How to Lose Weight and Keep It Off

Weight loss is something that many people struggle with. They count calories, latch onto diet fads, and have contentious relationships with their bathroom scales.

Obesity in the United States – even the world – is an epidemic. “If you look back 100 years, the number of people who are carrying extra weight has greatly increased,” says Dr. Joseph Caruana, Chief of Bariatric Surgery at Sisters of Charity Hospital. “That’s accelerated during the past three decades.”

A sedentary lifestyle, encouraged by the use of computers and televisions, and fast foods are big contributors.

As a child, Dr. Caruana’s mother, a teacher, prepared dinner at 4:30 p.m., and the family gathered to eat two hours later. Today, Dr. Caruana says that home cooked meals are rare, and busy adults turn to convenience foods instead. “There’s the impulse to go to food that is prepared or to skip meals altogether and catch up later with the calories that are needed.”

Overweight children are experiencing what were once considered adult diseases, such as Type 2 Diabetes and high blood pressure. Some patients of Dr. Caruana’s practice, Synergy Bariatrics, have battled obesity since they were young.

In addition to diabetes and hypertension, excess weight can lead to joint problems and decreased mobility. “If you have joint problems and you can’t walk, then you become more sedentary, and it’s really a vicious cycle,” says Dr. Caruana.

So, how much weight is too much? A Body Mass Index (BMI) calculator (click here for our BMI calculator) relates your weight to your height, recognizing that someone tall can accommodate more weight than someone who is petite. Calculate your BMI to see how much, if any, you have to lose.

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Spotlight on Health

Weight Management & Bariatric Surgery – 96.1 JOY-FM, January 29, 2012
Download this thirty-minute radio program to hear from featured guest Dr. Joseph Caruana, Chief of Bariatric Surgery at Sisters of Charity Hospital.

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Approaches to Weight Loss

The best way to lose weight is through education and empowerment, says Dr. Caruana.

Dr. Caruana’s most successful patients are those who are knowledgeable. “They may have tried and failed numerous times. They may have even been labeled as failures by themselves or their family. But if they’re motivated and they’re knowledgeable, then they can go a long way toward working with us to achieve a good end.”

Over-the-counter and Prescription Drugs

When considering weight loss drugs, Dr. Caruana recommends caution, especially when the promise seems too good to be true.

“I am upset when I see TV advertising that shows a potential weight loss drug and offers a quick fix. ‘Lose 30 lbs. in 3 weeks.’ Who might not be attracted to that, especially when it’s bundled in a Hollywood type of format? I understand why people might go this route. But it’s probably something that is not going to lead to long-lasting success.”



All weight loss drugs have their limitations. Dr. Caruana says that many over-the-counter drugs have little evidence to support their long-term effectiveness. And FDA-approved drugs, which try to suppress appetite or stimulate your system to burn calories faster, may not have reliable data to support their claims. They can also cause health problems, such as elevating your blood pressure or putting strain on the heart.

Drugs that limit the amount of fat absorbed in what you eat show promise, according to Dr. Caruana. But, you may experience unpleasant bowel movements and other bowel activity.

Weight Loss Surgery

Weight loss surgery, also called bariatric surgery, may be an option for people who have BMIs of 35 and above.

There are three types of surgeries:

• laprascopic adjustable banding, in which a device is wrapped around the stomach to prevent eating,
• gastric bypass, which rearranges the stomach and small intestine to allow food to pass differently, and
• sleeve gastrectomy, in which the excess part of the stomach is physically removed, reducing the amount that can be consumed.

For patients at Synergy Bariatrics, Dr. Caruana helps to match the procedure to the patient. “Some may be candidates for all of them, and others we would want to steer one way or another based on their specific needs.”

But don’t make the mistake of thinking that weight loss surgery is an easy solution. Patients must continue to eat a healthy diet, exercise and take vitamins and minerals. Dr. Caruana’s patients are patients for life, even if they visit the practice just once a year.

“We can address issues that their primary physician may not be able to pick up. We can also be sure that they’re taking their vitamins and minerals the way they’re supposed to, and try to address any behavioral issues that may be interfering with their progress.”

Don’t Give Up

Dr. Caruana understands that losing weight can be a difficult process, but he warns people against being too hard on themselves.

“I think that many times, the treatments that we have fail the patients as opposed to the patients failing them,” says Dr. Caruana.

Researchers are continuing to learn about and understand the causes of obesity. And bariatric surgery may be getting to the root of the problem.

“We are learning much more about the causes of obesity, that obesity is probably a metabolic disease. Many of the surgeries that we’re doing are actually getting at the causes of obesity on a metabolic level,” says Dr. Caruna.

For more information about bariatric surgery, visit the Catholic Health website.