miércoles, 4 de enero de 2012

Weight Loss: Mission Not Impossible

So it's just a few days into the new year and there's a good chance you've already broken your diet and also a good chance that you've concluded you will always break diets and that, despite all you know about the health risks of excess weight, despite the fact that you don't like the way you look and feel, you will never lose weight. And if you read the New York Times Magazine last Sunday, the cover article may have dashed the last shred of hope you had about this subject: it details research about how our brains and bodies conspire to hold on to every ounce we try to lose. Especially discouraging, Tara Parker-Pope, the author of the article and the Times' health columnist, a woman who knows more about nutrition and exercise than just about anybody, acknowledges that she is 60 lbs overweight and unable to lose it.

My practice certainly echoes the statistics Parker-Pope quotes in her article. Like the average American, many of my patients are slightly overweight in their 20s and 30s, gain weight throughout middle age (women, particularly at menopause), and re-gain any weight they manage to lose.

But, I do have several patients who have achieved lasting weight loss:

N, a man in his 40s, lost 50 lbs four years ago by running and cutting back on junk food.

M, a woman in her 70s, lost 50 lbs decades ago with Weight Watchers and now serves as a group leader in that program.

S, a woman in her 20s, has maintained her 40 lb weight loss by keeping track of her diet through dailyburn.com, learning how to cook healthy meals for herself, and a regular yoga and gym routine.

K, a woman in her 50s, lost 35 lbs seven years ago when she got the flu, stopped eating for a few days, and then, once she recovered, reflected on how much she normally overate. She also took up a new sport, SCUBA diving, that requires her to be fit.

C, a man in his 50s, lost 40 lbs eight years ago by walking miles every week and bringing lunch to work instead of eating take out.

A, a woman in her 50s, lost over 100 lbs with gastric bypass surgery. She now goes to the gym regularly and has drastically altered her diet.

And I could go on.

Doctors who focus on individual cases rather than statistics are sometimes accused of practicing "anecdotal medicine," ignoring the realities that studies of large populations reveal. But, in the matter of weight loss, I think individual cases are instructive. And what do they tell us? Patients like those I've mentioned, and others I've seen who've lost weight successfully, are similar to those enrolled in the National Weight Control Registry, a project involving people who have lost at least 30 lbs and kept it off for a year or more: they've used different methods to lose weight--some have followed structured diets, some not--but they have, I think, three important things in common:

They pay attention. Whether they are keeping food journals, weighing themselves every day, or simply planning meals, their weight loss goals are never far from their minds...ever.

They've found a reason to lose weight that is truly meaningful to them. Whether it's a new sport, a new grandchild, a health scare, or--most powerful--how much better they feel being thinner, they stay mindful of why they wanted to lose weight.

They take the long view. They lose weight slowly, roll with the ups and downs, steer clear of rigid goals and deadlines. They've signed up for a permanent change.

In a postscript Q&A after her Times Magazine article, Tara Parker-Pope said that the research she did into the grim prospects for weight loss success may have, ironically, given her efforts a boost in that she will, knowing more about the science of obesity, be less hard on herself.

I'm all for it. Absolutely, be less hard on yourself. Self-punishment only fuels overeating.

But know that there are exceptions to the statistics, and aim to be one of them.

Dr. Suzanne Koven
http://www.boston.com

ArturoRodriguez, MD
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177

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