More and more experts are saying that the main goal of medical weight loss should be to adopt better lifestyle habits. Thus, present and future health is improved. The weight loss that can result should instead be considered a “side effect”.
A comprehensive approach
The most effective approach to improving long-term health is personalized, multidisciplinary and requires regular follow-up. The therapeutic approach should ideally include the services of the following professionals: a physician, a dietitian, a kinesiologist and a psychologist.
You have to start with a medical check-up by a doctor. This is followed by consultations with other health professionals. It is best to follow up over several years, even during the weight maintenance phase. Unfortunately, few clinics offer such support.
According to experts at the Mayo Clinic in the United States, weight loss of 5% to 10% of body weight can significantly improve health19. For example, for a person weighing 90 kilos, or 200 pounds (and being obese according to his body mass index), this corresponds to a weight loss of 4 to 10 kilos (10 to 20 pounds).
Weight loss diets: to be avoided
Most weight loss diets are ineffective for long-term weight loss, in addition to being risky, according to studies4,18. Here are some possible consequences:
- long-term weight gain: the caloric restriction imposed by diets is often untenable and generates intense physical and psychological stress. When deprived, appetite increases and energy expenditure decreases.After analyzing 31 studies conducted in the United States and Europe, researchers observed that weight loss could occur during the first 6 months of a diet4. However, 2 to 5 years later, up to two-thirds of people regained all the weight they had lost and even gained some more.
- Food imbalances: According to a report published by France’s Agence nationale de sécurité sanitaire, dieting without the advice of a specialist can lead to nutrient deficiencies or even excesses55. Experts have studied the effect of 15 popular diets (including Atkins, Weight Watchers and Montignac).
With the help of a dietitian-nutritionist, it’s about finding a nutritional approach that suits our own tastes and lifestyle, and learning to decipher our eating behaviours.
On this subject, see two articles:
Weight problems – obesity and being overweight: taking on new lifestyles.
Weight problems – obesity and overweight: dietary recommendations and weight loss menus.
Increasing your energy expenditure helps a lot in weight loss and improving your overall health. It is prudent to consult a kinesiologist before undertaking any physical activity. Together, you can choose a training program appropriate to your physical condition and interests.
Consulting a psychologist or psychotherapist can help you understand the origin of excess weight, change certain eating behaviours, better cope with stress and regain your self-esteem, etc. Consult our Psychotherapy fact sheet.
Some prescription drugs can help you lose weight. They are reserved for people with significant risk factors for cardiovascular disease, diabetes, hypertension, etc. These drugs cause modest weight loss (from 2.6 kg to 4.8 kg). We have to keep taking them so the effect stays. In addition, they must be associated with a strict diet and have several contraindications.
Orlistat (Xenical®). The effect is a reduction in dietary fat absorption of approximately 30%. Undigested fat is excreted in the stool. It should be accompanied by a low-fat diet to avoid or reduce side effects.
Common side effects: liquid and oily stools, an urgent need to have a bowel movement, flatulence, abdominal pain.
Note:In the United States and Europe, orlistat is also available over the counter at half the dosage, under the brand name Alli® (in France, the drug is kept behind the pharmacist’s counter). Alli® is for people who are overweight. It may cause the same types of side effects as Xenical®. It must also be accompanied by a low-fat diet. Contraindications apply. It is recommended to consult a doctor before starting treatment with this drug in order to obtain a health check and a global approach to weight control.
Note that Meridia® (sibutramine), an appetite suppressant drug, has not been on the Canadian market since October 2010. This is a voluntary withdrawal by the manufacturer, following discussions with Health Canada56. This medicine increases the risk of myocardial infarction and stroke in some people.
Bariatric surgery most often involves reducing the size of the stomach, which reduces food intake by about 40%. It is reserved for people who suffer from morbid obesity, i.e. those whose body mass index exceeds 40, and those whose BMI is greater than 35 and who have a disease related to obesity.
Note. Liposuction is a cosmetic surgery and should not be used to lose weight, according to experts at the Mayo Clinic in the United States.
Some immediate benefits of weight loss include
- Less breathlessness and effort sweat;
- Less painful joints;
- More energy and flexibility.