Principles of Obesity and Weight Management
I am a proud member of Canada’s Obesity Network, and I embrace their principles when advising patients about weight loss and weight management:
Obesity requires long-term solutions: Obesity is a chronic progressive, condition that requires life long treatment. ‘Quick fix’ approaches to weight loss are not recommended.
Health is more than numbers on a scale: Weight management is about improving health and well being, not just decreasing numbers on a scale.
Everyone is Different: Every patient has their own unique drivers of weight gain — an individualized plan that addresses these problems is essential.
Set up for Success: Focusing on an ideal weight or dream weight is generally viewed as unrealistic and unsustainable. Health and quality of life goals such as disease prevention, increased functionality, or higher self-esteem are preferred.
Best Weight: Your best weight is the lowest weight you can achieve while maintaining the healthiest lifestyle you can enjoy.
Do you want to lose weight? A good weight management doctor asks the right questions and helps you choose the right approach to weight loss or weight management:
Do you have medical reasons to lose weight or medical reasons not to lose weight? Assessing whether someone's weight is unhealthy is not as simple as taking their body mass index (BMI). In fact, there are individuals who are classified as obese (BMI > 30) and are probably healthy just the way they are. Your doctor must consider several factors when considering if a patient needs to lose weight, and they must also check their own biases and prejudices at the door.
Are you ready to make a change to your lifestyle? If so, how motivated are you? As a physician helping patients make behaviour change, I always assess what stage of change they are at before providing advice - there is no use advising someone on weight loss if they do not believe their current weight is a problem for instance. For patients who exhibit ambivalence, I utilize motivational interviewing techniques to help move them through the various stages of change.
How much time are you willing to put aside to make changes to your lifestyle? Lifestyle change is the cornerstone to weight loss and weight management. Patients need to think hard about the amount of time they can realistically put toward new health endeavors, and build a program around what time is available.
Have you tried to lose weight in the past? Past attempts at weight loss can provide valuable information about some of the underlying drivers of weight gain. Whether those drivers are metabolic, psychological, social, or rooted in physical inactivity, a plan to address these factors can be started right away if appropriate.
Should you decide on a weight loss program, what are you primary goals and expectations? Setting the wrong goals can set yourself up for failure. For instance, Individuals that are searching for a certain number on the scale, or you are hoping for a certain physical look have a high rate of long term failure in maintaining weight loss. A good weight loss doctor helps you get focused on the goals that will help you get what you really want.
As your Naturopathic Doctor, here are some other important guiding principles I would use in planning your weight loss program:
- Always plan a weight maintenance phase after the weight loss phase - any program that does not require weight maintenance for their weight loss patients is practicing bad medicine in my view. This phase should be the same amount of time or more than the weight loss phase.
- Plan for life long follow up with an obesity physician regarding ongoing weight maintenance. You wouldn't treat your blood pressure for only 3 months, think of your weight in the same fashion.
- You have to self monitor your behaviours at some point in your program. Journaling dietary intake as well as thought logs or exercise logs is a must do portion of your program, because they are very effective.
- A certain amount of the program must be spent on problem solving, in sessions or alone. The process of problem solving over time is often where the root drivers of weight gain are discovered and addressed.