I do not believe weight loss is achieved by starving patients, having more willpower, or discovering a secret combination of foods – it is about balance, in every aspect of life and a long-term commitment to health and thriving! This is my approach to supporting patients with weight concerns.
Medical weight management is the holistic evaluation of a person’s weight that includes a comprehensive metabolic, hormonal and nutritional analysis, individualized and evidence-based recommendations for lasting results. Recommendations are based on the Obesity Algorithm by the Obesity Medicine Association1 and clinical experience. This is not a quick fix or a fad diet but a collaborative effort between patient and health care provider and considering solutions tailored to the patient’s metabolism and individualized needs. The goal is to maximize overall health, reverse co-morbidities when possible and get patients healthy and active – the focus is not solely on weight loss.
I encourage patients to take charge of their health and take an active role in their health plan. This may mean daily tracking of activity or exercise and doing an occasional diet diary or food tracking. This ensures that recommendations are realistic and doable and removes some of the guess work. Tracking does not have to be overwhelming and many patients enjoy using devices such as Our ring, FitBit or Garmin2 or online apps such as LoseIt and MyFitnessPal3. Or, one can use pen and paper if that is more convenient. While I do not encourage calorie counting I do however find that calculating grams of macronutrients (protein, carbohydrate and fat) is helpful and will have patients do this early on to help them become aware of what they are eating. Tracking macronutrients also helps for certain dietary approaches I use such as with a low carb or ketogenic diet. Studies have shown the efficiency of a low carb diet in losing weight, managing insulin resistance (pre-diabetes), managing diabetes and in achieving favorable changes in cardiovascular disease risk factors4 – 6. I also evaluate if additional emotional or psychological support is needed and refer patients to local therapists and practitioners (such as faster EFT for eg) if applicable.
Remember, it is NOT about willpower when patients take on change and if the struggles are emotional then it is my, it is our, responsibility to set patients up for success and help them change negative emotional patterns – “try harder” is not a solution! Here’s to thriving!
- Seger JC, HornDB, Westman EC, Lindquist R, ScintaW, Richardson LA, Primack C, Bryman DA, McCarthy W, Hendricks E, Sabowitz BN, Schmidt SL, Bays HE. American Society of Bariatric Physicians Obesity Algorithm: Adult Adiposity Evaluation and Treatment 2013. www.obesityalgorithm.org
- Mobbs CV, Mastaitis J, Isoda F, Poplawski M: Treatment of diabetes and diabetic complications with a ketogenic diet. J Child Neurol. 2013. 28:1009-1014.
- Foster GD, Wyatt HR, Hill JO, Makris AP, Rosenbaum DL, Brill C, Stein RI, Mohammed BS, Miller B, Rader DJ, Zemel B, Wadden TA, Tenhave T, Newcomb CW, Klein S: Weight and metabolic outcomes after 2 years on a low carbohydrate versus low fat diet: a randomized trial. Ann Intern Med. 2010. 153:147-157.
- Westman EC, Feinman RD, Mavropoulos JC, Vernon MC, Volek JS, Wortman JA, Yancy WS, Phinney SD: Low carbohydrate nutrition and metabolism. Am J Clin Nutr. 2007. 86:276-284.