OTC: Specialists in Obesity

ARE YOU OBESE? READ THIS BLOG IF YOU SAY “NO”

From:  John Hernried, M.D.

    

Most patients who come to the Obesity Treatment Center have a medical diagnosis of obesity and know they need help.  However, I know we are treating the tip of the iceberg when it comes to obesity. I was always amazed in my internal medicine practice, when an obese patient would say; “I may need to lose a few pounds sometime.” Even if I pointed out that their weight was dangerously high and would lead to serious medical problems, they would say:  “At least I’m not obese.”

      

It turns out this type of thinking is not uncommon in the overweight. An  interesting new study presented in April at The American Society of Nutrition Conference by Dr. Kimberly Truesdale of the University of  North Carolina at Chapel Hill asked patients of various weights to assess their own weight status (underweight, normal weight, overweight, or obese).  Those who were of normal weight or overweight estimated correctly about 90% of the time.  However, only 15% of patients who were obese correctly assessed their own status as being obese. 

      

“These findings have important public health implications,” says Dr. Truesdale. “If obese adults do not consider themselves to be obese, they are not likely to pay full attention to public health messages about the consequences of being obese. More research is needed into why obese adults do not consider themselves to be obese, with two possibilities being perception and denial.”

      

I’m concerned because I’m only reaching 15% of the population at risk and wonder how to get the message out to the rest.  I believe that not recognizing your body size is an image disorder just the opposite of anorexia but just as pernicious.  There is likely a neurobiological component that allows the body to be in denial and “save” the excess storage for time of famine.  Learning how to address this denial will play a key role in dealing with the obesity epidemic.  I am greatly encouraged that BMI is being noted at nearly every physician visit at many medical institutions in my community because it is an objective measure that cannot be denied.

      

I recently read a business book that discussed how several good companies faced the “Brutal Reality” in order to make the necessary adjustments to be successful.  If you are reading this blog entry, take a deep breath, and link to our BMI calculator and see where you are.  If you have a BMI over 30, take another deep breath and consider asking for assistance.  Congratulations, you are now in the 15% that realize you have a medical condition that requires attention.  This is a big first step!!

Magical Weight Loss Cures

       

I review all applications for patients joining OTC. I am constantly amazed at the number of patients who mention using over-the-counter weight loss supplements.  I have yet to see a patient with long-term success with any of these.

      

Then why do my patients, who are very insightful and intelligent, spend good money for their products?  Are they convinced they are effective?  Are they desperate to try anything?  Are they aware of the risks?  Are they getting spammed on the internet or are they watching infomercials at 3 am?

      

I am amazed when I see a huge newspaper ad claiming miraculous benefits or a B list celebrity touting “medical proof” of a health claim.  The marketing must const hundreds of thousands or millions to peddle a $50 bottle of pills.  Clearly it works.  The sales of weight loss products is 23 billion dollars a year.

    

The truth is…THERE IS NO OVER-THE-COUNTER WEIGHT LOSS MEDICATION THAT IS EFFECTIVE FOR LONG-TERM WEIGHT LOSS.  Even more, some of them are dangerous to your health.  Unfortunately, there is little the medical profession can do to stop the sale of “miracle” cures.

      

How did we get to a place where ineffective products can be sold?  Congress intended to pass a law to control substances that claimed to offer health benefits.  Instead, the 1994 dietary supplements Health & Education Act gave free reign for substances to be sold without scrutiny.  This is compared to prescription medications which must undergo years of testing before it is approved by the FDA.

      

So what are the substances and can it cause you harm?  Man of these were products where tested by Consumerlab, an independent lab that evaluates products for their content.  According to Consumerlab, many products did not contain what was on the label.

    

“Ephedra Free” products usuall contain a similar compound called synephrine (listed on the bottle as Bitter Orange) plus a load of caffeine.  Combined, these can cause significant cardiovascular side effects.  For example, Ripped Fuel Ephedra Free contains as much caffeine as 14 colas plus synephrine and Zantrex-3 has as much caffeine as 30 colas a day (or 12 cups of coffee).

    

Chromium picolinate is a substance that has been around for a long time.  I have been concerned about the side effects, including kidney, liver and blood disorders.  Part of the complications may rise from a contaminant found in chromium picolinate products called hexavalent chromium.  This is the same cancer causing compound that was made famous in the movie “Erin Brockovich.”

    

There are several other products sold that have shown no effectiveness in weight loss.  These include:  pyruvate, conjugated linoleic acid and chitosan.  In addition, testing of the products has shown either lower or higher amounts in the pills than what is listed on the bottle.  Higher doses can lead to toxicity and increased and dangerous side effects.

    

The hottest product out here is Hoodia.  There is NOTHING known about the product, yet is widely used.  I will write on this product in an upcoming blog.

    

The sad thing is that all these products distract from some of the proven treatments that exist.  Searching for the elusive “magic pill” enhances the sense of failure and futility.  This is just another way these pills cause harm.

From:  John Hernried, M.D.