Have you heard people say “I’m tired of being on a diet”? When I hear this I say if you are not on a diet  then what are you on? If you think about it for a second, all of us are always on a diet even if we are not eating anything which would then be a fasting diet. In truth we are either on our own diet on someone else’s diet. So which diet works best for you?

If your primary concern is weight loss then your thinking should be not which diet should you try just to lose weight because then what do you do after you lose a few pounds? Do you go back to your own diet? Is the diet you used to lose weight a diet you would want to follow for the rest of your life to keep the weight off? Many people either don’t think this through or go on an extended rotation of a “weight loss diet” then back to their own diet and end up feeling frustrated and may give up the weight loss battle.

People should not blame themselves for these dietary dilemmas. There is information overload in the media about diets and many people end up confused. The false promise of the dietary and weight loss industry is the newest diet will be better than any previous diet. The essential question however is what diet will be sustainable for a person for the long term. Recently U.S. News and World Report asked over 20 experts to rate the best known diets for overall health including weight loss and disease risk reduction. They choose the DASH diet (dietary approaches to stop hypertension), the TLC diet (therapeutic lifestyle changes), the Mayo Clinic diet, and the Mediterranean Diet as the four best plans.

Our weight loss program used the Mediterranean Diet which is essentially a combination of the other three diets. We focus not just on weight loss but risk reduction for heart disease, high cholesterol, blood pressure, diabetes, osteoporosis and many other chronic diet related conditions. See our success stories video to learn more.

Many people including doctors don’t believe that people can keep weight off for the long term. A 20 year study has proven this to be wrong. Conducted through Brown University Medical School, the researchers have collected information from 10,000 people who have lost at least 30 pounds  and kept it off for one year to be members without using gastric bypass surgery or lap band surgery. It is called the National Weight Control Registry (NWCR). Here are some quick facts about the group:

• 80% of persons in the registry are women and 20% are men.
• The “average” woman is 45 years of age and currently weighs 145 lbs, while the “average” man is 49 years of age and currently weighs 190 lbs.
• Registry members have lost an average of 66 lbs and kept it off for 5.5 years.
• These averages, however, hide a lot of diversity:

v  Weight losses have ranged from 30 to 300 lbs. (without weight loss surgery)

v  Duration of successful weight loss has ranged from 1 year to 66 years!

v  Some have lost the weight rapidly, while others have lost weight very slowly–over as many as 14 years.

So how do they do it?

• 45% of registry participants lost the weight on their own and the other 55% lost weight with the help of some type of program.
• 98% of Registry participants report that they modified their food intake in some way to lose weight.
• 94% increased their physical activity, with the most frequently reported form of activity being walking.
• Most report continuing to maintain a low calorie, low fat diet and doing high levels of activity and…

v  78% eat breakfast every day.

v  75% weigh themselves at least once a week.

v  62% watch less than 10 hours of TV per week.

v  90% exercise, on average, about 1 hour per day.

We offer a proven lifestyle program that can improve all of the same risk factors promised by weight loss surgery. Psychologists tell is it takes about 45 days to create lasting lifestyle habits.  If you are considering weight loss surgery you will be “forced” into a new lifestyle after the surgery. We help people make lasting changes through our intensive one on one program. They feel empowered to take control of their lives and their choices. Please call us today for a program that can change  your life for the better. See our success story video. You do have options!

Recently, a local bariatric surgeon was quoted on the front page of the Arizona Daily Star saying, “no one can diet forever”. Later in the article he said his patients will be on a post surgical diet (presumably forever). Aside from this obvious contradiction, medical research does not support his first statement. This is exemplified by the 10,000 members of the National Weight Control Registry each of whom lost at least 30 lbs and kept it off for one year to qualify as a member. The average member has lost 65 lbs and kept it off for 5 1/2 years.

Some Facts:

• 80% of persons in the registry are women and 20% are men.
• The “average” woman is 45 years of age and currently weighs 145 lbs, while the “average” man is 49 years of age and currently weighs 190 lbs.
• Weight losses have ranged from 30 to 300 lbs.
• Duration of successful weight control has ranged from 1 year to 66 years.
• Some have lost the weight rapidly, while others have lost weight very slowly–over as many as 14 years.

The original purpose of the National Weight Control Registry was to dispel the prevailing thinking amongst medical professionals that long term weight loss and maintenance was unachievable. These 10,000 women and men are using low tech lifestyle habits to control their weight. Hopefully now after nearly 18 years of research, medical providers can begin to believe that it is possible for their patients to achieve and maintain weight loss and convey a positive message about this issue. Lifestyle changes are essential for long term weight control and disease risk reduction. Our weight program is designed to help people with long term weight reduction without bariatric surgery, hormones or injections. See our FirstLine Therapy pages and success story video.

Remember the old commercials: “it’s a breath mint, no it’s a candy mint” or “it tastes great, no it’s less filling”. These were false arguments because both statements are true. The same goes for our FirstLine Therapy program because it’s both a weight reduction program and a disease reduction program. Leading health organizations and medical experts―including the National Institutes of Health, American Heart Association, American Diabetes Association, and Arthritis Foundation―now recommend lifestyle interventions (lifestyle medicine) as the “first line of therapy” for treating and reducing the risk of common weight related conditions such as:

• High cholesterol
• High blood pressure
• Metabolic syndrome
• Type 2 diabetes
• Cardiovascular disease
• Overweight/Obesity
• Osteoporosis
• Osteoarthritis
• Polycystic ovary syndrome

Healthy lifestyle choices are also the key to addressing other health concerns and symptoms which can be related to weight control, such as:

• Fatigue
• Hormone imbalance
• Menopausal symptoms
• Low sex drive
• Stress-related symptoms
• Poor memory or lack of mental clarity

Many programs for weight reduction promise fast ways to lose weight not understanding that it takes about 6 weeks for people to make healthy lifestyle changes—the new habits that will lead not only to weight reduction but also long term disease reduction. Everyone knows that eating right and staying in shape are important for overall health. But life’s everyday pressures—hectic schedules, work deadlines, family issues, etc.—can make it difficult to find the time for good nutrition, exercise, and adequate rest.

Our program of intensive individual instruction and coaching from a certified Lifestyle Educator with nutritional expertise and a medical doctor who specializes in Lifestyle Medicine helps people achieve their goals. Please visit our FirstLine Therapy page for more information and watch our success story video. Make a decision today to show your spouse, significant other, children or primary care physician that you can make healthy changes for yourself even if they don’t think you can do it and give us a call.

Some medical weight loss clinics offer vitamin B-12 injections as part of their weight loss programs promising quick weight loss. However there are no credible medical studies that vitamin B-12 in any form, including vitamin B-12 injections, improves weight loss. Vitamin B-12 is a water-soluble B complex vitamin found naturally in a variety of foods, including meat, fish and dairy products. Vitamin B-12 is added to some foods and is available as a dietary supplement in tablet form or as an injection. Vitamin B-12 is commonly prescribed to help treat pernicious anemia and B-12 deficiency.

Proponents of vitamin B-12 injections in weight loss programs say the shots give you more energy and “boost your metabolism”, helping with fat loss. If you have a vitamin B-12 deficiency documented through a blood test, vitamin B-12  can help with energy but it doesn’t need to be through an injection. The under the tongue form works just as well according to medical research. I believe B-12 injections are unnecessary for most people for any reason however they do provide a strong placebo effect because the doctor “did something”. Historically people believe that injections are a more powerful form of medical treatment compared to pills but in medical studies found this belief has turned out to be a placebo effect.

Healthy, safe long term weight loss can be achieved without any injections, hormones or diet pills. Our weight reduction program also promotes weight management over the long term. We also call it a disease reduction program. While weight loss often occurs, it’s only secondary to the primary goal helping you achieve and maintain a healthy body composition (lean-muscle-to-fat ratio) to improve health, manage disease, feel better, and reduce your risk to more serious conditions. Our program is covered by most insurance. See our success story video.

People interested in fast ways to lose weight frequently resort to highly advertized diet pills or weight loss supplements. In addition to the over the counter Alli (orlistat) most other OTC diet pills contain herbal substances such as African mango, caffeine, Phenylethylamine (PEA) found in chocolate, green tea extract (EGCG), CLA (conjugated linoleic acid), bitter orange, chitosan, chromium, hoodia to name a few of the common ones. Most of these substances have very little valid medical research to support their claims. Some substances such as ephedra and bitter orange are dangerous.

Ephedra (ma haung) was banned by the FDA in 2004. A review of ephedra-related adverse reactions, published in the New England Journal of Medicine in 2000, found a number of cases of sudden cardiac deaths (100 people) or severe disability resulting from ephedra use, many of which occurred in young adults using ephedra in the labeled dosages.

In 2010, the U.S. Food and Drug Administration today advised consumers who have Slimming Beauty Bitter Orange Slimming Capsules not to use the product. FDA warns that Slimming Beauty Bitter Orange Slimming Capsules contain the active pharmaceutical ingredient sibutramine, a prescription-only drug which is a stimulant that was removed from the U.S. market in October 2010 for safety reasons. Sibutramine is not listed on the product label and could harm consumers, especially those with cardiovascular conditions. FDA lab tests reveal that the product contains excessive amounts of sibutramine that may be dangerous to people who have a history of cardiovascular disease, because it can lead to elevated blood pressure, stroke, and heart attack.

On October 18, 2011 The Food and Drug Administration (FDA) is advising consumers not to purchase or use “P57 Hoodia,” a product for weight loss sold on various websites and in some retail stores. FDA laboratory analysis confirmed that “P57 Hoodia” contains sibutramine.

In contrast to the supermarket tabloids promising fast ways to lose weight, our weight loss program follows the medical studies recommending 1-2 pounds per week for safe weight loss. We evaluate your individual health risks for heart disease and diabetes and other weight related conditions. We recommend lifestyle adjustments to help you keep the weight off so you can enjoy your life. Our weight loss program is covered by most insurance. See our weight loss success story video.

In today’s blog I will cover prescription diet pills and next time I will cover over the counter (OTC) diet pills. Some commonly prescribed weight loss pills are Adipex-P, Loniman Pro-Fast (all contain the appetite suppressant phentermine, a component of Fen-Phen withdrawn by the FDA in 1997), Xenical (orlistat that blocks fat absorption) now sold OTC as Alli and Meridia  (no longer available in the U.S. due to heart attacks and other heart problems).

Phentermine is chemically related to amphetamines or stimulants that decrease appetite and can be habit forming. It is generally prescribed for 3-6 weeks along with a restricted diet. OTC Alli is ½ the strength of prescription Xenical. Because it is a fat blocker it may block the absorption of fat soluble vitamins like A, E, D and K.  Users are supposed to avoid foods and meals containing more than 30% fat or they may experience leakage of oily stool, increased number of bowel movements, abdominal cramping, gas, and the inability to control bowel movements. It has not been studied for long term usage i.e. longer than two years.

As you can see these diet pills are intended to help get weight off quickly but not to keep it off for a lifetime. We know from studies of 10,000 people (80% women) in the National Weight Control Registry started in 1994  whose members have lost an average of 66 pounds and kept if off for five and a half years, that long term weight control is possible without diet pills. Their secrets are simple and inexpensive such as:

• 78% eat breakfast every day.
• 75% weigh themselves at least once a week.
• 62% watch less than 10 hours of TV per week.
• 90% exercise, on average, about 1 hour per day.

Our office based program covered by most insurance, not only helps people reduce weight but provides a long term plan for weight control and decrease risk for heart disease, diabetes and many other conditions. See our success story video.

I do not prescribe HCG for weight loss and here’s why. HCG (human chorionic gonadotropin)  is a normal pregnancy hormone that was first used in a European health spa about 50 years ago for weight loss. The HCG plan involves injecting this hormone into the muscle and going on a 500 calorie per day diet.

In response to inquiries stirred up by the diet’s popularity, the FDA warned in January that “homeopathic” forms of hCG, like lozenges and sprays, sold over the Internet and in some health food stores, are fraudulent and illegal if they claim weight-loss powers. The injectable, prescription form of hCG, is approved only as a treatment for infertility and other uses, and it is legal (but not recommended) for doctors to prescribe it “off-label” for weight loss.

The F.D.A. has also reiterated a warning, first issued in the mid-1970s, that is required on hCG packaging: It has not been shown to increase weight loss, to cause a more “attractive” distribution of fat or to “decrease hunger and discomfort” from low-calorie diets. The F.D.A. recently received a report of a patient on the hCG diet who had a pulmonary embolism, said Christopher Kelly, a spokesman for the agency. He said the hormone carried risks of blood clots, depression, headaches and breast tenderness or enlargement.

Pieter Cohen M.D., an assistant professor at Harvard medical school who researches weight-loss supplements, said that aside from the issue of side effects, the use of hCG as a diet tool was “manipulating people to give them the sense that they’re receiving something that’s powerful and potent and effective, and in fact they’re receiving something that’s nothing better than a placebo.”

Both the Journal of the American Medical Association and the American Journal of Clinical Nutritionsay that hCG is neither safe nor effective as a weight-loss aid. There have been no credible medical studies to prove HCG is safe and effective for weight loss and there are not likely to be any in the future.

Our weight loss program is supported by many years of research in major medical journals in lifestyle medicine, the Mediterranean Diet, exercise and stress reduction. Please see our success story video and weight loss pages. Call our office today to start your lifelong weight loss plan.

Ingredients:

• 2 tablespoons low-sodium soy sauce
• 1 tablespoon rice wine vinegar
• 2 teaspoons sugar or honey
• 2 teaspoons dark sesame oil
• 2 teaspoons cornstarch
• 2 tablespoons canola oil or peanut oil
• 1/2 pound firm tofu, cut in 1- x 2-inch dominoes
• 2 teaspoons minced fresh ginger
• 2 garlic cloves, minced
• 3/4 pound butternut squash, cut in 1/2-inch dice
• Salt to taste
• 1 1/2 pounds red cabbage, cored and coarsely chopped
• Rice, bulgur or buckwheat noodles for serving

1. In a small bowl, whisk together 1 tablespoon of the soy sauce, the rice wine vinegar, sugar or honey, sesame oil and cornstarch. Set aside.

2. Heat 1 tablespoon of the oil over medium-high heat until a drop of water sizzles and evaporates upon contact. Add the tofu, and stir-fry until lightly colored, about three minutes. Remove from the pan, and season to taste with soy sauce.

3. Add the remaining oil to the pan. When it is hot, add the butternut squash. Stir-fry until it begins to color, five to eight minutes. Add salt to taste, the ginger and garlic. Stir-fry for about 30 seconds, and add the cabbage. Stir-fry until the squash is tender and the cabbage is crisp-tender, about six minutes, adding about 1/4 cup water to the pan from time to time if the vegetables begin to stick. Return the tofu to the pan.

4. Stir the sweet and sour mixture, and add to the vegetables. Stir just for a few seconds until they are glazed. Remove from the heat and serve with grains or noodles.

Yield: Serves four.

A recent excellent article by Tara Parker-Pope in the New York Times Magazine discusses important realities about weight loss that you won’t hear from commercial weight loss programs or clinics such as:

• 10,000 people in the National Weight Control Registry have lost at least 30 lbs and kept that weight loss for at least one year.
• The average member has lost 70 lbs and kept it off for six years.
• The average member puts in the equivalent of a four mile daily walk seven days a week; usually one or more hours of exercise per day.
• They drink water (or green tea) constantly throughout the day.
• After losing weight your muscles burn 20-25% fewer calories during everyday activity.
•  A dieter who thinks they are burning 200 calories during a brisk walk is probably burning closer to 150-160 calories.
• Research finds that out bodies weight related hormones and brain functioning may be working up to six years or longer to keep your body at its old weight.
• This doesn’t mean it’s impossible to keep weight off, it just takes a lot more vigilance to keep it off.
• To burn off one pound of fat the average person needs to walk about 4.5 hours (for some it might be more, for others it may be less).
• Exercise helps to keep the weight off more than it helps to get the weight off.

In our weight loss program we discuss these points so that people can have realistic expectations about their goals. We have individualized coaching usually every other week and measure progress with a bioimpedance analysis for muscle mass and body fat. In my next blog, I will discuss how genetic factors influence weight control and expand on some of the points above. See our website and click on success stories.