By: Linda G. Everett, MD, MHA

We all know how difficult it is to lose weight, but believe it or not, losing weight is only half of the battle. The ability to maintain weight loss is really what separates the girls from the women. The secret to long term weight management is total lifestyle change. New exercise and eating habits must be developed during the weight loss phase, and continued to be practiced for a lifetime.

Behavior modification is the process of changing ones actions toward a positive goal. In terms of healthy weight management, this means maintaining an active lifestyle which includes at least 30 minutes of dedicated exercise 4 times per week, and eating a balanced diet which is restricted to a certain number of calories on average per day. For most of us, living such a lifestyle involves a lot of reprioritizing, planning, and gaining control of our time. Obviously, this cannot happen overnight, but rather requires consistent, incremental changes which will eventually lead to a healthier, leaner way of life.

To be successful at losing weight and keeping it off, patients must not only understand their condition, but also obtain the skills to set goals, solve problems, monitor outcomes, and overcome barriers to action. Most of us know what needs to be done to lose weight: Exercise more, eat less, and cut down on foods which are high in saturated fat and simple carbohydrates. Unfortunately, knowledge is not always power. In this case, we need solutions to actually implement these ideal behaviors into our everyday lives.

Traditionally, such behavior modification was best accomplished via meetings with a qualified professional: either a nutritionist, physician, or in some cases an athletic trainer. Such meetings are most effective when they occur weekly, and can be either individual or in groups. This is where solutions to problems can be formulated, progress can be measured, and goals can be set, met, and readjusted.

Scientific evidence of the effectiveness of behavioral intervention in improving health is overwhelming. The Diabetes Prevention Program was a highly successful lifestyle intervention program administered to 1,079 participants, which included 45% racial and ethnic minorities and resulted in a 58% reduction in the incidence of diabetes. The main goals in this program were to achieve a minimum of 7% weight loss and weight maintenance and a minimum of 150 minutes of weekly physical activity equivalent to brisk walking. Key features of this program included goal based behavioral intervention delivered by highly trained lifestyle coaches. There was frequent contact and ongoing intervention throughout the trial to help participants achieve and maintain the weight and activity goals. Specific strategies to tailor the intervention to the individual participant were implemented. Lifestyle coaches met with participants regularly over a year long period to complete a structured 16 session curriculum. Each lesson taught behavioral self-management strategies for weight loss and physical activity. The result was that most participants met their weight loss and activity goals, maintained them over time, and significantly reduced their risks for diabetes.

Unfortunately, the amount of time, traveling distance, and high cost involved with such a comprehensive program prohibits most people from participating. Fortunately, in this age of computer technology, online tools can extend the medical practice and provide this support through cost-effective programs that help clinicians guide their patients to better manage their conditions. Several internet based programs available for self directed lifestyle management, but not all are created equal. The best online self-management education and support programs are rich in pertinent content, provide engaging interactive elements, and offer a tailored, personalized learning experience. They contain self-assessment tools and ways for the individual to monitor performance and changes in biologic measurements such as weight, blood pressure, and blood sugar.

A few examples of self management tools are listed below:
PERAfit – The National Jewish Medical and Research Center, building on more than 20 years of experience with telephonic and behavioral change programs, has launched a unique weight-loss program that relies on customized personal coaching, Internet education and support, and wireless activity monitors and scales. Members of the Colorado Public Employees’ Retirement Association (PERA) will be the first customers to benefit from the program.

Virtual Lifestyle Management – The Virtual Lifestyle Management program is the online translation of the proven Diabetes Prevention Program protocols. The service allows for learning, planning, self-monitoring and encouragement, and provides support through personalized electronic coaching. Patients improve their physical activity and nutrition habits and sustain these new behaviors to live longer, healthier lives. Organizations as diverse as Monarch HealthCare, an IPA in Orange County, Motion Picture Television Fund, a healthcare provider in Los Angeles, and Government Employees Hospital Association, a health plan in Kansas City, are currently using the VLM with their patients and employees.

Dr. Everett is pleased to offer the Virtual Lifestyle Management program to new and existing patients. The VLM is an easy-to-use, web-based link to Dr. Everett as your personal diet coach. Through your computer, Dr. Everett and the VLM program will help you:

• Better understand health lifestyle choices
• Identify interesting and easy ways to increase your physical activity
• Monitor and track your success
• Adopt and maintain new healthy behaviors

No driving or attending meetings! You will only need to access a computer with high speed internet access and audio capabilities.

Here’s how it works:

• As a patient enrolled in the VLM service, you will work through interactive weekly lessons to help you gain the knowledge and skills you’ll need to be successful in learning new healthy behaviors.
• In addition, The VLM service combines human coaching from Dr. Everett with a powerful web based intervention that includes ongoing feedback through secure email messaging and real time group chat sessions. Dr. Everett actually acts as a personal coach to help encourage you to work past any barriers you may face.
• You will be asked to plan your weekly activities by using a simple and fun “Drag & drop” planning calendar. You will receive daily emails to help you remember and track the activities you’ve planned.
• Each participant also receives a welcome kit, containing an accelerometer (advanced pedometer), calorie and fat counter reference book so that you can easily track your activity and calorie and fat consumption.

Using the VLM is simple and intuitive – you will usually spend about five minutes per day to track activities, and about 30 minutes once each week to complete the lessons and reflect and plan your next week’s activities.
VLM is a year long program that our office is offering at an introductory price of only $300 for the entire year!

If you have questions about the Virtual Lifestyle Management or The Center’s other services or would like to get started, please send an email to DrEverett@rxdietplan.com or call our office at 610-467-0446.

Dr. Linda G. Everett received her undergraduate degree in Biology at Johns Hopkins University, and her medical degree at Jefferson Medical College. She also received a Masters in Health Administration from Widener University. She completed her residency in Internal Medicine at Christiana Hospital in Newark, DE. Dr. Everett is board certified in Internal Medicine, and has received extensive training in bariatrics. She is a member of the American College of Physicians as well as the American Society of Bariatric Physicians.

After practicing Internal Medicine for 5 years, Dr. Everett decided to open the Center for Medical Weight Loss. At The Center, she offers rapid, long-lasting weight loss even for the most difficult cases. Unlike commercial programs, Dr. Everett is able to use products and techniques only available to medical doctors. These include FDA approved prescription appetite suppressants, medically prescribed low calorie diets, and metabolic supporting injections.

Since insurance coverage for the treatment of obesity is variable, insurance is not accepted for care at The Center, but she does provide the necessary information so that eligible patients can submit their own claims for reimbursement. The Center for Medical Weight Loss is located at 2217 Baltimore Pike, Oxford, PA. For more information or to schedule an appointment, call 610-467-0446.