What strategies can help in achieving a healthier weight?

Hello,

Welcome to icliniq.com.

I understand the level of frustration you feel regarding your weight. It can seem nearly impossible to maintain a reduced weight through diet and exercise alone. Creating a comprehensive plan for weight loss is not something that can be accomplished in a single consultation; it requires a long-term commitment to yourself and collaboration with a multidisciplinary team, which may include a dietitian, a bariatric endoscopist (gastroenterologist), a behavioral therapist, and a bariatric surgeon.

The probable cause in your case is obesity. I suggest you undergo a few investigations, like complete blood count, TSH (thyroid-stimulating hormone), FT3 (free triiodothyronine), FT4 (free thyroxine), liver function tests, fasting lipid profile, serum CRP (C-reactive protein), albumin, total protein, AG (albumin/globulin) ratio, arterial blood gases, urinalysis, and urine for albumin.

I would like to provide you with some facts and figures regarding weight loss therapies. Currently, your body mass index (BMI) is 34.3. The goal of any weight loss treatment is to achieve a weight range that supports both physical and psychological well-being. Individuals with a BMI over 40 should consider bariatric intervention, either endoscopic or surgical. Those with a BMI of 35 who also have other conditions, such as uncontrolled diabetes, coronary artery disease, or lung dysfunction, should also seek intervention. However, not everyone fits neatly into these categories. Many individuals with a BMI below 35, like yourself, may experience significant challenges, which call for an individualized approach, whether through medication, endoscopic, or surgical intervention.

Diets and regular weight loss exercises can lead to a reduction of 7 to 10 percent. Currently, available medications can help reduce weight by 10 to 20 percent. Certain endoscopic bariatric procedures, such as balloon placement in the stomach and sleeve gastrectomy, can facilitate weight loss of around 25 percent. Surgical options, like laparoscopic adjustable gastric banding, sleeve gastrectomy, and Roux-en-Y gastric bypass, can result in weight loss of 30 to 35 percent. These figures vary significantly among individuals.

It is important to note that these interventions should be accompanied by optimal dieting and exercise, even after surgery or medication. Without this, there is a risk of regaining the weight. The information provided is meant to help you understand your options. I recommend starting with a calorie-restricted diet (keeping daily intake below 1500 kcal), along with regular activities like running, swimming, and weight lifting. I also suggest consulting a dietitian, either through iCliniq or in person, to develop a diet plan tailored to your calorie requirements.

While I can suggest some medicinal treatments, they are prescription medications and may not be available over the counter. Typically, these need to be taken for at least six months to see effects. Naltrexone or Bupropion is an FDA-approved option that may be appropriate for you. However, I need more information about your health to assess your condition accurately and determine the best treatment approach, considering potential side effects.

Additionally, I would like to know about your family support system, the availability of occupational therapy near you, your current job status, and details about your health insurance, including whether the cost of these medications is covered. In the meantime, I recommend the following blood tests to better understand how obesity may be affecting your body.

I hope this answers your questions.

Thank you.