Weight Loss

How can I help my child lose weight without making him feel deprived?

DEAR DOCTOR K: My 12-year-old is overweight. How can I help him achieve a healthy weight without making him feel deprived?

DEAR READER: Being overweight makes it hard for a child to keep up with friends on the playground. And the teasing can be merciless. What's more, kids who are overweight are at greater risk for lots of health problems as teens and later in life. Children who are overweight or obese are more likely to develop high blood pressure, high cholesterol and heart disease as adults. Long-term obesity also increases the risk of arthritis, diabetes and certain kinds of cancer.

How can I quit smoking without gaining weight?

DEAR DOCTOR K: I want to quit smoking, but I'm worried about gaining weight. Is it possible to quit smoking without packing on the pounds?

DEAR READER: Smokers do tend to gain some weight when they quit. Why? Nicotine reduces appetite and revs up metabolism (the rate at which the body burns food). Breaking free of nicotine allows appetite to come back and also slows metabolism. In addition, many people substitute food for cigarettes when they quit. By definition, an unhealthy weight is not good for your health. But quitting smoking is good for a person's health.

Will my son grow out of his childhood obesity? I don’t want to make a big deal about his eating habits.

DEAR DOCTOR K: My 9-year-old son is very overweight. I don't want to make a big deal about his eating habits, because I assume he'll grow out of his obesity later in life, and because we already set so many rules for him to follow. Do you agree?

DEAR READER: I wish I could, but I can't. A child's eating habits, and weight, can adversely affect his or her health later in life. The healthy eating habits you set with young kids not only influence their eating habits later in life, they also influence the chemistry of your kids' bodies so they are less likely to get fat as adults. All the talk about childhood obesity is not just media hype.

I’m obese. Should I be on a weight-loss drug to lower my heart disease risk?

DEAR DOCTOR K: I take medications for high blood pressure and high cholesterol. I am also obese, which is another risk factor for heart disease. Should I be on a weight-loss drug?

DEAR READER: You're right that being obese can put a heavy burden on your heart. It boosts your heart attack risk by about 60 percent. Diet and exercise are always the first steps toward controlling excess weight and other heart disease risk factors. When lifestyle changes aren't enough, doctors often prescribe medications, like statins for high cholesterol. But the medical options for weight loss are more limited.

What are some healthy habits to help manage your weight?

DEAR DOCTOR K: One popular book claims that there are "7 habits of highly effective people." Do people who effectively lose weight and keep it off also have habits in common?

DEAR READER: That's a very interesting question -- and I think the answer is "yes." There are certain "habits" that help, but only if you make a long-term commitment to them. Lasting weight loss demands that you transform your eating and exercise habits. But many other choices you make each day can also make a difference. What follows are several habits that can help people achieve -- and maintain -- their target weight.

Should I try the new FDA approved weight loss drug?

DEAR DOCTOR K: I heard about a new drug that can help people lose weight. I'm overweight. Should I give it a try?

DEAR READER: You're likely referring to Contrave, a drug the FDA approved in September of 2014 to help people lose weight along with a reduced-calorie diet and exercise. Contrave combines two drugs, naltrexone and bupropion. These drugs are already approved for other uses. Naltrexone is used to help kick alcohol and narcotic addiction. Bupropion is used to treat depression and seasonal affective disorder. Many people also take bupropion to stop smoking. Neither naltrexone nor bupropion by itself has been approved for weight loss.

Does eating several smaller meals help with weight loss?

DEAR DOCTOR K: Does eating several smaller meals throughout the day rather than three larger meals help with weight loss?

DEAR READER:We know that eating fewer calories is important to losing weight, but there is less agreement on the specifics. Are three meals a day best for weight loss? Or is it better to eat more -- or less -- frequently? We can rule out eating fewer than three times a day. You'll feel hungry, making it more likely that you will overeat and choose less healthy foods when you do eat.

How do I lose weight without a supportive spouse?

DEAR DOCTOR K: I've gained several pounds since getting married. My husband thinks he is supportive of my weight-loss efforts, but he doesn't exercise or make healthy food choices himself. How can I lose weight without my husband's support?

DEAR READER: Each of us is the person most responsible for living a healthy lifestyle. But we're not islands when it comes to our weight, and family and friends can profoundly influence what we do. That's the message in the important new book "Thinfluence," written by my Harvard colleagues Dr. Walter Willett and Dr. Malissa Wood, with Dan Childs.

What are the best ways to get rid of abdominal fat?

DEAR DOCTOR K: You've written that abdominal fat is particularly bad for your health. What are the best ways to get rid of it?

DEAR READER: When it comes to body fat, location counts. Visceral (abdominal) fat accumulates deep inside the abdomen. It pads the spaces between our abdominal organs. Compared to the fat just beneath the skin -- the kind we can grab with our hands, called subcutaneous fat -- visceral fat appears to be more harmful to health.

How can I tell if I’m a good candidate for weight-loss surgery?

DEAR DOCTOR K: New Jersey Gov. Chris Christie's announcement about his weight-loss surgery got me thinking. Can you tell me more about this surgery and who might be a good candidate for it?

DEAR READER: Governor Christie -- as well-known for his waistline as his politics -- recently confirmed that he had weight-loss surgery. There are several types of weight-loss surgery (also called "bariatric surgery"). They work either by shrinking the size of the stomach, reducing the absorption of calories and nutrients in the intestine, or both.