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March is National Nutrition Month, which can also be a time of reflecting on New Year’s resolutions—particularly when it comes to weight management. Have we set attainable goals? When is it time to see a physician about weight loss?

Sarah R. Barenbaum, MD, specializes in the care of patients with obesity and weight-related medical complications, and sees patients at the Comprehensive Weight Control Center and the GI Metabolic and Bariatric Surgery Program, where she serves as the Obesity Medicine Director. Here Dr. Barenbaum discusses effective ways to set weight management goals, and what role physician can play in the process.

What guidance would you give for people embarking on a weight loss journey right now?

Know that losing weight and maintaining weight loss is hard! I recommend setting incremental, achievable goals along with bigger picture goals. For example, set a goal to lose two to four pounds a month, along with the bigger goal, like trying to lose greater amounts of weight.

If you choose a specific diet, select one you can stick with long-term, not one that will be difficult to maintain after a few weeks.

If you hit a tough stretch and stop losing weight, or start to regain weight, don’t get discouraged. Seek help.

In your experience, how successful is it when patients make weight management goals in the New Year? Is that effective?

Any time of year you feel motivated to lose weight is the “right” time to start! Setting a realistic weight loss goal during the New Year can be effective--if the goal is attainable. I urge patients to remember that the length of time it takes to achieve a goal is not as important as getting there, so be take it slow and steady.

What advice would you give to someone looking to manage weight for the first time?

View losing weight as a journey. Be patient with the process--and yourself. Keep goals small and achievable as you reach your overall goal. And choose a diet you can maintain. Trying to lose a lot of weight rapidly can be a recipe for discouragement if the goal is not met. If you’re not sure where to start, meet with a registered dietitian.

What unique role can the Comprehensive Weight Control Center play for patients looking to start the New Year with diet-related resolutions?

We’re uniquely positioned to help patients at any stage of their weight loss journey. We can help those about to embark on their first attempt and don’t know where to start, to patients who feel they’ve tried everything without success.

Our multidisciplinary team of board-certified physicians includes different medical backgrounds: internal medicine, nutrition, and/or endocrinology, registered dietitians, a family nurse practitioner, and a diabetes educator. Together, they help patients lose weight and maintain the loss through a combination of interventions, including lifestyle, medication, and sometimes surgical referral. 

What role does exercise play in weight loss?

Developing both healthy eating habits and engaging in regular physical activity is essential for weight loss. Exercise influences the composition of weight loss to target fat instead of lean muscle. The calories expended in exercise also may help offset the reduction in resting metabolic rate that can occur with weight loss.

The American Heart Association, American College of Cardiology, and The Obesity Society all recommend at least 150 minutes of exercise per week to manage weight and obesity. Exercise becomes even more important during weight maintenance after weight loss--at least 200 to 300 minutes per week is recommended. Physical activity should be a combination of both aerobic exercise (like walking, running, cycling) and strength training at least two days per week.

The pandemic has induced stress for so many people. How, if at all, is stress and patients’ emotional states related to weight management and eating habits?

The pandemic has been a stressful and scary time. We’re still learning how this stress has affected weight, food choices and behaviors through ongoing studies at the Comprehensive Weight Control Center.

Stress can make it difficult to adhere to goals, and maintain healthy eating and exercise habits. People may find that certain meals or types of foods can provide comfort in times of uncertainty, even when they’re not hungry.

It has been said that people carrying extra weight may be at higher risk for complications if they contract the virus that causes COVID-19. Please discuss this. What amount of weight loss that might lower that risk?

People with obesity are at higher risk for severe disease from COVID-19, independent of their obesity-related comorbidities. We’ve hypothesized that patients in a weight-reduced state may have a reduced risk for severe disease, compared to their weight-maintained peers.

We don’t know yet the amount of weight loss that might make a difference to lower the risk of complications associated with COVID-19 in clinically obese patients. We’re looking to learn more from ongoing studies.

At what point should patients involve a physician in their weight-loss journey?

You can involve a physician at any point! Whether it’s your first attempt at weight loss, or you’ve experienced weight loss and weight regain multiple times, physicians can guide you.

It’s especially important to meet with a physician if you have a medical condition that might affect the safety of diet or exercise, require close monitoring of your condition during this process, or have a medical condition related to weight (such as diabetes, high blood pressure, high cholesterol or sleep apnea).