Posted by on February 14, 2014 - 2:04pm

With the recent controversy surrounding Rachel Frederickson’s extreme weight loss on The Biggest Loser, it’s time to shed light on the proper (and safe) way to lose weight. For those unfamiliar with reality television, The Biggest Loser centers around overweight contestants attempting to lose weight to win a cash prize. The winner, whoever loses the highest percentage of weight, is given the title “the Biggest Loser,” along with a cool cash prize of a quarter million dollars. This past season’s winner, Rachel Frederickson, has stirred up much press when she dropped 60% of her bodyweight, going from an original weight of 260 lbs. down to a meager 105 in roughly 7 months—a new record for the show.

Rachel reportedly exercised for at least six hours a day and ate a diet of only 1,600 calories per day. Despite her claims that this workout/diet routine mimicked that of an athlete—did she go too far? Perhaps. This extreme decrease in weight certainly points to unhealthy habits. Each body is unique and it’s important to be aware of what you can and cannot handle when trying to lose some pounds. WebMD advises aiming to lose 1-2 pounds per week—if you’re looking to shed weight—anything extremely more can be too much, too fast. Fad diets are inadvisable, as they can often be unhealthy and don’t usually last. Burning 500 more calories than you eat every day for a week should be sufficient to help you lose 1-2 pounds safely. Doing slightly more to lose weight, such as eating 1,200 calories a day and exercising for one hour each day could help you lose 3 or more pounds a week—but this can be inadvisable for many people, depending on their unique health conditions.

Eating healthily is a key component to losing weight properly. Focusing on fruits, vegetables, egg whites, soy products, poultry, fish, nonfat dairy, and 95% lean meat is a great start. Drinking plenty of water, eradicating tempting foods from your home, not skipping meals, and staying busy are all other tips to help you reach your goal. While it is unclear if Rachel Frederickson lost weight healthily, it is important to monitor the limits of your body closely. Consulting with your doctor and devising a healthy weight loss or weight management plan will help ensure you’re losing the weight in a proper and safe way.

Sources: CBS News and WebMD

Posted by on September 3, 2013 - 1:30pm

A recent study published by researchers at Duke University highlighted the fact that some populations of women are more receptive to weight-management interventions than programs advertising weight loss. Weight loss is difficult across all populations and many programs aimed at reducing the pounds may end up providing only a temporary reprieve.  As weight gain and obesity are ever-increasing concerns, some researchers have tried to tackle this problem from another angle.  Instead of designing weight loss programs, health enthusiasts should focus on weight management initiatives for certain populations.

Duke University researcher Gary Bennett, PhD, who headed this study, found that African-American women responded more favorably to a weight control program than the traditional weight loss regime. On average, premenopausal African-American women have more weight gain per year than women of other racial and ethnic groups.  Furthermore, by the time African-American women are 59, twice as many “have class 2 obesity as do white women and three times have the prevalence of class 3 obesity.”  Current obesity treatments are not as effective for this population of women, and their underrepresentation in clinical trials studying weight loss interventions points to a dire need for understanding and implementing positive approaches to fight obesity. Re-angling the strategy towards prevention of weight gain requires a less-intensive intervention strategy, which many women are more responsive to.

The clinical trial involved overweight and class 1 obese women between the ages of 25 to 44.  The women were randomly placed in either a health clinic’s usual care cohort or the experimental “Shape Program.” The intervention program had five primary components: tailored behavior modification goals, weekly self-monitoring by interactive voice response, 12 monthly counseling calls by a registered dietitian, tailored skills training, and a 12-month YMCA membership. After the 18 month trial, patients in the “Shape Program” had a “mean weight loss of more than 2 pounds versus continued weight gain” in the control group. These positive results have inspired Duke researchers to continue unlocking the motivations behind weight management and weight loss in women. Furthermore, this research provides an opportunity for clinicians to breach the subject of weight management with their patients through a new lens.

To read more about this study, please click here.


Posted by on July 25, 2012 - 2:30pm

The FDA recently approved the first weight-loss drug, Belviq (lorcaserin hydrochloride), in 13 years.  Arena Pharmaceuticals of San Diego developed the pill to help people lose 3-4% of their body weight when coupled with exercise and a healthy diet.  The FDA approved the pill for obese people (BMI over 30) and some overweight people (BMI over 27) who suffer from high blood pressure, high cholesterol, and type 2 diabetes.

Potential weight-loss drugs face increased scrutiny tod
ay by the FDA for efficacy and safety as many recent ones (fenfluramine, for example) have been recalled due to heart-valve complications.  In March, the FDA’s advisory committee introduced mandatory tests for cardiovascular risks for all obesity drugs, which makes the current clinical trials even longer.

In 2010, Arena applied for approval of the drug. The FDA denied approval because it was deemed responsible for causing tumors in rats and because it could not definitively rule out an increase in heart-valve defects.  The pharmaceutical company conducted echocardiograms for 8,000 patients to determine heart-valve function.  This trial could not verify an increase in heart-valve defects in the users of the drug, convincing the FDA to approve it.  The company committed to perform six post-marketing studies with a long-term cardiovascular trial that will search for heart attack and stroke risks.

The drug works to suppress food cravings by mimicking the effects of serotonin in the brain.  Along with many other vital functions, the neurotransmitter serotonin plays a role in controlling appetite.  Within the brain, neurons pass messages back and forth using chemical messengers (neurotransmitters).  The messages may involve information concerning emotions, body temperature, behavior and appetite.  The specific kind of information delivered varies with which neurons become activated and where the brain becomes stimulated.  The neurotransmitter leaves the neuron and enters the synapse (the space between the two “communicating” neurons).  The neurotransmitter links with the receptor on the other neuron, which sends the message.  This can then be repeated through a process called reuptake.  Serotonin qualifies as a neurotransmitter.  The drug Belviq mimics serotonin by activating the 2C receptor, which increases the amount of serotonin to carry messages and increases the probability that the message is received.  Thus, the drug causes people to eat less and feel full.

Non-diabetic patients reported headache, dizziness, fatigue, nausea, dry mouth and constipation as side effects.  Other side effects include serotonin syndrome especially in combination with depression or headache medication that increase serotonin levels or that activate serotonin receptors.  The drug may also affect attention or memory.  In diabetics, side effects include low blood sugar, pain, cough and fatigue.

On average, a 198-pound patient taking Belviq will lose six to seven pounds in a year.  20% of patients lose at least 10% of their body weight.  Comparatively, 47% of patients without type 2 diabetes taking the drug and 23% of those taking a placebo each lost at least 5% of their total body weight.  38% of patients with type 2 diabetes taking the drug and 16% of those taking a placebo each lost at least 5% of their total body weight.  Type 2 diabetics who toke Belviq proved to be twice as likely to regulate their blood sugars compared to those who toke the placebo.

While it may help those suffering from diabetes, it may cause heart complications.  The company advises patients with congestive heart failure or pregnant patients to not take the drug.  CNN’s Dr. Melina Jampolis, a physician nutrition specialist and diet and fitness expert, calls the results modest and says, “But most experts agree that even a 5% weight loss has significant implications in terms of reducing the risk of obesity associated diseases including heart disease and diabetes.”

The drug may be risky, but risks also come with the rising obesity rate such as diabetes and heart disease.  With more than 1/3 of the adult population being obese, the drug may prove worthwhile.






Posted by on June 4, 2012 - 11:32am

Interesting research on the outcomes of "The Biggest Loser" reality TV show highlight important news for diabetics! According to Robert Huizenga, MD , the medical advisor for the show, diabetic and prediabetic contestants were off medications within a few weeks of starting the intensive exercise regimen that are part of the intervention.    The contestants who were part of the study, averaged about 5-6 hours of TV watching a day and they were exercising about 120 minutes per week BEFORE they went on the show.   The exercise regimen while on the show comprised about 4 hours of daily exercise that included intense aerobics and resistance training for 2 hours and another 2 hours of moderate aerobics.

The study consisted of 17 men and 18 women who were followed for 24 weeks; 17 participants had normal glucose tolerance, 12 had prediabetes; 6 had diabetes.  The mean weight was 315 lbs!

Within one week biomarkers for those with prediabetes/diabetes improved significantly.   A positive change in blood pressure was almost immediately noticed and everyone was off their blood pressure medications within 5 weeks!

Interestingly, by week 5, "all diagnostic criteria for prediabetes, diabetes, and hypertension were absent in each participant, despite discontinuation of all diabetes and hypertension medications," according to the study.

Huizenga and colleagues found that at 24 weeks, the percentage of body fat decreased from 48% to 30%, which Huizenga said is "somewhat more than is lost with Roux-en-Y gastric bypass surgery."    He found that the participants tended to sit less after going through the program.

At the end of the program, participants are told to exercise for 90 minutes a day for the rest of their lives. Huizenga said he is often told by those listening to him that a daily 90-minute exercise regimen is impossible because everyone has such busy lives.  He replies,  "It's about setting priorities. Time is not the issue; priorities are the issue."

Primary source: American Association of Clinical Endocrinologists
Huizenga R, et al "Rapid resolution of diabetes related risk markers and hypertension in morbidly obese individuals with an exercise-centric intense lifestyle intervention" AACE 2012; Abstract 1330.


Posted by on April 25, 2012 - 8:30am

Recently Miley Cyrus has been touting a gluten free diet as a way to lose weight.   Is this true or just another celebrity fad? Gluten is a protein present in foods including wheat, rye, oats, and barley  but may also be found in everyday products such as medicines, vitamins, and even lip balms.    There's absolutely nothing wrong with eating gluten unless you have celiac disease, or gluten sensitive enteropathy (GSE), an autoimmune disease that damages the small intestine and interferes with absorption of nutrients from food. If you are sensitive to gluten, the body produces an abnormal immune response to it, attacking the lining of small intestine where digestion takes place. This leads to the symptoms of celiac disease: • abdominal bloating and pain • chronic diarrhea • vomiting • constipation • pale, foul-smelling, or fatty stool • weight loss About 1% of the population has GSE. But there may be another 9% or so who have what is called gluten sensitivity or gluten intolerance. These people may have similar symptoms to those with GSE but do not show the same damage to the bowel as those with GSE. The only treatment for celiac disease is a lifelong, gluten-free diet.  But can it cause you to lose weight?  The answer is complicated.  Studies have shown that patients with GSE who were underweight gained  weight on a gluten-free diet. Those with GSE and obesity tended to lose weight after starting a gluten-free diet. What about people who don't have GSE? Celebrities have touted a gluten-free diet as a way to lose weight. Proponents hype it as a healthier way to eat. They claim it improves sleep, increases energy, and clears skin. Some go so far as to say it helps those with autism and rheumatoid arthritis. But Dee Sandquist, MS, RD, a spokeswoman for the Academy of Nutrition and Dietetics, who also happens to have celiac disease, says:   There is nothing magical about eliminating gluten that will improve your health or enhance weight loss unless you are intolerant to gluten.   The academy points out that "Research on individuals with celiac disease reports that long-term compliance with a gluten-free dietary pattern improves outcomes related to bone density, iron deficiency anemia, villous atrophy, gastrointestinal and neurological symptoms, pregnancy outcomes and quality of life." One problem is the fact that many people with GSE don't even know that they have the disease, and those with gluten intolerance are less likely to be diagnosed.  Researchers conclude that there is no scientific evidence supporting the alleged benefit that a gluten-free diet will promote weight loss and  that adherence to the gluten-free dietary pattern may actually result in a diet that is low in carbohydrates, fiber  and important vitamins. Many confuse a gluten-free diet with a low-carb diet (which can promote weight loss).     A gluten-free diet eliminates foods such as bread and pasta, it doesn't eliminate other high-carb foods such as rice, beans and corn.    The popularity of gluten-free diets has lead to an explosion of gluten-free food availability and a financially growing industry that  is expected to exceed $5 billion by 2015! This is great if you need to be on the diet. However, people need to be aware that these are not low-calorie foods! Some prepared foods have additional fat and sugar added and mixed into substitute flours such as white rice flour or potato starch to make them more palatable. A gluten-free diet is not a panacea for weight loss. It is, however, an important diet for those who suffer from GSE or intolerance.

Posted by on January 21, 2012 - 7:54am

Women typically find it harder to lose weight and inches than men.  This, in part, is due to the fact that  men have more lean muscle mass and a higher resting metabolic rate. Another issue that makes weigh loss challenging for females:   women store fat differently from men--more of it goes to their thighs, buttocks, and hips, where it can be harder to shed.  Finally, female hormones promote the storage of calories as fat, and fat takes up more space than muscle.

As the obesity rate keeps rising, especially among teenage girls, we need to press for more sex based research on exercise, diet, hormones and metabolism!


Posted by on November 27, 2011 - 1:12pm

The Old--remember these?

Remember those weight loss machines that consisted of a vibrating belt you put around your waist?   They were often part of a comedy routine on early TV.  Well,  they are back in the form of a whole body vibration machine.

With the new whole body vibration, you stand, sit or lie on a machine with a vibrating platform. As the machine vibrates, it transmits energy to your body, forcing your muscles to contract and relax dozens of times each second. (The old version only shook the belt)  You may feel as if you're exerting yourself when you do whole body vibration. You can find a whole body vibration machine at a local gym, or you can even buy one for home use.

The New --Whole Body Vibration Machine

Advocates say that as little as 15 minutes a day of whole body vibration three times a week can aid weight loss, burn fat, improve flexibility, enhance blood flow, build strength and decrease the stress hormone cortisol.   But comprehensive research about whole body vibration is lacking. It's not yet clear if whole body vibration provides the same range of health benefits as exercise you actively engage in, such as walking, biking or swimming. Some research does show that whole body vibration may help improve muscle strength and that it may help with weight loss when you also cut back on calories.

One of the selling points of this machine is the belief that it may increase bone mineral density and thus help prevent osteoporosis.  But a new study does not support this hypothesis.

A year of whole-body vibration (WBV) did not alter bone mineral density (BMD) or bone structure in postmenopausal women taking vitamin D and calcium supplements, Canadian researcher Angela Cheung, MD, and colleagues from the University Health Network in Toronto reported.

"Whole body vibration has been introduced in the past decade as a promising new anti-osteoporotic therapy, because significant improvements in bone formation, BMD, and cortical thickness were found in animal models," wrote the authors.   "Although commercially available WBV devices are marketed to and used by patients," they continued, "the beneficial effects of WBV on fracture risk and BMD have not been established, and recent randomized, controlled trials in postmenopausal women have shown conflicting results."

To clarify the issue, the researchers studied healthy postmenopausal women with BMD T-scores between -1.0 and -2.5 who were not prescribed bone medications. (A T-score between +1 and −1 is considered normal or healthy. A T-score between −1 and −2.5 indicates that you have low bone mass, although not low enough to be diagnosed with osteoporosis. A T-score of −2.5 or lower indicates that you have osteoporosis. The greater the negative number, the more severe the osteoporosis). Patients were randomly assigned to three groups: two groups were asked to stand on a low-magnitude WBV platform for 20 minutes daily, and the third group served as the control group.

The groups did not differ in the number of clinical fractures during the period.  None of these fractures that did occur were  related to frailty because they were caused by car, household, or sporting accidents or involved only the small bones of the foot.

"[Twelve] months of low-magnitude WBV at either 90- or 30-Hz had no effect on BMD or bone structure in healthy, community-dwelling, postmenopausal women who received calcium and vitamin D supplementation, and thus is not recommended for preventing age-related bone loss in this population," wrote the researchers.


Posted by on August 18, 2011 - 6:38am

Munching more unprocessed plant foods may help keep the middle-aged bulge away (AKA muffin top) , a new study suggests. On the other hand, meat, french fries and sugar-sweetened drinks can help pack on the pounds. The findings suggest that the types of food you choose, not just calories, are important for avoiding age-related weight gain.

Weight gain results from an imbalance between how much energy you take in and how much you expend. Even small amounts of excess weight can increase your risk for disorders such as diabetes, cardiovascular disease, metabolic syndrome and cancer.

A research team at the Harvard School of Public Health, led by Dr. Dariush Mozaffarian and Dr. Frank Hu, sought to gain insights into the changes in people’s lifestyles that lead to gradual, long-term weight gain.

The team followed the lifestyle and dietary habits of 3 large groups of health professionals, totaling over 120,000 people, for 12 to 20 years.

The researchers found several general lifestyle changes linked to weight gain over a 4-year period. Participants who increased their physical activity gained less weight than those who didn't. However, only increases in activity during the period studied produced this result; absolute levels of physical activity (across the lifespan) weren't associated with weight change. People who slept for less than 6 hours a day or more than 8 hours gained more weight. Increases in TV-watching led to an average gain of about a third of a pound for every hour of TV watching per day.

Food choices also affected weight. Potato chips, sugar-sweetened drinks, processed meats and unprocessed red meat were each linked to weight gain of about a pound or more. Eating more french fries led to an average gain of over 3 pounds. Eating more refined grains and sweets or desserts led to about half a pound of weight gain. By contrast, eating more vegetables, whole grains, fruits, nuts and yogurt was linked to reductions in weight over a 4-year period. Yogurt led the pack, with an average of 0.82 pounds of weight lost.

The researchers suggest that highly processed foods may not satisfy hunger as well as less processed, higher fiber foods, causing a higher total intake of calories. “The idea that there are no ‘good’ or ‘bad’ foods is a myth that needs to be debunked,” Hu says.

This was an observational study, in which people were asked to recall the foods they ate. While the findings are compelling, future controlled studies will be needed to confirm whether eating particular foods can affect long-term weight gain more than simply counting calories.  The study appeared in the June 23, 2011, issue of the New England Journal of Medicine.

Posted by on August 8, 2011 - 11:24am

Why are some people obese while others are lean? Obese people must make poor eating choices, but could there be a physiological basis for those poor choices? A new study reveals that obese and lean people make decisions about short-term versus long-term rewards differently and have physical differences in their brains. Surprisingly, some of these behavioral and physical differences are found only in women.

An article recently published in the journal Frontiers in Human Neuroscience tested how lean and obese people relate to rewards using a simple card game. In this game, participants had to choose between two decks of cards. One deck provided large immediate rewards but overall losses in the long-term. This deck was meant to parallel the immediate reward of eating and the long-term negative effect of overeating on body weight. The other deck gave subjects smaller immediate rewards but was more advantageous in the long run. This deck represented healthier eating choices – less fulfilling immediately but more beneficial in the long term.

The researchers found that obese women choose immediate rewards more often than lean women. In fact, as the body mass index or BMI of the subjects increased, so did the number of times that they chose from the deck that provided large immediate rewards.

Additionally, as they played this card game over time lean women altered their choices and started to choose more cards from the deck that was advantageous in the long run. In contrast, obese women did not change their decision-making over time and continued to choose just as many cards from the deck that provided large immediate rewards but overall losses as the game progressed.

Remarkably, these behavioral differences between lean and obese participants were limited to women. No difference was seen between lean and obese men.

To investigate the possible basis of the behavioral differences between subjects, the brain structure of lean and obese men and women was examined using magnetic resonance imaging or MRI. Differences in brain structure between obese and lean people have been reported previously. This study found additional differences that were only present in obese versus lean women and not men.

Both the behavior and brain structure of the obese women observed in this study suggest that obese women might make poor eating choices because they are more sensitive to rewards and are driven more by habit-like behavior rather than goal-directed behavior. It is not known, however, if the alterations in brain structure in obese individuals are themselves the cause of obesity and overeating behaviors, or if the alterations are the effect of obesity-related behaviors.

The differences in behavior and brain structure between lean and obese women uncovered in this research could be important for the development of gender-specific treatments for obesity.


Posted by on May 18, 2011 - 10:47am

Have you been losing weight and despite staying on your diet and exercising, your weight suddenly stays the same?   Don't get discouraged, it's normal for weight loss to slow down and even stop.   This phenomenon is called the "weight-loss plateau" and it's more common than you think.  Even the best planned weight loss program can become stalled.

According to the Mayo Clinic, here's why this happens.   A rapid weight loss is common during the first few weeks of a well planned diet.  When calories are reduced the body gets needed energy by releasing its stores of glycogen, a type of carbohydrate stored in the liver and muscles.   Glycogen holds a lot of water so when it is used up at the beginning of a diet, it also releases the water--about 4 grams per gram of glycogen, resulting in a sudden weight loss that is mostly water.

Once your diet progresses and  you start burning lean muscle tissue, your metabolism slows.  Metabolism is the process of converting food into energy.  When you lose weight you lose fat and lean muscle and this weigh-loss changes once your metabolism slows.   At this point,  you need to increase your exercise or decrease your food intake if you want to lose more weight.   If you continue the diet/exercise regimen you started with, you will maintain your weight but probably not continue to drop many pounds.

To get past this weight loss plateau, you need to

  • Review your eating/exercise habits and be sure you haven't "cheated" along the way
  • Cut more calories--try reducing your diet by 200 more calories
  • Increase your workout...either in time or intensity
  • Try to increase movement during the day----take stairs instead of the elevator, run your errands on foot.
  • Applaud your success and make sure your goals are reasonable--just don't fall back.