Obesity has become an epidemic in American society. It is a strong predictor of risk for many diseases including diabetes, hypertension, heart disease, certain cancers, menstrual disorders and infertility. Obstetricians/gynecologists play an important role in helping patients avoid and manage obesity and its complications.

Obesity is basically caused by an imbalance between energy intake (calories ingested) and expenditure (calories burned.) It involves the enlargement of fat cells and an increase in fat mass. These fat cells then act as an endocrine organ producing biochemicals, which lead to the above diseases.

The body only requires a certain amount of calories every day. This is known as the basic metabolic rate, or BMR. When more calories are eaten then the body uses, weight gain occurs and is stored as fat. Conversely, weight loss occurs when caloric intake is less than output. Height and gender are the most important factors that determine a BMR. Exercise increases the BMR and helps convert calories to muscle mass and release the energy from stored fat cells. There are other modalities such as dietary changes, behavior modification, nutritional supplements, herbal therapies, medications and surgeries. These modalities are used to control hunger, reduce calories or even increase the metabolism. All of these can be used in any number of ways with each other to achieve effective weight loss. Safety needs to be a concern with any approach. However, it still comes down to you and your willingness to lose weight.

Statistics show that dieting alone; people achieve a 10 percent weight loss. Certain medications produce a 15 percent weight loss; this is a 50 percent greater weight loss than dieting alone. Statistically surgeries can increase weight loss to 30 percent; this is a 200 percent increase than just dieting alone. I take a sensible approach to weight loss: A thorough understanding of the physiology and pathophysiology of women and men's metabolisms.

During the initial consultation we will record multiple measurements, which reflect current health status and health risks. We help the patient develop a plan using many modalities to achieve weight loss sensibly. Overwhelmingly, the 10 percent weight loss occurs within the first four months and 15 percent within six months. We will see the patient twice in the first month and then monthly for six months. Generally people reach a plateau and, therefore, the therapy needs modification. This is not a failure of the therapy; it is the body reacting to a new homeostatic state. Continued monitoring needs to occur in order to keep weight from being regained or to have the weight loss continue. That schedule and continued prescribing of medication is determined by the doctor and the patient.

We have a 95 to 98 percent success rate. We also offer dietary aids, multivitamins, calcium supplementation and protein drinks designed to improve weight loss and then maintain the hard achieved weight loss.

Dr. Schlotterer conducts a weight loss clinic on Tuesday evenings in Ahwatukee Foothills, 4530 E. Ray Road, Suite 171.

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