Optimal Health Newsletter #8
Weight Management
In this issue of Optimal Health Newsletter I want to begin a discussion on the topic of weight management. This is a very complex subject, and this edition will primarily cover general aspects and basic principles of metabolism and weight management. In a subsequent OHN I will get into more specific details of various tests, diets, and supplements that can be useful.
The subject of weight reduction and management is one that has been of interest to me for the entire time that I have been practicing medicine (no, I’m not going to tell you how long that has been…). More than just about any other aspect of medicine, I am interested in why people get sick. Overweight involves many aspects of metabolism that contribute to pathologic processes. Most everyone reading this newsletter is aware of the numerous health problems associated with being overweight. The list is long, including a higher incidence of diabetes, heart attacks, strokes, high blood pressure, elevated cholesterol, etc. More that the health risks, however, what bothers the vast majority of overweight people are the psychological aggravations associated with their physical appearance. People just don’t like looking or feeling fat!
For many years I have felt that finding a safe and effective remedy or solution to excess body weight would be the medical equivalent of discovering the ‘rosetta stone’ of medicine. From a health standpoint, solving this one problem would do more good for more people than any other single thing that I can think of. Unfortunately, this ‘discovery’ is yet to be found, and may never be. Weight reduction and management is incredibly complex, involving multiple, simultaneously operating metabolic reactions. Because of the biological uniqueness of every individual, there is no single system or approach that is going to work for everyone. To me, this has been the most obvious failing of all of the so-called ‘plans’, ‘diet centers’, books, and weight-loss programs. Over the years I have seen all kinds of ‘systems’ for weight reduction come and go, and then come around again years later, renamed but not actually changed or modified much, and then go again…and return…on and on. During this time, however, there have been amazing advances in our knowledge of cellular biology, physiology, and metabolism. There have also been significant advances in laboratory testing and biological measuring techniques. Even though pharmaceutical agents (drugs) don’t appeal to me much, there have been developments in this arena that have potential benefit. These are some of the reasons that I find this aspect of medicine to be both fascinating and challenging!
So, given that this is a tough problem, let’s explore some of the principles and factors that can make a difference. Here are some of the basics…
Principle #1: In most situations, overweight is the result of genetic and metabolic conditions, not overeating or lack of exercise.
One of the first things to realize and accept about overweight is that there are multiple genetic predisposing factors. This needs to be understood by everyone, not just people with a weight problem. Two separate people can eat exactly the same food and participate in exactly the same exercise, and one will gain weight and the other will not. For far too long there has been a general conception that overweight people ‘eat too much and don’t exercise enough’. "If they just had the will power to diet and exercise they too could be thin" - No way! If this were true, no one with will power would be overweight. Some of the most determined and motivated people I know have fought with a weight problem all of their lives. Yes, it is true that a person can eat their way into an overweight condition, but this is seldom the situation, especially if a person is trying to lose weight. In almost all situations, obesity is a metabolic condition that has a great similarity to type 2 (non-insulin dependant) diabetes. For diabetics, although eating too much sugar will certainly make the condition worse, but they did not become diabetic from eating too much sugar, cake, or cookies. Therefore, when we are looking for the most effective, safe, and efficient method(s) for weight reduction, we have to look very closely at metabolic issues. This will be discussed more in a future OHN.
Principle #2: In spite of principle #1, diet and exercise are important… (but not for the reasons that most people think.)
Go into any bookstore and look in the area where the ‘diet books’ are located. It is truly amazing! One local bookstore that I visited once had three entire sections, from floor to ceiling, filled with different diet books. I didn’t count them, but I wouldn’t have been surprised if there had been over 100 different titles. Most of the books were variations of the two basic plans: high-protein, low carbohydrate (Atkins, Sugar Busters, Protein Power, etc.) or high complex carbohydrate, low fat (Ornish, Pritikin). In addition, there were many others with varying unique approaches (Blood Type, Cabbage Soup, and different ‘fad’ techniques). One thing that all the books had in common. Avoid refined sugar and products made of white flour! While different types of programs might work for different people, not a single one didn’t stress the avoidance of these substances. I won’t go into further detail in this newsletter regarding the reasons for the above. I have already gone on too long. So without elaborating, my main dietary recommendation for weight loss, maintenance, and general good health, is Avoid refined sugar and products made of white flour!
Exercise: The main reason to exercise is because it raises the metabolic rate. It is not primarily to ‘burn calories’ by the exercise itself. (If this were true, in order to burn 3500 calories - one pound of fat – a person would have to walk 22 miles). Exercise such as walking for about 15 to 20 minutes will raise the bodies metabolic rate for about 14 to 16 hours. So if you want to optimize exercise for weight loss purposes, walk for a short time (15 – 20 minutes) twice a day. This will keep the metabolic rate up ‘around the clock’. You don’t have to join a gym or buy expensive exercise equipment. Just walk – its cheap and easy. But it has to be done each day. Weekends, holidays, every day. Although its ‘easy to do’ its easier not to do.
Principle #3 – drink lots of water (8 to 10 glasses a day)
If a person is trying to lose weight, it is essential to drink adequate amounts of water. When the body burns fat, metabolic by-products are created and these need to be eliminated so that further fat combustion can occur. The situation is very similar to what happens in a fireplace. If the wood is dry the fire will burn, but only if the smoke can get out. If the chimney is blocked the combustion products can’t be removed and the fire will never burn. The manner in which fat metabolism wastes are removed from the body is via the urine. To establish and maintain a good urine flow adequate water intake is necessary. Without this, all measures for safe and effective weight loss will be ineffective.
So, these are three of the basic principles for weight reduction, management, and good health in general. There is an enormous amount of additional information and I will try to cover some of this in future issues of OHN.
I am very fortunate to be able to work with an outstanding nutritionist, Robin Marzi. Together, in the office, we are offering what we call the ‘Optimal Weight Loss Plan’. This is a very individualized program, recognizing the biological uniqueness of each individual. If you interested in more information about this program call our office (963-1824) and ask about an initial consultation with Robin or myself.
I apologize if I went on too long on this topic, but believe me, this is just the tip of the iceberg. If overweight were a simple problem, no one would be fat.
Best regards,
