I am 41, obese with T2D and HTN. How to manage?

Question

Hi doctor,

I have been struggling with my weight my entire adult life, and it has reached a crisis point that is affecting everything. I am 41 and currently weigh 298 pounds, which is the heaviest I have ever been in my life.

Tried literally every diet program available, Weight Watchers, keto, intermittent fasting, Jenny Craig, meal replacement shakes, but always regained the weight plus additional pounds. My knees ache constantly from carrying this excess weight, and I am completely out of breath walking up a single flight of stairs.

I developed type 2 diabetes 18 months ago, and my blood pressure requires three different medications to control. Sleep apnea has gotten so severe that I need a CPAP machine, but I still wake up exhausted every morning.

My eight-year-old daughter asked why I am so much bigger than other daddies, which absolutely broke my heart. Work productivity has significantly declined because I am perpetually tired, and my self-confidence is completely destroyed.

Depression has worsened as the weight increased, creating a destructive cycle of emotional eating binges. Insurance denied bariatric surgery coverage, claiming I need to complete physician-supervised weight loss first, but I have failed at that approach repeatedly.

My father was morbidly obese and died from heart complications at 49. I am terrified of following the same path. Are there any effective long-term weight loss medications available now? What realistic surgical options exist at my current weight? How can I break this endless cycle of losing and regaining weight?

Please advise.

Answer 1

Hi

Welcome to icliniq.com.

Thank you for posting your query. It is not only diet, exercise, and sleep, but stress management also helps.

You must decrease your intake of processed foods, and added sugars can help you lose weight in seven days. Drinking plenty of water and adding fiber to your diet might also help. That said, many factors influence your ability to lose weight, and it is better to aim for slower and more sustainable weight loss of 0.5 to 2 lbs per day.

Cutting back on calories and engaging in regular physical activity may lead to gradual and sustained weight loss. Experts recommend getting at least 150 minutes of exercise per week (or 30 minutes per day, five days a week) and eating 500 fewer calories a day to lose up to 1 pound per week.

I would advise you to do the following to lose weight as fast as possible:

Drink enough and drink the right water.
Adjust the protein content of each serving.
Limit the amount of carbs in the body.
Do exercises to burn fat.
Add more fiber to each meal.
Create a scientific sleep schedule.

The following are ways to overcome the weight loss plateau:

Reassess your habits. Look back at your food and activity records.
Cut more calories. Further cut your daily calories, provided this does not put you below 1,200 calories.
Rev up your workout, increase protein intake. Pack more activity into your day.
If you have been stuck in a plateau for weeks, it usually indicates that calorie input (what you are eating) is equal to calorie output (what you are burning through physical activity). The only way to break through a weight-loss plateau is to cut calorie intake further or burn more calories through exercise.
Strength training and cardio are good options. Annual health checkups are fine.

I hope this solves your query, and I will be happy to help you further.

Thank you.