Weight Loss
Sutter Medical Center, Sacramento

by Maxine Barish-Wreden, M.D.

Now that ephedra has been pulled off the market by the FDA, people are looking for alternative weight-loss supplements sold over-the-counter. The quest for weight loss in the U.S. is big business, especially since approximately 65 percent of Americans are now overweight. Most of the weight-loss supplements left on the market contain stimulants that have some similarities to ephedrine; these include:

  1. Bitter orange - contains synephrine
  2. Country mallow/heartleaf - contains ephedra-like compounds
  3. Guarana, green tea extract, mate, cola nut - contain caffeine
Hoodia is another weight-loss supplement that has gained popularity recently. Hoodia is a plant that grows in the South African desert. It has traditionally been used by tribal hunters to suppress hunger while they are out in the bush.

In the final outcome, none of these supplements produce any long-term success. This is because we have "super-sized" our food intake at the same time that we have decreased our physical activity with conveniences like cordless phones and remote controls. In addition, some people are genetically predisposed to weight gain. We are only beginning to understand the complex interactions of hormones, neurotransmitters, and other chemicals that interact with the brain and stomach, signaling us to eat or to push our plates away.

In April of 2003, the Wall Street Journal published an article on weight loss that was full of common sense. In that article, they looked at the factors that were common to people who have been able to lose weight and keep it off. In fact, there is an academic study called the National Weight Control Registry that studies just such people, and we can learn a lot from them (after all, we tend to focus on people who have failed at weight loss, instead of looking at people who have succeeded). The NWCR is a longitudinal prospective study of people 18 years and older who have lost a minimum of 30 pounds and have kept it off for at least one year. The registry currently includes about 3,000 individuals. The average person in this study has lost about 60 pounds and has kept if off for about five years; two-thirds of them were overweight as children. This is what people who have successfully lost weight do:
  • They write down everything that they eat every day, including the calorie content of that food. This is very important: the first step in losing weight is to become conscious of what we are actually putting into our mouths every day. Without this knowledge, most of us tend to vastly underestimate how many calories we're taking in every day.
  • They weigh themselves often.
  • They stop drinking sodas and other "empty calorie" drinks; even fruit juices can add a lot of calories every day.
  • They eat foods that are high in volume, but low in calories, e.g., air-popped popcorn; these tend to fill us up and keep us from consuming richer foods.
  • They pay attention to portion size. If our meal is "super-sized," we'll tend to eat it all, even if we're full.
  • They eat portion-controlled pre-packaged foods on a regular basis.
  • They avoid buffet lines. Variety excites the appetite and makes us eat more.
  • They avoid refined carbohydrates, including white sugar, flour, rice, and pasta.
What else can affect our ability to lose weight? If you are constantly feeling stressed out or sleep-deprived, you may find it harder to lose weight. Stress and sleep deprivation tend to increase our blood cortisol levels and decrease our growth hormone levels, and both of these seem to cause increased fat deposition, especially around our waist area. Many other hormones are involved in fat metabolism, and we are just beginning to understand the complex interactions between these chemicals that can make it tough to lose weight. More research findings are on the horizon!

You may also want to ask yourself, "Why do I want to lose weight?" Losing weight alone is not a very effective goal; it's often a way that we (especially women) punish ourselves: "I'm not okay the way I am right now, but when I lose 10 or 20 or 50 pounds, then I'll be okay, then I'll be lovable..." The problem is, when we begin from this place, we tend to never feel satisfied with how we look. Instead, you may want to think about creating fitness as your goal, instead. Cardiovascular and musculoskeletal fitness will keep your heart and blood vessels happy, improve your mood, and increase your energy levels, even if you don't lose an ounce! And, fitness allows us to follow our dreams--to pursue what's important to us.

So, think of a goal you'd like to achieve for yourself. It may be that you want to be able to hike with your kids or grandkids, or go back to school, or pursue a hobby that has always been important to you. Then use healthy diet and fitness as a means to achieve that broader goal. Allow that goal to guide your actions regarding your health and well-being every day. You are worth it, and you deserve everything you dream of for yourself. So go for it!

For more information:

Alternative Diet Programs
Fitness
Healthy Weight
Obesity
Sutter Integrative Health Services
Weight Loss and Obesity