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Very Obese Can Lose With Program
An intense program that does not involve surgery can help some extremely obese people lose weight, a new study found.
The study included 390 adults. They had a body mass index of 40 or more, which is very obese. People were randomly assigned to a weight-loss program or an Internet program. The program included medicine, a short-term liquid diet, a longer-term diet and group counseling. About half of each group stayed in the study for two years. In that time, 31% of those in the intensive program lost 5% or more of their body weight. About 7% lost at least 20% of their body weight. Those who received usual care lost less weight. About 9% of them lost at least 5% of their weight. About 1% of this group lost 20% or more.
The study appeared January 26 in the journal Archives of Internal Medicine.
What Is the Doctor's Reaction?
More than one- third of Americans were considered obese in 2009. This means that their body mass index (BMI), a measure of weight to height, was between 30 and 39.9. For example, a woman 5 feet, 5 inches tall and 180 pounds has a BMI of 30. So does a man 6 feet tall who weighs 223 pounds.
People who are overweight and obese are at much higher risk for a variety of serious health problems. Among them are high blood pressure, diabetes, back problems, liver problems and arthritis. Obese men and women spend more money on health care than people of normal weight.
In my practice, I find myself spending more and more time counseling people about the need to maintain a healthy weight. It's a frustrating topic for both doctors and patients. We all wish for an easy fix; there are none. I wish I had better tools to help my patients.
This study focused on men and women with extreme obesity. They had a body mass index between 40 and 60. About 200 people took part in a program through their primary care doctor. The program included a short-term liquid diet, behavior counseling, a longer-term diet and a choice of medicines for weight loss. A comparison group was referred to an Internet weight loss program.
About half the people dropped out of each group. Of the people who stayed in the active weight loss program, one-third lost 5% of their body weight. About 7% of them lost more than 20% of their body weight. People in the comparison group did not lose much weight. Blood pressure and lab tests generally improved. However, the change was small enough that it could have occurred by chance.
This study shows that well-supported primary care clinics can help very obese patients to lose weight. More than half of the patients in both groups were unable to complete the study. This is disappointing. I know the stresses that primary care doctors and their practices face. Therefore, I can't help but wonder if this study would be easily repeatable in different settings.
What Changes Can I Make Now?
For starters, know what your BMI is. If your BMI is 20 to 24.9, that's normal. From 25 to 29.9 is considered overweight. Above 30 is considered obese.
If your weight is higher (or much higher) than is desirable, consider doing something about it. You are in the driver's seat. Talk with your doctor. Many weight loss options are available. They include commercial programs, medically supervised programs, medicines and obesity surgery such as gastric bypass.
I think any weight loss program that involves some group work is helpful. You have a responsibility to the group and you derive support from the group. The group could be at your doctor's office, your workplace or with a group of friends at home.
Realize that weight does not come on in a day, nor will you be able to lose it overnight. Recognize that weight loss, more than anything your doctor can provide, involves changing your behavior. This is very hard! Don't give up if it doesn't work the first time. Keep trying.
What Can I Expect Looking to the Future?
This program shows promise. However, I think it would be realistic only if primary care doctors begin to use more of a team approach. I would love to see primary care doctors equipped to have group visits along with providers skilled in behavioral medicine and weight loss counseling. Maybe then the average doctor could replicate the promising findings of this study.
The study included 390 adults. They had a body mass index of 40 or more, which is very obese. People were randomly assigned to a weight-loss program or an Internet program. The program included medicine, a short-term liquid diet, a longer-term diet and group counseling. About half of each group stayed in the study for two years. In that time, 31% of those in the intensive program lost 5% or more of their body weight. About 7% lost at least 20% of their body weight. Those who received usual care lost less weight. About 9% of them lost at least 5% of their weight. About 1% of this group lost 20% or more.
The study appeared January 26 in the journal Archives of Internal Medicine.
What Is the Doctor's Reaction?
More than one- third of Americans were considered obese in 2009. This means that their body mass index (BMI), a measure of weight to height, was between 30 and 39.9. For example, a woman 5 feet, 5 inches tall and 180 pounds has a BMI of 30. So does a man 6 feet tall who weighs 223 pounds.
People who are overweight and obese are at much higher risk for a variety of serious health problems. Among them are high blood pressure, diabetes, back problems, liver problems and arthritis. Obese men and women spend more money on health care than people of normal weight.
In my practice, I find myself spending more and more time counseling people about the need to maintain a healthy weight. It's a frustrating topic for both doctors and patients. We all wish for an easy fix; there are none. I wish I had better tools to help my patients.
This study focused on men and women with extreme obesity. They had a body mass index between 40 and 60. About 200 people took part in a program through their primary care doctor. The program included a short-term liquid diet, behavior counseling, a longer-term diet and a choice of medicines for weight loss. A comparison group was referred to an Internet weight loss program.
About half the people dropped out of each group. Of the people who stayed in the active weight loss program, one-third lost 5% of their body weight. About 7% of them lost more than 20% of their body weight. People in the comparison group did not lose much weight. Blood pressure and lab tests generally improved. However, the change was small enough that it could have occurred by chance.
This study shows that well-supported primary care clinics can help very obese patients to lose weight. More than half of the patients in both groups were unable to complete the study. This is disappointing. I know the stresses that primary care doctors and their practices face. Therefore, I can't help but wonder if this study would be easily repeatable in different settings.
What Changes Can I Make Now?
For starters, know what your BMI is. If your BMI is 20 to 24.9, that's normal. From 25 to 29.9 is considered overweight. Above 30 is considered obese.
If your weight is higher (or much higher) than is desirable, consider doing something about it. You are in the driver's seat. Talk with your doctor. Many weight loss options are available. They include commercial programs, medically supervised programs, medicines and obesity surgery such as gastric bypass.
I think any weight loss program that involves some group work is helpful. You have a responsibility to the group and you derive support from the group. The group could be at your doctor's office, your workplace or with a group of friends at home.
Realize that weight does not come on in a day, nor will you be able to lose it overnight. Recognize that weight loss, more than anything your doctor can provide, involves changing your behavior. This is very hard! Don't give up if it doesn't work the first time. Keep trying.
What Can I Expect Looking to the Future?
This program shows promise. However, I think it would be realistic only if primary care doctors begin to use more of a team approach. I would love to see primary care doctors equipped to have group visits along with providers skilled in behavioral medicine and weight loss counseling. Maybe then the average doctor could replicate the promising findings of this study.
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