Over a 30-year span, 90 percent of men and 70 percent of women will be or will become overweight, according to a study in the Annals of Internal Medicine .
If you are one of those overweight adults, UI Weight Management could be the program to change your life forever. Joseph Dillon, MBBCh, clinical director of UI Weight Management at University of Iowa Hospitals and Clinics, talks about the risks of obesity and the weight management program
If a person is truly obese, what health risks increase with the extra weight?
Well, being truly obese, which I would classify as a body weight of greater than 30 pounds over the optimal, or what we would call a body mass index, or BMI, of greater than 30, really confers a lot of risks on almost all your body systems. There's increased risk of
Diabetes
Heart attack
Heart failure
Stroke
High blood pressure
Abnormal cholesterol
Certain cancers can be increased by up to six fold over the level of people who are not obese; Certain lung diseases such as asthma
Sleep apnea
In women, there's increased risk of infertility and polycystic ovary syndrome; incontinence; liver failure can be caused by fatty liver infiltration; and obesity and extra weight is really hard on your joints and osteoarthritis of the legs and back is very common.
There are a number of other complications, including gout, gall stones, and depression is very common, among other things.
What are the criteria needed to join the UI Weight Management program?
In our clinic we usually see people who are very significantly obese, that is over 100 pounds over the optimal weight, or a BMI of greater than 40. However, people who have a BMI of greater than 30, that's just more than 30 pounds overweight, if they have some of those complications that I've spoken about just a moment ago, we see them too, because those complications will improve with weight loss.
What does the UI Weight Management program consist of - what staff are involved in the program?
Because different people need different approaches to the same general goal of taking in less calories than they use up in activity, we've really assembled a diverse group of specialists for the program. So the individuals that are actually involved in the program are a dietitian, physical therapist, a clinical coordinator, a clinical psychologist, we have a psychiatrist, and we have three internal medicine physicians who specialize in obesity treatment.
How does the program work to achieve weight loss?
We really focus on helping people make permanent changes in their diet and activity. We have an intensive phase I of the program, which is 16 weeks, where a person will be seen either weekly or every two weeks for that 16 week period. That's followed by a secondary phase where we see people every month or two as required.
At the first visit, folks are interviewed by one of the internists in the program who will try to determine what the key causes of their weight gain have been, which will help guide the treatment plan. The physician will determine if they've got any of those complications of obesity that I mentioned previously, and that might need separate treatment. We test their metabolic rate and their fat mass to really guide us in prescribing the optimal diet. At the end of that visit with the physician, we'll send people away with an outline of a plan that focuses on increasing their education about diet, increasing their education about a balanced diet with a specified calorie content, and giving them some goals for activity and exercise.
Folks will then meet with a dietitian on day one; within the following two weeks they'll meet with the physical therapist to assess fitness and prescribe an exercise plan; they'll meet again with the dietitian to really review progress and increase their knowledge and kind of really help them learn some ways to increase the satisfaction in their life in ways that don't require them to overeat.
Depending on the first meeting with the physician, we'll have people meet separately with the clinical psychologist or psychiatrist, if the physician and the patient really feel that this would be a worthwhile approach; and then people come back every two weeks to see the dietitian and physician alternately for the next 16 weeks. We do use medications in the clinic if we feel that these will be beneficial, but they're not used as a primary treatment, as unfortunately, they're not really effective on their own and they all have plenty of side-effects and costs. Apart from those aspects we have, people can call in to open phone-in lines that we have and we have a Web support site to help them as they go through this program.
How much weight does the typical patient loss within the 16-week period?
What we aim for is a 10 percent weight loss over that 16 week period and we average pretty close to achieving that. I need to stress that what we're trying to do is get people to learn new habits that they'll continue for the rest of their lives, so we really expect the weight loss to continue through the second phase, which is after the 16 th weeks. I also should mention that many of the medical issues are associated with obesity improve with even a five percent weight loss, so people see real changes in their health over the 16 week period and continue to improve thereafter.
Is this weight loss program covered by insurance?
Well, more insurance companies and programs are covering these services as the importance of obesity becomes clearer, but it's really important that perspective attendees check with their insurance companies to determine that coverage and our clinic coordinator can certainly help folks in finding out that information.
If someone wanted to learn more information about the UI Weight Management program, who would they contact?
They can contact Marsha Kremer at 384-6581 or weight-management@uiowa.edu . |
