Four Elements of a Successful Weight Loss ProgramPosted: May 03 in Weight Management Strategies by Dr. Lazarus
Let’s face it – losing weight, and more importantly, keeping it off, can feel like a huge challenge. While many get off to a great start and initially lose weight, the challenge of keeping it off many times feels overwhelming. That’s why I like to simplify the process down to the four most important elements of a successful weight loss program. These elements are important when losing the weight and while working on keeping weight off.
- Healthy Eating
- Decreasing Physical Inactivity
- Proper Medical Management
Support Visits for Weight Loss and Weight Loss Maintenance
The best evidence-based tool for losing weight and keeping it off is support visits. In fact, the more visits attended, the more weight people lose, and more importantly, the better people do at keeping the weight off. Medically, we call these visits “Intensive Lifestyle Intervention,” or ILI for short. The reason ILI is so important is that obesity is mostly caused by a complex interplay between our genetics and our biology and the environment. Because we can’t change our genetics, it is important we address the other two areas. I’ll discuss biology in a bit.
But the environment is the real kicker. the American way of life has made sustaining a healthy body mass index virtually impossible, with 2 out of 3 people now at an unhealthy weight in our country. Intensive lifestyle intervention focuses on helping you make real changes to your environment so you can address stressors, sleep disturbers, barriers to weight loss, and find strategies that really work to keep the weight off.
ILI helps us address the environment and why we eat, but what we eat is equally important. Our weight will ultimately be a function of how healthy we eat on a day to day basis. There is not a magic diet that is best for most people – everybody feels satisfied with different foods. That’s why we customize food plans for each person we work with.
There is also good evidence for meal replacement strategies – as the use of fixed calorie meal replacements (like Optifast and Nutrema) increases, so does weight loss. This is a simple way to help improve nutrition and decrease daily calories.
But this must go hand in hand with the support visits (above). That way, we are not just working on what you eat, but also working on why you eat what you eat.
Decreasing Physical Inactivity
Unfortunately, it seems that most of us spend most of our time sitting at a desk, often in front of a computer or a smart phone. No wonder keeping weight off is so hard! A guiding principal of keeping weight off is finding ways to decrease this sedentary time and move!
This does not necessarily mean going to the gym and running on a treadmill. Not that there is anything wrong with this strategy, but most evidence on successfully maintaining weight loss shows that minutes of activity are more important than the type of activity.
Fitness trackers, smart watches, moving workstations. Finding ways to move for 1 to 2 hours a day will help keep the weight from creeping back on. Part of this can be structured exercise like weights, yoga, pilates, cardio, exercise bike, swimming, etc. But a bigger part should focus on not sitting.
Obesity is a disease and it responds well to medical treatment. Nevertheless, it is estimated that in our country today, only 1.4% of people with this disease receive medical treatment. This is in contrast to a disease like type 2 diabetes, where 86% of affected people are on prescription medication.
The anti-obesity medications are safe and effective. They can help address the biology of obesity. Medications can decrease hunger, improve satisfaction and reduce cravings. Our bodies’ biology has defensive mechanisms in place that resist weight loss, and after weight loss, cause us to regain the lost weight. These mechanisms, now called metabolic adaptations, slow metabolism, increase hunger, and reduce satiety. No wonder keeping weight off is even harder than losing it! Medications can help overcome these defensive mechanisms.
We can help work with you to see if you are a good candidate, and if so, which treatment is best.
In addition, we can work with you to identify other medications you may be on that encourage weight gain. Many medications can cause trouble including:
- Over the counter and prescription sleep aids
- Anti-depressant medications
- Anti-anxiety medications
- Pain medications
- Blood pressure medications
- Diabetes medications
Four Elements of Successful Weight Loss
By addressing all four elements, you will experience greater weight loss, and more importantly boost your odds of keeping the weight off.