Skywatch: A look back at 2023 and what lies ahead, masslive.com/living
Better Health D |
SPRINGFIELD MUSEUMS: The science of animation, D9 FILM: Tina Fey discusses ‘Mean Girls’ then and now, D9 HEALTH: When is a cough a concern, D9
| SUNDAY, JANUARY 21, 2024
As the New Year begins,
thoughts and resolutions
often turn to
Losing Weight
The numbers tell the story. By Keith J. O’Connor
(ABOVE PHOTO COURTESY OF ISTOCK IMAGES)
your healthy weight and to maintain Why should you always check with your primary care physician that loss in the long term. before starting any diet? How much should you lose in a week/month? Changing your diet could alter
how your medications work and you need to be certain that you are in Nearly 1 in 3 adults are overweight. good cardiovascular health before More than 2 in 5 adults have obesity. starting a fitness plan. And about 1 in 11 adults have severe How can you determine if you obesity. truly need to lose weight? When most people think of obeThe bottom line is if you think sity, their thoughts usually don’t you need to lose weight, you likely go much further than the notion do and should discuss it with your of being overweight. But, in truth, there’s a lot more to obesity than the primary care physician. Normal BMI is 25 or below. Sadly, most Amerinumbers on the scale. cans are above this number. BMI is “Obesity is itself a disease that your weight in kilograms divided often triggers a number of severe health conditions. Over time, those by height in meters squared. There conditions can become chronic, progressive, debilitating, and potentially life-threatening. For many, the struggle to lose weight is complicated by the challenge of managing those health conditions. Individuals who are unable sustain a healthy weight and are experiencing chronic conditions are often strong candidates for weight loss surgery,” said Dr. John Romanelli, Medical Director of Bariatric Surgery and Chief, Division of General Surgery at Baystate Health. Factors that may contribute to excess weight gain among adults include genetics; types and amounts of food and drinks consumed; level are many BMI calculators available of physical activity; degree of time online to help. spent on sedentary behaviors, such as watching TV, engaging with a Why is it important to computer, or talking and texting lose weight? on the phone; sleep habits; medical Our body physiology works more conditions or medicines; and where effectively when we are the correct and how people live, including weight. Virtually every body system their access to and ability to afford is adversely affected by being overhealthy foods and safe places to be weight. The most obvious systems active. As the New Year begins, thoughts are cardiovascular – high blood pressure, heart disease – and endocrine and resolutions often turn to losing – diabetes. But all body systems work weight. Dr. Romanelli answers the less well when you are overweight. following questions for those conLosing weight safely and at a sidering losing weight this year to realistic pace is the best way to reach benefit their health: Special To The Republican
It is different for all patients, so this is hard to generalize. But the best weight loss intervention is to do something that is sustainable in the long term. Otherwise, you risk reverting to “normal” eating behaviors/habits, which got you into the need to diet in the first place.
How do you make head or tails among all the advertising promoting various diets in the New Year?
Any significant diet should be discussed with a healthcare profes-
in the physiology of appetite. Zepbound additionally blocks another hormone called Gastrointestinal Peptide (GIP). There is a third drug coming to market in 2024 (not yet trade named) that blocks three hormones and has the best potential yet. These drugs slow the emptying of the stomach, which is desirable because it will take you longer to get hungry. Whether or not this effect (called gastroparesis) is permanent is unknown. I have heard from several patients and colleagues that the effect lasts after stopping the drugs. Both medications seem to cause a lot of nausea; an oral version of one of these drugs has been pulled from clinical trials because it was just too hard to take. Whether or not these
“Weight loss surgery is a tool that can be very helpful when employed the right way and only works well in coordination with calorie burning exercise, substantial behavioral changes, and a firm commitment to eating a better diet.” Dr. John Romanelli, Medical Director of Bariatric Surgery and Chief, Division of General Surgery at Baystate Health.
sional prior to starting it. Two tenets: if it sounds too good to be true, you are likely correct, and if it sounds like it isn’t good for you, you are also probably correct.
What about the weight loss drugs we are hearing so much about in the media?
drugs have long term success will depend on whether they are tolerable. Currently, they are injections, and patients must administer them to themselves. I do think the popularity will increase when the cost comes down (currently more than $1,000 per month) and there is a tolerable oral form. These medications are popular because they have shown the most promise.
There are two new drugs on the market for weight loss: Wegovy (the weight loss form of Ozempic) and How can a dietitian help? Zepbound (the weight loss form of Mounjaro). Wegovy works as Most of us know very little about how to eat correctly, and what we an agonist to the hormone GLP-1, which is proving to be a major player are taught in schools is inaccurate,
unhelpful, and for those of us in our 40s or older, has been debunked. Dietitians can teach many things about hunger, appetite, and making good food choices. For example, do you read the labels on the food products that you buy? You should, but very few people do so.
When should bariatric surgery be considered? It should be seriously considered when sustained efforts at dieting and exercise have failed, and a doctor thinks it is the next step for a patient. Dr. Romanelli is one of two surgeons in the Bariatric Surgery program alongside Dr. Jay Kuhn, who have a total of 37 years combined in their consistent efforts to bring the best in bariatric surgery to western Massachusetts. “Ours is a comprehensive program that will take patients anywhere from six months to one year to complete. Patients need to know that this is not something that can be done overnight. Weight loss surgery is a tool that can be very helpful when employed the right way and only works well in coordination with calorie burning exercise, substantial behavioral changes, and a firm commitment to eating a better diet,” Dr. Romanelli said. Weight loss surgery is an option for people who are severely obese (about 100 lbs. over your ideal body weight and a BMI – body mass index - of 35 and above) and cannot lose weight with diet and exercise alone. Improving your lifestyle, eating right, and staying active is still important.
To learn more about Baystate Health’s Bariatric Surgery program, call
413-794-7020 in Springfield or 413-773-2626 in Greenfield.