At Tonbridge Health, we believe in using well-proven science as the basis for an effective and safe weight-loss program. We built Meg to reflect the weight-loss guidelines developed and endorsed by the American Heart Association (AHA), The Obesity Society, the American Society for Nutrition, and other medical professional organizations like the Centers for Disease Control and National Institutes of Health. The AHA developed these principles based on an in-depth review across years of medical research on weight loss, health and dieting.
Eric W. Terman, MD, clinical assistant professor of medicine at Northwestern University’s Feinberg School of Medicine, chairs Tonbridge Health’s Clinical Advisory Board. Dr. Eric describes the medical science behind Tonbridge Health’s approach to weight loss in the following interview.
Meg: Why did the AHA decide to review the medical research on medical obesity and weight loss?
Dr. Eric Terman: The AHA regularly surveys the medical research on major cardiology-related health issues to determine the scientifically-based best practices and guidelines for treatment based on multiple studies. Overweight, obesity and weight loss comprise a topic area with many points of view, some of which are not based on science at all. The AHA recognized that updated guidance was needed to help doctors, consumers and health professionals dealing with weight loss.
Meg: How did the AHA develop their guidelines?
Dr. Eric: The AHA and partner professional organizations convened a panel of medical experts across the major fields involved in evaluating and treating obesity. These included cardiologists, endocrinologists, nutritionists and other medical specialties. The panel generated a list of questions related to the diagnosis and treatment of obesity. Then they gathered studies from around the world related to the questions. Each study was assessed for its research quality and findings. As a result, the panel was able to determine overall answers to each question and rate their confidence in each recommendation based on the research depth and quality that supports it.
Meg: Where did the panel start?
Dr. Eric: The panel first confirmed that Body Mass Index (BMI) is an important measure of the health risks caused by excess weight. BMI is easy to measure because it involves dividing a person’s weight by their height. Even though BMI appears simplistic, the panel found that the higher your BMI above normal, the greater the risk of cardiovascular disease, hypertension, type 2 diabetes and other co-morbidities.
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Meg: How does my BMI relate to my health?
Dr. Eric: The research shows that overweight adults (those with a BMI from 25 to 29.9) may be at elevated risk of cardiovascular disease compared to normal weight adults (BMI less than 25). Medically obese adults (BMI of 30 or above) may be at elevated risk of cardiovascular disease and mortality from many other causes.
She: So, weight loss is important to becoming healthier?
Dr. Eric: Yes. The research shows that lifestyle changes that produce even modest, sustained weight loss of 3% to 5% in a person’s weight lead to clinically meaningful health benefits. So, for a typical individual, that means that a sustained weight loss of even 10 pounds makes you healthier. And more weight loss produces greater health benefits.
Meg: What are the guidelines for an effective weight-loss program?
Dr. Eric: The panel found that the most effective and healthy weight-loss programs have three parts:
- Weekly or more frequent weight monitoring
- A reduced calorie diet of 1200–1500 calories per day or a daily deficit of 500 calories
- Physical activity of 200 to 300 minutes per week (3.5 to 5 hours)
In addition, support and counseling from a registered dietary nutritionist can be helpful in guiding people toward a sustained weight-loss plan. Meg contains these weight-loss elements and provides guidance to help you succeed with and maintain your weight-loss program.
Meg: What about maintaining weight loss?
Dr. Eric: The most effective way to achieve sustained weight loss is to participate for more than 6 months in a comprehensive lifestyle program like Meg that helps you stick to a lower-calorie diet and to increased physical activity through the use of behavioral strategies. Even after losing weight, research shows added health benefits from a long-term (over 1 year) comprehensive weight-loss maintenance program. Meg can help you do that, too.
Meg: What about diets? Which one is best? Paleo, Keto…?
Dr. Eric: It turns out that the research shows a variety of diets can produce weight loss as long as the diet reduces calorie intake and provides balanced nutrition. This includes diets that restrict certain food types, such as high-carbohydrate foods, low-fiber foods, or high-fat foods. Most people find that the best diet for them is the one that is easiest for them to follow and enables them to stick with it.
Meg: Which diets work with Meg?
Dr. Eric: Meg can work with any diet that provides proper nutrition. In fact, Meg allows you to determine your own eating plan if you have one that works for you. If not, Meg provides the DASH (Dietary Approaches to Stop Hypertension) eating plan developed by medical professionals at the National Institute of Health which is endorsed by the AHA and many other medical organizations. We like the DASH diet because it is simple and flexible, making it easy to follow for many people.
The DASH diet has four elements:
- Eat more fruits, vegetables, and low-fat dairy foods
- Cut back on foods that are high in saturated fat, cholesterol, and trans-fats
- Eat more whole-grain foods, fish, poultry, and nuts
- Limit sodium, sweets, sugary drinks, and red meats
Meg: What kind of diets should I avoid?
Dr. Eric: The research shows that crash diets and those with severe calorie deprivation providing 1,000 calories per day or less typically lead to temporary weight loss that cannot be maintained. Essentially, your body shifts into starvation mode and becomes super-efficient. That reduces the calories you burn just through daily living, sometimes called your resting metabolic rate. Once this baseline calorie burn goes down, maintaining weight loss becomes even more challenging. In addition, any diet should provide a nutritionally balanced meal plan to avoid complications. Severely obese adults (those with a BMI of 40 or more) should always consult a physician before starting a weight-loss program.
Meg: How can I learn more about the AHA guidelines?
Dr. Eric: The full report is available as a PDF here: https://www.ahajournals.org/doi/pdf/10.1161/01.cir.0000437739.71477.ee
Meg: How can people reach you if they have additional questions?
Dr. Eric: You can send me a note with your question here: eric@tonbridgehealth.com
