Issue 14 - October 2004

‘Why can’t I lose weight?’
How to answer your patients’ dieting questions
By Shari Lieberman, PhD, CNS, FACN

The world is filled with frustrated dieters. And many of them are — or can be — your patients, especially if you decide to expand your services to include this area of anti-aging medicine.

The weight-management industry is expanding as fast as the waistlines of Americans. The U.S. government has targeted obesity as one of its national health objectives, with a goal of reducing obesity in Americans by 15 percent by 2010.

Although much information is available to overweight people, much of it is confusing and contradictory, resulting in patients trying various means to lose weight — often unsuccessfully.

Here are some of the questions your patients may ask you — and the answers you can give them to quell their frustrations, get them on the road to healthy eating and you on your way to an anti-aging practice:

Q I’ve tried just about every diet. I used to be able to lose weight, but now at age 45, I can’t seem to shed the pounds. Why is this happening?

A. When you diet — by cutting your calories, consuming a protein shake twice per day or eating just one meal per day — you actually slow your metabolism down by 10 percent to 15 percent.

When you go back to eating more normally, even if your diet is healthy, your slower metabolism reduces your ability to burn calories and body fat. Even worse, when you lose weight by dieting, you lose muscle rather than body fat.

Muscle dictates your metabolism. When you gain the weight back, you gain it back as body fat — and fat slows your metabolism even more.

To lose weight correctly, do it so that you change your body composition and lose fat, not muscle. This requires adopting a plan for life — not a quick diet fix.

QMy husband loses weight so much easier than I do. We started a health plan together by cleaning up our diet and exercising. I do see results, but mine are definitely slower in coming than his. Why is this and what can I do to speed this up?

Overweight men have a lower percentage of body fat and higher percentage of muscle than overweight women. Optimal body fat for a man is 9 percent to 18 percent. At 26 percent, a man is overweight.

For women, optimal body fat is 18 percent to 25 percent. So, a woman becomes overweight with 30 percent to 35 percent body fat.

Because men have more muscle and less body fat even when they are overweight compared to a woman, their weight loss is generally faster, especially if they are exercising.

Cross-training helps the weight-loss process for both men and women. Aerobic exercise burns body fat (which then revs up the metabolism) and strength training preserves and increases muscle mass.

Some supplements also help accelerate weight loss when they are taken in conjunction with a healthy diet and exercise program. These include green tea, chromium and 5-hydroxytryptophan.

(See Issue 4, 2004, “No More Fad Diets!”)

QWhy does a low glycemic index diet work better than other types of diets?

A. A low glycemic index (GI) diet is the type of diet that our ancestors ate. It can be followed indefinitely.

A low GI diet simply restricts foods that raise blood sugar quickly, such as white flour and sugar. A quick rise in blood sugar raises insulin levels fast. When blood sugar and insulin levels rise simultaneously, the body throws a metabolic switch and stores fat.

This metabolic phenomenon explains why many people don’t lose weight on diets that ignore the GI of foods and only concentrate on calorie-counting.

A low GI diet prevents the metabolic switch from being thrown. Another benefit: A low GI does not slow the metabolism but it does increase satiety. It allows dieters to consume “good” carbs — those that have little or no impact on raising blood-sugar levels.

QCan being fat be genetic? Both my parents are fat and I was a fat child and have struggled ever since I can remember.

A. Studies have shown that the way we eat is really a learned behavior. As children, we ate what our parents fed us. If they fed us sweets, we developed a “sweet tooth.” If they gave us food containing a lot of salt and fat, we learned to crave these types of foods as well.

If a family has a genetic propensity toward obesity, it is especially important to make sure children eat a low GI diet, get a lot of physical exercise and not eat a lot of fat. Children who follow this type of diet do not develop obesity.

The bottom line: Kids (and adults) don’t get fat if they eat right and exercise.

Q I started exercising (cross-training) a few months ago. I am definitely thinner and my clothing is loser, but I really haven’t lost a lot of weight. My MD said I was about 20 pounds overweight and needed to lose this amount to prevent heart disease. I am a 45 year old male. What am I doing wrong?

A. It sounds like what you are doing is right — especially if you are eating a low GI diet most of the time.

Don’t let the scale dictate your weight. Instead, have your body composition analyzed. If you are cross-training you could be losing body fat and gaining muscle mass.

Muscle weighs twice as much as body fat. If you are on a rigorous body-building regime, I think it is more important to keep track of your change in body composition rather than just weigh yourself. If your body fat goes down to between 9 percent and 18 percent — and your muscle mass increases — that would mean that you are losing weight as body fat and gaining muscle mass. u

Shari Lieberman, PhD, is a nationally-known nutritionist. She is the author of several books on nutrition, including The Real Vitamin & Mineral Book and Dare to Lose: 4 Simple Steps to a Better Body. She can be contacted through her Web site, www.drshari.net.