Why most medical weight loss will fail…

I’ve heard that quite a few patients are doing medically supervised weight loss plans.

1. When patients do temporary plans, they have temporary weight loss.
2. When the diet stops, the patient is largely destined to regain weight. although this sounds like #1, it’s different. When you have to purchase foods or shakes or meal replacements, NO ONE will do this lifelong. Therefore they will only have temporary weight loss. The average American cannot afford the additional expense for a lifetime.
   
3. Protein shakes as meal replacements don’t work. the feelings of fullness are partially generated by chewing your food. You will not get this from drinking a smoothie or drinking a protein shake.
   
4. If the stomach is not properly filled, the patient stays in a starvation state. Studies of contestants from the Biggest Loser showed that their basal metabolic rate (BMR) went down by 25%. However, the same studay also showed that the BMR decreased with gastric bypass. The differences are the following…there was a smaller decrease with bypass and the calorie intake was lowered so much with bypass that patients were much more likely to keep weight off.
   
5. Most patients I see for bariatric surgery have tried some gimicky medical weight loss plan…usually with Phentermine. If this really worked well, they would not be considering bariatric surgery!

Clearly, patients can regain all their weight after bariatric surgery. The top reasons for weight regain are 1) snacking. 2) high cal liquids like sodas, sweet tea, alcohol. 3) lack of exercise (a much lesser problem). These are prime reasons why patients gained weight to begin with!

What does work?…lifestyle modification with our without bariatric surgery! Patients on medical weight loss plans WILL eat more than bariatric patients!!! Everyone has to understand that. We have to properly fill the large stomach in medical weight loss plans. Therefore, patients HAVE to eat till they are comfortably full, otherwise they stay in a starvation state. Patient will need to exercise. Generally, lots of cardio (like walking) doesn’t work very well for weight loss. Ask your fellow bariatric patients…”what kind of exercise were you doing most BEFORE bariatric surgery?” Most patients were doing lots of cardio and failing with their weight control. “What kind of exercise has been recommended by Dr. Chang especially AFTER bariatric surgery?” By far, we are now emphasizing the weight lifting/toning/resistance exercises as the best method to promote weight loss and maintain muscle mass. This makes so much sense…but most medical weight loss plans don’t do it…therefore, they will likely fail to achieve the optimal weight.