Alkaline, anti-inflammatory, flexitarian, paleo, keto, South Beach, volumetrics. You know what we’re talking about: diets. There are more named diets than we can list or even count, and each has helped someone lose weight.
“There’s no one diet or plan that’s right for everyone,” says Columbia endocrinologist Judith Korner, MD, PhD. “Successful weight loss is the result of someone finding what’s most successful for them.”
Guided by evidence-based medicine, Korner opened Columbia’s Metabolic and Weight Control Center in 2006 to help people manage their weight. In that time, the center has worked with thousands of patients to establish individualized treatment plans aimed at achieving and maintaining a healthier weight.
We asked Korner about what it really takes to lose weight and when it might make sense to become a patient.
What are the most important things to know when trying to lose weight?
It’s OK, and encouraged, to seek help.
Losing weight is not something you have to do on your own. We seek help for a lot of other things. We go to the beauty parlor to get our hair colored and barbershop to get our beards trimmed. We have personal trainers and videos to work out. There’s no reason to keep banging our heads against the wall trying to lose weight without any help.
Beware of gimmicks, namely supplements.
There are a lot of non-regulated, untested dietary supplements and injections, along with places that offer unproven metabolic testing of blood, urine, amino acids, and more. None of that is proven to do anything helpful.
When you find a supplement in a store or online that makes claims to help you lose weight or says “clinical studies have shown,” look for the clinical studies, ask your doctor. The best-case scenario with a supplement is you waste your money. The worst case is the likes of organ failure. There are reports of individuals who took these so-called weight-loss supplements and experienced liver failure that required a liver transplant.
Supplements also add a sense of failure to people who are struggling to lose weight. People ask themselves, “Why does this work for everyone else but not for me? What is wrong with me?” and it adds to the internal stigma. From a psychological perspective, supplements and other unproven tactics do so much harm.
What do you think about diet trends like keto? If someone requested to follow one, does the center help?
Yes. We work with people on different diets if we determine the regimen is safe for them. Our baseline is balanced diets and minimal processed foods. We find what works for each individual person, for their body, and their life. It’s not one size fits all. No one diet is best for everyone.
We work with you to figure out what foods you like, incorporating the healthiest options, and your work and lifestyle. How much time do you have to shop and cook? Family members with different needs? Some people benefit from food logging. Others do not. Again, do not compare yourself to other people. We can help you create the regimen that’s ideal for you as an individual.
When should someone consider weight loss drugs or surgery?
Weight loss medication and surgery are tools. When you start thinking broadly about weight loss you should become knowledgeable about all the options and their risks and benefits. Talk to your doctor. Know what makes sense for you.
“Medication and surgery are not a last resort because you failed at something else: They are tools to help you along the way.”
People often view the need for medications or surgery as a failure on their own part to achieve weight loss. But as with other diseases, personal failure is not why you need medication. If you have developed an ulcer or hypertension you go on medication.
If non-surgical options worked only partially or haven’t worked at all, consider surgery. Data shows surgery is most effective if you have it earlier in the stage of disease.
Medication and surgery are not a last resort because you failed at something else: They are tools to help you along the way.
How do you successfully lose weight and maintain a healthy weight?
Have short term goals.
Don’t think: “I have to lose 50 pounds.” Have smaller, realistic, achievable, day-to-day goals. Think about what you can do, one step at a time.
Find the combination of things that work for you.
Successful weight loss, weight management, and overall health happens with a combination of things specific to each person: diet, physical activity, sleep, stress management, and more. Finding what works for you is the best thing you can do for your health.
How do you become a patient of Columbia’s Metabolic and Weight Control Center?
Our doctors typically see people who are at least 30 pounds overweight, but anyone age 18 and over who is unable to achieve their weight loss goals can make an appointment for evaluation.
If a child under age 18 is looking for help losing weight, visit Pediatric Endocrinology, Diabetes, and Metabolism in the Department of Pediatrics to make an appointment with a pediatric endocrinologist.
What is the goal of weight loss doctors?
The center’s doctors aim to reduce the severity or risk of developing weight-related conditions such as insulin resistance, diabetes, polycystic ovarian syndrome (PCOS), high blood pressure, elevated cholesterol, joint pain, fatty liver, and obstructive sleep apnea. We work with each patient to optimize therapy to achieve and maintain weight loss.
How many visits are necessary to lose weight?
The number of return visits depends on the goals of the patient and doctor and the treatment. Appointments with our dietitian are typically scheduled between doctor’s appointments to improve outcomes.
Patients on medication often ask how long they will take it. At the center we treat overweight and obesity like every other chronic disease and medical issue. Medication is not a temporary fix. If someone makes significant changes that can be maintained, we consider titrating down medication, carefully. But in most cases the hunger, and then the weight, return if the medication is discontinued.
- Patients on prescription medications for weight loss, and patients with a history of weight regain, need to be evaluated on a regular basis with the frequency determined on an individual basis.
- Patients planning to have weight loss surgery often need six months of attempted weight loss documented by a doctor for their insurance to cover the cost of surgery.
- Patients who have met weight loss and maintenance goals might come in less regularly to monitor their health.
Judith Korner, MD, PhD, is an endocrinologist with a PhD in biochemistry and molecular biophysics. She is director of the Metabolic and Weight Control Center and professor of medicine in the Division of Endocrinology at Columbia University Vagelos College of Physicians and Surgeons. She is a diplomate and current chair of the American Board of Obesity Medicine. Korner’s research is focused on hormones and metabolic factors that regulate appetite, body weight, and glucose metabolism.