Weight Loss Clinic

Galway Bay Medical Centre run a GP-led weight loss clinic, a new concept in weight management.

Recently, hospitals have started to recognise the huge impact obesity is having on the health of the nation and endocrinologists are running obesity clinics. However, access to these clinics is restricted by lack of resources so there can be long delays in accessing them – usually only those with a very high BMI will be treated.

Background

GPs are ideally placed to offer this service on a more personal level with much easier access, as patients can simply phone for an appointment at a time to suit them. We are delighted to welcome patients for this service, which is run in a similar way to those run by Consultant Endocrinologists around the country.

In Galway Bay Medical Centre, we recognise that there are a variety of factors involved in weight gain and that getting back to a healthier weight is a difficult task with many angles to consider.

In basic terms, weight is controlled by calories taken in versus calories burned. Therefore weight loss occurs by either taking in less calories (eating less) or by burning more calories (exercising more). For sustained weight loss and the aim of longterm healthy weight, both must occur. This is easier said than done as there are usually several complicating factors and bad habits that are hard to shake.

DIETS MAKE YOU FAT. This may sound strange but is often true. In many cases, people who prefer crash diets and fad diets don’t ultimately lose weight, as their basic lifestyle and eating patterns remain unhealthy in the long term. Invariably the weight gained after each diet period increases every time so the net result is weight gain. What is needed is a broader approach, which is what we offer in Galway Bay Medical Centre.

The Plan

When you join the Weight Loss Clinic, your first visit is a double appointment with the doctor (please specify at the time of booking your appt that it is for the weight loss service). She takes a detailed history with physical examination and relevant blood tests, to determine any associated medical conditions. Fasting blood tests are required (no food in previous 12 hours) so an early morning double appointment is advised. The doctor makes her assessment and gives you a customized plan to help you reach a healthy weight. Follow-up visits with the doctor aim to assess your progress and advise regarding what further changes need to be made.

Later steps may involve you meeting with the dietitian or food psychologist. You are more likely to lose weight and shake bad eating habits with the added help available from a dietitian and/or psychologist. Follow-up visits may rotate between the doctor, dietitian & food psychologist. In some cases referral to a personal trainer, or to the new GP Exercise Referral Program (www.exercise-referral.ie), may assist. Each patient’s case is different, which is the reason that this program must be customised and adapted to suit the patient.

In certain cases where specific advice fails to reduce your weight as expected and health risks exist, you may be started on medication to boost your weight loss. In extreme cases (BMI over 45 approx) with major health risks, where all other treatment fails you may be referred for consideration for weight loss surgery. This is not suitable for the majority of people, who should respond to our usual treatment plans.

Health Risks

With obesity reaching epidemic proportions around the world as well as in Ireland, there has been a huge increase in the incidence of health problems caused or exacerbated by carrying excess weight. More people are suffering ill-health and ultimately dying prematurely as a result of being overweight or obese. The rate of obese adults in Ireland is increasing at a rate of approximately 1% per year. 38% of Irish adults are overweight, with a further 23% in the obese range. Just 1-2% are underweight, leaving a minority of 38% of the Irish population in the healthy weight category.

Obesity is classified as having a BMI (body mass index) of over 30. BMI is calculated by dividing your weight (in kgs) by your height squared (metres squared). A BMI of 18.5-25 is a healthy weight, 25-30 is overweight, 30-35 is obese, 35-40 very obese, >40 morbidly obese.

Example: A person who is 5' 6" tall and weighs 14 stone has a BMI of 31.6 and is obese.Reducing weight to 11 stone would put them in the healthy BMI range, however this should be done slowly. A more realistic initial target is to lose 10% over a few months (almost one and a half stone) – this has significant health benefits.

Obesity is associated with an increased risk of death from cardiovascular disease, diabetes, kidney disease and obesity-related cancers (breast, oesophageal, colon, uterine, ovarian, pancreatic and kidney). Being overweight or obese is also associated with an increase in certain medical conditions which can be harmful in themselves as well as contributing to an increased risk of death from other causes, for example, hypertension, high cholesterol levels, high sugar levels, fatty liver disease, obstructive sleep apnoea, depression, subfertility, pregnancy problems.