Thursday, September 15, 2011

Weight Loss Question

Hello Docs,

I am having trouble losing weight. I tend to yo-yo on the weight thing. I have tried Weight-Watchers and Nutri Systems, but I get so hungry I eventually binge and end up back where I started. What are options for me besides surgery? I am female and 40 years old. I am 5' 4'' and weigh 260 pounds. I have no other medical problems. I have had a recent complete physical including a thyroid check. I'm healthy but fat! What to do?



Dear Cynthia,

Thanks Cynthia for your question. There are as many ways to approach weight loss these days as there are people trying to lose weight. Weight Watchers and Nutri-System are great programs, but when it comes down to the essentials it takes two things to lose weight: good diet and regular exercise. The reason that most diets fail is because there is (believe it or not) too much self-reliance or (worse) reliance on friends to be a support structure for continued success.
You've done a good job by getting a primary physician to see you and get some routine lab work. However, the usual amount of time your primary provider has to devote to you (especially if you are an established patient) is going to be about 15 minutes. In my practice, I have found that it takes about 30-45minutes of time just to get a good history from the patient to make a plan about any further diagnostic testing or a treatment plan.
If you are ok physically, then you need to get a strong team together to help you succeed. A physician or other provider can often be a good source for accountability by following up at regular intervals. A dietitian can help you get on the right track instead of trying to wade through a sea of diet books and philosophies. Lastly, a good personal trainer can often be your best cheerleader. You might even consider a psychologist or psychiatrist if you think that there are issues that may be hindering your success.
Sometimes weight loss medication can help get you from the bad habits to the good habits. I often tell my patients that weight loss medication can help you lose weight even if you sit on the cough, but they are BETTER used as a means of helping you make a transition to a healthier lifestyle. Otherwise, they will be a miserable failure.
I would recommend that you seek the guidance of a physician who practices "bariatric medicine" (notice that I didn't say "bariatric surgeon"). If you look on the website for the American Society of Bariatric Medicine for a listing of physicians in your area that specialize in this expertise, then you may find the perfect partner in your weight loss goal. The website is Good luck to you!!! _DOC2


The HipCrip said...

Docs, Welcome to the Blogosphere and congrats on your inaugural post.

love the concept of the blog, but the format direction in which you seem to be heading isn't going to work. Each blog post should include the question AND your answer, and leave the comments section for follow-up discussion about your advice. Much more concise, and it saves those who may not wish to have to skim all submitted comments when they're only interested in hearing what you have to say.

Just a thought.

DOC1 said...

Many thanks. Your suggestion will be followed.

DOC2 said...

Cynthia, see my comments in your post. Thanks! DOC2

DOC1 said...

Hey DOC2,

Please tell me what the "HCG DIET" is and if there's anything to it? Human Chorionic Gonadotropin? Really? And Acai berry? Hydroxycut? All this supplement business has to be a bad idea at best and a scam at worst. I'm actually asking for one of my patients who told me they wanted to go on the HCG diet and I heard "HGH" and told them they were crazy. I think I was right but for the wrong reasons.


DOC2 said...

HCG. Works. Short-term success. Long-term failure as soon as you get off of it. Two studies I found showed that HCG was comparable to placebo with no significant difference between them. It costs a lot of money, and it's a terrible way to treat your body. The plan usually dictates you take regular injections of HCG and eat a 500 calorie (or so) diet. Very few could maintain that kind of diet. You do little exercise only because you will get muscle breakdown if you do too much. It's a scam because of how much they charge for treatments and because it has no ability (or schema typically) to ease you into a new plan for living.

Acai? Love it dipped in chocolate. That's all it's good for.

Fat-burners? If you like high blood pressure and palpitations, then they are the right thing for you. They tend to have more side-effects than benefit. So, if you're not getting uncomfortable side-effects, you are not getting benefit either. If you notice, all of these supplements are going to say that they cause weight loss "with a sensible diet and exercise plan". Really? If that's the case, I can bottle water as a nutriceutical and make the same claim. I saw a commercial for a "cortisol-reducing" weight loss medicine that claimed to have exceptional weight loss properties in a "major clinical study". In the fine print at the bottom of the screen, it said something like it had an average weight loss of 3 pounds over a 12 week period. (it went by so fast that I'm not completely sure EXACTLY what it said.) Well, it's truly exceptional I guess.

This stuff infuriates me. We could feed the world with the money we spend on this garbage.

DOC1 said...

Medfast is a complete waste of money.