This is discussed in the program by dietitian doctor Dalia Petrauskienė working at the ID clinic.
Read more Due to the drought caused by «El Nino,» the Panama Canal is considering further restricting shipping
According to the doctor, the first step to assess whether a person is dealing with obesity is quite simple. “The primary indicator is to calculate your body mass index,” explains D. Petrauskienė. BMI can be calculated on special websites, for example, manosvoris.lt.
A body mass index of 30 or more is considered an indicator of obesity. However, the doctor emphasizes that this number alone is not enough to fully assess a person’s health. “It is very important to understand that the body mass index is only a primary indicator. Later, it is very important for us to find out the internal results,” she says.
It is worth coming to the doctor prepared
Noticing that weight has become a problem, a person can start with their family doctor, who, if necessary, will refer them to a dietitian doctor. It is also possible to go directly to a dietitian or endocrinologist.
According to D. Petrauskienė, the most important thing is to come not only with the desire to talk about weight but also with the intention to treat it. “Preparing for a dietitian consultation is quite simple, but first of all, you need to come with a treatment mindset. This would be a very important component,” emphasizes the doctor.
It is worth bringing existing blood test results and previous test history to the consultation. It is also very useful to write down in advance what a person eats – a food diary can be kept for at least a few days or a week. Equally important is a physical activity diary – this helps to more accurately assess the patient’s daily habits. In addition, the doctor should be told about any comorbidities, medications taken, and other important health history.
The obesity consultation is not just a conversation about how much a person weighs today. The doctor is interested in the entire weight history – how the weight has changed over life, what methods the person has already tried, and what results were achieved. “During the consultation, the dietitian doctor first assesses your entire weight history, your attempts to lose weight and treat it,” says D. Petrauskienė.
A general anamnesis is also collected, blood tests are prescribed if necessary, body composition analysis is performed, waist-to-hip ratio is assessed, and blood pressure is measured. The doctor also evaluates comorbidities, medications, and dietary supplements. Only after gathering all this information is a decision made about the most appropriate treatment for the individual.
“After assessing your entire condition and history, we prescribe appropriate treatment, decide on the approximate duration suitable for the treatment period. It is also very important that the patient evaluates expectations and possibilities together with the dietitian doctor,” says the doctor.
Obesity is treated in stages
There is no universal method for treating obesity. According to D. Petrauskienė, treatment starts with basic things – nutrition and physical activity.
First, the patient’s eating habits and physical activity are assessed and aimed to be corrected. If lifestyle changes do not achieve the desired result, the doctor may consider other treatment methods.
One of them is medication treatment. The doctor explains that modern drugs can affect mechanisms related to appetite regulation, glucose and insulin balance, and signals in brain centers. “Modern treatment drugs help treat the disease and regulate disrupted signals in brain centers, as well as glucose and insulin balance, and help reduce appetite,” explains D. Petrauskienė.
When medication treatment begins, its results are monitored. The doctor indicates that the treatment progress is often evaluated over about three to six months. If the desired result is not achieved with medication and the body mass index is very high, surgical treatment options may be considered – stomach reduction surgery.
However, it is important not to focus only on physical indicators. At all stages of treatment, the person’s psychological state must also be assessed. “And if necessary, apply psychotherapy or behavior modification methods,” says the doctor.
Myths that scare
There is no shortage of discussions and myths about modern medications for treating obesity. One of the most common is that taking such drugs causes a person to lose not only fat but also a large portion of muscle mass. D. Petrauskienė admits hearing this myth often but emphasizes that with proper treatment supervision, muscle mass changes can be controlled.
“Under the supervision of a dietitian doctor, collecting the appropriate amount of protein, applying suitable physical exercises, and performing body mass analysis, the condition of muscle mass is very well controlled and usually lost minimally,” she states.
Therefore, according to the doctor, medication treatment should not be understood as a simple way to “lose kilograms.” The goal of treatment is to change a person’s behavior, eating, and physical activity habits together.
Another common question is what happens when stopping medication. D. Petrauskienė points out that one of the most important goals of medication treatment is precisely the formation of new habits. “The drug is prescribed to form proper behavior, eating habits, and appropriate physical activity. And this is our main goal when prescribing medication treatment,” she emphasizes, so treatment should not be separated from daily habits: if a person learns to eat differently, becomes more physically active, and changes behavior patterns during treatment, better weight control results are expected after stopping treatment.
Another myth is related to the fear that taking medications will cause many severe side effects and make the person feel bad. The doctor explains that side effects are monitored and controlled individually by selecting treatment. The drug dose is gradually increased, considering the person’s well-being. “Side effects are always controlled by titrating the dose, talking with the patient, and adjusting the dose they receive at that time,” says D. Petrauskienė.
According to her, due to this treatment principle, side effects are usually minimal, and the body’s adaptation occurs within the first few weeks.
Among fears discussed online, there are claims that taking semaglutide can cause the stomach to stop working. The doctor explains that the drug indeed slows gastric motility, but this does not mean stomach “paralysis.” “The truth is that semaglutide slows gastric motility, but again, these symptoms are controlled by properly titrating the dose and starting from the lowest,” she says. Therefore, according to the doctor, this side effect is very rare when treatment is properly supervised.
Rapid weight loss is often associated with the so-called “sunken face” effect. The doctor admits that as body mass decreases, fat tissue is lost in the face area as well, but the most important thing is the pace of weight loss.
“When body mass decreases, of course, we lose fat tissue in the face area as well, but again, it is very important to control body mass properly and not lose weight too quickly,” explains D. Petrauskienė, so the goal during treatment is not the fastest but a sustainable result.
10 kilograms per month – not necessarily a good result
One of the most interesting points from the doctor is the attitude towards the speed of weight loss. Although people often expect the fastest result and dream of losing ten kilograms in a month, the doctor does not consider this a good goal. In her opinion, a much more sustainable goal is to lose about 2–4 kilograms per month.
Why? Slower weight loss allows maintaining the long-term loss of fat tissue and reduces the risk of losing muscle tissue.
“The result will come gradually, slowly. This way, a proper and stress-free result is created,” emphasizes the doctor.
It is important to start viewing obesity as a disease, not a personal failure
The main message from the doctor is that obesity should not be viewed only through the prism of willpower, appearance, or rapid weight loss. It is a chronic disease whose treatment may include not only dietary changes but also physical activity, medications, psychological support, or in some cases, surgical treatment.
The most important thing is to choose treatment individually, considering the person’s entire health condition, previous attempts to control weight, and realistic expectations.
Obesity is a chronic disease, so when faced with it, it is worth consulting a doctor and seeking appropriate treatment rather than blaming oneself for failures in trying to control weight by willpower alone.
Read more UK will ban goods from expanding Israeli settlements in the West Bank
