Treatments for Obesity

Treatment list for Obesity:

The list of treatments mentioned in various sources for Obesity includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

• Diet changes
• Low Calorie Diet - 800-1500 calories
• Very Low-Calorie Diet (VLCD) - less than 800 calories
• Exercise
• Appetite-suppressant medications
• Orlistat
• Sibutramine
• Dexfenfluramine (Redux:withdrawn)
• Diethylpropion (Tenuate, Tenuate dospan)
• Fenfluramine (Pondimin:withdrawn)
• "fen/phen" Fenfluramine/phentermine (withdrawn)
• Mazindol (Sanorex, Mazanor)
• Orlistat (Xenical)
• Phendimetrazine (Bontril, Plegine, Prelu-2, X-Trozine)
• Phentermine (Adipex-P, Fastin, Ionamin, Oby-trim)
• Sibutramine (Meridia)
• Drug combinations
• Treatment of any underlying causes of obesity
• Vitamin D - possibly used for treatment of vitamin D deficiency

Treatments of Obesity: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the treatments of Obesity.

Obesity: Treatment
(In A Page: Pediatric Signs and Symptoms)

• If syndrome or no known disease as etiology
  –Nutritional education and diet manipulation
  –Exercise regimen (energy expenditure must exceed intake)
  –Behavior modification involving family
• Hormonal etiology
  –Hormone replacement for hypothyroidism or growth hormone deficiency
  –Surgical intervention if hypercortisolism caused by tumor
  –Decrease exogeneous glucorticoids if not medically contraindicated
• Leptin treatment in leptin deficiency (therapeutic trials)
• If patient also has type II diabetes mellitus, insulin or oral medications may be required in addition to improved diet and exercise

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Abdominal distention: Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))

If the patient displays abdominal distention, quickly check for signs of hypovolemia, such as pallor, diaphoresis, hypotension, a rapid thready pulse, rapid shallow breathing, decreased urine output, and altered mentation. Ask the patient if he’s experiencing severe abdominal pain or difficulty breathing. Find out about any recent accidents, and observe him for signs of trauma and peritoneal bleeding, such as Cullen’s sign or Turner’s sign. Then auscultate all abdominal quadrants, noting rapid and high-pitched, diminished, or absent bowel sounds. (If you don’t hear bowel sounds immediately, listen for at least 5 minutes in each of the four abdominal quadrants.) Gently palpate the abdomen for rigidity. Remember that deep or extensive palpation may increase pain.

If you detect abdominal distention and rigidity along with abnormal bowel sounds and if the patient complains of pain, begin emergency interventions. Place the patient in the supine position, administer oxygen, and insert an I.V. line for fluid replacement. Prepare to insert a nasogastric tube to relieve acute intraluminal distention. Reassure the patient and prepare him for surgery.

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Obesity: Treatment
(Professional Guide to Diseases (Eighth Edition))

Successful management of obesity must decrease the patient’s daily calorie intake while increasing his activity level. Effective treatment must be based on a balanced, low-calorie diet that eliminates foods high in fat or sugar. Lifelong maintenance of these improved eating and exercise patterns is necessary to achieve long-term benefits.

The popular low-carbohydrate diets offer no long-term advantage; rapid early weight reduction is due to loss of water, not fat. These and other crash or fad diets have the overwhelming drawback that they don’t teach the patient long-term modification of eating patterns and often lead to the “yo-yo syndrome” — episodes of repeated weight loss followed by weight gain. This can be more detrimental than the obesity itself because of the severe stress it can place on the body.

Total fasting is an effective method of rapid weight reduction but requires close monitoring and supervision to minimize risks of ketonemia, electrolyte imbalance, hypotension, and loss of lean body mass. Prolonged fasting and very-low-calorie diets have been associated with sudden death, possibly resulting from cardiac arrhythmias caused by electrolyte abnormalities. These methods also neglect patient re-education, which is necessary for long-term weight maintenance.

Treatment may also include hypnosis and behavior modification techniques, which promote fundamental changes in eating habits and activity patterns. In addition, psychotherapy may be beneficial for some patients, because weight reduction may lead to depression or even psychosis. Antidepressants are also helpful in weight loss.

Amphetamines and amphetamine congeners have been used to enhance compliance with a prescribed diet by temporarily suppressing the appetite and creating a feeling of well-being. However, because their value in long-term weight control is questionable, and they have significant potential for dependence and abuse, their use is generally avoided. If these drugs are used at all, they should be prescribed only for short-term therapy and should be monitored carefully.

The drug combination known as fen-phen (fenfluramine and phentermine) had been touted as an effective method of suppressing appetite. However, after researchers linked the drug combination to potentially fatal heart valve disease, fenfluramine was withdrawn from the market in September 1997. Phentermine wasn’t withdrawn but physicians are no longer allowed to combine the two drugs.

As a last resort, morbid obesity, which is indicated by body weight that’s 50% to 100% higher than ideal, body weight that’s 100 pounds higher than ideal, or a body mass index greater than 39, may be treated surgically with a variety of restrictive procedures. The two most popular bariatric surgeries are vertical banded gastroplasty and gastric bypass surgery. These procedures decrease the volume of food that the stomach can hold or bypass the stomach, with the goal of producing satiety with small intake. Bypassing the stomach also induces diarrhea when concentrated sweets are ingested. These techniques cause fewer complications than jejunoileal bypass, which induces a permanent malabsorption syndrome. Extended liquid diets are necessary adjuncts to surgery. Psychological counseling is also recommended.

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Abdominal distention: Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))

If the patient displays abdominal distention, quickly check for signs of hypovolemia, such as pallor, diaphoresis, hypotension, rapid and thready pulse, rapid and shallow breathing, decreased urine output, poor capillary refill, and altered mentation. Ask the patient if he’s experiencing severe abdominal pain or difficulty breathing. Find out about any recent accidents, and observe the patient for signs of trauma and peritoneal bleeding, such as Cullen’s sign  or Turner’s sign. Then auscultate all abdominal quadrants, noting rapid and high-pitched, diminished, or absent bowel sounds. (If you don’t hear bowel sounds immediately, listen for at least 5 minutes.) Gently palpate the abdomen for rigidity. Remember that deep or extensive palpation may increase pain.

If you detect abdominal distention and rigidity along with abnormal bowel sounds, and the patient complains of pain, begin emergency interventions. Place the patient in the supine position, administer oxygen, and insert an I.V. line for fluid replacement. Prepare to insert a nasogastric tube to relieve acute intraluminal distention. Reassure the patient and prepare him for surgery.

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Abdominal distention: Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

If the patient displays abdominal distention, quickly check for signs of hypovolemia, such as pallor; diaphoresis; hypotension; rapid, thready pulse; rapid, shallow breathing; decreased urine output; poor capillary refill; and altered mentation. Ask the patient if he’s experiencing severe abdominal pain or difficulty breathing. Find out about any recent accidents, and observe the patient for signs of trauma and peritoneal bleeding, such as Cullen’s sign or Turner’s sign. Then auscultate all abdominal quadrants, noting rapid and high-pitched, diminished, or absent bowel sounds. (If you don’t hear bowel sounds immediately, listen for at least 5 minutes.) Gently palpate the abdomen for rigidity. Remember that deep or extensive palpation may increase pain.

If you detect abdominal distention and rigidity along with abnormal bowel sounds and the patient complains of pain, begin emergency interventions. Place the patient in the supine position, administer oxygen, and insert an I.V. line for fluid replacement. Prepare to insert a nasogastric tube to relieve acute intraluminal distention. Reassure the patient, and prepare him for surgery.

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Abdominal distention: Nursing considerations
(Nursing: Interpreting Signs and Symptoms)

▪ Position the patient comfortably, using pillows for support.

▪ If the patient has flatus, place him on his left side to help flatus escape.

▪ If the patient has ascites, elevate the head of the bed to ease his breathing.

▪ Insert a nasogastric tube for bowel compression; monitor amount and type of drainage.

▪ Administer drugs to relieve pain, and offer emotional support.

▪ Prepare the patient for diagnostic tests, such as abdominal X-rays, endoscopy, laparoscopy, ultrasonography, computed tomography scan or, possibly, paracentesis.

▪ Prepare the patient for surgery, if indicated.

Patient teaching

▪ Teach the patient to use slow deep breathing to help relieve abdominal discomfort.

▪ If the patient has an obstruction or ascites, tell him which foods and fluids to avoid.

▪ Emphasize the importance of oral hygiene to prevent dry mouth.

▪ Explain the underlying disorder and treatment plan.

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Medications used to treat Obesity:

Note:You must always seek professional medical advice about any treatment or change in treatment plans.

Some of the different medications used in the treatment of Obesity include:

• Benzphetamine
• Didrex
• Diethylpropion
• Tenuate
• Tenuate Dospan
• Ifa Norex
• Neobes
• Sibutramine
• Meridia
• Raductil
• Reductil
• Phentermine
• Duromine

Unlabelled alternative drug treatments include:

• Fluoxetine
• Alti-Fluoxetine
• Apo-Fluoxetine
• Gen-Fluoxetine
• Med-Fluoxetine
• Prozac
• Prozac Weekly
• Sarafem
• Dextroamphetamine
• Dexedrine
• Dextrostat
• Phentermine
• Adipex-P
• Ionamin

Medical news summaries about treatments for Obesity:

The following medical news items are relevant to treatment of Obesity:

• Arthritis Foundation reports on top 10 arthritis developments in 2004
• Aspirin may reduce risk of type 2 diabetes in obese people
• Chinese herbal company has released natural alternative for cholesterol reduction
• Common co-morbidities causing complications post-operatively
• Cortislim’s advertising under fire from consumers and FDA
• Deceitful diet company being sued
• Diet drug manufacturer seeks approval for multimillion-dollar national settlement over it’s banned diet drug
• Diet supplements may not be as good as they claim
• Drug similar to aspiring may unlock the key to obesity
• Elderly diet supplement carries unknown risks
• Experimental weight-loss drug shows multitude of health benefits
• Internet company ordered to fully refund customers for diet patches due to misleading claims
• Juvenile arthritis can affect infants
• Long term effects of obesity surgery examined
• Metabolic syndrome (X)
• Metabolic syndrome mechanism defined
• New appetite suppressant has good results
• New diet wonder drug - Accomplia
• New drug aimed at providing a tan, improving sex life and reducing weight
• New Ephedra alternative aimed to promote weight loss
• Obesity surgery carries risks
• Operation options for obesity
• Oral contraceptive use may increase risk of high blood pressure
• Overweight women more likely to fall pregnant while on the Pill
• Pancreatic cancer surgery less common in black men
• PCOS alleviated by diabetes drug
• PCOS may be improved by the diet drug Xenical
• Pharmaceutical company wins one case and pays $250,000 in another diet drug case
• Risky obesity operations
• Risky obesity surgery
• Scientists find exercise secrets in order to develop a pill to take the place of exercise
• Some antipsychotic drugs linked to increased risk of developing type 2 diabetes
• Some herbal medications found to contain toxic levels of heavy metals
• South African cactus used to develop appetite suppressant
• Steroid drugs used to treat nephritic syndrome do not affect bone mass
• Surgeon sued for gastric bypass surgery misdemeanors
• Surgery a viable option for elderly obese
• Surgery delivers better weight loss than dieting
• Suspension of Aleve comes as a surprise
• Weight loss drug, orlistat, proves itself in trials

Discussion of treatments for Obesity:

Understanding Adult Obesity: NIDDK (Excerpt)

The method of treatment depends on your level of obesity, overall health condition, and motivation to lose weight. Treatment may include a combination of diet, exercise, behavior modification, and sometimes weight-loss drugs. In some cases of severe obesity, gastrointestinal surgery may be recommended. Remember, weight control is a life-long effort. (Source: excerpt from Understanding Adult Obesity: NIDDK)

Am I at Risk for Type 2 Diabetes: NIDDK (Excerpt)

If you are overweight or obese, choose sensible ways to get in shape:

• Avoid crash diets. Instead, eat less of the foods you usually have. Limit the amount of fat you eat.
• Increase your physical activity. Aim for at least 30 minutes of exercise most days of the week. (See below for easy suggestions .)
• Set a reasonable weight-loss goal, such as losing 1 pound a week. Aim for a long-term goal of losing at least 7 percent of your total body weight.

Make wise food choices most of the time

What you eat has a big impact on your health. By making wise food choices, you can help control your body weight, blood pressure, and cholesterol.

• Take a hard look at the serving sizes of the foods you eat. Reduce serving sizes of main courses (such as meat), desserts, and foods high in fat. Increase the amount of fruits and vegetables.
• Limit your fat intake to about 25 percent of your total calories. For example, if your food choices add up to about 2,000 calories a day, try to eat no more than 56 grams of fat. Your doctor or a dietitian can help you figure out how much fat to have. You can check food labels for fat content too.
• You may also wish to reduce the number of calories you have each day. Your doctor or dietitian can help you with a meal plan that emphasizes weight loss.
• Keep a food and exercise log. Write down what you eat, how much you exercise--anything that helps keep you on track.
• When you meet your goal, reward yourself with a nonfood item or activity, like watching a movie.

Be physically active every day

Regular exercise tackles several risk factors at once. It helps you lose weight, keeps your cholesterol and blood pressure under control, and helps your body use insulin effectively. People in the DPP who were physically active for 30 minutes a day reduced their risk of type 2 diabetes. Many chose brisk walking for exercise.

If you are not very active, you should start slowly, talking with your doctor first about what kinds of exercise would be safe for you. Make a plan to increase your activity level toward the goal of being active for at least 30 minutes a day most days of the week.

Choose activities you enjoy. Here are some ways to work extra activity into your daily routine:

• Take the stairs rather than an elevator or escalator.
• Park at the far end of the lot and walk.
• Get off the bus a few stops early and walk the rest of the way.
• Walk or bicycle instead of drive whenever you can.

Choosing a Safe and Successful Weight-Loss Program: NIDDK (Excerpt)

Almost any of the commercial weight-loss programs can work, but only if they motivate you sufficiently to decrease the amount of calories you eat or increase the amount of calories you burn each day (or both). (Source: excerpt from Choosing a Safe and Successful Weight-Loss Program: NIDDK)

Choosing a Safe and Successful Weight-Loss Program: NIDDK (Excerpt)

A Responsible and Safe Weight-Loss Program (Source: excerpt from Choosing a Safe and Successful Weight-Loss Program: NIDDK)

Choosing a Safe and Successful Weight-Loss Program: NIDDK (Excerpt)

Obesity is a chronic condition. Too often it is viewed as a temporary problem that can be treated for a few months with a strenuous diet. However, as most overweight people know, weight control must be considered a life-long effort. To be safe and effective, any weight-loss program must address the long-term approach or else the program is largely a waste of money and effort. (Source: excerpt from Choosing a Safe and Successful Weight-Loss Program: NIDDK)

Gastric Surgery for Severe Obesity: NIDDK (Excerpt)

Severe obesity is a chronic condition that is very difficult to treat. Surgery to promote weight loss by restricting food intake or interrupting digestive processes is an option for severely obese people. (Source: excerpt from Gastric Surgery for Severe Obesity: NIDDK)

Gastric Surgery for Severe Obesity: NIDDK (Excerpt)

Surgeons now use techniques that produce weight loss primarily by limiting how much the stomach can hold. These restrictive procedures are often combined with modified gastric bypass procedures that somewhat limit calorie and nutrient absorption and may lead to altered food choices. (Source: excerpt from Gastric Surgery for Severe Obesity: NIDDK)

Gastric Surgery for Severe Obesity: NIDDK (Excerpt)

Restriction operations are the surgeries most often used for producing weight loss. Food intake is restricted by creating a small pouch at the top of the stomach where the food enters from the esophagus. The pouch initially holds about 1 ounce of food and expands to 2-3 ounces with time. The pouch's lower outlet usually has a diameter of about 1/4 inch. The small outlet delays the emptying of food from the pouch and causes a feeling of fullness. (Source: excerpt from Gastric Surgery for Severe Obesity: NIDDK)

Physical Activity and Weight Control: NIDDK (Excerpt)

Research consistently shows that regular physical activity, combined with healthy eating habits, is the most efficient and healthful way to control your weight. Whether you are trying to lose weight or maintain it, you should understand the important role of physical activity and include it in your lifestyle. (Source: excerpt from Physical Activity and Weight Control: NIDDK)

Prescription Medications for the Treatment of Obesity: NIDDK (Excerpt)

Most available weight-loss medications are "appetite-suppressant" medications. Appetite-suppressant medications promote weight loss by decreasing appetite or increasing the feeling of being full. These medications decrease appetite by increasing serotonin or catecholamine--two brain chemicals that affect mood and appetite.

In 1999, the drug orlistat was approved by the Food and Drug Administration (FDA) as an obesity treatment. Orlistat works by reducing the body's ability to absorb dietary fat by about one third.

Most currently available weight-loss medications are approved by the U.S. Food and Drug Administration (FDA) for short-term use, meaning a few weeks or months. Sibutramine and orlistat are the only weight-loss medications approved for longer-term use in significantly obese patients, although the safety and effectiveness have not been established for use beyond 1 year. (See table 1 for the generic and trade names of prescription weight-loss medications.) While the FDA regulates how a medication can be advertised or promoted by the manufacturer, these regulations do not restrict a doctor's ability to prescribe the medication for different conditions, in different doses, or for different lengths of time. The practice of prescribing medication for periods of time or for conditions not approved is known as "off-label" use. While such use often occurs in the treatment of many conditions, you should feel comfortable about asking your doctor if he or she is using a medication or combination of medications in a manner that is not approved by the FDA. The use of more than one weight-loss medication at a time (combined drug treatment) is an example of an off-label use. Using weight-loss medications other than sibutramine or orlistat for more than a short period of time (i.e., more than "a few weeks") is also considered off-label use.

Table 1

Prescription Medications for the Treatment of Obesity: NIDDK (Excerpt)

Combined drug treatment using fenfluramine and phentermine ("fen/phen") is no longer available due to the withdrawal of fenfluramine from the market. Little information is available about the safety or effectiveness of other drug combinations for weight loss, including fluoxetine/phentermine, phendimetrazine/phentermine, Xenical/sibutramine, herbal combinations, or others. Until more information on their safety or effectiveness is available, using combinations of medications for weight loss is not recommended except as part of a research study. (Source: excerpt from Prescription Medications for the Treatment of Obesity: NIDDK)

Very Low-Calorie Diets: NIDDK (Excerpt)

Traditional weight loss methods include low-calorie diets between 800 to 1,500 calories a day and regular exercise. An alternative method sometimes considered for bringing about significant short-term weight loss in moderately to severely obese people is the very low-calorie diet (VLCD). (Source: excerpt from Very Low-Calorie Diets: NIDDK)

Very Low-Calorie Diets: NIDDK (Excerpt)

VLCDs are commercially prepared formulas of 800 calories or less that replace all usual food intake. VLCDs are not the same as over-the-counter meal replacements, which are meant to be substituted for one or two meals a day. VLCDs, when used under proper medical supervision, effectively produce significant short-term weight loss in moderately to severely obese patients. (Source: excerpt from Very Low-Calorie Diets: NIDDK)

Weight-loss and Nutrition Myths: NIDDK (Excerpt)

Fad diets are not the best ways to lose weight and keep it off. These eating plansoften promise to help you lose a lot of weight quickly, or tell you to cut certain foods out of your diet to lose weight. Although you may lose weight at first while on these kinds of diets, they can be unhealthy because they often keep you from getting all the nutrients that your body needs. Fad diets may seriously limit or forbid certain types of food, so most people quickly get tired of them and regain the lost weight. (Source: excerpt from Weight-loss and Nutrition Myths: NIDDK)

Weight-loss and Nutrition Myths: NIDDK (Excerpt)

Your body needs a certain amount of calories and nutrients each day in order to work properly. If you skip meals during the day, you will be more likely to make up for those missing calories by snacking or eating more at the next meal. Studies show that people who skip breakfast tend to be heavier than those who eat a nutritious breakfast. A healthier way to lose weight is to eat many small meals throughout the day that include a variety of nutritious, low-fat, and low-calorie foods. (Source: excerpt from Weight-loss and Nutrition Myths: NIDDK)

Weight-loss and Nutrition Myths: NIDDK (Excerpt)

It is possible to eat any kind of food you want and lose weight. But you still need to limit the number of calories that you eat every day, usually by eating smaller amounts of food. When trying to lose weight, you can eat your favorite foods--as long as you pay attention to the total amount of food that you eat. You need to use more calories than you eat to lose weight. (Source: excerpt from Weight-loss and Nutrition Myths: NIDDK)

Weight-loss and Nutrition Myths: NIDDK (Excerpt)

It doesn't matter what time of day you eat --it's how much you eat during the whole day and how much exercise you get that make you gain or lose weight. No matter when you eat your meals, your body will store extra calories as fat. If you want to have a snack before bedtime, make sure that you first think about how many calories you have already eaten that day.

Try not to snack while doing other things like watching television, playing video games, or using the computer. If you eat meals and snacks in the kitchen or dining room, you are less likely to be distracted and more likely to be aware of what and how much you are eating. (If you want to snack while watching TV, take a small amount of food with you--like a handful of pretzels or a couple of cookies--not the whole bag.) (Source: excerpt from Weight-loss and Nutrition Myths: NIDDK)

Weight-loss and Nutrition Myths: NIDDK (Excerpt)

No foods can burn fat. Some foods with caffeine may speed up your metabolism (the way your body uses energy, or calories) for a short time, but they do not cause weight loss. The best way to lose weight is to cut back on the number of calories you eat and be more physically active. (Source: excerpt from Weight-loss and Nutrition Myths: NIDDK)

Helping Your Overweight Child: NIDDK (Excerpt)

Children should never be placed on a restrictive diet to lose weight, unless a doctor supervises one for medical reasons. Limiting what children eat may be harmful to their health and interfere with their growth and development. (Source: excerpt from Helping Your Overweight Child: NIDDK)

Obesity: NWHIC (Excerpt)

The key to reaching and staying at a healthy (or healthier) body weight is to balance healthful eating with regular physical activity. The Surgeon General suggests the following steps to better health.

• Aim for a healthy weight. If you are overweight or obese, losing just 10 percent of your body weight can improve your health. Lose weight gradually — 1/2 to 2 pounds per week. Do not go on fad diets. These can often hurt your health. Ask your doctor about the best weight loss plan for you.

• Be active. Be physically active for at least 30 minutes on most days of the week. Regular exercise is very important in weight control and has many other health benefits.
  
  Some examples of good ways to exercise include walking, yard work, housework, and dancing. More vigorous exercise can raise your HDL ("good cholesterol") level and make your heart stronger. This kind of activity is called "aerobic" and includes jogging, swimming, jumping rope, or brisk walking or bicycling. Be sure to build up your activity level gradually over a period of several weeks. Check with your doctor before starting a vigorous exercise program.

• Eat well. Eat smaller portions, eat more foods that are lower in fat and calories, and follow the Dietary Guidelines for Americans. These guidelines call for eating plenty of fruits, vegetables, and whole grains. Try to eat five servings of fruits and vegetables every day. Choose foods that are low in saturated fat and eat fewer foods that are high in sugar or salt.

If you are overweight or obese, talk with your doctor or health care provider about ways to improve your health. If you already have health problems related to obesity, such as high blood pressure or diabetes, follow the treatment plan prescribed by your doctor. (Source: excerpt from Obesity: NWHIC)

Weight Loss: NWHIC (Excerpt)

There is no "best" way to lose weight. Don't forget to talk with your doctor about setting up a weight loss plan. (Source: excerpt from Weight Loss: NWHIC)

Weight Loss: NWHIC (Excerpt)

Some general guidelines for losing weight safely are:

• Eat fewer calories. The best formula for losing weight is to decrease the number of calories you get while increasing your physical activity every day. Depending on how active you are, you may need between 1,500 — 2,500 calories a day. A safe plan is to eat 300 to 500 fewer calories a day to lose 1 to 2 pounds a week.

• Lose weight slowly. It is best to aim for losing 1/2 to 2 pounds a week. By improving eating and exercise habits, you will develop a healthier lifestyle. And, this will help you to control your weight over time. You will also lower your chances of getting heart disease, high blood pressure and diabetes. "Crash" diets may take off pounds faster, but can cause you to gain back even more pounds than you lost after you stop the diet.

• Exercise. Get active for at least 30 minutes every day. You don't have to train for a marathon to be active! Brisk walking, gardening, riding a bicycle, tennis and dancing all count as exercise. You can also break up the 30 minutes into three 10-minute periods. To get even more active every day, you can do things like park farther away from the mall in the parking lot and take the stairs instead of the elevator. The idea is to use up more calories than you eat each day. This will keep the calories from being stored as fat in your body.

• Eat less fat and sugar. This will help lower the number of calories you eat each day. Select foods whose labels say low, light or reduced to describe calories or fat, including milk products and cheese. Eat lean types of meat, poultry, and fish. Eat less sugar and fewer sweets (don't forget that soda and juice can have lots of sugar). Drink less or no alcohol.

• Eat a wide variety of foods, including starches and dairy products. This helps your body to get the nutrients and vitamins it needs to be healthy. Include plenty of vegetables, fruits, grain products and whole grains each day. Don't skip dairy products — there are many good tasting low, no, and reduced fat milks, yogurts, cheeses, ice creams, and other products to choose from. Proper calcium intake is needed for all women to prevent bone loss.
  
  Starch is an important source of energy that all bodies need, even when a person is trying to lose weight. It is found in foods like potatoes, rice, pasta, bread, beans, and some vegetables. Foods high in starch can become high in fat and calories when you eat them in large amounts, or when they are made with rich sauces, oils, or other high-fat toppings like butter, sour cream, or mayonnaise. Stick to starchy foods that are high in fiber, like whole grains, beans, and peas.

• Practice portion control. Eat smaller amounts of food at each meal. Let go of belonging to the "clean plate club." Don't feel like you have to eat everything on your plate, even when eating out. You can also try eating more small meals throughout the day, rather than three large meals.

• Get support. It can be hard to start a weight loss program, particularly if you are out of shape and not used to exercising. Ask your family and friends for support. Try to find an exercise buddy. Make your activity fun and social — go on a walk or hike with a friend or learn a new sport like tennis or ice-skating.

• Treat yourself (once in a while). When trying to lose weight, we all feel tempted to "cheat" by eating a favorite, rich food like cake or cookies. But, sometimes it can be helpful to eat a small amount of a favorite food. This may keep you from craving it and overeating if you do "cheat."

Weight Loss: NWHIC (Excerpt)

There are many types of diet pills and herbal, or natural, supplements that you can buy over-the-counter at a drug or discount store, or on-line. You can't assume that a product that is called "natural" or "herbal" is safe. It may also hurt you if you are on other medications. It is best to always check with your doctor before using any herbal or natural weight-loss product.

Diet pills you can buy over-the-counter don't make much of a difference in how much weight you lose, how fast you lose it, or how long you keep the weight off. Some diet pills can raise your blood pressure. Also, cough or cold medicines often have the same drug used in diet pills. If you take both products together, you may get too much of the same drug and have harmful side effects. For some people, diet pills prescribed by a doctor can be helpful. If you do use these, be sure to follow your doctor's directions.

In 1997, The Food and Drug Administration (FDA) removed the weight-loss drug called Fen-Phen (fenfluramine and dexfenfluramine) from the market because this drug was found to cause heart valve disease. Today, there are weight loss products containing herbal fen-phen, which do not contain fenfluramine or dexfenfluramine, on the market. These products, not regulated by the FDA, often contain ephedra and have caused side effects in people using them. Always talk with your health care provider before taking any over-the-counter weight loss product, even it if is herbal or "natural." (Source: excerpt from Weight Loss: NWHIC)

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