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Obesity and Medical Weight Loss: Knowing Your Options

February 22, 2019
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Bipan Chand, MD, and Faisal Saeed, MDBy Bipan Chand, MD, and Faisal Saeed, MD, Bariatrics

With the start of a new year, resolutions to lose weight, eat healthier and exercise more are in full swing, right?

For some, weight loss goals can be daunting to tackle alone without an expert and knowledegable medical weight loss team to support you every step of the way.

Medical weight loss is a comprehensive approach towards achieving a healthy weight and treating the chronic disease of obesity. For best results, a multidisciplinary team approach is needed to establish patient care. At Loyola Medicine, our team is comprised of a bariatrician, psychologist, exercise physiologist and a bariatric surgery team.

Obesity is a complex disease. Treatment plans are based on identifying the underlying causes of obesity, creating a tailored and customized plan for each individual and providing close follow-up care over time.

Medical weight loss is strongly based on dietary and behavioral changes. A complete lifestyle modification is required for success in losing weight and keeping it off. Weight management medications may be used in addition to diet and exercise initially to expedite weight loss and to help control your appetite while you start to work on behavioral changes.

The obesity treatment model is not much different than the treatment of any other chronic disease, such as diabetes, where continuous monitoring and education are required for successful management. At the same time, medical weight loss is a patient-driven physician directed treatment model in which you choose treatment options, based on degree of obesity and expected outcomes of the treatment plans.

In past 10 years, the Obesity Medicine Association has established updated guidelines and a great amount of work has been achieved in field of obesity medicine.

Currently, research has found 203 diseases linked to obesity. In addition, weight loss has been considered the first treatment option in treatment of diabetes, sleep apnea, arthritis, back pain and migraines, among many other chronic issues.

Dietary Changes

Making changes to your diet for weight loss begins with two objectives: calorie restriction via portion control and changing the composition of nutrients. The most successful approach with the most consistent results is reducing carbohydrates to significantly low levels and increasing proteins. This helps reduce your appetite and promote weight loss while preserving lean muscle mass.

A more intensive approach is to reduce calories to the levels where body goes into ketosis (fat burning) and a significant reduction in fat tissue has been observed with this approach. Our program has registered dietitians that help tailor the approach to each individual.

Exercise Changes

Starting an exercise routine is always challenging, especially when you are overweight or have other limiting factors such as arthritis. Patients are strongly advised to seek a trained exercise physiologist to gradually ramp up exercise without hurting their bodies.

Sports injuries are very common with unguided exercise. Targeted exercise goals can be achieved with weight loss and progressively increasing your endurance. Our program offers resources to help start and sustain this exercise plan.

Medications

Weight management medications can be used in addition to dietary and exercise strategies. We recommend using these medications for a short period of time, but they may be continued for up to two years on a case-by-case basis.

The most successful strategy for weight maintenance has proven to be self-monitoring. Patient-driven physician directed treatments continue to be the best option for long-term weight loss.

Endoscopic Options and Surgery

Working closely with the medical team, patients looking to have a greater degree of weight loss or those that do not obtain the expected medical weight loss can choose various endoscopic or surgical options.

These may offer a greater degree of weight loss and have more substantial improvement in medical conditions associated with obesity. Talk to your doctor to determine if weight loss surgery is the right choice for you.

Bipan Chand, MD, is the co-director of Loyola Medicine’s Digestive Health program and director of the Loyola Center for Metabolic Surgery & Bariatric Care. His clinical interests include obesity treatment and management, as well as other gastrointestinal diseases.

Dr. Chand earned his medical degree from the University of Missouri, Kansas City School of Medicine, and completed a residency in general surgery and an advanced laparoscopy and endoscopic fellowship at the Cleveland Clinic Foundation.

Faisal Saeed, MD, is an obesity medicine specialist in Loyola Medicine’s Digestive Health program. His clinical interest is focused on obesity treatment and management.

Dr. Saeed earned his medical degree from Dow Medical College in Pakistan, and completed a residency in internal medicine at Chicago Medical School - Rosalind Franklin University of Medicine and Science.