The Great Weight-loss hoax – part 2

obesity-crop-187102.JPGUnderstand this:

Obesity is a medical condition. Like all other medical conditions, obesity needs medical attention. Period.

So, first and foremost, you must consult your primary healthcare provider.

Disregard all promotional hype about supplements or herbals. Remember, this stuff is not made by people who deeply care about your weight or your health. These are people who want your money.

That does not necessarily mean that all nutra-peddlers are dishonest. But it also means that they are not necessarily scrupulously honest.

You have a medical condition. You talk to a medical professional.

So what are my options?

If you’re a few kilos overweight, and below a BMI of 26 or so, then a sensible doctor would advise proper diet and exercise – and nothing more.

Dieting means eating smart, making the correct choices, and still eating well. Exercise does not mean huffing and puffing in a stinking, expensive gym. It means getting off your butt, getting into moderate aerobic and anaerobic workouts, and also workouts that improve your flexibility and balance, like hathayoga.

The first-line treatment for weight management has always been, and will always be, diet and exercise.obesity-crop-1920.JPG

Across the world, every single government agency that regulates public healthcare solidly endorses this line of treatment. Diet and exercise.

What if I’m really obese?

If you’re above BMI 27 and you have a family history of diabetes or coronary disease, you are morbidly obese. Don’t worry. Your doctor has several options:

1) Prescription meds: These are medicines approved by the USFDA or the relevant government agency in your country, and available only on prescription.

Do they work? Yes, they do, within reasonable limits. And when taken under medical supervision.

Are they safe? There is no “safe” drug.

There is no “safe” dietary supplement or nutraceutical either.

In a medical context, “safe” means that the drug has been approved after rigorous testing over several years, and the benefits of the drug outweigh its potential side-effects.

Even so, any responsible doctor will think twice before prescribing a drug for weight-loss.

Six prescription drugs are in common use for obesity management. I won’t mention any names, in case you think I’m promoting any particular medicine. Each of them is useful in treating severe obesity and each has its own benefit-to-risk profile.

How long do I take prescription meds?

This is the difference between scientific obesity management and nutra-quackery.

Prescription meds are taken under medical supervision for limited periods of time. Depending on your response to the drug, your doctor may prescribe it for a few weeks to a few months. The doctor’s objective is to use drugs to bring down your weight to the point where you can take up a diet and exercise program. At this point, the drug will be discontinued.

The nutra-peddler on the other hand, will try to convince you that you should buy his “safe” nutraceutical stuff for the rest of your life. It’s “just” a dietary supplement, you will be told.  You can take his “safe” dietary supplement for the rest of your life and remain slim and sexy for the rest of your life.

Yeah, sure.

If you’re expected to consume a nutraceutical, every single day, for the rest of your life, don’t you think you should be deeply worried about its long-term effects on your body? And don’t you think your nutra-peddler should give you safety data on his weight-loss supplement? By long-term, one means over a period of ten years at least.

In most cases, your nutra-peddler won’t give you this data. Because he doesn’t have it. Because long-term safety studies cost money. Because it’s cheaper to hire a smart lawyer instead.

2) Surgery

For patients whose obesity is potentially life-threatening, and cannot be managed even with prescription drugs, a doctor will consider bariatric surgery. The objective of bariatric surgery is to temporarily or permanently reduce the size of your stomach, and thereby restrict the amount of food you can eat.

Bariatric surgery can result in significant and sustained weight-loss. But remember that any surgical procedure, even a simple tooth cavity filling, has an element of risk. And also remember that bariatric surgery is not a cosmetic procedure, like a liposuction or a facelift. Bariatric surgery is a serious intervention and it does carry some risk. When it is performed by the right surgeon, the procedure can be life-changing.

Any kind of surgical intervention is used as a last resort, and bariatric surgery is no exception.

But then, most obesity patients can be readily treated with diet and exercise, and if really necessary, a short course of prescription drugs.

Obesity can be psychologically devastating. I’ve seen how bad it can get.

In my opinion, nutra-peddlers who exploit your fear to sell you worthless and very expensive nutra-crap, are the lowest forms of human life on this planet.

I have spoken.

Srini.

 

Key references:

The NHLBI’s Obesity Education Intitiative, under the US government’s Dept of Health and Human services provides a wealth of information and booklets that you can download. I would seriously recommend that you read them.

Here’s the link:

https://www.nhlbi.nih.gov/health/resources/heart#obesity

Nutra Tamasha – The great weight-loss hoax – Part 1.

obesity-crop-187102.JPGTamasha: In India it means “farce”.

Obesity: In the world of nutraceuticals, it means “cash-cow”.

Nutra-peddlers can always count on your irrational obsession with your waistline – to improve their bottomline.

Every profit-making nutraceuticals manufacturer (and there are a lot of them, thanks to you), has at least one “guaranteed” product in his arsenal for weight loss. You can safely bet that half their profits come from your paranoia about your bulging belly and your jiggling butt.

Whether any of these weight-loss nutraceuticals or dietary supplements actually work is debatable. Very debatable.

The root cause of the problem is social. We have weird, illogical, physiologically unattainable and medically ridiculous standards of beauty. We judge others by their physical appearance, not by their competence.

In other words, the root cause of the problem is not the nutra-peddlers, but you.

Nutra-peddlers know this very well and they exploit your stupidity to the hilt, as they ply you with one “scientific” dietary supplement after another, each backed by “research”, each guaranteed to make you as sexy as Adonis (or Aphrodite), and each equally worthless.

What’s obesity anyway?

Ah. That’s a good question. Innocent laypeople (that’s you), cannot distinguish between normal weight gain and morbid obesity.

I said, normal weight gain. It is perfectly normal to gain some weight as one ages. Obviously, you cannot expect to be as slim and hard at fifty as you were at twenty. Normal human beings tend to gain some weight, as their metabolic rates decline with age.

The technical term is basal metabolic rate or BMR. Simply put, BMR is an indicator of how much energy you consume at rest. As you age, your BMR will decrease. This is a natural process and not something to be tampered with.

Many nutra-peddlers claim that their products, uniquely, can increase your BMR and make you lose weight dramatically.

Bullshit.

It is exceptionally difficult to raise your basal metabolic rate, partly because it is difficult to accurately measure your BMR in the first place. No nutraceutical or dietary supplement that I know of can increase your BMR to the point where you will lose weight just like that.

If any supplement does increase your BMR, then I would definitely wonder about what that supplement actually contains – because only certain prescription drugs are known to affect BMR, and those drugs have nasty side-effects.

How do I know if I’m just overweight or really obese?

What you need to know is your body-to-mass index, also known as BMI. It’s easy to calculate. Simply divide your weight in kilos by your height in square meters.

For a 6 foot tall man weighing 80 kgs, his BMI would be 80/(1.83)^2 = 23.8.

Another quick calculation is your waist-to-hip ratio. That’s easy. Measure waist, measure hips. Divide.

A BMI of more than 26 is generally considered obese. If your BMR is more than 30, that’s morbid obesity.  If your waist-to-hip is more than 1.2, and your BMR is in the high twenties, it would be a good idea to seek professional help.

Mind you, professional help. Not nutra-crap in a bottle.

Up next: How to properly treat obesity.

Stay tuned.

Srini.

 

Key reference:

Weight control, US Dept of Health and Human Services.

https://nccih.nih.gov/health/weightcontrol