Medical Facts...and Fiction

The goal of this section is to define the problem, the epidemic of obesity in this country in adults and in children. Data in this section are designed for the health care professions as well as for the public, with relevant references. In this regard, we will not re-invent the wheel, but will access all useful sources already published...invoking the "Fair Use Doctrine" for this educational effort when actual citations are not given. Of course, with over 50 years of clinical experience represented among the professional complement of this family enterprise, in addition to the experience of guest contributors, we will often express our own insights and opinions.

GS

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Tid Bits...

January 6, 2007

  • In addition to diet, food types, exercise, daily weights and regular external reinforcement, there is a role for medications and also for bariatric surgery...but that role is much less important and more circumscribed.  Medications should only be considered for a patient with a BMI of 30 or over, and then only with careful consideration regarding blood pressure effects.  They should only be used under the regular observation of a personal physician.  Newer products under active research include "Rimonabant', a cannabinoid receptor blocker, and an "anti-Ghrelin" chemical.  More about this can be found in the January 2007 issue of Reader's Digest ("Fighting Fat - New Frontiers", by Patricia Curtis, p85).  Bariatric surgery can be literally life-saving...but subjects must be carefully chosen, and the post-operative course is forever.  Yale University offers a bariatric surgery program that can be highly recommended...for the right subjects!
  • Recent studies of "Low Carb Diets" have shown them actually to increase total and LDL lipids - not a good thing.  Furthermore, trying to eliminate carbs and substituting proteins helps only if the source of those proteins is vegetables. 
  • Really: eat your veggies.  A recent study shows that eating them, especially dark green leafy vegetables, delays brain aging and reduces the incidence of cancers. 
  • Drinking carbonated beverages, particularly colas, reduces bone density and thus increases the risk of fractures in older people. 
  • For pudgy pre-schoolers, just increasing exercise, even substantially, does not solve the problem.  Their dietary habits must be changed.  Start by eliminating sodas and fruit drinks.         GS
  • This is very clear: maintenance of weight loss is the biggest challenge.  It is reported that most successful dieters regain 1/3 of the lost weight in the next year...and most are likely to back to baseline within three to five years.   The only approach that can work is regular reinforcement of the program with the help of others.  Weight-Watchers works...if you keep going to the meetings.  Our Mediterranean Diet program works...if you have regular meetings with a nutritionist or knowledgeable physician.  This is not magic;  it's physiology and human psychology.  Use it if you want to lose it.

    • GS


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