Weight loss diets

Weight-loss and major lifestyle changes may be more effective than intensive insulin therapy for overweight patients with poorly controlled, insulin-resistant type 2 diabetes, according to a diabetes researcher at UT Southwestern Medical Center.The National Heart, Lung, and Blood Institute of the National Institutes of Health recently halted part of an ongoing clinical trial on diabetes and heart disease after more than 250 people died while receiving intense treatment to drive their blood glucose levels below current clinical guidelines.

The evidence is compelling that when insulin levels are high, certain tissues are overloaded with fatty molecules, which leads to insulin resistance. And yet, the high blood glucose levels of many obese patients with insulin-resistant type 2 diabetes are being treated with increasing amounts of insulin in an attempt to overpower that resistance. While high doses of insulin may lower glucose levels, it will also increase the fatty molecules and may cause organ damage.

In a commentary in the March 12 issue of The Journal of the American Medical Association,  professor of internal medicine, wrote about the recent findings of his own and other labs that link insulin resistance to excess accumulation of fatty molecules in liver and muscle.

Dr. Unger, who has investigated diabetes, obesity and insulin resistance for more than 50 years said intensive insulin therapy is contraindicated for obese patients with insulin-resistant type 2 diabetes because it increases the fatty acids that cause diabetes. Instead, the most rational therapy eliminates excess calories, thereby reducing the amount of insulin in the blood and the synthesis of the fatty acids stimulated by the high insulin. Giving more insulin simply increases body fat.

Giving more insulin simply channels the glucose into fat production. There is now a spectrum of therapies that improve diabetes by correcting the insulin resistance by reducing the body fat. Insulin treatment would be indicated only if all these fail.

Dr. Unger said insulin should be given to patients with insulin deficiency, but not if the insulin levels are already very high but ineffective. “Giving more insulin to an insulin-resistant patient is akin to raising the blood pressure of a patient with high blood pressure to overcome resistance to blood flow. Instead, you would try to reduce the resistance,” he said.

In the commentary, Dr. Unger said the increase in the number of patients with insulin-resistant type 2 diabetes can be traced to the epidemic of obesity that began in the U.S. after World War II, when food preparation was moved from the family kitchen to factories and companies that produce high-fat, calorie-dense foods, leading both men and women to consume substantially more calories on a daily basis. In addition, technological advancements such as televisions, computers and automobiles reduced the number of calories burned per day.

Type 2 diabetes occurs when the body is unable to make enough of the hormone insulin to compensate for insulin resistance.

Factors that increase the risk of type 2 diabetes include obesity, age and lack of exercise. Over a period of years, high blood sugar damages nerves and blood vessels, leading to complications such as heart disease, stroke, blindness and kidney disease.

Pop singer Janet Jackson, whose fluctuating weight has fascinated the tabloids for years, is co-writing a book about her journey as an “emotional eater.”
A title and publication details are expected to be announced soon, but Jackson hopes to have the book out by the end of the year.

She is collaborating on the project with her nutritionist, David Allen.

“It’s not just this sterile, weight loss and how to do it book, but my journey even from when I was a kid … being an emotional eater,” said Jackson, who is 41.

“It takes you through those moments in my life up ’til now and what worked for me. And hopefully within that, if it doesn’t work for them, maybe they’ll find something that does work for them and a nice place for them to be content with who they are.”

Jackson, who said last month on CNN’s “Larry King Live” that she liked French fries, sweets, caramel and candy apples, reportedly put on 60 pounds in 2006.

Maybe you remember this television commercial for the diet pill, alli. A blonde woman sits in front of her computer. Viewers can see her conversation about alli, a Food and Drug Administration approved, over-the-counter weight loss product, in an instant message window. Different people answer her questions and inform her of their satisfaction with the product. Her final comment, “but I still don’t understand how it works,” may explain many people’s feelings on dietary products.

How do diet pills work? Do they work? And are they safe?

Do they work?
According to the FDA, approved prescription dietary products may help obese people lose weight. Most approved prescription drugs work as appetite suppressants, except for Xenical (orlistat). Xenical, approved by the FDA in 1999, is the first in a line of drugs set to prevent obesity by decreasing fat absorption. To receive a prescription, a patient must fall into a certain category of body mass index, or must be under special circumstances such as diabetes and high blood pressure.

John VanDeVoort, director of pharmacy at Sacred Heart Hospital, 900 W. Clairemont Ave., said Xenical contains the same chemical ingredient found in the over-the-counter product, alli. The only difference is the dosage, as Xenical tablets have 120 milligrams. Alli tablets are half strength, with 60 milligrams. VanDeVoort said he believes that diet pills can be beneficiary.

“An individual will need to ultimately change his or her diet and activity levels to sustain weight loss,” he said. “Clinical studies show that patients lose weight faster when they take Xenical or alli, following a low fat diet versus dietary changes alone.”

Side effects
The two common diet pills VanDeVoort mentioned, Xenical and alli, can cause bloating, gas, stomach discomfort and diarrhea, he said. However, these symptoms depend upon diet. The more fat taken in, the greater the side effects. A low-fat diet, which is consistent with losing weight, would result in less of the side effects, VanDeVoort said.

“(It) depends on how much fat is taken in,” he said.

VanDeVoort also said the pills are generally considered to be safe.

“(They’re) the only diet aid that’s prescribed or recommended.”

Problems
Some issues in the past include amphetamines, which could be prescribed, or found over the counter, VanDeVoort said. In the late 1960s and 70s, amphetamines were used as diet pills, but were highly addictive.

A popular drug on the market that fell into this category was fen-phen. This product was shown to cause heart problems, such as heart attacks, and actually faced class action lawsuits, he said.

Other diet products from the past include stimulants such as Ephedra and caffeine, but were also pulled off the market because of concerns, VanDeVoort said.

Other problems concern unapproved diet pills. According to the FDA, it does not approve many diet supplements on the market. The producers of these products claim their products are herbal remedies, or are natural, but are untested. The FDA advises that before using diet supplements, patients visit their doctors, because some ingredients could cause health problems.

Alternative choices
It isn’t uncommon to see diet pill commercials for products which promise weightloss. Freshman Kirsten Kuehni said she believes these advertisements are common today, because they are money makers.

“I think a lot of companies jump on the bandwagon because people use them,” she said.

The reason diet pills are so popular, is because the process seems simple, said Susan Miller, clinical dietitian at Sacred Heart Hospital.

“It sounds easier to take a pill,” she said, in regard to conventional weightloss methods. Miller added people believe that if they take a diet pill, their weight will melt away overnight. But that isn’t the case.

“The biggest thing is that losing weight is what people want,” she said, “it will take work on our part.”

Kuehni said she has never used diet pills and does not know anyone who does. In previous health courses, she said she learned diet pills do not actually work. She said she agrees with Miller about why so many people use them in order to lose weight.

“I think a majority of people are too lazy to do work,” she said, adding a magic pill in a bottle would do the work instead.

One current diet pill Miller mentioned, alli, interferes with fat absorption and should be combined with a low-fat diet. However, Miller does not believe it makes a difference. People should follow a low fat diet anyway, she said. Miller also said she does not believe that pills, whether approved by the FDA or not, are good.

“Even FDA (approved) pills have been taken off the market,” she said.

Miller said she prefers different methods for weightloss than diet pills or herbal supplements, because some of them have had adverse effects, such as causing blood pressure to rise.

Miller said in order to lose weight, people should get physical activity, such as walking, although, “the best way to lose weight is eating less.”

Green tea or green tea supplements are being added to many weight loss programs because of the potential benefits, affordability and effectiveness of the tea.

This tea has had numerous studies associated with it for different health benefits but we’ll focus on just weight loss. Green tea stimulates the body’s thermogenesis process which means more energy is created by oxidizing fat in the body and the metabolic rate is raised above normal which helps you burn this energy.

Many compounds found in plants will increase the thermogenesis process but green tea does it without increasing the heart rate unlike some of the others.

Keeping the heart rate at the same level is very important for many people but especially for those that are obese, have hypertension or have other cardiovascular health issues. Since your heart rate isn’t artificially elevated, you may be able to safely increase your activity levels at a faster pace

The only way you are going to lose weight is if you burn more calories than you consume. This usually means:

• You must eat less and exercise more which isn’t always easy.
• Change what foods you eat and how often can also help.

• Adding green tea or green tea supplements to either of the above will speed up the weight loss process.

Studies have shown that green tea works by increasing the energy output by as much as 4 percent. Most scientists believe that this is caused by the high quantity of catechin that is in the tea and its extract.

Green tea does contain caffeine so you should either eliminate or reduce your intake of other beverages that contain caffeine (i.e. coffee, soda and other forms of tea) while you are taking it. Do not try to substitute the decaffeinated tea for use in your weight loss program because the chemical processes that are used to remove the caffeine may destroy the beneficial properties of the plant.

This tea or the supplement can be a very powerful part of your weight loss program as long as you stick to a sensible diet and exercise program that has you burning more calories than you consume. The power of this aide is its unique ability to help you increase your metabolic rate and burn some of the energy that’s currently being stored in fat cells.

Green tea is a simple, easy and affordable weight loss aid that can easily be added to any weight loss program that may last for a lifetime.