No Magic Pill for Weight Loss

Q:  I’m a post-menopausal woman of 55 years – and, unfortunately, about the same number of pounds (~50) over what I weighed before menopause. I sent once or twice for a diet aid through the mail, and since then I’ve been inundated with literature from every diet aid vendor in the world, it seems!

Just recently, I received two offers promising to make me lose five or more pounds a day! I also saw an ad for an easy exercise system that can "oxidize" fat away. Can you comment on these seemingly impossible promises? And how do I get rid of the new spare tire around my waist that never was there before?

A:  "Impossible promises" is exactly what all these amazing diet offers are, even though they come with a "money-back guarantee." It seems that whenever I open the newspaper or a magazine or see a flyer posted on a board, I read about some miracle drug or supplement that will enable a person to lose lots of weight in a short time.

After working with various obese patients and friends over the years, I'm convinced that there is no magic pill. Yes, phentermine and the Fen-Phen combination enabled people to lose 30, 40 or even 50 pounds, but as soon as they stopped taking the appetite suppressant, the weight returned. And fenfluramine, the "fen" part of fen-phen, has been shown to cause some heart valve problems, so was eventually taken off the market. (Phentermine is thought to be safe and is still in wide use.)

I've recently prescribed Xenical, which blocks the fat in the food you eat from being absorbed by your body, but it's too soon to tell how well it's going to work.

So how do you lose those extra 10-15 pounds that are gained by the average menopausal woman and most importantly keep it off? The key is discipline. You have to make a point of changing your lifestyle (eating habits and exercise pattern) and then stick with it daily. My pastor's wife went from a size 16 to a 2 (I'm guessing) by cutting out fat and sugar and walking an hour a day, rain, snow or shine. Unless you exercise and lower your body's "set point," your body will simply maintain its weight even though you're eating less calories.

Here are some simple tips that I give patients to get them started:

1. Stop all between meal snacking, especially late at night.
2. For dinner, eat early and eat light. (An interesting study done in Tunisia with 160 obese women, aged 23-45, found that they lost 15% of their body weight by not eating between 5 pm and 6 am. During the day they could eat whatever they wanted to.)
3. Stop drinking juice – it is loaded with calories.
4. Save dessert for the weekend.
5. Walk or exercise at least 45 minutes per day.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.