It’s not that the new drugs don’t work to suppress appetite and reduce weight; they do — 5%-10% in several studies. But just as with previous attempts at weight loss in a pill, whether prescription medicine or supplements, the substances change brain chemistry temporarily without changing conditions that lead to the behavior.
Unless the person deals with the environmental, emotional, cultural, social, and/or psychological issues that resulted in excess weight, the extra pounds will always come back — whether they remain on the medication long term or not.
The overweight/obesity crisis isn’t getting better, despite recent years’ leveling off in the rate of increase. A wellness practitioner’s role will remain as it has for decades: Provide tools to those who are ready to make behavior changes to achieve and maintain a healthy weight.
But beyond the tools, for real impact on individual and population health, we have to be straight with participants. We have to stop feeding people the notion that little changes here and there will add up to a healthy weight, when there is zero evidence that little changes work. None.
Think about clients you’ve worked with over the years who’ve lost a significant amount of weight and kept it off; all of them made big changes. They went from no exercise to 30-60 minutes daily, from a pantry full of junk food to a full vegetable drawer in the fridge, from regular late-night noshing to no after-dinner eating, from a daily can of soda (or 2 or 3) to water instead, from weighing themselves once a year to checking their weight every day.
It’s more than just semantics. If you interview people who have accomplished long-term weight loss (3 years or more), they don’t describe what they’ve done as little changes. And they don’t say it was easy. Reversing years or decades of ingrained habits takes a Herculean effort, not just parking an extra hundred yards from the entrance to the store.
Regardless of what weight loss tools you offer your population, maybe the most important thing you can do is convey the message that losing weight and keeping it off take a huge effort. That changing the habits causing overweight will require extreme vigilance. That little changes are too close to old habits — taking responsibility for their weight and their health means completely breaking out of old habits. It’s not easy counsel to give or receive, but it’s the truth. And their resulting feeling of control will serve them well in many areas of life… something no pill can accomplish.
Understanding the facts will give your participants a real shot at finally making the big changes needed to achieve and sustain a healthy weight.
There’s evidence that being overweight or obese doesn’t automatically qualify as being unhealthy. An Archives of Internal Medicine study of more than 5000 adults showed half of the overweight and a third of the obese are “metabolically healthy.” This means they have good cholesterol, blood pressure, and glucose levels as well as other low risks for heart disease. At the same time, about 25% of those who fall into the healthy weight range have at least 2 risk factors typically associated with obesity.
For all the population-based data on the health risks of overweight and obesity, it still comes down to the individual and the choices they make each day. That message — you have control of your health now — may be the most important one to convey to those you serve. No matter what you’ve done to this point, no matter what shape you find yourself in, you have the ability to do something about it today. That doesn’t mean you ignore professional medical advice. But it does mean that health isn’t defined as a size 6. You can achieve health goals that are right for you without feeling like you need to reach a number on the scale or a “normal” BMI.
For practical guidance on how to drive healthy eating and physical activity in your organization, download Produce First — The Compelling Case for Simplifying Workplace Nutrition Programs and A Healthy Dose of Nature Is Good for Business.