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alt.support.diet FAQ, part 3/5

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Archive-name: dieting-faq/part3
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Last-modified: 1998/05/17
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See reader questions & answers on this topic! - Help others by sharing your knowledge
 LIQUID DIETS AND FASTS

-Are liquid diets a good way to lose weight?-

They're probably not the best answer for most people, since slurping down a
high-protein, low-fat, minimal calorie, blenderized concoction doesn't do
much to teach you the new, healthier eating habits that you'll need to
maintain your weight loss. These diets can also be expensive--an average of
US$2,000-3,000 for a medically-supervised six month plan--especially in
light of the fact that the "food" you're paying for isn't much more than
dried egg whites (an excellent source of protein) and flavoring. Although
nearly all liquid diet programs include classes to help participants ease
back into eating regular food and to maintain their weight loss, the ratio
of clients who actually maintain their new weight for long periods is low.
On the other hand, some obese people have found that the fast, steady weight
loss and ease of such diets (there's no need to plan menus) can help them
lose significant amounts of weight for the first time in their lives. Liquid
diets can succeed, but only if those who use them are dtermined to adopt
healthy eating habits once the diet is over.

-Is fasting a good way to lose weight?-

No. Prolonged fasts can cause serious harm by depleting the levels of
protein, calcium, phosphorus, sodium, and potassium in your body. Fasting
can also cause toxic levels of ketone bodies (compounds produced when body
fats are broken down) to accumulate in the bloodstream, despite the popular
belief that fasting is a good way to "cleanse the system." On the other
hand, short (1-2 day), occasional (no more than once every few weeks) fasts
do not appear to be harmful to most healthy people. [The previous sentence
is intended as recognition of the fact that many people fast for religious
or spiritual reasons; it is not intended to encourage fasting, however
briefly, or weight loss purposes.--kbc]

WEIGHT LOSS ORGANIZATIONS, PLANS, AND DIET BOOKS

NOTE: Mention of an organization, weight loss plan, or diet does not imply
an endorsement of that organization, plan, or diet.

-How does Weight Watchers work?-

Weight Watchers is a commercial diet organization that offers a variety of
eating plans and aids for weight loss. Members who follow the selection plan
(an exchange-type plan) are allowed to consume a certain number of servings
from each selection group (breads, fruits/vegetables, proteins/dairy, and
fats) each day. For example, if you've chosen to eat five bread selections
per day, you can choose five servings of any item categorized as a "bread,"
be it whole wheat bread, rice, a corn tortilla, or any of the other foods
that fall into the bread group. The number of selections you consume per
group per day depends on how fast you wish to lose weight; the program
recommends a maximum loss of 2 pounds per week. The selection plan allows
members to stray from the plan occasionally to accommodate special foods or
events, and a "Weekends Off" option permits less regulated eating on
weekends in exchange for smaller portions through the rest of the week.
The Weight Watchers 123 Success Plan was started in the US on August 24th,
1997. It gives all of the foods you eat a certain amount of points.  You eat
the foods, add up the points and you are done for the day.  Everybody is
given a different point range depending on their starting weight. They do
give you some nutritional guidelines, such as drinking 6, 8-oz glasses of
water a day, eating 5 fruits and vegtables, and having 2 milk products a
day.  You are encouraged to do at least 20 minutes of exercise a day, and
for every 20 minutes after that, you can "earn" another point for your daily
total.  You can carry unused points, (also known as "Banking your points")
from one day to the next.. But only after-you have consumed your minimum
points allocated for the day, in your point range are you allowed to bank
these unused points.  If you don't use them by the end of the week, you lose
them.  You are given a "sliding scale" that helps determine point values for
all foods with a nutritional label depending on fat grams, fiber and
calories. They have new cookbooks, a "points manager" calculator to help
figure out points, and other products to help make the plan even easier.
There has been a really positvie response to this plan because of the
flexibility. Members are happy because they can eat what they want, within
reason, and not worry as much about getting all of their fat, protein, and
bread selections each day.  They just need to make sure they don't go above
their point allotment for the day.

The old plan  "Fat and Fiber"  was added in December 1994. Under this plan,
members are instructed to limit fat intake to between 15 and 35 grams daily
(men and youths can go up to 45 g/day), eat between 20-60 grams of fiber
daily, consume a minimum of 2 servings of dairy foods daily (3 servings for
youths), eat at least 5 servings of fruits and vegetables daily, and limit
intake of refined sugars and alcoholic beverages.
WW markets several types of processed foods, which are not necessarily lower
in calories than "regular" or other diet plan products, but are designed to
fit easily into the WW program; use of the WW brand foods is completely
optional. WW encourages moderate exercise in combination with the diet plan.
Each member sets his or her own goal weight based on a height/weight chart
compiled by WW from several sources. A big part of the WW plan is weekly
meetings, which feature a "weigh in" for each member (your weight is
revealed only to you and the person doing the weighing, not to the rest of
the group) and various activities such as motivational videos,  discussions,
distribution of program materials and recipes, etc. Members who attain their
goal weights become "lifetime members," and can attend meetings for free so
long as they maintain their new weights. There is an initial membership fee
(~US$15-20, but low-cost or free specials are frequent), plus a fee for each
meeting attended (~US$9-12). The June 1993 isse of "Consumer Reports"
reported that the average cost for several months' participation in WW is
approximately US$110.

Weight Watchers has a Web site at http://www.weight-watchers.com/. There is
also a Weight Watchers mailing list, run by Michele Coleman
(coleman@leland.stanford.edu or owner-ww-support@lists.stanford.edu), which
is intended as a friendly place for people following the Weight
Watchers plan to exchange support and suggestions. To subscribe to the list,
send an e-mail message to majordomo@lists.stanford.edu, and put the command
"subscribe ww-support yourname@someplace.com" (without the quotes) on a line
by itself in the body of the message.

-How does Jenny Craig work?-

The JC program combines a diet of frozen and shelf-stable pre-packaged foods
with one-on-one counseling, independent homework (which includes
instructional workbooks and video tapes, and motivational audio tapes) and
group classes on behavior modification. Participants initially purchase most
of their food, particularly entrees, from JC; these foods are supplemented
with regular (grocery store) foods such as dairy products and fresh
vegetables. As the diet progresses, the ratio of JC foods to regular foods
is gradually lowered. There are different menu plans (regular, no red meat,
vegetarian) available. The prepackaged foods are intended to teach
participants about portion control while freeing them from the necessity of
weighing, measuring, and preparing food. The behavior modification classes
are supposed to teach participants how to make healthy food choices once
they've been weaned off the JC foods. (A maintenance program is available
for those who've reached the goal weights that they've chosen for
themselves; goal weights should not fall below those on a standard
height/weight chart.) Exercise is encouraged. There is an initial
registration fee (one a.s.d member reported a US$19 sign-up fee); the cost
of the JC food averages US$60-70 per week.

-How does Nutri/System work?-

N/S is very similar to the Jenny Craig plan in format and price--it provides
prepackaged foods (shelf-stable only, no frozen foods), individual
counseling sessions, and group classes. Nutri/System has a Web site at
http://www.nutrisystem.com/.

-How does Overeaters Anonymous work?-

OA is a 12-step program, very similar to Alcoholics Anonymous, designed for
people who consider themselves compulsive overeaters, who believe that they
are powerless over food and that their lives are unmanageable. (Not all
members are overweight; some suffer from other eating disorders such as
bulimia.) Members are encouraged to turn their lives over to a "higher
power" (be it a personal deity or the strength of the group), to form a
relationship with a "sponsor" (another OA member who provides one-on-one
support), to give up "problem foods" permanently (as an alcoholic gives up
alcohol), and to attend OA meetings regularly (daily, weekly or monthly) for
the rest of their lives. OA does not advocate any specific diet plan;
members who are interested in better nutrition are urged to seek qualified
professional advice. (Note: One a.s.d reader reports that some OA groups are
offshoots of various eating disorder clinics, and that some such groups do
advocate specific diets which may not conform with current standards of
effectiveness and safety.) There are no dues or fees, although donations are
welcome. As with AA, members' anonymity is preserved; first names only are
used during meetings.

-How does TOPS work?-

TOPS ("Take Off Pounds Sensibly") is an international, non-profit weight
loss support group. TOPS does not advocate any particular food plan, but
rather encourages members to consult their physicians for individually
tailored diets. The TOPS philosophy includes weekly meetings at which
members are weighed in (amounts lost or gained are publicly announced,
although members' actual weights are not announced), using food diaries to
track your daily intake, awards of non-fattening gifts from other group
members for the person who loses the most each week, small monetary
penalties (e.g., US$0.05-0.50) for those who gain weight, etc. TOPS
encourages lifetime membership to keep the pounds from creeping back on;
their maintenance program is known as KOPS ("Keep Off Pounds Sensibly"). One
a.s.d reader reports that TOPS membership fees are US$16/year for the first
two years, US$14/year thereafter; there are also weekly fees (usually a few
dollars, but this varies from chapter to chapter). TOPS' official Web site
is at http://www.tops.org/. Rick Stonehouse, a TOPS member, also maintains
an unofficial TOPS Web site at http://www3.ns.sympatico.ca/stoner/tops.html.

-How does "Stop the Insanity" work?-

"Stop the Insanity" is a program promoted by Susan Powter, a trim,
assertive, crewcut blond who formerly weighed 260 pounds. According to her
30-minute infomercial, the program is based on the principles that: a) diets
don't work, b) you can lose weight by eating high volumes of low-fat foods,
and c) you must exercise to burn fat and adequately oxygenate all parts of
your body. Ms. Powter shuns the concept of weighing, advocating instead
measuring your body fat percentage (using calipers provided with the program
materials) and tracking weight loss progress in terms of how many clothing
sizes you lose. The program materials consist of audio tapes, booklets, and
videotapes that discuss deciphering food labels, exercise techniques, and
motivational tips. The current cost of the program is about US$80.

-What is the Carbohydrates Addict's diet?-

The premise of this diet is that there are people who, for biological
reasons, develop unmanageable cravings for carbohydrates which can lead to
weight gain. The authors believe that this results from an overproduction of
insulin, impairing glucose metabolism, and an insufficient rise of brain
serotonin, responsible for the feeling of satiety. The objective of the diet
is to control insulin release by minimizing the carbohydrate consumption
which triggers it.

The basic daily diet consists of two carbohydrate-restricted meals, and one
"reward" meal which must be consumed within 60 minutes, but at which you may
eat absolutely anything. At the restricted meals, you eat standard portions
of such foods as eggs, fish, meat, cheese, salads and most non-starchy
vegetables. The general rule of thumb for restricted meals is that an
allowable food contains no more than 4 grams of carbohydrate per standard
serving. Some surprises among the foods not allowed at these meals include
fruits, broccoli, milk and yogurt. No snacks are permitted.
Depending on the foods you select, the diet can be compatible with the
standard recommendations for healthy eating (low-fat, high-fiber, etc.). The
authors recommend a weight loss of no more than two pounds per week.
Guidelines suggest variants on the diet based on how much weight you have
lost in the past week, and what your goals are for the following week. A
short paper and pencil  test helps you determine if you are a carbohydrate
addict. There are currently three books in the Carbohydrate Addict series,
all by Rachael and Richard Heller: The Carbohydrate Addict's Diet, The
Carbohydrate Addict's Gram Counter, and The Carbohydrate Addict's Program
for Success. The first (and most useful) contains the theory, the diet,
lists of foods permitted and not permitted for the restricted meals,
recipes, and a host of success stories. The second is a small handbook with
an itemized list of foods, identifying those believed to trigger addictive
behaviors in carbohydrate addicts, which expands somewhat on the original
material. The third book is a workbook with more success stories and general
dieting tips, but no obvious new news.

-What is Dr. Atkins' diet?-

The Atkins diet is something of a precursor to the Carbohydrate Addict's
Diet in that it advocates unrestricted amounts of protein and fat, but
restricted carbohydrate intake. The diet was developed by Robert C. Atkins,
M.D.; he published a book about the diet in the 1970's, and has recently
released a new book titled The New Diet Revolution. According to Dr. Atkins,
many people react unfavorably to carbohydrates by overproducing insulin,
which causes the body to retain excess fat. Therefore, carbohydrates are
held to an absolute minimum (in contrast to CAD, which allows the
consumption of reasonable amounts of carbohydrates, but only during one meal
per day). The goal on the Atkins' diet is to get your body into a state of
ketosis, a condition in which the body burns stored fat, rather than
carbohydrates, for fuel. The presence or absence of ketosis can be
determined by testing your urine with Ketostix, which are readily available
at drugstores. Dr. Atkins has a Web site at http://www.atkinscenter.com/.
There are multiple mailing lists and Web sites devoted to the discussion of
CAD, Atkins, and other restricted carbohydrate diets; please see the Mailing
Lists and World Wide Web sites sections.

-What is the Zone diet?-

The Zone diet is described by Barry Sears, Ph.D., in his book The Zone: A
Dietary Road Map. It recommends balancing one's intake of protein,
carbohydrates, and fat so that, along with every 7 grams of protein, 9 grams
of carbohydrates and 3 grams of fat are eaten. Carbs contribute about 40% of
total calories on the diet, while fats and proteins each contribute about
30% of the calories. (This varies from current dietary recommendations from
the American Heart Association and similar groups, which recommend 30% of
calories from fat, 55-65% calories from carbohydrates, and 10-15% of
calories from protein.) Serious athletes are advised to ingest 4.5 grams of
fat for each 7 grams of protein, resulting in a diet in which approximately
40% of calories are supplied by fat. Sears believes that the diet, which
restricts calories, carbohydrates, and saturated fats, and limits protein to
the amount required for the individual (which depends on the individual's
lean body mass and activity level) prevents excess formation of insulin and
leads to optimum mental and physical performance (i.e., "being in the
Zone"). The goal of the diet is to switch the body's metabolism from a
carbohydrate-burning mode to a fat-burning mode.

There are a number of Internet-based resources on the Zone diet, including a
variety of Web pages and a mailing list. Russell Swan's Zone page
(http://www.cs.umass.edu/~swan/zone.html) provides a list of pointers to
other pages. To subscribe the Zone diet mailing list, send an e-mail message
to majordomo@fish.com, and put the command "subscribe zone" (without the
quotes) on a line by itself in the body of the message.

-What is the "TJ Soup diet" (a.k.a. "The Sacred Heart Hospital Diet" or
"Cabbage Soup Diet")?-

The "TJ Soup" diet (also known as the "Sacred Heart Hospital Diet" or
"Cabbage Soup Diet") purports to take off 10-17 pounds within one week
through the use of a "miracle" vegetable soup, along with a strict rotating
diet of fruits and vegetables, meat, and brown rice. The soup may be eaten
as often as desired. Alcohol, carbonated drinks (including those made with
artificial sweeteners), and fried foods are not allowed. Although the diet
is adequate in vegetables (from the soup) and features fruit on several
days, it is not well balanced. Day 5, for example, calls for 10-20 ounces of
beef or skinless chicken, 6 tomatoes, and the soup. Aside from brown rice on
the 7th day, no grains are permitted. Dairy products, which many women use
to increase their calcium intake, are not allowed except on day 4, when
you're supposed to consume 8 glasses of skim milk (along with 6 bananas and
the soup). While you probably can lose weight on this diet, you should keep
in mind that: 1) the first several pounds lost on any dit are usually water
weight, not fat, and 2) almost any diet which forbids you to eat your usual
foods will cause at least temporary weight loss. Although this diet has been
repeatedly linked with one hospital or another (allegedly recommended for
heart patients awaiting surgery), it is highly unlikely that any reputable
medical practitioner or organization would recommend such a diet. (Check out
the American Heart Association's position on this and other fad diets at
http://www.amhrt.org/pubs/phoney.html.)  The full text of the diet is
available via WWW at http://kxan.com/special.html for the insatiably
curious.

DIET AIDS (PILLS, ETC.)

-I've heard about several weight loss aids like herbal teas, "fat-burning"
pills, etc. Do any of these work?-

Some of the non-prescription drugs can temporarily cause your weight to
drop, but not because they're eliminating excess fat from your body. Most
over-the-counter "diet aids" contain stimulants, which hike up your central
nervous system and decrease your appetite, and/or mild diuretics which cause
you to eliminate fluids (by urination) more quickly than normal. The
stimulants can cause unpleasant side effects such as dizziness and nausea,
and the diuretics can make it difficult for you to get too far away from a
bathroom. And as soon as you go off the pills, your weight bounces right
back up to its previous level, making such nostrums useless for long-term
weight loss.

-What about prescription drugs (phentermine, fenfluramine)?-

On September 15, 1997 the perscription weight loss aids redux and
fenfluramine were recalled by their manufactureers afte the FDA reccomendeed
a that anyone who is taking them stop and consult with their doctors.
Phentermine, is not affected by the withdrawal, but patients could no longer
use the combination.

The FDA asked manufacturers to withdraw the drugs after reviewing the
records of 291 patients and found 30 percent had abnormal
echocardiograms -- a test that shows doctors how the heart is functioning --
even though they had no symptoms yet. Some 92 patients had problems with
their aortic or mitral heartvalves, the data showed. The FDA said the
numbers were much higher than it had expected, prompting the agency to
recommend stopping salesof the drugs.
The withdrawal comes after doctors at the Mayo Clinic announced inJuly they
had discovered 24 cases of a rare heart valve defect inwomen who took
fen-phen. The FDA later announced that it had received 66 additional reports
ofthis dangerous valve disorder, including some that were also seen
inpatients taking Redux.

These prescription weight loss aids had show somewhat more promise than the
non-prescription nostrums. Fenfluramine (marketed as "Pondimin") suppresses
appetite by acting on the brain chemical serotonin. Phentermine (marketed as
"Ionamin") is an amphetamine-type stimulant and appetite depressant. The two
drugs are often used in combination with each other in order to provide more
effective weight control while minimizing side effects; a study on the
combined effects of the drugs is available at
http://www.weight.com/nongifphenfen.html. The newest addition to the
pharmacological weight-loss arsenal is Redux (dexfenfluramine), which is
essentially the active portion of fenfluramine and is used in smaller doses
than fenfluramine. Studies indicate that these drugs do cause weight loss in
many people, but they can also cause side effects: nervousness, dry mouth,
rapid or irregular heartbeat, etc., in the case of phentermine, while
fenfluramine and dexfenfluramine can cause dry mouth, sleep disturbances,
diarrhea, depression, etc., and have been associated with a few cases of a
serious condition known as pulmonary hypertension. Participants in studies
of these drugs gradually regained the weight they'd lost when they stopped
taking the medication.

Additional information on prescription drugs used in weight control and the
recall of redux and phenfluramine can be found at
http://pharminfo.com/pubs/msb/obesity.html and
http://pharminfo.com/pubs/msb/seroton.html. Barbara Hirsch
(bhirsch@vais.net) maintains a very comprehensive list of medication-related
links on her Phen/Fen Web site at http://www.vais.net/~bhirsch/phenfen.htm.
There is also a newsgroup, alt.support.diet.rx, which is devoted to the
discussion of medications used in weight control.
-Do I need to take a supplement (vitamin/mineral pill) while dieting?-
A balanced diet (see "Food Pyramid") which is low in fats, sugars, and
alcohol and is adequate in calories (no fewer than 1,200 cal/day for women,
1,400 cal/day for adolescent girls, 1,600 cal/day for men) may contain
sufficient vitamins and minerals to meet the FDA's recommended Daily Value.
However, not many of us meet those requirements every day, and some
physicians and researchers feel that the FDA's recommendations regarding
many vitamins and minerals are too low to promote optimal health. (The
recommended Daily Values are intended to prevent deficiency-related diseases
such as scurvy and pellagra; they do not necessarily reflect the amount of a
vitamin or mineral
needed to sustain an adequate reserve against illness or injury.) If you do
decide to take a vitamin/mineral supplement as insurance against an
inadequate diet, you should look for a brand which contains a variety of
vitamins and minerals, and keep in mind that excesses (amounts greater than
100% of the FDA's recommended Daily Value) of certain vitamins and minerals,
in particular Vitamin A and iron, can be toxic. -

-What is chromium? Can taking a chromium supplement help me lose or maintain
weight?-

Chromium is a nutrient which plays a factor in maintaining blood glucose
(sugar) levels. Chromium occurs naturally in the diet, and is found in foods
such as brewer's yeast, whole grains, liver, and shellfish. Individuals
whose diets consist mainly of processed foods may not have an adequate
intake of chromium; symptoms of chromium deficiency include weight loss and
impairment in the body's ability to maintain blood sugar levels. Although
there is no recommended daily allowance for chromium, a daily intake of
between 50 and 200 micrograms (g) is recommended by many physicians and
nutrition experts. Chromium is available in several forms, including
inorganic chromium, high-chromium yeast, chromium picolinate, and chromium
polynicotinate. Of these, chromium polynicotinate seems to be the best
absorbed. While chromium does seem to be of benefit in regulating blood
sugar in diabetics, its role in weight loss or maintenance for non-diabetics
is not yet clear. Some individuals who have made a conscious effort to raise
their chromium levels through diet changes or dietary supplements have
reported that chromium does seem to lessen their cravings for sweets, but I
am unaware of any formal studies that support this. Additional information
on chromium picolinate is available via WWW at
http://www.lifelines.com/libry1a.html.




















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