When Your Doctor Prescribes Weight Loss

When your health’s at risk, it’s time to get serious.

From the WebMD Archives

You may know that being overweight or obese isn’t good for you. Still, it can be incredibly upsetting when your doctor says you need to lose weight for your health.

You’re not alone, though. More than 30% of the U.S. adult population is obese, with a body mass index (BMI) -- a measure of body fat based on height and weight -- of 30 or more. As a comparison, healthy BMIs are between 18.5 and 25.

Why Did My Doctor Prescribe Weight Loss?

The health risks that come from being overweight or obese include high blood pressure, arthritis, diabetes, heart disease, and cancer. At the same time, you may find that being overweight seriously affects your emotional well-being, especially in our thin-obsessed culture.

Even though it can be difficult, try not to take offense when your doctor recommends weight loss for health reasons. Your doctor has your best interest in mind and is trying to improve your health and quality of life.

“Your doctor has given you the advice to lose weight because of his concern to try and stop the condition you may have from progressing any further,” says Toby Smithson, RD, a national spokesperson for the American Dietetic Association. “Overweight and obesity have become a major public health issue that has a domino effect with many associated chronic diseases and conditions. Many people start to gain weight and as their weight increases it affects their well-being from their head to their toes.”

How Do I Get Started With Weight Loss?

The first step to successful weight loss is gathering information about your options. So when your doctor tells you to lose weight, it’s important to ask questions and seek advice from your physician.

You might begin by asking your doctor how much weight you need to lose to improve your health. How long will it reasonably take to lose that weight?

It can be overwhelming to choose among the different options for achieving weight loss. There are diet and exercise programs, medications and surgical procedures. Talk with your doctor about which weight loss methods are right for you, given your medical history and current health status.

If your doctor isn’t comfortable making recommendations or if you’d like to meet with a specialist, ask for a referral to medically supervised weight management center at an academic institution. These centers have multidisciplinary teams of experts, which include doctors, dietitians, and exercise physiologists, who are skilled in helping people lose weight and keep it off.

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Take the Initiative With Your Doctor

What should you do if your doctor has not prescribed weight loss, but you wish your doctor would to give you that extra motivation to lose weight? Go ahead and schedule an appointment to discuss weight loss for health reasons. If you’re nervous, it might be helpful to bring along a supportive friend or family member, and to write down your questions ahead of time.

And how about if your doctor only prescribed weight loss for something that’s bothering you, like osteoarthritis in your aching knees, instead of addressing the condition? Remember that weight loss itself often does resolve a number of medical conditions, so your doctor may be trying to take a conservative approach. If you aren’t comfortable with the recommendation, ask whether there is something you can do to help solve your medical condition while you’re working on your weight loss.

Weight Loss for Health Reasons: What Are the Options?

When you need to lose 50 pounds or more, it can seem like an impossible task. While weight loss isn’t easy, the good news is that there are a number of ways you can successfully work toward your goal.

Diet and Exercise

“The best technique for losing weight is to lower your calories, but not too low, and to increase your physical activity with a starting goal of 30 minutes at least five days a week, increasing to 60 minutes,” Smithson tells WebMD. “This is the foundation of losing weight.”

Whether you’ve tried to lose weight in the past or this is your first attempt at weight loss, it is helpful to consult a registered dietitian for advice on the types and amounts of foods you should eat. A dietitian will work with you to design an individualized diet program that works for your lifestyle, preferences, and health needs. Some dietitians will even make trips to your home to help you create a home environment that can help you lose weight.

If you’d rather not consult a dietitian, or if your insurance won’t cover the visit, there are other options available, including commercial weight loss programs. If you choose to go this route, experts recommend choosing a program that has proven successful for many people and is backed by scientific evidence. These types of programs will also provide you with a supportive community of people who are also working toward weight loss.

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Regardless of the food program you choose to follow, remember that exercise is just as important as diet for weight loss. Before beginning your exercise program, be sure to consult with your doctor to make sure the activities you’re planning on are safe for you. While joining a gym or your local YMCA is a great option, remember that walking is a great way to get exercise – and it’s something you can do anywhere.

“I recommend that people get a pedometer,” Apovian tells WebMD. “People should try to do 4 miles a day for weight loss, or about 10,000 steps.”

Medications for Weight Loss

While there aren’t any medications that cause weight to fall off overnight, there are some prescription drugs available that may help a bit with your weight loss.

“The medications we currently have can help you lose about 10% of your body weight,” Apovian says. These include sibutramine, a medicine that helps control appetite, and orlistat, which helps block the absorption of some fats and vitamins. Orlistat is available in both prescription and over-the-counter formations.

There are also many drugs in the pharmaceutical pipeline that may be more effective than currently available ones, enabling people to lose 15% to 17% of their body weight.

Medications for weight loss are not for everybody, though. If you have high blood pressure or heart disease, sibutramine is not a safe choice. Orlistat may interfere with the absorption of some vitamins and medications. Be sure to check with your doctor before taking any form of orlistat.

Experts recommend you stay away from any supplements for weight loss that have not been approved by the FDA, such as ephedra or ma huang, as they may have serious health consequences.

Finally, remember that even if you and your doctor decide to use medication to help with your weight loss, it’s still essential for you to follow a healthy eating and exercise plan.

Surgery for Weight Loss

If your BMI is 35 or higher, you might be a candidate for weight loss surgery.

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Options that you can discuss with a doctor who specializes in bariatric surgery are banded gastroplasty and gastric bypass surgery.

In banded gastroplasty, a band is placed around the upper portion of your stomach to limit the amount of food it can hold at one time.

For gastric bypass surgery, a small stomach pouch is created with a bypass around the area of your small intestine that absorbs the majority of the food you’ve eaten.

These procedures carry with them the risk of serious side effects and will require a lifelong commitment to diet and exercise for you to remain healthy. But if your weight is causing significant harm or risk to your health and you haven’t been able to lose weight with diet and exercise alone, surgery may be the best option for you.

“Most patients who come to see me who need to lose 100 pounds or more don’t want surgery because they’re scared,” Apovian says. “I don’t think anyone should be pushed into surgery, but I do think people should look into it as a viable option. It will take away years of frustration, of losing weight and gaining it back. For people whose health is at risk, perhaps due to diabetes or hypertension, in one year they can lose all the weight they need to lose with gastric bypass.”

How Can I Stay Motivated for Long-Term Weight Loss?

For starters, pat yourself on the back for making the commitment to lose weight for health reasons. The road to weight loss can be long and frustrating, so be sure to take time to recognize your hard work.

Remind yourself why weight loss is important to you. Perhaps your goal is to stay off blood pressure-lowering medication, or maybe you want to be able to play baseball with your kids in the backyard.

Finally, remember that there are thousands of individuals out there who have been able to lose significant amounts of weight and keep it off. The National Weight Control Registry has more than 5,000 members who have lost 30 pounds or more. Try visiting the registry’s web site to read success stories and find out what worked for other people.

Just think, in a few years you, too, could join the registry as a successful "loser" and serve as an inspiration to others.

WebMD Feature Reviewed by Laura J. Martin, MD on 7/, 010

Sources

SOURCES:

CDC: “Overweight and Obesity.”

Toby Smithson, RD, national spokesperson, the American Dietetic Association.

WebMD Medical Reference: “Obesity Basics.”

Caroline Apovian, MD, director of the Center for Nutrition and Weight Management, Boston Medical Center; associate professor of medicine, Boston University School of Medicine.

National Institute of Diabetes and Digestive and Kidney Diseases Weight-Control Information Network: “Choosing a Safe and Successful Weight-loss Program.”

WebMD Health News: “Modest Results From Weight Loss Drugs.”

National Heart Lung and Blood Institute: “How are overweight and obesity treated?”

The National Weight Control Registry.

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