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More than 2 in 5 adults are obese in the United States, according to the National Institutes of Health. Obesity contributes to other chronic conditions such as type 2 diabetes, hypertension and arthritis. Yongsu Lee, a nurse practitioner specializing in bariatric surgery at MedStar Washington Hospital Center, says he considers several factors when approaching weight loss and management for patients.
鈥淯sually, I go with the BMI first, or I usually talk about their lifestyle,鈥� he said. 鈥淚 try to figure out what your eating habits are like, what their food choices are like, or are they physically active, or do they have a sedentary lifestyle.鈥�
Lee covers a variety of options for patients to assist with weight loss goals.
鈥淲e consider different options to help them by talking about the pros and cons of each option, and I actually do have patients who are making vigorous lifestyle modifications, and they’re not on any medications.鈥�
According to Lee, 聽several factors can lead to obesity, developing as a chronic disease.
鈥淥besity has genetic factors, environmental factors, and it also has psychological as well as a behavioral component.鈥�
He also analyzes stress and sleep factors because people tend to use food as comfort and sleep deprivation can lead to certain food cravings.
A lack of education can also contribute to obesity. For example, Lee said oftentimes, people think drinking fruit juice is much healthier than drinking soda, but that鈥檚 not always true.
鈥淎nd over time, once you start gaining weight from the energy expenditure imbalance, then your body goes into a chronic inflammatory state,鈥� he says.
At this stage, Lee said it becomes even more difficult to lose weight.
鈥淚t鈥檚 not just about what you eat or how much you move around 鈥� no matter what you do, your weight tends to stay the same or you continue to gain weight.鈥�
Lee also educates patients on nutritional pack labels and how they affect the body.
鈥淵ou definitely want to know what’s going into your body, what it鈥檚 doing to your body, and I often go over the nutritional pack labels, and I tell my patients to go over them.鈥�
Patients are discouraged from starting unsustainable diets that completely cut out a specific food group saying this can also lead to unhealthy cravings.
Some additional guidance Lee offers to patients that can be immediately implemented includes psychological changes like removing stigma or guilt associated with certain foods and replacing them with sustainable options.
If medications like Wegovy are too expensive for patients, Lee said Metformin is one option that aids in weight loss. Lee said the medication has been around for a while and provides 聽additional benefits, such as kidney and heart protection.
鈥淚t can kind of curb your appetite as well, because a lot of side effects are GI symptoms. So many of my patients have told me that they actually have less cravings for sweets, after taking Metformin,鈥� Lee says.
For patients who are not pre-diabetic, Lee starts them off with a low dose and monitors their A1C. He said the medication should be used to support other lifestyle changes geared towards weight loss.
Patients are often referred to dieticians and psychiatrists or therapy, so that they stay engaged in the program.
鈥淚 try to focus on the positive reinforcement, so that they’re more likely to come back for weight management,鈥� Lee adds.
Obesity is a chronic illness that requires long term management just as any other disease would. Lee said removing the stigma related to obesity and increasing education should be the priority.
鈥淪o for the next generation, teaching your children about healthy food choices, and healthy eating habits, and making sure that they’re mentally healthy, as well.鈥�
Managing your weight can be tough, especially if you鈥檙e dealing with obesity. Fortunately, there are several options offered by specialists at MedStar Washington Hospital Center. Lee says you just have to be willing to take the necessary steps.
鈥淚 usually empower the patient and make them kind of lead me because at the end of the day, it鈥檚 their body, it’s their health,鈥� he said. 鈥淪o, they should make the ultimate decision, but I’m there as a guide, to make sure that patients understand the risks, or the benefits of each option fully.鈥�
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