Weight Loss: December 2009

The Soy Advantage

If you are looking for a new menu option as part of your weight-loss or weight-maintenance program, you may want to consider — or reconsider — soy.

Adding soy to your diet can have advantages, such as providing fewer calories, less saturated fat, and more fiber than other more traditional, high-quality protein sources. Soy is also a common ingredient in weight-loss diets, since it can replace higher-calorie foods without reducing protein intake, thus making you feel fuller longer.

And if you are trying to lose weight, soy can play a key role in helping you preserve lean body mass while you are working to lose weight. This is because soy is a complete protein, meaning that it contains the same essential amino acids as animal sources of protein. Essential amino acids cannot be made by the body and must be consumed from food sources.

Soy has so many benefits, in fact, that the FDA authorized the health claim that 25 grams of soy protein a day can be part of a diet low in saturated fat and cholesterol that will improve heart health. Soy can also assist in protecting against bone loss and some types of cancer.

If, like me, you are not an automatic fan of most soy products, take another look at the supermarket shelves. You may be surprised at how the taste and texture of the new soy products have been improved. Soy has come a long way. The next time you visit the store, check out all the options: soy burgers, soy sausages and brats, soymilk, soy crisps, soy flour — even soy nut butter.

Anorexia Nervosa - What Happens

What Happens

Anorexia nervosa almost always begins with a plan to follow a strict weight-loss diet. Limiting foods then leads to malnutrition and unhealthy weight loss. As malnutrition sets in, the brain and metabolism change. This limits the appetite, how the body can use food, and the person's ability to think clearly and make good decisions.

After anorexia starts, it is very difficult for the person to return to normal eating without help. When left untreated, anorexia can continue for a lifetime. This leads to long-term malnutrition or starvation—and sometimes death.

If you struggle with anxiety, tend to finish the things you start, and strive for perfection, you may be at risk for crossing the line from dieting to anorexia.^5,²For some people, anorexic eating habits can meet a need for personal control and self-esteem. Some teens may fall into this pattern as a way to cope with big changes and challenges.

Early treatment of anorexia offers the best chance of recovery. The more irrational eating habits that a person develops, the harder it is to return to a healthy outlook on nutrition. Because people who have anorexia tend to strongly deny that they have a problem and are secretive about their eating, family members or loved ones usually seek help for them on their behalf.

As the illness advances, irrational behaviors begin. These can include:

Making rules about food—for example, eliminating dairy products or meat because they are perceived as "high-calorie."
Creating rituals about how food should be eaten—chewing food a certain number of times.
Developing a fear of food—fearing weight gain if any food at all is eaten.
Losing the ability to feel hunger or learning to ignore the feeling of hunger.
Exercising too much.
Taking laxatives or water pills (diuretics) or making yourself vomit because of fear of gaining weight (bulimia).

People who have anorexia can become socially withdrawn and lose interest in the outside world.⁶

Starvation and malnourishment from anorexia commonly cause complications, such as osteoporosis or an irregular heartbeat. Often other mental health conditions occur along with anorexia, such as depression. Treating a mood disorder is an important part of treating anorexia.

A person who has anorexia is usually seen by a health professional for other complaints that are related to anorexia. These may include:¹

Fatigue and lack of energy.
Abdominal pain and, sometimes, constipation.
Absence of menstrual periods.
Frequent vomiting (although the person does not admit that it is self-induced).
Symptoms of depression.
Suicide risk.
Joint pain (from excessive exercise or an electrolyte imbalance).

Get Your Girl to Slim Down

She was a bombshell when you met her, but as long-term commitment settled in so did a few extra pounds on her hips. We all gain a little weight as we age, but if she now ignores healthy habits altogether, it's time to help her realize the risks, without being cruel. There's a fine line between insulting her, and helping her. Learn how to approach the subject the right way.

You'll never get anywhere if you say, "Looks like you've put on a few pounds" or "Are you really going to eat that?" Most people are well aware that they've gained weight, and criticizing her actions will probably make her increase her unhealthy behavior, to defy her "controlling" husband or boyfriend, saysEdward Abramson, Ph. D., Professor Emeritus of Psychology at California State University, Chico, and author of Body Intelligence.

The best thing you can do is to be a nutritional and fitness role model and support healthy behavior. "Let her see you engaging in healthy habits," Dr. Abramson says. "When she does something that's more desirable Ãƒƒ¢Ãƒ‚€Ãƒ‚“ like preparing a healthy meal or turning down dessert — make sure it's recognized and appreciated." Here are 11 ways to get your girl to slim down, without hurting her feelings.

1. Focus on health, not weight
If you want to discuss weight gain with her, do so after she returns from a doctor's appointment, Dr. Abramson says. When she returns from the physician, ask, "Did the doctor bring up any health concerns?" Use this opportunity to discuss high blood pressure, high cholesterol, and the importance of becoming more active and eating healthier together in order to live a longer life, be more active with your children, or to prepare for childrearing if you want to have kids in the future. Always use the phrase, "Let's do this together."

2. Make it a team effort
Do anything you can to encourage physical activity as a couple. Suggest walking after dinner, biking, hiking, working in the yard, or even washing the car. Make it fun. Join a softball team or bowling league together. "Couples that play together, stay together," saysDebra Mandel, Ph. D. psychologist and author of Healing the Sensitive Heart. It doesn't have to be a 2-hour sweat session in the gym. Someone who has previously been sedentary won't want to do that right off the bat. "Do anything to get her off the couch and into life," Dr. Mandel says.

3. Go grocery shopping together
"Make grocery shopping a couples' project, so she feels like she has your support," Dr. Mandel says. Establish healthier eating habits by emptying your kitchen cabinets of refined carbohydrates, sugar, soda, junk food, and other processed foods, saysKristin Reisinger M.S. R.D., personal trainer and nutritional consultant.Replace white bread and white ricewith whole grain products and more vegetables. "If someone eliminates refined carbohydrates, they'll see weight loss after a few weeks," Reisinger says. Here's yourhealthy shopping list.

4. Make her dinner
You want her to eat healthier? Then cook for her. Pick up a healthy cookbook or a magazine like Cooking Light, and put together ahealthy meal. "Volunteering to do some of the cooking is a great way to show her how to make healthy choices, and on the other hand, the wife or girlfriend is going to appreciate his sharing in that responsibility," Dr. Abramson says. "It makes her life a little easier."

5. Take on more responsibility
Enable her to have the time to work out, saysDeanna Conte, M.S., R.D., L.D., co-author of A Guy's Gotta Eat. If you have children, volunteer to watch the kids, or you can simply pick up other responsibilities around the house or take on some of her chores. That way, she can't say, "I don't have time."

6. Make it a habit
If it's affordable, buy 10 personal training sessions, and join the gym together, Dr. Mandel says. If the money's already been spent on the lessons, she'll feel obligated to go. The trainer will help her feel comfortable in the gym, and encourage her with positive reinforcement. Set aside time throughout the week to go to the gym, and make it part of your weekly schedule. "Do it together, so it feels more supportive," Dr. Mandel says.

7. Or take her to the gym with you
If she's intimidated by the gym, take her there and go through all the cardio machines and weight-training methods with her, says Reisinger. Or you can encourage her to take a fitness class like kickboxing, yoga, or pilates and do it with her. Once she's there and sees a lot of other women taking the classes, she'll catch on and want to do it for herself.

And don't ignore weight training. It can help her see results faster. "A lot of times women don't want to work out with weights because they think it will bulk them up," Reisinger says, "Teach her proper form, and her insecurity will go away." Show her basic weight-lifting exercises that hit all areas of the body, like these moves in theAbs Diet Circuit.

8. Take a dancing class
She'd rather stay home and watch Dancing with the Stars? Engage her interests by signing up for a dance class. Fitness doesn't always have to be attained in a gym. "You need to find physical activities that are enjoyable to her. Dancing is physical, involves movement, and will get her heart rate up," Dr. Abramson says. "It's not seen as a chore, or something she'll dread having to do."

9. Bring it home
Bring fitness equipment and healthy cookbooks into the home, but don't give them as gifts. "I don't recommend going out and buying a Stairmaster, and putting a big bow around it," says Conte. Purchase fitness equipment for yourself, and encourage her to use it with you, she adds. The same goes for diet books. Buy a book like theSouth Beach Dietfor yourself, and say you find it interesting. Set an example of fitness and healthy eating, and hopefully you'll find she'll want to do it for herself.

10. Don't be a hypocrite
If you expect her to care about her weight, it's not helpful to order a pizza and eat it in front of her. "Be conscious of what you're eating," Conte says. "You need to play an active, helping role, whether you're dining out or eating at home." Order healthy items to be supportive. And if you absolutely must have that hot fudge sundae? Go out and eat it elsewhere, instead of bringing it home and eating it in front of her.

11. Have realistic expectations
Men need to understand that a woman's metabolism slows with age, while a man's metabolism stays strong longer in life, Dr. Mandel says. "Men need to be realistic in their goals," she says. "It's not realistic for a woman in her 40s to look like she did in her 20s." Think in terms of health, fitness, and realistic attraction, not Hollywood perfection.

Less Is More

Make portion control your ally in long-term weight loss.

In a recent study, controlling portion size emerged as one of the most effective strategies for shedding excess pounds and keeping them off. Use small plates, eat slowly, and eat fiber-rich, balanced meals to help you feel satisfied while curbing any tendencies to eat too many calories.

A recent study of 300 overweight and obese people revealed that one of the most effective strategies for long-term weight loss was portion control. Exercising, eating more fruits and vegetables, and decreasing fat intake helped as well. However, reports suggest that study participants who included portion control as one part of their overall weight loss plan lost the most weight and were able to keep it off during the course of the 2-year study. To control portions, try using 9-inch plates, which can trick your mind into feeling satisfied. Also, eating slowly can give your body time to register that you're full. Eating high-fiber, nutrient-dense foods may help you feel fuller longer and reduce the urge to overeat. Remember that any effective weight loss plan involves expending more calories than you take in, so include exercise in your weight loss strategy.

Bitter Fruit for Better Weight Loss

Are the rumors true? Could grapefruit -- touted for years as a weight loss wonder -- actually work?

Possibly. In one 12-week study, obese people who ate half a grapefruit before each of three daily meals shed more pounds than their counterparts did.

Show Me the Grapefruit
In the study, whole grapefruit also took a bite out of insulin resistance in folks with metabolic syndrome -- a constellation of conditions that can raise the risk for several serious health problems, including diabetes. Find out if you could be at risk for metabolic syndrome.

Go Whole
Although grapefruit juice and grapefruit capsules also may have pound-shedding potential, whole fruit was clearly the winner in the study -- probably because the whole fruit has appetite-controlling fiber as well. Thescent of grapefruit may help you, too. Here’s why.

Combine Your Efforts
Exercise and a calorie-controlled diet remain the true cornerstones of weight loss, but if grapefruit helps, great! However, if you’re taking medications of any kind, talk to your doctor before adding grapefruit to the mix; it interacts with several meds. (Here’s one example.) Try these other fat-blasting tips, too:

Walk with me. Walking has the highest stick-to-it rate of any exercise. And a walking buddy can help even more. Here’s a video that can help you walk off pounds right in your own living room.
Be sane. Fad diets, like the famous but extreme 600-calories-or-so-a-day grapefruit diet, may help some people lose weight temporarily, but most gain it all back in the long run. Here's a sensible weight loss plan that really works long term.
Get a grip. Do you eat when you’re bored? Stressed? Sad? Find out what’s behind emotional eating and what you can do to curb it.

RealAge Benefit: Maintaining a constant desirable weight can make your RealAge 6 years younger.

Weight-Loss Drugs Don't Fulfill Promise

Not long ago I railed against the many unproven weight-loss products being advertised prominently in newspapers, magazines, and online.

To be fair, though, the two latest FDA-approved weight-loss drugs — orlistat (Xenical or Alli over the counter) and sibutramine (Meridia) — haven't produced spectacular results, either.

A recent analysis of 264 studies that compared people taking either of these two drugs with those taking a placebo found that the drug-takers lost an average of less than 8 lbs., or about 5 percent of their mean total body weight - 6.5 lbs. in the 16 trials of orlistat, and 8 lbs. in the 10 trials of sibutramine.

The authors pointed out that even these modest positive results may be overblown, since 90 percent of the trials were funded by the manufacturers of the drugs themselves. And, as is common with trials of weight-loss drugs, between 30 percent and 40 percent of the subjects dropped out of the studies, possibly due to disappointment with the small weight losses or to side effects from the drugs.

Even such small reductions in weight are, of course, not to be sneezed at. They can lower blood pressure, help to prevent diabetes in people at risk, and improve blood glucose control in those who already have diabetes.

But it is important to recognize that neither of these drugs is the long-awaited "miracle" weight-loss pill. These medications cannot produce the amount of weight reduction needed by most obese individuals unless accompanied by a calorie-restricted diet and exercise.

While both drugs are safe, they can each cause troublesome side effects. Since orlistat works by blocking the action of an intestinal enzyme that digests fats, this undigested fat is lost in the stools. Common side effects include crampy pain, urgency, increased defecation, flatulence, and oily stools. The manufacturer suggests that people taking orlistat take a change of clothes with them to work. Users may also need to take a daily vitamin pill to replace fat-soluble vitamins lost in the stools.

Sibutramine lessens appetite by raising levels of the neurotransmitters serotonin, norepinephrine, and dopamine in the brain. Its most common side effects are dry mouth, headaches, constipation, and insomnia. People with heart disease or uncontrolled high blood pressure are warned to use this drug only with caution because it slightly increases both blood pressure and pulse rate.

What about using these two drugs in combination? In one study, orlistat produced no further weight loss when added to the regimen of obese women who had already been taking sibutramine for one year.

A third weight-loss drug, rimonabant, was also included in the analysis. Rimonabant produced a somewhat greater average weight loss of 10 lbs. compared with the placebo. But this highly promising drug recently failed to obtain FDA approval because it was associated in these trials with worsening depression and anxiety, especially in people with a history of such disorders.

Low-Carb Diets for Weight Loss

Although there are many weight-loss diets, statistics show that most people who lose weight on a diet regain that weight, and sometimes they gain more. The best ways to stay healthy are eating well and being physically active.

Two of the better-known low-carb diet plans are the Atkins and the South Beach Diet.

Atkins

The Atkins program is a four-phase eating plan for losing weight. The last phase involves how to maintain the weight loss.

Basic concept

Atkins promotes limiting carbohydrate grams. You limit nearly all carbohydrate in the first 2 weeks of the plan, then gradually add some carbohydrate back into your diet later.

How it works

Phase 1: Induction: During a 2-week induction program you eat no more than 20 grams of carbohydrate a day.
Phase 2: Ongoing weight loss: This is similar to the induction phase, but in Phase 2 you begin to add more foods to your diet and increase your carbohydrate grams. New foods include nuts, seeds, and some berries.
Phase 3: Pre-maintenance: When you are 10 pounds from your goal weight, you start Phase 3. You add 5 to 10 grams of carbohydrate to your diet each week as long as you are continuing to lose weight. You add new foods slowly.
Phase 4: Maintenance: After you have maintained your goal weight for about a month, you move into Phase 4. At this point, you know how many carbohydrate grams you can eat without gaining weight.

On the menu

Eggs, meat, fish (all proteins)
Olive oil, butter, cheese, olives
Lettuce, cucumber, tomato, broccoli, avocado (most vegetables)
Artificial sweeteners (such as Splenda)

Off the menu

Sugar and baked goods
Starchy vegetables, like corn and sweet peas (none in Phase 1, added back in later phases)
Bread, pasta, potato (none in Phase 1, added back in later phases)
Fruit (none in Phase 1, added back in later phases)
Alcohol (none in Phase 1, added back in later phases)
Nuts (none in Phase 1, added back in later phases)

This diet is very high in saturated fat and cholesterol, and quite low in fiber and whole grains. The minimum recommended intake of carbohydrate is 130 g.

The South Beach Diet

The South Beach Diet is a three-phase eating plan for losing weight. The last phase is ongoing in order to keep the lost weight from coming back.