Why wait to lose weight?

 So just tell me: do Neapolitans like you and me really need more advice about weight loss? Well, I think I know your answer, but hear me out. I'm a local family doctor and I like to throw my weight advice around! Some of it may sound just a bit contrarian.

About one in four of us make New Year's resolutions, and losing weight is a perennial front-runner in the annual national survey run by The Economist.

No wonder. Federal data says more than 40 percent of American adults are obese; another 30 percent are overweight. Obesity is linked to a couple of hundred diseases, including cancers, heart ailments, kidney disease. You knew that.

It's hard to find reliable information on how many of us succeed in following through on those weight-loss resolutions, but there's unanimous agreement that it's far fewer than half. What have we figured out about how to keep our January promises about weight loss, and improve the odds that favor a longer and healthier life? ­­

The medical journal Family Practice published a study just before Christmas that nails part of the problem: often, weight-loss advice from the family doctor is generic and ineffective. The findings were that we general practitioners often "lack knowledge and confidence when giving advice for weight loss; "mostly give generic advice, which patients report as unhelpful;" "specific weight-loss recommendations...were rarely evidence-based." More guidance is needed for the family doctors giving weight-loss guidance, the study concluded.

And then, you may have heard about a couple of new obesity drugs originally developed for diabetics. They're effective for weight loss, and that's gratifying. They come with a long list of potential side-effects, some merely unpleasant, some much worse. And you have to take them for the rest of your life.

 Zhaoping Li, a professor of medicine and chief of the division of clinical nutrition at the University of California at Los Angeles, told a reporter that the new drugs are useful tools but by no means The Answer. “I don’t want people to lose their attention on the fundamental issue — we really need to help each individual have the best lifestyle for their bodies and themselves,” Li said.

 That's where you and your family doctor can have a really useful conversation about what we're eating and how we're moving, and set reasonable goals for improvement. Maybe that's already happening for you, and bravo!

Dr. Diana Macian is board certified in Emergency Medicine and has treated a wide range of medical issues, from a bad cough to cardiac arrest and stroke. Before joining WellcomeMD, Dr. Macian worked in the Emergency Department at Naples Community Hospital on the frontline throughout the COVID-19 pandemic.

She attended medical school at the Uniformed Services University of Health Science and completed her residency at the Portsmouth Naval Medical Center. While serving throughout the Iraq and Afghanistan conflict, she developed a passion for veterans’ healthcare issues and providing outstanding medical services to those who have served our country.