Combating Obesity

with Jeffrey Bahr, M.D., Internal Medicine, Advanced Healthcare

Posted: Jan. 1, 2005

Jeffrey Bahr, M.D., Internal Medicine, Advanced Healthcare "We need to re-educate our obese patients on the need for smaller portions and more nutritious foods like fruits and vegetables."

Obesity is a medical condition with serious consequences.

“Obesity should be taken very seriously because it’s a significant hindrance in the management of serious illnesses such as Type 2 diabetes, heart diseases of many varieties, strokes, cancer, sleep apnea, osteoarthritis, gall bladder problems and some types of liver diseases,” said Jeffery Bahr, M.D., a general internist with Advanced Healthcare.

“Obese individuals are at greater risk for developing these problems, and if one should have any of these diseases, obesity makes it more difficult to treat them,” he added. “So the thing to do is lose weight.”

The most effective way to drop those excess pounds is through proper diet and exercise, yet this is the least frequently attempted method of weight loss in the United States, according to Dr. Bahr. “It’s important to motivate and educate a patient about properly eliminating obesity.”

Caution with medications
Dr. Bahr believes that medications for obesity are not a primary treatment option. “There’s a paucity of medications that are both completely safe and completely efficacious,” he said. “There are some available, however, that are approved by the FDA (Food & Drug Administration), but they’re down the list on treatment options, and I rarely prescribe them.”

According to the American Obesity Association, new medications, usually prescribed along with a program of diet and exercise, have been shown to increase the rate at which the weight loss occurs. However, weight loss plateaus for most people after several months and weight is often regained if the course of medication is discontinued. Current drugs can also have serious side effects, which must be carefully considered
by the physician and the patient, the association says.

Lifestyle changes bring success
In the first six months of an attempt to lose weight by diet and exercise, the majority of weight loss is attributable to dietary changes, not exercise, says Dr. Bahr. “So why exercise? Because there are other important benefits, such as improved cardiovascular health, better muscular conditioning, and better mental health.

“But once you reach that six month period, continued exercise starts to contribute more significantly to weight loss, and prevents, to a good degree, the gaining back of those lost pounds,” he said.

Dietary counseling can be essential. “When we preach diet, we don’t suggest dieting for a specific period of time, during which you control the amount and quality of your food — we’re talking about initiating a lifestyle change. We’re preaching a sustainable style and quality of eating to maintain a healthy weight, and we’re talking about doing it over a patient’s lifetime.”

Behavior modification, he says, plays an important role.

“Culturally in this country, a high percentage of obesity comes from the ‘meat and potatoes family.’ We are taught to eat three big meals a day and to sit down to a big family dinner on Sundays,” Dr. Bahr says. “Today’s super-size portion is a cultural phenomenon in this country. See any fast food restaurant. We’re taught more is better, but that’s just not true. We need to re-educate our obese patients on the need for smaller portions and more nutritious foods like fruits and vegetables.

Carb control
“We also need to emphasize eating smaller amounts of carbohydrates. I don’t mean eliminating carbs from a diet. I simply want my patients to eat the proper amounts and quality of carbs — like complex carbs such as whole grain bread,” Dr. Bahr said. “Carbs are an essential part of the human diet, but in our culture we’ve been encouraged to eat simple carbs like French fries and processed foods that are loaded with simple sugars that are not adequate for good nutrition.”

Changing your lifestyle to include a healthy diet is essential in combating obesity.

“Exercise, get three meals a day but watch what you’re eating, and avoid snacks if you can,” he advises patients. “If you absolutely must have a snack, plan ahead and make sure nutritious foods, like fruits or vegetables are handy, instead of junk foods from a convenience store.”

Dr. Bahr also points to the fact that you can get exercise without necessarily going to a gym. “Take the stairs regularly instead of an elevator. Walk a half hour each day. Park your car at a good distance away from the store you visit at the mall. That’s all good.”

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