Category Archives: Weight Loss

Gastric Bypass Surgery May Increase Risk of Suicide

according to an article at MedPageToday.

Steve Parker MD, bariatric surgery

Band Gastric Bypass Surgery

Self-harm emergencies rose by 50% after gastric bypass surgery in the Canadians in this study.

Folks on my diets lose weight without an increase in suicide risk, as far as I know. Click on my name for the diets.

Steve Parker, M.D.

PS: If you’re thinking about killing yourself, please please please call the National Suicide Prevention Lifeline or some other reliable source for help!

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Overweight Women Lose More Weight If Main Meal Is Lunch Rather Than Dinner

Conquer Diabetes and Prediabetes, Steve Parker MD

It may not matter whether you eat this particular low-carb meal at lunch or dinner

They say that to lose excess weight, you should eat breakfast like a king, lunch like a prince, and dinner like a pauper.

A recent study tested whether weight loss in dieting women was more effective by making lunch rather than dinner (evening meal) the main meal of the day. Over the course of 12 weeks, dieters making lunch their main meal lost 4 lb (2 kg) more than the other group. Furthermore, the lunch eaters had better improvement in their insulin resistance (as measured by HOMA-IR)

From the abstract:

“Background: The association between the time of nutrient intake and health has been described in a few studies. To our knowledge, no study has evaluated the relation between high energy intakes at lunch compared with at dinner on weight loss in overweight and obese subjects.

Objective: We compared the effect of high energy intake at lunch with that at dinner on weight loss and cardiometabolic risk factors in women during a weight-loss program.Design: Overweight and obese women [n = 80; body mass index (BMI; in kg/m2): 27–35; age: 18–45 y] were asked to eat either a main meal at lunch (LM) or a main meal at dinner (DM) for 12 wk while in a weight-loss program.

Conclusions: The consumption of higher energy intake at lunch compared with at dinner may result in favorable changes in weight loss in overweight and obese women after a weight-loss program of 12 wk. The consumption may also offer clinical benefits to improve insulin resistance.”

Source: Beneficial effect of high energy intake at lunch rather than dinner on weight loss in healthy obese women in a weight-loss program: a randomized clinical trial

I don’t have the full text of the research report, so I don’t know what kind of diet the women were on. The researchers seem to be based in both Iran and Great Britain. I don’t know the nationality of the women participating. The metabolism of Iranians may be different from Brits.

Steve Parker, M.D.

 

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What’s the Average Weight Gain Around the Upcoming Holidays?

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MNT has the details:

“Around the world, weight gained from holiday feasting takes months to lose, a study found.

Christmas Day in particular is a holiday that appears to pack on the pounds: in a study of some 3,000 individuals in three countries, Americans showed an average 0.4% weight gain from 10 days before Christmas to 10 days after; Germans gained 0.6% more weight; and the Japanese 0.5%.

U.S. participants packed on 0.7% more weight in total during the full Christmas-New Year holiday season, but the Germans had us beat with a 1.0% weight gain, according to Brian Wansink, PhD, of Cornell University in Ithaca, N.Y. and colleagues.”

Source: Holiday Feasts Take Months-Long Weight Toll | Medpage Today

Those percentages aren’t very helpful, are they? In real life, if you weigh 180 lb (81.8 kg) and gain an extra 0.7%, you’re all the way up to a whopping 181.26 lb (82.4 kg). But if you do that—1.26 lb—every year for 20 years and fail to lose the weight, you’re up to 205 lb (93.2 kg) and now you’ve got diabetes and high blood pressure.

Here are a few tips to avoid the weight gain:

  • On the day of the major feast, just eat two meals, and make one of them small
  • Don’t  snack or graze; just eat at mealtimes
  • Work in some extra exercise
  • Minimize the alcohol that weakens your discipline

Steve Parker, M.D.

Pro Tip: Read one of my books before you make your annual New Year’s weight-loss resolutions.

PPS: Click for the research report in NEJM.

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Save $26,000 on Weight-Loss Surgery and Do This Instead

Dr. Sarah Hallberg makes a hell of a lot of sense in her New York Times article:

“Recently, 45 international medical and scientific societies, including the American Diabetes Association, called for bariatric surgery to become a standard option for diabetes treatment. The procedure, until now seen as a last resort, involves stapling, binding or removing part of the stomach to help people shed weight. It costs $11,500 to $26,000, which many insurance plans won’t pay and which doesn’t include the costs of office visits for maintenance or postoperative complications. And up to 17 percent of patients will have complications, which can include nutrient deficiencies, infections and intestinal blockages.

It is nonsensical that we’re expected to prescribe these techniques to our patients while the medical guidelines don’t include another better, safer and far cheaper method: a diet low in carbohydrates.”

Source: Before You Spend $26,000 on Weight-Loss Surgery, Do This – The New York Times

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Was William Banting’s Diet LCHF? (Low-Carb, High-Fat)

"Those numbers are so small!"

“Those numbers are so small!”

I’ve been reading about Banting’s diet for at least six years. Thanks to Tim Noakes in South Africa, it’s seeing a mini-surge in popularity. William Banting published his Letter on Corpulence in 1863. Eating like him to lose weight is sometimes referred to as “Banting.” It’s one form of a low-carb diet and considered a precursor to the Atkins diet.

Form your own opinion of what William Banting may have eaten by reading these:

In terms of macronutrient calories, here’s my rough back-of-the-envelope synthesis of Banting’s diet:

  • 20–25% carbohydrate
  • 25% protein
  • 20–25% fat
  • 25% alcohol
  • 1800–2000 total calories

For the 200 lb (91 kg) man that Banting was, 2000 calories would almost certainly have been a calorie-restricted diet. Leigh estimated he was eating at least 2800 cals/day at baseline before losing weight. I don’t doubt that.

In summary, Banting drank a lot of alcohol (even more than on the Ketogenic Mediterranean Diet), and ate fairly low-fat, moderately carb-restricted, and relatively high protein. In other words: low cal, low carb, low fat, high protein, high alcohol.

His weight loss, assuming it wasn’t a hoax, came from calorie restriction. Something about that combination of macronutrients apparently allowed him to stick with the program and maintain a 50-lb (23 kg) weight loss. Protein is particularly satiating. Your mileage may vary.

I’m concerned that 25% of calories from alcohol would displace more healthful micronutrients.

Steve Parker, M.D.

PS: Fun Fact: William Banting was a distant relative of Frederick Banting, the co-discoverer of insulin in 1921.

PPS: My diets are healthier than Banting’s, thanks to 150 years of nutrition science since then.

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How to Overcome a Weight-Loss Stall

 

Strength Training Helps Get Excess Blood Sugar Out of Circulation, But Exercise Is Often Disappointing As A Weight-Loss Method

Strength training helps get excess blood sugar out of circulation, but exercise is often disappointing as a weight-loss method

It’s common on any weight-loss program to be cruising along losing weight as promised, then suddenly the weight loss stops although you’re still far from goal weight. This is the mysterious and infamous stall.

Once you know the cause for the stall, the way to break it becomes obvious. The most common reasons are:

  • you’re not really following the full program any more; you’ve drifted off the path, often unconsciously
  • instead of eating just until you’re full or satisfied, you’re stuffing yourself
  • you need to start or intensify an exercise program
  • you’ve developed an interfering medical problem such as adrenal insufficiency (rare) or an underactive thyroid; see your doctor
  • you’re taking interfering medication such as a steroid; see your doctor
  • your strength training program is building new muscle that masks ongoing loss of fat (not a problem!).

If you still can’t figure out what’s causing your stall, do a nutritional analysis of one weeks’ worth of eating, with a focus on daily digestible carb (net carbs) and calorie totals. You can do this analysis online at places like FitDay or Calorie Count.

What you do with your data depends on whether you’re losing weight through portion control (usually reflecting calorie restriction) or carb counting. Most people lose weight with one of these two methods.

Are you eating too many of these?

Are you eating too many of these?

If you’re a carb counter, you may find you’ve been sabotaged by “carb creep”: excessive dietary carbs have insidiously invaded you. You need to cut back. Even if you’re eating very-low-carb, it’s still possible to have excess body fat, even gain new fat, if you eat too many calories from protein and fat. It’s not easy, but it’s possible.

Those who have followed a calorie-restriction weight loss model for awhile may have become lax in their record-keeping. The stall is a result of simply eating too much. Call it “portion creep.” You need to re-commit to observing portion sizes.

A final possible cause for a weight loss stall is that you just don’t need as many calories as you once did. Think about this. Someone who weighs 300 lb (136 kg) is eating perhaps 3300 calories a day just to maintain a steady weight. He goes on a calorie-restricted diet (2800/day) and loses a pound (0.4 kg) a week. Eventually he’s down to 210 lb (95.5 kg) but stalled, aiming for 180 lb (82 kg). The 210-lb body (95.5 kg) doesn’t need 3300 calories a day to keep it alive and steady-state; it only needs 2800 and that’s what it’s getting. To restart the weight loss process, he has to reduce calories further, say down to 2300/day. This is not the “slowed down metabolism” we see with starvation or very-low-calorie diets. It’s simply the result of getting rid of 90 pounds of fat (41 kg) that he no longer needs to feed

Steve Parker, M.D.

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Filed under Overweight and Obesity, Weight Loss

19 Weight-Loss Tips

My son Paul made this GIF

My son Paul made this GIF

These don’t work for everybody, but they work for a lot. Take what works for you and discard the rest. You won’t know until you try.

1.  Record-keeping is often the key to success.

2.  Accountability is another key to success. Consider documenting your program and progress on a free website such as FitDay, SparkPeople, 3FatChicks, Calorie Count (http://caloriecount.about.com), or others. Consider blogging about your weight-loss adventure on a free platform such as WordPress or Blogger. Such a public commitment may be just what you need to keep you motivated.

3.  Do you have a friend or spouse who wants to lose weight? Start the same program at the same time and support each other. That’s built-in accountability.

4.  If you tend to over-eat, floss and brush your teeth after you’re full. You’ll be less likely to go back for more anytime soon.

5.  Eat at least two or three meals daily. Skipping meals may lead to uncontrollable overeating later on. On the other hand, ignore the diet gurus who say you must eat every two or three hours. That’s codswallop.

6.  Eat meals at a leisurely pace, chewing and enjoying each bite thoroughly before swallowing.

7.  Plan to give yourself a specific reward for every 10 pounds (4.5 kg) of weight lost. You know what you like. Consider a weekend get-away, a trip to the beauty salon, jewelry, an evening at the theater, a professional massage, home entertainment equip-ment, new clothes, etc.

8.  Carefully consider when would be a good time to start your new lifestyle. It should be a period of low or usual stress. Bad times would be Thanksgiving day, Christmas/New Years’ holiday, the first day of a Caribbean cruise, and during a divorce.

Credit: Zvonimir Atletic / Shutterstock.com

Christmas holiday isn’t the best time to start a diet. New Years’ Day is better. 

9.  If you know you’ve eaten enough at a meal to satisfy your nutritional requirements yet you still feel hungry, drink a large glass of water and wait a while.

10.  Limit television to a maximum of a few hours a day.

11.  Maintain a consistent eating pattern throughout the week and year.

12.  Eat breakfast routinely.

13.  Control emotional eating.

14.  Weigh frequently: daily during active weight-loss efforts and during the first two months of your maintenance-of-weight-loss phase. After that, cut back to weekly weights if you want. Daily weights will remind you how hard you worked to achieve your goal.

15.  Be aware that you might regain five or 10 pounds (2-4 kg) of fat now and then. You probably will. Don’t freak out. It’s human nature. You’re not a failure; you’re human. But draw the line and get back on the old weight-loss program for one or two months. Analyze and learn from the episode. Why did it happen? Slipping back into your old ways? Slacking off on exercise? Too many special occasion feasts or cheat days? Allowing junk food back into the house?

16.  Learn which food item is your nemesis—the food that consistently torpedoes your resolve to eat right. For example, mine is anything sweet. Remember an old ad campaign for a potato chip: “Betcha can’t eat just one!”? Well, I can’t eat just one cookie. So I don’t get started. I might eat one if it’s the last one available. Or I satisfy my sweet craving with a diet soda, small piece of dark chocolate, or sugar-free gelatin. Just as a recovering alcoholic can’t drink any alcohol, perhaps you should totally abstain from…? You know your own personal gastronomic Achilles heel. Or heels. Experiment with various strategies for vanquishing your nemesis.

My nemesis

My nemesis

17.  If you’re not losing excess weight as expected (about a pound or half a kilogram per week), you may benefit from eating just two meals a day. This will often turn on your cellular weight-loss machinery even when total calorie consumption doesn’t seem much less than usual. The two meals to eat would be breakfast and a mid-afternoon meal (call it what you wish). The key is to not eat within six hours of bedtime. Of course, this trick could cause dangerous hypoglycemia if you’re taking drugs with potential to cause low blood sugars, like insulin and sulfonylureas. Talk to your dietitian or physician before instituting a semi-radical diet change like this.

18.  One of the bloggers I followed when I had time is James Fell. He says, “If you want to lose weight you need to cook. Period.” James blogs at http://www.sixpackabs.com, with a focus on exercise and fitness.

19.  Regular exercise is much more important for prevention of weight regain rather than for actually losing weight.

 

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Filed under Overweight and Obesity, Weight Loss