Health News / July 2007
The Deal with Diet Pills
Few women looking in the mirror are completely happy with what they see and the desire to lose at least a few pounds is almost universal. Since the CDC estimates 66 percent of American adults are either overweight or obese, shedding a few pounds probably is a good idea.
Despite fervent wishes and magical thinking, the basic formula for weight loss hasn’t changed much over the centuries - eat less, exercise more, be patient.
It’s only natural women seek more attractive alternatives, like diet pills.
Unfortunately, they have a poor track record and an unappealing list of side effects from heart attacks and stroke to anal leakage.
Diet pills work in different ways depending on their ingredients.
Prescription appetite suppressants, like Meridia, affect the hypothalamus, the appetite-regulating region of the brain. They block the re-uptake of the chemicals serotonin and norepinephrine, which create that satisfied feeling after eating a big meal. With more of the happy chemicals circulating in her brain, a woman feels full and eats less.
Prescription fat blockers, like Xenical, inhibit the action of the enzyme lipase that breaks down fat in the intestinal tract. With a lipase inhibitor, a percentage of ingested fat is discharged through bowel movements rather than being broken down and absorbed.
But prescription diet pills aren’t appropriate for a woman who just wants to lose 10-20 pounds. Only women who are thirty percent over their ideal weight, or have a Body Mass Index (BMI) of 30 or more, are candidates for prescription diet medications, according to the National Institutes of Health (NIH). And, the side effects, like cramping, gas and diarrhea or headaches, insomnia, raised blood pressure or irregular heartbeat, often aren’t worth the loss of pounds.
Even the most effective diet pills are only meant to be taken for short periods, usually six months or less. Prescribed weight-loss drugs can trim 5 to 22 pounds, or up to ten percent of body weight. But after six months, the body develops a tolerance to the drugs and weight loss hits a plateau. Without healthy eating and exercise, weight comes right back.
Herbal diet pills, though their label says “all natural,” can have potentially dangerous side effects depending on the ingredients. “Herbal” doesn’t necessarily mean “safe.” Also, since herbal products are regulated differently by the FDA, there’s no guarantee they can live up to their claims.
In the mid-’90s, a common diet pill ingredient was a powerful amphetamine-like stimulant called ephedra. Combined with caffeine, it triggered significant weight loss. But because it also increased the heart rate, ephedra dramatically increased the risk of heart attack and stroke. In 2003, the FDA banned the sale of all ephedra-containing drugs.
“Natural” dietary supplements often contain synephrine, an ephedra-like compound derived from certain citrus fruits. Citrus aurantium, also known as bitter orange, is now one of the most widely used dietary supplements. Citrus aurantium contains synephrine that, like ephedra, stimulates the central nervous system and may boost metabolism but it may cause health problems similar to those of ephedra and the long-term effects are unknown
Of the numerous weight-loss pills available at drugstores, supermarkets, health food store and especially online, most haven’t been proved safe and effective, and some are downright dangerous.
Chromium, supposed to reduce body fat and build muscle, seems relatively safe, but is unlikely to cause weight loss and the long-term effects are unstudied. Green tea extract promoters claim it increases calorie and fat metabolism and decreases appetite but there’s limited evidence supporting the claims. Plus, it can cause vomiting, bloating, indigestion and diarrhea. Country mallow (heartleaf) is said to decrease appetite and increase calories burned, but it contains ephedra, which is dangerous. Conjugated linoleic acid (CLA) is touted for reducing body fat, decreasing appetite and building muscle. Although it might decrease body fat and increase muscle, it isn’t likely to reduce total body weight and can cause diarrhea, indigestion and other gastrointestinal problems. Chitosan, supposed to block absorption of dietary fat, is relatively safe, but also unlikely to cause weight loss and can cause constipation, bloating and other gastrointestinal complaints
It’s hard for a woman to know what she’s getting, or even if the list of ingredients matches what’s in the bottle. Many weight-loss pills contain multiple ingredients. Some have more than twenty herbs, botanicals, vitamins, minerals or add-ons, like caffeine or laxatives. How these ingredients interact individually and collectively with each individual woman is just unknown and using them can be a risky venture, especially if a woman is taking any other medications,including hormone replacement therapy or birth control pills.
The Way to Weight Loss
Science and celebrity secrets haven’t changed the basic formula for losing weight. To lose about a pound a week, a woman must consume fewer calories that she burns, at least 500 calories less than usual, every day.
In their June 2007 review of the latest diet methods and literature, Consumer Reports rated the latest diet plans, books and dieting claims. Their top-rated diet was “The Volumetrics Eating Plan” by Barbara Rolls,Ph.D., a professor in the department of nutritional sciences at The Pennsylvania State University. Weight Watchers came in second, with Jenny Craig a very close third. However, even the highest-rated diets generally produced less than a 10 percent weight loss after a year and had dropout rates of more than one in five participants.
Eating healthfully, but sparingly, seems to be the most effective diet. Through a growing body of research, nutritionists are recommending a diet with plenty of fruits and vegetables, some lean meat and fish, healthy fats, and whole grains, and a minimum of refined grains, potatoes and extra sweeteners.
Although some diets focused on ‘power foods’. According to Consumer Reports, although junk food doesn’t help a diet, there’s no evidence that the presence or absence of any individual food will make or break a diet of the right calorie level. It is not one food, but the dietary pattern that is key to weight loss.
According to CR, there is solid science behind diets based on avoiding foods that cause a rapid rise in blood sugar, “high glycemic-index” foods. If blood sugar shoots up abruptly, the body responds by pouring out insulin to handle it, making blood sugar drop, and creating hunger cravings. But since people eat mixed foods, rather than single foods, predicting the blood sugar response is difficult. Also, research studies have reached conflicting conclusions about whether cutting the glycemic load of a weight-loss diet actually improves results. It may be more practical simply to remember that lean proteins, healthy fats, and high fiber fruits, vegetables, and grains slow down glucose absorption. A small serving of white bread, white rice, or potatoes, surrounded with with those slowly absorbed foods may help dieters feel full without consuming too many.
While may dieters try to save save calories by skipping breakfast, eating a substantial morning meal was recommended by every diet book that Consumer Reports analyzed. And, it’s hard to argue with success - seventy-eight percent of the successful losers at the National Weight Control Registry said they eat breakfast, typically some cereal and fruit. The 5000 members of the Registry can document they have lost more than 30 pounds and kept it off for at least a year.
Low-calorie-density diets seemed to be most effective in helping dieters shed pounds and control hunger. Low-calorie-density foods have high water and low fat content. They include fruits and vegetables, soups, lean meat, and low-fat dairy products.
The low-calorie-density diet allows for satisfying portions of food, which decreases feelings of hunger and deprivation while reducing calories. Starting meals with a low-calorie soup or salad and eating main dishes full of vegetables and fruits are the main tactics. Government food consumption have shown that people who eat a low-energy- density diet consume hundreds fewer calories per day than those with a high density diet, yet eat a greater amount of food. Research on volunteers at Penn State found that consuming a low-density diet helped people lose weight and kept them thinner.
“Volumetrics,” is based on that research.
The Big Picture
Lifestyle is an important part of weigh loss, and equally important in keeping the weight off. Researches have found that those who report greater daily “screen time”, either in television viewing or computer use outside of work, were more likely to regain weight than those who limited their screen time.
Individuals who put in four hours or more daily at a compute, not counting the work hours at the computer, or watching TV were twice as likely to regain weight as those who put in just up to one hour a day. Whether the pitfall is from displacing exercise time with television time or the seductive habit of snacking while watching.
Summer reruns may be a dieters best friend. TV watching is a behavior associated with weight gain.
Copyright © 2007 A Woman's View. All rights reserved.
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