It’s a cycle that begins anew very New Year’s Eve: You resolve to adopt a healthier lifestyle, hit the ground running for a time, see some promising results, but then gradually lose motivation and lapse back into unhealthy habits. Before you know it, you’re back to square one with your health and fitness goals. Why does this self-defeating cycle play out again and again for so many people?
According to Matthew Fourman, MD, Director of Surgical and Medical Weight Loss for Mercy Health – Weight Management Solutions, there are some very common pitfalls that prevent people from either following through on their fitness resolutions or maintaining the results. “A lot of times, the problem with health resolutions is people either make them too broad or they try to ‘shoot for the stars’ right out of the gate, which makes their goals unattainable or unsustainable,” he says. “For example, if someone who never exercises resolves to go to the gym seven days a week, the odds are pretty slim that he or she will stick with it for the long term.”
Dr. Fourman emphasizes that it’s not necessarily a bad thing to want to make drastic changes to one’s health habits, such as losing a significant amount of weight or considerably increasing one’s exercise commitment. However, “swinging for the fences” right off the bat sets people up for failure, which leads to frustration and backsliding. “I’d rather set folks up for success by encouraging them to set modest, attainable goals and build on them incrementally. Remember, you may want to get from point A to point C, but you still have to go through point B first,” he says.
Setting attainable goals and tackling them one at a time is also the best approach for people who have multiple health goals, for example those who want to exercise more as well as adopt better eating habits. What can they do to get started without defaulting to fad dieting and going all-in with seven-day-a-week workouts? “In this type of situation, I challenge people to start by making one nutritional change, such as eliminating all liquid calories. It’s amazing how many calories you can cut by eliminating sodas, flavored coffee drinks, and even fruit juices, which are chock full of sugar. For exercise, perhaps start with just three trips to the gym per week, even if just for a half hour. Also, when it comes to introducing exercise, it’s not about what you do initially. It’s about making exercise part of your weekly routine. Once you establish the habit, we can tweak what you’re doing from there,” Dr. Fourman states.
With respect to sustaining healthier habits for the long term, Dr. Fourman advises people to make an honest assessment of their life situation—family commitments, work responsibilities, etc.—to determine where and when they can realistically fit exercise or other healthy habits into their already busy lives. “And when it comes to sustaining weight loss, we have to recognize that being overweight or obese is a very complex problem that can’t always be fixed by calories alone. Many people need other forms of support in addition to diet and exercise. That’s why a practice like ours is so beneficial. We have two dietitians on our team, and we offer a wide range of surgical options and non-surgical programs to help people lose weight and keep it off for life. Also, because successful and permanent weight loss often requires accountability, we offer weekly group meetings that can help participants hold onto their results long term,” he adds.
Among the non-surgical programs available at Mercy Health – Weight Management Solutions is the Junior and Adolescent Program, which is designed for younger people who are struggling with excess weight. This program consists of two groups, one for ages seven to 12 and another for ages 12 to 16. Why is it important to start attacking the problem of obesity so early? Bariatric surgeon Gregory Johnston, DO, of Mercy Health – Weight Management Solutions explains what’s at stake: “If a child reaches age 16 or 17 with a body mass index, or BMI, in the 40s, he or she has only a five-percent chance of ever getting back to a normal BMI.”
Another non-surgical weight-loss option is the HMR Meal Replacement Program, offering high-protein, low-carbohydrate, low-calorie meal replacements that help take the guesswork out of healthy eating. “The distinction between this meal-replacement program and similar programs out there is the coaching element. Participants can come in and meet with a coach and our staff for motivation and accountability,” Dr. Johnston says.
For those not interested in, or unable to afford, a program like HMR, Mercy Health also offers the Group Lifestyle Balance Program, which includes education and counseling on diet and nutrition with no requirement to purchase meal replacements.
In cases where diet and exercise aren’t working, bariatric surgery may be a good alternative. In fact, according to Dr. Johnston, if you compare outcomes, bariatric surgery has significantly better long-term results than has been seen with simple diet and exercise, including the currently popular Keto and Paleo diets.
To be a candidate for bariatric surgery, patients typically must have a BMI of 40 or higher, or a BMI of 35 or higher along with at least one obesity-related comorbidity such as diabetes, sleep apnea, high blood pressure, high cholesterol, metabolic syndrome, or osteoarthritis.
Dr. Johnston states that the two bariatric procedures most commonly performed at Mercy Health – Weight Management Solutions are sleeve gastrectomy and gastric bypass. With sleeve gastrectomy, the surgeon removes 70 to 80 percent of the stomach and creates a smaller, tube-shaped stomach, which not only restricts the amount of food the patient can consume, but also produces certain hormonal changes that reduce hunger cues and help with diabetes.
During gastric bypass, the upper part of the stomach is divided from the rest of the stomach, creating a small pouch, approximately the size of an egg. The intestine is then connected to this small pouch so any food that’s eaten bypasses the larger portion of the stomach and travels directly to the intestine. With this procedure, food volume is restricted and fewer calories are absorbed. “Plus, gastric bypass may speed up the metabolism, has hormonal benefits such as reducing hunger cues, and is more effective at reversing diabetes. Typically, five years after the procedure, 80 percent of patients keep off half of their excess weight. No diet even comes close to that statistically,” Dr. Johnston says.
In addition, the Mercy Health – Weight Management Solutions surgeons offer revisional surgery to patients who have had prior bariatric surgery and are struggling for various reasons. “Most centers won’t see you if you’ve had a procedure done elsewhere or simply won’t do revisions because they’re complicated. However, we’re glad to do them because we want to give our patients every opportunity for a positive outcome,” adds Dr. Johnston. ❦