Friday, July 27, 2018

Less Common Weight Loss Methods

Diet, exercise, lifestyle modification, and anti-obesity drugs are the most common methods employed in the fight against overweight and obesity. Other less commonly used weight loss approaches include bariatric surgery, endoscopic approaches and methods that interrupt the nerve that carries hunger signals to the brain. One new nerve-interrupting approaches freezes that nerve.

Bariatric surgical approaches either shrink the size of the stomach or prevent calories from entering the digestive system. Examples of bariatric surgery include gastric bypass surgery and the sleeve gastrectomy. Endoscopic weight loss approaches are "performed entirely through the gastrointestinal (GI) tract using flexible endoscopes ..." Usually there is no surgical incision associated with Endoscopic weight loss methods. Many of the methods mimic the functions of bariatric surgery.

An example of the hunger-signaling nerve interrupting method is the Vagal Blocking Therapy or VBLOC. VBLOC was developed by EnteroMedics Inc., based in Minnesota. “VBLOC therapy works to control sensations of hunger using a pacemaker-like device your doctor is able to implant during a minimally invasive procedure. This device empowers you to eat less, make healthier choices and lose weight, without the lifestyle implications of traditional weight loss surgeries.”

Another example of the hunger-signaling nerve interrupting approach is one where one of the nerves that carry hunger signals to the brain is frozen. “During the procedure, an interventional radiologist inserts a needle through the patient's back and, guided by live images from a CT scan, uses argon gas to freeze the nerve, known as the posterior vagal trunk. This nerve, located at the base of the esophagus, is one of several mechanisms that tells the brain that the stomach is empty.”

In a preliminary study consisting of ten subjects with a BMI range of 30 to 37, the average weight loss was 3.6 percent.  According to the investigators, “Freezing the nerve that carries hunger signals to the brain may help patients with mild-to-moderate obesity lose weight ... . The treatment was determined safe and feasible in the initial pilot phase.”

More studies are planned. And if the nerve-freezing approach is effective, we will have another tool in our weight loss arsenal. 

Saturday, July 21, 2018

A Recent CDC Survey Gives More Evidence That Diet Is More Important in Weight Loss Than Exercise

A 2015 New York Time magazine article suggests that exercise does not promote an appreciable amount of weight loss compared to diet. The article's author concludes that for the most part, it is the food you eat that counts in weight loss and not your physical activity. Most people who have looked at weight loss studies would say that exercise, alone, is not as effective, in losing weight, as exercise plus a low calorie diet. And a 2018 CDC survey provides more evidence that exercise is probably less important than diet in weight loss.

According to the survey, obesity rates continued to rise from 1997 until 2017, while physical activity has been on an uptrend from 2009 to 2017. In fact, over 50 percent of Americans are meeting the CDC guidelines for physical activity. Thus, the increase in physical activity is not curbing the obesity epidemic. This seems to indicate that diet is the missing element in most people's weight loss program.

The survey results promote the approach that most weight loss programs use: Diet plus exercise is an important combination in weight loss and weight loss maintenance. Diet may be even more important during the initial months of a weight loss programs than in the later months.  

Exercise may not be as effective as we might expect it to be because the human body has built up defenses over time. According to some research, our bodies have learned to adjust, for example, to reduced energy intake. Millions of years of evolution enable our bodies to "adapt to our daily routines and find ways to keep overall energy expenditure in check.”

Still, exercise is an important part of losing weight and maintaining the weight loss in the long-term. Furthermore, even without weight loss, exercise is very important to our health. So, combining a healthy, low calorie diet with frequent exercise is a winning approach to long-term good health. This combination is also key to weight loss maintenance. Weight loss service providers should always make this clear.

When diet is combined with exercise by most in the U.S., we may see a decline in obesity.

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