What to Ask About Obesity
How severe is my weight problem? Without intervention, what should I expect?
Generally, a patient with a body mass index, or B.M.I. of 25 to 29.9 is considered overweight; one with a B.M.I. of 30 or higher is considered obese. (See our B.M.I. calculator to determine yours.) Excess weight is associated with an increased risk of heart disease. stroke, high blood pressure. diabetes. gallstones and some forms of cancer.
How much weight should I lose?
Permanent weight loss is extraordinarily difficult, studies show, and ideal weights are rarely reached. A weight loss goal should be realistic, researchers say, and should take into account your family history and current risk factors. Many people find it useful to set goals in stages for example, to lose 10 pounds within two months, then another 10, and so forth.
What kind of diet do you recommend for me?
Avoid diets that exclude entire categories of food. Popular high-protein menus may work for some patients in the short term, some researchers have found, but fruits and vegetables should be the foundation of any long-term diet.
Does meal frequency matter?
Some patients find it helpful to eat small meals five or six times a day. Complicated regimens involving macronutrients consumed only at certain times of the day have not been well supported by research.
Should I join a weight-loss program?
Studies show that certain patients are more likely to lose weight in a structured program like Weight Watchers. Several are relatively inexpensive.
Should I consider drug therapy?
Frequently used drugs include benzene derivatives, laxatives, herbal preparations, amphetamines and other substances that act mainly as appetite suppressants. A new over-the-counter drug, Alli, blocks absorption of fat in the intestine. Weight-loss drugs rarely produce long-term results, studies show, and they may have serious side effects. They are rarely evaluated for long-term use.
Do I need gastric bypass surgery?
In a recent study, one in 50 gastric bypass patients died within a month of surgery. This procedure is an option only for people who are severely obese and cannot lose weight by other means.
Is it safe for me to exercise? How should I begin?
Moderate exercise usually is safe even for obese patients, though it is wise to undergo a physical evaluation before beginning a new program. Patients should begin slowly with activities they enjoy.
What if I lose weight and put it back on again?
Some studies suggest that weight cycling, or yo-yo dieting, may be linked to high blood pressure, high cholesterol. gall bladder disease and other health problems. Strive to maintain a modest 10 percent weight loss before trying to lose more.