Sustaining Success - Chapter 13

Sustaining Success – Chapter 13 

Weight loss medication is an important component to many people’s weight loss journey. These medications are both well-tolerated by patients and incredibly effective in dropping the pounds. Weight loss drugs are meant to be used long term, however, many individuals discontinue therapy because of issues with cost, accessibility, or side effects. The unfortunate news is that stopping a weight loss drug has been associated with rebound weight gain. 

So, what if you need to discontinue therapy? To prevent the challenges of maintaining weight loss after medication, we need to take a holistic approach. This involves integrating lifelong fitness and wellness habits to sustain your physical health for the long haul. 

Understanding the Role of Medication in Weight Loss 

The results emerging from clinical trials in the weight loss realm are striking. Newer weight loss drugs are inducing incredible effects, leading to reductions of as many as 20 percent of people’s body weights. How exactly, however, does this happen? 

Most of the newer weight loss drugs belong to the class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. These drugs bind the GLP-1 receptor, signaling the body to slow down gastric emptying. Gastric emptying is the process in which food moves through the digestive tract. When you delay this process, you end up feeling fuller for longer. When your appetite is suppressed in such a way, you eat less and thus lose weight. 

The other main way GLP-1 medications contribute to weight loss is through the insullin and glucagon pathways.  By mimicking the effects of the naturally occurring hormone GLP-1, these medications enhance insulin secretion in response to elevated blood glucose levels, leading to improved glucose uptake by cells and reduced blood sugar levels. Simultaneously, they suppress the secretion of glucagon, a hormone that usually increases blood glucose levels, thereby reducing hepatic glucose production and promoting the utilization of stored fat as an energy source, contributing to body fat loss. 

While this mechanism is very effective in inducing weight loss, it does not cause a permanent change in the body. If you were to stop taking a GLP-1, for example, your digestion would return to normal and your usual appetite would return. Thus, weight regain remains a major concern for those looking to stop weight loss treatment. 

Because the results from weight loss medication are not always sustainable, it is important to support your weight loss journey from other angles using a more natural and holistic approach. 

Setting Realistic Goals

Weight loss medications have given us a “quick fix” way to lose weight. However, weight loss is not something that typically happens overnight. Working towards living a healthier lifestyle requires motivation, patience, and persistence for long-term success. 

To maximize your chances of success, it will be essential to set achievable and measurable goals. These goals could be related to eating a healthy diet, exercising a given amount, or making a lifestyle change (e.g., quitting smoking, reducing alcohol intake, etc.). You can adjust these goals to meet your needs and advance your progress as you continue throughout your journey. 

Developing a Balanced Diet 

Have you ever heard the phrase “the abs start in the kitchen”? Although most of us are not seeking six pack abs, the same principle applies to weight. A cornerstone of weight management is implementing a balanced diet. 

When a lot of us think about weight loss and food, we think about restrictive dieting. While we certainly need to be eating in a calorie deficit for weight loss, we can still enjoy our food. It’s all about implementing nutrient dense and whole foods to support our wellbeing while avoiding harmful foods and drinks in the process. A healthy diet will include lots of fruits, vegetables, lean proteins and meats, complex carbohydrates, healthy fat, and fiber. It will limit sugar, sodium, overly processed foods, junk foods, and alcohol.   

It isn’t just about what we eat but how we eat it. Portion control, for example, is critical. A portion refers to the amount of a certain food that you eat. Depending on the type of food, we want to ensure we are eating the correct portions. For example, when thinking about a plate, we typically aim for half a plate of vegetables, a quarter plate of complex carbs, a quarter plate of protein, and a half tablespoon of healthy fats. We can also improve portion control by using smaller dinnerware and avoiding eating out of bags or containers. 

Another important component is mindful eating. Mindful eating involves putting your full attention on consuming your food and observing how you feel in response. To be a mindful eater, eat slowly and without distractions like your phone or TV. Listen to your hunger and satiety cues. If you feel hunger, you may be able to eat more, but if you are full, do not push yourself to consume more. 

Establishing a Consistent Exercise Routine 

Getting your body moving is another critical step to maintaining your weight loss. It also can improve so many aspects of your health, including your sleep quality, pain, blood pressure, bone health, mental health, and risk for other diseases like diabetes, stroke, heart attack, and cancer. 

When you work out, your body burns extra calories. Thus, if you are both eating less calories and burning more calories, you are putting yourself in a greater caloric deficit which leads to further weight loss. Exercise also needs to continue regularly in order to maintain weight loss. 

To maintain one’s weight, individuals should aim for 150 minutes of moderate to intense aerobic exercise every week. This can be broken up over several days, for example, 30 minutes daily for five days a week. To keep consistent with a routine, it is important to find the right type of exercise that you enjoy and can sustain over time. Overall, you should balance activities like cardio, strength training, and flexibility to achieve the best results 

Managing Stress and Emotional Eating 

Our mental health has a lot to do with our ability to gain or lose weight. In particular, negative feeligns and stress can lead to emotional eating. Emotional eating refers to eating as a means to dealing with tough emotions. It does not relate to our hunger cues, and thus, we will sometimes eat more calories than what we need in the process. 

To avoid emotional eating, it is important to develop new coping skills for managing stress outside of food. This could include going to therapy, working out, talking with a friend of family member, going outside, or engaging in a hobby. Mindfulness, including meditation, can be another great way to bring yourself calmness and peace to emotionally regulate. 

Ensuring Quality Sleep 

One of the lesser known ways to manage weight is to ensure you are getting quality sleep. Sleep deprivation can affect your eating habits, metabolism, and hormones, thus having an adverse impact on weight. Thus, getting a good night’s rest should be a priority, but that is something many struggle with. 

Implementing good sleep hygiene is essential to getting high quality sleep. Some general sleep hygiene tips include: 

• Avoiding screen time one hour before bed 
• Only getting into bed for sleep or intimacy 
• Dimming the lights a few hours before bed 
• Avoiding eating three hours prior to bedtime 
• Going to bed and waking up at the same time every day 

Building a Support System 

Weight management is no easy feat, and it shouldn’t be something that you have to go through alone. Establishing a strong support system will be essential to getting you through the more challenging days. Tap into your network of friends, family, therapists, and support groups both in the good and bad times. 

Additionally, do not be afraid to ask for professional help. Consulting with qualified providers during your weight loss journey can make a world of a difference. Seek guidance from a doctor, dietician, or fitness coach. They will be able to provide you evidence-based advice on how to achieve your weight goals. 

Monitoring Progress Without Obsession 

Tracking your progress can be a great way to keep motivated and course correct if needed. However, consider monitoring your progress via factors other than your weight. The benefits of weight loss and management extend beyond just the number on the scale. Being a healthy weight can also improve things like pain, quality of life, mental health, and more. Focus more on your overall wellbeing by checking in on these non-weight related health markers. 

Adjusting Lifestyle for Sustainable Changes 

As aforementioned, progress does not happen overnight. Making gradual lifestyle changes that are sustainable is what will allow you maintain a healthy weight in the long-term. Additionally, progress is not linear. Sometimes our bodies and life circumstances change, which require us to be flexible in our weight management strategies. If you experience a change or setback, do not be discouraged, but instead adapt to your new circumstances without derailing your progress. 

Embracing a Holistic Approach to Health 

There is so much more to weight loss than the number on the scale. For effective weight loss, a holistic approach is essential, considering not just your physical wellbeing but also your mental and emotional, wellbeing. Thus, incorporating practices that improve all facets of your life will have a trickle-down effect on your weight. 

Conclusion 

In order to maintain your weight loss after stopping medication, you will need to take a holistic approach to health. This will involve implementing a well-balanced diet, exercising regularly, managing stress, getting high-quality sleep, and having a support system. While there is no “quick fix” for weight management, you can embrace the journey with patience and persistence, trusting that you are in control of the future of your health and wellness. And of course, always seek professional advice when needed. 

Author

David J. Bauder, PA-C David Bauder, PA-C, is a certified physician assistant and the assistant medical director at Weight Loss and Vitality in Manassas and Alexandria, Virginia, Washington, DC; and Gaithersburg, MD. He enjoys helping patients optimize their physical and mental health to improve their overall well-being. He earned his physician assistant degree from the University of Texas Health Science Center at San Antonio. Afterward, he gained admission into the reputable graduate program for physician assistant studies at the University of Nebraska Health Science Center in Omaha. David has over 26 years of experience working as a physician assistant. He’s practiced in podiatry, family medicine, emergency medicine, general surgery, urgent care, and functional medicine.