Obesity is a chronic disease. The good news is that it is reversible. However, the cause of obesity is complicated. Obesity is multifactorial and impacted by social, spiritual (beliefs & values), cultural, behavioral, metabolic, and genetic factors.
We know that 2/3 of the United States population is either overweight or obese. We can identify the root cause of this epidemic to dietary changes that started in 1977 and went into effect around 1980. Since then, this epidemic has been on the rise since then. We know that our diet, behavior, and other lifestyle choices, not simply our genes are to blame here.
We know that diets don’t usually work.
Effective Weight Loss Requires High-Intensity Lifestyle Change
The good news is that we have research that is showing us what works. One example of that is the thousands of patients that the National Weight Control Registry (NWCR) has studied over the years.
The USPSTF has nicely summarized that body of research into guidelines and said the following in a recommendation.
|“The USPSTF found that the most effective interventions were comprehensive and were of high intensity (12 to 26 sessions in a year). Most of the higher-intensity behavioral interventions included multiple behavioral management activities, such as group sessions, individual sessions, setting weight-loss goals, improving diet or nutrition, physical activity sessions, addressing barriers to change, active use of self-monitoring, and strategizing how to maintain lifestyle changes. Weight-loss outcomes improved when interventions involved more sessions (12 to 26 sessions in the first year). Behavioral intervention participants lost an average of 6% of their baseline weight (4 to 7 kg [8.8 to 15.4 lb]) in the first year with 12 to 26 treatment sessions compared with little or no weight loss in the control group participants. A weight loss of 5% is considered clinically important by the FDA. For obese patients with elevated plasma glucose levels, behavioral interventions decreased the incidence of diabetes diagnosis by about 50% over 2 to 3 years (number needed to treat, 7). Behavioral interventions also demonstrated some improvement in intermediate health outcomes, such as blood pressure, waist circumference, and glucose tolerance”|
I’ve seen a lot of amazing results in my patients when I put them through my intensive program. Recently, I saw a 62-year-old patient with severe diabetes (A1C 10.7) weekly for the first month and then about monthly for three months. By the fourth month, her diabetes was essentially reversed (A1C 5.6) with her being on only one medication, Metformin. The plan is to wean her off that medication in a few months. She lost a significant amount of weight in the process which all worked with the dietary treatment to help reverse her diabetes.