Diet & Behavior Modification
Exercise
Over-the-Counter & Prescription Drugs
There are literally hundreds of diets available. Moving from diet to diet in a cycle
of weight gain and loss - yo-yo dieting - that stresses the heart, kidneys and other
organs can also be a health risk.
Doctors who prescribe and supervise diets for their patients usually create a customized
program with the goal of greatly restricting calorie intake while maintaining nutrition.
These diets fall into two basic categories:
- Low Calorie Diets (LCDs) are individually planned so that the patient takes in 500
to 1,000 fewer calories a day than he or she burns.
- Very Low Calorie Diets (VLCDs) typically limit caloric intake to 400 to 800 a day
and feature high-protein, low-fat liquids.
Many patients on Very Low Calorie Diets lose significant amounts of weight. However,
after returning to a normal diet, most regain the lost weight in under a year. Ninety
percent of people participating in all diet programs will regain the weight they've
lost within two years.
Behavior modification uses therapy to help patients change their
eating and exercise habits. Like low-calorie diets, behavior modification, in most
patients, results in short-term success that tends to diminish after the first year.
If diet and behavior modifications have failed you and surgery is your next option,
it is important to understand that diet and behavior modification will be instrumental
to sustained weight loss after your surgery. The surgery itself is only a tool to
get your body started losing weight - complying with diet and behavior modifications
required by most surgeons would determine your ultimate success.
Starting an exercise program can be especially intimidating for someone
suffering from morbid obesity. Your health condition may make any level of physical
exertion next to impossible. The benefits of exercise are clear, however. And there
are ways to get started.
A National Institutes of Health survey of 13 studies concludes that physical activity:
- results in modest weight loss in overweight and obese individuals
- increases cardiovascular fitness, even when there is no weight loss
- can help maintain weight loss
New theories focusing on the body's set point (the weight range in which your body
is programmed to weigh and will fight to maintain that weight) highlight the importance
of exercise. When you reduce the number of calories you take in, the body simply
reacts by slowing metabolism to burn fewer calories. Daily physical activity can
help speed up your metabolism, effectively bringing your set point down to a lower
natural weight. So when following a diet to attempt to lose weight, exercise increases
your chances of long-term success.
Examples to get you started:
- Park at the far end of parking lots and walk
- Take the stairs instead of the elevator
- Cut down on television
- Swim or participate in low-impact water aerobics
- Ride an exercise bike
Overall, walking is one of the best forms of exercise. Start out slowly and build
up. Your doctor, or people in a support group, can offer encouragement and advice.
Incorporating exercise into your daily activities will improve your overall health
and is important for any long-term weight management program, including weight loss
surgery. Diet and exercise play a key role in successful weight loss after surgery.
New over-the-counter and prescription weight loss medications have been introduced.
Some people have found them effective in helping to curb their appetite. The results
of most studies show that patients on drug therapy lose around 10 percent of their
excess weight and that the weight loss plateaus after six to eight months. As patients
stop taking the medication, weight gain usually occurs.
Weight loss drugs can have serious side effects. Still, medications are an important
step in the morbid obesity treatment process. Before insurance companies will reimburse/pay
for weight loss surgery, you must follow a well-documented treatment path.
"Since many people cannot lose much weight no matter how hard they try, and promptly
regain whatever they do lose, the vast amount of money spent on diet clubs, special
foods and over-the-counter remedies, estimated to be on the order of $30 billion
to $50 billion yearly, is wasted." (New England Journal of Medicine)
