Everyone knows that losing weight can be a real struggle, and is generally not something that happens quickly. But arming yourself with knowledge about what your excess weight means for you medically - and knowing that there are resources and options available - can help get you focused.
BMI and health risks
“I think one of the first questions to talk to them about is what is their current body mass index number and how does that impact their health,” Dr. Miller says.
Body mass index, or BMI, is a measure of your weight in relation to your height, and it’s used to help assess how much extra weight a person is carrying. Normal BMI is considered to be 18.5 to less than 25, while readings of 25 or higher indicate someone is overweight.
Higher readings also correlate with increased risk for diseases like Type 2 diabetes and heart disease; having a BMI between 30 and 34.9 - the first category of obesity -has been linked to being 2.5 times more likely to get Type 2 diabetes than people of normal weight.
Knowing your risks can help you better understand the stakes - and it might serve as more powerful motivation to shed weight.
It’s a good idea to ask your doctor whether you’ve been screened for health problems associated with being overweight.
Blood tests can screen for Type 2 diabetes or prediabetes, high cholesterol, fatty liver and insulin resistance. Measurement of neck circumference and a screening questionnaire can evaluate your risk for sleep apnea. “The reason that’s important is that sleep apnea can lead to other problems,” Dr. Miller says. “It can be associated with atrial fibrillation, for example.”
Setting a goal
Ask your doctor what your initial goal for weight-loss should be - and in what time frame.
Dr. Miller says a reasonable initial weight-loss goal is losing 5 percent of your total body weight over three months. Studies have shown that can significantly improve your health, with benefits to your blood-sugar levels, cholesterol and risk for diabetes. You can set additional goals after that period.
Medication side effects
Some medications - such as psychotropics, steroids, hormones and certain diabetes medications - can promote weight gain as a side effect. Ask your doctor whether any medications you’re on promote weight gain, and whether there are any alternatives.
“They might be able to switch them to a different medicine,” Dr. Miller says. “There are certain antidepressants, for example, that are associated with weight gain.”
Alternately, are there any targeted weight-loss medications that can help?
Dr. Miller says there are medications that have been around for decades that are approved for short-term use, plus several newer drugs meant for long-term use.
Resources or programs
Ask whether there are any weight-loss resources or programs in your area. Your doctor might be able to refer you to a comprehensive, medically supervised program or commercial program, or to a dietitian.
Ask whether you’re a good candidate for weight-loss surgery, which is a good option for people with a BMI of 40 or higher, or 35 or higher with certain medical conditions.
“That’s the most effective treatment we have right now for pretty severe weight problems,” Dr. Miller says.