Effective Weight Loss Programs

There is an increasing number of drugs, fat and carbohydrate substitutes, surgical procedures and group programs that have the potential for helping people manage their weight. Some are effective; others are risky. None is a definitive answer to weight control.

The phen/fen craze that swept the nation during the early and mid 1990s has subsided, although the two drugs are still prescribed. The medications — phentermine and fenfluramine — had been used separately in the United States for several years. After a University of Rochester study was published in 1992, the two substances were combined and taken together.

The first, phentermine, increases the metabolic rate and decreases the appetite. Its side effects of headaches, hypertension, insomnia, dry mouth, nervousness and constipation can be diminished by controlling the dosage. Fenfluramine increases the level of serotonin, which also depresses the appetite. Its side effects include drowsiness and diarrhea. In simple language, one is an upper; the other a downer. They theoretically balance each other.

Fat and Carbohydrate Replacers
Procter & Gamble spent 25 years and 200 million dollars developing olestra, a chemical consisting of sugar and vegetable oil that looks and tastes like regular fat. It isn’t. It is a no-calorie fake fat that passes right through the body without ever being digested. It can replace up to 35 percent of fat in oils and shortenings used at home and as much as 75 percent of fats used in the commercial deep-frying process. The Food and Drug Administration approved olestra in January 1996 and it can be found in supermarket products such as potato chips and crackers.

Olestra has its critics. Some contend that it causes stomach and intestinal difficulties, though the FDA says these problems have been corrected by the manufacturers. Proctor & Gamble claims that most of those cases were similar to the reactions triggered by eating high-fiber foods. There have been additional claims that olestra depletes the body of fat-soluble vitamins and carotenoids that may help protect against cancer.

Research shows that olestra and other fake fats are decreasing the total fat in diets. By replacing fatty acids, olestra might be beneficial in reducing the risk of heart disease and cancer. On the other hand, we believe natural foods rather than a lot of fake substances that are new to our bodies.

Z-Trim, a fat-replacer developed by the U.S. Department of Agriculture, is made from the hulls of oats, soybeans, peas and rice, or bran from corn or wheat. It can be used to replace fat in cheese, meats and baked goods, but it can’t be used in frying. The USDA is licensing Z-Trim to private companies. There are other fat replacers — Simplesse, DDM, EPG and TATCA — and the number is growing as manufacturers compete for a share of the weight loss market.

Most of the ingredients used to modify the fat content of foods are combinations of substances/foods that already exist. Before they can be marketed, they must either be scientifically recognized as safe or they must be approved by the Food and Drug Administration. The American Dietetic Association recognizes that the use of good-tasting, fat-free or fat-modified foods is one strategy to meet the goal of consuming less than 30 percent of daily calories from fat. The association also states that the individual shares the responsibility for the appropriate use of these substances.

Surgical Procedures
Surgical procedures to treat obesity should be considered drastic measures. Gastric bypassing involves partitioning off the bottom part of the stomach and leaving only a fraction of the top part open to receive food. Then a small opening is made to connect the stomach to the small intestine. The most widely used procedure is vertical banded gastroplasty (stomach stapling). It closes off part of the stomach, but leaves a small opening through which food can pass into the stomach’s lower portion and on to the small intestine.

Both procedures reduce the size of the stomach so that only small amounts of food can be stored there at any given time. However, food has to be chewed thoroughly in order for it to pass through the opening, and attempting to eat too much too fast can cause nausea. Although weight loss is dramatic, neither process is a quick-fix solution. There are the normal risks associated with surgery as well as the possibilities of nutritional deficiencies, ulcers, gallstones and a stomach pouch that can get bigger.

A more recent surgical method involves the stomach being fitted with a band that creates a thin canal. This canal slows digestion and gives a feeling of fullness as the person eats. It is also impossible to eat more than a half cup of food at a time without regurgitating. With a fourth procedure, the stomach wrap, a mesh product surrounds the stomach to limit its size.

On the average, patients who have stomach surgery lose 40 percent of their excess weight. Keeping the weight off is a challenge and few reach their ideal weight. Without follow-up and commitment, many people regain at least some of the weight they lost. Long-term success of surgical weight loss methods has been estimated to be 70 percent to 80 percent.

The Spiritual Approach
Some people are more successful in losing weight when they are part of a group. Groups provide structure, social interaction, emotional support and a forum for people to declare publicly that they have a weight control problem. For those seeking a systematic group approach with a spiritual basis, there are some interesting choices.

First Place
In 1981, 12 members of the First Baptist Church of Houston got together to develop a weight loss program that included not only the physical approach, but one that also included mental, emotional and spiritual components. That approach became First Place and has spread to 10,000 churches of 32 denominations in 13 countries.

The people who become part of First Place tell us that their lives have changed in ways they never expected. Addressing the four-sided individual — spiritual, physical, mental and emotional — is the difference between First Place and other weight loss programs. There are no statistics that compare First Place success rates with those of other programs.

Weigh Down
The Weigh Down Workshop goes one step further than First Place in the direction of seeking spritual solutions to the physical and emotional elements of losing weight. Created and directed by Gwen Shamblin, a Franklin, Tenn., registered dietitian, the workshop is a 12-week series of classes that includes Shamblin’s tapes and literature. The cost is $103 — a figure that has not stopped an estimated 250,000 people from signing up.

The program is different from others in that the participants can eat whatever they want as long as they stay within the boundaries of hunger and feeling full. “No exercises, no counting calories … just God-given controls” is an approach that is sure to have an appeal for chronic dieters. Bible-based solutions accompanied by prayer and group support are offered for all of the complex reasons that people overeat. There is no shortage of Weigh Down followers who have been successful in losing weight. Testimonials fill Weigh Down’s literature. Those who believe the Bible contains teachings for all areas of life, including science, have no trouble in matching scriptures with weight control strategies. Overeating is presented simply as a will power problem that can be overcome by obedience to God’s will.

There are enough red flags to make the nutrition and scientific communities skeptical about the Weigh Down option. Those caution signs include no supporting research, oversimplification, no exercise component, complete dismissal of genetic factors, advertisement by testimonials and required, for-profit reading materials.

Although radically different from approaches that emphasize nutritional principles, Weigh Down will take its place beside countless other weight management programs. It has an appeal to a certain segment of the population that will be given an effective tool for losing weight. Like the other programs, it won’t work for everyone.

Source: Ivanhoe Newswire

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