How do you separate the dietary hucksters and the hype? These ten facts will help you avoid promoting dangerous weight loss drugs and diet plans.
As a reputable health professional you can ill afford to circulate misinformation to your patients, leaving them with lighter wallets and a heavy sense of failure. Make no mistake, the choices made by the DC in the promotion of a weight management practice will have a profound impact on chiropractic by either enhancing the credibility and services offered by the profession, or by compromising its credibility at a time when chiropractic is finally achieving the recognition it so justly deserves. This article is for those practitioners who wish to enhance both their professional stature and the art of chiropractic.
Ironically, the reason weight loss is so lucrative is because the success of this industry depends upon the consistent failure of its products and programs! Consumers are looking for a “magic bullet” for instant weight loss and there simply isn’t one. This fact, however, does not deter either the dietary hucksters nor the pharmaceutical industry from promoting fad diets, worthless diet aids, and dangerous drugs and weight loss programs. As my father so aptly stated many years ago, “We all want something for nothing and are willing to pay top dollar to get it!” Obviously, dad was an adroit student of human nature.
I have an entire file draw filled with promotional materials on weight loss products, programs, and diets. All of them make ludicrous statements such as, “Lose 20 Pounds in 30 DaysGuaranteed” or “Lose Weight While You Sleep.” My all-time-favorite is “Housewife in Geneva Accidentally Discovers The Secret To Losing Weight Without Diet or Exercise!” These, and other equally outrageous claims, rely on ignorance.
Before initiating a weight management practice, it is important that the DC fully understand the mechanics of weight loss, how the body converts food to energy, and why 95 percent of diet programs ultimately fail.
It is imperative that you impart such knowledge to your patients to provide them a realistic basis upon which to judge a truly effective weight management program. To do otherwise is to ensure they end up disappointed and disillusioned.
Body fat is simply stored calories fat tissue contains about 3500 calories per pound. To lose excess fat, the patient must burn more calories than he or she consumes. Period.1 (see references at end of article) The average woman burns 2,300 calories per day; the average man 3,000. It does not take a rocket scientist to compute that you can’t take 3,500 calories out of a patient’s daily diet unless he or she is eating at least this much food to begin with!
Clinical research on rats, mice, monkeys and other species found evidence that primates, such as humans, could live longer by reducing calories by 30%. Such reduction also lowered the rate of cancer, heart disease and diabetes in the test animals.2 Therefore, if the average daily intake of calories is ideally reduced by 30%to 1600 for women and 2100 for menit would take five days for women to lose one pound of fat and four days for the men, all other conditions being equal.
Beware of vendors claiming your patients can lose several pounds a day on their diet programs or in combination with their diet products.
What the vendor is really saying is that his diet program can “trick” the body into losing water weight quickly by use of a low-carbohydrate diet and/or diuretics. The results are always temporary and often dangerous as the electrolytic balance of the body becomes disturbed.3
All diet supplements use herbs and chemicals with one or more of the following five properties to cause weight loss.
- Stimulants encourage the body to burn more calories (examples: ephedra, guarana, cola nitida, pyruvate).
- Diuretics cause the body to excrete water through excess urine (examples: agave, bearberry, caffeine, buchu, celery seed, and high-protein consumption).
- Cathartics act as a laxative to cause evacuation of the bowels or reduces calorie consumption by impeding full digestion (examples: senna, cascara sagrada bark, aloe).
- Appetite suppressants reduce hunger by altering mood or satisfying taste (examples: hydroxycitric acid (HCA), ephedra, phenylpropanolamine (PPA).
- Fiber acts to increase stomach volume, promote satiety and bind fats (examples: guar gum, chitin, psyllium seed).
No diet aid should be utilized on a consistent basis for more than two to three weeks.
Many of these diet aids may be health endangering to your patients, particularly if utilized over a prolonged period of time. (See Figure One).
Beware of vendors who promote high fiber dietary weight control products as a substitute for proper eating habits.
The best sources of dietary fiber are found in foods such as green leafy vegetables, fresh fruits, brown rice, whole grain bread and cereals, potatoes, and Jerusalem artichoke pasta.16 In other words, permanent weight management cannot be achieved without lifestyle changes involving the types and quality of food consumed on a regular basis. Learning how to eat is what’s important, not learning how to diet.
Beware of vendors who promote their own brand of dietary foods or “special diets.”
Dieting in general leads to the emaciation of muscle cells, bloating of fat cells, accumulation of toxic fats in tissues, and fatigue. The more rapid the weight loss, the higher the risk of heart complications from muscle loss.17
The patient should be encouraged to eat a wide variety of foods. Individuals who eat a varied diet have a better nutrient intake than those whose diet remains limited.18 The diets most likely to be dangerous are those that severely limit the variety of food.19
All weight management programs should include a quality multi-vitamin and/or anti-oxidant supplement for the patient.
All weight management programs create a “catch 22” nutritional situation. On one hand, mature adults must reduce calories to achieve weight loss or avoid obesity due to their reduction in basal metabolism.20 Yet, if the patient maintains the recommended ideal caloric intake of 1600 calories for women and 2100 for men, it becomes difficult to get enough of the required nutrients the body requires.
We have the agri-business industry and the junk food merchants to thank for the current poor quality of foodstuffs fostered upon us. The US Nationwide Food Consumption Survey reveals that 90% of Americans show some symptoms of malnutrition!
The patient should also be advised to stay away from foodstuffs with a long shelf life. Food spoilsnon-foods don’t. Avoid food substitutes such as Olestra (fake fat), margarine (fake butter), and hydrogenated oil (fake oil) which are alien to the body and can cause serious long term health problems. If you don’t have a fake body, stay away from fake foods. Period!
All weight management programs must include exerciseboth aerobic and weight resistance training.
Although fat loss is 10% dependent on exercise and 90% dependent on food, exercise is absolutely mandatory for permanent weight management.21 Without proper exercise during calorie reduction, the body will turn to its own tissues for fuel, breaking down muscle protein while conserving fat. (The evolutionary advantage of this genetic trait to our primitive ancestors who frequently went through times of famine is obvious).
The body evolved, and is designed, to be active rather than sedentary. Scientist have shown that many diseases may be caused by the disuse of the body.22 Regular exercise lowers blood pressure, fats in the blood, and pulse rate while improving blood glucose, alertness, self-image, absorption of nutrients, and life span.23
Exercise, both aerobic and weight training, increases oxygen uptake, which is used in the oxidation of fats. Further, exercise also increases the levels of enzymes which utilize fat. The net result is an increase in the overall ability of muscle to burn fat.24
All weight management programs must include patient attitude adjustment and behavior modification training.
A diet low in natural fiber but high in refined carbohydrates and fats, combined with little or no exercise, are believed to be the major factors responsible for the tremendous amount of obesity in America.25 The patient must be lead to understand that small modifications in behavior are more successful in achieving fitness and weight control than exotic diets leading to failure and potential health problems.26
The human body did not evolve to thrive on a continuous diet of refined sugar, hydrogenated fat, salt, pastries, bleached white flour and rice, cola drinks and high fat beef. Poor eating habits promote obesity. In studies involving lifestyle, obesity was six times more common among lower class women than among upper class women.27 Poor food choices and ignorance of sound nutritional practices among lower income individuals is believed to responsible.
First, do no harm!
Clearly, the DC considering a weight management practice must educate his patients as well as himself. To be successful he must help his patients implement proper weight management techniques and procedures and, most importantly, protect his patients from harmful dietary advice and products. There are a number of reliable sources for additional information in Figure Two.
Many of these diet aids may be health-endangering to your patients if used over a prolonged period.
Stimulants raise blood pressure and also act as mild diuretics.4 They should never be taken unless accompanied by exercise, or the patient may become hypertensive, stressed, or “wired.”5
Diuretics can deplete electrolytes and potentially cause cardiovascular problems.6 Prolonged use induces dehydration which stresses the liver and kidneys as well as leaches necessary minerals out of the body. Clinical studies show that with a mere 1% loss of body weight in water, there is a measurable decline in physical abilities and stress to the heart muscle.7
Cathartics (laxatives) may become addictive and irritate the bowels producing side effects ranging from dizziness and fatigue to decreasing body fluids.8 Oral ingestion of aloe, for example, may cause abdominal cramping and electrolyte imbalance as this plant is a strong cathartic as well as a laxative.9, 10
Appetite suppressants such as phenylpropanolamine (the active ingredient in Dexatrim), can induce heart damage, seizures and hallucinations.11 The long term effects of many appetite suppressants are currently unknown while others may be of marginal benefit in weight loss.
Fiber aids in weight control by providing bulk and binding fats while providing no calories itself since it is not digested or absorbed. A diet providing a daily intake of 40 to 50 grams of dietary fiber is essential for a healthy colon and the natural elimination of bodily waste and toxins. Most Americans, however, consume 10 to 30 grams per day of fiber.12
Unfortunately, many manufacturers of diet formulations add excessive amounts of processed fiber to their weight management products. More than 50 grams per day of fiber does not appear to improve bowel function or weight loss.13 Too much fiber also binds essential minerals such as zinc, iron and calcium which are already in short supply in the typical American diet.14 Further, excess amounts of processed fiber can cause severe abdominal cramps, gas, and bloating.15
There are a number of reliable sources for the DC to obtain additional information if in doubt concerning what his vendor is or isn’t telling about his programs or products:
- Phone the Regional Medical Library’s toll free number, 1-800-338-7657, for assistance in identifying the Health Sciences Library serving your region which can answer your question(s) regarding an ingredient, product, or procedure concerning weight management.
- Bastyr University Research Institute at 425-602-3172 or e-mail buri@ bastyr.edu.
- Internet Grateful Med, a service of the U.S. National Library of Medicine at igm.nlm.hih.gov.
- Tufts University Nutrition Navigator at navigator.tufts.edu.
- Alternative and Complementary Medicine Topics at galen.med.virginia.edu.
- Accomplish a data search by topic at healthfinder.gov.
Galen O. Ballard began his career as a consultant to the resort and spa industry. As his interest in holistic health grew, he established a marketing and consulting firm specializing in the chiropractic practice. The firm was later acquired by Titan Marketing Group, the parent company of Titan Laboratories, where he has been senior vice president since 1988. Galen, is a self-described “activist” who has written numerous articles on health issues and the government’s failure to protect the health of US citizens, can be contacted at 1-800-929-0945 or e-mail to firstname.lastname@example.org.
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17. “Obesity and Weight Management”, Alternative Medicine, The Definitive Guide, Future Medicine Publishing, Puyallup, WA, 1993
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19. Deutsch, R, et al., Realities of Nutrition, Bull Publishing, Palo Alto, CA, p. 12, 1993
20. O’Hanlon, P, et al., Amer. J. of Clinical Nutrition, vol 31, p. 1257, July 1978
21.Allen, DW, et al., Medical Journal of Australia, vol 2, p. 434, 1977
22. Bortz, WM, Journal of the American Medical Assoc., vol 248, no. 10, p. 1203, Sept. 10, 1982
23. Taylor, CB, et al., Public Health Reports, vol 100, no. 2, p. 195, March 1986 24. Horton, RL, et al., Exercise, Nutrition, and Energy Metabilism, Macmillan Publishing, NY, 1988
25.Anderson, JW, et al., American Journal of Gastroenterol, vol 81, pp. 898-906, 1986
26. Dusky, L, et al., “How to Eat Like a Thin Person”, Simon and Schuster, NY, 1982
27. Deutsch, R, et al., Realities of Nutrition, Bull Publishing, Palo Alto, CA, p. 48, 1993