We are a weight-focused society but when it comes to managing weight long term, having a weight-only narrow focus can be detrimental.
Throughout my 4-decade career I have stressed the importance of lifestyle modification being foundational for losing weight and achieving better health.
Now with an average 15-20% weight loss with the new injectable obesity medications, clinicians and patients alike are wondering if lifestyle modification is still needed.
Whether or not you are considering medication therapy, taking one of these new medications or prescribing them for your patients, we are all looking for the best weight management outcomes possible.
Here are some tips to refocus weight management efforts beyond the scale:
1-Rethink End Goal
The goal of treatment is improved overall health and health-related quality of life, not solely weight loss.
For everyone looking to manage weight better (including those taking the newer generation of medications that are more effective for weight loss), it is important to focus on additional HEALTH BENEFITS that accrue, such as:
- increased vitality
- improved self-esteem
- taking less medications for high blood pressure or diabetes
- improved metabolic and heart health
- less joint pain or stiffness
- better mood
Feeling better, having more energy and enjoying life to the fullest will help you stay motivated as you lose weight.
2-Build Enjoyable, Sustainable Healthy Habits
A big focus of my weight management approach is helping patients build day-to-day healthy habits that are enjoyable and sustainable.
This involves planning ahead to make time for healthier diet and activity patterns.
For those of you with a suppressed appetite from taking one of the newer obesity medications, your diet patterns may shift away from calorie restriction to getting a nutritionally adequate diet.
Diet quality, proper hydration, eating the right foods to minimize medication side effects and maintaining muscle mass through diet and exercise become the new focus.
Feeling energetic and healthier while taking the new medications (in addition to losing weight) are all signs you’re on the right track.
3-Get Support
Obesity and overweight are chronic complex health conditions that require a team-based approach to improve outcomes.
If you wonder if you’re a candidate for one of the newer injectable medications, talk to your primary care clinician.
If you’re already taking one of the newer medications but are experiencing unpleasant side effects with dose escalation, talk to your prescriber.
Anyone trying to manage weight better can benefit from the following referrals – even if you’re already losing weight on a medication:
- Seeing a registered dietitian nutritionist can help improve your diet quality and better manage medication side effects.
- With less food noise, other psychological issues may come to the forefront such as anxiety, depression or social isolation, necessitating referral to a health psychologist to improve your mental health.
- If you need more help attaining fitness and a healthy body composition, find an exercise specialist in your area.
If you want to establish lifestyle behaviors for long term weight and health management, using a team-based approach is best.
I’m excited to share that my next book, Patient Centered Weight Management: The Six Factor Professional Program and Toolkit (coming in Spring 2025), covers many of these issues to help clinicians within their busy practices improve weight management outcomes.
RK
Robert Kushner, MD
