Your Weight, Your Life
You’ve tried the diets, the pills, the mail-order meals, the home exercise machines. But you’re not feeling thinner — you’re feeling failure.
Dr. Shana Weiss, who specializes in internal medicine and bariatrics (the medical treatment of obesity), explains why it’s time to stop beating yourself up and consider a fad-free approach.
Women & Obesity
More than one-third, or 72 million people, in the United States are obese. After little change during the 1960s and 1970s, obesity nearly doubled between 1980 and 2004 — with women gaining pounds at a slightly higher rate than men.
“Obesity” is generally defined as a Body Mass Index (BMI) of 30 or higher (BMI = weight [lbs] divided by height [in.] divided by height [in.] x 703). For example, a woman who is 5’ 0,” 160 pounds and has a BMI of 31 is considered “obese.” A BMI between 25 and 29 is considered “overweight.” You can calculate your BMI at cdc.gov/healthyweight/assessing/bmi.
The Number One Killer of Women
Heart disease is the leading cause of death for women in the United States — and heart disease is often brought on by obesity. In fact, for a BMI ranging from 30 to 40, a heart attack could occur six to 12 years earlier than in someone with a healthy BMI. Obesity can also lead to stroke, type II diabetes, cancer, infertility, osteoarthritis, depression, skin problems, sleep apnea and other diseases.
Northwestern Lake Forest Hospital’s Dr. Shana Weiss is board certified in internal medicine and also is a Diplomate from the American Board of Bariatric Medicine. She decided to pursue rigorous post-graduate training in bariatric medicine after seeing so many obesity-related problems.
“I had to work with patients to get their weight down as part of managing their illnesses,” she says. “Developing weight loss plans became part of their treatment.”
Willpower Has Its Limits
About 80 percent of Dr. Weiss’ practice is made up of patients with an array of internal medical conditions. But the patients coming in purely for weight loss help have something in common: frustration.
“Most women feel that they’ve failed in some way,” she says. “They’ll tell me, ‘I’m just not good at this.’ But they may be working uphill — against their genes, the way the brain and stomach work together and lots of biochemical issues.”
Evidence keeps mounting that genes influence appetite and obesity, and the brain plays a key role in a person’s weight. If you are genetically prone to obesity, you may be less sensitive to signals like feeling full. And the more weight you gain, the harder it is for your body to establish its normal appetite set-point.
This means that even with good intentions, weight loss is a difficult journey.
“Clearly, we’re more sedentary than we used to be,” says Dr. Weiss. “But research is showing that something else may be overriding or switching signals in an overweight person, turning more food into fat instead of fuel.”
An Expert on Your Side
A partner, and a personalized plan, may help overweight and obese women win the weight war. Bariatric specialists integrate many components to develop a customized plan: diet, exercise, behavior modification, health conditions and, possibly, medication and meal replacements.
“Find someone you are comfortable with who will customize your treatment. A high protein diet might work for you, but not for someone else,” Dr. Weiss advises. “Your behavior, such as stress-related eating, should be analyzed.”
And those products and books that promise to “target” belly fat or “jumpstart” metabolism?
“In reality, those claims don’t play out because you simply can’t target one body part or system,” she explains. “Avoid over-the-counter diet drugs and focus instead on a holistic program with exercise. Exercise may be the best way to break the cycle created by genes and behavior.”
Heartening Success Stories
Good programs are tailored to the patient’s needs — and the results of those who stick with it are impressive.
“I have several female patients who lost 60 pounds, another who lost 100 pounds and many others who have lost 50-55 pounds,” Dr. Weiss says. “They simply followed the program, including exercise. They also had someone — in this case, me — to whom they were accountable.”
She explains that no program, product or diet plan — even those guided by a physician — will work well without exercise.
“I tell people that if they commit to 12 weeks for a plan and follow all of its components, including exercise, they can lose five to ten percent of body weight in the first few weeks,” she says.
Dr. Weiss does not perform bariatric surgery, but she refers patients to those surgeons if appropriate. Gastric banding (such as LAP-BAND®) and gastric bypass surgery, the most common procedures, require follow-up treatment with bariatric specialists like Dr. Weiss to ensure healthy recovery and long-term success.
Can Anyone Try Medical Weight Loss?
Weight loss programs aren’t limited to those carrying 50 to 100 excess pounds. Dr. Weiss explains that women can face psychological-social trauma even when the gain is small.
“Everyone’s tolerance is different. Some women have been thin their whole lives; then they put on five or 10 stubborn pounds and become very unhappy,” she says. “Others have been obese for years and losing weight has never occurred to them.”
But most importantly, Dr. Weiss believes women need to take charge of their health — especially when obesity is putting their life on the line.
“Not all women ‘count’ weight loss as part of their overall preventive care,” she says. “But stress, weight and other conditions all affect how you look, how you feel and how long you’ll live.”