For many suffering from morbid obesity, surgical procedures such as gastric bypass surgery and gastric bands may seem like the only options available for losing significant amounts of weight. There are other options that can work, however; individuals such as David Smith of Phoenix, Arizona, prove that it is possible. Smith lost over 400 pounds through diet and exercise with the aid of a personal trainer, eventually receiving certification as a trainer himself.
According to the Obesity Action Coalition, severe or morbid obesity occurs when an individual reaches a body mass index score of 40 or over or is 100 pounds or more overweight; a lesser BMI or weight can also qualify if the individual has certain medical conditions such as diabetes or hypertension. Once a person reaches the point of morbid obesity his likelihood of suffering from obesity-related diseases significantly increases. Losing this weight can be difficult without surgery; the University of California San Francisco Medical Center estimates that less than 5 percent of morbidly obese individuals who try to lose weight without surgery fail to see any significant weight loss.
Diet and Nutrition
Losing weight requires that you take in fewer calories than you expend each day through exercise and other daily activities. Creating a deficit of 3,500 calories is equal to losing 1 pound of fat. Doctors and nutritionists working with a morbidly obese individual may put him on one of two types of calorie-restrictive diets to increase the rate at which he loses weight without sacrificing his basic nutritional needs. Low-calorie diets attempt to reduce caloric intake to between 500 and 1,000 calories less than the dieter's body burns each day, resulting in the loss of up to 2 pounds per week. The doctor may also try a very-low-calorie diet in some cases; these diets include only 400 to 800 calories per day and are comprised of high-protein, low-fat liquids.
Exercise plays an important role in losing weight and keeping it off. Exercise prevents the body from slowing its metabolism in response to a lower caloric intake and burns additional calories as well, making it essential for large-scale weight loss without surgery. A morbidly obese individual may have difficulty exercising, however, especially if his obesity is severe enough that it places strain on his joints when standing and limits his mobility. Clinical guidelines established by the National Heart, Lung and Blood Institute recommend that exercise be introduced slowly and increased in intensity over time, with low-impact exercises such as swimming or walking being a good starting point for physical activity.
Goals and Motivation
Setting goals is essential to the success of non-surgical weight loss in the morbidly obese. Working toward both intermediate and overall goals makes it easier to envision the loss of weight, with the intermediate goals acting as weight-loss milestones that are easier to reach on the road toward major weight loss. Keeping a weight-loss diary, maintaining a social support network of family or friends and rewarding positive behaviors can help morbidly obese individuals to reach these goals. Chris Powell, the personal trainer who helped David Smith to lose over 400 pounds, recommended an overall weight loss goal of 401 pounds to make it seem more real; the extra pound in Smith's goal drove home the point that every pound counts when trying to lose weight.
Even if someone who is morbidly obese loses a significant amount of weight without surgery, other surgical procedures may be required. When losing a large amount of weight, surgery to remove excess skin may be necessary; it took two separate surgeries to remove 23 pounds of excess skin from David Smith once he lost his weight. Other surgeries may be required as well, especially if organ damage has occurred as a result of obesity or the attempt to lose weight without gastric bypass or gastric belt surgery fails. Even if surgery is unavoidable, however, dietary and lifestyle changes will still have to be made to keep the weight off permanently.
- ABC 20/20: Morbidly Obese Man Loses 400 lbs, Inspires Others
- University of California San Francisco Medical Center: Obesity Treatment
- Obesity Action Coalition: What Is Severe Obesity?
- National Heart, Lung and Blood Institute: Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults
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