Dr. Swiner’s Medical Note of the Month-Sept. 2009-Obesity and Diet Pills

This topic makes me cringe a bit, because I’m a female who is concerned about her weight on a pretty regular basis. I try not to worry because, thankfully, I’m very healthy and don’t require any medicines for my health at this time. My blood pressure is normal, and my blood sugar and cholesterol are good.

The other part of worrying is the fact that worry can make the situation worse and cause more weight gain. Of course, I want to remain healthy, especially since there is a history of heart disease in my relatives as they age. I’m comforted by the fact that when I’m motivated to lose weight naturally, my body is still able to do that with a reasonable “diet” and exercise routine. 

For my wedding preparation this past year, I was successful with the practical principles of Weight Watchers (not to advocate one program over another) and exercising three to four times a week. I was able to lose 15 or so pounds for my wedding dress. I was happy and content with that, but now some of that weight is coming back as I relax into the bliss of married life.

I introduce the whole topic of weight loss this way, because it’s a common pattern for most people. The back and forth pendulum swing of weight loss and weight gain is a regular occurrence for us all, particularly for women as we approach our 30s and 40s. That word “metabolism” becomes an issue and ever-burning thing in our mind, and an ever-decreasing thing in our bodies. The word obesity is one being used more frequently because of the increase in the weight and waistline of America.

The Centers for Disease Control and Prevention states in 2003-04, the percentage of Americans 20 years and older in the overweight and obese category measured 66 percent. Overweight and obese children and adolescents measured around 20 percent. That number is growing. But never fear, there are practical and reasonable guidelines to follow to keep our weight at a healthy range.

The first thing to note is to stop with all the crash diets. I put the word “diet” in quotes in the beginning for a reason: They rarely work for long-term success. It’s ridiculous and unhealthy to drop 20 to 30 pounds in less than two weeks. I counsel patients often in my practice about weight loss, and I always re-define the concept to avoid emphasizing quick and rapid weight loss, and unhealthy ways of doing it. Rapid weight loss does not last; it returns and rebounds as rapidly as it comes off once the diet is discontinued. Also, all over-the-counter and prescription medications and popular surgeries all have side effects. Be smart and seek intelligent advice about whatever you’re going to try first.

Here are some guidelines to start you off:1. Nothing is more tried and true than diet and exercise. Period. I like Weight Watchers, not because I make any money off advocating them, but they have the right principles at heart: portion control and input being less than output.

2. Count your calories. Start with an average of 1,500 to 2,000 calories per day. Once you know what you take in (input), try to knock off 500 calories per day. That will equal approximately one pound of weight loss per week.

3. Now for exercise (output). Start easy, sneak in 10-15 minutes first thing in the mornings, and then try to increase it to 30 minutes two to three times per week. It takes about three weeks for something to become a habit. After a month, exercise will seem like a natural part of your lifestyle.

4. Don’t skip breakfast! Skipping meals lower metabolism. It’s more beneficial to eat your three-square meals with healthy snacks (fruits, vegetables, fiber, protein) in between as energy-burning fuel.

5. Watch your liquid calories. Sweet tea, flavored/sugary coffee drinks, juice and sodas can be your worst enemy. Look at the label and see more than 120 calories per serving, which is usually double or triple that in a bottle.

Regarding prescription medications, yes, I use them, but only if a patient is serious and committed to his or her diet and exercise plans first. Don’t be fooled. If you use any of these medicines without the proper regimen, you will be disappointed in the long run. Also, all have side effects that may not be worth the trouble if you’re not motivated to do your part.

The only FDA-approved over-the-counter diet pill is alli. This is what I call a “fat-blocker,” as it is meant to block fat absorption in your diet. No other medications sold online or at stores has been studied by the FDA for dangerous side effects, and they should not be used.

Ask your doctor before starting any medication if diet and exercise are not enough for you.

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