Medical Weight Loss
Overweight and obesity is the fastest-growing epidemic disease in the United States. The latest statistics reveal that over 75% – three of every four of us – are overweight. Being overweight (BMI over 27) has a 50% chance of reducing your life expectancy. Being obese (BMI over 30) has a 100% chance of reducing your life expectancy. Alarming? Yes. Avoidable? Absolutely!
We approach overweight and obesity as a chronic relapsing disease. The American Medical Association (AMA) decided to call obesity a disease in 2014 (We were a few years ahead!).
*Results may vary
Three stages to successful weight loss
The Central Oklahoma Weight Loss Method includes three distinct phases.
- “Active” weight loss phase
- “Transition,” or adjusting phase
- Maintenance” phase to ensure long-term success.
Allow us to explain, Active weight loss, Transition and Maintenance (sometimes called relapse prevention and intervention).
The Central Oklahoma Weight Loss Method for treating overweight and obesity is to adopt is to adopt the treatment program of any other lifelong disease that may have “flare-ups” or attacks. We think asthma is a good comparison.
Active weight loss. Let’s use a patient example to explain the three phases of treatment, active weight loss, transition and maintenance.
PHASE 1: ACTIVE WEIGHT LOSS
EXAMPLE PATIENT #1
39 year old female arrives for weight loss.
Her beginning weight was 198.
During active weight loss most patients are seen monthly. Many weight loss programs ask their patients to come weekly. We know how hard it is to get off work and to make time for ourselves. Our patients are just like us, we all have busy lives. We designed our program to be effective with monthly visits. Typically your first appointment you are with us around 2 to 2.5 hours. We explain the program. The medical doctor does the history and physical. You attend a class with 3-5 other persons who are struggling with weight. The class is given by the doctor.
After the first visit follow-up visits are generally very fast, unless you need extra time with the doctor. Most visits are under 30 total minutes door to door.
Phase one is very variable. Some patients may stop losing over 3 or 4 months, some may lose steadily for two years. The average first time active weight loss is between 6 -9 months.Then we move to the next phase: Transition.
Monthly visits continue until
A. PATIENT REACHES GOAL
B. THE MAXIMUM WEIGHT LOSS FOR NOW IS ACHIEVED
C. PATIENT NEEDS ARISE
The patient reaches some other need to space medications and visits. E.g.:
Costs: “I can’t afford monthly visits at this time.”
Diet Fatigue: I have worked as hard as a I can for as long as I can for now.
PHASE 2: TRANSITION
EXAMPLE PATIENT #1
Visit spacing, medication modifications, monitoring.
In Transition several important things happen.
First, the frequency of visits is decreased starting to save the financial costs. Typically there are three visits over the next six months. They go from monthly to every other month then every third month.
Second, during this spacing of the visits there is a spacing of the medicines. The doctor and staff carefully review with the patient which medications are spaced and which, if any, medications are continued daily.
Third, the importance of daily weights in monitoring oneself is explained. Finally in this phase the long term safety plan called CAP (Control, Action, and Panic) are established.
155 or less. The patient is educated if the AM weight is in the control range keep doing whatever you are doing, the disease is under control. That would be like an asthma patient having clean clear lungs with no wheezing. It would be like a Diabetic’s blood sugar in the normal range.
156 -164. At an action range the patient just needs to work harder for a couple of days to lose the weight gained over the weekend or the three or four pounds gained on vacation
165 or higher. Once the panic weight is achieved (Don’t really panic, CAP just made a good pneumonic Cap the weight) whether it is six months or twenty years, that is when the patient is instructed to return for treatment.
PHASE 3: MAINTENANCE
EXAMPLE PATIENT #1
Monitoring, following the CAP guidelines
In this case example, she decided to see us about 1 year or four visits taking the meds twice weekly to help her maintain the weight. Then she did ½ more year, with visits every three months without medications for the accountability and training. She has now been over two years monitoring herself and keeping her weight under the panic weight and has not needed to return.
In example # 1 our patient as of yet has not hit her “Panic” weight.
EXAMPLE PATIENT #2
In example number 2, this patient has had two “fat attacks” over 6 years. She started at 194 pounds 37 years old. During active weight loss she went from 194 to 150. Then we started Phase two at 150, the transition phase
Key points to notice on this patient.
- When her weight was high and coming down when she hit 155 going down, it took her about 5 months to go from 155 to 148 (A)
- When her weight was down but going up at the 155 mark we could get her back to 148 in just one month (B) and (C)
- Since C, she has not had any more “fat attacks” and kept her weight in the control range.
Why is staying below the panic weight so important? This next patient graph demonstrates what happens when we gain and lose and gain and lose. It becomes harder and harder to get down. In fact, the P weight become a strong resistance point in getting back down.
Example patient #3 Patient regains above panic weight before returning for treatment.