BY Samuel Mathis, MD, MBA
In 2018, a NIH report was published regarding the rates of obesity in America. They found that nearly 1 in 3 American adults are overweight and over 42% of adults have obesity. The prevalence of obesity has also been increasing over time with it showing up earlier in age among children and teens as well. Over the past 20+ years, rates of obesity have climbed 12%. With the numerous medical complications that arise from obesity, this is a condition that must be addressed on a personal and systemic level. I regularly speak with patients about their weight and provide recommendations on how to naturally lose weight. Many times, patients cannot afford expensive weight loss medications or have other health issues that limit their ability to utilize more affordable weight loss options.
The primary way to improve health, weight, and reduce the complications of obesity is through a healthy diet and exercise. A 2023 systematic review that looked at the combination of diet and exercise effect on weight found that combination strength and endurance exercise with customized hypocaloric diets specified to the patient needs had the greatest effect on weight loss and BMI (1). However, providing patient specific dietary plans can be very challenging in the short time we have with patients. I often will provide exercise recommendations and use Michael Pollan’s Food Rules to help promote broad dietary recommendations. His rules are as follows: 1: Eat (real) food. 2: Not too much. 3: Mostly plants. In this regard, recommending patients limit their processed food intake, work on portion control, and increase vegetable and fruit intake can have profound impacts on both health and weight.
Another integrative therapy that shows some promise in helping with weight control is acupuncture. While acupuncture cannot be the primary means of weight loss, it shows promise as an adjunct to standard therapy. Full body or even auricular acupuncture can be used to help curb appetite and improve body weight when paired with lifestyle interventions (2). In addition to weight loss, the acupuncture group was also found to have improved fasting glucose levels and improved lipid metabolism. It is unclear whether this result is due to acupuncture or a placebo effect. Nevertheless, many patients find the treatments to be beneficial in multiple ways, and it should not be discounted for those interested.
The final integrative therapy many patients may want to explore on their weight loss journey is the use of herbs and supplements. A walk down the supplement aisle at any grocery store will show numerous compounds that claim to influence weight. Most research looks at individual or similar compounds and supplements. Some small studies have found mild effectiveness in certain compounds like caffeine, green tea extract, capsaicinoids/capsinoids, and choline (3). However, there are no large-scale studies that have found consistent evidence of the effectiveness of any supplement or herbal compound by itself. Any supplement used to aid in weight loss should be used as an adjunctive therapy with healthy food choices and regular physical activity.
So how can we best address the topic of obesity in our patients? One way is to incorporate it as part of our discussions surrounding vital signs. Informing patients of their BMI and its relation to their health. A phrase I commonly use is “Your BMI is XX. A normal BMI is between 18-25 and we find that there are significant health risks associated with a BMI over 30. May I provide a handout on some proven lifestyle changes that may help improve your BMI?” Many patients may have questions about where they can get more information on healthy eating. The website “myplate.gov” is a great resource to help patients with basic information about healthy food choices. Finally, referral to a nutritionist or dietitian can also be helpful for patients wanting specific dietary plans that are optimal for their health conditions.
References:
- Olateju IV, Opaleye-Enakhimion T, Udeogu JE, Asuquo J, Olaleye KT, Osa E, Oladunjoye AF. A systematic review on the effectiveness of diet and exercise in the management of obesity. Diabetes Metab Syndr. 2023 Apr;17(4):102759. doi: 10.1016/j.dsx.2023.102759. Epub 2023 Apr 10. PMID: 37084486.
- Zhao X, Wang Y, Li X, Hu P, Pan XF, He B, Liu Y, Hu Y, Zhu T. Acupuncture as an Adjunct to Lifestyle Interventions for Weight Loss in Simple Obesity: A Systematic Review and Meta-Analysis. Diabetes Metab Syndr Obes. 2024 Nov 20;17:4319-4337. doi: 10.2147/DMSO.S484565. PMID: 39582784; PMCID: PMC11585983.
- Mah E, Chen O, Liska DJ, Blumberg JB. Dietary Supplements for Weight Management: A Narrative Review of Safety and Metabolic Health Benefits. Nutrients. 2022 Apr 24;14(9):1787. doi: 10.3390/nu14091787. PMID: 35565754; PMCID: PMC9099655.