Weight Loss Take 2: A Dr O. Weight Loss Primer
"How can I lose weight?" We should all realize, as I've said before, that obesity is the new tobacco. Here is what you need to know about the nonsurgical management of Obesity.
Starting Out
1. Readiness is an important predictor of success so you have to be ready to change your course--I mean really ready.
2. See your doctor to have blood pressure, fasting blood sugar, cholesterol, liver function and your heart tested before you begin.
Comparing Diets
1. Low Fat Diets: The traditional approach to weight reduction is to restrict dietary fats to less than 30% of total calories. A very low fat diet is no more than 15% of total calories from fat and studies show these are hard to maintain on a long term basis and thus controversial.
2. Low-carbohydrate Diets: In recent years Atkins and South Beach have received quite a bit of attention and it may be warranted. Trials done comparing diets have shown that in the first 6 months low carb diets results in significantly more weight loss than low-fat diets. Diets low in carbs result in lower glucose levels but also tend to increase LDL cholesterol levels.
3. Low-glycemic Index Diets: simply put, these diets have not resulted in increased weight loss beyond that explained by caloric restriction.
4. High-Protein diets: Diets high in protein are usually high in fat which is good because it fills you up. In studies substitution of protein for carbs in calorie-restricted diets did result in more weight loss.
5. Head -head comparisons of specific commercial diets: Atkins did better than the Zone in a study on women 20-50 years old. In a study in the UK comparing Atkins, Slim-Fast, Weight Watchers or Rosemary Conley all led to similar losses at 6 months.
Physical Activity. My motto with my patients is: disease never hits a moving target. Start moving!
1. Increased physical activity alone without decreasing your caloric intake will result in only modest weight reduction.
2. Stating the obvious: Increases in physical activity combined with caloric restriction results in more weight loss than either alone.
3. Your goal is 30 minutes of physical activity three times a week (but that's a whole separate blog).
The weight loss drugs:
1. Phentermine: Studies show 3-4% greater weight reduction in the Phentermine group than the placebo group. Dependency is a concern and this has been listed as a controlled substance which has the potential for abuse. This is not a choice I pick often for my patients.
2. Meridia (Sibutramine): I have prescribed this in my practice with some success. In several studies weight loss was 5% greater if you take Meridia than if you don't. The biggest downside is cost as it isn't covered by insurance and costs about 100 bucks a month.
3. Orlistat (Xenical): when added to a weight loss regimen results in 3% more weight loss. Available over the counter is the half dose of Orlistat which is Alli. Alli has been shown to result in 2% more weight loss over a period of 4-24 months.
Keeping it off: How can I help?
Long-term patient-provider contact is protective against weight gain. Schedule three month follow up visits with your doctor because apparently our gentle or not so gentle nagging helps!
Dr O.
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Weight reduction clinics for women recommend best fat reduction tips and advices. Overweight causes morbid obesity in women which is gives foundation for the fatal diseases. Specialized surgeons prescribe various effective surgery techniques for rapid weight loss.
http://www.weightlosstreatments.net/
By WeightReduction February 24, 2009 7:05am
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The promises that Michelle Aguilar has made to her family would soon be realized. The family vacation, a new handbag for her mom and a lot more things for her family. Winning the prize of $250,000 was quite a payday. The slim, 110 pound beauty was crowned “The Biggest Loser.” It’s hard to believe that this 26 year-old girl was the same girl who began her journey to weight-loss just three months ago. Michelle has lost a total of 132 pounds. Many fans of the NBC hit show were stoked that Michelle beat out competitors Vicky Vilcan and Heba Salama, who were not the favored competitors. The final recap was the most exciting part of the season. Wife Heba was pitted against her husband, Ed Brantley, for the third place spot. It was up to the viewers to choose which of the two would compete for the grand prize. Devoted Ed urged the viewers to vote for his wife, but the strategy backfired and Ed won 84 percent of the viewers’ votes. To find out who else took home a handsome payday at “The Biggest Loser” finale, check out this article.
By JaceX January 2, 2009 1:10am
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My Pdoc recommended the Medi-Fast Diet for me. In the first week, I've lost 4lbs and 3" off my abdomen!
Check with your Doc if you're interested in this diet, and you can check out www.medifast1.com for more info.
By TLCDaisy June 28, 2008 10:01pm
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Dr G I have tried many ways to loose weight and I have to loose 100lbs total in a long term goal and with all my physical problems and other medical issues. I really would like to be able to do this.
thank you T
By fusagirl308 June 24, 2008 10:25pm
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Dear Dr. O
What's your thoughts about Topamax?, my cousin was on this, for bipolar disease and she lost a nice amount of weight. When she went off it, she gained some of it back. What about just for a jump start.
Thanks Ree
By reenee June 17, 2008 2:17pm
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i know this is a bit off topic but
went to an endo today she mentioned a heart medication that lowers testosterone to treat my hair growth from the pcos ( i also have mild hypertension it spikes rather than being constant, however as well as a high resting heart rate) . i wanted to look it up but i cant even remember the name. would you happen to know what its called?
she wants to start me on it after i stop breast feeding and would like to know all i can about it before i start.
Thanks in advance Tam.
By raeofsunshine80 June 11, 2008 1:58am
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Yes PCOS patients respond well to Metformin (it regulates periods, helps to lose weight and helps with excess hair growth)
Great to hear about your progress
Dr O.
By DrOrrange June 9, 2008 5:16pm
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i have always had weight issues in my adulthood. as high as 110lbs higher than my ideal weight (not includeing how heavy i got during my pregnancy)... but i have PCOS, and the only way i can lose weight is either on diabetic medication (metformin) so my liver isnt over producing triglicerides... or drastically reducing my caloric intake i mean drasticly 900-1200 calories. and getting my dietary needs through supplemants. and i cant keep that up.
even on Xanacal eating little and low fat i was gaining 2 lbs a month. and had the most horrific side effects. it must have been trapping the fat my liver was producing too because i wasnt eating that much. it was gross...
but a year before i got pregnant i was finaly diagnosed with pcos lost 30 lbs in ten months changeling nothing but taking the med. and just not worrying about it.
now a month after starting up on met again ive lost 15 lbs this month alone! but mind you i have a 9 mo old and live in the mountains now and have no choice but to exorcise if i want to do something like leaving the house. i know this rate wont keep up but its really nice to see a waist again. i haven't been this light for 8 years and i would be happy if i only lost 35 more lbs.
as well on metformin i no longer crave sugar or carbs this week i was in the store and just looking at candy and bread made me sick to my stomach. so its like im on south beach anyhow. and last time i cut out most simple carbs i felt amazing.
By raeofsunshine80 June 9, 2008 11:19am
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Dr. Orrange,
I am on HRT for SEVERE menopause symptoms Effexor for anxiety. Over the last year, since I began both meds, I gained 13 pounds. Weight loss has always been a problem even though I have been on Synthroid for years for my slow thyroid (I get my levels checked regularly).I eat well and even tried Weight Watchers for 10 weeks and lost nothing. I also exercise regularly. I am frustrated and I have been told by my PCP and an endochronologist that weight loss on these meds are impossible. I also take allergy meds and Zocor for cholesterol. What is a girl to do? I've already gone up 1+ size???????
By RonnieG June 6, 2008 2:56pm