Table 1: Proposed, implementable principles of obesity medicine and bariatric intervention [3,7,10-19].

Something is better than nothing [20]

· The American Heart Association, Centers for Disease Control, and the American College of Cardiology (among others) categorically agree that “progress, not perfection” should be our goal.

· Time and time again the pursuit of perfection leads to failure. Inability to keep a predetermined schedule leads to the all - or - nothing decision to “quit your diet.”

· Patients and the public should strive to accumulate as much change as possible in the long run. That is, successful weight loss will come for the person that is persistent about accumulating 15 workouts or 15 healthy meals or 15 recoveries in total, rather than necessarily in a specified amount of time (i.e., 10 pounds in 10 days).

Flexibility is associated with success [2,4,5]

· Rigid structure leads to failure. Patients repeatedly fail attempts to follow generalized day by day schedules for a host of reasons: the body rebels, life gets in the way, motivation wanes, etc.

· Weight Watchers is endorsed by many medical groups, and has been successful largely because of the implantation of flexibility to obtain the long term goal. This proposed program introduces a method by which users can enjoy the same control while staying on track with regard to fitness, recovery, and diet.

Recovery is essential for actual body change to take place [18,19,23-26]

· Successful people in the fitness space attend to recovery

· Obese individuals do not have the exercise capacity to significantly affect calorie balance

· Exercise in this group should be utilized to induce adaption so that:

· Individuals will improve, in a kinetic fashion, their ability to burn absolute calories

· The body will initiate neural signals from the periphery to the brain resulting in cortical (brain) reconstruction (change) that will ease the burden of exercise

The concepts of self-monitoring, stimulus control, specific nutritional choices, motivational interviewing, and physical activity are proven effective in weight loss [7-9,21,145]

· The combination of these techniques, introduced in a piecemeal, “digestible” fashion for the non-medical professional, may accelerate users through the stages of change toward long term effect by teaching them to apply these principles in their own lives

The hunger hormone system can be bypassed and appetite can be changed [7,11,15-17]

· A complex system of hunger hormones exist that drives human beings to eat in order to survive

· This system is responsible for the intense hunger pangs, fatigue, and motivation “zap” that follows the onset of calorie restriction and new exercise

· This system can be modified through careful (intentional) activity and supplemented recovery to keep patients and the public on track