The dietary treatment of weight problems and obesity.
As with any type of treatment which is designed to have an impact on your health, it is essential that you have a full understanding of the benefits and risks which may be associated with the treatment, and that you consent to undergo the treatment with full knowledge of all the positive and negative aspects.
The purpose of this section is to outline these benefits and risks in terms which you understand fully. If there is anything unclear to you after you have read it, then you should contact a health care professional to have it explained to you until you understand it. Or, you or your chosen health care professional may e-mail us for clarification of any points that appear obscure, but understand that we cannot supervise your dietary treatment from a distance! Once you understand all about the benefits and risks, then you should reveal all pertinent facts about yourself which could affect the results of a dietary weight loss programme to the supervisor or Counsellor of your proposed diet programme. If this is not your doctor, then you may have to demonstrate to the supervisor that you have obtained the approval of your doctor, and confirm that you accept any benefit or risk of the programme as your own responsibility.
The fact you must know before you even start is that simply reducing your intake of normal food, or starving yourself, is not a diet. It is no biological coincidence that consuming about 1800 - 2200 kilocalories of sensibly-chosen conventional foods provides about the right amounts of both macro- and micro-nutrients to ensure good health (thus protein, carbohydrate, fat including essential fatty acids, vitamins and minerals). Simply reducing food intake without making allowance for the reduced intake of essential nutrients may expose you to deficiencies, some of which may be rather horrible (see other sections of this web site for some examples), and is quite likely to cause a loss of lean body mass, which you will never recover. Going further, and just starving yourself, is worse, and could kill you!
The next thing you must understand is that being overweight, even by only a few pounds, will reduce your life expectancy; for every 10% over your ideal weight, statistics show a reduction in life expectancy by at least one to three years! The reason for this is that overweight or obesity intensify, or predispose to, many medical complaints, some of which are serious and can be life-threatening:
Cardiovascular disease, such as hypertension, atherosclerosis and coronary heart disease, strokes (associated with hypertension), varicose veins, heart failure.
Metabolic disorders, such as diabetes mellitus (adult onset type), hyperuricaemia and gout, disorders of lipid metabolism (including high blood cholesterol levels), gall bladder disease.
Hormonal disorders, such as disturbances of the menstrual cycle, hirsutism, and a possible relation to endometrial and breast cancer. Reduced libido may also occur.
Mechanical disorders, such as the aggravation of arthritis, hiatus hernia, constipation, skin irritation (particularly at folds, sometimes with infections).
Some types of renal disease (sometimes due to the effects on the circulation).
In addition to the above, weight problems increase the risk of surgical procedures (obesity increases the technical difficulty for the surgeon, increases the incidence of side-effects from the anaesthesia, and predisposes to post-operative complications). Furthermore. overweight and obesity result in social problems, and also result in an increased accident risk.
The benefits of successful weight reduction are that any weight-related disorder will improve, and some may disappear completely. Statistics show, for example, that after successful weight reduction, life expectancy is restored to normal values, provided you do not "yo-yo". There is some evidence that the benefits of weight reduction diminish with each cycle of those that "yo-yo" (meaning those who lose weight, then regain it, then lose it again, and continue doing so in cycles). The reason for this is explained elsewhere in this web site.
You should be aware that there are several methods of weight reduction. You can take various drugs (Prescription or Over-The-Counter) to suppress appetite or hunger, but these do not work well and often have side-effects; you can use Dietary Supplements that have been shown to be effective in weight loss by increasing thermogenesis; you can submit to surgery (gastric bypass appears quite successful, but the older procedures of gastric stapling or shortening of the intestine often do not work); you can have your teeth stapled (socially unacceptable); you can have a balloon inflated in your stomach (which will not change your behaviour, and may cause an obstruction when it bursts); or, you can follow a good diet plan. In some cases, the combination of a diet plan with a thermogenic Dietary Supplement can be particularly effective, but label instructions and cautions for the Dietary Supplement must be carefully followed.
The safest way to diet is to follow a programme supervised by experts, who can ensure that your intake of necessary nutrients is adequate, and can adjust the diet to meet your specific needs. In such cases, dietary treatment of weight problems is safe, and risk of adverse effects is kept to a minimum.
There are, however, still risks, most of which apply to weight loss by any means, not just weight loss associated with use of a reduced-energy diet. In other words, the risks are inherent to weight loss in itself, and have to do with the way the body adapts to the loss of mass. These can broadly be classified into five types:
Information on medications and disorders which may prevent you following a dietary programme is given on the following pages.
YOU MUST NOTE THAT YOUR WEIGHT PROBLEM IN ITSELF HAS SUBSTANTIALLY INCREASED YOUR RISK OF A VARIETY OF MEDICAL DISORDERS, SUCH AS GALL BLADDER DISEASE, AND ONE OR OTHER OF THESE DISORDERS COULD MANIFEST AT ANY TIME! IN MOST CASES, THIS RISK WILL ONLY DIMINISH GRADUALLY, AND EVEN AFTER YOU HAVE SUCCESSFULLY COMPLETED THE DIETARY PROGRAMME AND ACHIEVED YOUR IDEAL WEIGHT, YOU WILL CONTINUE TO BE AT INCREASED RISK FOR MONTHS, OR EVEN YEARS. THIS IS PARTICULARLY TRUE OF GALL STONES; THOUGH YOUR DIET CREATES CONDITIONS IN WHICH GALL STONES ARE NO LONGER FORMED, THOSE WHICH YOU ALREADY HAVE MAY TAKE UP TO TWO YEARS OR MORE TO REDISSOLVE, AND THEY COULD GIVE YOU SYMPTOMS AT ANY TIME DURING THIS PERIOD!
If you fall into any of the above categories, you must have your doctor's permission, and his agreement to supervise you, before starting any diet! You may need a modified and milder plan, since the loss of weight may be desirable.
DIETING IS COMPATIBLE WITH SOME MEDICAL CONDITIONS, IF MEDICALLY SUPERVISED OR APPROVED.
Medical supervision is particularly important when losing weight for the very elderly, growing children and adolescents, or if you have heart and cardiovascular conditions, diabetes, gout, kidney disease, stroke, chronic infections, hypoglycaemia, or are under medical care for any other condition. Your doctor will be able to advise you whether or not you should follow this diet programme, and may want to adjust any medication you are taking. Any carbohydrate-restricted diet may induce water loss, therefore diuretics or any medication which produce water loss should not be taken while on the diet, except with the approval of your doctor.
The following tables
give further information on medications and conditions which all require
that you have medical permission, and if necessary, supervision, while
on the diet programme!
OF DIETS WITH MEDICATION:
USE OF A DIET
IS COMPATIBLE WITH CERTAIN MEDICAL CONDITIONS:
A small proportion of patients on any diet may experience side effects, some of which are transient and most of which are mild, such as headaches, mild dizziness, constipation, diarrhoea, nausea, irritability and dryness of the skin. For most people the advantage of losing weight overrides any short-term discomfort which may be experienced. These effects can generally be eliminated with appropriate supplementation. Some possible causes and short-term remedies are:
HEADACHES may occur as a result of carbohydrate or caffeine withdrawal. Simple headache remedies taken for a day or two should alleviate the problem.
CONSTIPATION - though bowel movements may be less frequent because the diet contains less bulk, it is generally considered that constipation is partly a consequence of essential fatty acid deficiency, and it usually disappears with supplementation. If constipation remains a problem fibre-based laxatives or herbal laxative teas are useful, or more vegetables can be eaten.
NAUSEA and DIARRHOEA are sometimes signs of essential fatty acid deficiency, but may also occur as a result of not drinking enough water. Drinking plenty of liquid is necessary, to allow the body to regulate its own water and electrolyte balance; if you try to interfere by restricitng your fluid intake, thinking you will thus lose more weight, you may aggravate adverse effects of this nature! Intolerance to a constituent of the diet is a possible but unlikely cause of these symptoms.
DRYNESS OF THE SKIN and SLIGHT HAIR LOSS, occurring later during the use of a diet, almost always indicate a mild essential fatty acid deficiency. This problem can be eradicated by adjustment of the diet, or use of an essential fatty acid supplement.
YOU ARE UNLIKELY TO HAVE ANY ADVERSE EFFECTS WHATSOEVER, AND WILL BENEFIT MOST FROM A DIETARY PROGRAMME, IF:
The last is most important; you must follow any prescribed diet strictly, since it is designed to keep you in perfect health while you lose weight!
Having read the
foregoing, and hopefully having understood it completely, or having
obtained clarification of any points you did not understand, you will
be aware that weight problems are serious health hazards, and that well-constructed
dietary programmes are designed to reduce this health hazard in the
safest possible fashion. You will also be aware that weight problems
of themselves may have resulted in some hidden medical conditions, which
could become manifest at any time during use of a diet. You will also
understand that if such events occur, they are not caused by the diet,
but are a consequence of the weight problem, and that those who diet
may remain at some small degree of risk for a while after reaching ideal
here if you have read and understood the information