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Thursday, January 19, 2017
Diet and Nutrition
Diet and exercise advice needed
Hello. I have a few questions I was hoping someone could help me with. I am obsese. I`m a 28-year-old female, 5`5", and about 286 lbs. I already have a diet (NutriSystem) and exercise plan that I have decided on, and I have an appointment to see my doctor as well, but there were a few things I wanted to get some feedback on. Because I have a huge amount of weight to lose, I am concerned about having loose, flabby skin and cellulite after I lose all the weight. At least at the beginning of my diet, I plan to start walking, but I want to do a few toning things too to help minimize loose skin (I was thinking of walking with 1 lb. wrist weights and adding some sit-ups or crunches and doing some hand-held small weight lifting, etc). When it comes to the areas where I might have leftover loose skin, I am especially concerned with my stomach, the underside of my upper arms (are these the triceps?), my breasts, and for cellulite, my buttocks and the back of my thighs. I am also concerned because I took a quiz that is supposed to help you determine your body shape, and I think I fall into the hourglass body shape category, and for that type, they suggested I do little, if any, resistance training/weight training, I believe, in my exercise routine. So, I`m not sure what to do. Basically, to sum up, I don`t want to be one of those people who has to have plastic surgery after they lose 100-200 lbs. of weight because they are left with sagging skin and cellulite that no amount of exercise will fix. So what do you recommend?Also, I have one more question. Although I plan to include diet and exercise, it would be nice if I could also add an appetite suppressant, at least for a little while, when I first start my diet, to help with the hunger pains I am bound to have at the beginning. I am taking Effexor XR and a generic form of Remaron. My psychiatrist suggested I try the over-the-counter drug Hoodia. She says it works for her. She didn`t think it would interfere with my meds, but she didn`t seem positive. She said she had no side effects on it. I plan to ask my regular doctor about it, but I was wondering if you know anything about it. I have heard mixed reviews. If not Hoodia, do you have a better suggestion, over-the-counter or prescription? I don`t want something that will give me trouble with sleeping at night or cause my heart rate to increase too much. Thank you so much for your time. I really appreciate the help.
You have a legitimate reason to be concerned about loose skin after weight loss. A factor you have in your favor is that you are still a young adult. Skin loses elasticity as you get older, so there is more chance for your skin to stay firm as you lose weight at your current age compared to being older. However, smoking and sun exposure age skin prematurely, so the addition of these factors could reduce the elasticity of your skin at your current age. Keep yourself hydrated so your skin cells can respond well to the good nutrition you will be providing them.I'm glad you are including exercise. Exercise helps keep your body from going into starvation mode (which it does by slowing your basal metabolism -BMR) when you reduce your calorie intake. Exercise that includes resistance training is important because resistance training helps you build muscle. You burn 3-10 times as many calories to maintain a pound of muscle compared to a pound of fat. You may want some of your exercises to target some of the muscles in your stomach, buttocks and thighs. But keep up the walking or other aerobic exercise too.I don't think you will need an appetite suppressant if you are on the NutriSystem plan. It is set up to give you 5 meals a day, so that you are eating every 3-4 hours except during sleep. It has adequate protein and fiber, which are two food components that provide a meal with satiety (a sense of fullness) within about 20-30 minutes of eating.Hoodia (plant genus and species Hoodia gordonii) has not been evaluated in any good clinical study in humans. Here are the results of an unpublished efficacy study by Goldfarb for Delmar labs. He studied DEX-L10, the 500 milligram hoodia capsules sold by Delmar Labs. In his study, 7 overweight participants were told to take 2 Hoodia gordonii (DEX L-10) capsules a day, eat a balanced breakfast and take a multivitamin, and keep other eating and exercise habits the same. The participants' starting weight was 193 to 345 pounds. They lost on average, about 3.3% of their body weight (10 pounds over 28 days). Most of the participants reported their calorie intake dropped to less than half within a few days of starting hoodia, and they didn't report any jitteriness or insomnia as side effects.Another study out of England in 2001 (reported only of the Unilever website) reported that a derivative of hoodia, P57, caused a reduction in average daily calorie intake and in body fat with 2 weeks.Goldfarb thinks Hoodia gordonii works within the satiety center of the brain by releasing a chemical compound similar to glucose but up to 100 times stronger. "The hypothalamus receives this signal as an indication that enough food has been consumed and this in turn decreases the appetite."Most weight loss professionals don't think two unpublished studies are enough to recommend using hoodia, though some have had patients try it with varying results.There are a lot of scams surrounding hoodia, so the most difficult thing is to get a product that really has hoodia in it in an amount that will be efficacious. This could be one reason why some people have had poor results and others have liked the results. If you decide to try hoodia buy at a reputable store and buy a reputable brand. Stay away from products that are sold over the internet.Good luck.
Sharron Coplin, MS, RD, LD
Food & Nutrition
College of Education and Human Ecology
The Ohio State University