Dude Looks Like a Lady

Wow, it’s been a whole year since my last posting. I need to get back on the horse… how about another diet review…

I've been hearing a recent diet fad lately is taking the hormone 'hCG'. In doing my research, I found, it’s actually not new, and has been around since the 1930s. hCG stands for Human Chorionic Gonadotropin. It is the hormone than women make when they are pregnant, and the one that is detected in the urine for pregnancy tests. The basic theory doesn't sound too crazy. It is based on the idea that women who are pregnant and don't eat enough for their fetus just burn fat and not muscle, so if you take it when you diet, you should burn fat more specifically. It also has claims that it decreases feelings of hunger. There are two ways to take it orally or injection. And the earth shattering surprise: in addition to the daily dosage it is recommended to have 500 cal/day diet!

Hmmm, where do we start on the issues with this one? First off, I don't know how many pregnant people you know, but appetite suppression isn't one of the things I use to describe them. In fact with my wife's last pregnancy, the moment I really knew she was pregnant was when she wanted 'Animal Style' french fries from In-N-Out several days in a row. One order every 6 months or so is usually enough for her.

Plus, there are very few hormone therapies that can survive digestion, so those of you who take it orally are basically just taking whatever products are left after it passes through your stomach, which likely don't resemble or act like hCG at that point.

Most importantly, multiple studies (some even 50 years old!) have been shown that there is no difference between those taking an injection of hCG or placebo as far as weight loss or hunger pains go. In other words... it just plain doesn't work. So why all the attention? A guy (Kevin Trudeau) wrote a book about it in 2007 entitled,The Weight Loss Cure 'They' Don't Want You to Know About. I'm not sure who 'they' are, but I'll tell you what HE (Trudeau) doesn't want you to know about... He has been investigated by the FTC (Federal Trade Commission) for promoting all kinds of fake medicines and as of 2004 has been banned by said Commission from appearing in any infomercials on TV. Source: http://articles.latimes.com/2009/nov/02/health/he-nutrition2/2

Ease of following: As easy to follow as any 500 calorie/day diet. Which should be read as = hard. In my dieting experience, the lowest I ever got was 1200 cal/day and at that point I was constantly hungry and bit anyones head off that crossed me. Throw in daily injections and I'd say its not that easy.

Medical safety: It probably won't cause any major problems, but some side effects that have been reported are: headaches, mood swings, depression, blood clots, confusion, and dizziness. Women who use this hormone can also develop Ovarian Hyperstimulation Syndrome (OHSS), which is usually mild, but ironically can result in weight gain. And if you are a guy you could start to look like this:

Or this:

I do have concerns of living with a prolonged diet of 500 calories. You are basically starving yourself, and if done for a prolonged time you could suffer similar consequences of those with anorexia nervosa. If you decide to stop the diet after a prolonged period, be very careful not to increase your intake suddenly, even to a normal level, as it may cause ‘refeeding syndrome’, which is a common cause of death among anorexics.

I generally would not recommend ever being on a diet of 500 calories for any amount of time, but some people like to do it to ‘kick start’ their diet, and if you feel so inclined, I wouldn’t do it longer than a month. Decreased calorie diets are not only recommended, but needed, but you can go too far. For the RIGHT way to do so see my previous post:

http://exwandering.blogspot.com/2009/03/dont-count-me-out.html

Check this one out, too (because diet can’t do it all):

http://exwandering.blogspot.com/2009/04/body-movin.html

Chance of keeping weight off:

Almost zero unless you add to this diet a long term diet/lifestyle change to keep your calories down (but obviously not this low)… FOREVER. If not, weight will be regained, plus more. Starvation diets such as this decrease metabolic rate, and therefore will cause you to gain MORE weight when you return to your old habits. Which most people do.

Conclusion:

A friend of mine in medical school used to sit around and make plans for a diet supplement we were planning on making that just consisted of lawn clippings in a capsule with the recommendation of: “Best results obtained when used with a combination of diet and exercise changes.” Apparently this diet beat us to the punch. It is a sham is just about every way possible.

But if you are the type of person who is sensitive to placebos and need a kick start to your diet, I guess you could do worse. But seriously, I can sell you some capsules with lawn clippings for a lot cheaper than you are probably paying for the hCG. And PLEASE do yourself a favor and make plans for what changes you are going to make in your life AFTER the diet, or you will end up heavier than when you started…

More on the hcg diet:

http://health.howstuffworks.com/health-illness/wellness/physical-fitness/weight-loss/hcg-diet4.htm

http://www.dietsinreview.com/diet_column/07/hcg-diet-look-elsewhere-for-weight-loss/

I wanted to run, but she made me walk...

Have you reached a plateau in your workout, weight loss routine? Do you just want to get 10 more pounds off? I've got a great suggestion for you... INTERVAL TRAINING.

Just a few months I was feeling stuck in my routine of running 30 minutes three times a week* (with weight training interspersed on other days). I substituted interval training for one of my 30 minute cardio workouts, and dropped 10 pounds quickly. My other runs during the week got faster, too.

The fitness guru pediatrician at my work says he tells marathon runners that they aren't really in shape unless they do anaerobic exercise. I wouldn't go that far, but it really does make a big difference.

Anaerobic exercise means it can't be sustained for extended periods of time without resting to breathe. (As opposed to aerobic exercise that theoretically can be maintained indefinitely - jogging, aerobics, etc). Here's where interval training comes in. Interval training is mixing in high intesity workouts sporadically (in intervals) with low intesity workouts. Some explanation and suggested workouts can be found here.

I personally run around a squarish park with 4 equal sides (not perfectly, but close). We'll say each side has distance of X. I sprint at about 80% of my max for 2X (two sides) and then walk one. I do this for 30 minutes and get a great workout.

If you haven't tried it, give it a try. It doesn't take any more time, just takes more calories.

*For the record, most health providers are recommending 5 cardio workouts a week (including myself). Yes, I usually only can make it to 3 a week, but I'm working on it, too!

Meat is Murder

Now on to the next of my diet reviews. I'll just clump all of these in the same bunch: Protein diet, low carb diet, Atkins diet, South Beach diet, etc.





They are basically all built around a basic concept: increase the protein and decrease the carbs. What you do with 'fat' varies from one diet to the other. Here's the secret (and the thing you can really take away from these diets when coming up with your own personal diet): protein/meat has relatively low calorie density (compared to carbs and fat) but helps you feel satisfied sooner and stay full longer. So in other words, this is another low calorie diet 'in disguise'. You'll see that ALL weight loss diets are just way to get you to eat less calories.

Ease of following: In the short term, not too difficult, especially if you are a carnivore. Due to the popularity of these diets, there are tons of recipe books and frozen dinners available. In the long term, some people have hard time staying on a diet with so many rules. Some are more strict than others on the amount of carbs you can take. The 'no carb' diets can be very difficult, because carbs actually make up a high percentage of Americans' diets and are difficult to avoid.

Medical safety: Pretty safe. There are some concerns about the extreme diets that force your body into ketoacidosis (due to no carbs) which is basically a form of starvation. WARNING: any time your body thinks its starving the metabolism slows down, and you NEED exercise to keep it up. All weight loss diets cause your metabolism to go down to some extent, but these tend to do so a little more (theoretically). Also there are some that feel so much protein can be hard on the kidneys if the diet is maintained for an extended time, but I haven't heard that this has shown to be true when studied.

Chance of keeping weight off: If you stay on the diet, it will. But if you come off of the diet, you will likely gain the weight back and more (due to decreased metabolism) if the diet was done without exercise. The best practice would be to transition to a more 'regular' diet that still keeps the calories down enought to maintain your weight.

Conclusion: It works... But long term is rarely successful.

What you should take from this diet: LEARN about calorie content in your food. Eat foods you like, but limit your portions to limit your calories (see previous posts on this). But feel free to add some additional protein in if you are finding it difficult to stay satisfied/not hungry before your next meal.

Jenny (867-5309)

I thought I'd start a series of diet reviews to evaluate the pluses and minuses of each of the popular diets available.... I'll rate each on ease of following, medical safety, and chance of keeping the weight off.

The first 'diet' I'll start with are the prepared food plans (like Jenny Craig, Nutrisystem, Weight Watchers, etc).

***the funny thing about this ad, is it says 'results not typical'. I've seen that disclaimer on the 150 pound losers, but 30 lbs? It's not typical to lose 30 lbs?

The basic plan is to eat the food they have prepared for you, and if you only eat a certain amount of it, you will lose weight. Honestly, I'm sure it's clear that this is just a low calorie diet (as I have said previously is the best) where they count the calories for you. Most of these diet plans are based on an 1800 calorie a day intake. If you learned to count calories yourself and kept to 1800 calories a day, you would lose weight for free. But, yes, that does take a lot of work at first, and these companies eliminate that work for you.

Ease of following: Pretty easy, as long as you have to money to pay for it. You do have to buy food to eat anyway, so its probably not exorbitantly more expensive than regular food. In fact, if you eat a Claim Jumper for every meal, I'm sure it is cheaper. The big problem with its 'ease' is it is a little restrictive; ie, if you wanted to Taco Bell for lunch, you can't. And if you like fresh food from your garden, that's not part of the plan either. Its mostly frozen food from the microwave.

***mmm looks delicious

Medical safety: Very safe.

Chance of keeping the weight off: Good until the money runs out, or you get bored of their food. Actually, 80% of Jenny Craig's business is repeat. In fact, if she got everyone to lose weight and keep it off, she would go out of business. She wants you to depend on her. (I shouldn't be too hard on Jenny Craig keeping people fat, so she can have business, as my grandmother thinks doctors keep people sick, so they will have business!)

Conclusion: Learn about what you are putting in your mouth! Learn how to count calories yourself and plan your own meals with your own food (and even Taco Bell's food, if you'd like). Plus you develop a life long skill and habit (if you get really good at it) that will help you be healthy FOREVER (well at least until you die).

Body Movin'

How's the calorie counting going? Now that you've got that down, we're going to talk about a different calorie count: your calories burned... Don't stress! This kind of calorie counting is waaayy easier. If you remember our equation to losing/gaining weight:

Calories eaten - calories burned = weight loss or weight gain

BMR:
We already figured out what how many calories you burn just existing here. Remember that is an average of everyone, and we have all experienced that everyone has a different metabolism. Some people can eat anything, and not gain a pound. Some people eat a potato chip and sprout a 4th chin:

You probably have a good idea of what end of the spectrum you are on and can assume the actual number may be higher or lower.

There is one definite way to lower your BMR (which you don't want to do) is diet. People who get stuck in a diet cycle of dieting over and over again without exercise, just keep driving their BMR lower and lower, thus making it harder and harder to lose weight. This is because when you are dieting, your body thinks its starving, and slows its own metabolism.

Ways to raise your BMR:

1) Nicotine

2) Crystal methamphetamines or phenphen

3) Caffeine

4) Building your muscles

I have to say I do not recommend 1-3, but many people already are using method #3. And no, the caffeine from a soda doesn't increase your metabolism enough to burn the calories you drink with it (not even close). Even though traditionally weight lifting has gotten a bad rap when trying to lose weight, adding some to your exercise regimen can help. For every pound of muscle you gain, your BMR can increase in the range of 10-50 extra calories per day.

Exercise:

Any exercise you do is extra calories on top of your BMR to put in the 'burnt' column. This is even easier to figure out than food, because most of us only participate in a few different exercises (the more variety the better, but lets be real). Here is the calculator for a bunch of exercises based on your weight. If the one you like isn't there, you can probably find it somewhere online. Plus, after you exercise, your body's BMR can stay elevated for several hours afterward.

How much exercise? The recommendation used to be 3 days a week of 25-30 minutes of cardiovascular exercise, but now many are recommending 5 days a week. That can be tough, so shoot for 3 days a week at first and expand as you can. Try to mix in a couple days of strength/weight training a week, too.

I personally like the days I exercise because I tell myself I don't have to be as strict watching my calories eaten on those days.

Everything Counts

Here's another post for you big kids (I didn't mean big as in BIG, I mean big, like grown up - gosh you're so sensitive) who are trying to lose weight:

You've heard a million times that the key to successful weight loss is including both diet and exercise changes. Sounds simple enough, right? Well the answer actually is pretty simple in an equation that I gave you in my last weight loss post:

Calories eaten - calories burned = weight loss or weight gain

Yeah, okay, I'll admit it, it may be a simple idea, but not simple in practice. When you are bombarded with all this diet information in the media: good carbs/bad carbs, high protein, fat free, etc, etc. I'm here to tell you it is actually pretty simple once you've had a little practice. It involves the scary step of calorie counting, but it gets easy after a while.

How many calories am I eating?
The first step to counting calories is transforming what is on your plate to a number on a piece of paper (or in your iPhone apps). Duh - look at the back of the Doritos bag. Yeah, I know not everything you eat comes out of the Doritos bag. Some of it comes from McDonalds, some from Papa Johns, and some from Taco Bell. Oh wait, those are all the places I eat. Here is a tool that is abosultely necessary to learn calorie counting (it makes it sooooo easy):


I actually have the program on my palm and I'm sure there are iPhone apps as well. In today's world, we eat out so much that its nice to have all those restaurants' calorie information in a easy to find source (it cost like $6 and is at pretty much every bookstore). You could check all the restaurants websites (this does work) but it is a lot of work. Do yourself a favor and buy this book. (Disclaimer: I am not recieving any financial benefit from Calorie King for endorsing this product.) If it doesn't have the exact item you are looking for, you can always find a similar one, it doesn't have to be an exact science.


All calories are created equal!

Despite much of what the media inundates us with, the scientific reasarch does not show any difference between one calorie of chocolate and one calorie of steak and one calorie of papaya. No matter how well written the book is and how smart the author sounds (cue pictorial example):

All calories are created equal! I'm not going to say this is an irrevocable truth of all eternity, we may uncover subtle differences in the years to come, but as far as the equation above goes, it doesn't matter. Just ask this young woman with the obviously great personality:

Let's not get crazy now, if all you eat all day is chocolate, you will be eating VERY little food and not getting many of the wonderful benefits that come with eating other things (vitamins, minerals, fiber, variety). I'm just saying this is part of the good news: you don't have to quit your favorite foods cold turkey (in fact cold turkey is delicious). Turns out the foods that are the most filling for the calorie toll they take are fruits and vegetables, so make friends with them. Also, lean protein tends to keep you satisfied longer, so make friends with those foods, too.

Another calorie inequality rumor that I don't buy in to is that calories are worse after 8PM. Your calorie metabolism is more a refection of how you have been eating over a few days, and late calories do not automatically become fat. I do, however, think that not eating after 8PM is a good idea, because if you are like me that is when you pound the treats. It is an easy way to stop some mindless eating (while you are watching American Idol) and thus the racking up of empty calories.

How many calories should I be shooting for?

This is a little more complicated, but again has some simple mathematical solutions. If you want to lose weight slowly (which is BY FAR the best way to do it, and the best way to ensure lasting weight loss): just take a week or two to calculate how many calories you are currently taking in. Sometimes just keeping track of what you are eating will result in weight loss. Lets face it, some of us are lazy, so eating that extra cookie is so much more work when you have to get up and write it down. After you've figured out what your average is per day, cut it by 25% and see how it goes. If you really eat a lot, it may need further trimming.

Want to lose weight fast? First calculate your basal metabolic rate (BMR), which can be done here . Your BMR is the amount of calories you would burn in a day if you were in a coma. In other words, sleeping all day without any exercise. For quicker weight loss, set your calorie goal at this level, but I wouldn't recommend going more than 200-300 less than your BMR. This calorie total is basically at an unsustainable level, so when you finally get back to a 'regular' diet don't let the numbers bounce up too high or all the pounds will come flying back.

Tip for success:

Give yourself a day off every week (I stole this from Body for Life - italics due to book title, not sarcasm). This will increase your chace of staying on your diet and give you a well deserved break. Don't be stupid about it, though. There is no point in eating 1500 calories a day for 6 days if you eat 10,000 calories on one day. Just relax the the reigns a little bit.

WARNING: USING THIS POST (AND ANY WEIGHT LOSS PROGRAM THAT IS JUST BASED ON DIET) AND NOTHING ELSE WILL RESULT IN FAILURE. Any diet that produces weight loss automatically sends the body into some state of starvation. The body's natural response is to turn down the metabolism. Thus decreasing your 'calories burned'. The ONLY HEALTHY way to increase metabolism is to exercise. Diet after diet with no exercise will just decrease your BMR so low that it is almost impossible to lose weight, and will make you gain weight back faster when you are eating a 'normal diet'.

The secret to weight loss

I thought I'd take a divergence from pediatrics for those of you who may be reading that don't have small kids and talk about something I have very intricate experience with... weight loss. Of course pediatricians don't have to deal with weight loss right? The sad truth is incidence of childhood obesity and diabetes increase every year. But more importantly, 3 years ago I was 50 pounds overweight, and decided I needed to change my habits. I lost 50 pounds in about 6 months (which I acutally don't really recommend).
Here was my 'after' photo:

Everyone asked what my secret was, but after I told them they always seemed disappointed. Its actually quite simple (conceptually at least).

Here it is:
Calories eaten - calories burned = weight loss or weight gain

Sorry, I know you were looking for an easier way. But the secret is, there are no shortcuts. When you are ready to accept this reality, you are ready to make some positive life changes that will help you lose weight and keep it off. If you are looking for a shortcut, you will continue to fight a losing battle. Don't get me wrong, I think there is a place in this world for crash diets.. a wedding coming up soon and you need to fit into your dress, the Oscars are coming up and you don't want Joan Rivers to mock your bulge, or you are appearing in the latest "Men on a Mission" Calendar:

But crash diets have no place in the quest for long term weight loss, and most of them will make you end up heavier than you were before you started. Its the truth!

A good friend of mine in medical school had a million dollar idea... He was going to mow his lawn and package it into capsules and sell it as a weight loss supplement. He was going to sell it as a 'doctor recommended' item. On the packaging of the supplement he was going to make sure to include the footnote *best results obtained when combined with low calorie diet and regular exercise. That is the basis of all the 'tricks' to lose weight... they work well if you exercise more and eat less.

I'll post more in the future (I'm trying - but not succeeding - to make my posts shorter) on the things I found to be the most helpful in my weight loss quest, and maybe they will help someone else. Just being the kind of person I am, I heavily researched it before I jumped in, and at the time felt I could write a book on it. But I figured no one wants to know that weight loss takes a little work, and there's actually a million books out there that already say that.

Here's a little tidbit of knowledge that can take you a long way: A 12 oz can of soda is about 150 calories. To cut one can out per day, you decrease your calorie intake by about 55,000 calories per year. For most people that would result in a 9-10 pound weight loss in a year. In fact, I lost my first 10 pounds by deciding to drink only water and lots of it (and an occasional glass of milk), but I ate pretty much the same. I lost 10 pounds in two months with just that change. Try it!