This month’s Healthy Actions column features a monthly medical topic of interest to local professionals, focusing on doctor-tailored medical weight loss programs.
Dr. Manjinder Kaur is an endocrinologist and Director of the Medical Weight Loss Program at Western Reserve Hospital in Cuyahoga Falls.
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Kaul said anti-obesity drugs and other therapeutic tools have advanced in recent years.
This is an edited version of my interview. A Beacon Journal podcast of interviews is also available.
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What is a Physician-Supervised Medical Weight Loss Program?
Western Reserve offers non-surgical and surgical weight loss programs. Our programs provide patients with non-surgical tools, lifestyle changes, medications, guidance and support.
When will the patient see a specialist?
Obesity is a chronic medical condition and should be identified as such. When we think of medical problems such as high blood pressure and diabetes, we go to our doctors for help. Have to.
Because this is a medical problem, you should seek help from your doctor or weight loss health care professional to help you reach your goal weight.
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Obesity can increase the risk of various metabolic diseases such as diabetes and hypertension. Weight loss can have a significant impact on these patients.
Patients can either get a referral starting with their primary care physician or call them directly.
In general, patients with a body mass index greater than 30 or a BMI greater than 27 and with weight-related conditions such as diabetes, hypertension, and sleep apnea are eligible for medical weight loss programs.
Who treats obese patients?
We have three endocrinologists who are board certified in bariatric medicine. This means that they are specially trained to treat patients with additional tools. We have 2 registered dietitians and 1 nurse.
Obesity can make patients reluctant to voice their concerns. There is a lot of stigma and stigma surrounding obesity. We provide a safe space where patients feel comfortable, non-judgmental and can voice their concerns.
What treatment options are available?
Antiobesity drugs may help with some weight loss. We offer a multifaceted program for weight loss. This includes lifestyle changes and diet and nutrition.
Sometimes patients have every intention and knowledge of eating healthy, but they need the help of a nutritionist to take their medication with us.
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We meet where the patient is. Maybe you just want to talk to a nutritionist and start from there.
We also have a structured meal replacement program for interested patients. Usually we replace some of their calories with meal replacements. This is a healthier option than what they are eating.
Some plans work with a nutritionist to replace some of your meals.
Is there a period for patients to replace meals?
it really depends. Not applicable to all patients. Some patients prefer to have a plan, while others prefer to work with a nutritionist to eat healthy. Some patients say that perhaps after 3 months he will feel that he has new skills, structures and accountabilities that he can replicate at home.
I have other patients who have been on diet replacement therapy for two years. Perhaps they weren’t candidates for surgical weight loss, but we started them on this program and they were able to get results and get off insulin and other medications.
Similarly, is there a time period during which patients can participate in the weight loss program?
As weight is a chronic medical problem, it requires regular attention from doctors and patients. So even if you reach your goals, weight loss patients know that weight loss is difficult, but maintaining it is even harder.
The patient continues to be followed up.
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How do you help patients who have lost weight and are likely to put it back on?
We start by talking to patients and getting them to change their mindset that this is a medical problem that requires long-term attention. Reach your goal weight one day, stay there and never forget it.
Second, the point of anti-obesity drugs is that they may require additional treatment options in addition to lifestyle changes, much like the drugs someone takes to stabilize their blood pressure. is not the only cause. It is physiological, genetic and environmental.
The Food and Drug Administration (FDA) has approved these drugs for weight loss as well as maintenance.
Many times it has been argued that once a patient reaches a certain weight and asks if they should stop taking the medicine, they can stop at any time. Some patients are able to maintain or gain weight without problems without medication. He quickly realized that he could not stick to the drug and wanted long-term medication.
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What role does exercise play in your program?
Exercise is very important. We all know that it is important for cardiovascular health and mobility.
Many patients who come to our clinic are overweight, have joint pain, and cannot move much. That’s why we focus on nutrition and eating healthy and shedding some of the weight so they feel excited and motivated to move around. Every time he goes to exercise, if he can’t move for the next three days because of pain, he can get discouraged.
Focus on nutrition and healthy eating first, then incorporate exercise. Patients participating in a structured program come here every two weeks. Part of that appointment included education on a variety of important topics to help patients lose weight, such as how not to eat emotionally, how to get enough sleep, and how to deal with stress. and exercise is a big part of it.
Some patients work with a trainer, but start where the patient is comfortable. It’s a 15-minute walk every day for which you show up consistently and build on that.
Why do some people say, “My friend lost 20 pounds and I’m doing the same and I’m not losing anything”?
Because you and your friend are not the same person. We all have different genes. Being overweight has many causes. It’s not just about diet and exercise. They play an important role, but your genetics, family history, environment, stress, sleep, age, gender, place in your life, and more can all contribute.
I really encourage my patients to focus on their path and actually create results for themselves.
Things have changed a lot in the last few years. A few years ago, we had limited options for our patients other than telling them to exercise and eat right. However, new anti-obesity drugs are now producing 20-25% weight loss.
If you’re exercising and eating right and you’re not seeing results, don’t get discouraged. Maybe there’s a cause that hasn’t been addressed. It could be another medical problem or a side effect of a medication. That’s when you seek medical care and an individualized plan for you.
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What about open market products that promise magical weight loss results?
Weight loss is a multi-billion dollar industry. Patients may pay thousands of dollars upfront or buy supplements over-the-counter that promise quick results.
They may not be safe, and most supplements are not FDA-approved, so we have no idea about their safety. Monitor for weight loss.
When should I consider bariatric surgery?
The criteria are a body mass index greater than 40 or a BMI greater than 35 and weight-related conditions such as diabetes, sleep apnea, and high blood pressure. We do and work with medical and surgical weight loss at Western Reserve Hospitals.There may be patients starting with us who need or want more weight loss. If they meet criteria for surgical weight loss, coordinate with that department.
Similarly, some patients started in bariatric surgery departments because their insurance required them to lose weight before surgery.
Any other tips?
Many patients have lost and gained weight over the years and it is frustrating. Pursue healthy weight loss options. There are more treatment options available today than there were even a few years ago.
Instead of thinking about the big ladder you have to climb, think about prioritizing your health and taking it step by step.
Believe you can do this. We are here to guide you, encourage you, and give you the tools to help you reach a healthier weight.
To read previous Healthy Actions columns, visit www.tinyurl.com/BettyHealthyActions.
Beacon Journal staff reporter Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow @blinfisherABJ on Twitter or follow us at www.facebook.com/BettyLinFisherABJ.
