Weight loss, or helping a patient achieve their ideal weight, is one of the most important and rewarding projects that a doctor should do with their patients.
This is because even moderate weight loss can bring on profound health benefits: improved energy, better blood pressure, decreased risk for diabetes and cardiovascular diseases among others.
Weight loss can be many things: treating an underlying illness such as low thyroid function, a change in paradigm, a diet and lifestyle change, but it is always a process.
Here is an example of how I approach weight loss:
Step 1: Assessment
We do a health history and a physical exam to understand a patient's strengths and opportunities. Some patients may need more help with diet, others with exercise or stress management.
We order any labs if needed such as thyroid tests, blood sugar, etc.
We also do a physical exam as we get a patient to increase their exercise regimen.
In this visit, I do a Body Impedance Analysis (BIA) to measure Body Mass Index, % Body Fat, % water weight etc. This provides our baseline and helps us track progress. I do the BIA every month so monitor how the patient is doing and to adjust the treatment plan if needed.
Step 2: Diet
I compute for the Basal Metabolic Rate. This is the amount of calories a patient needs every day. This helps us figure out the healthy amount of calories a patient needs each day to lose weight.
Click and scroll to second page for sample BMR calculation sheet.
After we compute for caloric intake, we design a menu plan that works for the patient. This is a totally interactive process where the patient and I brainstorm ideas that work for the patient. Ultimately, the menu has to conform to the patients tastes, food preferences, ability to prepare meals (or not) for this process to work.
The diet can be described as high in proteins, high in vegetables, low in simple carbs and sugars, and calorie appropriate.
Click here for sample menu work-sheets.
Step 3: Excercise
We discuss and agree on an exercise plan. We review the exercise plan on a regular basis to check on progress.
Click here for sample diet and activity diary.
To repeat an important point: This is a totally interactive process where the patient and I
brainstorm ideas that work for the patient. Ultimately, the menu and exercise plan has
to conform to the patients tastes, food preferences, ability to prepare
meals (or not) for this process to work.
