Readers who have been following my posts for a few years know that weight-loss surgery is amassing an impressive body of scientific evidence supporting its effectiveness and safety. (Links to my previous posts about weight loss surgery are below.)
This week, two studies in the Archives of Surgery attempted to compare the different kinds of weight loss surgery. An LA Times article (link below) has a clear explanation of the different kinds of surgery and summarizes the findings of the studies. T...
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Sleep Deprivation Sabotages Dieting
The correlation between obesity and inadequate sleep has been known for some time. But does one cause the other or are they coincidental? It’s also known that inadequate sleep increases hunger, an effect I can attest to from my memories of medical training. I always ate more than usual on the days following nights spent in the hospital.
So people who don’t sleep enough feel hungrier and presumably eat more than people who get enough sleep. Is that the only mechanism connecting poor sleep to...
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Startling Scientific Finding: Dieting Leads to Weight Loss
What sort of diet helps people lose more weight? Do overweight people lose more weight on a low-carbohydrate diet (like Atkins) or on a low-fat diet (like Weight Watchers and others)?
A carefully designed study published in the current issue of the Annals of Internal Medicine answers that question. The study enrolled over 300 obese adults and randomized them to a low-carbohydrate diet or a low-fat diet. Importantly, patients with diabetes, high cholesterol and high blood pressure were exclud...
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A New Medication for Weight Loss
Obesity is an increasingly prevalent problem in developed countries, and a safe and effective medication for weight loss is eagerly sought. Most weight loss medications have been plagued by serious side effects.
Fenfluramine, a medication used with phentermine in the popular “fen-phen” combination in the 1990s, was found to cause serious heart valve abnormalities and was withdrawn from the market. The two prescription medications currently available are only modestly effective and each suffer...
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Vitamin E is Effective for Fatty Liver
My regular readers know my skepticism about vitamin supplements. I leap at the chance to bring you news that some vitamin has been tested for some disease and found useless. So for balance, I have to also report when a well-designed study finds that a vitamin actually helps something.
This week’s New England Journal of medicine published a study about the treatment of nonalcoholic steatohepatitis (NASH). NASH, also known informally as fatty liver, is a condition in which fat is deposited in ...
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A Dietitian’s Thoughts on Diet Sodas
Two weeks ago I wrote a post about the mistake we make when we think of some medicine or food as generally “good for you” or “bad for you” as opposed to having specific benefits and harms. I started with an anecdote in which a friend asked me whether diet sodas or regular sodas were better for you.
Susan Dopart, a terrific dietitian who I’ve known for over a decade, emailed me to bend my thinking about diet sodas and about non-nutritive...
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Erroneous Evidence about Enough Exercise
This week, a study in the Journal of the American Medical Association received a lot of undeserved media attention. The study wanted to examine the relationship between exercise and long-term weight changes among women who were eating a normal diet (i.e. not dieting). It followed for over a decade 34,000 women who were 45 years old or older and correlated their self-reported physical activity and body weight.
The study found that on average, the women gained about 6 lb during...
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Gastric Banding is an Effective Option for Obese Teens
What’s my advice to my overweight patients? Eat less and exercise more. I give this advice every day, but following this advice is much harder than giving it. Overweight people frequently struggle with diet and exercise for years, sometimes successfully, sometimes regaining their previously lost weight.
And as we become more overweight as a nation, obesity is no longer just a problem for adults. Over 5 million adolescents are estimated to be obese in the US, which predicts bad things for th...
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Normal Weight Obesity: Why Losing Weight Is Not Always the Answer
Weight loss is one of the most common recommendations that doctors make. How do we know if a patient should lose weight? We usually use the Body Mass Index (BMI) which is a way to compare a patient’s weight to her height. (For all you math geeks, it’s the weight in kilograms divided by the height in meters squared. For all you physicists, I know the units make no sense.) A BMI of 18.5 to 25 is considered normal. A BMI of 25 to 30 is considered overweight, and over 30 is considered obese. ...
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Happy Thanksgiving!
I’m grateful to all the readers of my weekly posts for all the stories you’ve pointed me to and all your valuable feedback. Thanks for reading.
I’m grateful to my partners Dr. Rubencio Quintana and Dr. Dorothy Lowe for making our office a happy and intellectually stimulating place to work.
I’m grateful to Jaymes, Nancy and Jill for helping us take great care of our patients. I couldn’t dream of a better support staff.
I’m grateful to my parents for bringing me to the US, where we are judged...
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