Super morbid obesity is rampant in America and it ain't getting any better. Non surgical weight loss options should always be the first step in any weight loss program. Everyday, I see more and more data suggesting that most gastric bypass patients will experience significant complications at some point in their recovery process. Even the Medicare National Bank's centers of excellence haven't been shown to be so excellent. So what's a patient and doctor to do? What kind of non surgical weight loss options are there? The Happy Hospitalist has the answers you seek. When used in combination with diet and exercise, diet and exercise have been shown to work, over and over again. But, their's a new method in town that's gaining traction and I feel compelled enough to spread this break through finding with all the Happy readers out there. What is this magic pill? They're called diuretics.
That's right folks. I've expanded my nonsurgical weight loss options list from diet and exercise to diet, exercise and diuretics. Why you ask? As a hospitalist, I've seen some incredible hospital based weight loss solutions. Whether it's the little old 88 year old lady stricken with chronic systolic heart failure, oxygen dependent chronic obstructive pulmonary disease and end stage renal disease on Monday-Wednesday-Friday dialysis who has recently initiated chemotherapy for widely metastatic small cell lung cancer, or whether it's the 600 pound morbidly obese gentleman who presents with bilateral cellulitis and complaints of shortness of breath that nobody can figure out why, both patients can have hospital implemented non surgical weight loss plans initiated, intentional or unintentional, with dramatic results.
In the case of the later, I've discovered diuretics to be an important modality for rapid water detoxification of the morbidly obese. This non surgical weight loss modality carries with it a near 100% success rate when randomized head to head with watching television all day long. Who was my most dramatic diuretic responder? How about ten liters of water diuresis in a 24 hour period. That's as far from decreased urine output as one can get. That's 416.666667 cc of urine per hour. That's so far outside the normal range that I would expect this finding to rise to the level of urgency for a stat page as say, a critical hemoglobin of 7.8 that's been 7.8 for 14 straight days. But, for reasons, unknown to me, high urine output is not considered a nursing emergency like the 5 am call for only 200cc of urine output in the last 10 hours for the 94 year old hospice patient with stage IV chronic kidney disease.
Ten liters of urine out put in a 24 hour period. One liter of water weighs one kilogram. One kilogram is equivalent to 2.2 pounds. That means, my diuretic induced non surgical weight loss plan for this guy helped him lose 22 pounds in 24 hours. That's just under one pound an hour. That's freakin' nuts. Total weight loss? 50 pounds in 72 hours. Now, that's a physician directed hospital based weight loss program worth duplicating. Or, you could just chalk up the obesity to a metabolism problem, as this medical someecard helps explain.
I'm a true believer in diet and exercise. When you burn more calories than you consume on a daily basis, the laws of chemistry, physics, and all other natural sciences say that you will lose weight. There's also the option for gastric bypass, which is really nothing more than a really expensive way to make you stop eating so much. Unfortunately, it's not a nonsurgical option. If you don't exercise while you diet, or don't continue to exercise after you stop dieting, your body will eventually slow down its metabolism and weight loss will become harder and harder. You will gain your weight back.
Some people Many people have literally eaten their way through a gastric bypass procedure and find themselves right back at square one.
Weight loss is never easy. You don't get fat overnight. It takes years of hard work to become a member of the small but growing group of Americans known as the super obese. Those folks who are so over weight that they literally cannot walk. These folks can't function. These folks can't do their activities of daily living. These folks have life threatening cardiac and respiratory complications of their eating disorder. These folks often require an intensive inpatient multidisciplinary team of doctors, nurses, nutritionists, and psychologists to save their life. So it didn't surprise me when 32 year old Mrs Smith returned a year later and one hundred pounds heavier on the doorstep of death. Her 600 pounds was literally crushing her from the outside in. What was this weight loss option that failed her so? In the words of her surgeon:
I offered to refer her to a surgeon who specializes in gastric bypass. She declined. I offered to arrange for evaluation of her heart failure and breathing problems. She declined. So I gave her a copy of the book "Finding a Thin Person Hiding Inside of You".
It didn't work. Which makes this the greatest weight loss fail ever.