By the time our patients have arrived at our office, they have tried 8-12 diets. Serial dieters, people who go from diet to diet have learned the experience is uncomfortable. They adopt the belief that in order to lose weignt, they have to suffer. Previous attempts have relied on willpower. Unfortunately, willpower quickly wears out. This cycle repeats itself, furthering their feelings of hopelessness. Self-help diets rarely lead to dramatic weight loss.
Why is dieting on your own so difficult? Our bodies fight weight loss through a process called metabolic adaptation. The more weight we lose, the more our appetite increases, and the more our metabolism drops. We have a weight set point, a result or generations of life saving survival tactics. That worked great during the dark ages when starvation was common, but not so much in the fast-food environment.
How are we supposed to keep off any weight at all? Weight managers learn that losing and keeping weight off requires an entirely different approach. Successful weight loss relies on preventing hunger and fueling frequently rather than meal skipping. In order to adjust to our natural tendency to hold on to calories, exercise becomes a critical component of weight control. That may seem like very hard work!
Fortunately, physicians have great tools that make weight loss and maintenance much easier. Weight loss medications reduce the discomfort of hunger. In our patients, hunger is rarely a problem because there are many tools physicians can prescribe that are not available to self-help dieters.
Weight loss (“obesity medicine”) physicians can prescribe medications to assist with weight loss. Stimulants, such as phentermine, have been available since 1959. Contrave is highly effective at reducing cravings. GLP-1 drugs like semaglutide and the newer drug tirzepatide (a GLP1/GIP drug) are appetite killers. Coupled with accountability, weight maintenance is a relatively easy process.
In summary, getting professional help makes losing and maintaining weight loss the norm, not the exception. It reduces reliance on willpower and makes the process comfortable. So don’t try harder, try easier!