The Weight Loss Plateau.
44 year-old female frustrated with hitting a plateau with her weight loss. 44 year-old female frustrated with hitting a plateau with her weight loss.44 year-old female with a BMI of 28.3 (5”3”, 160lbs) has struggled to reduce her weight to her current weight successfully having lost 40lbs over the past 2 years. She is frustrated with her current plateau having been at her current weight for the past 4 months. She has met with a nutritionist and followed through with the various diet modifications as well as adding a significant exercise regimen of 60 minutes 5x/wk at a local gym. Her labwork is normal including adrenal and thyroid studies. There is no underlying depression and she is not on any medication that may promote weight gain. She has a regular menses and a medium bone structure. She has one sibling that is obese, and two in the normal range. Her mother is obese and her father is in the normal range. Her BMI in her late 20s was 24. She has a regular restful sleep schedule of 7½ hours/night. She is compliant with her diet with healthy smaller more frequent meals actively avoiding junk food and soda. She does have an occasional coffee, otherwise, no caffeine. There is no history of tobacco use.44FemaleAs noted above.As noted above. Additionally, she has done an excellent job avoiding the temptation for televised and store products promising quick weight loss.I appreciate Dr. Mark Nelson’s thread elsewhere in this site where he posed the question “How do you help overweight patients in your practice lose weight and improve their overall health?” What I would like to provide this patient is a series of options for adjunctive therapy to her current regimen with some sense of expectations when initiating the therapy. The Natural Medicine Database lists very few that natural medicines that have been shown to be effective and are tailored to specific populations (St. John’s wort for weight loss associated with depression), or are a part of a specific deficiency such as calcium or Vitamin D. The Natural Standard reports good evidence for 5-HTP, DHEA and psychotherapy and a slew of modalities in the category of unclear or conflicting scientific evidence including hypnosis, acupuncture, psyllium and evening primrose. I admit I don’t have much experience in any of these otions. This is a very motivated patient who has done an excellent job in getting as far as she has gotten. I would love to be able to assist her to get over this hump and to her goal of a sustainable BMI < 25. Anecdotes appreciated!