If you’ve ever tried to lose weight, you know what a struggle it can be. But it can be even more challenging during the long, cold winter, when many people tend to eat more and exercise less. Finding the right approach and ongoing support can help you lose weight and keep it off for good. With this two-fold strategy, perhaps this New Year can be your year for success.

Before you begin, it helps to understand why losing weight is so difficult. “Our bodies are designed to store calories – as protection for when food isn’t readily available,” explains William “Troy” Donahoo, MD, medical director of clinical weight management at Kaiser Permanente Colorado. “When we try to lose weight, we’re asking our bodies to go against what they are designed to do.”

No one-size-fits-all strategy
People’s bodies also regulate calories in different ways. Consequently, strategies that work well for some people may not work well for others.

To help patients get off to a successful start, the weight management team at Kaiser Permanente Colorado helps patients choose an approach that is most likely to work for them. They often begin by asking patients about strategies that worked well in the past. They also consider patients’ current weight and medical conditions, as well as the resources available to them. For example, some patients are appropriate for weight-loss surgery while others are not.

Sometimes, an approach that worked well in the past may not be as effective when used again. “We work to help patients find the right weight-loss strategy at the right time,” Dr. Donahoo says. “If one approach isn’t working, we support them in trying others.”

Strategies for success
A healthy lifestyle that includes eating well and getting sufficient exercise is the foundation of any successful weight-loss and weight maintenance strategy.

A healthy diet focuses on eating fruits, vegetables, whole grains, lean proteins, and low-fat dairy – and limiting sweetened drinks, high-fat foods, and refined carbohydrates. To learn more about healthy eating as a basic weight-loss strategy, primary care physicians often refer patients to a dietitian and recommend online resources.

Being physically active is also important. To stay healthy, the goal is to get about 30 minutes almost every day or 150 minutes a week of activity. To lose weight or maintain weight loss, aim for about 60 to 90 minutes of daily exercise. To squeeze this amount into busy schedules, it helps to find enjoyable activities and exercise in several small increments throughout the day.

Sometimes, patients find diet and activity are insufficient for achieving their desired results, or they are unable to be sufficiently active. In these cases, patients must consult with their physician or weight-loss team about using other weight-loss tools and strategies. Doctors recommend these according to each patient’s specific needs.

Medications can also help facilitate weight loss. There are two medications approved by the FDA for long-term use in weight management. One works by suppressing the appetite, another works by preventing fat from being absorbed by the body.

“Appetite suppressants have been available for decades,” Dr. Donahoo continues. “Those approved for long-term use are very well studied, and can be especially helpful when combined with a healthy diet and activity.” Most people who use appetite suppressants, such as Meridia^®, can expect to lose about 8 to 10 percent of their body weight.

“There is a small group of patients for whom the fat-blocking medication is a good fit,” Dr. Donahoo adds. This drug is available over-the-counter and goes by the brand name Alli^®.

The low-calorie OPTIFAST^® diet is sometimes recommended for patients who need to lose larger amounts of weight. At Kaiser Permanente Colorado, patients use the OPTIFAST diet two different ways – as a total meal replacement or partial meal replacement.

Although patients typically consume less than a thousand calories a day, this plan allows them to meet the recommended dietary allowances for vitamins and minerals. When OPTIFAST is used as a total meal replacement, patients consume only OPTIFAST shakes, soups, and bars for the first 16 weeks. On the partial program, they replace two meals a day with OPTIFAST foods, and eat one regular, portion-controlled meal daily. There is long-term support following the weight loss to help with the more difficult part of maintaining the lost weight on regular food.

Patients can lose about 15 to 20 percent of their body weight on the OPTIFAST diet. To help maintain weight loss afterward, patients work closely with the weight management team for about three months as they return to eating regular foods.

Weight-loss surgery is sometimes appropriate for people who are severely obese or have life-threatening health conditions. “We offer two types of weight-loss surgery – gastric bypass surgery and adjustable gastric band surgery,” Dr. Donahoo explains. Patients lose, on average, about a third of their total body weight within nine months of surgery.

Due to the risk of the procedure, not everyone is appropriate for weight-loss surgery. Also, not all insurance plans have weight-loss surgery as a benefit. After patients are accepted for weight-loss surgery, they undergo a medical and mental health evaluation. The also attend classes to gain an understanding of the different surgical approaches and what to expect after surgery, including the dietary and lifestyle changes that will need to be made. After surgery, patients continue with behavioral support and nutritional and medical monitoring. They can also attend ongoing support groups for as long as they like.

“Once people reach their weight-loss goals, they often find that maintenance can be an even bigger challenge,” Dr. Donahoo continues. “We often treat these two phases differently.” OPTIFAST and surgery incorporate maintenance into their programs. With other strategies, the weight management team can help patients find ongoing support to ensure long-term success.

Other sources for help
If you are considering losing weight on your own or if you have only a few pounds to lose, Dr. Donahoo suggests going online for weight loss tips. Kaiser Permanente Colorado patients can also gain access to a personalized program known as HealthMedia^® Balance^™ and enjoy special rates on Weight Watchers^® programs.

To learn more about successful weight management, visit KaiserPermanente.org.

Dr. Donahoo received his medical degree from the University of Colorado, where he also performed his residency and fellowship in internal medicine.