By Maria Fleet
What if you went to a doctor for treatment of excess weight and they didn’t weigh you?
That just might happen if you talk with a physician in Canada who specializes in weight management. Take Dr. Judy Shiau, medical director at the LEAF Weight Management Clinic in Ottawa. “If people came to my clinic and didn’t want to be weighed in, I’d be so happy. Because really, it’s about quality of life, and finding a lifestyle you enjoy,” she told My Weight – What to Know.
Doctors who treat patients with excess weight are flipping the script on weight loss, asking people to focus on achieving better health instead of a number on the scale. The optimum healthy lifestyle is one that balances nutrition and exercise with deriving pleasure from life, because otherwise – what’s the point?
Most of us can’t follow a strict regimen forever. And unfortunately, for most people who struggle with weight, keeping their weight under control is a lifelong battle. We’re in this for the long term – so we have to find something sustainable that we can do… and keep on doing.
Dr. Arya Sharma, one of the founders of Obesity Canada, is another doctor who asks people to forget about the scale. He says when he treats people with obesity, he wants to treat them not to reduce their body weight, but to improve their health.
“If you eat better, if you get more physically active, if you sleep better, if you have good coping skills and stress management skills, if you feel good about yourself, you’re going to be a lot healthier,” Dr. Sharma says. “And I tell my patients, you can achieve all of those goals without changing the number on the scale.”
No doubt, it can be sobering to think you likely are not going to get back to the weight you were at an earlier stage in life. Once a person gains weight, their body works to hold on to that weight, and it can be really hard to lose – especially as we age.
“Obviously, you can get a lower weight if you do more,” Dr. Sharma explains. “But there’s a limit to how much you can do. Very often, when I look at a lot of people who’ve lost a lot of weight with lifestyle change and they’re keeping it off, we look at what they’re doing… they’re doing a lot. It’s like a full-time job – they’re running marathons, doing ironman competitions, restricting every bite they put in their mouths. They’ve got a plan, and they’re holding on for dear life because that’s what it takes to keep that amount of weight off with lifestyle. And not everybody can do that.”
That’s why he wants patients to focus on health, instead.
“It’s not how much weight you can lose – it’s how much weight you can lose and keep off,” Dr. Sharma says. “And that’s when we talk about this concept of ‘best weight’.”
‘Best weight’ is an idea also championed by weight management expert Dr. Yoni Freedhoff, Associate Professor of Family Medicine at the University of Ottawa.
“A person’s best weight is whatever weight they reach when they’re living the healthiest life they actually, honestly enjoy, where a person could not happily eat less, and they could not happily exercise more. Whatever their weight is living that life, that’s their best weight,” Dr. Freedhoff says.
He told us that his patients instantly embraced the concept of best weight when he introduced it into his practice back in 2005.
“I think giving people permission to do their best rather than to try to always be perfectly perfect was extremely important for people’s long-term abilities to maintain their efforts at behavior change,” Dr. Freedhoff says.
But what about that number on the scale? Dr. Freedhoff has an answer. “What I try to explain to people is that scales don’t measure the presence or absence of health,” he says. “The most important piece to remember is that scales don’t measure anything other than gravity.”
Dr. Sharma, who co-authored a ground-breaking guide for clinicians on helping patients manage weight with Dr. Freedhoff, says there is evidence that losing just 5% of body weight can result in health benefits that patients will be able to feel. “For someone who weighs 300 pounds, that’s just 15 pounds – this is still going to leave you at 285 pounds, but you know what? You’re going to be a lot healthier at 285 because to achieve that weight loss, you’re going to have to start eating better, exercising more, feeling better about yourself – and you’re going to have made all of these behaviors part of your daily life,” Dr. Sharma says. “If you can achieve that, you’re going to be a much healthier person than before, even if those numbers on the scale haven’t changed all that much.“
Editor’s Note: There are medical treatments (medications and surgery) that can help many people sustainably lose more weight than lifestyle efforts alone. If you’ve reached your “best weight” and feel that additional weight loss would improve your health, talk to your physician about the medical treatments available.
To find a doctor near you who specializes in weight management, click here.