Non-Surgical Treatment Options

While the Center for Weight Loss Surgery at Newton-Wellesley Hospital offers bariatric surgery, we also encourage our patients to explore non-surgical weight loss treatment options.
 
In fact, most of our patients must show a history of medically-supervised weight loss efforts to qualify for insurance coverage of weight loss surgery.

Many non-surgical weight loss programs are based on a combination of changes in diet and behavior and regular physical fitness. They can include:

Diet and Behavior Modification
There are literally hundreds of diets available. Moving from diet to diet in a cycle of weight gain and loss - yo-yo dieting - stresses the heart, kidneys and other organs and can also be a health risk.

Doctors who prescribe and supervise diets for their patients usually create a customized program with the goal of greatly restricting caloric intake while maintaining nutrition.

These diets fall into two basic categories:

  • Low Calorie Diets (LCDs) are individually planned so that the patient takes in 500 to 1,000 fewer calories a day than he or she burns.
  • Very Low Calorie Diets (VLCDs) typically limit caloric intake to 400 to 800 a day and feature high-protein, low-fat liquids.

Many patients on VLCDs lose significant amounts of weight. However, after returning to a normal diet, most regain the lost weight in under a year. Ninety percent of people participating in all diet programs will regain the weight they've lost within two years.

Behavior modification uses therapy to help patients change their eating and exercise habits. Like low-calorie diets, behavior modification in most patients results in short-term success that tends to diminish after the first year.

If you have been unsuccessful in diet and behavior modifications and surgery is your next option, it is important to understand that diet and behavior modification will be key to your weight loss after your surgery. The surgery itself is only a tool to get your body started when losing weight -following diet and behavior modifications required by most surgeons determines your long-term success.

Exercise
Starting an exercise program can be intimidating if you are morbidly obese. Your health condition may make any level of physical exertion next to impossible. The benefits of exercise are clear, however. And there are ways to get started.

A National Institutes of Health survey of 13 studies concludes that physical activity:

  • results in modest weight loss in overweight and obese individuals
  • increases cardiovascular fitness, even when there is no weight loss
  • can help maintain weight loss

New theories focusing on the body's set point (the weight range in which your body is programmed to weigh and will fight to maintain that weight) highlight the importance of exercise. When you reduce the number of calories you take in, the body simply reacts by slowing metabolism to burn fewer calories.

Daily physical activity can help speed up your metabolism, effectively bringing your set point down to a lower natural weight. So when following a diet to attempt to lose weight, exercise increases your chances of long-term success.

Examples to get you started:

  • Park at the far end of parking lots and walk.
  • Take the stairs instead of the elevator.
  • Cut down on television.
  • Swim or participate in low-impact water aerobics.
  • Ride an exercise bike.

Overall, walking is one of the best forms of exercise. Start out slowly and build up. Your doctor, or people in a support group, can offer encouragement and advice. 

Adding exercise into your daily activities will improve your overall health and is important for any long-term weight management program, including weight loss surgery. Diet and exercise play a key role in successful weight loss after surgery.

Over-the-Counter and Prescription Drugs 
New over-the-counter and prescription weight loss medications have been introduced.

Some people have found them effective in helping to control their appetite. The results of most studies show that patients on drug therapy lose around 10 percent of their excess weight and that the weight loss levels off after six to eight months. As patients stop taking the medication, weight gain usually occurs.

Weight loss drugs can have serious side effects. Still, medications are an important step in the morbid obesity treatment process. Before insurance companies will reimburse/pay for weight loss surgery, you must follow a well-documented treatment path.

Always consult your doctor when thinking of taking over-the-counter or prescription drugs.

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