Weight Management
and Bariatric Medicine
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Am I obese? Why lose weight? How much should I lose?
Often one doesn't "feel" the weight one has put on. Obesity is measured in various ways. Common biometrics - easily done at home - measure waist circumference and BMI (body mass index). They are valuable for the initial health risk assessment and subsequent periodic progress monitoring. Someone with a BMI above 25 is considered "overweight", while "obesity" refers to a BMI above 30. However, the particulars of your body and fitness level modify these simple measurements. Each individual body composition analysis requires more specialized testing.
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BMI
(kg / m2)*
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Obesity
Class
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| Underweight | less than 18.5 | |
| Normal Weight | 18.5 - 24.9 | |
| Overweight | 25.0 - 29.9 | |
| Obesity | 30.0 - 34.9 |
Class
I
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| 35.0 - 39.9 |
Class
II
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| 40.0 or higher |
Class III
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*Body Mass Index (BMI) is your weight divided by your body surface area.
Different people have different reasons for why they want to lose weight. You will feel better, you will look better, many of your aches and pains may ease with progressive weight loss. As a physician I believe I can serve people best if I can help prevent serious threats to their well-being. Every 10% excess fatty tissue weight lost will significantly lower the risk of developing serious complications as a consequence of being overweight. Obesity is an independent risk factor for developing many chronic and life-threatening diseases such as degenerative joint disease (arthritis), diabetes, cardiac disease as well as certain cancers.
How much and how fast you lose weight depends on your starting point,
your goals and the resources to get you there. During your initial visit
we will match details of your needs and history with healthy and achievable
steps for the short term and the long term. 
Diet X helped me lose some weight but my friend
has been on diet Y and has lost more. Should I switch?
There is no one “diet” that’s right for everyone. For
that matter there’s no single treatment that helps everyone equally.
If you’re otherwise fairly healthy it probably doesn’t matter
how you initially lose weight. There are many commercial and individual
options for the initial weight loss period. We would like to help you
chose the right one for you, and develop strategies to stick with your
new habits. It seems more important to set realistic goals and achieve
them gradually over time. These deliberate lifestyle adjustments will
then last a lifetime to maintain a healthier weight.
I’ve tried everything but I gain every
pound I lost right back, plus some. What’s next?
“Yo-yo dieting” is a well-known phenomenon among people trying
to lose weight. And they do temporarily. Rather than viewing the re-gain
as a complete failure, you should feel encouraged that you can shed pounds.
Now you have to learn how to keep them off. This is where medically supervised
weight loss programs have been helpful to many people. We believe you
will reap the maximum benefit from a program that involves a physician,
who can assess any problems early on and address primary and preventive
care concerns during the process.
Appreciating obesity as a chronic disorder - not as a transient problem
like the flu, and not as a character weakness - is a key to lasting success.
The disease mechanism is a complex interaction of a person’s genetics,
environment, and behavior. Only a life-long commitment to change can maintain
your weight loss, no matter how you lost it.
Isn’t there something I can take to lose my weight?
Yes and no. There are
medications that have proven beneficial when integrated
into weight loss programs, but they all have possible adverse effects
and don’t work well as the sole treatment. Some require frequent
medical monitoring to check for potential problems. However, they can
be very effective adjuncts during weight loss and weight maintenance phases
in select patients. Together we will weigh the benefits and risks carefully
to optimize your personal weight loss regimen.
How long do I have to stay in treatment?
Treatment of obesity can be divided into several phases: an initial weight
loss phase, followed by an early maintenance phase going into a long-term
maintenance phase.
The length of the first segment depends on how much weight you’d
like to lose and if there are coexisting illnesses. People who lose weight
more slowly are generally better able to keep it off. They seem to integrate
the necessary changes into their daily routines more thoroughly. This
requires more patience at first, but is often rewarded by greater success
in the later phases. As you feel more energetic it will become easier.
Weight loss and early maintenance phases may be condensed in those who
have only 10 to 20 pounds to lose to be in a healthy weight range. Someone
who has a lot of excess weight will take a longer time to lose it and
keep it off. In the weight loss phase it is important that you follow
up frequently, often weekly, to adjust your regimen to what works best
for you.
Going into the early maintenance phase, regular visits allow for fine-tuning
your techniques to keep off what you lost. This is when you cement your
healthier habits, new food choices, and channel your higher energy level
into a more active lifestyle.
Then your visits are spaced out for monitoring after a sustained period
of maintaining a certain weight. If you do start to regain weight, we
can quickly reevaluate your maintenance regimen, identify problem areas,
and make adjustments. Some people may choose to go back to more intense
supervision and lose some more weight. Bear in mind what often took years
to develop will likely take some time to heal.
During all of these phases we consider primary and preventive care issues.
Your treatment needs, such as medications for other medical conditions,
may change with weight loss. For example people with diabetes or hypertension
may respond better to lower doses of their usual medications.
We offer various plans for different people depending on their goals.
Our rates are comparable to many other weight loss programs. The medical
management of many illnesses related to obesity is
covered
by medical insurance policies. For our patients who want to submit
their bills to their insurance carriers for reimbursable services we break
bills down with codes for diagnoses and procedures. You may want to ask
your medical insurance if they cover medically supervised weight loss
as a preventive service. Some employers offer incentives to their employees
for weight control; ask your human resources department. Also, since the
federal government has recently recognized obesity as a “medical
condition”, many of your expenses associated with your weight control
efforts may be
tax-deductible.
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