Obesity is complicated and so is treating it
Many people do not regard obesity as a disease, but rather as a moral failure. But Dr. Fatima Cody Stanford, a medical instructor at Harvard Medical School and a researcher and practicing physician at the Massachusetts General Hospital Heavy Center, pointed out that obesity is a complex chronic disease. Stanford's recent presentation of interest and informative describes how the body uses and stores energy, and describes the complex interactions of genetic, developmental, hormonal, environmental, and behavioral factors that contribute to obesity. Obesity is complicated and so is treating it
Obesity isn't only "calories in calories burned"
Obesity is not just about the balance of energy, ie calories in / calories out. "That's simple, and if the equation is easy to solve, we will not have the prevalence of obesity we have today," Dr. Stanford explained. He went on to say that not only the wrong energy balance theory, but a focus on simplistic equations and blaming patients has contributed to the obesity epidemic. Stigma, blame, and embarrassment add to the problem, and are barriers to treatment. Indeed, more than 36% of adults in the United States are obese, and the world is not far behind. Obesity is complicated and so is treating it
He describes his research and experience in the treatment of obesity, including some cases from his own clinic. These are the cases that interest me, because they clearly show the effect of different treatment approaches (and combinations) on obesity: diet and lifestyle (ie behavior), drugs, and surgery. Stanford has seen remarkable and long-lasting positive results with everyone, but he has always stressed the diet and lifestyle changes first and foremost. The program (called Healthy Habits for Life) offered at the MGH Weight Center is a big commitment, but it can help reframe someone's relationship with food, emphasize high-quality diets, and instead of calorie counting. Obesity is complicated and so is treating it
Components of successful treatments for obesity
Abeer Bader is a registered dietitian and clinical nutrition specialist at the center. He explained the program to me in more detail: this is a 12 week group based education and support program with a structured curriculum and frequent contact with patients. These classes are 90 minutes long and led by registered dietitians, and cover everything from obesity to healthy eating to debunking popular diet myths, plus recommendations for eating out, grocery shopping, food preparation, physical activity, and more again. "The goal of the HHL program is to provide patients with the education, support, and tools to lead a healthy lifestyle."
The diet they are promoting loosely is based on the DASH diet and Mediterranean diet, as this meal plan is rich in vegetables, fruits, lean protein, and whole grains. They used Healthy Plates Healthy to describe healthy and balanced meals.
But it is also a very individual program. "We work with patients to collect realistic goals. I think the most important part of approaching goal setting and behavior change is to first determine what they want to improve. Often as service providers, we tell patients what they need to do, but when you allow patients to highlight areas they want to work on, you may see better compliance, "Bader said.
Other similar comprehensive programs have been shown to help patients achieve lasting diets and lifestyle changes, lose weight - and avoid diabetes. The Diabetes Prevention Program helps those with obesity and the risk of developing diabetes loses 5% to 7% of their body weight, and reduces the risk of diabetes by 58% and 71%.
As the state of Bader, "I think it's important to note that a" successful "diet is a diet that a person will obey for the rest of his life. We really emphasize the importance of lifestyle changes versus improving the short-term diet in order to have the greatest success in achieving a healthier weight. "This statement is based on evidence, as the latest review of several studies looking at different weight loss diets found that all work together.
What cures people (including doctors) is how helpful weight-loss drugs can be, though it can take some trial and error to find out what will work for a person . "These drugs affect how the brain manages the center of gravity, and how the brain interacts with the environment. But sometimes there is no rhyme or reason why one drug works for someone, but the other does not. "Unfortunately, as shown by the study, weight-loss drugs are not adequately prescribed .
In short, obesity is a chronic complex disease with many contributing factors. Primary care physicians and obesity specialists can guide treatments that include lifestyle approaches such as diet, exercise, and overcome the emotional factors that contribute to obesity. For some people weight loss surgery can be an option (subject to another post).
Centers for Disease Control Adult Facts Obesity .
The media and its influence on obesity . Current Obesity Report April 2018.
Assess evidence for weight loss strategies in people with or without diabetes . World Journal of Diabetes October 2017.
Safety and tolerability of new generation anti-obesity drugs: Narrative review . Postgraduate Medicine March 2018.
Utilization of low-obesity drugs. What are the implications for clinical care? Obesity: Research Journal September 2016.
Obesity is complicated and so is treating it