Significant loss of weight requires a support system
DEAR DR. ROACH: My grandson, age 26, was diagnosed with aortic stenosis at birth. He has had two surgeries to temporarily fix the problem.
He recently saw his doctor and was told that he must reduce his weight (311 pounds) within a few months in order to undergo his final surgery (valve replacement).
He was told how to do this — more exercise and healthier eating habits — but one might just as well talk to the wall. The doctor has told him that ideally his weight should be 200 pounds, but the doctor would be satisfied with 225-250.
How do I get him to see the importance of becoming healthier so he doesn’t die on the operating table or not be able to have the surgery?
ANSWER: I wish I knew the answer that would work for everyone.
I would settle for an answer that would work for most.
Your grandson’s doctor is certainly right that a better diet and more exercise are an effective way to lose weight. Unfortunately, advice alone rarely leads to sustained significant weight loss. There are many reasons that people gain weight and others that make it hard to lose weight. Simply receiving the advice is probably not going to work. Very few people successfully lose 100 pounds and keep it off.
Given how serious his issue is (it is not good to be carrying an extra hundred pounds when he doesn’t have a properly functioning aortic valve), your grandson should be seeing an expert in weight loss.
In addition to diet advice and exercise, he certainly should consider other treatments, including medication and surgical procedures. These increase the likelihood of long-term significant weight loss.
Some procedures to help people lose weight can be done endoscopically with minimal risk. This is especially relevant for people who are not good candidates for traditional surgery, such as people with heart problems.
You would think that a necessary cardiac surgery would be sufficient motivation to lose weight, but my experience suggests that he will need much more help.
DEAR DR. ROACH: I like to research my various conditions online so that I can have discussions with my physicians. The internet is wonderful for that, but I am increasingly frustrated with the plethora of pseudoscience sites/articles.
What tips can you suggest in order to find accurate, scientific information for health concerns?
ANSWER: I share your concern completely. The misinformation I see on a daily basis ranges from benign to dangerous. You can find something that will agree with whatever position you want to take.
There are a few sites that I trust. My first place to start is the National Library of Medicine at www.medlineplus.gov.
The information, some of which comes from the National Institutes of Health and some from trusted partners, is reliable and written at different levels of sophistication to match the type of question.
Some institutions, such as the Mayo Clinic, have very robust and reliable information written for the public. UPTODATE, a continuously updated medical textbook for professionals, has a patient education library with well-written information.
Many medical societies have excellent-quality information. Unfortunately, there are unreliable groups with very reliable-sounding names, so one must be very cautious.
There are sites that rate health information as to reliability. The Health On the Net Foundation certifies websites as to trustworthiness with its HONcode, which can be found on pages that meet its criteria.
Web of Trust is an add-on to web browsers that rates reputation of websites. This can sometimes let you know when you are on an unreliable site.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.