Why do I gain weight despite diets and exercise programs?

Question

Hello doctor,

I have struggled with my weight for years. Despite trying various diets, exercise programs, and working with nutritionists, I continue to gain weight. I am now 105 pounds heavier than I was five years ago. My knees and back hurt constantly, I get winded when climbing stairs, and I snore so loudly that my wife sleeps in a separate room. My family has a history of diabetes and heart disease.

My recent lab results showed a fasting glucose of 134 mg/dL, HbA1c of 6.3 percent, blood pressure of 156/94 mmHg (millimeters of mercury), cholesterol level of 268 mg/dL (milligrams per deciliter), and triglycerides of 285 mg/dL.

Could hormonal or metabolic issues be contributing to this?
Have I developed metabolic syndrome?
What medications are available for weight loss, and am I a candidate for bariatric surgery?
What types of bariatric surgery exist?
Will insurance cover it?
What are the potential risks, and can diabetes and hypertension be reversed through weight loss?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

After reviewing your blood reports, it is clear that you are already in the diabetic range. You also have hypertension and dyslipidemia, which put you at a higher risk of heart disease. Since you have a family history of these lifestyle-related conditions, your risk increases further.

It is essential to initiate medications promptly to manage your blood pressure and abnormal lipid profile. You may consider starting Amlodipine or Telmisartan for blood pressure management, and Atorvastatin for cholesterol control, if not already prescribed by a physician.

Having obesity, dyslipidemia, hypertension, and diabetes together indicates metabolic syndrome. I understand that you have already made multiple efforts to lose weight without success.

Yes, medications for obesity are available, such as Orlistat, and bariatric surgery is also an option. However, I recommend consulting a general surgeon to discuss the types of bariatric surgery performed. These surgeries primarily work by limiting food intake or reducing nutrient absorption. They are not always the best or safest way to control your condition, as they can have significant side effects. Although these procedures may help improve other lifestyle-related problems, they also come with potential complications that should be carefully considered.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.