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10 Things Your Primary Care Doctor Does That Should Make You Run for the Hills
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Dr Orrange received her BA in Biology at the University of California San Diego and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health She received her MD from the USC Keck School of…
FAST FACTS
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.
CATEGORIES:
Tips
CONDITIONS AND COMMUNITIES:
Arthritis
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Back Pain
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Chronic Fatigue Syndrome
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Chronic Pain
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Coronary Heart Disease
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Degenerative Disc Disease
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Degenerative Joint Disease
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Diabetes Type 2
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Diets & Weight Maintenance
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Fibromyalgia
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Fitness Goals
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Heart Attack
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High Blood Pressure
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High Cholesterol
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Hypothyroidism
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Menopause
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Obesity
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Polycystic Ovarian Syndrome (PCOS)
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Sleep Apnea
Displaying comments 9-1 of 9
Got a Question?
http://www.weightlosstreatments.net/
Check with your Doc if you're interested in this diet, and you can check out www.medifast1.com for more info.
thank you T
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
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.
Great to hear about your progress
Dr O.
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.
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???????