It's not your fault that you're fat?

Sorry I haven't posted much in a while but I've been pretty busy and just haven't had the time. This came to my email this morning and I felt compelled to share it.

As many of you know, my health has been an issue in recent weeks. I am taking positive, proven steps to counteract stress and years of inactivity. I have never been one to jump on any bandwagon or weight loss fad.

Recently, the Atkins and South Beach diets have been getting a lot of attention. Several years ago, it was the Beverly Hills diet and more recently it has been Sugar Busters and a whole host of other diets that just don't make sense... they don't ring true to me.

Even commercial weight loss programs seem problematic. Take Jenny Craig, for instance. You meet once a week and eat the food they provide... and only the food they provide. Of course you lose weight. The food they provide is nutritionally balanced and portion-controlled. But, does it teach you how to eat properly when you stop paying them $58 (or more) per week for their pre-packaged meals? Yes, that's what the weekly meetings are all about but how many of you are able to truly absorb a lesson when it is presented to you only in lecture format? Raise your hands... I thought so.

To be truthful, I've never thoroughly investigated any of the pre-packaged food programs. I know they wouldn't be effective for me. If they've been effective for you in losing weight and maintaining a healthy lifestyle, I am honestly proud of you and am glad that it was effective for you. I know that is a difficult road to travel.

The only commercial weight loss program I have used is Weight Watcher's. When they used the exchange method, I could see that, for one, it taught balance in the foods you ate and portion control (a key to any weight loss), and also taught you how to manage your food intake and lifestyle in the real world.

I haven't returned to Weight Watcher's because they've switched to a "points" system. The points system, for me, does not encourage me to remain in balance or make healthy choices. When I can spend 10 points on 8 ounces of soda or 8 ounces of fruit juice (value given as an example only), what about that encourages me to make the healthier choice of drinking the fruit juice?

I think you see my point. Fad diets are just that: Fads. They may work for some but, especially in the case of any diet where you virtually eliminate necessary nutrients and food substances, can be extremely dangerous for others. On the other side of the coin, any program that doesn't teach you how to eat healthy and eat properly in real world situations is probably not going to serve in the long run.

I told you all of that to give you some background on my rather jaded view of the weight-loss industry. The email I received has something to do with a contender gaining new ground in the battle of the bulge: The magic weight-loss pill.

I'm sure most of you have seen the commercials for these weight-loss supplements that cost an exorbitant ammount of money, tell you it's not your fault, and promise to block some chemical in your body that is allegedly making you fat.

Well, here's a little deeper look at the situation:
(NOTE: I am not employed by this company nor do I subscribe to their newsletter. The contents simply rang true to me and I thought I would share the information.)

The BLI Letter (4.14) - Weight-Loss Wonders

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The BLI LetterVolume 4, Number 14 Weight-Loss Wonders

They're everywhere--magazines, commercials, infomercials, the Internet--ads touting the next generation of weight-loss supplements. By next generation, I mean the post-ephedra generation, now that ephedra and its derivatives have been banned by the U.S. Food and Drug Administration (FDA). At BLI, we've been getting several questions:

* What are these supplements--pharmaceuticals or food supplements?
* Is there science behind these products or the ingredients in the products?
* Do these products actually help people lose weight without diet and exercise?

Let's answer these questions, and in the process, explain how to separate the wheat from the chaff when it comes to weight-loss products. I'm not naming names, but you'll know which products I'm referring to if you notice ads in the media.

Are these products pharmaceuticals?

The names and the type of packaging used try to give the impression that they are medications. Some of the ads state that the products are so strong and cost so much that they should be used only by someone who has over 50 pounds to lose and is serious about losing weight. It sounds compelling--as if these products are pharmaceuticals or prescription-strength medications.
Simply put, that's an advertising ploy--nothing more. Medications must be prescribed by a physician, and the fact that these can be bought over the counter tells you that these are dietary supplements, not pharmaceuticals.

Is there science to support the products or their ingredients?

Let's examine the issue of science in two ways: the theoretical basis for the product and the efficacy of the ingredients in the products.

Theory
These weight-loss products sometimes pick a theory or hypothesis of obesity and try to address the issue by the nature of the ingredients in the product. Case in point is the cortisol theory of obesity. Cortisol is a steroid hormone that is released in response to stress; this theory basically says that we overproduce cortisol because of societal stress, and the excess cortisol causes us to store fat. That's taking the stress response to an extreme level. Several products contain ingredients which are supposed to reduce stress levels or reduce the production of cortisol in some way on the assumption that if you reduce the cortisol, you'll reduce the obesity.

But at this time, no one knows if excess cortisol is the cause of obesity or the effect of being obese. On top of that, people who have abdominal obesity (a big belly) have different cortisol levels than those who have peripheral obesity (fat everywhere, not just the belly). Therefore, without knowing what is cause or what is effect, creating a product is premature. They could be correct and maybe the product will work, or they could be wrong and you've wasted your money. For a product that costs $50-150 per month, you'd probably like to have better science than that.

Ingredients
The ingredients in these products vary, but most have herbs that contain caffeine such as kola nut or guarana, herbs that stimulate metabolism such as green tea extract, herbs that help with blood sugar such as garcinia cambogia and gymnema sylvestre, or minerals that help with blood sugar such as chromium and vanadium. These substances have been used for many years and are effective to one degree or another, but the key is something to stimulate metabolism. Green tea may do it, but not as effectively as ephedra.

Some of these products contain an herb designed to replace ephedra called bitter orange (Citrus aurantium), which contains an active ingredient called synephrine. It seems to have a thermogenic effect (raises metabolism) without stimulating the central nervous system like ephedra does.Unfortunately that research is limited. In a review article, Preuss, et al., reported that the results were short term--there's no way of knowing whether the effect would last long enough to aid weight loss (1). More research is needed to find out if it's really effective and can avoid the problems associated with ephedra.

Can I skip the diet and exercise if I use these products?

The ads for these products imply that all you have to do is to take the pills--nothing else. No exercise. No change in eating patterns. No change in lifestyle. Wouldn't that be nice? But, sadly, the answer is no--there is no known supplement (or pharmaceutical, for that matter) that will allow you to lose weight while you eat whatever you want in any quantity you want and sit in a recliner all day.

How can a person who's not a scientist identify what's real and what's not?

It's not easy, but here are a few clues.

Labels: The only way I was able to obtain some of the labels from these products was from people who copied and posted them on websites--nothing from the manufacturers themselves. If they don't easily provide a product label with a complete list of ingredients, stay away.

Proprietary blend: This is a way of not revealing the complete quantities of each ingredient in the product. If a product says only that it contains bitter orange, ginseng, chromium, and vanadium, you have no way of knowing what the amounts are. There could be efficacious amounts of the active ingredient or miniscule amounts. When it comes to potential stimulants such as bitter orange, it's important to know the quantity.

Science: If the research was not done on the product itself with the complete blend of ingredients, you don't know (and neither does themanufacturer) if it will work in the way it was intended. Look for statements like "Research on one of the ingredients in X has been shown..."That ingredient may not work with the other ingredients as intended.

Here's the bottom line: there's no easy way to lose weight. You have to change your lifestyle in order to lose weight and keep it off, and that means eating less and exercising more. Some supplements such as garcinia cambogia, chromium, and conjugated linoleic acid can give you an edge in controlling your appetite and cravings or may stimulate fat loss. But if you take the supplements and don't change your lifestyle, you're going to be disappointed. There are simply no shortcuts on the path to a better life.

Reference:
1. Preuss HG, et al. Citrus aurantium as a thermogenic, weight-reduction replacement for ephedra: an overview. J Med. 2002;33:247-64.

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