There are 4 inescapable truths (derived from the National Weight Control Registry research databases) about weight loss maintenance: self-monitoring, accountability, individualization of diet and adequate exercise. Many people confuse the first two, but they are different.
In other words, because you track your weight, your steps, your belt holes doesn’t mean you change them.
If, however, you are accountable to someone for identifying why the tracking did or didn’t make enough of a difference in your food choices, exercise regime or wine consumption to move the needle on the scale (or the blood pressure cuff or the cholesterol test or your blood sugar), then you are half way to control.
Some of my patients have told me that having me on their shoulder is the accountability they need for the steady, slow, deliberate, steady results that our program provides . People love to have a coach, and have an expert in their corner.
And next year, some clinicians will begin to try out a new step-by-step approach to helping patients lose weight, for two reasons:
And second, because Aetna will now cover the new obesity drugs, Qsymia and Belviq if the insured’s plan covers obesity drugs (many do not); if (1) their BMI is> 30 kg/m2,; or if it’s > 27 kg/m2 with one of five risk factors (coronary heart disease, high cholesterol, hypertension, sleep apnea, and type 2 diabetes) and (2) if they have tried for 6 months but have not lost an average of a pound per week.
From a health policy and payment standpoint, it’s important that obesity is recognized as a chronic disease with significant health consequences, not as a cosmetic or willpower problem. From a patient care view, however, I don’t have a single patient who thinks he is chronically ill, irrespective of his medications or conditions. And to me, he or she is not: my patients are on their way to being better men, better women, better and healthier versions of themselves.
Here’s a recent Foodbank video I participate in that illustrates men and women doing just thatnot just by getting healthier, but by helping others who do not have enough nutrition or enough food.