Three Elements of a Successful Medical Weight Loss Program

Posted: Jun 24 in Medical Weight Loss News, Weight loss by Dr. Lazarus

Losing weight is not easy. Keeping it off is even harder. As a Board-Certified Obesity Medicine Physician, I’ve been helping patients in Denver, Colorado do just that for over 16 years. Since 2014, when I took over the Denver Medical Weight Loss center Clinical Nutrition Center, I’ve had the opportunity to speak with countless patients who successfully engaged in a medical weight loss program with us and not only lost the weight but kept it off.

In these discussions, my patients have helped me understand the most important elements of a successful and sustained medical weight loss program. They are:

1. Structure
   This is a critical element in losing weight and keeping it off. My patients who have experienced successful weight loss do it with a plan that they can follow every day. The structure of a successful medical weight loss program begins with a good night’s sleep, planned meals (often using 1-3 meal replacements for meals and/or snacks), planned time for physical activity, planned time for fun activities, and a scheduled bedtime.
2. Support
   Sometimes our environment makes sticking with a plan difficult. This is why many people need help. You do not need to embark on this medical weight loss journey on your own. I don’t know of any concert pianists who became proficient on the piano watching youtube videos. Similarly, I know of few individuals who have successfully lost weight and kept it off long-term using a fitness tracker or a phone app. These things are certainly handy and convenient, yet nowhere near as effective as interpersonal communication and support. Particularly in these COVID-19 times of “Social distancing” the interpersonal communication and support is more helpful than ever. Similarly, for keeping weight off, my experience shows that attending office visits is one of the most helpful strategies to stay on track.
3. Metabolic Advantage
   Keeping weight off is hard because our body wants to return back to the original weight. When we lose weight, our body will be in a much slower metabolic state than it was prior to weight loss. Further, our body will produce fewer satisfaction hormones and more hunger hormones. It is thought that this metabolic adaptation to weight loss (Increased hunger, decreased satiety, decreased energy expenditure) is the main reason people have trouble keeping the weight off. For this reason, we need to focus on strategies that provide people who have successfully completed the weight loss phase of their medical weight loss program with a metabolic advantage to improve the odds of keeping that weight off! There are several ways we can offset these adaptations including:
   1. Weight loss medications (now called anti-obesity medications): These can offset the increase in hunger and decrease in satiety. The older medications may also provide an increase in metabolism, although the evidence supporting this claim is conflicting.
   2. Protein drinks / bars: Continuing a structured higher protein / lower carb food plan may help because it forces the body to spend energy converting the protein into the fuels that we need. One study showed that low glycemic index / high protein meal planning was effective for sustaining weight loss.
   3. Resistance exercise: increasing our lean body weight provides an increase in our metabolism, and can help us improve calories burned during walking and cardio workouts.
   4. Sleep: our brains burn a ton of calories while we sleep! Getting a good night sleep helps normalize our hunger hormones so we aren’t exhausted and starving all day long!

So there you have it – decades of experience running a medical weight loss center in Denver, Colorado have helped me identify these three key elements of successfully losing weight and keeping it off.

-Ethan Lazarus, MD