Weight loss may require approaches in addition to food management and exercise. If you have tried to lose weight and have been unsuccessful even though you made a sincere effort to stick to the diet your doctor gave you and you have incorporated physical exercise into your daily routine, you may be a candidate for additional approaches.
1. Behavioral therapy is a means to maximize your weight loss efforts through a variety of ways: support, therapy to help you understand factors other than food which play a role in your weight, stress management, family dynamics, and so on. This is not necessarily a lengthy program. Often what may be hidden to you may be glaringly obvious to someone else. There are often community resources available at little or no cost.
2. Drugs may be necessary in certain cases, especially if you are severely overweight or if your weight is making you vulnerable to other medical conditions (hypertension, diabetes, arthritis). Medication is not a substitute for healthy eating and exercise. It is often used as a “jump-start” to get you on your way. These drugs are not intended for long-term use. Do not use over-the-counter weight loss products because they are ineffective and can be dangerous. The most commonly prescribed medications are those which either interfere with fat absorption (Orlistat) or those which suppress the appetite (Sibutramine). You doctor will need to monitor you for adverse effects.
3. Surgery is the most extreme approach to weight management because it is a major procedure which changes the natural lay-out of your stomach and intestine. Suitable candidates for this surgery are those who are in reasonably good health, have made sincere effort over time, have a BMI over 40, and have serious complications from their obesity. Some conditions typically render one not suitable for surgery: psychosis, uncontrolled alcohol or drug use, clotting disorders, or psychological profiles which indicate low likelihood that an individual will follow a nutritional plan after the surgery.
Weight loss surgery (bariatric) is usually one of two kinds. The first approach is called banding and involves dividing the stomach into two pouches thus reducing the amount of food that can be eaten before one feels full. Banding is safer than some of the other procedures and the band can be removed in the future if desired.
A second approach, called “Roux-en-Y”, re-routes food from the stomach to a portion of the small intestine lower than when food normally enters. Thus, caloric absorption is limited.
If you are obese it is important to keep in regular contact with your doctor for management of your weight and its consequences on your health.