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Persons who are concerned about weight loss should first establish whether there is a genuine need to lose weight, then determine what will and what won't work to shed the excess poundage and finally learn how to obtain qualified help which can contribute to a successful and permanent weight loss.
Overweight refers to the pounds an individual carries that are in excess of desirable body weight, and its occurrence is judged most commonly on the basis of weight to height. Obesity is a term which implies a serious amount of fatness 20% or more above desirable body weight. A common method for determining excessive is by examining height/weight charts. These charts, such as those published by the Metropolitan Life Insurance Company of New York City, show the range of weights for men and women at a specific height that is associated with the lowest mortality rate. In other words, these charts indicate the weight range in which people of a given height tend to live the longest. While not perfect, they give us a reasonable way to estimate desirable weight. Other methods, which are used mostly by researchers and health professionals, include the caliper test, which measures skin fold thickness, and weighing a person under water to determine body density. Once these tests have been performed, the results are inserted into a formula to obtain the percent of body fat. For adult women, body fat usually represents 22-24% of total body weight; for adult men, the amount is 16-18%. Those persons above the norms for desirable body weight and percentage of body fat are most likely candidates for weight loss.
People who have determined that they need to lose weight often look to the marketplace for weight-loss aids or services. Products and services for weight loss are discussed in the following section.
Running the gamut of weight-loss promotions
According to a Food and Drug Administration (FDA) advisory panel, only two drugs, phenylpropanolamine (PPA) and benzocaine with caffeine, may be used in non-prescription diet aids. Phenylpropanolamine is chemically related to amphetamine and is used in many over-the-counter diet pills to suppress the appetite. Medical experts, who examined diet products for FDA, advised that PPA seems to be safe and effective. However, it should not be taken by everyone, especially those with high blood pressure, diabetes, or thyroid or kidney problems. FDA is currently reviewing safety data to determine whether PPA is safe and effective in controlling weight.
Benzocaine is an active ingredient currently found in many over-the-counter diet gums and candies. It numbs the tongue, reducing the sense of taste. FDA is also reviewing the safety and effectiveness of this diet aid.
Other weight-loss pills which have been offered through the mail or via health food stores have included a variety of questionable ingredients. Some have contained herbal blends or diuretics; another was found to have freeze-dried cow brains. Generally, weight-loss pills are in the following forms:
Starch blockers generally sold in pill form, allegedly block starch digestion in the body and thus help in weight reduction. Some ads have claimed that people taking starch blocker pills could eat up to 600 calories a day of food such as bread, potatoes and pasta without absorbing the calories.
Although starch blockers are made from raw beans, FDA considers these products to be drugs (and therefore subject to FDA approval before marketing) because of associated claims that these pills can control or reduce weight by blocking or interfering with digestion.
FDA has seized many shipments of these illegal new drugs. In addition, the FDA has received complaints that use of these products have caused nausea, vomiting, diarrhea and stomach pains.
"Bulk Producers" or Fillers
Bulk producers have been promoted for weight loss due to the alleged "feeling of fullness" that results with the use of these pills. One such product is glucomannan which is processed from the roots of the konjac plant. Promoters claim that glucomannan and other bulk producers, taken before meals, absorb liquids and swell in the stomach to form a gel and "reduce hunger." FDA has stated that use of bulk producers are safe, but their value in reducing weight has not been established.
Grapefruit Diet Pills
Grapefruit diet pills have been promoted to "burn off fat or cellulite (those fatty lumps)" while allowing users to consume as much food as they want. Ingredients in these pills have been found to vary. As well as a grapefruit extract, some grapefruit pills have contained a diuretic (increasing elimination of water through urination) or glucomannan (a bulk producer). Others may combine an appetite suppressant such as phenylpropanolamine with herbs or other ingredients. FDA has not approved any "grapefruit" pill for weight-loss or any other medical purpose and is unaware of any valid scientific or medical evidence proving such products to be safe or effective.
There have been many different types of pills or substances promoted for weight loss including dehydroepiandrosterone or dehydroandrosterone (DHEA) and cholecystokinin (CCK). DHEA is a steroidal hormone, CCK is a hormone which is involved in the human digestive process. In pill form, CCK has no effect because the chemical cannot survive in the digestive track. FDA considers both products to be drugs requiring FDA premarket approval. FDA has not yet received requested substantiation of weight-loss claims from DHEA and CCK manufacturers.
Another pill containing the amino acids, arginine and ornithine, has been promoted for stimulating the human growth hormone causing the user "to burn fat overnight." To date, no data has been submitted to the FDA to support this claim.
Diuretics are used to rid the body of excess water by increasing the flow of urine. They have sometimes been given to people who want to lose weight but the most they can do is help the dieter shed a few pounds of water weight, not fat. Diuretics are not intended to be used as a weight-loss product. They are primarily available as prescription drugs and are used to reduce swelling often caused by conditions such as congestive heart failure or cirrhosis of the liver. However, certain herbs or other substances have a natural diuretic effect and have been found in some pills promoted for weight loss.
Weight-loss clinics offer a variety of different plans for losing weight. Some clinics provide diet guidelines using a participant's regularly purchased food from a local supermarket; others provide food or other supplements such as formula diets (discussed below) that must be purchased through the program. Clinics may offer counseling by a medical staff such as nurses, doctors, registered dietitians or other counselors and stress changes in eating habits. These clinics may also include exercise equipment and/or exercise classes.
Many clinics provide legitimate and valuable service to aid individuals wishing to lose weight however, some clinics use questionable methods. For example, many persons may be attracted to advertisements for weight-loss clinics that claim guaranteed or quick weight loss. Some clinics have combined reduced calorie diets with injections or pills of HCG (human chorionic gonadotropin) a hormone extracted from the urine of pregnant women. This hormone is purported to enable a person to lose weight without eating less. This method is not effective for permanent weight loss. In fact, FDA requires all labeling and advertising of HCG to state that it is not approved by the FDA as safe and effective in the treatment of obesity or weight control. Amphetamines, prescription drugs, have been used in some clinics. They have been found to be addictive and may contribute to problems of the central nervous system. Laxatives and diuretics have also been used by some clinics to reduce weight through elimination of water and body wastes. FDA recommends against their use for weight loss.
Formula Diets/Diet Plans
One type of diet that was promoted in the 1970's for quick and easy weight loss was the very low calorie/high protein diet. This diet was advertised as a panacea for the overweight, with promises that they could "burn fat off" more quickly than with a regular balanced diet. As with many "crash" diets, not only was the quick weight loss that the dieter experienced on these low calorie/high protein regiments, temporary, but also dangerous. In addition to a loss of body fat, such an excessive loss of body fluid or dehydration, electrolyte imbalance, and loss of lean body mass. Also, no foods have the ability to "burn off fat." Body fat is "burned" or gotten rid of only using more calories or energy than is supplied by the food you eat. According to the Food and Drug Administration, a claim that a food can "burn fat off" is fraudulent.
Most of today's very low calorie diets differ from the liquid protein diets of the past. These diets seek to reduce the caloric intake below normal levels while providing sufficient quantities of proteins as well as vitamins, minerals and other nutrients needed by the body. Powdered mixtures may be added to skim milk or other liquid and are usually consumed in place of one or more meals. Their popularity stems from the fact that "caloric counting" has already been done for the user. Critics of formula diets state that the use of these products may not teach good eating habits to aid overweight individuals in maintaining weight goals when dieting has stopped.
Some formula diets have been incorporated in a total diet plan that offers a variety of weight-loss and or dietary supplement products for a claimed nutritional plan. These plans often feature products that include herbal blends. Many health experts are concerned about use of these products over any length of time. Although the powdered or other mixture may be promoted with a meal, some believe that many individuals will skip the meal reducing the total calories consumed to very low daily levels.
In addition, these products may be promoted by "independent counselors" who have had no nutritional or medical training. Diet plans may be sold through a multi-level marketing promotion or other quick profit incentive programs. Health officials have questioned the credibility of some of these offers.
Other weight-loss promotions
"Burn fat while you sleep," "Erase waistline bulges instantly," "All the figure toning of 3,000 sit-ups without moving an inch" are some of the many claims made by promoters of diet books, body wraps or other fad products. Many of these weight-loss promotions are subject to question and may even contribute to other serious health problems with their use.
The following provides a sampling of the more common quack or unproven promotions one might encounter on the way to seeking slimness:
Body wraps are bands of rubber or plastic material worn around the hips, waist, thighs and suits (sometimes advertised as "sauna suits" or "reducing pajamas") that cover the whole body. One promoter even offered a plastic band that was inflated with air from an electric hairdryer. These "wraps" may be promoted alone or in combination with a cream, gel or lotion that is applied to the skin before the wrap is worn. One company advised soaking the "wrap" in Epsom salts before applying to the body; another suggested using its lotion with one's own plastic food wrap. Some "wraps" are to be worn while carrying on routine activities, others while exercising and some while sleeping.
These garments and wraps, with or without lotions or creams, temporarily cause a loss of inches and perhaps pounds due to fluid loss or perspiration. The fluid, along with the inches or pounds, is soon replaced by drinking or eating. Furthermore, wraps in any form have no effect on fat deposits and will not dissolve fat in the body.
Experts state that use of these wraps or garments are potentially dangerous because they can bring about severe dehydration, personal injury from circulatory construction or cardiac incident while exercising.
Electric Muscle Stimulators (EMS)
Promoters of electrical muscle stimulator devices allege that muscle stimulator shocks usually conducted through contact pads that are attached to the body. Advertisements for these devices claim weight loss through "no work" or "passive" exercising. Like many quack gimmicks, these electric muscle stimulators are prescription medical conditions such as muscle atrophy from disuse. None of the legitimate uses is related to slimming or weight loss.
The Food and Drug Administration, which regulates EMS as medical devices, has seen no evidence that these devices are safe and effective for home use or for those uses touted in health spas and beauty salons. FDA considers EMS to be misbranded and fraudulent when promoted for weight-loss purposes. EMS devices can cause electrical shocks and burns. In addition, the FDA warns that these devices should not be used on pregnant women, persons with heart problems and people with cancer or epilepsy.
Fad and Novelty Diets
Fad diets usually focus on one food, foods not usually associated with weight loss, limited combination of foods, or other substances. They are promoted as having almost magical or undiscovered weight-loss properties that provide "negative calories", "increase metabolic rate" or "burn or melt fat" in the body. Some fad diets suggest eating mostly protein foods with few, if any, carbohydrates; others promote the reverse. Bread and butter, ice cream or yogurt diets are a few of many of the foods promoted in fad diets.
Fad diets are usually short lived in popularity. The names of these diets are often colorful, e.g., "The Amazing Grapefruit Diet". Claims and opinions cited in articles or books on dietary regimens are protected under the First Amendment of the Constitution. This means that anyone, despite lack of medical expertise or other nutrition or educational background, can express any weight-loss opinions they wish in articles or books without having to substantiate them.
According to the Food and Drug Administration, in cases where fad diets are successful, the weight loss usually results from the reduction of caloric intake, not some magical property of the foods eaten. Additional considerations with fad diets are that eating only certain foods often results in boredom and failure to stick to the diet, such diets are seldom helpful in maintenance of weight-loss, and many may not be healthful if followed for some time.
How to lose weight - really!
With the many unsuccessful products promoted for weight loss, one may wonder what magic formula actually works for losing additional pounds. According to the American Dietetic Association and the Food and Drug Administration, the only demonstrated way to lose weight is to consistently eat fewer calories than your body needs and uses. One can lose weight by reducing energy intake (food), by increasing energy output (exercise) or preferably by a combination of both.
A sensible weight-loss program is one that results in a slow, steady loss of weight, about one to two pounds per week, to a proper level which the dieter can maintain permanently.
Sources of help and information
Overweight individuals often try to find their own way to reduce. For many, will power in cutting back food portions and increasing exercise is all that's needed, but still many fail. An appointment with a doctor before attempting weight loss will determine any underlying problems that may have contributed to an individual's weight problem. One bariatric physician (a physician who specializes in treatment of the over-weight) stated that many overweight persons "lack knowledge on how to lose weight". Furthermore, "those who know what is necessary to lose weight do not know how to put this information to practice". Finally, some have an "inability to modify (bad) eating behaviors (that contribute to the overweight problem) due to psychological problems."
The treatment of overweight or obese individuals is handled on a casebycase basis. One doctor from a diet clinic stated that there are a variety of treatments proposed depending on the nature of the problem. Some use formula diets temporarily. According to the American Society of Bariatric Physicians, changes in eating habits and increasing exercise are to be stressed as well as possible use of medications. A patient should be closely monitored whatever combination of treatments are prescribed.
- The Food and Drug Administration has jurisdiction over, among other things, any food, drug, device or cosmetic that is adulterated or misbranded. For example, FDA has exercised its authority by seizing and destroying products from firms that were improperly selling or using electric muscle stimulators for weight loss. The FDA's field offices (see your local telephone directory under Dept. of Health and Human Services) can often answer questions about a product's legitimacy and the truth of claims made for it.
- The Federal Trade Commission (FTC) has jurisdiction over the advertising of foods, nonprescription drugs, cosmetics and devices which are involved in interstate commerce. For example, the FTC charged the marketers of a diet program that promoted eating unlimited quantities of foods on certain days followed by severely restricted low calorie intake with the company's products on the remaining days with unsubstantiated advertising claims. To settle these charges without admitting a violation of law, the company signed a consent agreement with the Federal Trade Commission.
- The United States Postal Service (USPS) has jurisdiction over fraudulent marketing promotions conducted by mail. In one such case postal service authorities seized product orders for a nationally advertised grapefruit pill when the manufacturer violated a consent agreement that prohibited it from making unsubstantiated weight loss claims that consumers would "lose greater amounts of weight than scientific evidence showed." The SUPS invites complaints from the general public about possible quackery claims. Your local post office can give you an appropriate address to write to.
- Other government agencies include state attorneys general and consumer affairs offices (usually located in a state's capital city). These offices often take on quackery investigations on a casebycase basis.
- The American Dietetics Association (ADA) in Chicago, Illinois is a professional organization that provides direction and leadership for quality dietetic practice, education and research to promote optimal health and nutrition status of the American population. Consumers may call (312) 2805000 or write 430 N. Michigan Avenue, Chicago, Illinois 60611, for information on publications available on nutrition and health through this organization.
- Better Business Bureaus are self-regulatory consumer service organizations supported by businesses. They provide reports about companies located in their service areas and tips on avoiding medical quackery. Better Business Bureaus work with law enforcement agencies to combat fraudulent activities. For the address of your nearest Better Business Bureau, contact the Council of Better Business Bureaus, Inc., 4200 Wilson Blvd., Arlington, VA 22203 or your local library.
Tips for successful weight loss
- Before buying any product which makes weightloss claims or committing to any other weightloss program, consumers should check with their physician, a qualified nutritionist or registered dietitian, Better Business Bureau, local or state health department, an extension agent with the United States Department of Agriculture, or nearest Food and Drug Administration office.
- Be leery of any diet that provides fewer than 800 calories a day, promises weight loss greater than two pounds per week or focuses on one or a few food groups.
- Significant weight loss should not be undertaken without competent medical supervision, especially if the amount of weight loss sought is more than 10% of normal weight of an individual.
- Diets should be nutritionally wellbalanced with a variety of foods including dairy products, meats, poultry, and fish; fruits; vegetables, legumes and whole grains.
- Any diet pill or other weightloss product is at best, only a temporary or partial measure; long term weight loss requires a permanent change in eating habits.
- Look for certain key words. "Breakthrough," "secret," "exclusive," or "special" are not scientific words and often appear for promotions of quack products.
- Be cautious if immediate, effortless and/or guaranteed weight loss is promised.
- Be wary of health remedies sold doortodoor by peddlers or selfproclaimed health advisors who sell their product at public lectures, traveling from town to town. High pressure sales tactics and onetimeonly deals are clues that something is wrong.
- Be cautious of vaguely worded testimonials that cannot be verified. Also, an ethical health practitioner is not likely to advertise accomplishments about miracles performed on famous people. Testimonials should not serve as a substitute for scientific proof of a product's efficiency.
- If you have questions about an advertised product, check with your nearest FDA office and Better Business Bureau BEFORE buying the product. Investigate the company and the product before calling the 800 tollfree number to order the product with your credit card or sending an order via the mail.
- If the promotion or plan sounds too good to be true, it probably is.
Questions and Comments
Comment Submitted 2/8/2014
Information about weight loss is really good.
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