Calories, Exercise and Weight Management

By Kavian S. Milani, MD

Virginia Family Medicine

. http://www.virginiafamilymed.com/

More Weight Control, Nutrition & Exercise Articles

Calories, Exercise and Weight Management

As people embark on a weight loss plan, they need to learn how to use the tools that allow for long term and sustained weight maintenance. And, the really good news is that everyone who wants to lose weight can do so with some help. Amazing tools are now available now in terms of applications, exercise programs and medically managed diet plans that have a strong track record in both safety and success.

In this article let's focus on medical management of obesity. The critical element here is calorie restriction. The diet is the most difficult part of weight management. Weight management is essentially a calorie consumed vs. calorie expenditure balance.

A strict diet helps tilt the balance towards weight loss. This is the most difficult part of weight management but given medical tools available it is actually much easier than one may think. In general, any medically managed program should provide an additional 4-5 pounds of weight loss per month. The pitfall here is not the first 10 pounds, but it is how to sustain the weight management over the next 12 months, and how to avoid a “yo-yo” diet.

After the first successful period of weight loss the body reacts in a number of ways and metabolism actually slows down. The body produces a hormone called ghrelin, which increases appetite to negate any weight loss to restore the original (non-desired) weight.

After a 20 pounds of weight loss ghrelin increases by about 30% creating a ravenous appetite that will quickly force one to gain the weight back, negating any success. This can last up to a year. Patients and physicians struggle with this issue and patients lose momentum and become discouraged when any success is reversed despite their best efforts.

The really good news is that the correct use of medications can really enhance the original weight loss, and counter the body's attempts to reverse the weight loss. There are amazing medications available, all FDA approved with an excellent track record in a medically supervised weight management program. Weight loss medications need to be highly personalized and there are no “cookie-cutter” approaches or shortcuts.

In the next installment of this series on weight loss, we will explore the types of medications available and how to navigate the terrain of weight loss medications.