Today I am going to present three items that you can use to begin to manage weight control problems more effectively.  They will include another concept to help orient you, a powerful tool to help uncover causes and a list of some easy to reverse mechanisms behind excessive weight gain.  First the concept:

• If you were to evaluate 100 people with weight control problems, you would find 100 different  problems.

Experienced health care professionals are already aware that every person is different and may respond to any intervention, medication or strategy in unpredictable ways.  In addition, the cause of overweight problems is almost always complex and frequently includes a number of destabilizing factors.  Everyone has different needs.  What this tells you is that a rigidly structured weight loss plan, even if it is very good, will help only a percentage of those who try it.  On the other end of the spectrum, it also means that the best plans will involve experienced practitioners that can tailor the plan to the individual’s needs.  This is a large part of why I am as effective as I am in treating this problem; I have accumulated a lot of experience which I can use to fashion a strategy to meet the needs of each individual.

Next, I will outline a powerful tool to help find the causative factors behind a person’s weight problems.  Armed with this, you will be in a much better position to develop effective techniques tailored to specific needs, and to separate the tough to treat situations from the easy ones.  The tool is to make a record of a person’s body weight changes over the course of their lives. If you know how to interpret what it is saying, and how to tie it in with what else is happening in that individual’s life, it is a veritable gold mine of useful information.  Sometimes, a good weight history zeros in immediately on a simple factor that is the key to a person’s problems.  I discover these easy answers only a small percentage of the time, but it is very important to find them when they are present.  The following is a brief list of easy solutions.

LACK OF EDUCATION:  A poor understanding of basic, sound nutritional principles is almost universally present in the people I see in my office.  This complicates the effort to control body weight for nearly everyone, but occasionally it is the whole problem.  Even well read and very well educated people often lack an understanding of sound nutritional principles (although they usually think they are knowledgeable) since the majority of what is presented in books, magazines, online and in the news is misleading, at best, and highly detrimental, at worst.  I will be providing a brief outline of important nutritional concepts in later articles of this series – enough to effectively guide successful weight control efforts.

PERIODS OF ENFORCED IMMOBILITY:  Usually people pick up on this one fairly easily.  For example, they know their weight was fine until they broke their hip and, as a consequence, couldn’t walk much for several weeks and they realize that it was the injury that did it.  Usually, out of habit, they eat about the same way they did before becoming immobile.  Prevention is the key in these kinds of situations, remedying the problem after the fact can be tough.  A dramatic weight gain in response to immobility also indicates that the individual involved is highly sensitive to changes in activity levels (not everyone is).

HYPOTHYROIDISM:  This is easy to diagnose and easy to treat, but fairly rare.  I always check.

SUCCESSFULLY QUITTING SMOKING:  Just about everyone who quits gains weight for six to twelve months if steps aren’t taken to avoid weight gain.  I almost always prescribe weight loss medications for extended periods for people who have recently quit. This usually works nicely.  Weight gain is a very important reason why people start smoking again.

COMPLICATIONS OF CERTAIN MEDICATIONS:  The weight change history is VERY important in discovering this cause.  Sometimes medications that you wouldn’t expect to cause a gain, like blood pressure medicines, can be the culprit.  Just about everyone knows that steroids like prednisone are a common cause of weight gain.  Certain antidepressants can also be a big factor.  Many of the older diabetes drugs as well as insulin treatment are frequent causes.  Some of the newer diabetes drugs, though, are actually excellent weight control medications.

DEPRESSION:  Depression can also be the sole cause of excessive weight gain.  Some depressed people lose weight, but most gain.  I always look for depression and treat even mild cases (which are often overlooked both by patients and other physicians).  Weight gain can be the clearest symptom of an otherwise hard to recognize depression.  I have gotten very good at treating depression.

Well, I am about at the end of my easy solutions.  Obviously, it is important to make sure the easy problems are taken care of before assuming more difficult situations are at play.  But even if your problem is not one of the few that are easy ones to fix, there is a whole lot that can still be done.  Next I will look at a very important factor that applies to just about everyone: the critical importance of having realistic expectations.

Chuck