Over 100 million, or 2 out of every 5 adults in the United States are considered obese and another 22 million have severe obesity. Many find it very difficult to lose and keep the weight off. In many ways, obesity is a medical problem that creates more medical problems. Obesity is unfortunately associated with many negative health outcomes such as heart disease, high blood pressure, osteoarthritis and obstructive sleep apnea. While a number of weight loss treatments, medications, and surgeries are available, most plans won’t be effective and long-lasting unless they are person-centered.
Obesity and Co-Occurring Health Concerns
Obesity is a chronic yet treatable condition associated with excessive weight and a body mass index (BMI) greater than or equal to 30. It’s associated with a number of serious physical illnesses including:
- Heart disease
- Type 2 diabetes
- Prediabetes
- Asthma
- High blood pressure
- Osteoarthritis
- High cholesterol
- Obstructive sleep apnea
- Non-alcoholic fatty liver disease
Physical problems are only half of the problems experienced by people who are considered obese or severely obese. They can experience a range of emotional or psychological problems as well including:
- Depression
- Low self-esteem
- Eating disorders
- Body image disturbance
- Stress
- Low quality of life
Weight Loss Methods
Science and medicine have come a long way in the pursuit of reducing weight and keeping it off. Weight loss is incredibly important, because losing just 5% to 15% of a person’s total weight can improve a number of weight-related health issues. A weight loss plan may begin after complete physical and psychological evaluations, and involve medications, eating healthier foods, exercising and staying active, remaining motivated to reach set goals, drinking lots of water, intermittent fasting, and if necessary, bariatric surgery. Any plan to lose and keep off excess weight has a better chance of success if it’s person-centered.
Benefits of Weight Loss
The benefits of weight loss are almost limitless and any loss in weight moves the individual to better health, happiness and quality of life. Losing just a little bit of weight can:
- Increase energy
- Decrease daytime fatigue
- Lower cholesterol
- Reduce blood pressure
- Increase libido or sex drive
- Increase mobility
- Improve mood
- Improve breathing
- Reduce risk of certain cancers
- Enhance quality of sleep
- Prevent type 2 diabetes
- Reduce risk of heart disease or stroke
These are just several benefits that can improve a person’s life, but there are many more benefits that can affect one’s social, financial, interpersonal, academic, professional, and spiritual well-being.
Person-Centered Bariatric Care
For some individual’s, medications, nutrition and exercise may not be enough to reduce weight and keep it off, and therefore will need some type of bariatric care including bariatric surgery. This type of surgery, also known as weight loss and metabolic surgery, may be recommended when all other methods have failed. It involves reduction of stomach size and/or nutrient absorption, alteration of gut hormones, and uses standard surgical procedures including:
- Roux en-Y bypass
- Sleeve gastrectomy
- Biliopancreatic diversion with duodenal switch
Regardless of the procedure, and of course, aftercare, the plan of care ideally should be one that involves the patient and fits with what he or she is ready and able to do. Person-centered bariatric care means listening to the patient’s thoughts and opinions and doing so with respect and dignity. This level of care also means entering a genuine relationship with the individual and providing all of the information and education needed to succeed.
A multidisciplinary team consisting of physicians, nurses, social workers and perhaps most importantly, dieticians, will carefully craft a plan of care with the input of the patient. Their ultimate goal is to live a healthier lifestyle and keep the weight off, thereby reducing a multitude of co-occurring illnesses. The team will teach the individual skills to keep the weight off and motivate him or her to stick with the plan and keep their appointments. Depending on the unique needs and preferences of the individual, a wide range of dietary changes can include:
- Low calorie eating on most days
- Flexibility for eating a little more on some days
- Staying on a low carbohydrate diet, especially for those at risk for type 2 diabetes
- Meal replacement shakes
- Intermittent fasting
- Low calorie liquid diet
These strategies and many more can be customized according to the person.
Final Thoughts on Person-Centered Bariatric Care
Some experts say that obesity in the United States is an epidemic. It certainly is associated with far too many dangerous physical and mental health problems and is very costly to the health care system. While a wide range of medications, life-style changes and treatments are available to many people, they may miss the mark unless the person is in the center of the treatment plan and has a voice, choice and motivation to lose and keep off the weight.