Nutritional Plans
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Myth:   Permanent weight loss is extremely difficult for those who reach obesity"
Reality:   Each year thousands of Americans achieve significant weight loss ... And maintain it long term.
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If you suffer from overweight or obesity you are not alone. Millions of other Americans today share this health concern - which has finally reached "epidemic" and "crisis" proportions - according to NIH CDC. Having plenty of company may bring little solace, when the health risks are so real. If you desire a life that is both lengthy and enjoyable - then you need to solve your problem. Thankfully, help is available - but the program you choose can make the difference between frustration and success.

One Reason is Enough

Some people actually ask: why bother? If one isn't concerned with high fashion or competing in sports, then why deprive oneself of culinary delights? The answer, in a word, is health ... your's! Human evolution has equipped us with fat storage and conversion processes to help us survive food shortages and famine. Regrettably, it didn't provide a defense against the opposite problem: over-abundance! Bodies burdened with excess fat over time incur health risks that are magnified in our later years.

American life, with its endless panorama of rich, fatty, convenient foods, can only exacerbate the problem - as well as our modern work-places; requiring only a fraction of the calories used by previous generations. All these factors point to the real question: how can we maintain healthy, low-fat bodies and still eat well ... enough to both enjoy a satisfying "fullness" and obtain the nutrients necessary to maintain a healthy, energetic lifestyle? This is the question every fad-diet claims to answer - and fails (obviously) since the problem of obesity continues unabated. In reality, the "answer" is as simple or complex as each individual's health, lifestyle, and genetic background, and therefore will vary from patient to patient. That's why the Nu-Living solution is based on Individualized Assessment and Treatment.

What is Bariatrics?

Considering its harmful impact on society, it's not surprising that a medical specialization has been created to address the problem of obesity. "Bariatrics" deals with the diagnosis, treatment, and management of obesity, overweight and weight-related health problems. Bariatric physicians receive extensive specialized education that enables them to design safe, effective weight loss and management programs based on the most advanced medical knowledge and tailored to each patient's unique needs.

The Bariatrician recognizes no single, or "one-size-fits-all" solution exists for the disease of obesity. He (or she) treats the individual with a comprehensive program of diet and nutrition, exercise, lifestyle changes and, when indicated, the prescription of appetite suppressants and other appropriate medications. 

This website includes a wealth of information on overweight and obesity: its associated health risks, the wide range of treatment options available, and a number of helpful learning tools and quizzes. 

 


OBGYN.net Weight Management
Weight Loss Programs

 

Whether you decide to use do-it-yourself, non-clinical, or clinical weight loss programs, your chosen weight reduction plan should help you lose weight and keep it off by teaching you healthy eating and physical activity habits that you will be able to follow for the rest of your life. If you have medical problems, or if are severely overweight, weight loss programs run by trained health professionals may be best for you. These professionals are more likely to monitor you for possible side effects of weight loss.

What is a diet? A diet is a specific eating plan based upon a measured intake of calories, proteins, carbs, salts and sugars. There are many different kinds of diets but the basic types are:

  • Low-Fat Diet - The general aim of a low fat plan is to provide a balanced diet for slow steady weight loss. This type of diet is favored among experts as a more healthy way to eat for life not just weight loss. The diet is low in fat, unlike high protein diets. So red meat is limited, but poultry and white fish are encouraged. The diet is high in fruit and vegetables. Starchy carbs also play a larger role in the form of whole-wheat bread, potatoes, and whole-wheat pasta.
  • Glycemic Index Weight Loss Diets - Originally devised for diabetics, the Glycemic Index (GI) is an index of carbohydrate foods ranked according to the rate at which blood glucose levels rise when a particular food is eaten. Glucose itself has a rating of 100, so the closer to 100 a food is, the higher its 'GI' rating and the more quickly it is absorbed. A food with a low GI rating is absorbed more slowly and likely to keep blood sugar levels constant, which may help avoid hunger, whereas a high-GI food may disrupt blood sugar levels causing appetite swings. Weight loss experts are still divided as to how useful the Glycemic Index is for weight management.
  • High Fiber Diets - The idea behind very high fiber diets is that food passes through our system so fast that the body doesn't have a chance to absorb all the calories eaten. So the more fiber you eat, the more calories will be excreted and the greater the weight loss. There is no evidence to suggest that a diet, which is very high in fiber, leads to fast weight loss purely because of its fiber content. Fiber-rich foods are filling and because fiber is indigestible and it has no calories. But eating lots of fiber does not guarantee weight loss. The only thing that guarantees weight loss is eating fewer calories than you burn.
  • Low-Carb diets - High protein/low-carb weight loss diets typically lead to faster weight loss although a higher proportion of this weight loss may be fluid. However, many clinical weight loss trials indicate that low carb weight loss diets are no more successful for long-term weight loss than any other type of calorie-reduced diet. High protein, low carb weight loss diets can result in a shortfall of various nutrients and their long term health risks are unclear. Most dieticians and weight loss experts do not recommend any diet that severely restricts any of the major food groups.
  • For some excellent nutrition information and advice, the American Dietetic Association offers free Nutrition Fact Sheets for consumers. Send a  self addressed stamped envelope. Or call 800-877-1600, ext. 5000 for other publications or 800-366-1655 for recorded food/nutrition messages.

Do-It-Yourself Programs - Do-It-yourself programs consist of you running your own diet and exercise program with or without like-minded co-workers, friends, or neighbors, including support groups, worksite or community-based programs. Individuals using a do-it-yourself program rely on their own judgment, group support, and products such as diet books for advice (Note: Not all diet books are reliable sources of weight-loss information). Some useful weight loss support and self-help programs are:

  • Overeaters Anonymous (OA) [website: http://www.oa.org/] - Overeaters Anonymous offers a program of recovery from compulsive overeating using the Twelve Steps and Twelve Traditions of OA. Worldwide meetings and other tools provide a fellowship of experience, strength and hope where members respect one another's anonymity. OA charges no dues or fees; it is self-supporting through member contributions.

  • TOPS Club, Inc (Taking Off Pounds Sensibly) [website: http://www.tops.org/]  - an international, non-profit, non-commercial weight-loss support group. Members bring their own exercise and food plan plus a target weight from their doctor. TOPS provide group support to help members achieve their diet and weight loss goals. Memberships include local and on-line communities.

  • Slimming World [website: http://www.slimming-world.co.uk/]  - A successful UK-based slimming and weight loss organisation which runs weight loss classes throughout the UK. For British forces overseas a limited number of classes are held in Germany. To find your nearest class, call 08700 754666.

  • Unislim [website: http://www.unislim.com/]  - Ireland’s longest running slimming and health organization with a network of over 700 weekly meetings organized by a team of 180 class leaders.

Non-Clinical Programs - Largely commercially operated through a privately-owned, weight-loss chain. They often use books and pamphlets that are prepared by health-care providers coupled with counselors. These counselors may or may not have special training or medical backgrounds. Some programs require participants to purchase the program's food. Some programs also have on-line versions to help you track your progress.

  • Jenny Craig [website: http://www.jennycraig.com/] - offers flexible plans to fit your lifestyle, the Jenny Craig Program has been designed by an expert Medical Advisory Panel and our own team of Registered Dietitians, whose recommendations are based on the latest nutrition, weight management and disease prevention research. 

  • Weight Watchers [website: http://www.weightwatchers.com/index.aspx] - The Weight Watchers weight loss plan is designed for a safe rate of weight loss - up to two pounds per week (after the first three weeks). WeightWatchers is adamant about the careful monitoring of your health while working towards your weight loss goal and strongly urge their clients to have regular medical checkups. Also available in 30 countries [http://www.weightwatchers.com/international.aspx]

  • NutriSystem  [website: http://www.nutrisystem.com/] - a glycemic index based diet program. Your on-line membership is free and includes counseling and support services but you have to buy the meals at a cost of about  $3.00 per meal (shipping to the US). One of the best resources available on this site is access to the fitness center with animations of various exercises [http://www.nutrisystem.com/main/exercise/].

Clinical Programs - Services are provided in a health-care setting, such as a hospital, by licensed health professionals, such as physicians, nurses, dietitians, and/or psychologists. In some clinical programs, a health professional works alone; in others, a group of health professionals works together to provide services to patients. Clinical programs may offer you a variety of services such as special diets, prescription medications, nutrition education, medical care, behavior modification therapy, physical activity and even surgical methods. These services may be commercially operated and may or may not be covered under your heath insurance.

  • OPTIFAST® [website: http://www.optifast.com/index.jsp] - is designed for people who are 50 pounds or more overweight, or have a body mass index (BMI) greater than 30. It is a medically supervised program of fortified liquid replacements, which eventually includes food bars and more regular food. Counseling, lifestyle change and exercise are central to the program. The goals of the OPTIFAST® Program are to help participants achieve and maintain significant weight loss in order to improve health, lower weight-related health risks, and enhance their quality of life. For a person who is obese, under medically supervised conditions, this is a suitable program for rapid weight loss. Special nutrient rich foods are available for WLS patients.

  • New Direction Weight Loss Program [website: http://www.mbmc.org/med_serv/wellness/nutrition/weight_management.htm#new]  -  New Direction® provides a medically-supervised, safe and effective weight loss program for women who need to lose more than forty pounds, and men who need to lose more than fifty pounds. The program combines nutrition education, behavior modification, exercise instruction and group support for a comprehensive approach to weight loss.

  • Medifast [website: http://www.medifastdiet.com/] - Medifast is a meal replacement program that helps most people lose weight faster than traditional food-based diet plans. Medifast products come in individual packets that you mix with water to create a "shake" similar to an instant breakfast drink. Medifast is available in a wide variety of flavors as well as several alternate choices including protein bars, creamy soups, chili, oatmeal and hot cocoa. Medifast programs have been tested and proven to be effective in clinical studies conducted by the U.S. Government and Johns Hopkins University.

  • The Rice Diet [website: http://www.ricedietprogram.com/] - is a rapid weight loss diet program with medical supervision developed by Duke University for treatment of diabetes, hypertension and obesity in 1939. It is a low fat, low salt diet for optimal health. Phase I of the weight loss diet consists of grains and fruits. This phase requires medical supervision and should not be attempted at home. Phase II incorporates choices of vegetables, beans and other carbohydrates, in addition to grains and fruit. Fish is also served once per week. Phase II incorporates choices of vegetables, beans and other carbohydrates, in addition to grains and fruit. Fish is also served once per week. The Rice Diet reduces cholesterol, blood pressure, heart size, weight and abnormal blood sugars, thus often reducing or eliminating the need for medications.

Meal Replacement, Supplements, Pills and Wraps - Meal replacements' nutrient composition is covered by legislation so that you won't go short of any vitamins, minerals or major nutrients on the diets but they are, in essence, not natural foodstuff with all the many phytochemicals that 'real' foods such as fruits and vegetables contain. Prescription Weight Loss Drugs should be used only if you are likely to have health problems caused by your weight. You should not use drugs to improve your appearance. Prescribed weight-loss drugs, when combined with healthy weight loss diet programs which include regular physical activity, may help some obese adults lose weight. A few of these formulations are listed here:

  • SlimFast Diet is based on meal-replacement shakes, snack bars and one real-food dinner, giving a total of about 1200 calories per day. Like any 1200-calorie diet plan, SlimFast can almost guarantee weight loss. The problem, as with all meal replacement diets, is the risk of regaining weight if a person reverts to their previous dietary habits. However SlimFast offers weight loss support to overcome this weight-regain issue as well as meal planning tips and recipes on their website: [http://www.slim-fast.com/index.asp?bhcp=1]. 

  • The Skinny Pill weight loss plan 'Skinny Pills' supposedly help 'burn fat' around the clock, including while we sleep. There is little medical evidence to prove this. The pill is under scrutiny and congressional review, however, the diet plan book contains some healthy recipes based on the food pyramid which should contribute towards weight loss, our recommendation, follow the recipes, forget the pill.

Commercial Diets - There's no such thing as a perfect weight loss diet. Almost all weight loss diets help us lose weight and teach us something about healthy weight control. But exercise is an important part of all weight loss programs, so set aside enough time for an aerobic workout. Most of these diets are complicated and restrictive, they also largely contradict each other. If you have other health problems such as diabetes, heart or kidney disease, high cholesterol or other metabolic disorders you should discuss any diet program with your health care provider first. We've listed some of the good, the not-so-good and the ridiculous:

  • Total Wellbeing diet is a high-protein, low-fat eating plan focusing on protein-based foods such as lean red meat, fish and chicken and plenty of vegetables, cereals, dairy products and grains. Tested in the laboratories of the Commonwealth Scientific and Industrial Research Organisation (CSIRO) [website: http://www.csiro.au/index.asp?type=division&id=Human%20Nutrition]. 

  • The Pritikin Calorie Density Solution offers an integrated approach taught by health professionals with years of experience which combines low-fat, high-fiber eating with structured exercise in a way that is customized to fit your own personal lifestyle. The Pritikin Diet menu is practically vegetarian and focuses on whole, unprocessed foods like fruits, vegetables and low-fat carbohydrate foods. A healthy range of foods and generous portions should fill you up without any danger of weight gain. Dieters are required to walk for at least 45 minutes each day. This is a healthy diet which offers the prospect of lasting weight loss. [website: http://www.pritikin.com/benefits/benefits_WeightLoss.shtml]. 

  • The Zone Diet is mainly comprised of a 40 percent carbohydrates, 30 percent fat, and 30 percent protein diet. It's a complicated diet requiring careful monitoring and attention to the individual foods and portions you are eating at each meal. [website: http://www.zoneperfect.com/Site/Content/index.asp

  • The South Beach Diet™  is not low-fat or low-carb. It teaches you to rely on the right carbs and the right fats. Developed by renowned cardiologist Dr. Arthur Agatston, the South Beach Diet™ is a clinically tested program that will not only help you lose weight but also improve your health.. The website: http://www.southbeachdiet.com/ has shopping list generators and meal planners.

  • The Rotation Diet a/k/a The T-Factor Diet, written by Martin Katahn, works on the basis that weight loss is best achieved by rotating or varying the amount of calories we eat. Dieters vary the number of calories they consume during a three-week period (the rotation for women is 600/900/1200 calories; for men, 1200/1500/1800) for 3 weeks. [website: http://www.wwnorton.com/tfactor/rotation.htm

  • Sugar Busters! involves eating high fiber vegetables and whole grains. Fruits are encouraged and are excellent as snacks. Meats are an important source of protein but should be lean and trimmed. Plan followers are encouraged to select reduced fat products when choosing milk and cheese and strongly advocate careful attention to saturated fats. Exercise is stressed as an important part of establishing a nutritionally healthy lifestyle. [website: http://www.sugarbusters.com/]

  • The Subway Diet - Subway offers a good selection of low-calorie subs and salads. Simply eating these sandwiches and salads may not cause any actual weight loss but can add variety to your diet and exercise plan. [website: http://www.subway.com/subwayroot/index.aspx

  • Raw Food Diet advises that you eat at least 75 percent of your food in raw or natural state without commercial processing or cooking. With a completely raw diet based on plant foods alone, choices are limited and certain vitamins and minerals may be in short supply. The nutrients in some foods are better absorbed when cooked. There is no special magic in raw foods that will help you to lose weight, other than that it is hard to overeat when much of your diet is raw and high in water and fiber.

  • The Scarsdale Diet does not advocate exercise and concentrates on a low-carb, low calorie, high water-intake method for losing weight. It also advocates the use of sugar substitutes, diet pills and other methods that may have serious side-effects. Not highly recommended.

  • The Suzanne Somers Diet a/k/a The Somersize plan recommends the consumption of 1200 calories a day. At this calorie level, you could eat virtually anything and still lose weight. However, there is no scientific evidence to suggest that food-combining assists weight loss. This plan is a another multi-phase plan but the phases contradict each other, exercise is not encouraged other than Ms. Somers's other products.

  • Rosemary Conley's Hip and Thigh Diet is a sensible low-fat weight loss diet that reduces weight all over the body. If you are female and pear-shaped, this diet is no more likely to reduce the fat on your hips and thighs than any other sensible diet plan.

  • Peel Away the Pounds Patch claimed that simply applying a seaweed based patch would cause a weight loss of 3-5 pounds per week. For more information read http://www.ftc.gov/opa/2004/03/peelaway.htm 

  • The Doctor's Quick Weight Loss Diet one of the first modern high-protein weight loss diets, after which came the Atkins Diet, the Zone Diet, etc. The diet was even more strict, allowing not even vegetables - it was basically meat, poultry, fish, cheese, eggs and water. Now you are unlikely to find a copy, which may be for the best as any weight loss diet that discouraged vegetables is not a serious diet plan.

For more information please see the following publications:

 


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Copyright © 2008 Faith M Gray, M.D.
Last modified: August 15, 2009