28 Jun Making the Case for Science-Based Weight Loss
In the 1990s, a popular series of books and movies began with the humorous yet heartrending saga of the main character’s diary entries that day. The anguished pennings prominently featured being overweight and various attempts to diet. Each increasingly desperate failure was saturated with self-loathing on the premise that weight loss should be achieved through virtuous food- and exercise-related behavior. Willpower! Discipline!
The overwhelming majority of people still believe this, regardless of evidence to the contrary. Please note: there is substantial evidence to the contrary, but more about that later.
To be sure, nutritious eating habits are important. The best foods for our bodies have far-reaching effects on overall health. Getting regular exercise reaps many rewards for hearts, muscles and joints. However, as for the entrenched and widespread perception that anyone who “eats right” and hits the gym will automatically enjoy an ideal weight and body shape…well at best, this is shortsighted. For many, the road to disaster lies ahead. The frustrated overweight often resort to yo-yo/fad dieting and/or over-exercising, sometimes to the point of serious illness or injury.
Extensive and myth-busting research on obesity is available these days. Let’s set aside your neighbor’s astonishing weight loss success allegedly achieved from pepper-lemon-water fasting and a rockin’ vision board. Instead, why not at least consider what decades of legitimate scientific study have to offer regarding the causes and treatments for obesity? One of the most recent studies was published this spring in the Journal of the American Medical Association.
More and more, primary care physicians are referring their overweight patients for bariatric surgeries and procedures. Studies tracking the long-term effects on patients who pursued such solutions indicate the vast majority of results are positive and lasting. Not only do these patients maintain more ideal body mass indexes, they experience lower incidences of weight-related diabetes and high cholesterol. The case has been made, with a resulting impact on mainstream medical practices.
What’s the Hold-Up?
An estimated 20 million individuals with serious weight loss issues in the United States have been deemed eligible for bariatric procedures, yet less than one percent have chosen this option to date. Why do those suffering from obesity hesitant to grab this life preserver?
In a kind of chicken-or-egg-first dilemma, bariatric procedures haven’t become more commonplace precisely because they haven’t become more commonplace. Perhaps this life-changing alternative to the grapefruit diet has yet to completely shake the stigma from its early days of practice when bariatric procedures were more invasive with a higher rate of complications. Quite simply, patients may be scared, albeit with rapidly disappearing justification. While any medical process carries some risk, bariatric procedures now rank among the safer ones.
State-of-the-Art Example: ESG
Some past approaches to bariatric intervention have fallen out of favor and are rarely used anymore; however, some got plenty of negative publicity back when. Public awareness that there are more effective and less invasive options for many patients has lagged in the years since. For instance, Endoscopic Sleeve Gastroplasty (ESG) is a procedure whereby an endoscope inserted down the throat with a suturing device draws the lateral edges of the stomach together, altering the shape and holding capacity of the stomach without removing tissue.
The prognosis: low risk, no abdominal incisions, no scars, less pain, accelerated recovery time. Generally, ESG is an outpatient procedure. That’s a far cry from the long-ago bariatric medical practices that many patients still recall and reject out of hand.
Fighting the Diet-and-Exercise Super Powers
Another formidable foe of the medical treatment of obesity is the multi-billion-dollar diet and exercise industry. Besieged in the grocery store line by airbrushed magazine cover photos of women with 20-inch waists and men with six-pack abs, we are primed to pay out for miracles. Unfortunately, no matter how many ads tout “take the weight off and keep it off,” those claims are rarely backed with legitimate scientific study.
Most major diet corporations offer only anecdotal evidence and cherry-picked testimonials. Worst of all, the biggest money for the diet industry comes from repeat business—from failure, basically. A tidal wave of money is made every minute of every day from the misery of the chronically overweight. As soon their weight returns, the diet/exercise tsunami begins raging anew in pursuit of another empty miracle.
The Legitimate Solution
Patients should no longer settle for a PCP who tosses off “lose some weight” at the conclusion of performing an annual physical. Patients need to start asking “how?” if this happens. Patients need to persist in asking “how?” until they find a doctor who is up-to-date and proactive regarding current weight loss practices as indicated by the latest findings from the science and medical communities. Advances in modern medical treatment of obesity are remarkable—and they’re real.