Pat said:They had a doctor, Arthur Frank, M.D., of George Washington University
Hospital's Weight Management Program, answer questions on obesity on the
Diane Rehm show. http://www.gwhospital.com/p11917.html
He had some interesting comments. One was when he rebutted people who like
to say, "It's all about calories in and calories out." when he said that
isn't true: that individual metabolism and other things (such as age,
hormones, illnesses, genetics, etc.) pay a large part in obesity. He also
said that weight maintenance was primarily about exerting one's will over
the "triggers" and bodily influences that can urge people to eat and overeat
because in most people, these urges are built-in and will not go away. He
said that people cannot just diet but have to re-order their way of eating
and this lack of a new way of eating is why many people gain the weight
back. And, he decried the impulse of our society to blame people who are
overweight in a way they wouldn't blame people for other things, such as
accidents or illnesses.
Pat in TX
Thanks for the information. I greatly enjoyed reading the materials at
the link you gave.
I have attached some of the Q&A from the web page, as it reflects on big
issues of percentage of people successful in A) Weight Loss and B) Life
Changes To Keep WEight OFF....
And some other issues of general interest.
I attempted to cut out the few "sales" oriented program details and less
interesting (to me) pieces of information.
Again, thanks for the link.
I feel I learned a little more.
Jim
------------ Q&A ------------- Selected -------
Q: Are there any special pills involved in this program?
A: No megadose vitamins or minerals are used. No water pills, shots or
secret preparations are used. The vitamins and minerals which are
provided are standard preparations used in standard doses. They are
carefully selected and balanced to meet the needs of patients on a low
or very low calorie diet.
Q: I want to keep my regular physician involved in my medical care. Can
I do this?
A: You should discuss this with your physician. Our staff will be happy
to review the details of the program with your physician and keep your
physician informed of your progress as you proceed. <snip>
Q: Are there side effects or risks associated with this program?
A: Yes. Any weight loss program will produce some occasional side
effects. In either the food-based or the formula program, the side
effects are infrequent and are usually well tolerated. Almost all of the
side effects are resolved within the first two weeks of the program. Our
staff will review and provide you with a summary of the potential side
effects when you start the program. It should be emphasized that we have
encountered no serious or significant problems in more than 20 years and
in treating over 6,000 patients. We have had no patients who have
required hospitalization or experienced unmanageable complications
because of the program. The potential side effects of these weight loss
programs appear to be less frequent and less troublesome than the risks
of untreated obesity.
A summary of possible side effects is provided to all patients. You may
call our office and request that a copy be mailed to you.
Q: Will I be able to continue my regular activities while I am on this
program?
A: Yes. Patients are urged to continue their regular activities
including employment and exercise programs. Patients on either the
food-based or formula program ordinarily feel entirely well.
****************
Q: How successful is this program in getting people to lose weight?
A: About 75% of the patients who start the program will lose more than
half of their excess weight. About 45% will reach a goal weight. This
compares favorably with traditional programs for weight loss which
ordinarily report that less than 5% of their patients lose 40 or more
pounds.
*****************
Q: What about long-term maintenance? How good is this program at
assuring that I can maintain my weight loss?
A: No program can assure you that you can maintain your weight loss. The
best we can hope is that you will become familiar with the techniques of
maintenance and will be able to incorporate these into
your own personal practices for sustaining your weight loss. Part of the
program includes a very comprehensive effort directed at assisting
people in maintaining their loss. No one should be unrealistic about the
difficulty of weight maintenance. No one should expect that obesity can
be cured. Our goal is that each patient will lose weight, learn new
techniques for maintaining the weight loss and that the quality of life
will be improved during the time that control can be maintained.
<snip>
Q: So much of my success in weight loss depends upon the assistance of
my husband (or wife) and yet there often seems so little that he (or
she) can do. Is there any way in which my spouse can be involved and
become familiar with the problems I am having?
A: Yes, One of the sessions in our groups is oriented to family members.
Concerned individuals in your family are urged to attend. We have
organized special meetings for spouses and have found them to be
remarkably effective. We will continue to conduct spouses’ meetings.
**************************************
Q: How can I not be hungry while eating so little food on a formula program?
A: We are not certain why people are no longer hungry, but it is clear
that hunger is rarely a problem. Most patients recognize that
significant problems with hunger are not an issue while they are on this
formula program. Although patients will occasionally feel the sensation
of wanting to eat, they usually recognize that there is no need to do
so. There is no clear metabolic explanation for the absence of hunger.
************************************
<snip>
Q: My experience with psychologists and psychiatrists has been negative
and I am reluctant to participate in the group sessions. Is it an
obligatory part of the program?
A: We strongly believe that the group sessions are an important and
intrinsic part of the process of losing weight and of maintaining the
weight loss. Although there is no absolute requirement that every
patient attend the group sessions, we have found that patients who
participate in the classes and groups are about twice as likely to
succeed in their weight losing efforts as those who decline to
participate. Because our charges are based on the assumption that all
patients participate in groups, there is no reduction in the fees for
patients who choose not to do so.
Q: About how rapidly can I expect to lose my weight?
A: If you assume an average rate of weight loss on a formula program,
you will lose about 1/4 of your body weight in three to four months and
about 1/3 of your body weight in four to five months. You can make
individual calculations by assuming that you will lose about nine or ten
percent of your body weight in the first month and about seven or eight
percent of your then-current weight in each subsequent month. The
rapidity of weight loss on a food-based program depends on the
particular program used. Occasionally patients reach a plateau in their
weight loss. This always represents water retention in compliant
patients. Water retention and shifts in water balance are totally
unrelated to the rapidity of the fat loss. Fat is lost at a steady rate
regardless of any factors related to water balance.
Q: How many calories will I be able to eat when I resume a regular diet?
A: This varies substantially from one person to another. We will develop
an individualized set of recommendations about your food and dietary
patterns before you are ready to reintroduce food.
Q: Why bother? 1 know I can lose weight, but I’ve lost and gained weight
so many times that I am very pessimistic about my ability to sustain a
normal weight. Is it worthwhile to try another diet? Isn’t it dangerous
to bounce up and down?
A: Most chronic diseases have a fluctuating pattern of symptoms and
disability. Obesity is not different. Techniques for assured long-term
control do not exist, but many good techniques can be helpful for a
patient who is willing to maintain a continuing, deliberate, probably
life-long effort. Most patients who have not been able to maintain
control have never participated in a comprehensive program or have never
learned appropriate maintenance techniques. Many of these patients have
never been at a comfortable normal weight and even after reducing their
weight, they continue to struggle with old and tired procedures for
dieting to lose those last few pounds. These patients have never truly
tried a maintenance program. Even if control is not perfect and some
weight is regained, many patients recognize that they are significantly
more comfortable, often for long periods of time, when they can maintain
their weight below their maximum. Again, as with most chronic diseases
(diabetes and arthritis are good examples), the obese patient is clearly
healthier and more comfortable when under control even if there is a
possibility of a recurrence of loss of control.
It has recently been suggested that “yo-yo” dieting damages or
irrevocably changes the already slow metabolism which is often a part of
the problem for many obese patients. Careful studies have refuted these
claims. All patients on any diet will slow their metabolism while they
lose weight. Metabolism recovers, however, with stabilization and
maintenance of weight loss. There is no permanent change in metabolism.
No one suggests that weight cycling is a prudent form of management. The
issues surrounding fluctuating weight loss emphasize that the complex
task of weight loss should be done carefully so as to avoid the
possibility of weight cycling regardless of any impact this might have
upon metabolism.
<snip>
