Four strategies for losing weight and keeping it off

Jennifer Farrington of Falmouth wanted to lose weight but had failed at her attempts in the past because of overwhelming expectations. She decided to participate in the shared medical appointment program that Miguel Prieto, MD, an internist at Bourne Primary Care offers to those who are looking to trim some pounds and live healthier lives.

“What I am most excited about is that this program includes lifestyle changes instead of just focusing on diet,” said Farrington. “I am looking for long-term results and not just a quick fix.”

A shared medical appointment is a group visit where multiple patients meet with a physician for follow-up care for chronic conditions, according to the American Academy of Family Physicians (AAFP).

Dr. Prieto has so far offered two series of shared appointments for patients who want to lose weight and live healthier lives.

“Based on medical studies, we are trying to implement a change in care delivery from being focused on medications to lifestyle choices that would minimize the need for interventions in developing disabling conditions,” he said. “We have been quite successful with this program. While the hope is to lose weight, it is just as important in helping to reverse diseases, including pre-diabetes, diabetes and heart problems, so that you need less medication and limit advance of your disease. It is also designed to keep you highly functional, always able to do the activities you enjoy and significantly decrease your risks of cognitive impairment and death.”

The program consists of a shared medical visit every two weeks for six weeks and then monthly follow-up visits. During the introductory appointment, Dr. Prieto explained the topics, strategies and support that will be provided during the sessions. Participants’ vital signs and weight are also checked at the beginning of every meeting.

During a recent session, Dr. Prieto spoke to the group about strategies to transition your diet from processed foods, which can contain artificial colors, flavors, preservatives, salt, sugar and fats, to whole foods (non-processed). He also talked about the added benefits of physical activity, managing stress, and the importance of starting slowly while keeping in mind sustainable goals.

“We are always told that to lose weight we need to eat less and exercise more, which is not true,” he said. “This is not a sustainable way for weight loss.”

Four Lifestyle Strategies

Dr. Prieto listed the following strategies and tips to begin a path to a healthier lifestyle:

1. Nutrition: Dr. Prieto stressed the importance of eating well. He is a proponent of the plant-based diet and explained the difference between eating processed foods and adding or supplementing those with vegetables, fruits and other whole foods. He cited a study that showed study participants who ate the same amount of ultra-processed foods as participants who ate non-processed foods took in an extra 500 calories per day and gained two pounds in two weeks. It has to do with the way your stomach fills up, said Dr. Prieto. It takes about four cups of food to fill your stomach and, if you eat food with a lot of calories from processed foods, that does not fill much volume in your stomach and doesn’t take your hunger away. Instead, you end up eating a lot of empty calories. He suggested choosing foods with fewer calories and higher water content, like raw fruits and vegetables such as watermelon, broccoli, cucumber, celery, zucchini, lettuce, and berries. If you eat five servings of fruits and/or vegetable per day, you will decrease the number of calories you eat.

Dr. Prieto also recommends using herbs and spices to flavor instead of sugar and salt, and to avoid frying.

2. Physical Activity: The goal of physical activity is to be able to do activities you want to do, like being able to get up off the floor, carry your luggage when you travel, open jars, so you will not lose your independence as you grow older.

Walking, yard work, swimming, dancing, riding a bike and strengthening exercises with resistance bands or light weights are all forms of exercise.

Start slowly to avoid injury, especially if you haven’t been exercising before. Make sure you do a variety of exercises and combine aerobic exercises with lifting weights, and try to do these with a buddy, especially walking.

If you are able to keep physically fit, you will keep the weight off and stay healthier overall, he said.

3. Managing stress: Managing stress has to do with the way you face your circumstances; it’s your approach and your attitude. Studies show the way you handle stress can impact your health and affect the way you heal. One of the most important strategies you can do in your life is to foster your relationships; don’t isolate, Dr. Prieto said. If you are upset, go for a walk, call a friend or exercise. Try the relaxation response when you are under stress by stopping what you are doing and taking a slow deep breath three times. When you do this, you are not paying attention to stress. Write down three things you are grateful for everyday, which force you to think about positive things, he suggested.

4. Goal setting: When setting a goal, it has to be sustainable and important to you. Rate your goal from 0-10. If it is not at least a 7, when it comes to being important, then don’t do it. Set a goal that is at least a 7 in importance and a 7 in how sustainable it is for you to do, even if you don’t think it is going to be enough, you start there, he said. It should also be measurable. For example: vow to make three meals a week from the recipe in the book Dr. Prieto provided or commit to losing three pounds over the next month by increasing the number of non-processed foods in your diet.

The suggestions outlined by Dr. Prieto at the shared office visits have so far been a big help to Farrington. Since her first meeting in September, she said she had incorporated many of the strategies recommended in the shared office visits.

“I am doing great,” she said. “I have lost 20 pounds, have lots of energy and made some really good changes in my lifestyle. Dr. Prieto helped me set reasonable goals, which has been very helpful.”

Dr. Prieto and his team are planning future shared medical visits that will be open to all patients with a referral from their primary care physician.