How Your Doctor Can Help You Lose Weight
Adult obesity rates have steadily increased for over 30 years; 41.9% of Americans are obese according to the Centers for Disease Control (CDC). If you want to lose weight but don’t know where to start, you’re not alone.
Successfully losing weight ultimately comes down to a formula: calories in, calories out (CICO). In other words, you need to burn more calories than you consume. Though the formula for losing weight is simple, actually shedding the pounds can be anything but easy.
In an analysis of 29 long-term studies, a National Institutes of Health report found that more than half of weight lost was regained within the following two years. After repeated failed attempts, many people report that they find it futile to keep trying to lose weight.
Whether you’re trying to lose weight for the first time or the tenth time, your primary care physician can be a valuable resource to doing it healthfully and sustainably. Your doctor can help you understand the benefits of losing weight, how to start a diet, if there is a faster way to fat loss for you and help you decide if you’d benefit from a weight loss clinic or a prescription medication.
First, let’s learn about obesity in the United States and the science behind weight loss and calorie management.
Is there really an obesity epidemic?
With obesity affecting more than two in five American adults, the U.S. is indeed suffering from an obesity epidemic. Though obesity impacts people of all cultural and socio-economic segments, there are higher obesity rates among Black adults, Hispanic adults and adults without college degrees. Obesity increases the risks of many chronic diseases, including diabetes, heart disease and hypertension.
Obesity is a complex public health issue and obesity rates across the world have been rising for years. Researchers have not found a singular approach to reverse our ever-increasing obesity rates. But just because there is an obesity epidemic does not mean you can’t get to a healthy weight by working with your doctor to understand and treat your personal weight management.
U.S. Obesity Fast facts/stats
- From 1999 to March 2020, U.S. obesity increased from 30.5% to almost 42%.
- Severe obesity during that time increased from 4.7% to 9.2% (NHANES, 2021).
- In 2019, obesity-related medical costs in the U.S. were estimated at nearly $172 billion.
- Annual medical costs for obese adults were $1,861 more than for those at a healthy weight.
Why Americans weigh more than they used to
Though the reasons why the majority of Americans are heavier than they used to be are debated, experts seem to agree on one thing: for many of us, the CICO formula (calories in, calories out) is off balance in the wrong direction. Basically, we eat too much and don’t exercise enough, which is a recipe for obesity.
According to research by the U.S. Department of Agriculture (USDA) and the World Health Organization (WHO), the average American consumed 20% more calories in 2000 than in 1983. These extra calories are attributed to increased meat and grain consumption, bigger portions, fast-food making up 11% of the average American’s diet and widespread consumption of sugary sodas and energy drinks.
Being sedentary is the new normal as more Americans spend their workdays sitting at a desk and driving and less time exercising or being physically active. Research shows we burn 120 to 140 fewer daily calories than we did in the 1970s and 80% of Americans don’t exercise enough.
The science of weight loss and weight gain
For our physiological systems to function, our body needs energy from food to power our organs and bodily biological functions, circulate blood and help our cells thrive. Calories are energy units and we gain weight when we taking in more energy (i.e., more calories) than our body is using.
This excess energy is stored as triglycerides, the most common form of lipid, or fat, that circulates in our blood. When we lose weight, it is because our body uses up all the calories/energy we consume, so it starts burning stored fat. Age, gender and genetic make-up also influence whether we hold onto weight or can easily shed it.
Metabolism and basal metabolic rate
Metabolism is the term for the chemical process that converts food and drink calories into energy that is used for essential bodily functions like digestion and breathing. Think of it like the engine process that converts fuel to power a car. Whether we’re running up a mountain or brushing our teeth, our muscles also need energy to perform.
Basal metabolic rate (BMR) is the minimum number of calories, or energy, your body needs to function while resting, including the ability to circulate blood, breathe, your heart to beat and your brain to think. To determine your approximate personal BMR, use an online calculator.
Calories in, calories out
As discussed above, CICO is the simple math equation of calories in vs. calories out. Think of it like a financial balance sheet. More calories in than out typically results in weight gain, i.e., fat credits. Not enough in and too many out equates to weight loss, i.e., a fat or calorie deficit.
Benefits of losing weight
Successful weight loss differs from person to person, but the numerous health benefits remain the same — even modest weight loss has big benefits to your health and longevity. Common benefits include moving more easily, better fitting clothes and better sleep. Weight loss can also help lower your blood sugar, blood cholesterol and blood pressure, as well as lower your risk for obesity-related chronic diseases like diabetes and heart disease.
The role of exercise in losing weight
Though exercise is not required to lose weight, it can help boost your weight loss because of CICO. To lose weight, you need to expend more energy than you consume in calories and exercising burns calories. and also provide many other benefits. If you’ve been sedentary for a while, you may see big benefit from even small amounts of exercise.
Experts say playing the long game in weight loss is best: incorporate physical activity combined with healthy eating and lose weight steadily over a longer period. This allows your metabolism to adjust and is more sustainable than rapid weight loss that you can quickly regain when your body fights your efforts by holding onto fat reserves.
You don’t have to start training for a marathon. Try incorporating small amounts of activity into your daily routine: go for a walk, dance while you dust, ride a bike or rake the yard. Get moving, start slowly and work your way up to 150 minutes a week of moderate intensity aerobic activity.
Aging and weight loss
As we get older, we typically need fewer calories because our BMR lowers as we age, and we start to lose bone and muscle density that make up our lean body mass. It’s common for older adults to have unintentional weight loss, but 28% of elderly patients have unintentional weight loss with no known cause. Eating a nutrition-filled diet is key for healthy weight management as you age.
Short-term vs long-term dietary changes
Research shows that adhering to a healthy eating plan of healthy calories has more impact on sustaining weight loss than restricting calories. This is because of calorie quality: a calorie is not just a calorie. You can eat healthy calories or bad-for-you calories. The key is to work with your doctor or a dietician to develop a nutritious healthy eating plan that works for you.
Fad Diets
There is no secret faster way to fat loss when it comes to sustainable long-term weight loss. Fad diets are often touted as the fastest or easiest way to lose weight, and they typically eliminate entire food groups or promote eating only certain foods.
But you cannot live on soup, fruit or bacon alone for long. Protein-only diets or cutting out carbs completely just won’t cut it: our body needs a balanced and nutrient-rich diet. And a diet that promises a quick fix is sure to backfire.
How to develop sustainable, healthy eating habits
Successful weight loss and healthy weight management for overall wellbeing comes down to developing healthy eating habits and working with your doctor to follow an evidence-based eating plan. These typically entail cutting out refined sugars, eating less meat, eating fresh not processed foods, eating foods high in key vitamins and nutrients, eating more fruits and vegetables, avoiding saturated fats and drinking plenty of water.
How your primary care physician can support you
Your primary care physician is your best advocate and collaborator on your weight-loss journey and can clearly explain the benefits of losing weight. A primary care doctor has a baseline knowledge of healthy eating habits and basic exercise needs. Your doctor also will know your health history, can show you how to calculate maintenance calories and can order a blood test and other labs to assess any underlying medical causes.
If appropriate, your doctor may prescribe weight-loss medications or recommend vitamins and supplements. Ask to schedule a regular check-in appointment so your doctor can see how you’re doing and address any questions or concerns. He or she can also refer you to a registered dietician, a weight loss specialist trained in both the psychological and behavioral aspects of weight loss, a physical therapist regarding any exercise concerns and/or a psychologist to help maintain your mental well-being.
How to talk to your doctor about weight loss
Be open with your physician about why you want to lose weight, for example to manage medical conditions, feel healthier or to have more confidence and energy. Share your health history and any weight-management roadblocks you’ve experienced in the past. Accept your doctor's recommended goal weight and timeframe to reach it. Discuss any health problems or medication side effects that may be affecting your weight and whether a weight loss clinic or surgery is an option. The key is to be honest and transparent with your doctor so he or she can guide you to your goal.
Be completely honest with your doctor.
Sometimes, it’s temping to be less than truthful with our doctors when it comes to fraught topics like diet, exercise and weight. It’s understandable to feel embarrassed or even guilty if you struggle with things like obesity, binge eating or addiction.
Your doctor has seen it all: You won’t be their first patient to struggle with these issues. You can also communicate to your doctor that you are anxious or embarrassed about these topics and that you could use reassurance.
Make a list of your questions and concerns.
It’s easy to forget important questions at the doctor, especially if your appointment is short or rushed. A simple solution is to write out your questions and concerns ahead of time. You could even keep a list on your phone or a pocket notebook and add to it whenever you think of something else you want to bring up.
If you are planning to make (or have already made) major lifestyle changes, it’s recommended that you check with your doctor to ensure these changes are safe and appropriate for you. Good general questions to ask include:
- What steps do you recommend for losing weight?
- Should I be tested for any obesity-related diseases?
- Do you have patients who successfully lost weight and maintained it?
- Is there a weight loss medication I should try?
- Are there weight loss books, podcasts, or literature I should check out?
- What lifestyle changes do you recommend?
Bring a spouse or trusted friend.
Not everyone knows that you are allowed to bring someone with you when you go to the doctor. Having a confidante by your side can make you feel more secure and help you remember what you want to talk about with your doctor. It also shows your doctor that you have a strong support system and research has shown that strong social and emotional support are associated with better health.
Take notes.
Doctor’s appointments can be overwhelming. To remember your doctor’s recommendations, it can be helpful to take notes during your appointment. If you bring someone with you, you can ask them ahead of time to take notes for you. You should also get a visit summary from your doctor after each appointment. If you are not sure how to access this summary, ask your doctor or a member of your doctor’s front desk staff.
FAQ about weight loss
How long does it take to lose weight?
It depends on your goal, health, age, any medical issues and your commitment to eating healthy and exercising. Experts recommend aiming for slow, steady weight loss of one to two pounds a week.
What exercise burns the most belly fat?
Research shows that a daily fitness routine that includes at least 30 minutes of cardio and aerobic exercise may be best for losing belly fat, with aerobic exercises helping to reduce belly and liver fat the most. Examples include brisk walking, running, rowing, swimming and cycling.
How much weight can you expect to lose in two months?
Eight to 16 pounds or one to two pounds per week. With more rapid weight loss, you increase your risk of health complications and regaining the weight.
Do carbs make you fat?
Research has shown no difference in weight-loss success between overweight and obese people who followed either a balanced-carbohydrate or low-carb diet.
Does cardio help you lose weight?
Cardio exercises burn calories. To maximize your weight loss potential, research recommends doing cardio for 30-40 minutes daily, at least five days a week.
Where do you lose weight first?
Everyone is unique and many factors impact where you lose weight first. In general, initial weight loss is internal with the loss of hard fat that surrounds your organs. Next, you will typically lose soft fat, such as around your thighs, waist and face.