Are advanced weight management options right for you

So who should consider advanced weight loss options? Anyone whose weight is excessive enough to be a health problem.

What should you do if you have tried everything to lose weight and still have excess pounds (or kilograms) that you need or want to lose?

Consult your physician

If you haven’t already, talk to your doctor. Your doctor can evaluate your weight in the context of your total health. Perhaps you have medical conditions or medications that promote weight gain or make weight loss more difficult. You may need to address those before any weight loss plan will be successful.

Beyond that, you and your doctor might then consider weight loss medications. In general, they can be helpful in the short run which may get you started with sustained weight loss, but in general none of them have proven as successful and doctors and patients would like. This post describes what’s available now.

Collage of Various Types and Colors of Medication

How to lose weight when nothing else has worked.

In helping people lose weight, there is a significant gap that needs to be closed. When diet/exercise fails, we need something less invasive  before resorting to surgery with its significant risks and complications. One option is prescription medication.

This information is current as of the publication date; it is general medical information that helps doctors and patients make decisions about what is right for them. Medical recommendations and practice changes as we learn new things. If you deal with any of these issues , please discuss with your doctor before taking any action.

Options beyond lifestyle alone

someone standing on a scale
New weight loss options are good news.

So who should consider advanced weight loss options? Anyone whose weight is excessive enough to be a health problem. In general this is considered to be those with

  • a BMI, body mass index, of 40 or greater.
  • a BMI of 30- 35 and certain medical conditions especially type 2 diabetes, heart disease, and sleep apnea

Calculate your BMI here.

Benefits of weight loss

Although these can be true even for people with lower BMI , when those with BMI 30+ lose weight, they can experience

  • improved blood glucose control in diabetics
  • lower cholesterol
  • lower blood pressure
  • less sleep apnea
  • less urinary incontinence
  • less back and joint pain
  • lower risk of many types of cancer
  • less gastroesophageal reflux-heartburn

Weight-loss Devices

The FDA regulates four devices intended for weight loss in certain adult patients age 18 and older.

Gastric Band –

bands are placed around the top portion of the stomach leaving only a small portion available for food.

Lap-Band Adjustable Gastric Banding System

Electrical Stimulation Systems –

electrical stimulator is placed in the abdomen to block nerve activity between the brain and stomach.

The Maestro Rechargeable System is implanted under the skin; an intermittent pulse generator delivers an electrical signal to the vagus nerve in the abdomen. The vagus nerve controls stomach action; when slowed down, one feels full sooner and theoretically will eat less. However, the company has not marketed it since 2018.

Gastric Balloon Systems

inflatable balloons are placed in the stomach to take up space and delay gastric emptying

The ReShape Integrated Dual Balloon System was approved by the U.S. Food and Drug Administration in July 2015. Apollo Endosurgery purchased it in 2018 and replaced it with their existing product the Orbera Gastric Balloon.

The company claims patients with Orbera experience three times more weight loss than diet & exercise alone and are provided with the right tools and resources to successfully learn to keep it off.

The device is placed into the stomach by going through the mouth and down through the esophagus with a tube called an endoscope. It takes about 30 minutes and requires on a mild sedative, not general anesthesia. Once in the stomach the “balloons” are inflated; by taking up space in the stomach it can trigger a feeling of fullness.

Gastric Emptying Systems

a tube is inserted between the stomach and outside of abdomen to drain food after eating

This device is called AspireAssist. This is a tube inserted into the stomach, from which a portion of the stomach contents can be “aspirated” (sucked out) after eating. The company claims patients lost 3 times more weight than those who received only diet and exercise counseling. The most successful patients lost over 100 pounds in the first year.

People lose weight with these devices largely due to the intensive counseling and support they received along with use of the device.

I encourage you to follow the links to learn more about each device.

 

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Obesity is defined using BMI, body mass index, but waist circumference is also important and may be more accurate.

Bariatric surgery

Two procedures comprise the majority of operations done to help people lose significant amounts of weight.

Sleeve Gastrectomy

In this procedure, a surgeon trained in bariatric procedures removes a large portion of the stomach.

The new, smaller stomach is about the size of a banana. It limits the amount of food you can eat by making you feel full after eating small amounts of food.

Gastric bypass

There are 2 steps during gastric bypass surgery:

In the first step the surgeon uses staples to divide the stomach into a small upper section and a larger bottom section. The top section, about the size of a walnut (called the pouch)will receive the food one eats. It holds only about 1 ounce (oz) or 28 grams (g) of food, causing one to eat much less.

The second step is the bypass. The surgeon connects a small part of the small intestine (the jejunum) to a small hole in your pouch. The food will now travel from the pouch into this new opening and into the small intestine. As a result, the body will absorb fewer calories.

Thus weight loss occurs from eating less and absorbing less food.

A success story

After gaining weight with her pregnancies, one woman , J.T. ,successfully lost weight with gastric bypass surgery.

I gained over 100 lb after my pregnancies. When my family doctor diagnosed me as borderline diabetic with high cholesterol, I panicked. Discouraged after failing numerous diets, I felt hopeful when I read about gastric bypass.

Learn about the lifestyle changes she made at this article from American Family Physician journal

 

Review these other posts about weight management
Obesity and BMI defined
How we should view excess weight 
How effective are weight management programs? 
A success story; how a doctor helped her patient lose weight
When diet alone doesn’t work
and, one of my all time most read posts

How my friend lost weight and inspired others with her example

exploring the HEART of achieving a healthy weight

Thanks for following this blog. If you’re visiting, I would love for you to start following Watercress Words : use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me. I also want you to find and follow me on Facebook, Pinterest , Instagram, and LinkedIn .

                              Dr. Aletha 

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Healthy holiday eating made easy

We all enjoy our holiday traditions of eating and drinking special foods and beverages. But these can cause problems for people who need to manage what they eat and drink for medical reasons.

We all enjoy our holiday traditions of eating and drinking special foods and beverages.  But these  can cause problems for people who need to manage what they eat and drink for medical reasons.

sliced Stollen

Nutritional management is a major part of living with these conditions-

  • diabetes and high cholesterol
  • celiac disease/gluten sensitivity
  • nut and other food allergies
  • lactose intolerance
  • overweight/obesity
  • alcohol dependence
  • heart, kidney, and liver dysfunction
  • pregnancy
  • migraine

PRACTICAL TIPS ON PARTY FOOD AND MEAL PLANNING

Planning ahead to manage holiday stress also applies to cooking, entertaining and eating during the holiday season.

a dining table decorated for Christmas

If you  plan and prepare holiday meals and parties, remember  some attendees need to avoid or restrict certain types of foods.  

Offer an ample variety of types of food and drinks so  your guests will find something that works for them.

If you have house guests, they will appreciate your asking them about dietary needs or restrictions so you can  have food available to meet their needs.

If you have special needs in regards to food, it may be wise to offer to bring a dish to an event , or take food to eat if you will be someone’s house guest.

from The American Diabetes Association

“Holidays can be a time of great anxiety for people with diabetes because it is so focused on food.

Don’t let questions about what to eat, how much to eat, and meal timing dampen your holiday. Plan in advance, so you can fend off stress and fully enjoy the day and keep your diabetes management on track.”

Here are the ADA suggestions for Holiday Meal Planning.

Are you worried about gaining weight from holiday meals, or trying to maintain a weight you have worked to achieve? Then try these

Top Holiday Healthy Eating Hacks

from Charmaine Gregory, M.D. at Fervently Fit 

“There is a huge amount of power in being mindful with your eating during this holiday season. “

HEALTHY HOLIDAY EATING MADE EASY

Try these Edible Christmas Gifts from Dr. Diana, an allergy doctor who blogs about cooking.

decorated Christmas cookies

 Delicious gluten free recipes from PositiveHealthWellness

apples, oranges, and walnuts

Addiction Hope 

offers advice for those with eating disorders – anorexia nervosa, bulimia nervosa, binge eating disorder )

” Eating disorders are not about food, it is about the underlying issues which can be triggered by anxiety and stress. Holidays can bring on both increased stress and anxiety and can be difficult for individuals to manage. When a person is in an active eating disorder, there are various ways to cope with the holidays.”

Read more at

Navigating the Holidays with a Food Addiction: 

These affiliate links are provided for your convenience and to help fund this blog. Thank you for considering.


Adagio Teas.

Gifts for lovers of tea with free wrapping of all items.

Christmas jazz piano album cover

Christmas music-Get in on iTunes Store and Listen on Apple Music

sharing the HEART of holiday eating

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

Thanks for following this blog. If you’re visiting, I would love for you to start following Watercress Words : use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me. I also want you to find and follow me on Facebook, Pinterest , Instagram, and LinkedIn .

                              Dr. Aletha