As the saying goes for many, you can’t be rich enough or thin enough. Many of our patients come in with unrealistic goals regarding their weight loss, and don’t give themselves enough credit for the weight they have lost. Many, for many reasons, regain.
Woman, 58 years of age, class II obesity, prediabetes (A1C 6.0%), HO depression, on antidepressants, weight of 188, BMI 38. Started on metformin and lower carb meal plan.
Warned her early on it’s not just about losing weight, but what’s important is keeping it off. We need plans for both.
Her treatment plan does not end when she loses weight. Over 6 months she lost 22 pounds. This is a 12% weight loss. BMI 33.5 now. No further weight loss since the 6-month period, but no weight gain.
Patient frustrated. She has upped her exercise. No longer wants to continue metformin. Encouraged her to continue her meal plan, metformin and bump up her exercise plan. Praised her for her weight loss and not regaining. And, reminded her this is what we discussed from the start. She remembered and said she’ll stay with the plan.
- Keeping weight off is a different stage of the weight loss journey.
- Reminder that losing 3-5% total body weight can improve health outcomes.
- 5-7% weight loss was shown in the DPP to prevent or delay type 2 diabetes.
- From the beginning, let patients know there are stages to losing weight. First is to lose, then it’s to keep off the weight lost. Make a plan for both.
- Regarding weight loss, put more emphasis on the food side.
- Regarding weight maintenance, put more emphasis on exercise.
- Remind patient of discussion and encourage patient to embrace the weight loss they have been able to achieve and keep off.