Cutting calories is still the best way to lose weight

Pamela Egan Practical Practitioner

 

By: Pamela Egan, FNP-C CDE

 


 

The best way to lose weight is to cut excess calories

 

 

Dear Pam,

My sister is losing weight on the Atkins Diet. What are the best ways to lose weight?


Over half of adults in the United States are overweight. Summer is approaching and people are asking about the best ways to lose weight.

The most popular diets are “Atkins” and “The Zone.” Atkins is high protein, low carbohydrates.

These diets work for some people, primarily by reducing calories. Protein and fats can reduce hunger, so people tend to eat less. It can also improve HDL, triglycerides and fasting glucose. There are concerns about possible long-term problems, such as heart and kidney disease and bone loss.

The Zone is more balanced. It uses a 40-30-30 rule. This means 40 percent carbohydrates, 30 percent protein and 30 percent fat. The idea is this ratio keeps insulin levels in “the zone” to reduce hunger, fat storage and inflammation. It’s easier to tolerate than Atkins to lose weight.

Drug therapy is appropriate for patients with a Basal Metabolic Index (BMI) greater than 30 or BMI greater than 27 with additional risk factors when diet and exercise are not enough.

Stimulants (phentermine, diethylpropion) can help suppress appetite but only short-term.

Meridia and Xenical are approved for long-term use. They reduce weight by about 10 percent over a year when combined with diet and exercise. Meridia can increase blood pressure. Individuals with uncontrolled hypertension or heart disease should not take Meridia.

Wellbutrin SR is structurally similar to diethylproprion. Wellbutrin SR is an antidepressant. It causes short-term weight loss, but there’s no reliable evidence it works long-term. Chronic use of the SSRI’s (Paxil, Zoloft, Prozac) sometimes leads to weight gain.

Zonegran and Topamax seem to decrease appetite and reduce weight by 6 percent to 10 percent. But these anticonvulsants can cause adverse effects such as fatigue, numbness in fingers, cognitive impairment and vision problems. Topamax along with Prozac is currently being used for the treatment of Bulimia.

Supplements such as Metabolife, Xenadrine, Dexatrim, etc. are promoted like crazy. Most are not proven safe or effective. I don’t recommend them.

You should be skeptical about all the new “ephedra-free” products. They often substitute a similar stimulant with a different name. Watch for labels that list bitter orange, country mallow, heartleaf and ma huang, as these all contain ephedrine-related compounds.

There’s no way around it… decreasing calories is required. By cutting 500 calories per day – one order of French fries – can lower weight by a pound per week.

Even these small weight reductions decrease complications of diabetes, hypertension, heart disease, etc.


This article was originally published June 16, 2003 in The St. Tammany News.

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