Urgent Weight LossSaturday, February 2, 2008
Obesity is a chronic disease and needs long-term treatment. Weight gain doesn’t happen overnight and obesity treatment is not about how much and how fast you can lose it.
Yet, there are situations where rapid and substantial weight loss may be indicated.
For example, patients with severe obesity who require urgent diagnostic procedures; patients with severe obesity needing elective surgery; patients with life-threathening medical issues made intractable by obesity; obese patient following acute illness, where recovery and rehabilitation is hampered by excess weight.
All of these situations may warrant “urgent” weight loss. The aim is not so much to provide long-term weight management – the aim is to acutely reduce weight to solve an immediate problem and get out of a tough spot.
In these situations, and only these, radical weight loss measures may be in order. This is where methods aimed at safe short-term weight loss are indicated. This is where treatments such as very low calorie diets, that may have limited efficacy in producing sustained weight loss, but can provide safe and immediate weight loss, can be helpful.
There is a wealth of literature supporting the safety and weight-loss efficacy of low calorie diets such as Optifast. While hardly sustainable in the long term, total meal replacements can provide a rapid and relatively safe strategy to substantially reduce body weight in the short term.
I have no doubt that the majority of patient will probably rapidly regain much of the weight lost, unless transitioned into a more sustainable form of obesity treatment – however, in the short term, this approach may help solve an otherwise intractable problem.
There are few published studies, let alone randomised trials on this concept. However, I have little doubt that given the dramatic increase in the number of severely obese patients in the health system, this approach will in clinical practice prove a rational and tangible path out of otherwise difficult situations.