Weight Loss

Why did TV’s “Biggest Losers” have trouble keeping the weight off?

DEAR DOCTOR K: I heard about a recent study that explained why the "Biggest Losers" had trouble keeping the weight off. Can you explain?

DEAR READER: You're likely referring to a study done at the National Institutes of Health (NIH). As many readers will recall, NBC television put on a competition reality show for several years, beginning in late 2004. Extremely overweight people competed to see who could lose the most weight, through diet and exercise, over 30 weeks.

Can you tell me about different types of abdominal fat?

DEAR DOCTOR K: In a column about abdominal fat, you talked about two kinds of fat -- brown fat and white fat. I'd like to hear more about them.

DEAR READER: I'm glad you asked, because the discovery of these two types of fat could prove to be very important. In the column you refer to, I discussed how visceral, or abdominal, fat (which accumulates deep inside the abdomen) is more harmful to our health than subcutaneous fat (the fat just beneath the skin). But when it comes to fat, it's not just location that matters. Color counts, too -- and brown is better.

How will losing weight help me sleep better?

DEAR DOCTOR K: I'm overweight. My doctor told me, among other things, that losing weight would help me sleep better. What's the connection?

DEAR READER: It's true. Losing weight, especially in your belly, improves the quality of sleep if you are overweight or obese.

How does weight-loss surgery work?

DEAR DOCTOR K: I'm very overweight. Diet and exercise help a little, but then I gain it back. My doctor is recommending weight-loss surgery. Does it really work, and how does it work?

DEAR READER: There are several types of weight-loss surgery (also called "bariatric surgery"). They work in various ways. They shrink the size of the stomach: The stomach gets full more easily. They reduce the absorption of calories and nutrients in the intestine. Some types of bariatric surgery also lead to hormone changes that reduce appetite and burn energy more efficiently.

How can I adjust my walking routine to start losing weight again?

DEAR DOCTOR K: When I first started walking for exercise, I lost some weight. Since then, my weight has plateaued. How can I adjust my walking routine to start losing weight again?

DEAR READER: To reignite your weight loss, you need to keep challenging your body. That means walking farther, faster and more often. The more vigorous your workout, the longer you'll continue to burn calories after you stop exercising.

How does weight loss help control Type 2 diabetes?

DEAR DOCTOR K: I was recently diagnosed with Type 2 diabetes. My doctor said the best thing I can do right now is to lose weight. Why?

DEAR READER: Type 2 diabetes usually starts after a person becomes an adult. It is by far the most common type of diabetes. It has been clear for many years that people who are overweight are at much greater risk for developing Type 2 diabetes. In the past 20 years, research discoveries have begun to explain why.

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.