With one-third of all American adults obese or overweight, it’s no surprise most of us are consumed with finding new ways to shed excess poundage. The problem, of course, is that there’s really only one way.
“It’s all about balance,” said John Pierce, a professor of family and preventive medicine at the University of California San Diego. “Calories in, energy out. Too much of the first and not enough of the second means you gain weight.”
Most Americans probably don’t want to hear it put quite so bluntly. We’d rather spend billions of dollars each year on newfangled diets; fancy gyms and exercise equipment; the latest weight-loss wonder drug. Some of which actually work, provided you know what you’re doing. Here’s some of the latest thinking on losing weight, safely and effectively:
DIET
A healthy weight begins with a healthy diet, and you know what that means: a balance of fruit, vegetables, meat and dairy products, light in sugar and fat. The generic adult diet is about 2,000 calories a day, but that’s just a guideline. Daily calorie intake should be 10 to 12 calories for each pound of ideal body weight. For example, a 150-pound man should eat 1,500 to 1,800 calories a day.
Most people try to lose weight by cutting back calories. One pound of fat equals about 3,500 calories. If you reduce your daily calorie intake by 500, that adds up to 3,500 missed calories by the end of a week and one pound lost.
But it’s rarely that simple or easy, which is why diets promising fast results with minimum fuss proliferate. Some diets actually do achieve measurable weight loss. A recent Stanford University study found that the low-carb, high-fat Atkins diet beat out the Zone, Ornish and U.S. dietary guidelines. Overweight female participants who followed the Atkins plan lost an average of 10 pounds over 12 months, compared with 5 pounds on the Ornish, 6 on U.S. guidelines and 3.5 on The Zone.
But critics of the study noted that few of the participants rigorously adhered to their assigned diets. The Atkins volunteers did best, but then it’s probably easier to follow a diet of bacon and Brie than one featuring apples and asparagus.
The biggest problem with most weight-loss diets, experts say, is that they can’t be sustained. Over the long term, they’re impractical, expensive, boring or just plain bizarre.
“With some diets, people basically starve themselves,” said Pierce. “When that begins to happen, it triggers a response in the body that makes you feel like you have to eat at any cost.”
EXERCISE
There’s no running away from it: If you want to be healthy and maintain an appropriate weight, you must exercise. “Nearly every expert says that,” said Pierce. “In fact, people need to exercise more.”
The current gold standard is 45 to 60 minutes a day of moderate to vigorous exercise. (”Moderate” is defined as enough exertion that talking becomes difficult.) People who haven’t exercised much or at all should begin slowly, under a doctor’s guidance, and build up their exercise time and intensity.
The dietary value of exercise lies in the fact that it boosts the body’s metabolism – the chemical and physical process by which the body converts food into usable energy. But all exercises don’t generate the same metabolic effect. Aerobic exercise tends to rev up the metabolism only while you’re doing it. Conversely, strength training, such as weight-lifting, can increase the resting metabolic rate for hours, even days, after the actual workout because tested muscles demand additional energy to repair and rebuild themselves.
Aside from the usual advice about medical supervision and knowing what you’re doing, some experts add a couple of provisos about working out. First, don’t exercise on an empty stomach. Your body is going to need energy, and the easiest way to get it is to break down muscle mass, not convert body fat. Second, eat soon after you exercise so that, again, your body isn’t cannibalizing itself to ill effect.
DRUGS
Every fat person dreams of a magic pill that will melt away unwanted pounds with no more effort than it takes to lift a glass of water. Or a milkshake.
That pill doesn’t exist. It probably never will. But the diet drug industry is looking hard. Worldwide, there are more than 20 weight-loss drugs in clinical trials and another 30 in the pharmaceutical pipeline.
A few diet drugs are already on the market; none is magic. All produce just modest weight loss; some have dreadful side effects; none works alone. They require other things to happen.
“Like being taken in conjunction with a healthy diet and regular physical activity,” said Jim Sallis, a psychology professor at San Diego State University and program director of the national Active Living Research project.
The history of diet drugs is pretty checkered. Amphetamines were once prescribed for weight loss but turned out to have serious risks of addiction, agitation and insomnia. In the 1970s, anti-obesity medications based on the drugs fenfluramine and phentermine appeared. These drugs help maintain high levels of serotonin, a brain chemical that regulates appetite, mood and other functions.
In the 1990s, however, it became clear that “fen-phen” drugs could also cause significant and potentially fatal side effects, from depression to heart valve abnormalities to a deadly lung disorder called pulmonary hypertension. Fen-phen drugs mostly disappeared from the U.S. market in 1997.
Currently, there are three main prescription anti-obesity drugs, though one is not approved for sale in the United States.
Rimonabant (marketed outside the U.S. under the name Acomplia) blocks brain signals that stimulate food cravings. Users say they feel full sooner, thus eating less. A 2006 report in the Journal of the American Medical Association found that 46 percent of obese patients who took Acomplia for two years lost 5 percent to 10 percent of their body weight.
The downside: Acomplia works only as long as it is taken. The same study also reported that 51 percent of the participants dropped out. And another study reported that patients on rimonabant were 2.5 times more likely to discontinue treatment due to depressive disorders.
Sibutramine (marketed as Meridia) debuted in 1997 as an alternative to fen-phen drugs. It also suppresses appetite by moderating serotonin levels and boosting the metabolism, but without the serious side effects. On the other hand, it does increase the risk of high blood pressure, constipation and insomnia, and can adversely interact with other drugs.
Xenical or Orlistat work in the intestine, blocking the absorption of fat. Last year, an over-the-counter version appeared, called Alli. Like prescription diet drugs, Alli generates modest weight loss if used correctly. But using it at all might be problematic.
Because it blocks intestinal absorption, Alli causes consumed fat to be quickly and unceremoniously excreted. Oily bowel movements are so frequent that women are advised to wear panty liners when starting the regimen.
“The way Alli really works is by making people regret eating fat,” said Cheryl Rock, a professor of family and preventive medicine in UCSD’s School of Medicine.
America is indisputably getting fatter by the day. Most alarming, note experts, is the dramatic rise in childhood obesity – up to 9 million kids, a tripling since 1980.
“These kids don’t know what it’s like not to be fat,” said Pierce. “And changing bad eating behaviors is always harder than preventing them in the first place.”
But anyone, said Rock, can lose weight.
“Fatness isn’t about being stupid or lazy. It’s about knowing what to do. And there are a lot of things people can do.”
Source: http://www.paramuspost.com/article.php/20080529230612604
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