Orlando Gonzalez
Obesity is a worldwide epidemic that has proven difficult to treat. In the United States, over 70% of Americans are considered overweight. Using a multifaceted psychosocial approach appears to have higher impact than traditional obesity management in combating obesity rates and decreasing dependence on medication for chronic morbidities due to obesity. Objectives: In this prospective observational study, we aimed to employ specific multifaceted approaches to decreasing weight in overweight individuals and follow their progress. Methods: This was an observational case series study that is ongoing. Our primary endpoint was to employ different methods, including lifestyle questionnaire, body composition analysis, dietary journaling, nutritional consultation, physical therapy evaluation, blood specimen analysis and motivational coaching, by various professionals including physicians, nutritionists, physical trainers and therapists and life coaches. Our goal here was to see if using this multifaceted approach actually increased weight management compliance. Results: One thousand one hundred (1001) patients were included. Average overweight in pounds was measured by our InBody Composition machine, and was 35 pounds. Targeting the patients??? objective by trying to change lifestyle incrementally, using a nutritionist for consultation and interpreting lab results and close follow-up resulted in an average weight loss of 30 pounds over a one-and-a-half year period. Every single patient lost some weight. Obesity raises risks for numerous conditions associated with chronic pain, including osteoarthritis, low back pain, diabetic neuropathy, fibromyalgia, and migraine.5-7 Obesity and chronic pain adversely influence each other,8 with obesity increasing inflammation and biomechanical stress on joints, changing pain tolerance, and other factors. Body mass index (BMI) is positively related to chronic pain.9 In fact, obesity may be associated with lower pain tolerance because weight loss has been shown to improve pain sensitization.10 Concomitant with the increase in obesity, there has been a dramatic increase in prescription opioid use in recent years. While opioids were previously limited to end-of-life care, post-surgical care, and acute pain, prescription opioids have been increasingly used for chronic pain, with usage rates quadrupling between 1999 and 2010.11,12 At the population level, obesity may be responsible for 14% of the prescription opioid use.13 This trend has also contributed to increased levels of opioid dependence and overdose deaths.14 To effectively mitigate the opioid crisis, obesity’s consequences cannot be overlooked. Therefore, treatment modalities and approaches must incorporate the mind, body, and spirit of the individual, as well as the community in which they liv One hundred (100) patients stopped their hypertensive medications and another 40 stopped their high cholesterol medications. This was an unexpected finding of our study. Of those that lost weight, 90% have kept the weight off. We lost 58 patients to follow up. Ninety-eight percent (98%) of patients reported feeling better and having more energy and 85% reported increase in life appreciation and enjoyment. Conclusion: Using different approaches within different disciplines and careful follow up appear to increase self-information awareness and better compliance which then leads to losing weight. It appears as well, that this approach would improve health outcomes and prolong and encourage more healthy lifestyle, as a number of our patients that were once hypertensive and hypercholesterolemic, no longer carried that diagnosis. Larger, comparative studies need to be performed before this multifaceted approach can be routinely and largely employed.
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