Belviq -- New Weight Loss Drug Approved by FDA

On June 27 the FDA gave the green light to the newest prescription weight loss drug, called Belviq (lorcaserin hydrochloride), describing it as an adjunct to a healthy diet and exercise for chronic weight management. As with any drug, there are potential side effects; although none serious enough to prevent the FDA from giving the go ahead for use of this drug with people who have a BMI 30 or greater, or a BMI of 27 or greater with concurrent morbidities such as diabetes or high blood pressure. (Ideal BMI range is 18-25 and you can calculate yours here.) When someone has conditions that could be improved with weight loss, the benefits of taking the drug often outweigh the possible complications that could arise from taking the prescription medication. 

I find the results quite disappointing for a prescription weight-loss drug that works by helping to reduce appetite. Trial participants taking Belviq for up to one year lost an average of 3 to 3.7 percent of their body weight. For a 250-pound person this is 7.5 to 10 pounds--hardly a noticeable amount for an obese individual. To make these results even more discouraging, the trial also included counseling for lifestyle modification including a lower calorie diet and exercise. Take note, this means there is no chance that this is the magic pill you've been waiting for!

Another drug expected to receive approval some time in 2012 is Qnexa. This prescription is a combination of two drugs; one (phentermine) that acts as an appetite suppressant and the other (topiramate--prescribed as an anticonvulsant) found to have weight loss properties.  These studies show a little more promise for weight loss than Belviq, with study participants averaging closer to 10% loss of their initial body weight over a year or two. As with Belviq, the drug is supposed to be used in combination with a reduced-calorie diet and exercise program.

Losing 10% of your body weight can, in many cases, improve blood pressure, cholesterol, and glucose levels, even reducing the need for medication. So it's still a good plan if nothing's worked in the past to promote lasting weight loss. Perhaps taking the pill gives some people the little boost they need to get moving on their new diet and exercise regimen. But if you just eat a little less and move a little more, you could lose more weight in less time. And with zero potential for serious side effects.

For assistance with your weight loss, visit The Diet Coach.

Is the Clean Plate Club Keeping You Fat?

Last week I was seeing a new weight loss client who brought along her adult daughter, telling me, "We both want to lose weight".  I thought it was great they each had a support system and "diet buddy". They both told me about diets they had been on in the past, and how difficult they found it to lose weight and keep it off--stories I hear every day.
I like to remind my clients of some of the reasons it is difficult to lose weight. Humans, after all, are programmed to want to eat whenever food is available. Our race would not have survived if we did not want to eat at every opportunity, or were just satisfied with a few nuts and berries.
Unfortunately for people who want to lose weight, food is everywhere now, and very easy to get: Drive through fast food, candy bars at every check-out lane, hot dogs and donuts when you go inside to pay for your gasoline, snacks at work, donuts at meetings and appetizers at friends' homes.
And, research shows, the portions are so large now compared to a few decades ago. Grabbing a burger, fries and a soda can mean nearly twice the calories it used to, with double burgers, extra large fries, and 32-oz sodas being the norm. You can see just how much things have changed in this helpful program brought to you by the National Institute of Health called Portion Distortion.

This prompted a comment from the daughter about how large the servings are in restaurants. She told me about a place where she and her husband had dined recently: "We are never going back there. The plate of food he got was so humongous, he actually had to rest halfway through the meal. He had to stop and take a break before he could finish it all. And when we left he was uncomfortably full. We aren't going back there again--it was a terrible experience."

I was speechless. My first thought--which I had to suppress from exclaiming--was, "Am I on Candid Camera?" Did she really just blame the restaurant for giving her husband too much food? Did they actually not see any option, obvious to every other person out there? Have they never left food on their plate or asked for a take-home container?

Yes, it's hard enough in all our fast-paced and hectic lives, to ignore yummy calorie-dense foods tempting us at every turn, to find time to exercise, and to resist craving the immense satisfaction we get from savoring a sweet or salty snack. It's hard enough to stop eating something we like when there's more of it, or to plop down on the couch instead of lacing up our sneakers and going for a walk.

Weight loss is hard. Don't make it harder by persisting to be a member of the clean plate club; by eating everything that is in front of you all the time; by ignoring the signs your body is sending you: "Stomach Ache!!" it screams. "Stop eating now or you'll be sorry in the next 10 minutes!!"

Just listen.

There are a lot of ways to lose weight. Some are tough; they require structure and discipline, planning and changing, hard work and deprivation.
And sometimes it just requires that you stop eating when you're full.

Uncle Sam Whole Wheat Cereal by Attune Foods

I agreed to try a box of this cereal when a dietitian with Attune foods offered it to me. I have to admit, it's not something I would normally reach for on the grocery shelf. With the only ingredients being whole wheat, flaxseed, barley malt and salt, I really thought it would taste like sawdust.

What a surprise! Somehow it tastes like a sweetened cereal. It has lots of crunch, and is very satisfying. As soon as I tasted it, I started thinking of how I could use it in recipes: It would be great as a topper for peach crisp! Then I found out their website already offers dozens of recipes that use the cereal  (http://www.attunefoods.com/products/Uncle-Sam/uncle-sam-original-heart-healthy-cereal-10oz/recipes). How convenient.

With 10 grams of fiber in a serving, I had to stop myself from pouring a second bowl--I wasn't sure what kind of digestive consequences there could be from all the extra fiber. Happily, my GI tract loved it and I don't have to worry about unpleasant grumblings as is sometimes the case when a new fiber is introduced into the diet.

I still have to get used to those whole flaxseeds in the cereal. I love the wheat flakes, but the little seeds give a different mouthfeel and tend to get stuck in between teeth.

The upsides are plentiful, though: Whole grain, 10 grams of fiber per bowl, 7 grams of protein, and less than a gram of sugar. It's a great breakfast for me with a nice crunchy texture and keeps me full through the morning until lunch time.

I would definitely recommend trying it!

Fiber One 90-Calorie Brownies Are Yummy!

 I heard about these Fiber One Brownies and thought I would give them a try. I'm always looking for some redeeming value in a sweet food with otherwise empty calories. It's nice to be able to feel like I'm getting something good-for-you while enjoying a tasty treat. And with only 90 Calories, what have you got to lose?

What a great surprise these were! A really decent sized brownie (I was expecting something half the size) that is moist and cakey. It sure doesn't taste like fiber, but each yummy individually-wrapped brownie--drizzled with peanut butter frosting--has 5 grams of fiber.

I would eat these even if they couldn't boast 20 percent of the daily fiber recommendation, since they have only 90 calories. It's not easy to find something that tastes so good and lasts more than two bites with under a hundred calories.

I will definitely be picking up more of these next time I go to the grocery store.

Ratings on the Most Popular Diets!

I love this ratings article from U.S.News on the top 20 most popular diets and how healthy they are. The panel of experts included registered dietitians, physicians, and others who specialize in healthy eating behaviors and food science.
I found it interesting that only two of the diets worked for the thousands of people surveyed who had tried the diets: Weight Watchers (which received a 4.4 out of 5 rating, and was ranked #6 for healthy diets), and a modified form of the Atkins diet called Eco-Atkins (ranking #15 and rated 3.1 out of 5 starts).
Click on the name of any diet and it brings you to a page showing how it rates for ease of following, support, nutrition, balance, and other factors.
The number one diet: The DASH diet plan, formulated for preventing high blood pressure. This diet is high in fiber, potassium and calcium; low in sodium and fat; composed of very nutritionally dense foods. It only received 3 stars for how easy it is to follow, but is healthy for virtually anyone who wants to lose weight, control diabetes, control hypertension, and eat for a healthy heart.

Visit this article and do some research before you start your next eating plan!
http://health.usnews.com/best-diet/best-healthy-eating-diets

How Will I Get Through Halloween Without Eating Candy?

This is a tough time of year if you're someone who likes to watch your intake of calories. It's only the beginning of being surrounded by tempting treats: People inviting you to parties, bringing in leftover candy from trick-or-treaters, leading up to more and more cookies and candies from Thanksgiving through Christmas. What's a sensible person to do?

Personally, I buy candy I don't like. I'm unusual in the sense that I'm not a big fan of chocolate. For me, buying Snickers fun-size bars or Milky Ways is not going to tempt me when they're around for the kiddies. If you are a chocoholic, what kind of candy doesn't interest you? Maybe candy corn does nothing for you (one of my favorites!), or the popular Sponge-Bob Crabby Patties turn you off. Choose whatever bags of candy you find least interesting so the temptation won't be there.
If you do have candy in the house that tempts you, ask someone to hide it for you so it will be out of sight. I usually hide treats from my family members in the potholder drawer where I know they will never venture. They'll know a place you won't look, too, like ... well, I don't want to give away any secrets!
So, the first step: Buy candy you aren't interested in, and second, have someone else be "keeper of the candy" until Halloween is over.
Have leftovers? Bring them to your workplace or, better yet, donate them to your local food pantry where they will toss a few pieces in with every family's grocery bag.

"I Can't Afford to Eat Healthy" Might Just be Another Excuse

As a registered dietitian, "I can't afford to buy healthy food" is a response I hear all too often from people who have diets too high in calories, fat, sodium, or some other nutrient that should be consumed in moderation. I would be tempted to be empathetic if they were just 20 pounds overweight and not 50, or if they didn't spend so much money on cigarettes, alcohol or other "extras" like acrylic nail manicures and tattoos.

When the patients I saw in a hospital a few years ago regularly told me, "I can't follow this low fat/low sugar/low salt [fill in the appropriate healthy diet] prescription because I rely on assistance from food stamps/the local food pantry/the soup kitchen," I set out to rectify the situation in my own town: I signed up to volunteer at my local food pantry.

The other volunteers at the food pantry made me feel welcome and were excited to show me around. I explained that I wanted to help re-organize the standard food list to include special foods for people who had to follow diets for their medical conditions. "They should be able to have healthy options to choose from, like canned fruit packed in its own juice instead of in heavy syrup, low-sodium canned soups, and whole grain products," I informed them. 

"Oh, we have those," the staff told me. "All they have to do is let us know what they're looking for and we're happy to provide the alternative selections. We regularly stock cereals without added sugar, whole grain breads and rice, low sodium products and sugar-free beverages."

Through my weeks volunteering over a period of two years, I seldom found anyone who would ask for "special diet food". There were signs up announcing the presence of a Registered Dietitian to help guide the patrons for healthier choices depending on their diet needs, and occasionally someone would have questions about losing weight or lowering their blood pressure. For the most part, though, the staff would be frustrated at the poor choices made by the customers. While there were a range of varieties available (people couldn't be forced to take brown rice over white, fruit juice over punch, or chicken over hot dogs), the vast majority of our disadvantaged citizens opted for convenience over health. When local farms would drop off cases of fresh vegetables, they would pile up during the week until the staff took them home on the weekend in lieu of tossing them out because they grew rotten. "But I don't want to have to peel vegetables and cook them," the clients would complain. "I just want something I can open and serve." I'm not sure why they were too busy to cook, since the majority were unemployed.

Recently in the hospital where I work I had a 250-pound woman explain why she couldn't lose weight: "I can't afford fresh fruits and vegetables," she said.  I asked, "Can you afford canned fruit and frozen vegetables?" and she said, "yes." Okay, next excuse?
By the way, she also refused to stop buying her cans of cola because she 'had' to have at least 3 a day.

Just because you can get dollar meals at fast food restaurants doesn't mean "food that is bad for you is cheaper". How about foregoing soda and chips and using that money to buy fruit and vegetables? How about making choices that make sense, like drinking skim milk instead of fruit punch or beer?

Not being able to afford "healthy" food is a poor excuse for being overweight. Fresh food that is not processed and can be prepared to be low in calories, sodium and sugar does not have to be expensive; no one is suggested you buy organic milk or salmon steaks when non-fat dry milk and canned tuna provide similar nutrients and cost less than half as much.

Need help planning healthy meals on a budget? There are plenty of resources available. Don't have a computer to look these up? Your local library will let you sign on there for hours. Start with the USDA's "Thrifty Meal Plan" download which provides shopping tips, recipes, and menus on a budget. http://www.cnpp.usda.gov/publications/foodplans/miscpubs/foodplansrecipebook.pdf

Then think about what you can trade off to make purchases that are better for you. That's what will save you money in the long run.