Dr Donna Ryan discusses why we need to think of weightloss in terms of percentages, not pounds shed, and provides insight into how as little as a 5% loss can improve individual health. MedTwitter
. For knee pain, the relationship to improvement is not based on achieving a percentage loss. Each pound of weight lost can result in a fourfold reduction in the load exerted on the knee per step during daily activities, but it is important to reduce weight before there is structural damage because weight loss can't repair damaged knee joints. Moderate weight loss produces improvements in quality-of-life measures, in urinary stress incontinence symptoms, and in measures of sexual function.
Think in terms of percentage weight loss, not pounds, and set goals at achievable time points. Help patients translate a percent weight-loss goal to a pound's goal at 3, 6, and 12 months. With the emergence of medications approved for chronic weight management with robust weight-loss efficacy, it now is possible to achieve a weight-loss goal of 10% or 15% with regularity, and some patients will be able to achieve 20% or 25% weight loss with newer medications.
We should help our patients set a goal by calculating a goal for certain time points. A good goal for 3 months would be 5% weight loss. For our 200-lb patient, we would translate that to 10 lb in 3 months. For 6 months, the goal should be 10% . The usual trajectory of weight loss with lifestyle intervention alone is for a"plateau" at 6 months, although with newer medications, weight loss will continue for more than a year.
Weight-loss calculators can be useful tools for patients and healthcare providers. They can be found online and include the
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