Health Features

Get ‘Thinspired’

Whoever comes up with the magic bullet for weight loss will have Americans beating down the door to pay for it. That is a given, judging from the many diets, exercise fads, supplements and meal plans popping up continually to offer hope to the flabby. See what the experts say about shedding pounds and keeping them off.

[1-the diet cycle]
We’ve all heard about them, and more than likely, we’ve even experienced them: fad diets that have us yo-yo-ing from several pounds lower than our ‘normal weight’ to several pounds (or more) higher. How can we break the cycle?

recipes for failure
“Diets are a dime a dozen. They all work in one form or another, but they are not going to be successful for you in the long run,” says Teresa Scott Syed, president and owner of OneLife Weight Loss & Wellness Solutions. “What we need to focus on is permanent life change.”

Eva Stottler, a certified integrative nutrition health coach and natural solutions educator, agrees. “Ten to 15 years ago, there were a lot of fad diets that would help you lose weight very quickly, but they weren’t very sustainable and they weren’t very healthy.” She says eating is not a one-size-fits-all activity. One person might gravitate toward protein, another toward carbs, which means the same eating pattern cannot suit both.

“Diets should be customized to the individual,” Stottler says. “A lot of people fail when they pick a diet that is too restrictive, or with food that is not enjoyable. People put a lot of emphasis on counting calories, which is not that important to me. You can have a 150-calorie candy bar or a 150-calorie apple.”

The popular Paleolithic diet is based on the basic foods that our cavemen ancestors would have eaten. “I actually think it’s pretty good because it gets you back to the basics: meat, fish, vegetables and fruits,” Stottler says. And it allows people to eat what they like within those food groups, she notes, which is a big plus. Eating is, after all, a pleasurable and social activity.

Severe restrictions are self-defeating, she adds. “If you starve yourself all day of the things you enjoy, by evening you have low blood sugar or you binge;” Stottler says. “My policy is 80-20: Eat exactly what is right for you 80 percent of the time, and 20 percent of the time, have a little fun.”

focus on fuel
Too much dieting without enough nutrition is self-defeating, too, Stottler says. “What people aren’t realizing is that they can be working out way too hard for the amount of calories and nutrients they are taking in,” she says. “We are seeing cognitive issues from the low-fat and low-calorie diets, because our brains feed off of healthy sugars and healthy fats,” she says.

healthy eating, not less eating
“Yo-yo dieting is not good for the body or for helping you meet your goals,” says Syed. “It is short-sighted to think you are just going to go on a quick diet.” For many people, change will require analysis of their relationship with food. “First, we focus on getting stress under control because stress makes you gain weight as well as lose weight,” Syed says. “Many people self-medicate with food.”

Food should be considered one part of a lifestyle, she says. “More than anything, it is about choosing to be healthy, not just getting skinny. Understanding what your triggers are can help you reframe the way you look at food, from pleasure to fuel—but you can have fun, too.”

pill-background[2–pills and supplements]
No pain, no gain—that is the conventional wisdom when it comes to weight loss. And while we all wish some new technology would come along to save us that pain, it hasn’t yet. Pills and supplements make big promises, but are they worth the side effects? will their benefits last?

field of dreams
Two types of pills fill most of the weight-loss-product bottles on pharmacy shelves, says Dr. James Shoemaker, associate professor of biochemistry and molecular biology at Saint Louis University School of Medicine. “Some are stimulants like caffeine and phentermine,” he says. “The stimulants make your heart race, make you breathe faster and make you too excited to eat. The other category is the cathartics. These are starch blockers or fat blockers in over-the-counter and prescription versions.”

Phentermine is an artificial counterpart to adrenaline, Shoemaker says. The stimulant keeps the body in an aroused state. “They do exactly the same thing as a really bad scare,” he says. “Most dieters wouldn’t want to be in a continually scared state, and the pills lose efficacy after time as your body adjusts with the production of its own stimulants.”

The cathartics work differently, preventing you from absorbing fats or starch, Shoemaker explains. “The fats and starch then get into your large intestine and become food for the bacteria there, producing acids and gas that make you feel uncomfortable and give you diarrhea. They may have some effectiveness, but you will be uncomfortable.” Additionally, cathartics can be associated with nutritional deficits, he says, specifically the fat-soluble vitamins A, D, E and K.

only for the obese
For the medically obese, the U.S. Food and Drug Administration recently has approved several medications, says Dr. Samuel Klein, director of the weight management program at Washington University School of Medicine. “This is very positive for the obesity field,” he says. “Having four new drugs approved within a relatively short period of time is unheard of.”

In medical terms, obesity begins with a body mass index of 30 or more. If you are somewhat below that threshold, you will be diagnosed just as overweight. “A BMI of 30 would be 30 or 40 percent overweight,” Klein explains. “These drugs are for people who have a body mass index of 30 and above, or people with a body mass index of 27 or above who have a complication such as diabetes or hypertension.”

The recently approved prescriptions are based on new ingredients or combinations of existing drugs, he says. Previous uses have been for treatment of binge eating disorder, seizure disorders, depression, addiction and smoking cessation. These drugs work in the brain rather than the intestine.

“The brain regulates food intake,” Klein says. “These drugs have been shown to be effective and relatively safe in helping people lose weight and keep the weight off long-term.” Reported average weight loss has been 3 percent to 12 percent annually. But here again, the drugs may come with side effects.

“All medications have side effects,” Klein says. “The side effects here are similar across many of the groups and include nausea, headache, constipation, dizziness, trouble sleeping and dry mouth. The complications may go away if you continue taking the drugs or lower the dose, and certainly if you stop taking the medication.”

These drugs are strictly for long-term weight issues, not short-term diets, he stresses. “Drug therapy for obesity means long-term, if not life-long therapy,” Klein says. “This should be treated like a chronic disease, such as high blood pressure or diabetes. You don’t stop your diabetes medication when blood sugar is normalized.”

Just as diets are debunked all the time, exercise theory has its ups and downs, too. Cardio, body mass index, metabolics, strength training—even the terminology can be confusing. But one thing everyone can agree on is that people need to get, and keep, moving for some part of the day, every day, in order to stay healthy.

aging & metabolism
“Back in the ’70s and into the early ’90s, cardio was all the craze, and that was what you were supposed to do for weight loss,” says Clint Schambach, a personal trainer with Level Up Fitness. “Our body tends to decrease in lean muscle mass as we age, and cardio doesn’t do a lot to preserve lean tissue the way resistance training does.”

Fitness experts realize that muscle mass is an important component in the fight against fat. “It is said that we lose 10 percent of our lean tissue every decade. As the lean tissue decreases, your metabolism will drop and that lean tissue is your metabolic driver,” Schambach says.

In the meantime, production of some hormones falls and slows the metabolism. “Our internal environments are constantly changing, and we are having a host of hormone changes,” says Michael Martino, lead trainer at Wellbridge Athletic Club and Spa. “Those hormones help your body maintain lean muscle and keep fat off.” Unchecked, these factors can produce a downward spiral, he says. “The less you move, the more you are going to affect those hormones and create an even greater deficit.”

resistance training rules!
The solution to stop the fat from taking over is the thing many adults have not been told to do—resistance training, as in lifting weights and pumping iron. “Older people don’t do a lot of resistance training for fear of getting hurt or from not being comfortable with weights,” Schambach says. “Also, back in the day that wasn’t what they were told to do.”

Staying active is crucial, says Martino. “Having a properly structured workout plan can improve your hormone profile and improve your metabolism,” he notes. “The general consensus is that you should be working out 30 minutes a day at a moderate intensity for five days a week, at least.”

interval training
The new paradigm of fitness is interval training—resistance training done at weight levels and pacing that builds muscle mass and delivers cardio and aerobic benefits, too. “You would want to put a majority of your focus on circuit training—you pair up multiple exercises, take very little rest between exercises—maybe 60 to 90 seconds—then repeat,” Schambach says. “You want to be taxing the muscles by lifting with a challenging weight. A rule of thumb might be a weight you can’t lift more than 15 times with good form.”

Resistance-based training sessions are worth about twice as much as cardio time on the treadmill or spinning bike. experts now think. “If you put in 75 minutes of very hard exertion over a week, you are going to get more benefit than if you work at a moderate to low intensity level for 150 minutes or more a week,” Martino says.

Exercise and rest intervals should keep the lungs slightly out of breath. “When your lungs are burning for oxygen, it helps mobilize fat into the bloodstream to better burn it off,” Schambach says.


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