Weight Management - Weight Loss that Works
As discussed previously, most approaches to weight loss fail because they don’t recognize the underlying causes and complexities of weight gain, most of which are not changeable or curable.
For treatment approaches to be effective, they should seek to:
Accept and ‘work with’ the genetic and biological underpinnings of weight gain:
This is why Semaglutide (Ozempic) and other Obesity Medications are effective. It is also why psychological and behavioural as well as surgical approaches are effective.
In order to accept this framework, it often needs to be acknowledged that patients have essentially been lied to - “Sorry about that, that actually wasn’t your fault, sorry if that was what we told you in the past. I wonder if you might be open trying again, except this time in a new way that is based on a better scientific understanding?”
Address underlying drivers and associated medical conditions
While genes and environment are the strongest drivers of weight gain, there are many other factors that ought to be assessed such as sleep, stress, pain, medications, social factors, hormonal and digestive health, or psychological underpinnings that might be as simple as certain knowledge gaps or more complicated such as low mood or confidence.
Be realistic with regards to expectations of cure vs long term management
Given that most drivers of weight gain are not going away and are ‘ever present’, it makes sense that if an individual stops treatment, the weight comes back. Thus, treatment needs to be reassessed and adjusted over time in order to be successful.
Put Otherwise, in Order to be Successful, “Weight needs to be Managed, not Lost”
As outlined in my last journal entry, Weight Loss Programs are problematic and suffer from the following flaws:
They are almost universally, short term in approach.
Are not Health Focused
Oversimplified
Perpetuate Harmful Messaging
Lack of emphasis on the prevention of weight gain
Overly focused on numbers on the scale - a non-controllable outcome.
Did I mention they don’t work? For health or weight goals.
Weight Management - the New Weight Loss
“Weight Management” is the ethical and evidence informed approach to helping people treat or prevent the development of unhealthy body fat. It refers to an approach that is sophisticated and takes the long view towards improving your health. It is the language that I hope people will adopt into the future, rather than “weight loss”. I think this transition will happen as we all become more educated about Obesity and more compassionate toward people living with these challenges (which is a majority of us by the way).
For now, I shall remain the hypocritical Weight Loss Doctor in Vancouver (Naturopathic Doctor) that continues to refer to weight loss in my marketing material so that I am searchable on the internet ;)
In health,
Dr.O