How Do We Undo The Obesity Epidemic? The Australian Solution.

Fat, Sick & Nearly DeadIt's hard to make weight loss into a movie, and it's harder to make it inspiring without a hard sell approach.  I was impressed by Fat, Sick and Nearly Dead.  Unlike almost any weight loss program I've seen, it really is about people getting well without any money in it for the producer. 

The movie is available at Netflix streaming, but you could also get a copy (so you can hand it to your relatives where it will sit on the shelf gathering dust until they have heart attacks like Bear in the movie did). 

If anyone is looking for someone to monitor the fast and do blood work, this is one I can get behind.  It's not permanent, but it is sustainable over time, and it's based on fruits and vegetables.
You can just look at the diet, but I'd watch the movie.  It's not often you see a trucker become an actor and make the transition gracefully. 

HCG Diet: Boy, I Wish I Could Get Behind It, But I Can't.

For those of you living in seclusion, the HCG diet is a great new craze.  Thank Kevin Trudeau, who publicized his own weight loss using the diet. 

Now, the basis of the HCG diet is a five hundred calorie diet.  Guess what, that's effective.  Starvation does actually lead to weight loss.  But the next step is to inject yourself with HCG.  For the men out there, this is the stuff that pregnant ladies generate.  And you'll be injecting that into yourself.  Hence my initial difficulty with the concept.

So does the HCG do anything?  Well, no.  It really doesn't.  Don't believe the experts, don't believe common sense.  Just have a look at the double blind, placebo controlled study.

S Afr Med J. 1990 Feb 17;77(4):185-9.
Human chorionic gonadotrophin and weight loss. A double-blind, placebo-controlled trial.

Bosch B, Venter I, Stewart RI, Bertram SR.
Department of Medical Physiology and Biochemistry, University of Stellenbosch, Parowvallei, CP.
Abstract

Low-dose human chorionic gonadotrophin (HCG) combined with a severe diet remains a popular treatment for obesity, despite equivocal evidence of its effectiveness. In a double-blind, placebo-controlled study, the effects of HCG on weight loss were compared with placebo injections. Forty obese women (body mass index greater than 30 kg/m2) were placed on the same diet supplying 5,000 kJ per day and received daily intramuscular injections of saline or HCG, 6 days a week for 6 weeks. A psychological profile, hunger level, body circumferences, a fasting blood sample and food records were obtained at the start and end of the study, while body weight was measured weekly. Subjects receiving HCG injections showed no advantages over those on placebo in respect of any of the variables recorded. Furthermore, weight loss on our diet was similar to that on severely restricted intake. We conclude that there is no rationale for the use of HCG injections in the treatment of obesity.
PMID: 2405506 [PubMed - indexed for MEDLINE]

So, while I'd love to have lots of patients and put them all on HCG, it hasn't been shown to work.  Starvation does work short term, but it generates long term problems.  As you generate a deficiency in the body, you are telling the fat cells that are left to become more active.  Fat is not just passive storage.  It works for your body by generating a range of hormones. 

BMC Med. 2011 Mar 16;9(1):25. [Epub ahead of print]


Regulation of vascular tone by adipocytes.

Maenhaut N, Van de Voorde J.
Abstract

ABSTRACT: Recent studies have shown that adipose tissue is an active endocrine and paracrine organ secreting several mediators called adipokines. Adipokines include hormones, inflammatory cytokines and other proteins. In obesity, adipose tissue becomes dysfunctional, resulting in an overproduction of proinflammatory adipokines and a lower production of anti-inflammatory adipokines. The pathological accumulation of dysfunctional adipose tissue that characterizes obesity is a major risk factor for many other diseases, including type 2 diabetes, cardiovascular disease and hypertension. Multiple physiological roles have been assigned to adipokines, including the regulation of vascular tone. For example, the unidentified adipocyte-derived relaxing factor (ADRF) released from adipose tissue has been shown to relax arteries. Besides ADRF, other adipokines such as adiponectin, omentin and visfatin are vasorelaxants. On the other hand, angiotensin II and resistin are vasoconstrictors released by adipocytes. Reactive oxygen species, leptin, tumour necrosis factor alpha, interleukin-6 and apelin share both vasorelaxing and constricting properties. Dysregulated synthesis of the vasoactive and proinflammatory adipokines may underlie the compromised vascular reactivity in obesity and obesity-related disorders.
PMID: 21410966

The bottom line is that I've just talked myself out of a whole bunch of patients looking for a quick weight loss solution.  But that's not what I want to do with patients.  What I want for patients is not term weight control, not just short term weight loss.  For that we have to use the body's wisdom to help people figure out what works for them. 

Kathryn Retzler of Hormone Synergy has done a wonderful job of summarizing the data on HCG.  http://www.hormonesynergy.com/resources.asp.  I hope she publishes her position paper, because we need people to understand the whole picture about HCG. 

A Diet Book I Like: The New ME Diet.

The Tetas have hit upon the metabolic effect, which allows you do exercise more intensely for shorter periods.  This is the focus of the book.  Dietary advice is basically South Beach/Atkins, and the exercises are not strenuous enough to get the kind of metabolic enhancement you really want. 

To get a sense of the actual workouts, here's one of the authors doing the workout. 

For those of you looking at weight loss:  have a look at the weight charts.  It's disturbing to see those numbers and realize they added five pounds for clothing (they also took away an inch for shoes). 

Osteoporosis: Beyond The Drugs, What Can We Do to Retain Bones?

We need to move beyond the calcium supplementation to addressing the core issues of osteoporosis.  It should be possible to alter the bone loss without resorting to lifelong estrogen replacement.  Some day we will treat this illness with comprehensive lifestyle changes, supplements, drugs, and hormonal balancing.

I've put some ideas about conservative treatments at: http://www.maloneymedical.com/id10.html

If patients were only encouraged to take specific exercise programs (extension, not contraction) we'd see less fracturing. 



Recycling from Weight Loss History: Simeons and HCG

Those who do not read history are doomed to spend their days starving themselves and giving themselves injections of pregnancy hormone.  Simeons' book has been rereleased, in large part due to Kevin Trudeau.  More importantly, now patients are able to buy pregnancy hormone over the counter.  It isn't very strong, but I wonder if it will lead to false positive pregnancy tests or people not realizing that they are pregnant.  I'm really not a fan, and I've written about why this should not be on your top one hundred possible ways to lose weight.  If you don't believe me (and you shouldn't believe anything you read on the web these days), have a look at the studies that have been done on Simeons work.  I have many ideas for weight loss that might actually work, and if you want to do a starvation diet of five hundred calories a day, for goodness sake do it with a trusted medical advisor.  Taking these drops and reading a book is really not a good idea.