To My Patients,
Many of you are aware that I offer Medically Supervised Weight Loss
Programs. You can read about these services by accessing my website
at
www.gynfo.com. I would like to take this opportunity to
present to you an E-Newsletter on:
Current Issues on the Overweight and Obese Patient
Introduction
About
65% of the U.S. population is overweight as defined by a body mass
index (BMI) over 25. To calculate your BMI, go to
www.weightwatchers.com and follow the instructions. In
addition, a waist circumference greater than 40 in men and greater
than 35 in women correlates with extra risks.
Goals of
weight loss management
First, a patient who is overweight or obese must recognize their
problem followed by begin a diet and fitness program. Data
show that diets average a short-term weight loss of 8% of initial
body weight. Very low calorie diets are defined as less than
800 calories per day and produce greater initial weight loss
with long-term results being questionable. Low calorie
diets are healthy diets that are low in total calories and fat and
allow the patient to transition to a long-term use. Low
carbohydrates diets reveal more weight loss compared to patients on
a low-fat, high carbohydrate diet and may be more sustainable for
some patients.
The
most successful approach includes regular self-monitoring of weight
for patient feedback; a diet low in fat, high in carbohydrates, but
low in calories!; frequent, but planned meals without fast
foods; and high levels of physical activity that includes one hour
of moderate-intensity activity daily! This is equilavent to
walking at 4 mph for one hour every day.
Drug
Treatment
Current weight loss drugs show an average of 3% to 8% of total body
weight after one to two years for phentermine and about a ten pound
loss within a year for sibutramine (Meridia) and orlistat
(Xenical). Medications are only successful if the patient is
already losing weight with diet and exercise!
Surgery
In highly selected patients who have a BMI over 40, the
restrictive procedure (Roux-en Y gastric bypass) reveals a loss of
50% of body weight over several years of study. The procedure has a
one in 200 death rate and potential complications that include
diarrhea, vomiting, ulcers, and gallstones.
National
Institute of Health Recommendations
A
flexible diet of carbohydrates, fat, and protein with fat intake as
low as possible and fiber as high as possible. Physical activity
should be at one hour per day.
Obesity and Quality of Life
Data
show that overweight and obese people have lower physical function
scores, lower general health perceptions, and lower “vitality”
scores.
Please call my office at
281.893.1246
for a consultation.
Surgery Update -Gynecological
Procedures
Today, about 90% of the gynecological procedures performed in our
practice are done by laparoscopic techniques. While this type of
surgery requires additional skills and much patience, the outcomes
are excellent with less hospital stays, quicker recovery time, and
much less postoperative pain.
The equipment used has become most sophisticated as well as
expensive! For those who need to schedule their surgery, please
realize that it may take several weeks to even months before a case
can be done. Since the surgery is so advanced, Dr. Birken will only
operate with other gynecologists who possess excellent laparoscopic
skills as well as years of laparoscopic experience.
Randy Birken, MD
www.gynfo.com
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