BY DR. HAZEM KANAAN and DIANA F. RAMIREZ
Teenage obesity and diabetes are becoming an epidemic, especially among Hispanics. During the days of famine and hard labor, it was considered a luxury and a sign of wealth when a person carried extra weight. Those days are over, and things need to change.
I am an obstetrics and gynecology physician who specializes in women’s medical weight loss, trying to help the Rio Grande Valley one patient at a time. When dealing with obesity, the treatment becomes an aggressive management of the disease in order to control metabolism and induce healthy medical weight loss.
Research has shown that women can gain significant amount of weight during pregnancy, which can be difficult to lose. Women who already struggle with diabetes and then become pregnant will influence their fetal genetic expression, making their child more susceptible to obesity.
Weight loss after a pregnancy is more difficult to achieve than weight gain prevention during pregnancy. Accumulative weight from subsequent pregnancies will add up to more weight gain during the peri-menopausal period and at menopaus.
Since 2012, the American College of Obstetrics and Gynecology has published its recommended weight gain for women during pregnancy. It recommends that all mothers whose Body Mass Index (BMI) is 30 or greater to only gain between 11 to 20 pounds during their pregnancy. What I believe is missing in their recommendation is the timing of this allowed weight gain.
I counsel my patients to resist any weight gain until after 32 weeks of pregnancy. Also, under careful and close monitoring, I counsel some patients not to gain any weight at all, especially those with a BMI greater than 40.
The most common changes I ask my patients to make when seeking medical weight loss are the following:
>> Reduce stress. Some patients seek a spiritual avenue, some seek exercise and some require guidance by professionals.
>> Prevent late night TV and blue light exposure and make sure you receive a minimum of 6 hours of continuous sleep.
>> Follow sleep hygiene protocol to assure the body recovers from daily stress and to re-energize.
>> Learn how to read nutritional labels while shopping for food.
>> Avoid processed food with high carbohydrate content.
>> Engage in any form of exercise at least 30 minutes daily. Choose an exercise buddy to hold you accountable.
>> Keep a food dairy using an application, journal or take pictures of what you eat.
>> If a patient is taking medications, make sure they do not contribute to weight gain.
>> If a patient has any chronic disease, follow up with your doctor regularly and make sure it is under control.
>> Follow recommendations for FDA approved weight loss medications and follow up with the physician prescribing them. There are many FDA approved medications to help with weight loss and some are now available in generic forms. Liragultide has demonstrated to be one of the leading FDA medications resulting in sustained weight loss for more than two years. I encourage many colleagues to consider it as a primary medication for weight loss.
Seeking surgical correction is a good option when a patient has a plan for preventing weight gain from reoccurring. Surgical Bariatric surgery is an amazing and life saving procedure that should be performed on those who are in need for it. Risk and benefit of the surgery must be discussed extensively with the surgeon and the team.
As a women’s weight loss specialist, I am a firm believer that I am helping slow down obesity locally by introducing comprehensive and individualized treatment for those patients who are motivated and willing to make a change in their life. It is time to change the local environment and start a movement for a mass public health improvement. Let’s make it happen, RGV.
The Rio Grande Valley Diabetes Association is a local non-profit organization whose mission is dedicated to the prevention of diabetes and its complications through educational services, early detection and awareness. The RGVDA’s focus is to bring attention to the growing health epidemic that affects one out of every four people in Hidalgo Country, making it one of the worst afflicted areas in the country. Type 2 diabetes is preventable and also manageable through a healthy regimen of exercise and dieting.
Kanaan is a Diplomat of American Board of Obesity Medicine and Diana F. Ramirez is the Executive Director of the Rio Grande Valley Diabetes Association.
The Rio Grande Valley Diabetes Association provides monthly articles to The Monitor to help educate the public about the prevention and control of diabetes.