Importance of Weight Loss Emphasized

with Ann Ruelle, Certified Diabetes Educator, Advanced Healthcare

Posted: Jan. 1, 2006

According to the Wisconsin Division of Public Health, 58 percent of Wisconsin’s adult population is overweight. Seventy-seven percent of them lack physical activity. And 78 percent eat less than five servings of fruits and vegetables daily.

“Those eye-opening facts put those Wisconsin adults at high risk for high blood pressure, which is now at 25 percent of the adult population; for diabetes, which is now at eight percent; and for high cholesterol, which is now at 32 percent,” said Ann Ruelle, certified diabetes educator and coordinator for Advanced Healthcare.

Ruelle also cited recent national data suggesting that obesity accounts for 14 to 20 percent of all cancer deaths, second only to smoking in terms of modifiable risk factors for cancer mortality.

“We now see a large amount of scientific evidence that brings us to an important conclusion: Even modest weight loss can have important health benefits,” she said.

According to Ruelle, modest weight loss often improves, if not controls, high blood pressure, diabetes, high cholesterol and various other medical problems.

“It’s recommended that you should lose five to 10 percent of your starting weight and maintain that loss. This approach is designed to achieve a healthier weight, and to push aside the notion of ideal weight. Virtually everyone can achieve a healthier weight, at which they will feel better, have more energy, and reduce their risk of health complications,” she said.

1. Self-directed exercise and diet, cutting 250 calories from each day’s meals and burning off 250 calories each day to result in one pound less per week.
2. Self-help or commercial programs, such as TOPS and other organizations, with a history of success in weight loss, as well as continuous support.
3. Portion-controlled, low-calorie diet that consists of 900 to 1,200 calories per day, and monitored by a physician. This should also include an exercise program that a physician deems appropriate.
4. Dietary restriction with medication therapy. Medications currently available can be divided by their mechanism of action: those that affect the neurotransmission in the brain and those that act by reducing food absorption in the gut. “The unfortunate thing is that many people have expectations that far exceed the ability of the medication,” Ruelle said. “There’s no magic in weight loss medication. Lifestyle change has to be accomplished. However, these medications can result in more weight loss than food restriction alone.”
5. Bariatric surgery, which has become mainstream therapy for extreme obesity. “This is increasing in prevalence because it is very effective in reducing weight and is currently the most effective long-term therapy for extreme obesity,” Ruelle said. “The complication rate of bariatric surgery is low, and most complications are manageable, especially if one is diagnosed early enough. The nutritional and metabolic complications are usually avoided when patients are compliant with prescribed supplements and follow-up visits are scheduled.”

Maintaining a weight loss is a major problem in the treatment of obesity, she said. “Participants will average a loss of eight to 10 percent of weight the first six months of treatment. And they will maintain approximately two-thirds of this initial weight loss at the one-year follow-up visit. Despite intensive efforts, weight appears to be regained for the next several years. This is why it is so very important to have a support system such as weekly meetings of TOPS or similar organizations.”

The National Weight Control Registry’s ongoing study of individuals successful at long-term maintenance of weight loss reported the following practices of those who have maintained their weight loss for more than six years:

• Individuals consistently report consuming a low-calorie, low-fat diet of 1,400 calories per day with 24 percent from fat.
• Less than one percent reported following a low-carb or Atkins diet.
• Regular eating, with five eating episodes per day was common. A total of 78 percent report consuming breakfast on a daily basis. They continue to dine out, but limit fast food meals to less than one per week.
• Physical activity and diet are used in combination. On average they burn 2,800 calories per week—equal to walking 28 miles per week or four miles per day, or 60 to 90 minutes of activity per day. Walking was the most popular form of exercise, but cycling, weight lifting and aerobics were also indicated.
• Most (78 percent) weigh themselves weekly.

Ann Ruelle, Advanced Healthcare

7878 N. 76th St.
Milwaukee, WI 53223
414-354-6434

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Wauwatosa, WI 53222
414-771-7900

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Menomonee Falls, WI 53051
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