to major health risks by stressing the heart, kidneys and other organs.

Ninety percent of individuals participating in all diet programs regain the weight they've lost within two years. For people that have weight-loss surgery, dieting is an instrumental part of maintaining weight loss after surgery.

If you choose to go on a diet, we suggest that you work with a health professional that can customize a diet to meet your needs. A diet needs to greatly restrict your calorie intake, but maintain your nutrition. Calorie-restrictive diets fall under two basic categories:

• Low-calorie diets (LCDs) are individually planned to include 500 to 1,000 calories a day less than you burn.
• Very low-calorie diets (VLCDs) usually limit intake to only 400 to 800 calories a day and feature high-protein, low-fat liquids.

Behavior Modification

The objective of behavior modification therapy is to change your eating and exercise habits to stimulate weight loss. Examples include:

• Establishing realistic weight loss goals-- short-term as well as long-term.
• Tracking your diet and exercise patterns in a diary.
• Recognizing high-risk situations and avoiding them.
• Rewarding specific actions, such as exercising for a longer time or eating less of a certain type of food.
• Adopting rational beliefs regarding weight loss and body image.
• Developing a support network, including family, friends and colleagues, or joining a support group that can help you concentrate on your goal.

Although some people experience success with behavior modification, most people achieve only short-term weight loss for the first year. If you intend on having weight-loss surgery, behavior modification and dieting will be critical in aiding you to maintain your weight loss after surgery.

Surgery is a tool to get your body to begin losing weight. Diet and behavior modification will determine your ultimate success.

Exercise

Exercise significantly increases your chance of long-term weight loss. It is a key component for any long-term weight management program, particularly weight-loss surgery.

Research shows that when you reduce the number of calories you consume, your body responds by reducing your metabolism to burn fewer calories, instead of promoting weight loss. Daily exercise can help speed up your metabolism, effectively minimizing the "set point"-- a kind of thermostat in the brain that makes you resistant to either weight gain or loss-- to a lower natural weight.

Starting an exercise program can be intimidating if you're morbidly obese. Your health condition may make any level of physical exertion extremely hard. But you can learn techniques to help you begin a realistic exercise routine. The following techniques can help you start exercising and can be integrated into your everyday routine:

• Park your car at the back of parking lots and walk through them. Walking is considered one of the most efficient forms of exercise. You can start slowly and build up over time.
• Reduce the time you spend watching television.
• Ride an exercise bike.
• Swim or participate in low-impact water aerobics.
• Take the stairs instead of the elevator.
• Walk briskly for five minutes in the morning and five minutes in the afternoon.

Medications

An assortment of over-the-counter and prescription weight loss drugs are available. Some people find these medications help curb their appetites. Studies show that individuals on drug therapy lose around 10 percent of their excess weight and that the weight loss plateaus after six to eight months. As individuals stop taking the medication, weight gain generally occurs.

Weight loss medications, approved by the U.S. Food and Drug Administration (FDA) for treating obesity, include:

• Beta-methyl-phenylethylamine (Fastin)-- This is a stimulant that boosts fat metabolism.
• Orlistat (Xenical)-- This drug works by blocking about 30 percent of dietary fat from being absorbed. Alli is a lower-dose, over-the-counter formula of the same drug.
• Phentermine-- Phentermine, an appetite suppressant, has been available for years. It is half of the "fen-phen" combination that continues to be available for use. The use of phentermine alone has not been linked to the adverse health effects of the fenfluramine-phentermine combination.
• Sibutramine (Meridia)-- This is an appetite suppressant approved for long-term use.

Medications are an important part of the morbid obesity treatment process but weight-loss medications can have serious side effects. We advise that you visit a licensed healthcare professional who can prescribe proper medications. Before insurance companies will reimburse you for weight-loss surgery, you have to adhere to a well-documented treatment plan that generally includes medications.

Surgery

Many individuals, that are morbidly obese and who have been unsuccessful in losing and keeping off the weight, decide on bariatric or weight-loss surgery.

Bariatric surgery, which involves sealing off most of the stomach to reduce the amount of food you can consume, can be an effective way for morbidly obese individuals to lose weight and maintain that weight loss.

To be considered for weight-loss surgery, you must meet at least one of the following qualifications:

• Be more than 100 pounds over your ideal, recommended body weight.
• Have a body mass index (BMI) of 40 or higher (20 to 25 is considered normal). BMI is a number based on both your height and weight. Surgery may be considered with a BMI as low as 35 if your physician determines that there's a medical need for weight reduction and surgery appears to be the only way to achieve the targeted weight loss.

To qualify for surgery, you have to complete a medical and psychological pre-evaluation process and show that you are committed to long-term, follow-up care after surgery. The majority of surgeons require that you show serious motivation and a clear understanding of the extensive dietary, exercise, and medical requirements that need to be followed for the remainder of your life.

The UCSF Bariatric Surgery Center has conducted surgical weight loss procedures since 1996. Different procedures involve different risks and benefits. During your initial consultation, your surgeon will go over in detail the different choices available to you, together with their associated risks and benefits.

The most common bariatric surgeries are "restrictive" procedures that reduce the size of the stomach and limit the calories you can consume.

For further information about Dr. Stengler’s practice and his clinic in Del Mar, California, please visit our website at MarkStengler.com or give us a call at (760) 274-2377