OTC: Specialists in Obesity

Intuitive Dieting?

From: Maureen Allen, M.P.H.

Another day, another diet. In case you missed it, Steven Hawks, a nutrition professor, was promoting his “Intuitive Diet” over airwaves and newspapers last week. Simply put, you eat whatever you want, including unlimited carbs, but you only eat when you’re hungry and stop when you’re full. www.intuitiveeating.com

To do this, Hawks had to learn to read his body’s cues for hunger and fullness. Hawks wasn’t so good at first. In fact he said it took him a year to figure it out. That could be the year of living dangerously for many and an expensive lesson. In addition to those and the reasons below, we responded. Again, in case you missed it…..

Letter to the Editor (Sacramento Bee, Dec. 13, 2005)

Knowing when not to eat

Re "Anti-diet guru eats junk food, loses weight," Dec. 5: Steven Hawks' shopping cart may be filled with junk food, but his stomach isn't because he eats only when he's hungry and stops when he's full. That's where he parts ways with most chronically obese people. In addition to eating when they are hungry, many also eat when they're happy, sad, lonely or depressed. And they don't stop when they're full because many report never feeling full.
Recent evidence as to a cause of obesity points to an overactivity of neurohormonal systems that link the intestinal organs to the brain. This overactivity leads to abnormal cues when it comes to food intake. Intuitive eating could be a great approach for people who read their body's cues. But it's not one size fits all by a long shot.

- John Hernried, M.D.
- Maureen Allen, M.P.H, Sacramento
Obesity Treatment Center Medical Group

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Editors Note: We will be taking a break from our blog during the Holidays. We wish you the best for a Happy and Healthful New Year!
JH & MA

A Great Holiday Gift—The Family Health History

From: John Hernried, M.D.

The Holidays are a time when families gather to celebrate. What a great opportunity (and gift idea) to create a family health history.

Many diseases, including obesity, are influenced by genetics. For instance, a person’s risk for developing type 2 diabetes is 7%-14% if one parent has diabetes. It skyrockets to 50% if both parents have diabetes.

I always say, “Too bad you can’t pick your parents!” While we have no control of our genetic makeup,
we certainly have control of our lifestyle. For instance, the Diabetes Prevention Program showed that daily aerobic exercise prevented the onset of diabetes by nearly 40%. Knowing that there are strong genetic influences in your family, is a good thing to know to prevent your own disease or those of your family.

The Surgeon General’s website has developed an easy to use tool to collect your family health history: https://familyhistory.hhs.gov/ Once you have obtained this information, you can enter it into the website and share it with your family. The information will also help your doctor order the appropriate preventive health tests.

Amidst your holiday celebrations or at half-time of a bowl game, spend a few minutes collecting this information. It just may save a life! What could be a better gift?

We Can Change Our Stripes!!

From: John Hernried, M.D.

Amidst the generally discouraging news of the obesity epidemic, there is some positive news on the battlefront. I was pleased to see an article from England on the changing choices being made in response to public health messages. In response to messages about the obesity risk, 2/3rd of the adult population is making smarter choices and exercising more.

The article, Fears of obesity epidemic bite into sales of chocolate and crisps, tells that people are choosing less caloric and energy dense food choices. For the first time, this appears to be a response to public health messages and NOT what the food industry is marketing. For instance, the sale of energy dense chocolate candy is being replaced by less energy dense chocolate crisps. While this does not seem like much of a change, if a person is satisfied with the same portion, they will consume fewer calories. In combination with many other small changes, it begins to add up. According to the article:

We're buying more ...
* Mineral water, fruit juices and smoothies
* Probiotic drinks that help your stomach
* Lighter crisps with less saturated fat
* Smaller chocolate bars like Cadbury Flake
* Crackers and cereal bars
* Premium dark and organic chocolate, such as Lindt and Green & Black
* Low cholesterol spreads such as Flora
* Rice and fresh and dry pasta
* Malt loaf, which has a healthy image
* Wine from big name brands from Australia and California

We're buying less...
* Calorific chocolate bars like Mars and Snickers
* Sugary sweets such as Polo and Maynards
* Ordinary fatty crisps. Pringles are down eight per cent
* Traditional chocolate biscuits such as Penguin
* Sugary orange drink Sunny D
* Fatty biscuits Viennese whirls, lemon slices and Battenburgs
* Tinned vegetables and fruit
* Frozen ready meals, particularly frozen pizza
* Fizzy drinks popular with children
* Ready to drink cocktails such as Smirnoff Ice

I am encouraged by this change and hope that Americans are also making these changes. The US government periodically surveys the population and we will know better. However, I personally have made many of these changes and have seen many of my friends automatically switch because of the public health messages about the obesity epidemic.

While it is too early to predict victory in the war on obesity, it is encouraging to know that big messages can lead to significant changes. Down the line, I am encouraged that it will lead to a healthier society.

This is one Christmas wish already given to me!

Sex Sells!

From: John Hernried, M.D.

My eye caught the headline of one of my nutrition newsletters: Sex diet promises weight loss to the frisky. The author, Kerry McCloskey had sex, wrote a book about it, and appeared on Oprah:

“By using the power of pleasure, McCloskey quickly lost 23 pounds and achieved her life-long dream of becoming a television star and model. Kerry explains, “My husband and I have sex about eight times per week. You do the math!”…And here’s their biggest secret: Ben, Kerry’s husband, eats a lot of celery. Kerry says when men eat celery they emit a scent that’s a turn-on. Who knew?”

Only in America! Have I missed the entire picture by recommending reduced calories and increased exercise? Is it as simple as having lots of sex and eating celery? It turns out that the answer is no. Going back to my previous blog on Curiosity, when something is too good to be true, it just isn’t.

Why am I suspicious? Well, she appears on Oprah and touts that 30 minutes of sex burns 130-350 calories. The higher end of her calculations comes from being “extra frisky.” She gives no citation on where she got her data. In fact, 30 minutes of “moderate” sexual activity burns about 36 calories. Sadly, bowling burns 4 times that amount. If you would like to know more about calories burned during physical activity, go to the Healthy Weight Forum and enter in your exercise. As I mentioned in a previous blog, beware of testimonials in place of evidence based data. Her website lists no data, but has the following testimonials:

“Kerry, you have changed my life and jump-started our marriage!”-Chrissy J., Ann Arbor MI

“Kerry’s book is so compelling, my girlfriend and I didn’t even make it through chapter 1 before starting our diet!” –Matt M., Los Angeles, CA

“My husband and I are already addicted.” –Linda C., Los Angeles, Ca

“Sexercise beats exercise any day.” –Sydney, New York, NY

“My friends don’t understand what my wife and I are up to, but they are all commenting on our special glow and newly slim figures.”—John N., Washington, DC

While this book ignites passion, it doesn’t demonstrate effective weight loss. I suspect that most of the patients I know would be disappointed with their weight loss. It would add to their sense of failure and many would develop new conflicts around their sexuality and relationship with their partner. Intimacy is a significant issue among overweight and obese patients, and it should not be treated lightly.

The author lives in New York, home to established obesity research centers. I would encourage her to bring her ideas to them. I doubt she will. After all, she is too busy promoting her book and working to keep her weight down!

Another Place To Eat

From: Maureen Allen, M.P.H.

      

In the 1970s I used to go to concerts at the Spectrum in Philadelphia.  The air was so thick with pot and cigarette smoke you could cut it with a knife. Thirty years later people are still inhaling at concerts. But now its garlic fries, nachos and sausage sandwiches to name a few.

At one point during the Bruce Springsteen concert at Arco I asked my husband if people realized they were at a live show as opposed to a TV show where you run to the refrigerator during commercials. The steady stream of traffic up and down the aisle with cardboard trays loaded with concert food looked more like a freeway during rush hour.

Going to the movies is like this too. Although butter saturated movie popcorn was never “healthy” it looks like Lean Cuisine when compared to rotisseries full of hotdogs, big ice-cream, big candy and big sodas.

This availability and promotion of food at events that have nothing to do with food has created anxiety in people trying to lose or maintain their weight .What happened to going to the movies to divert your attention away from food? Besides choosing a movie, now we have to worry about the side dishes.

I don’t blame promoters for selling the stuff, but it seems they’ve made everything bigger but the seats.

Sonny Boy’s Diet

From: Maureen Allen, M.P.H.

    

The other day my neighbor commented on my golden retriever’s weight loss. She asked what sort of diet he was on to lose 20 pounds in about two months. I told her everyday he eats a cup of kibble and a can of green beans. She quickly said, “I’m going to the market right now and get some green beans!”

If only it were that simple for us. I feed the dog. He couldn’t read labels or count calories even if he wanted to. He cheats with an occasional tub of Smart Balance or toast he surfs from the kitchen counter on his breakfast recon missions. The diet wasn’t his idea in the first place.

When a diet is your idea, it can be relatively easy. Someone else has made all  the choices and the rules are clear. Many patients say they’re not tempted to cheat because a) It’s not an option and b) they are not hungry on the diet.

When did either of those things stop someone from eating! The point is, maintenance, done with skills and knowledge shouldn’t be so scary. Maybe patients would be wise to carry over those two caveats into the maintenance phase. For example, some foods probably aren’t an option if they trigger binge eating. Also, if you follow a regimen like Volumetrics, you learn to get lots of food for few calories. There’s no reason to starve yourself to maintain your weight.

Sonny may be catching on.  This morning he trash picked an empty supplement envelope I had prepared for a quick breakfast and licked it clean.