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At BMC Center for Weight Management and Nutrition, health is a lifestyle

Banner Staff | 9/17/2008, 5:21 a.m.

Helping people get healthy is Stephanie Spaide’s job. Sometimes, that means being the bearer of bad tidings.

“It’s not what you want to hear,” says Spaide, director of outpatient nutrition services at the Center for Weight Management and Nutrition at Boston Medical Center (BMC). “But if you’ve been struggling with [obesity] for 25, 30 years, the chances of you just losing weight and never having to think about diet or exercise again [are] pretty much zero.”

Getting patients to accept two difficult truths — that losing weight requires effort and discipline, and that so-called shortcuts don’t work in the long run — is at the core of the center, the longest-running clinical weight loss program in Boston.

On average, the center treats about 250 patients each week. About 70 percent of patients are racial or ethnic minorities, groups hard hit by weight- and nutrition-related medical issues.

“Hispanic and black populations do have a higher obesity rate,” says Spaide. “Our [general] population is pretty bad itself, but when you look at the Hispanic population, specifically Hispanic women, and African American individuals, they are at more of a risk.”

While many of those who visit the center come for help with obesity-related problems, the team of dietitians, nutritionists and physicians also treats patients with diabetes, eating disorders, cardiac (heart) problems, hyperlipidemia (an elevation of fats in the bloodstream), pregnancy-related nutritional concerns and more.

Patients seeking the center’s help with a weight- or nutrition-related issue start by getting a referral from their primary care physician, then attending an orientation course. In the orientation sessions, which are held each Monday afternoon, prospective patients are introduced to “the idea that the program offers a lifestyle change, rather than a ‘dieting’ approach to weight loss,” according to a case study describing the center’s offerings.

Following the orientation session, patients schedule their first appointments. A doctor takes a full patient history, administers a physical examination and consults with patients on the selection of diet and exercise plans, and possibly even medication regimens.

Diet selection can be the key to keeping patients involved and on track with their weight management plan. The center offers six separate plans designed to fit a variety of lifestyles, accommodate cultural considerations and achieve specific health goals.

“Some people come and they know they want to go on a liquid diet because they need fast, safe weight loss,” says Spaide. “Some people … just want to be able to eat their normal foods in smaller quantities.”

The most popular choice is the low-fat, high-fiber option, because unlike some diets that have gained notoriety in recent years, it allows patients to eat carbohydrates — “significantly less than what they’ve had in the past,” Spaide notes, “but they still get to have something they know and like.” This diet has proven helpful for patients of Asian, Portuguese, Creole, Haitian Creole, Nigerian and Ugandan descent, for whom rice is a staple food.

Selecting the appropriate diet is one way to aid patients as they make lifestyle changes; another is the center’s wide-ranging 16-week support curriculum.