The number of Americans with clinically severe obesity is on the rise and this has extremely detrimental implications for the nation’s healthcare system. This is because highly obese patients have around twice as many chronic health conditions such as heart disease, diabetes and lung disease than do their averagely weighted counterparts. Although this is a well-established fact in the medical community there has been much debate regarding the best way to deal with this growing patient population. New evidence comprises a review of literature encompassing various types of weight loss programs, results from studies on effectiveness of bariatric surgery and identifies the recommendations regarding obesity and bariatric surgery case management programs.

In the primary practice setting disease management companies appear to be spending their time focusing on the general weight loss strategies such as diet and exercise. This is in contrast to larger national healthcare companies who tend to offer bariatric surgical services as a mainstay of treatment to those patients suffering from severe obesity. This means that case management programs within the healthcare systems, insurance companies and health management organizations are often faced with managing patients with severe obesity and, increasingly, these patients are requesting bariatric surgery. So what then is the most effective form of treatment for these individuals? and what should healthcare providers do when faced with these patients?

Research based evidence shows that severe obesity is a disease that is not very responsive to exercise, diet, or drug therapy and that in fact the best results come from those who undergo bariatric surgery. Surgical treatment has been shown to be more effective than drug treatment when it comes to weight loss. This extends to the fact that because bariatric surgery is more effective in providing weight loss it therefore has the greatest benefits for relief of secondary adverse medical conditions that tend to coincide with obesity. The number of Americans having weight loss surgery increased by 804% between 1998 and 2004, this seems to have sparked the recent development of obesity disease management and bariatric surgery case management programs.

Although this is still a very young field of surgery, it is exciting to know that there is an alternative for those who find other weight loss options and methods unachievable to reach their target weight. However bariatric surgery as with any operation is not without its risks and in fact extremely obese patients pose large challenges with regards to anesthesia due to their size and extra stress on their heart and lungs. It will also take them longer to recover post op and put them at higher risk of infection and other such complications as a result of generalized poor health. It is for this reason that there is simply no complete substitute for diet and exercise and in fact many hospitals require a certain amount of weight loss on the patient’s behalf prior to operation to show their commitment to losing weight. Expect to see lots more on this topic in the near future as bariatric surgery becomes more popular and our population as a whole gets more and more obese.

As we age, out metabolisms slow down. Therefore, we have to very careful of what we eat. People over forty just do not burn off the fat as fast as they did in their twenties. 

If you want to lose weight and get into shape it is critical that you get rid of all the junk food that is in your home. By removing the junk food your are removing the  temptation  to cheat with that bag of chips or bowl of ice cream. 

Learn how to replace those high calorie foods with something healthier. If you drink a lot of soda or kool-aid type drinks, then switch to water. If you do not like the taste of plain water, you can use sugar free flavor packets that taste delicious and have no calories. 

Take your lunch to work with you every day. This will help you to resist the temptation to run through the drive-thru at lunch. Make sure that you pack healthy in-between meal snacks in your lunch. This will keep you from hitting the snack machine during the day. 

Reduce your caloric intake by 200 calories per day. You can do this by adding more vegetables as a side dish. The vegetables will fill you up without the added calories. 

When you are trying to lose weight over forty, it is best that you stay away from fried foods. Bake or grill all of your meats. This will cut down on the fat content of the foods. It will also help keep your cholesterol levels under control. 

One of the biggest secrets to losing weight over forty is to increase your intake of whole grains and cereals. These food have a lot of fiber which is important for good digestion. Whole grains and cereals will also help lower cholesterol levels. 

But you must keep in mind that even if you eat a healthy diet, you will need to add exercise to lose weight. After forty, you are battling against a sluggish metabolism. It is up to you to increase your metabolism. Find a type of exercise that you enjoy doing and do it every day. If you really want to boost your metabolism, it is a good idea to add weight training to your routine. Adding muscle will help to burn more fat.         

Eating healthy over forty is critical if you want to lose weight. Cut out the junk foods and start eating lean meats, fresh fruits and vegetables. Get plenty of exercise and drink more water. By taking good care of yourself, you can maintain a healthy weight and enjoy a long, healthy life.                  

In some people with a BMI greater than 30, assistance with weightloss using Xenical may be of benefit. Weight loss with Xenical and a healthy diet also improves a number of weight-related health risks.