Weight Loss: Why You Need a Quiver Full of Arrows
Why you need multiple methods for success at weight loss

Weight Loss: Why You Need a Quiver Full of Arrows

Tirzepatide is a new weight loss drug that has favourable effects on appetite, food intake, and metabolic function. A group of 670 people with an average weight of 107 Kg ( 236 lb) lost almost 21% of their body weight in 36 weeks.

But in the next 52 weeks, further weight loss was only 5.5 %. And that is illustrative of almost every strategy used for weight loss. After a few months, the benefits taper off, and no one method seems able to get you to your desired, healthy weight.

Why Do Weight Loss Strategies Stop Working?

Almost every well-planned and rigorously followed weight-loss strategy is effective — until it isn’t. Low-calorie diets, drugs, surgery, and exercise all work wonderfully well for a few months, and then you can’t see any more gains.

That’s primarily because of your body’s resilience. If you starve it by dieting, it’ll alter its metabolism to get along at lower calorie intake after shedding some weight. If you burn calories by exercising vigorously, it’ll spare some energy by cutting down elsewhere. If you take some weight loss drugs, the hunger hormone ghrelin will step in again after a while.

In other words, your body takes whatever you’re doing in its stride. But it takes a while to do so, and your weight loss method works till then.

Your body has survival baked in and adapts to whatever you throw at it.

What Can You Do?

Don’t depend on just one weight loss approach.

Any strategy works for a few weeks or months. Follow your plan diligently and measure and record your weight regularly. Be alert to any slowing of weight loss and have an alternate method ready.

What are the weight loss strategies that work?

Dietary Changes

Dieting for weight loss is pretty simple. If you consume 25% fewer calories than your body needs, you will lose a pound a week. You can use this calculator to estimate how many calories you need each day to maintain your weight.

Plan a diet with 20-25% fewer calories than this for steady weight loss. Consulting a dietician would be wise, to ensure your diet has the required nutrients and you don’t suffer any deficiencies.

Making small changes can help in your dieting journey. Include vegetables and fruit in every meal; they’re low in calories and fats and keep you feeling full longer. Cut out fast food to reduce your carbohydrates and salt intake. Plan meals and buy food ahead of time so you don’t end up ordering fast food and takeaway.
Avoid fad diets that cut out entire food groups or require prolonged fasting. Drastic diets might yield impressive short-term weight loss but are difficult to sustain.

An effective weight-loss diet achieves gradual, sustained weight loss. However, after you’ve lost a few pounds, your body needs fewer calories and adapts to manage with your reduced intake. Weight loss slows or stops. There’s only so much you can cut your diet and still function.

Exercise Program

Exercise is essential to your weight loss plan, whatever other methods you choose. Exercise itself may not help you lose much weight, but it is crucial to keep you from regaining the lost weight in the long term.

If you don’t exercise, you’ll lose fat and lean mass. Lean mass is mostly muscle and is metabolically active; it burns up calories even when you are at rest. Maintaining lean mass by exercising while losing weight will maintain your strength and work capacity.

Even small amounts of physical activity benefit your health. The U.S. Department of Health and Human Services recommends that adults get 150 to 300 minutes of aerobic exercise weekly. You should also do some muscle-strengthening exercises twice a week.

Exercise keeps your muscles and bones strong as you lose weight.

Behavioural Therapy

Behavioural therapy helps you change your habits and attitudes towards food and exercise. Such therapy needs experts such as nurses, dieticians, psychologists, and doctors.

The aim is to provide you with a customized weight loss goal. This will consider your current health status, food preferences, work schedule, and other lifestyle factors.

Behavioural therapy uses experts and group counselling to aid you in controlling your eating patterns and other unhealthy habits. You will also learn long-term strategies to achieve a healthy weight and remain there.

Weight-Loss Medicines

Ideally, diet control, physical activity, and lifestyle modifications would be all you need to get and keep you at a healthy weight.

However, these measures don’t yield the expected results for everyone. Some people struggle to stay on a diet or an exercise program because their general health makes it hard. Approved weight-loss drugs can provide an initial result that makes you feel better and motivates you to make lifestyle changes.

You should try weight-loss medicines after a fair trial of dieting, lifestyle changes, and exercise. If your body mass index (BMI) is 30 or more despite dieting and exercise, or lower if you have other conditions like diabetes or high blood pressure, your doctor might prescribe one of these medicines. Several medicines are approved for anti-obesity use and fall into one of three groups.

Drugs acting on the nervous system. They stimulate the sympathetic nervous system and reduce appetite. Two such medicines are diethylpropion (Tenuate) and phentermine (Adipex). These drugs are combined with topiramate or naltrexone to control cravings and binge eating.

Lipase inhibitors. Lipase is an enzyme in your intestines; inhibiting it reduces the absorption of fats you eat. Orlistat is one such drug (trade names Alli and Xenical) that decreases fat absorption by 30% and helps weight loss.

GLP-1 agonists. Glucagon-like peptide-1 (GLP-1) is a hormone that stimulates appetite. GLP-1 agonist drugs like semaglutide (Wegovy), setmelanotide (Imciveree), and gelesis (Plenity) suppress the appetite and slow the emptying of your stomach after a meal. Tirzepatide (Zepbound) additionally acts through glucose-dependent insulinotropic polypeptide (GIP) and favourably affects appetite, food intake, and metabolism. GLP-1 agonist drugs were developed for the treatment of type 2 diabetes mellitus.

Your doctor will ask you to take the medicine for several months. Initial success is impressive, but you may not see additional benefits after a few weeks or months. Your doctor may switch to another class of drug when this happens. For example, if you were on a lipase inhibitor, they may prescribe a GLP-1 agonist medicine.

Stopping the medicines is often associated with weight gain.

Obesity (Bariatric) Surgery

Surgery for obesity should be the last resort. It is recommended only after trials of dieting, lifestyle modifications, exercise, behavioural therapy, and weight-loss drugs.

Bariatric surgery can be a lifesaver for people with morbid obesity. Literally. In a study of over four thousand people, the people who underwent surgery for obesity had far fewer deaths because of heart attacks and strokes (cardiovascular deaths). Bariatric surgery also reduces the risk of diabetes and cancer and reduces mortality.

There are several types of surgery for weight loss. You should consult an expert in bariatric surgery to learn about your options and decide what is best for you. Some types of surgery:

  • Gastric (stomach) bypass
  • Gastric balloon
  • Gastric band
  • Sleeve gastroscopy (accordion procedure)
  • Botulinum toxin stomach wall injection
  • Biliopancreatic diversion with duodenal switch

Most such surgery is done through laparoscopy and takes several hours. Like other types of surgery, bariatric surgery also carries risks of anaesthesia and the operation itself. Long-term complications may require reversal of the procedure.

Obesity and overweight affect your health, happiness, and social life. There are several reasons why people become overweight, and you should meet your doctor to find out any medical reasons. Regardless of the reason, losing weight improves your health, fitness, and work capacity. You also feel better about yourself. You might even reverse your diabetes.

There are several methods of losing weight. If followed diligently, any of them will work for you — for some time. Though you are diligent, you can’t lose more weight.

At such times, talk to your doctor, who may advise switching to a different strategy for weight loss. Medicines and obesity surgery are available now, in addition to the age-old methods of dieting and exercise.

Weight loss can be a lifelong effort, and one method may not take you to your goal. You and your doctor should be familiar with the various strategies available and switch between them as needed to achieve success on your weight-loss journey.

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