Every day you hear about a new trendy diet or workout that promises weight loss success, but very few actually work in the long run.
Even weight loss surgery requires significant and permanent changes in dietary patterns in order to be successful.
Roxana Merz, MD is here to give the best tips for weight loss that through science and research have proven to help people lose weight – and keep it off.
Selected Podcast
Evidence-Based Weight Loss Tips
Featured Speaker:
Roxana Merz, MD - Medical director, Medical Weight Loss Program
Roxana Merz, MD is the medical director for the Medical Weight Loss Program at Abbott Northwestern Hospital. She is a bariatrician with certification through the American Board of Obesity Medicine and a board-certified internist. Having also practiced as a primary care internist, Dr. Merz understands the importance of approaching her patients holistically, taking into consideration their unique medical, emotional and social needs. Transcription:
Evidence-Based Weight Loss Tips
Melanie Cole (Host): Every day you hear about trending new diets or workouts that promise weight loss success, but very few actually work in the long run. And even weight lost surgery requires significant and permanent changes in dietary patterns in order to be successful. My guest today is Dr. Roxana Merz. She’s the medical director for the Medical Weight Loss Program at Abbott Northwestern Hospital with Allina. Welcome to the show, Dr. Merz. Tell us a little about this obesity epidemic that we’re experiencing in this country and what are you seeing as a medical weight loss expert.
Dr. Roxana Merz (Guest): Well, thank you. I’m delighted to be speaking with you today. We really truly do have an obesity epidemic in the United States and actually throughout the world. More than one third of the US adults are obese, and that’s about 78.6 million people in this country. And two-thirds of our population is overweight. I have a medical weight loss clinic here at Abbott Northwestern Hospital, and I see patients struggling with this disease and disorder on a daily basis and also see the difficult medical problems that result from overweight and obesity on a daily basis.
Melanie: There are so many comorbidities, as they were, to being obese. Just give us a quick rundown on some of them so that we can then talk about really the ways to combat that.
Dr. Merz: Okay, sure. The most typical comorbid or associated health conditions that I see with the weight struggles are type II diabetes, hypertension, high cholesterol, sleep apnea, and even heart disease. There are many, many more, but those are the most common ones.
Melanie: How do you calculate whether you’re a healthy weight? How does somebody know? Is it waistline? Do you use BMI? What do you use?
Dr. Merz: Well, typically you really want to know your BMI, and that is a calculation that stands for the weight in kilograms divided by a person’s height in meters square. You can come by this number in several different ways. You could certainly ask your primary care provider what your number is for this, because all primary care providers now do record this number in your health history. There are also a number of online BMI calculators through the NIH. And Allina Health has its own calculator. Figure it out that way as well. BMI calculator can be found at allinahealth.org/medweightloss, and then look under referral resources.
Melanie: If you’re trying to lose weight, if you’ve determined that you are overweight or even obese, what do you think is the first step? Do you look to diet and what you’re eating, or do you look to exercise and getting active to start burning some of those calories?
Dr. Merz: Well, it’s really a combination of both. Both are so important, actually controlling portion sizes, developing healthy eating patterns, and keeping a general eye on the calories that you’re taking in is probably the most important first step. However, exercise is absolutely critical in order to keep weight off that has been lost. So it’s really a combination of both.
Melanie: When we’re talking about dieting and eating—and there are so many diets out there Dr.Merz—are you a fan of journaling? Are there any diets out there that you particularly want people to follow, or is it more portion control and what you’re eating?
Dr. Merz: Well, I really do believe in journaling, writing down what you’re eating for at least a period of couple of weeks in order to just become more self-aware of where the calories are that you’re eating. When you’re eating, what conditions you’re eating under, are there emotional reasons why were eating, that sort of a thing. I don’t adhere to any specific or promote any specific diet. It has been shown that just about any diet can work for an individual. But really, what we find is that overall, in order to stick to a diet and keep weight off, it’s really about portion control and healthy choices in the long term.
Melanie: People see so much in the media and late night television about belly fat and cortisol levels and diet pills. Do you believe in any of those? Do you prescribe any kind of diet medications?
Dr. Merz: Well, I guess I do. That’s part of what I do with my medical weight loss clinic. However, I would like to state I do not recommend any over-the-counter diet pills, and I do believe that weight loss medications can work and be successful but patients do need to be medically monitored when they’re on weight loss medication.
Melanie: Tell us a little bit about some of the weight loss medications that really do work, and why somebody would come and talk to you about them, because it is a little bit confusing.
Dr. Merz: First of all, there are many or at least several new weight loss medications in the last few years that have come out, and they really are approved for long-term use, which is something new in this area. And so, I have worked with most of those medications and find most of them to be very helpful for patients. But patients do need to continue to work on their diet and exercise as well in order to see significant weight loss.
Melanie: Well, how do these medications work? What are they intended to do? Do they help decrease the appetite or cravings? Do they help burn fat? What do they do?
Dr. Merz: That’s a great question. Medications typically fall into either the category of being an appetite depressant, or they can fall into the category of helping cravings, reducing cravings. And there’s even one newer medication that works on decreasing the cravings and that sense of reward that people get from eating. So it can be a combination of factors.
Melanie: As far as exercise, what do you recommend to your patients when they begin an exercise program? For how long?
Dr. Merz: Well, we recommend as the ideal goal that patients are exercising most days of the week, so that’s probably six days a week, and that they’re working up towards 30 to 60 minutes per day. Most of our patients who are starting at much, much lower levels are really not having routine activity in their days. It’s a gradual process, but the goal long-term is to hit that 30 to 60 minutes most days of the week.
Melanie: And what do you tell someone Dr. Merz when they feel so frustrated? Maintaining weight is much easier than weight loss. So what do you tell people that are frustrated or fall off the diet wagon as it were, and getting them back on? Please give us your best advice.
Dr. Merz: Well, we really want to encourage people to, first of all, get back on that wagon immediately. Don’t tell yourself I haven’t done well today, I’m going to start over tomorrow or next week. Get back on board right away so that a majority of your time is really doing the best job that you can. Every day will pose challenges. Life is stressful. There’s a lot of things that can get in our way. But just really getting back on track is as soon as possible is very, very helpful. Also realize that weight loss and weight maintenance are really a long-term journey and a long-term goal. Obesity is recognized as a disease now, and it’s a chronic disease, like many of our other health conditions that we see in medicine, and it really needs to be approached as such so that we are looking at the big picture, the long picture. And so, really take little steps, make small, sustainable goals, and this will help add to your long-term success.
Melanie: What other resources can you recommend for people on that weight loss journey?
Dr. Merz: Well, if you’re feeling that you have done everything you can do in your own power, you’re running out of ideas, certainly talk to your primary care provider about any additional resources that they have. Another thing that you can do is seek out the care of a bariatrician. And this is a physician who specializes in weight loss, and this is what I do in my clinic. I’m a certified bariatrician, and these physicians are trained in the use of weight loss medication as well as pre- and post-weight loss surgery care. And you can certainly come and see me in my clinic at Abbott Northwestern Hospital or our weight loss clinic as well.
Meanie: Thank you so much, Dr. Merz. You’re listening to the WELLcast with Allina Health. For more information on weight loss, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thank you so much for listening.
Evidence-Based Weight Loss Tips
Melanie Cole (Host): Every day you hear about trending new diets or workouts that promise weight loss success, but very few actually work in the long run. And even weight lost surgery requires significant and permanent changes in dietary patterns in order to be successful. My guest today is Dr. Roxana Merz. She’s the medical director for the Medical Weight Loss Program at Abbott Northwestern Hospital with Allina. Welcome to the show, Dr. Merz. Tell us a little about this obesity epidemic that we’re experiencing in this country and what are you seeing as a medical weight loss expert.
Dr. Roxana Merz (Guest): Well, thank you. I’m delighted to be speaking with you today. We really truly do have an obesity epidemic in the United States and actually throughout the world. More than one third of the US adults are obese, and that’s about 78.6 million people in this country. And two-thirds of our population is overweight. I have a medical weight loss clinic here at Abbott Northwestern Hospital, and I see patients struggling with this disease and disorder on a daily basis and also see the difficult medical problems that result from overweight and obesity on a daily basis.
Melanie: There are so many comorbidities, as they were, to being obese. Just give us a quick rundown on some of them so that we can then talk about really the ways to combat that.
Dr. Merz: Okay, sure. The most typical comorbid or associated health conditions that I see with the weight struggles are type II diabetes, hypertension, high cholesterol, sleep apnea, and even heart disease. There are many, many more, but those are the most common ones.
Melanie: How do you calculate whether you’re a healthy weight? How does somebody know? Is it waistline? Do you use BMI? What do you use?
Dr. Merz: Well, typically you really want to know your BMI, and that is a calculation that stands for the weight in kilograms divided by a person’s height in meters square. You can come by this number in several different ways. You could certainly ask your primary care provider what your number is for this, because all primary care providers now do record this number in your health history. There are also a number of online BMI calculators through the NIH. And Allina Health has its own calculator. Figure it out that way as well. BMI calculator can be found at allinahealth.org/medweightloss, and then look under referral resources.
Melanie: If you’re trying to lose weight, if you’ve determined that you are overweight or even obese, what do you think is the first step? Do you look to diet and what you’re eating, or do you look to exercise and getting active to start burning some of those calories?
Dr. Merz: Well, it’s really a combination of both. Both are so important, actually controlling portion sizes, developing healthy eating patterns, and keeping a general eye on the calories that you’re taking in is probably the most important first step. However, exercise is absolutely critical in order to keep weight off that has been lost. So it’s really a combination of both.
Melanie: When we’re talking about dieting and eating—and there are so many diets out there Dr.Merz—are you a fan of journaling? Are there any diets out there that you particularly want people to follow, or is it more portion control and what you’re eating?
Dr. Merz: Well, I really do believe in journaling, writing down what you’re eating for at least a period of couple of weeks in order to just become more self-aware of where the calories are that you’re eating. When you’re eating, what conditions you’re eating under, are there emotional reasons why were eating, that sort of a thing. I don’t adhere to any specific or promote any specific diet. It has been shown that just about any diet can work for an individual. But really, what we find is that overall, in order to stick to a diet and keep weight off, it’s really about portion control and healthy choices in the long term.
Melanie: People see so much in the media and late night television about belly fat and cortisol levels and diet pills. Do you believe in any of those? Do you prescribe any kind of diet medications?
Dr. Merz: Well, I guess I do. That’s part of what I do with my medical weight loss clinic. However, I would like to state I do not recommend any over-the-counter diet pills, and I do believe that weight loss medications can work and be successful but patients do need to be medically monitored when they’re on weight loss medication.
Melanie: Tell us a little bit about some of the weight loss medications that really do work, and why somebody would come and talk to you about them, because it is a little bit confusing.
Dr. Merz: First of all, there are many or at least several new weight loss medications in the last few years that have come out, and they really are approved for long-term use, which is something new in this area. And so, I have worked with most of those medications and find most of them to be very helpful for patients. But patients do need to continue to work on their diet and exercise as well in order to see significant weight loss.
Melanie: Well, how do these medications work? What are they intended to do? Do they help decrease the appetite or cravings? Do they help burn fat? What do they do?
Dr. Merz: That’s a great question. Medications typically fall into either the category of being an appetite depressant, or they can fall into the category of helping cravings, reducing cravings. And there’s even one newer medication that works on decreasing the cravings and that sense of reward that people get from eating. So it can be a combination of factors.
Melanie: As far as exercise, what do you recommend to your patients when they begin an exercise program? For how long?
Dr. Merz: Well, we recommend as the ideal goal that patients are exercising most days of the week, so that’s probably six days a week, and that they’re working up towards 30 to 60 minutes per day. Most of our patients who are starting at much, much lower levels are really not having routine activity in their days. It’s a gradual process, but the goal long-term is to hit that 30 to 60 minutes most days of the week.
Melanie: And what do you tell someone Dr. Merz when they feel so frustrated? Maintaining weight is much easier than weight loss. So what do you tell people that are frustrated or fall off the diet wagon as it were, and getting them back on? Please give us your best advice.
Dr. Merz: Well, we really want to encourage people to, first of all, get back on that wagon immediately. Don’t tell yourself I haven’t done well today, I’m going to start over tomorrow or next week. Get back on board right away so that a majority of your time is really doing the best job that you can. Every day will pose challenges. Life is stressful. There’s a lot of things that can get in our way. But just really getting back on track is as soon as possible is very, very helpful. Also realize that weight loss and weight maintenance are really a long-term journey and a long-term goal. Obesity is recognized as a disease now, and it’s a chronic disease, like many of our other health conditions that we see in medicine, and it really needs to be approached as such so that we are looking at the big picture, the long picture. And so, really take little steps, make small, sustainable goals, and this will help add to your long-term success.
Melanie: What other resources can you recommend for people on that weight loss journey?
Dr. Merz: Well, if you’re feeling that you have done everything you can do in your own power, you’re running out of ideas, certainly talk to your primary care provider about any additional resources that they have. Another thing that you can do is seek out the care of a bariatrician. And this is a physician who specializes in weight loss, and this is what I do in my clinic. I’m a certified bariatrician, and these physicians are trained in the use of weight loss medication as well as pre- and post-weight loss surgery care. And you can certainly come and see me in my clinic at Abbott Northwestern Hospital or our weight loss clinic as well.
Meanie: Thank you so much, Dr. Merz. You’re listening to the WELLcast with Allina Health. For more information on weight loss, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thank you so much for listening.