Better Ways of Weight Loss

Written by Bakersfield Magazine

Where will never be a gondola with hot chocolate service that ushers one up Everest just as there will never be a quick and easy way to lose weight. In a country where the majority of citizens are overweight, Bakersfield ranks number seven for most overweight metro cities according to the 2009 Gallup Healthways Well Being Index. Six out of ten people in Kern County are overweight or obese. These statistics show a serious problem, but there is good news for people looking to make a healthy change. Bakersfield is home to many physician-supervised, medically-rooted weight loss solutions.

Physician-controlled weight loss clinics are a healthy option, explained Dr. T. Anthony Don Michael, a board certified doctor in bariatric medicine, internal medicine, and cardiology. He applies these three specialties at the Advanced Heart and Medical Center to treat and prevent obesity-caused diseases and medical problems.

“Our approach is very detailed,” said Dr. Don Michael, who has each of his patients watch an orientation video to ensure they know exactly what to expect in his program. “We are particularly concerned with what else is wrong with each patient.” He looks to identify what conditions have developed due to the excess weight and aims to treat those, as well.

For Dr. Don Michael, the medical approach to weight loss has five components.

n One is diet. Patients meet with a registered dietician, at least once a month to learn and plan their ideal diet, adapting to food preferences while maintaining the nutrition needed to lose weight healthfully. Dr. Don Michael does not recommend weight loss fads or frozen food diets saying, “you see all these ads that say you can eat pizza and cake and lose weight, but they’re all nonsense.”

n The second component is exercise. Patients are asked to do a minimum of 30 minutes of exercise at least four times a week. Types of recommended workouts are cardiovascular exercise and weightlifting to increase fat-burning muscle. Dr. Don Michael also said exercise can come in the form of ballroom dancing and skiing.

n The third component is medication. When people come to a weight loss clinic saying, “In the middle of the day, I get so hungry,” some physicians will then consider adding an FDA-approved appetite suppressant into the weight-loss plan.

n The fourth component is that the patient must change his or her behavior. Behavior modification is a vital part of a patient’s success and counseling is a large part of that. Psychologists help address why a patient has become overweight and what he or she needs to do to change their life to lose the weight.

n Dr. Don Michael’s fifth and final component of medical weight loss is surgery. Patient’s who face serious health complications often require surgery to get the initial weight off to gain mobility and reduce the severity of obesity-caused conditions in order to make diet and exercise safe and effective.

Patients with a body mass index (BMI) of 40 or more (a BMI is calculated by comparing a person’s weight with their height), or of 35 with co-morbid conditions such as hypertension, diabetes, or sleep apnea, are likely to be candidates for bariatric surgery.

When these factors are present, being obese begins to cost the person not only financially but in quality of life. Bariatric surgery uses two approaches: restriction and malabsorption. Restriction is a method that shrinks the stomach and restricts food intake. Restrictive methods include the Lap Band and Vertical Banded Gastroplasty. These methods are the easiest, but the slowest form of surgical weight loss. Dr. Don Michael explains that the Lap Band, in particular, is great for adults who qualify for surgery but don’t have a large amount of weight to lose. However, he added that the band does tend to slip, and young people may get restless eating such limited portions for the rest of their life. Malabsorptive surgeries alter the digestive system so that the body can’t absorb as many calories. These procedures include gastric sleeves and duodenal switches, but these approaches are seen in more extreme medical situations where patients will often be weighing in near 400 pounds and have serious, often life-threatening, medical problems that have developed from the excess weight.

Dr. Maureen Martin, Chairman of Surgery at KMC and bariatric surgeon with Kern Faculty Medical Group Bariatrics prefers to use a method that uses both restriction and malabsorption, the Roux-en-Y gastric bypass. The gastric bypass is one of the most common types of bariatric surgery and is often considered the most effective. The stomach is stapled to create a smaller pouch, and the intestine is then rerouted to the pouch. The now smaller pouch gives the patient a feeling of fullness much faster and doesn’t allow the body to absorb as many calories. Dr. Don Michael agreed that the Roux-en-Y gastric bypass is best for people with a significant amount of weight that face obesity-related diseases. In his vast experience, he has seen the gastric bypass completely cure type 2 Diabetes, asthma, and return an enlarged heart to a normal size.

“We look at it as a tool, not as a treatment,” said Dr. Martin. Her patients are given the tools to change their lifestyle before they have a surgery and must practice controlling what they eat. On occasion, the pre-surgery diet has worked so well with the patient they’ve opted out of surgery to continue with supervised diet and exercise. Candidates are also psychologically evaluated to see if they have the support they will need post-surgery and also to rule out any undiagnosed mental illness that would inhibit the patient’s success. Dr. Martin feels keeping the weight off is impossible without a support system. To maintain the success that bariatric medicine can bring, “they’ve got to lead a healthy life,” she added. That healthy life not only includes controlling diet and staying active but staying inspired and choosing to be around people that are supportive. Dr. Don Michael’s patients attend a support group before and after their surgery to relate with others, stay motivated, and keep an eye on their progress.

Physician-controlled weight loss is certainly a safe approach to weight loss, but for extremely self-motivated people, it isn’t necessarily the only option. With strict dedication to diet and exercise, some real weight loss can be achieved and maintained.

If you have ever watched The Biggest Loser and thought, “If only I had access to something like that,” you’re in luck. Right here in town we have a wide selection of boot camps and weight loss challenges that provide group training with coaches and help to plan meals and diet. Tim Gojich has been a trainer with Fit For Life for nine years and said the organization’s philosophy of helping people achieve major weight loss is to start by “putting function back into their bodies.” For very overweight and obese people, being sedentary has become a part of their life and suddenly trying to keep up with athletes is not going to be effective. That’s why most fitness camps offer varying levels of exercise plans. Gojich explained that “starting as a beginner and regaining strength will help those with the most to lose avoid setback-causing injuries.”

At the beginning of a boot camp program, participants are given a handout with specific portions according to weight that give the person the tools to control their diet and see better gains during the program. Gojich has seen boot camp and exercise help reverse the effects of obesity and explained that boot camp can “educate and get them moving for the rest of a person’s life.” It’s really the personal training in a group atmosphere that set boot camps and fitness challenges apart from a gym membership.

It’s all about getting motivated and staying motivated. There are countless websites dedicated to motivating those on the road to weight loss by including inspiring stories of those who’ve accomplished their weight loss goals. Reading online how other people have stuck it out and achieved success can help keep you inspired and focused on your goal, making the old fashioned diet and exercise approach very effective.

Weight loss is life changing as long as the commitment lasts. It can bring about positive behavioral changes, confidence, and renewed health, marking an overall improvement to one’s quality of life. The common denominator that every weight loss professional will agree on is that the secret to weight loss success is motivation. Whether the weight loss comes about by way of a clinical program, a surgery, or even diet and exercise, the results will be the same if the motivation is there. Dr. Martin explained that most failures to maintain weight loss, regardless of the method, occur when the person loses their support system. Choosing the right road for weight loss depends on the individual but when excessive weight is affecting your life, choosing to do nothing is not an option.*

*Please consult with a physician before starting any exercise routine.

Work-out images courtesy Lomas Photos

Article appeared in our 28-2 Issue - June 2011