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Jaime Almandoz, M.D. Answers Questions On: Nonsurgical Weight Management
I’ve read that bariatric surgery – the surgical management of obesity – is the surest and fastest way to get rid of unwanted weight, but you specialize in the nonsurgical management of obesity. How does that work?
Bariatric surgery is one of the most effective ways to lose excess weight, but once you have the surgery you need someone who specializes in metabolism and nutrition to be involved in your care.
Many of the patients I see have had bariatric surgery elsewhere, and they’ve been unsuccessful in meeting their weight loss goal or are struggling to keep the weight off. On top of this, they are also dealing with nutritional deficiencies and other metabolic issues like diabetes or underactive thyroid. Follow-up with an obesity medicine specialist should be part of this process to maximize weight loss and wellness after the surgery, and to prevent problems such as nutritional deficiencies.
For obese patients who have not had weight-loss surgery, how do you help?
Everyone is different and we individualize each plan of care according to that person’s needs and medical history.
Many of my patients have struggled with weight for years and have been unsuccessful with dieting and other strategies. They end up losing hope instead of weight, but I like to show them that there are other options. As part of the initial evaluation, I rule out medical problems that may contribute to weight gain and work with the patient’s other doctors to ensure that other conditions, such as sleep apnea, are well managed.
We offer personalized nutritional education and programs to modify calorie intake, which can include meal replacements. We also help patients devise physical activity programs suited to their needs and limitations by collaborating with our colleagues in physical medicine and rehabilitation or orthopaedic surgery. Some of our patients benefit from working with specialists in psychology who can help manage conditions like depression or anxiety, which may have contributed to the weight gain or may be interfering with weight loss.
What about weight-loss medications – are they for me?
Several new prescription weight-loss medications have been approved in the last few years. These new developments are another way we can help our patients achieve their weight-loss goals.
Although these medications appear to be safer and more effective than the treatments we had in the past, as with all medications, there are potential side effects. It is best to work with an obesity medicine specialist to see if it is appropriate for you to try these medications and to monitor your progress.
Does it help to wear an activity monitor or to use an app that tells you how many calories you’re burning versus what you’re eating?
We rely on technology to help us with many aspects of our busy lives, and weight loss should be no exception. These devices help us to be more mindful of our physical activity and energy balance.
To use myself as an example, I spend most of the workday sitting in my clinic seeing patients. I rely on my activity monitor to ensure that I get a minimum amount of physical activity every day, which helps to keep my weight in check.
Applications that track calorie intake are a great resource for busy people who don’t have time to keep a food diary or to look up the calories in everything they eat. Some apps even use the camera on your phone to scan barcodes on food packaging to make tracking easier. By being mindful of our calorie balance, we become more empowered on the journey for weight management.