Why is it so hard to loose weight? Wouldn’t it be wonderful if weight loss was as easy as weight gain!
Talking abut weight management is NOT the same as body shaming. This discussion is focused around the health conditions that can evolve from carrying too much weight and the treatments and recommendations to loose unwanted and unhealthy weight.
So, what is unhealthy weight? Typically a person’s Body Mass Index (BMI) is calculated by dividing weight by height. For example; a person who weights 150lbs and is 67 inches in height has a BMI of 23.5. So what does this mean?
BMI falls into several categories.
BMI |
Weight Status |
Below 18.5 |
Underweight |
18.5—24.9 |
Healthy Weight |
25.0—29.9 |
Overweight |
30.0 and Above |
Obesity |
Remember, BMI does not measure fat or muscle. Measuring skin fold thickness, evaluation of diet and exercise, as well as family history are all important in the evaluation of a healthy weight.
The goal is to maintain a healthy weight. Sometimes we fluctuate up and if we reach a BMI of 30 or above we are considered obese. Obesity leads to many health concerns such as diabetes, high cholesterol, metabolic syndrome, high blood pressure, heart disease, shortness of breath with exertion and poor self- esteem or confidence. For some, obesity can cause difficulty with mobility, making walking and outdoor activities difficult.
One of the best ways to maintain or reach a healthy weight is thru regular exercise and lifestyle changes. This is not ignoring the fact that this can be a hard change to make.
At times, the use of medication can be an option that allows this weight loss to happen at regular intervals if there are also lifestyle changes made on a consistent basis.
For these purposes I will only discuss the use of medication to lifestyle changes. There are surgical options for some people, but we will not discuss these here.
What are the medications currently available?
- Semaglutide- a once weekly injectable medication has been FDA-approved for weight loss. Improved glycemic and lipids (cholesterol) have also been
- Liraglutide- a once daily injection that is effective for weight This can be used in patients with or without diabetes.
- Phentermine-topiramate- oral medication that is taken
- Phentermine, benzphetamine, phendimetrazine, and diethylpropion are approved by the FDA for short term therapy (i.e.12 weeks). Side effects are greater and there is potential for abuse.
- Orilstat- not a first line recommendation due to side effects of gastric distress
- Bupropion-naltrexone- similar as orlistat, but has more contraindications and may have more side Again, not a first choice of medication to use for weight loss.
With each option, lifestyle changes are required for best results and at times, for any type of result to take place.
The goal of therapy is to improve health and seeing a 5 to 22 percent weight loss when lifestyle modification is incorporated into a daily routine.
For some people weight is increased due to medication that they take for other health concerns. Diabetes is a great example. The use of insulin will make an individual gain weight. Some antidepressants are known for causing weight gain. Not exactly what an individual needs to add to their daily struggles.
These side effects can be a reason why an individual discontinues their treatment for diabetes or depression. That is where the above medications like Semaglutide or Liraglutide is recommended. These medications along with consistent lifestyle changes will bring about positive results.
What are lifestyle changes? These are the things you can change. Exercising, dietary intake, behaviour modification or coping mechanisms. These changes are not going to take place overnight. This takes work and consistency, but this will increase the success rate of reaching your goal(s) and having a healthy weight.
