Weight Loss Treatments

There are many weight-loss methods available but many are unsuccessful and temporary, especially for those who are morbidly obese. Amongst the morbidly obese, less than 5 percent are successful 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.

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

A lot of people participate in a combination of the following treatments:

Dietary Modification

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

Ninety percent of people 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 decide to go on a diet, we advise that you work with a health professional who can tailor a diet to meet your needs. A diet needs to considerably 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 just 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:

• Setting realistic weight loss goals-- short term and long term.
• Recording your diet and exercise patterns in a diary.
• Identifying high-risk situations and avoiding them.
• Rewarding particular actions, such as exercising for a longer time or consuming less of a certain kind of food.
• Adopting realistic beliefs about 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 therapy and dieting will be critical in aiding you maintain your weight loss after surgery.

Surgery is a tool to get your body to start 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, especially weight-loss surgery.

Research shows that when you decrease the number of calories you consume, your body responds by reducing your metabolism to burn fewer calories, rather than promote weight loss. Daily exercise can help accelerate your metabolism, successfully minimizing the "set point"-- a sort 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 might make any level of physical exertion extremely challenging. But you can learn strategies to help you begin a realistic exercise regimen. The following techniques can help you start exercising and can be integrated into your everyday routine.:

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

Medications

A number of over-the-counter and prescription weight loss medications are available. Some people find these drugs help suppress 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 patients stop taking the medication, weight gain usually occurs.

Weight loss drugs, 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 medication works by blocking about 30 percent of dietary fat from being absorbed. Alli is a lower-dose, non-prescription formula of the same drug.
• Phentermine-- Phentermine, an appetite suppressant, has been available for many 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 go to a certified health care professional that can prescribe appropriate medications. Before insurance providers will reimburse you for weight-loss surgery, you have to adhere to a well-documented treatment plan that usually includes medications.

Surgery

Many people that are morbidly obese and who have been unsuccessful in losing and keeping off the weight, opt for 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 people 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 a normal). BMI is a number based on both your height and weight. Surgery might be considered with a BMI as low as 35 if your doctor determines that there's a medical need for weight reduction and surgery seems the only means 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. Most surgeons require that you show serious incentive and a clear understanding of the extensive dietary, exercise and medical guidelines that need to be followed for the remainder of your life.

The UCSF Bariatric Surgery Center has conducted surgical weight loss procedures since 1996. Various procedures involve different risks and advantages. During your first consultation, your surgeon will discuss in detail the various choices available to you, together with their associated risks and advantages.

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

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

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