Tuesday, March 12, 2013

Are There Natural Ways to Lose Weight?


Who does not want to shed some pounds? But, it’s so difficult! It’s not rare to hear the question as to whether “something out there” could help with the weight loss. People want something “natural.” Often this means not using prescription pills or having surgery. Let me share with you the advice I share with those who come to see me.
First, if you are overweight or obese, you will have to make some changes. To lose fat weight, you have to eat fewer calories, or burn more calories, or both. And you have to sustain this over time, which is the hard part. No matter what else you do, you always have to return to this basic rule.
Weight loss can be supported in many ways. Appetite can be suppressed, more calories can be burned by stimulating metabolism, or digestion can be inhibited to decrease how many calories are absorbed by the body. All of these methods also can be combined.
So, what is out there to consider using? Well, there are many claims but much less science to support that any of these really do what they are “advertised” to do. You are your own experiment. Be careful in your choices because you do not want the risks of a supplement to outweigh any benefits. And, watch the cost! These can be expensive and hurt your personal finances.
Here are some of the products you may find in your quest for “natural” weight-loss treatments.
APPETITE SUPPRESSANTS
Anti-depressant medications that increase a substance called serotonin [ser-o-TONE-in] in the brain can sometimes cause weight loss. St. John’s Wort and 5-HTP work the same way. 5-HTP decreases carb (sugar and starch) intake, causes early fullness, and helps weight loss in the short term. The same holds true for St. John’s Wort. However, we only have people’s reports of the effectiveness of those two agents. There is no evidence of long-term benefit in managing obesity with those agents.
Hoodia grows in the Kalahari Desert. The San Bushmen eat Hoodia to keep hunger away during long hunts. The precise way that Hoodia works is not known, but like 5-HTP and St. John’s wort, it helps make you feel full sooner. Here’s what I tell my patients: if they walk as much as a San Bushman does when he is hunting, then Hoodia will probably help the weight-loss process!
THERMOGENIC (CALORIE -BURNING ) AGENTS
Wouldn’t it be nice if you could increase your metabolism [meh-TAB-o-liz-um] so you could burn more calories without having to be more physically active? That is what thermogenic agents are supposed to do. These are known as “fat-burning” agents. Have you heard of an “adrenaline [uh-DREN-uh-lin] rush”? This is what you get when you have to fight or run away. Adrenaline is a hormone and it gets your metabolism going. When you have an “adrenaline rush” your heart beats faster, you get shaky, you are more alert, and you release energy from your body stores. An “adrenaline rush” causes a thermogenic effect – it increases your body heat. Adrenaline is also called epinephrine [eh-pi-NEPHrin].
Norepinephrine [NOR-eh-pi-NEPH-rin], which is like epinephrine, decreases appetite.
Ephedrine [eh-FEH-drin] is a thermogenic agent. It is often combined with caffeine. Ephedrine decreases the breakdown of norepinephrine at the nerve endings. Neither ephedrine nor caffeine alone does much to help weight loss. However, when combined, ephedrine and caffeine do cause weight loss.
Ephedra [eh-FEH-druh], also known as ma huang [ma hwong], was often used in the past to help people with weight loss. The ephedra plant naturally contains ephedrine, pseudoephedrine [soo-doh-eh-FEH-drin], and phenylpropanolamine [fen-ul-pro-puh-NA-lameen], which are sold as medications. Ephedra is no longer a good option. In 2004, the US Food and Drug Administration (FDA) banned ephedra products because they were linked with serious or fatal side effects. Unfortunately, ephedra products are still around in the black market.
With ephedra gone, bitter orange is now popular. Bitter orange contains 1% to 6% synephrine [sih-NEF-reen]. Synephrine may cause weight loss because it is similar in its effects to ephedra. This means that bitter orange has the same potential for harm as ephedra. In fact, bitter orange supplements have been linked to stroke and heart damage, cardiac arrest, loss of consciousness, chest pain, and death.
Thermogenic products have chemicals that may seriously affect your health. If you have hypertension or known heart disease, stay away from them. Otherwise, make sure you are under the care of a doctor who may monitor your blood pressure and heart health.
One last word on thermogenic agents: caffeine sources include not just coffee, but also guarana [gwa-ra- NAH], cola nut, maté, and tea extract. Claims that these natural products cause significant weight loss are untrue. The very best way of increasing fat burning (thermogenesis) is to become more physically active on a regular basis.
DIGESTION INHIBITORS
Foods that contain fiber stretch the stomach and get digestion started. This causes fullness and may also cause the gut to absorb less of food. Psyllium [SILL-i-um] seeds, barley, and guar gum are some examples of natural products tried for weight loss. High-fiber foods decrease fat being absorbed by binding fats within he gut. Upping fiber intake lowers serum cholesterol [ko-LESS-tuh-roll] and triglyceride [try-GLIS-er-ide] levels. The effects on weight loss, however, vary.
The flip side of digestion inhibitors is that they may keep your prescription medications from being properly absorbed. If you use digestion inhibitors, be sure to take your medications one hour before or two hours after taking the high-fiber product.
OTHER AGENTS THAT MAY AID WEIGHT LOSS
There are several other natural products that are marketed for weight loss. These include:
  • Glucomannan [gloo-ko-MAN-nen], which is extracted from the konjac [KOHN-yak] plant.
  • Guggul [GOO-gul], which produces a gummy resin that is used in supplements.
  • Inulin, which is a sugar that comes from chicory.
  • Conjugated linoleic [lin-oh-LAY-ik] acid, which is found mainly in dairy products and beef.
  • Calcium in foods, because adults and children with low calcium intake are more likely to gain weight, have a higher body mass index (BMI), and be overweight or obese, compared with people with higher calcium intake.
  • 7-keto-DHEA, which comes from the hormone DHEA and may boost basal metabolism and thermogenesis. As opposed to DHEA, 7-keto-DHEA is not converted to sex hormones, so it may be safer in this form.
  • Garcinia [gar-SIN-ee-uh] fruit and rind extracts, which contain up to 50% hydroxycitric [hy-drox-ee-SIH-trik] acid.
  • Chromium, which is an element found in nature that people use for high cholesterol, diabetes, and obesity.
  • Pyruvate [pie-ROO-vate], which taken in large amounts (22-44 grams) instead of carbs, may cause weight loss. The problem here is that pyruvate causes significant side effects in the gut, including diarrhea, bloating, and flatulence.
  • “African mango” or “bush mango,” which is a tree from Africa that produces a mango-like fruit. The seeds have high fiber content and function as a bulk-forming laxative.
MAKE IT COUNT!
When it comes to supplements, there is a lot of marketing, but little science. Here is the most natural way of losing weight that I know of, and what I tell my patients to do. There is actual science behind these recommendations. Counting is the key and these tips are brought to you courtesy of the numbers “2” and “10.”
  • “2”: Every hour on the hour during the waking hours of the day, get up and walk away for a minute. Then walk right back to what you were doing. These two minute walks add up to a 30-minute walk at the end of the day. When you are home at night, turn the TV on. At the beginning of every commercial break get up, and go up and down two flights of stairs. If you have the TV on two hours every night, then every night you will climb a 40-story tall building!
  • “10”: Aim for 10 servings of fresh fruits or vegetables every day. One serving is the size of a measuring cup. Eat two servings with breakfast, lunch, and supper. And eat one serving mid-morning, mid-afternoon and in the evening. You choose when to have the last serving. Increasing the amount of fresh fruits and vegetables in the meal plan does indeed help you lose weight! Just make sure these are fruits that have high fiber such as berries, apples, or cantaloupe, and if you have diabetes or prediabetes, check with your doctor to see what fruits and vegetables to avoid.
These recommendations help establish the building blocks to good health, which are healthy eating and physical activity.

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