The Medical Minute: No quick fixes for obesity

The Medical Minute: No quick fixes for obesity

By Dr. John Messmer
Penn State Milton S. Hershey Medical Center

Chances are you are on a diet -- or you were on one in the last year. Tens of millions of Americans are dieting at any given time. Together they support a $33 billion industry of weight control products. Despite the attention we pay to dieting, one-third of us are obese, defined as a body mass index over 30 or approximately 50 pounds over our ideal weight. Another third of us are overweight or a body mass index between 25 and 30 (about 15 to 50 pounds over ideal weight).

What's wrong with being a little too heavy? Well, obesity is such a big problem it may soon pass heart disease as the nation’s number one killer. In fact, being overweight causes heart disease, in many cases. Obesity increases the risks of diabetes, high blood pressure and some forms of high cholesterol, all of which contribute to heart disease and stroke. As if that weren't enough, extra weight increases the risk of sleep apnea, gall bladder disease, infertility and pregnancy complications plus cancer of the uterus, colon, prostate and breast. It also increases the risks of surgery.

How did it happen? Gradually -- that's why we are just now noticing it. If you can't fit into last spring’s clothing, you understand how slowly our habits can increase our girth. You may not think you overeat, but if you are overweight, you probably do -- there is rarely another explanation. You may be on a medication that stimulates your appetite, but it's by eating that you actually gain.

You might think that you just need more exercise. That's probably true. Fewer than 15 percent of us exercise at least 20 minutes three times a week -- the absolute minimum amount for good health. A quarter of us get no exercise at all. If you exercise at a moderate intensity for 30 minutes, you burn off about 200 calories. If you think that amount of exercise will allow you to eat to your heart's content, think again. You need to burn about an extra 1,000 calories a day to eat whatever you want -- that's a 10-mile run or walk every day!

Diet types are limited only by the imagination of the creators. No matter the name, fad diets fall into three types: high protein and fat, low fat, and very low calorie. Each creator devises a gimmick to make it easier for the dieter to follow the rules. The caveman diet, for example, emphasizes only food found by hunting and gathering with an emphasis on meat. The grapefruit diet is basically a high protein diet that includes a lot of grapefruit. Some of these diets are not so bad nutritionally, but they are so limited in food choices, they cannot be followed indefinitely. Once you go off the diet, you go back to your old habits and regain your lost weight -- the fate of nine out of 10 dieters.

There are reasonable commercial diet plans available, but they are based on using foods supplied by the diet company. The diets are balanced and healthy, but you must buy the food from them. If you can afford it, they can help you, but if you do not learn to choose foods yourself, you must use their food for life.

So what is the best way to attain and maintain a healthy weight? The simple math is: to lose weight, you must eat less than you burn off. Most of us can cut back for a couple days, but most diets fail due to inconsistency. When we cut back our intake enough to burn off fat, the body wants to maintain weight, even if you are too heavy. So, if you cut back a few days, then overeat, you store the extra calories as fat. You think you are dieting all the time and not losing weight, but the truth is you are not being consistent. It is easy to get discouraged when you don't see results.

No quick fixes

It's important to remember that there are no quick fixes or rapid weight loss schemes that give long lasting results. If it sounds too good to be true, it probably is. You should first decide to begin eating properly for life. Choose small amounts from a variety of foods. Throughout the week, include fruits and vegetables from many colors: green, red, yellow, orange and dark colors. Women should have five servings of fruits and vegetables daily and men, seven. A serving is a portion you can easily hold in your hand. Be sure to include legumes -- beans, lentils, etc. Add 3 ounces of lean meat once or twice a day and you have your diet for life.

What about fun foods? If you are trying to lose weight, it is likely to fail if you add extra calories. Rather than trying to include junk foods, spread your eating out over the entire day, consuming multiple small portions frequently to reduce your cravings for snack foods. After a little while, you will no longer crave sweet, salty and high fat snacks.

When you achieve a healthy weight, your activity must balance your eating. Exercise regularly and try to avoid overeating. Weigh yourself regularly to be sure you are maintaining a healthy weight. If you stop paying attention to types and quantity of foods, that is, if you go back to your old habits, you will soon be your old weight.

Some people stay lean because they stop eating when they have had enough. If you are not one of those people, you must always pay attention to what you eat. The reward will be more energy, less risk of disability and disease and lower medical costs.