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Options for Treatment

For anyone who has considered a weight loss program, there is certainly no shortage of choices. In fact, to qualify for insurance coverage of weight loss surgery, most patients are required by their insurance to have a history of medically supervised weight loss efforts.

Most non-surgical weight loss programs are based on some combination of diet/behavior modification and regular exercise. Unfortunately, even the most productive interventions have proven to be effective for only a small percentage of patients. It is estimated that fewer than 5 percent of individuals who participate in non-surgical weight loss programs will lose a significant amount of weight and maintain that loss for a long period of time.

For many patients, the risk of death from not having weight-loss surgery or bariatric surgery is greater than the risk of possible complications from the procedure.

Diet & Behavior Modification

There are literally hundreds of diets available. Moving from diet to diet in a cycle of weight gain and loss — yoyo 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. 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.

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 will determine your ultimate success.

Exercise

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 your body is programmed for and fights to maintain) 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. When following a diet 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.

Over-the-Counter & Prescription Drugs

Some people have found the newly introduced over-the-counter and prescription weight loss medications effective in helping to curb their appetites. However, 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 Surgery

Weight loss surgery or bariatric surgery is major surgery. The growing trend to use it for treating morbid obesity is the result of three factors:

  • Our current knowledge of the significant health risks of morbid obesity.
  • The relatively low risk and complications of the procedures versus not having the surgery.
  • The ineffectiveness of current non-surgical approaches to produce sustained weight loss.

Weight-loss surgery should be viewed first and foremost as a method for alleviating debilitating, chronic disease. In most cases, the minimum qualification for consideration as a candidate for the procedure is 100 lbs. above ideal body weight or a Body Mass Index of 40 or greater.

Occasionally a procedure will be considered for someone with a BMI of 35 or higher if the patient's physician determines that obesity-related health conditions have resulted in a medical need for weight reduction and, in the doctor's opinion, bariatric or weight-loss surgery appears to be the only way to accomplish the targeted weight loss.