Overweight

New Ways to Get Rid of the Unwanted Pounds

Even if fleshy thighs and generous abdomens were suddenly as attractive as they were back in the days of the Flemish painter Rubens, being overweight still wouldn't be desirable.

Aesthetics aside, being overweight is simply not healthy. Carrying an extra 20, 30 or 50 pounds or more raises your risk of diabetes, high blood pressure, heart disease and cancer of the breast, colon and uterus, among other illnesses. Carrying extra pounds also strains your spine, muscles, joints and ligaments, contributing to chronic back and joint problems.

If you're like a lot of women, you probably know that you'd benefit by losing unneeded weight. And you've probably tried. According to the National Center for Health Statistics, more than half of all overweight people say that they've tried to lose weight within the past year.

IN SEARCH OF THE PERFECT WEIGHT-LOSS AID

In their efforts to lose weight, women have tried scores of diet gimmicks: over-the-counter appetite suppressants, diet shakes, high-protein diets, grapefruit pills, thigh wraps and more. Or they go on starvation diets. Invariably, the weight comes back.

"Ninety-five percent of all diets fail," says Diane Grabowski-Nepa, R.D., nutrition educator at the Pritikin Longevity Center in Santa Monica, California. "Women diet, they starve themselves, then they go off the diet and they binge and feel miserable, so they go back on a diet. It's a vicious cycle, and it isn't working."

Some women try teas and capsules containing ma huang, the Chinese name for the herb ephedra (Ephedra sinica). Ephedra contains ephedrine, a compound that raises your metabolism, so you burn more calories. It's natural, but it's far from safe: This herb can speed up your heart rate and blood pressure and trigger a heart attack. Some weight-loss products even combine ma huang with caffeine, enhancing its risk.

"These pills are harmful and shouldn't be used," says Susun S. Weed, an herbalist and teacher from Woodstock, New York, who is the author of the Wise Woman herbal series and who speaks widely on the topic of healing herbs at medical gatherings.

Medical doctors agree that diet gimmicks are dangerous or useless or both. At the other end of the spectrum are prescription drugs such as dexfenfluramine (Redux). This so-called miracle drug prompts your body to raise your level of serotonin (a brain chemical), which in turn dampens your appetite, so you eat less.

Though medically approved, this prescription drug is no miracle. In a year-long study of 900 severely overweight men and women, almost two-thirds of those taking dexfenfluramine lost less than a tenth of their total weight. The remaining third lost virtually no weight at all.

Questions have arisen over the safety of dexfenfluramine as well. The drug has been linked to serious brain and lung problems.

SAFE, NATURAL WEIGHT LOSS

Women who want to lose pounds have other, safer options. A vegetarian diet can help you lose weight permanently, without starving yourself. Certain foods, herbs and minerals can speed up your metabolism safely. And acupuncture can increase serotonin and regulate appetite naturally--as can listening to music. Even the way that you think can help you lose weight.

Coupled with more conventional wisdom about what works and why, safe alternative methods can and do work.

FAT-DUMPING STRATEGIES

It's no mystery that much of the unwanted fat on your body comes from fat that originates on your dinner plate. In a study conducted at Indiana University in Bloomington, of 17 lean and 15 severely overweight women, the overweight women consumed diets much higher in fat. Among the very overweight women, 36 percent of their total calories came from fat, compared to just 29 percent for the lean women. So, getting no more than 30 percent of your daily calories from fat--about 30 grams of fat a day--helps keep the fat off your body, says Michael Steelman, M.D., president of the American Society of Bariatric Physicians in Oklahoma City, Oklahoma.

Fat has three strikes against it. Strike one: Gram for gram, fat contains more calories than carbohydrates--nine calories per gram of fat versus four calories per gram of carbohydrate.

Strike two: It's easier for your body to store fat calories than calories converted from carbohydrates to fat. To digest, transport and store fat uses just 3 percent of the fat calories eaten. But carbohydrates--whole grains, fruits and vegetables--burn 24 percent of the calories that are going to be transformed and stored as fat.

Strike three: Fat is less satisfying than carbohydrates. After eating high-fat foods, you don't feel as full as you do after eating carbohydrates, so you overeat, says Ken Goodrick, Ph.D., psychologist at Baylor College of Medicine in Houston.

The study also found that the lean women consumed an average of 22.7 grams of fiber, compared with 15.7 grams consumed by the overweight women.

Together, dumping fat and adding fiber are effective first steps on the road to lasting weight control. Here's what alternative-minded practitioners suggest.

Switch to a high-fiber, natural-food vegetarian diet. Giving up animal foods is the single easiest way to cut fat and calories from your diet, says Joel Fuhrman, M.D., physician in Belle Mead, New Jersey, and author of Fasting--And Eating--For Health. "Three hundred calories worth of meat--about six ounces of beef--takes up very little room in your stomach. In comparison, 300 calories in fiber-rich foods such as whole grains, fruits and vegetables makes you feel full and satiated. These foods don't turn into fat in your body as rapidly. Plus, the typical serving of meat gets 50 percent of its calories from fat."

Double your fiber intake. Fiber is the part of food that doesn't break down--the skins of fruits, outer layers of beans, the bran in brown rice and oats and other components of food that simply pass through your digestive tract since your body doesn't produce the enzymes needed to digest them.

Experts say that we should consume between 20 and 30 grams of fiber a day. Yet many women consume much less. And too little fiber translates into too many pounds, says Marg Alfieri, R.D., coordinator of the bariatric clinic at the London Health Science Center in London, in Ontario, Canada. In a study at the center that examined the eating habits of 150 people (including 125 women), researchers found that moderately or severely overweight people ate significantly less fiber than those who were not overweight.

"Normal-weight individuals ate an average of 19 grams of fiber a day," says Alfieri, who conducted the study. "In contrast, overweight people consumed far less--only 13 grams."

Fiber facilitates weight loss in a couple of ways. "First, most high-fiber foods are great in volume and low in calories, so they fill you up without a lot of calories," says Edward Saltzman, M.D., medical director of the Obesity Consultation Center at the New England Medical Center at Tufts University in Boston.

"Second, foods with more fiber, especially raw vegetables like carrots and celery, take longer to chew. You spend more time chewing. People get tired of chewing, so they eat less," Dr. Saltzman says.

Eating fruits, vegetables and whole grains every day gives you the dietary fiber that you need every day to lose weight, says Dr. Saltzman. It's best not to increase your fiber through supplements, says Dr. Salzman. Adding supplements to an unhealthy diet is not a nutritionally sound way to lose weight.

FOODS THAT BOOST YOUR METABOLISM

You've probably known women who seemed incapable of losing weight no matter how little they ate. They probably attributed their excess weight to slow metabolism.

Some people do burn calories more slowly than others, making it harder for them to control their weight. Perhaps you're one of those women.

In about one person out of four, the problem isn't slow metabolism, per se, but a defect in the way that their bodies metabolize sugar and convert it into fat. In the normal course of consuming and burning calories and carrying on everyday functions, your body produces insulin, a hormone produced and released by your pancreas. Insulin controls the rate at which blood sugar--your body's fuel--is absorbed by cells throughout your body.

Some people, it seems, produce higher-than-normal levels of insulin--not necessarily high enough to bring on diabetes but high enough to affect their metabolisms, appetites and weights. Too-high levels of insulin trigger the body to manufacture more fat cells than normal when certain foods are consumed. The more easily foods are converted into sugar in the body, the more pronounced this effect. The overmanufacture of fat cells also slows down your metabolism. The net effect is that you gain weight.

By selecting what some doctors call low-glycemic foods--foods high in carbohydrates and fiber that don't stimulate overproduction of insulin--people who've failed to lose weight may at last succeed. Here are the do's and don'ts.

Load up on fibrous fare. Eat plenty of oatmeal, barley, sweet potatoes, whole-grain breads like rye and pumpernickel, beans, fruits and broccoli and other vegetables, recommends Dr. Steelman. These foods don't seem to stimulate insulin production easily. Yogurt, chicken and turkey also seem to be low-glycemic foods.

Skip the white stuff. In contrast, white potatoes, bread, pasta and noodles made from white flour seem to prompt an increase in blood sugar levels, says Dr. Steelman. Known as high-glycemic foods, these foods are quickly absorbed into your system, sending a signal to your pancreas to produce and release more insulin, so they're best avoided. Sugar does the same thing.

Fight fat with flaxseed. If you don't get enough omega-3 fatty acids (essential compounds found in some oils), your fat cells become insensitive to insulin, prompting your pancreas to produce too much insulin. Taking a tablespoon a day of flaxseed oil--a rich source of omega-3 fatty acids--helps improve the function of your insulin, notes Michael Murray, doctor of natu-ropathy in Bellevue, Washington, instructor at Bastyr University of Naturopathic Medicine in Seattle and author of Natural Alternatives for Weight Loss.

MINERALS HELP, TOO

While modifying what you eat and stepping up the number of calories that you burn are the mainstays of weight control, other factors exert smaller but significant effects on the effort.

Consider chromium. Taking 200 micrograms of chromium a day also helps regulate insulin levels, says Dr. Steelman. (Before taking this much chromium, talk to your doctor.) Chromium works closely with insulin in controlling the intake of blood sugar into your cells. Without enough chromium, the insulin's action is blocked and blood sugar levels rise, contributing to weight gain. Foods rich in chromium include whole grains, such as oatmeal and whole-wheat bread, vegetables, wheat germ, soy, brewer's yeast and chicken.

Caution: While some authorities cite studies in which people consume up to 1,000 micrograms of chromium a day with no toxic effects, it's best to consume no more than 200 micrograms a day from supplements without medical supervision.

Mind your magnesium. Dr. Steelman suggests taking 500 milligrams a day of magnesium. This mineral can help cut down on chocolate cravings, which are sometimes the downfall of women trying to lose weight. "We see magnesium levels drop in premenstrual women, which is when the cravings usually pick up," he says. "So it only makes sense that magnesium might help reduce the cravings." If you have heart or kidney problems, talk to your doctor before taking magnesium supplements.

Rely on mineral-rich herbs. Use herbal infusions that are made with herbs rich in calcium, magnesium and potassium, says Weed. Calcium may help to regulate your thyroid, an endocrine gland in your neck that regulates your metabolism, so every little bit helps. Try herbal infusions made from stinging nettle, oatstraw, red clover, peppermint or lemon balm, says Weed. To make an herbal infusion, take one ounce of a dried herb, put it in a quart jar, fill it to the top with boiling water and let it sit overnight. Then strain and drink it hot or cold. You can find these herbs in health food stores.

MOVE IT TO LOSE IT

If you aren't exercising, you may be missing out on one of nature's most valuable weight-loss aids and metabolism boosters.

Exercising will burn calories and raise your metabolic rate both during and after your workout. Researchers at the University of Vermont in Burlington compared women who exercised regularly to women who were sedentary. The active women had significantly faster metabolic rates. More than ten hours after their workouts, they were burning calories 6 percent faster than inactive women.

Exercise is like marriage. In order for it to work, you have to be committed to it, come rain or shine. But also like marriage, commitment is a lot easier if you also enjoy it.

Experts agree that when it comes to weight loss and maintenance, the following forms of exercise are among the best when done several times a week and coupled with calorie control. Here's what they recommend.

Walk to keep it off. Walking is an effective exercise for keeping the weight off once it's gone, says Philip Ewbank, exercise physiologist and supervisor of exercise physiology at the William Beaumont Hospital Division of Preventive and Nutritional Medicine in Birmingham, Michigan. It's easy to do, convenient and a good activity to do with friends, he says.

Ewbank and fellow researchers traced a group of 45 formerly obese people who had lost an average of 62 pounds on very low calorie diets. Typically, people who go on very low calorie diets gain back all the weight that they've lost, and then some. But in this study, people who exercised regularly for two years, mainly through walking, regained just 24 percent of the weight that they'd lost (about 15 pounds). This high-activity group burned 1,575 calories a week through walking 16 miles per week. In comparison, those in the low-activity group who walked 4.8 miles a week burned about half as many calories through exercise--fewer than 850 calories. And they gained back more than twice as much weight--72 percent (roughly 45 pounds).

How much walking is enough? In the study, the exercisers who minimized weight gain were walking three miles a day, five to seven days a week. That's about an hour's worth of walking a day, nearly every day.

Pump iron. Walking alone may not be enough to reach your goal. For those last stubborn pounds, you may need to add resistance training--working out with light weights such as dumbbells, for example.

Lifting weights for about an hour three times a week may help speed up your metabolism, says Ben Hurley, Ph.D., director of the exercise science lab at the University of Maryland College of Health and Human Performance in College Park.

When you build muscle, you facilitate weight loss in two ways. Muscle burns more energy than fat does, so the more muscle you create, the more calories you'll burn, says Dr. Hurley. In contrast, fat is not as metabolically active, so it burns fewer calories.

Building muscle also increases your resting metabolism. In other words, if you lift weights every other day or so, your body burns more calories while you're sitting around or sleeping than it would if you didn't exercise. Since you spend about 16 hours or more a day at rest, the afterburn effect can give your weight loss effort an additional assist, he says.

MOZART AND MANICOTTI

Practiced regularly, mind-body therapies such as imagery, visualization and music therapy can be perfect complements to an overall weight-loss program, says Peter Miller, Ph.D., clinical psychologist, executive director and founder of the Hilton Head Health Institute in Hilton Head Island, South Carolina, and author of The New Hilton Head Metabolism Diet.

Imagery may be as simple as picturing how you'll look thin and wearing a sleek, black cocktail dress. Music therapy may consist of listening to Mozart as you munch manicotti to make you eat more slowly.

Here are some effective mental strategies to aid your weight-loss efforts.

Munch to music. Listening to gentle music while you dine forces you to concentrate on what you're eating, which means that you'll eat more slowly and probably be more satisfied with what you've eaten, says Dr. Goodrick. "We know that if you watch TV and eat without being aware of it, you'll probably eat more, simply because the eating becomes automatic. From the very beginning of behavior modification, we've talked about focusing on the food so that you're better able to appreciate it."

See yourself reject food. Envisioning yourself avoiding the pitfalls of overeating is a creative tool in weight loss, says Dr. Miller.

Visualize a situation that makes you vulnerable to cravings. Maybe you know that you're going to find yourself home alone with half a cheesecake leftover from a party. "Imagine smelling it, looking at it, letting the craving develop and not fighting it. The next step is to see yourself destroying the food or putting it away in the refrigerator, out of sight," he notes. "Then, when the situation arises, your mental rehearsal will help you avoid devouring the food."

To keep cravings under control, practice your craving-control visualizations two or three times a day for about five minutes, recommends Dr. Miller.

Picture yourself thin. Another positive visualization is to see yourself achieving your weight-loss goal, says Dr. Murray. "You should put yourself into a relaxed state and see yourself losing weight and imagining what it would feel like. Imagine how your body would feel and what it would look like. This programs the subconscious mind to do what you want."

Ask for acupuncture. Acupuncture is best known for relieving chronic pain. But acupuncture may possibly help weight loss. Research suggests that by stimulating certain energy channels, or meridians, acupuncture can prompt the release of serotonin, the brain chemical that suppresses appetite, says Lixing Lao, M.D., Ph.D., licensed acupuncturist and assistant professor in the Department of Family Medicine at the University of Maryland in Baltimore. But unlike some medications, acupuncture has few harmful side effects. (For information on finding a practitioner qualified to provide acupuncture treatments, see page 33.)

Try cognitive therapy. Another key to losing weight and keeping it off is to figure out what drives you to overeat in the first place, says Dr. Murray. Cognitive therapy, or talk therapy, can help. "Many people want to be thin but don't believe that they can be. A therapist can help people realize that they have the power to achieve their weight-loss goals," he notes.

Visits to a health professional trained in cognitive therapy can also help you to mentally adjust to your new body once you've achieved your weight-loss goal. "When some women start to lose weight, it changes how they see themselves, and they're not prepared to deal with it." If you don't address these emotional and psychological issues, the weight will most likely return, he says. (For information on how to locate a cognitive therapist in your area, see page 81.)