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New Methods For Maintaining Weight Loss
by John Hernried, M.D., F.A.C.P., Medical Director
Many patients have described to me their difficulty in maintaining their weight. They usually say: “I’m a great faster, but keeping it off has been difficult.” There are many reasons this problem can occur: a physical illness that limits exercise, a return of stress-induced eating, a sense of being overpowered by food or not remaining in the Skills program after the diet. We know that there are also biological reasons for weight regain: our brains often send signals to us to crave food, sometimes to the point of obsession.
We have a new treatment option at OTC in the form of medication, for patients who have these anxious or obsessive feelings, or those who do not develop a feeling of fullness after a meal. The primary medication we use for this is Meridia (Sibutramine); reports from patients indicate that Meridia is very helpful, especially in counteracting the “white knuckle syndrome” (the anxious feeling that old overeating behaviors may reoccur at any time).
While Meridia is approved for weight loss, our experience is that it is an even better weight maintenance drug. Meridia has been available for three years, and is different from any other weight loss medication. It works by increasing the neurochemicals serotonin and norepinephrine in the brain, with the results that you feel full sooner and experience a decrease in thoughts and compulsions about food—including those dreaded carbohydrates!
Meridia appears to be a safe medication, and it is approved for long-term use. It is closely related to various antidepressants such as Prozac and Effexor, which have been in use for years. To date, there have been no reports of major ill effects from Meridia—certainly none of the concerns reported on phen/fen and Redux. Side effects that occur with Meridia may include dry mouth, insomnia, headache and dizziness. These are usually transient. While you can still become hungry, the beneficial effects of Meridia become apparent when you are faced with difficult situations (i.e. holidays and social events). You will likely notice a drop in caloric intake in your food records.
There are few contraindications to take Meridia. If you have hypertension, Meridia cannot be started until your blood pressure is under good control. In less than one percent of patients, it will cause a rise in blood pressure. This returns to normal after discontinuation. It is also contraindicated if you are taking a serotonin antidepressant such as Prozac, Paxil, Zoloft or Celexa. However, we have become skilled in combining these medications in low doses and have had no major problems to date.
If you are an OTC patient who has been on the diet before and failed to maintain your weight, consider trying again with the combination of the Skills program and Meridia. For many, this has proven to be the successful combination finally leading to long-term weight management. Interested? Call OTC at 916-978-0300 for more information, or to make an appointment.
The Hot News on Protein
by John Hernried, M.D., Medical Director
During the past year the media has been sounding the death knell to low carbohydrate diets. Low carb diet books and products sit in clearance bins at the market. Ironically, this is at a time when several recent clinical studies are showing the benefit of low carb diets.
What’s going on? Researchers are taking a closer look at low carbohydrate diets, such as Atkins and South Beach. While it was assumed that lower carbohydrate was the key to weight loss in these diets, new research show that an increase in protein may be responsible. It appears that a diet higher in protein may help curb appetite and increase metabolic rate. Two recent studies bear this out. In one study, the researchers varied the amount of protein dieters consumed from 15 percent of daily calories to 30 percent. Over the course of the 16 week study, even when dieters were allowed to consume as many calories as they wanted, they lost almost 11 pounds.
Because they reported less hunger, they ate less. In fact, they consumed about 450 fewer calories per day. The second study examined the effect of a higher protein
diet on metabolism. The study found that blood sugar and muscle mass were much more stable with a diet higher in protein. They also noted the importance of having a protein serving at breakfast. Still another study showed that higher protein diets actually increase metabolic rate in addition to improving satiety (fullness). This is groundbreaking research that supports a dietary increase in protein.
But is it safe? Isn’t it true high protein diets cause kidney failure, osteoporosis, cancer and heart disease? No. In fact, the prestigious Institute of Medicine (a branch of the National Academy of Science) said there is no evidence to support these concerns. Further, they said there is evidence to support an increase of protein in the diet. For us at OTC, this only emphasizes the importance we place on protein consumption as an “anchor point” in Skills, combined with a balance of fat and healthy carbs to meet a calorie target. Yet, for many, controlling carbohydrates remains critical to weight control. This is why it takes time and experimentation in Skills to determine the best combination for you. Finding the right mixture sounds hard, but it doesn’t have to be.
The use of our supplement can easily meet your protein target without overshooting calories. They are convenient to store and mix and can be combined with other lean protein, fruits and vegetables to create an ideal diet plan. This is why we make New Directions supplement available to all current and former patients. For a person weighing 150 pounds, two supplements and one bar provides 60% of a day’s requirement of protein. Simply add a chicken breast at dinner and you have met your protein target. Our most successful patients have utilized meal replacements to optimize their weight management. We will continue to make available new lines of good tasting higher protein foods so that they can be part of your long-term strategy.
