Weight reduction is difficult for many reasons. Most patients do very well initially but tend to return to old habits. There is evidence that this tendency to regain weight is built into the human brain. When fat tissue is decreased or even increased, a central control system in the brain acts to restore the fat to the previous level. If liposuction is done, for example, the remaining cells swell up to hold more fat.
Still, losing weight and keeping it off is possible.
Types of diets
The numerous methods that are available for weight loss certainly suggest that no one method is especially better than all of the rest.
Among the many more drastic diets are the following:
- Very low calorie diets: These diets provide 400 to 800 calories daily of protein and carbohydrate with supplemental vitamins and minerals. They are safe when supervised by a physician and are used when you need rapid weight loss — for example, for a heart condition. They result in rapid initial weight loss with a fall in the need for medications. Weight restoration commonly occurs, however.
- Animal protein diets like the Atkins diet: Food is limited to animal protein sources in an effort to maintain body protein, along with vitamins and minerals. Patients often complain of hair loss. Weight is rapidly regained when the diet is discontinued. This is not a balanced diet and is not recommended for more than a few weeks.
- Fasts: A fast means giving up all food for a period of time and taking only water and vitamins and minerals. A fast is such a drastic change from normal eating habits that patients do not remain on the fast for very long, and weight is regained.
Several diets are associated with large organizations in the community and may require that you purchase only their foods. The support given by these organizations seems to be extremely helpful in weight-loss maintenance. In addition, the slower loss of weight and the connection to more normal eating seems to be result in a greater tendency to stay with the program and keep the weight off. The leading contenders for this type of diet are the following:
- Jenny Craig: This organization provides the food that you eat, which you must pay for. It offers some information on behavior modification. They also have special diets for people with diabetes.
- Weight Watchers: This organization emphasizes slow weight loss, exercise, and behavior modification. It charges for weekly attendance at its meetings, which are held all over the world. It does not require that you purchase any products. Foods are available for purchase. Its point program for increasing fiber in your diet may be especially helpful to the person with diabetes.
Surgery for weight loss
Surgery is used in the most severe and resistant cases of obesity. It has impressive effects, such as correction of high glucose and reduction or discontinuation of glucose-lowering drugs. Some of the reasons for bypass surgery include the following:
- You have a body mass index that is greater than 40.
- You have an obesity-related physical problem, such as inability to walk.
- You have a high-risk obesity-related health problem, such as heart disease.
The best surgical treatment for obesity is the gastric bypass operation in which the stomach is stapled to create a small pouch. A section of the small intestine is attached to the pouch so that food passes through very little of the small intestine, reducing calorie and nutrient absorption. Because the pouch is small, you tend to eat less. The usual loss of weight is two-thirds of the excess in two years. Some of the problems of gastric bypass include the following:
- The staple line can break down.
- Malabsorption of iron and calcium may occur.
- Anemia may occur from lack of vitamin B12.
- The dumping syndrome may occur. In this condition, stomach contents move too fast into the small intestine, provoking a lot of insulin with resultant hypoglycemia.
When you have bypass surgery for obesity, you must be willing to be committed to lifelong medical follow-up. You must be willing to give up large meals and be determined to lose weight.
Behavior modification
Years of working with obese patients have shown that diet and exercise must be accompanied by changes in behavior with respect to food. The first behavior changes are diet and exercise. After that, you can change eating behavior to make the diet easier to follow. Some of the best techniques include the following:
- Eat according to a schedule to avoid unscheduled eating.
- Find a single place to eat all food.
- Slow down your eating to make the meal last.
- Put high calorie foods away. Remove serving dishes and bread from the table.
- Don't dispense food to others to avoid exposure for yourself.
- Set realistic goals for weight loss.
- When eating out, be careful of salad dressing, alcohol, and bread.
- Get a ten-pound weight and carry it around for a while to appreciate the importance of a loss of even that little.
- At the market, buy from a list, carry only enough money for the food on that list, and avoid aisles containing loose foods, other than fruits and vegetables, like loose candy.
You can incorporate one technique into your life each week (or even longer) until you feel you have mastered it and have added it to your eating style. Then go on and take up another technique.
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