CONSIDERING PRESCRIPTION WEIGHT LOSS MEDICATION?

You have read books that tell you it’s all in your head, books that claim you are the victim of a global food conspiracy; books that make weight loss seem so easy or so complicated.

And all the while you have been told, in words, in gestures  and in stolen glances that your weight is your fault. Sometimes you have believed this yourself. Sometimes friends, spouses, children, parents and even doctors have told you this.

You may not have tried everything to lose weight, but you have tried a whole lot. But until now, there is one thing you have not tried: prescription weight loss medications.

Perhaps you never knew such medications existed, perhaps you thought they were just another gimmick or maybe you were justifiably leery because of dangerous weight loss drugs from the past. Maybe this is the first time your weight has ever become a real problem. Whatever the reasons, the leap to taking prescription weight loss medications is one you are about to take for the first time.

What ARE Prescription Weight Loss Medications?

The simplest definition is this: prescription weight loss medications are prescription drugs that have been shown in numerous peer-reviewed, placebo controlled clinical trials to be safe and effective for weight loss.

How Safe?

Like all medications, weight loss drugs are not for everyone and they can, when used inappropriately in people with certain serious medical conditions, be dangerous. But prescribed intelligently and carefully, these medications are both safe and effective.

How Effective?

Prescription weight loss medications really do work but they are NOT miracles. Studies show they can improve both the rate and amount of weight lost in people following a reasonable program of diet and exercise by increasing metabolic rate and reducing food intake. The effect tends to diminish but not vanish over time and so weight loss drugs generally only help “so far”. The rest remains up to each person individually and depends upon adherence to livable changes in eating and activity.

Holland Clinic uses medication as a part of a much larger program of education, motivation, behavior modification, dietary change and exercise to help our patients achieve the greatest amount of LIVABLE and SUSTAINABLE weight loss. Medications are the not the central focus of our program but they are an important aspect of it. As with any serious medical treatment our most important goals are your health and quality of life.

Is Your Weight Your Fault?

No. It is NOT. Fault implies that your weight is the result of an error. But what might such an error be? Did you somehow choose your genetics or your parents? Regardless of your genes, are you a glutton? Do you deliberately overeat simply because it “feels good”? Or are you lazy, failing to exercise because somehow you have no ambition? In 22 years of practicing medical weight loss, I have yet to meet anyone who satisfies even one of these criteria.

Might it be that you lack “willpower”? Well, most of my overweight patients are very successful people in life. They seem to have lots of willpower regarding other life goals like education, employment and parenting. So why would they somehow fail to use this willpower to alter their weight? Obviously they wouldn't.

No, again, your weight is not your fault any more than my male pattern baldness is my fault. Body weight is not a reflection of a person’s character. Not at all.

Do “Emotional Problems” Cause Obesity?

No. Obesity causes emotional problems. Any person who grew up being told by parents, teachers, doctors and society at large that he or she eats too much is certainly going to develop an unhealthy emotional relationship to food.  The weight comes first, the emotional issues second. It would happen to anyone.

Will Figuring Out “WHY” You Eat Solve the Problem?

Will learning why we breathe help us breathe less? No. We eat because we are hungry and hunger is a survival urge.  Hunger hurts.  The hungrier we are, the more we hurt. We might be able to rise above that for a short while but in the end, if we are hungry, we go on hurting until we eat.

The Many Flavors of Hunger

Have you ever been in a plane crash in the Andes mountains and starved for weeks? No, neither have I, but it’s reasonable to believe that any person under those circumstances would be hungry almost to the point of madness.  But what about the urge to eat chocolate 2 hours after lunch?  Is that hunger?  Yes, it is, but obviously it is hunger of a different character and intensity  than starvation. Have you ever awakened in the night and “had to have” a pickle or a soda? Hunger comes in many different flavors but in the end, it’s all hunger. Hunger is that which makes us want to eat.

Hunger and Metabolism are the Issues, Not Your Moral Fiber

Modern science is showing that obesity is a complex illness with many causes but in the end, it boils down to one or two basic problems: derangement of appetite and or derangement of metabolism.

Understanding the “Fat Thermostat”

Body weight is a REGULATED parameter. Normally we have hormones and neurotransmitters that carefully monitor and control body weight. In obesity, the balance of these factors becomes altered as if, by analogy, the thermostat in a room became damaged or broken. You can read a lot more about this in my online book.