Diets and Weight Loss

January 2001

As a practicing physician who specializes in medical weight loss, “diets” do not work for long term weight control. Obesity is a genetic, metabolic, chronic and progressive disease much like diabetes and hypertension. Chronic diseases need chronic therapy.

Diets and exercise, although important adjuncts, are by themselves “ineffective” for long term success., i.e., commercial weight loss programs @90% failure rate at 3 -4 years.

The key to long term success is aggressive and continued pharmacotherapy as the “foundation” for long term control.

Why should this disease be treated any differently than diabetes and hypertension? Once weight loss is achieved to “desireable not ideal” range, medication must be continued! One doesn’t stop their blood pressure medication once “control” is achieved, or their diabetic medication once blood sugar is brought to acceptable levels.

Why, then, should we stop weight loss medication once a patient’s weight is under control? The infamous “phen-fen” program (which I began using in May 1992), with all of its abuse and media hype proved for the first time in the history of obesity that long term weight loss could be achieved with the use of long term medication.

Current medications that are available (primarily off label) are now equally effective for most patients (without the potential for rare valvular disease or pulmonary hypertension).

Eventually, this disease will be treated with pharmacotherapy as the foundation and diet and exercise protocols as the adjuncts; as is currently the case in my bariatric practice.

Obviously, effective drug therapy would be a political and economic disaster for the commercial weight loss programs and all the worthless otc “dietary” supplements. (long overdue).

Sincerely,
Dr. Skversky


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