The American Society of Bariatric Physicians (ASBP) is a national professional medical specialty society of licensed physicians and osteopathy who offer specialized programs in the medical treatment of bariatrics and its associated conditions. Formed in 1950, ASBP has been instrumental in offering practical information that doctors can use in their bariatric practices and that members of the general public can use in locating a bariatric physician.

For physicians, ASBP offers an exciting series of continuing medical education programs, a peer-reviewed quarterly journal, The American Journal of Bariatric Medicine - The Bariatriciain, and a bio-monthly newsletter, News from ASBP.

For the public, ASBP has information on the growing problem of obesity in the United States, ways to lose weight and maintain a healthy weight and a way to reach member physicians for professional consultation in dealing with weight loss problems.

For recent developments in the field of obesity treatment and medical weight loss and news of ASBP activities, visit the News and Views section of the organization's Web site at www.asbp.org or contact The American Society of Bariatric Physicians, 5600 S. Quebec Street, Suite 109A, Englewood, CO 80111.

According to the federal guidelines on obesity, established in 1998, the following are recommended as strategies for encouraging weight loss.

• Patients should engage in moderate physical activity, progressing to 30 minutes or more on most or preferable all days of the week.

• Reducing dietary fat alone--without reducing calories--will not produce weight loss. Cutting back on dietary fat can help reduce calories and is heart healthy.

• The initial goal of treatment should be to reduce body weight by about 10 percent from baseline, an amount that reduces obesity-related risk factors. With success, and if warranted, further weight loss can be attempted.

• A reasonable time line for a 10 percent reduction in body weight is six months of treatment, with a weight loss of one to two pounds per week.

• Weight maintenance should be a priority after the first six months of weight loss therapy.

• Physicians should have their patients try lifestyle therapy for at least six months before embarking on physician-prescribed drug therapy. Weight loss drugs approved by the FDA for long-term use may be tried as part of a comprehensive weight loss program that includes dietary therapy and physical activity in carefully selected patients who have been unable to lose weight or maintain weight loss with conventional non-drug therapies. Drug therapy also may be used during the weight maintenance phase of treatment. However, drug safety and effectiveness beyond one year of total treatment have not been established.

• Weight loss surgery is an option for carefully selected patients with clinically severe obesity with coexisting conditions when less invasive methods have failed, and the patient is at high risk for obesity-associated illness. Lifelong medical surveillance after surgery is a necessity.

• Overweight and obese patients who do not wish to lose weight, or are otherwise not candidates for weight loss treatment, should be counseled on strategies to avoid further weight gain.

• Age alone should not preclude weight loss treatment in older adults. A careful evaluation of potential risks and benefits in the individual patient should guide management.

As obesity continues to be a concern in the health care arena, many patients are turning to surgery to help with losing weight. This interview was conducted in the hopes of bringing our readers a personal experience in dealing with the issue of bariatrics. James Elisha, 38 years old, Dallas, Texas, agreed to be interviewed about a recent surgery he underwent to help him lose weight. Answers are provided in his own words.

At the time of my surgery,I weighed 626 pounds.

I would say around age 10 to 13.

I have no heart problems or blood pressure issues. I have joint pain in my knees and back and sometimes have sleeping and breathing problems.

Jobs have been no problem for me because I have worked in the same place since I was 16 years old, but I think I would have a problem getting a job if I did not have this one. Flying has been bad. A year ago, I had to buy two tickets to Las Vegas because I could not fit in one seat, but this year, because of the surgery, I bought one and it made me feel really good.

This is a hard one to answer-I think I am more outgoing in a crowd of people but if I get one-on-one, I am kind of shy, especially around women. Ninety percent of women would not give me the time of day, and I can't say that I blame them.

Back in 1981, this doctor gave me pills which helped me lose weight but they became addicting and I had problems sleeping, so I quit taking them and then gained all the weight back. I have tried every diet under the sun and they did not work for me. This surgery was the last resort and I don't look back, because it was the best for me. Doctors told me I'd be dead before I was 40 if I didn't take it seriously and now I have a whole life to look forward to.

I guess I did not have any will power and I felt this surgery was right for me because I have no choice but to eat less. If I eat too much or too quickly it all comes back up. I am planning on going to the gym to work out because I have not been able to do so in the past, and I think it will only help me lose weight faster.

Stomach staples was what I finally decided to settle on. For years, I played like I was happy with myself when all I was doing was lying to myself about my weight problem and avoiding the situation. I was unhappy for a lot of years?people who tell themselves they don't have a weight problem are only lying to themselves and making the problem worse. Sometimes I think it's sad that I am 38 years old, single and I have no kids-that's not right. I should be living my life to the fullest.

This is the biggest step I have taken. I have lost 170 pounds in about 7 months so now I weight around 450 pounds.

I've had to make a lot of adjustments. I never knew how tough it would be. The fist six weeks, I only had liquids and the second six weeks consisted of chopped up food, and it was really difficult to go almost 12 weeks without eating whole foods. It's been difficult because different foods cause different reactions. It's sometimes hard to digest red meats, and it was really hard breaking the habit of eating fast food all the time. My doctor said I do need to start exercising and that's why I plan on joining the gym.

I have not felt better in years. I feel like I got another chance at life. My knees do not hurt as much although I still have some back problems. Breathing is easier and I sleep better. I just really can't put it all into words.

I would love to weigh around 250 pounds but anything under 300 pounds would be great.

The doctor told me I was losing the weight a lot faster than they thought. Keeping the weight off won't be as difficult because with the staples, it is difficult to overeat.

My weight has altered my lifestyle more than I could have imagined. I think about all the things I have missed out on, like prom night because nobody wanted to go with me. I feel like I should already have children and a wife with grandkids to follow. I sometimes felt some of my closest friends did not want to be seen with me. I have been lonely for a lot of years and even thought it is my entire fault, I refused to be pitied. I feel so much better since my weight loss. I just bought a new pair of pants today and it felt so good to have them eight inches smaller. I also bought a shirt from a normal store for the first time in 15 years. I feel it's a bit of a moral victory for myself. Sometimes I get bitter and think how great it will be to run into some of the people who treated me badly or differently because of my weight, but then again maybe I should thank those people because they are part of the reason I decided to make some changes.