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METHODS OF LOSING METHOD TO TREAT OBESITY – (05-08-05)
Meta-Analysis: Pharmacologic Treatment of Obesity
Speaking of less-than-preferred methods of losing weight…There is much debate about whether these drugs are actually even better than placebo, but lets say they are. Taking sibutrimine alone, the additional weight lost in a year over placebo was just shy of 10 pounds. The cost? Probably close to $1000. That’s about $100/per pound. Not to mention any costs associated with physician visits and costs associated with any interventions needed to deal with any serious adverse effects that occur. 10 pounds in a year.
On a strickly calories in/calories out model of weight loss, that could be achieved by cutting caloric intake by 57 calories per day. That’s like one less Snickers bar per WEEK. Why anyone would even consider these drugs is beyond me. They have side effects that, in some cases have been lethal, the cost ain’t exactly cheap, and they don’t teach anything about fixing the real problem which is lifestyle. Also, not surprisingly, any studies of these pharmaceutical approaches to weight loss focus on WEIGHT–not body composition. I would put some money on the fact that a large chunk of weight loss is coming out of the muscle mass.
METABOLIC RISK FACTORS IN OBESE WOMEN – (05-08-05)
Metabolic risk factors in formerly obese women-effects of a pronounced weight loss by gastric band operation compared with weight loss by diet alone
Some interesting observations here. First, while no one should be surprised, I am NOT a fan of any type of gastric bypass. Mother Nature put it there for a reason. I’m sure that, when all the long term data are in, we will see much greater risks of chronic diseases in these patients due to malabsorption of any number of vitamins, minerals and phytonutrients.
That being said, the patients undergoing surgery lost more weight than those choosing the diet route, however, their insulin sensitivity was better than their dietary counterparts prior to surgery–suggesting that they may not have been as metabolically “bad off” as the diet group.
What I find VERY interesting was that, after surgery, this group of patients had elevated levels of TNF-apha, a marker of inflammation that begins a cascade of further inflammation in the body. Not a good sign, at all. Even more interestingly, this data were mentioned in the conclusion but no importance was given to this finding.
SUCCESSFUL LONG TERM WEIGHT LOSS NEEDS ROUTINE EXERCISE – (12-03-07)
Long-term weight losses associated with prescription of higher physical activity goals. Are higher levels of physical activity protective against weight regain?
Not to burst anyone’s bubble, but we’re finding a much harder job of shutting the barn door after all the animals have gotten out. This article finds that very few people beginning an aggressive workout routine remained complaint w/ that routine, but these were the only ones that had successful long term weight loss.
Two things to consider here. First, obesity, just like any other chronic disease, is easier prevented then treated. Consider the overweight 10 year old. They actually have more fat cells, and as they lose weight, these cells merely shrink but do not go away. They will forever be fighting their weight. Second, maybe aggressive activity may not have been the answer to their exercise dilemma. Stay tuned to these Updates for further information on why many may not achieve balanced body composition with aerobic type exercises.
ARE YOU STILL DRINKING DIET SODAS???
For regular readers of Rantings, it should come as no surprise that I am vehemently opposed to all forms of artificial sweeteners. Period. No exceptions. The evidence is clearly not in support of the use of artificial sweeteners. Many have tried to argue that “it’s just a little.” That argument falls flat on its face.
It all starts with our taste buds. The taste buds in our mouth can obviously sense the artificial sweeteners, otherwise, why the heck are they in there? I think we can all agree on this fact. So, regardless of how “little” there is in the product, there is enough for our taste buds in our mouth to sense it and respond. Agreed? Good.
Unbeknownst to many, we have the same setup of taste buds lower in our small intestine. When these taste buds sense sweet, they respond by releasing a very potent hormone called GLP-1. GLP-1 then goes on to do many anti-diabetic “stuff” in the body. It’s a very nice relationship. We eat sweet stuff (on occasion) and the taste buds in our small intestine trigger the body to respond.
But what happens when the sweet taste is triggered but there is nothing for the body to actually do? Sort of a “where’s the beef” scenario. The body is all prepped to handle the calories coming in, but there are none because the artificial sweeteners are non-caloric. It is my belief that this disconnection between the perception of taste and our body’s response to the anticipation of “sweet” is the most dangerous aspect of artificial sweeteners. With continued use, our taste and our metabolism suffer a disconnect, leading to the development of obesity and diabetes–exactly what society thinks they are avoiding by using artificial sweeteners.
You can see from this logic that the fact that there is “just a little” has no bearing whatsoever. If it is enough to taste, it is enough for the body to respond to.
Of course, there is the ages-old concern that aspartame (and I’m sure we’ll see similar concerns with the new Neotame) increases the risk of brain tumors (true), but this is likely not a common occurrence. Far more frightening is how differently our bodies respond to artificial sweeteners. This can include:
- Alteration of the bacterial flora in the gut from Splenda / sucralose
- Activation of different regions of the brain than ordinary table sugar
So, while society generally thinks that, because it is “calorie free” that artificial sweeteners in pretty much everything we ingest (sodas, gums, energy drinks, candy) will help us to lose weight and / or keep it off. This is just not true at all. This particular study again confirms previous research that suggests that ingestion of diet sodas lead to worse markers for heart disease, NOT an improvement over the course of 20 years.
So, I have to ask, why the HECK are you still ingesting ANY amount of artificial sweeteners. Worse yet, why are you allowing and worse, condoning, intake of artificial sweeteners in your children…?
ADD THIS FOOD TO LOSE WEIGHT EASILY
Do some foods help us to lose weight? Everyone always wants the magic bullet. We want to take this supplement or that supplement to melt away fat and lose weight in time for that vacation or wedding in 2 weeks. Worse, we believe we can’t do it without help and undergo physiology-changing bariatric surgery.
I usually tell patients that, if they want guaranteed, rapid weight loss than amputation is the answer. Unless you have salamander ancestry, this weight ain’t coming back. This may not actually help you to fit into that particular dress, but the scale may reflect a better number.
However, are there really simple things that can be done that may increase the amount of calories that we burn by a small amount? Could the combination of small increases in calories burned multiplied by 6 months or a year lead to real weight loss?
Clearly, research has supported the intake of compounds like green tea and cinnamon as increasing weight loss. Again, these numbers are small–usually on the range of 3-6 pounds or so over 6 months.
Brown fat is the miracle weight loss fat in our bodies. Mammals use brown fat to turn up the thermostat, so to speak. It is a way of burning calories merely to generate heat and keep us warm. Babies and bats are well known to have higher amounts of brown fat, but humans lose brown fat as we age.
This particular article looks at the effect of a capsinoids, a natural compound found in chili peppers, on brown fat. Basically, a portion of the participants in this trial still had some degree of brown fat present that heated up in response to cold temperatures.
When these same participants were given the capsinoids orally, their energy expenditure jumped up a small amount even without the cold exposure. Essentially, their basal metabolic rate (BMR) went up as a result of oral intake of these compounds.
This does not mean that you should run out and drop money on the latest and greatest capsinoids supplement you can find. But is does suggest that frequent consumption of chili peppers may help with weight management in the long run.
CALORIE RESTRICTION LOWERS THE RISK OF CHRONIC DISEASES – (07-30-07)
Long-term low-protein, low-calorie diet and endurance exercise modulate metabolic factors associated with cancer risk
I would be happy going on record that I’ve never been a fan of the high-protein type diets, feeling that short term weight loss is traded for long term health. These types of diets will kill you if you stay on them long enough.
That being said, I’m really sorry to find a study supporting my position. But even more importantly, this is yet another study finding that calorie restriction lowers the risk of chronic disease. It is really at the point now that we can no longer deny that our culture’s obsession with larger portion sizes and the accompanying additional calories w/o the additional nutrition are killing us more rapidly then we could imagine.
ARE DAIRY PRODUCTS GOOD FOR US? – (07-09-07)
Adolescent Milk Fat and Galactose Consumption and Testicular Germ Cell Cancers
Almost everyone alive today has grown up under the idea that “Milk it does a body good.” Unfortunately, the research behind this is weak at best. Most people would accept that the drug companies have a tendency to market their products in a positive light that may not always be true. But, when it comes to the dairy industry, it is nothing but altruistic and the claims are never questioned.
And yet the Courts recently forced the dairy industry to stop its claims of weight loss from dairy products because there is no evidence to support it. The idea that dairy is good for us is so ingrained in our culture that every public health recommendation, every school lunch program and every state medicaid program includes the recommendations for daily servings of dairy. But, so it’s not good for you–but bad? Dairy has been linked to Type 1 diabetes, increased IGF-1 levels which are linked to prostate and breast cancer and now testicular cancer at a frequency of 1 serving/day. Now THAT’S good marketing done on a poor product!!!
HOW EARLY CAN BONE HEALTH BEGIN TO DETERIORATE? – (02-04-08)
Bone Loss, Weight Loss, and Weight Fluctuation Predict Mortality Risk in Elderly Men and Women
We view bone health as something that happens when we pass 60 years of age. However, this viewpoint grossly understates what bone health relates to and how early it can begin to deteriorate. Purely as a marker of Vit D status, it can give us an idea of whether we have enough Vit D decades before it may show up as something else.
This study finds that women with poor bone health have a higher overall mortality rate–again reflecting that the factors that negatively affect bone negatively affect everything else. As a society, we have to start placing increased value on checking bone density in men and women beginning in our 20s.
WHOLE BODY VIBRATION VS CONVENTIONAL PHYSIOTHERAPY
Whole Body Vibration vs Conventional Physiotherapy for Parkinson’s Disease
WBV is a therapeutic procedure gaining ground. Hopefully, the clinics advertising its using for weight loss will go out of business (not very effective here) and the legitimate uses of WBV will be promoted. Improvements in bone density, lean body mass, balance / fall prevention, circulation (varicose veins, peripheral neuropathy) just to name a few. In addition, the use of WBV sends a mass of “proprioceptive input” up to the cerebellum–signals from every receptor around every joint–that can help with a variety of other problems. Given these effects, the benefits of WBV in conditions like Parkinson’s are multifactorial. Given the safety, this is a treatment modality that should be implemented in every patient.
EFFECT OF DIETARY ADHERENCE WITH OR WITHOUT EXERCISE ON WEIGHT LOSS – (03-08-10)
Effect of Dietary Adherence with or without Exercise on Weight Loss
Fasten your seatbelts for this one. Regular readers know I am a huge fan of calorie restriction without nutrient restriction for weight loss and long term health.
In this particular study of calorie restriction and exercise, some interesting findings came out. Everyone was put on a 800 cal / day diet, which is quite restrictive. However, those that had greater restrictions (meaning they were taking in more calories before the study and the drop down to 800 was greater) had a harder time sticking to the diet. Makes sense. Also means that we should, in general, cut down our caloric intake, dieting or not. Next, those that exercised 3 x / wk lost more fat mass than the non-exercising group. So compare this to the HCG wonder diet that you hear on the radio so often. The diet associated with this is 500 cal / day and you can’t exercise.
I contend that the weight loss is from the calorie restriction and have seen nothing to suggest otherwise. Also, from this study we see that exercise is needed to lose more fat mass, and this is left out of the HCG diet. Stick to calorie restriction and save your money.
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