Losing weight is probably the number one New Year's resolution. Unfortunately, one size does not fit all when it comes to losing weight. Many experts blame diet. Others blame lack of exercise. But the research reveals the issue is a bit more complex.
The medical definition of obesity now applies when describing the "average" American. But despite over half the population experiencing some level of overweight issues according to the National Institutes of Health, few clinicians are willing to tackle the challenge. Clinicians tend to offer simplistic solutions to a problem where solutions are varied and often require personalized attention.
You would never tell someone with high blood sugar to just eat less and exercise more. Instead, you'd determine individual needs to treat the disease. Obesity needs the same focused approach as any other health challenge. Diet and exercise are still core solutions to losing weight. But research has shown that it is not always the patient's fault if weight loss solutions fail. There are many options to explore to address the challenge in such failures.
Surgical solutions are at one end of the scale. These solutions are reserved for serious weight loss challenges that may result in serious health problems if obesity is not reversed. The downside is patients undergoing surgical solutions still face a lifetime of follow up, diet and nutrient control.
On the other end of the scale are new drugs. At least half a dozen oral medications designed to combat obesity will soon hit the market. Progress has also been made on injectable drugs this past year. But none of these injectables are free of side effects. Risks include certain thyroid cancers, low blood sugar and kidney problems to name a few. Fortunately, the tumors often cited appeared in early rodent studies and the drugs involve naturally occurring hormones so they appear to have a reasonably good safety profile despite the early findings. The oral equivalents of these new drugs are still being studied. The upside is considerably positive as the medical community gains experience using these new drugs. The current barriers are cost and experience with long term outcomes.
In between are various exercise and diet plans. These plans range from fad diets that come and go to well-studied diets that have strong track records. There are also medically monitored diets where patients are followed under the care of a clinician. Lab work is followed as caloric intake is adjusted and nutrients are supplemented. The application of diet is just as varied as the diets that are available.
Patients who attempt these diet and exercise plans on their own have varying degrees of success. It is individual dependent. Medically monitored plans have a higher success rate and should have the goal of not only losing weight but to manage the patient's overall health during the process. Self-administered diets have lower success rates but are certainly more convenient.
Medically monitored weight loss programs also have many options even within this solution ranging from low calorie diets to very low calorie diets. The cost of medically supervised programs is generally offset by meal replacements being provided by the medically supervised program. So, the cost in the end is generally no more than the cost of food the patient would have paid anyway for each week with diagnostic testing included as well.
Biologists are beginning to understand that weight loss success is more than simply diet and exercise. Genetics and metabolism play a huge role. Co-morbidities must also be considered when designing a plan. There has even been research into genetic markers that predict the success of weight loss programs within given individuals.
The bottom line is that there is no such thing as the perfect diet or the perfect plan. It is also wrong to simply blame the patient for failures to lose weight. It not only is counter-productive but is scientifically unsound to dismiss failures without considering a multitude of factors like DNA, metabolism and co-morbid conditions that directly influence diet and exercise modalities.
The science on what to eat is even changing. Remember when all fatty foods were bad, then some fats were actually good? At one time the focus was on what we ate. Then it evolved to how much we ate. Then went back to what we ate again. Today we are moving from the idea of needing certain food groups to the evolving focus on certain individual nutrients that are needed instead.
If your diet is socially isolating, you're on the wrong diet. If you are simply told to eat less and exercise more, you're getting inadequate advice. If you have co-morbidities, a family history of obesity or struggle with success, you should ensure these factors are included in any plan to lose weight.
One size does not fit all when it comes to weight loss. Everyone responds differently. While there is no perfect plan, there is a perfect approach. And that approach is understanding individual biology.
Phillip Stephens, DHSc, PA-C is affiliated with Carolina Acute Care & Wellness Center, P.A. – www.CarolinaAcuteCare.com
