Thursday, March 1, 2012

Thoughts On Radical Weight-Loss Solutions

If you’re like most Americans who made a New Year’s resolution to lose weight, you may have given up on it already. I don’t think statistics exist regarding how many people make this sort of New Year’s resolution, and how long they stick with it, but suffice it to say that if these resolutions were widely successful, we wouldn’t be bombarded each January with advertisements trying to capitalize on the desire to lose weight.

I’ve blogged in the past about weight loss, about the importance of diet, exercise, support, and about following tried and true approaches to weight loss. I still stand by these recommendations, for though they require work, they also produce results. In my experience, it’s the support that is the absolutely crucial element of losing weight the old-fashioned way – having someone to go walking or jogging with, to eat with, or to periodic provide support as you make your way to your goal weight.

One of the core tenets of naturopathic medicine is that it’s best to start with low-force methods as much as possible. In practice, this generally means that we start with diet and exercise and work our way up from there, through supplements and herbs and then, if necessary, on towards medications and surgery. A healthy diet and regular exercise forms the basis for health and prevents nearly all chronic diseases, so not only do they help patients lose weight, but they also help prevent heart disease, cancer, diabetes, and many other chronic health problems.

However, naturopathic physicians are nothing if not practical, and we recognize that sometimes it’s necessary to intervene more drastically. For example, a person with a blood pressure of 140/85 can probably be helped strictly through diet, exercise, and perhaps some herbal therapies, but a person with a blood pressure of 210/100 needs much more drastic intervention, probably including multiple medications. Likewise, a person needing to lose 20-30 pounds can probably do it with diet, exercise, and support, but what about someone needing to lose 50 pounds? 90 pounds? More? In these circumstances, NDs recognize the need for more aggressive interventions. By no means does the need to intervene more strongly obviate the need to educate the patient about eating well and exercising, but it does necessitate our finding another solution that works more strongly and more quickly.

So why bring this up? I read an article recently about the Diet Tube, a weight-loss protocol developed in Italy that involves the insertion of a nasogastric tube in an otherwise healthy, ambulatory, but overweight patient. Sounds intense, right? The tube, and the pump to which it is attached, supplies the stomach with small amounts of a protein-rich fluid that triggers feelings of satiety, but without supplying significant amounts of calories. The article was decrying the modern obsession with easy weight-loss schemes that didn’t involve work from the patient – also on the list were gastric bands and gastric bypasses. While on the one hand, these weight loss programs could be considered the ‘easy way out’ for some folks, on the other, these programs provide some patients with their only real hope of attaining a healthy weight, and reaping the benefits thereof.

Naturopathic physicians cannot place gastric bands, nor can they place a Diet Tube (which I’m also fairly sure is not FDA-approved here in the US) but they can certainly help guide you in your efforts to lose weight as part of a team of providers. The whole point of integrative medicine is that no one health discipline has all the answers, and that these therapies need to work together. An ND can help educate you about diet and exercise, not only as a primary intervention for weight loss, but also as an aspect of weight loss concurrent with gastric bands or other weight loss programs. Additionally, they can help you work through the process of deciding whether the procedure is right for you, when to make the decision, what to try first, etc, not to mention monitoring your health as you lose the weight. Weight loss is a challenging prospect – never go it alone. The world is full of people and providers that are happy to help you on your way.