Expert Tips on Weight Management Programs for Obesity

1. What doctors should I see to help me begin a weight management program?

First, you should consider seeing your primary care physician. They can give you healthy weight loss guidelines based on your medical condition and age. They can also recommend appropriate workouts and the right diet plan for you.

If necessary, your primary care physician may refer you to a bariatric physician. These doctors specialize in weight management and typically study the causes of obesity and how to prevent it. They can provide you with in-depth information about your nutritional requirements and ideal exercise.

Bariatric surgeons are medical professionals who perform weight loss surgeries, such as a gastric bypass. Advanced interventional endoscopists are a subset of bariatric physicians who can assist you in weight loss through procedures such as an intragastric balloon. If your current weight loss strategies haven't been effective, you may want to consult with a bariatric physician.

Since several hormonal conditions may lead to obesity, your primary care physician may also refer you to an endocrinologist before sending you to a weight loss specialist or providing dietary recommendations.

2. What will a weight management program involve?

A weight management program aims to help you meet your weight loss goals through healthy, practical, and achievable choices, such as:

• Behavioral treatment focusing on lifestyle counseling. You'll learn healthy eating habits and smart ways to stick to your diet plan and physical activities. You may be instructed to keep records of your diet plan and workouts in a journal.
• Lifestyle tips. You may learn information about sleep and stress management, and the pros and cons of using weight loss medications.
• Dietitian feedback. A dietitian may monitor you throughout your weight loss journey and provide feedback.
• Weight loss goals. You'll have practical weight loss goals with steady progress, ideally losing one to two pounds weekly. You may lose weight faster in the initial phases of the program.
• Diet plan. A comprehensive diet plan will help you maintain your weight. You may be instructed to set goals and self-evaluate through your food journal with your doctor's guidance.

3. What can I expect at my first appointment when beginning a program?

You'll likely meet with your primary care physician or dietitian during your first appointment. They'll begin with a comprehensive diet history feedback form to assess your current dietary habits, weight loss history, and exercise behavior.

They'll ask you to record your daily food intake by keeping a food diary. Plus, your doctor will prepare you for healthy dietary changes and eating habits to help you succeed.

4. How can I receive financial help to afford a weight management program?

State governments, pharmaceutical companies, and nonprofit organizations offer assistance programs to help you afford weight loss medications.

You may qualify for medical assistance programs run by the government. These programs vary from state to state, and they are generally known as state pharmaceutical assistance programs (SPAP).

You can apply online by entering information about your condition and the medication your doctor has prescribed. The company evaluates your application, reviews your requirements, and determines your eligibility for the requested assistance.

Two examples of nonprofit organizations that can help you financially are NeedyMeds and The Weight Loss Surgery Foundation of America (WLSFA). NeedyMeds has a database that includes state assistance programs, patient assistance programs, economical or free medical care, and drug discount programs.

WLSFA is powered by people who've undergone weight loss surgery, medical professionals, and industry partners. They raise resources and money to give away in the form of medical grants.

5. What tips do you have for sticking to a healthy diet?

Follow these tips to stick to your diet plan:

• Set realistic goals and expectations. This will help you stay on track throughout your weight loss journey.
• Avoid keeping junk food in your house.
• Travel with healthy snacks. High-protein snacks can help you feel full and keep your diet balanced until you eat a complete meal.
• Eat mindfully. Pay attention to how your food tastes, smells, and feels.
• Keep a record of your progress. Tracking your food intake and workout routine can help you stay motivated. In a three-month study, women with obesity lost six times more weight when given pedometers on long distance walks compared to those who didn't use the device.

6. It's hard to find the motivation or time to exercise. What tips do you have?

The following strategies can help you keep your motivation level high:

• Find a partner. You're more likely to exercise consistently if you work out with a partner. One study found that people who are overweight tend to lose more weight if they spend time with their fit friends.
• Exercise in the morning. A study from 2017 found that morning people develop healthy habits more easily because cortisol levels are high in the morning.
• Choose convenience. If a gym is located near your house, you're more likely to go regularly. And if you have a treadmill, for example, keep it on the first floor of your house rather than in the basement.

7. Will I need to take medication, and if so, what are my options?

If diet and exercise fail to give you the desired weight loss results, your doctor may prescribe weight loss drugs.

The U.S. Food and Drug Administration (FDA) has approved the following medications:

• liraglutide (Saxenda)
• orlistat (Xenical)
• bupropion-naltrexone (Contrave)
• lorcaserin (Belviq)      
• phentermine-topiramate (Qsymia)

Most prescription weight loss drugs work by decreasing your appetite or increasing feelings of fullness. Some do both. The exception is orlistat, which works by interfering with absorption of fat.

These medications may have mild side effects, like diarrhea, constipation, and nausea. Although serious side effects are rare, it's important to discuss these medications thoroughly with your doctor.

8. How can a counselor or coach help me lose weight?

At times, you may find it difficult to follow your diet plan or workout routine during your weight loss journey. Weight loss counselors or coaches can support you during these times and help you alleviate your frustrations.

Finding a qualified counselor or coach can also help to hold you accountable and assist you in achieving your goals. It's important to find a coach who suits your needs and helps reduce any stress during your weight loss journey.

9. What kind of goals will I have in a weight management program?

You'll likely set dietary goals, physical activity goals, and behavioral goals in your program.

Your dietary goals may include eating calorie-counted food, having a nutrient dense diet, and eliminating unhealthy foods. You may set exercise goals by deciding how many times you'll go to your gym or fitness center, or how many steps you take during daily walks.

Adopting healthy behaviors to improve your weight loss progress is essential. Your behavioral goals can include determining your guilty pleasures, being honest about your fullness signals, or having the right portion size.

Remember that your goals should be S.M.A.R.T. This means they should be Specific, Measurable, Attainable, Realistic, and Timely. If you incorporate these elements into your goal-setting strategy, you'll have a plan that is easy to achieve and practical. These components can help you lose weight and maintain your weight loss.

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Dr. Saurabh Sethi is a board-certified internal medicine physician specializing in gastroenterology, hepatology, and advanced interventional endoscopy. In 2014, Dr. Sethi completed his gastroenterology and hepatology fellowship at Beth Israel Deaconess Medical Center at Harvard Medical School, and soon after completed his advanced endoscopy fellowship at Stanford University in 2015. Dr. Sethi has been involved with multiple books and research publications, including over 40 peer-reviewed publications. Dr. Sethi's interests include reading, blogging, traveling, and public health advocacy.