Options for Treatment
 
For anyone who has considered a weight loss program, there is certainly no shortage of choices. In fact, to qualify for insurance coverage of weight loss surgery, many insurers require patients to have a history of medically supervised weight loss efforts.

The Medical Weight Management program at Central Mississippi Medical Center offers you the opportunity to lose a significant amount of weight in a relatively short time, while being supervised by medical professionals. At the same time, patients are educated on nutritional choices, psychological “triggers” that might set them off, and proper exercise routines, designed for their specific needs and limitations. This is not an easy program, but it can accomplish desired results.

Sustained weight loss for patients who are morbidly obese is even harder to achieve. Serious health risks have been identified for people who move from diet to diet, subjecting their bodies to a severe and continuing cycle of weight loss and gain known as "yo-yo dieting."

The fact remains that obesity is a complex, multifactorial chronic disease.

For many patients, the risk of death from not having the surgery is greater than the risks from the possible complications of having the procedure.

That is the key reason that in 2002, approximately 63,100 weight loss surgical procedures were performed and why the American Society for Bariatric Surgery estimates that 95,000 weight loss surgical procedures were performed in 2003. Patients who have had the procedure and are benefiting from its results report improvements in their quality of life, social interactions, psychological well-being, employment opportunities and economic condition.

In clinical studies, candidates for the procedure who had multiple obesity-related health conditions questioned whether they could safely have the surgery. These studies show that selection of surgical candidates is based on very strict criteria and surgery is an option for the majority of patients.

Weight Loss Surgery

Weight loss surgery is major surgery. Its growing use to treat morbid obesity is the result of the following factors:

• Our current knowledge of the significant health risks of morbid obesity
• The relatively low risk and complications of the procedures versus not having the surgery

Surgery should be viewed first and foremost as a method for alleviating a debilitating, chronic disease. In most cases, the minimum qualification for consideration as a candidate for the procedure is 100 lbs. above ideal body weight or those with a Body Mass Index of 40 or greater. Occasionally a procedure will be considered for someone with a BMI of 35 or higher if the patient's physician determines that obesity-related health conditions have resulted in a medical need for weight reduction and, in the doctor's opinion, surgery appears to be the only way to accomplish the targeted weight loss. In many cases, patients are required to show proof that their attempts at dietary weight loss have been ineffective before surgery will be approved. More important, however, is the commitment on the part of the patient to required, long-term follow-up care. Our surgeons require patients to demonstrate serious motivation and a clear understanding of the extensive dietary, exercise and medical guidelines that must be followed for the remainder of their lives after having weight loss surgery (see Life After Surgery).

Diet & Behavior Modification

Let’s begin by examining a statement that you will hear, and probably HAVE heard over the years. The statement is:

“You can lose weight on this diet, but as soon as you go back to eating your regular foods, you will gain it all back.”

Of course, that is true. That should not be a discouragement to you. It is a fact of nature. Similarly, if you want to avoid getting a flat tire, you avoid driving over broken glass. This works ONLY AS LONG AS YOU PARTICIPATE IN THE PROGRAM. You cannot avoid broken glass for a while and then start driving your car over it again. It will inevitably lead to flat tires.

So it is with diets, behavior modification and even weight loss surgery. If you do not understand the process of losing the weight, and stick to the program that you are a part of, you will not be successful. On the other hand, success is in your grasp if you embrace your new lifestyle.

There are literally hundreds of diets available. Many people move from diet to diet in a cycle of weight gain and loss – often called yo-yo dieting - The stress this causes on the heart, kidneys and other organs can also be a health risk. We do not recommend a yo-yo diet, but a prescribed methodology that has worked for thousands of people for decades. We monitor your health throughout the weight loss process and teach you new ways to approach your life and your eating habits. We will teach you an individualized exercise program, designed to help you meet your fitness needs and desires.

You should realize that diet alone, behavior modification alone, exercise alone, or surgery alone will probably not lead to long term weight loss. However, you should understand that these treatments in combination can lead to long term success. Medical Weight Management will use diet, exercise, and behavior modification to make you successful.

If you are a candidate for the surgical option, it is important to understand that diet, exercise and behavior modification will be instrumental to sustained weight loss after your surgery. The surgery itself is only a tool to get your body started losing weight - complying with diet and behavior modifications required by our surgeons would determine your ultimate success.

Exercise

A National Institutes of Health survey of 13 studies concludes that physical activity:

• Results in modest weight loss in overweight and obese individuals.
• Increases cardiovascular fitness, even when there is no weight loss.
• Can help maintain weight loss.

New theories focusing on the body's set point (the weight range in which your body is programmed to weigh and will fight to maintain that weight) highlight the importance of exercise. When you reduce the number of calories you take in, the body simply reacts by slowing metabolism to burn fewer calories. Daily physical activity can help speed up your metabolism, effectively bringing your set point down to a lower natural weight. So when following a diet to attempt to lose weight, exercise increases your chances of long-term success.

Starting an exercise program can be especially intimidating for someone suffering from obesity. Your health condition may make any level of physical exertion next to impossible. The benefits of exercise are clear, however. And there are ways to get started.

Examples to get you started:

• Park at the far end of parking lots and walk.
• Take the stairs instead of the elevator.
• Cut down on television.
• Swim or participate in low-impact water aerobics.
• Ride an exercise bike.

Overall, walking is one of the best forms of exercise. Start out slowly and build up. Your doctor, or people in a support group, can offer encouragement and advice. Incorporating exercise into your daily activities will improve your overall health and is important for any long-term weight management program, including weight loss surgery. We feel so strongly about the role of exercise in long-term weight loss and improved health that we have used exercise physiologists to develop a specific exercise program for our weight loss patients. This is one of the few programs in the country to develop the exercise regimen to this degree. You can read more about it under the Medical Weight Management portion of this site.

Over-the-Counter & Prescription Drugs

New over-the-counter and prescription weight loss medications have been introduced. Some people have found them effective in helping to curb their appetite. The results of most studies show that patients on drug therapy lose around 10 percent of their excess weight and that the weight loss plateaus after six to eight months. As patients stop taking the medication, weight gain usually occurs.

Weight loss drugs can have serious side effects. Still, medications are an important step in the obesity treatment process. Before insurance companies will reimburse/pay for weight loss surgery, you must follow a well-documented treatment path. The Comprehensive Weight Management Center is not a provider and thus we do not prescribe medication for patients. Your physician will make medical decisions concerning your care, after a thorough evaluation.