Tag Archive for: weight loss

“Watching” Your Diet and Workouts

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While the strategy for eating less I described on Tuesday used no type of tracking, this story is going to be the opposite. I ran into another person who has spent a couple of years focused on getting to a normal body weight. A couple of injuries playing sports set him back a little, but as we talked and I relayed the story from the day before, he said he was just the opposite: he tracks everything on his watch.

He records every meal—including the fast food breakfast sandwich he was eating; a client had brought it in and he felt he needed to explain his food choice to me. Remember, every food is acceptable as long as you track the frequency and amount. He continued that he tracks every workout—two days running, two days swimming, a spinning class, and he tries to run over the weekend. He can chart just about everything to monitor progress. He’s reached his weight-for-height goal and intends to keep up the lifestyle, because now, it’s his lifestyle.

Two different people, two different approaches—both worked. I’ll bet you have a story yourself. If not, you can write yours now, this year in 2025, so you can share it. It may inspire others. If you have one that’s worked for you, let me know how you did if you want me to share it with our group. Science takes you only so far; it’s how you make science work for you that’s important. Eat better. Eat less. Move more. And do it your way.

What are you prepared to do today?

        Dr. Chet

“I’ll Have What She’s Having”

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My philosophy of getting to a normal weight and staying there is to find out what works best for you by trial and error. When you find something that works, stick with it. This week, I’m going to relay the conversations I had with two people within 24 hours and how they approached weight reduction.

I recently saw a physician I hadn’t seen in three or four months, and I noticed he appeared to have lost some weight. I commented that he looked leaner than the last time I saw him. Many people ask how a person lost the weight, but I think that’s a personal thing; if someone wants to share it, great. Evidently he decided he’d share it.

He knew that he was way over his weight for height based on BMI; he also relayed the fact that he didn’t want to track his calories. What he decided to do was to eat the way his wife ate. She’s about 5’ 1” tall and weighs 110 pounds; she’s always maintained that weight with no effort. He decided to eat the food that she ate in the serving size that she ate. I’d never heard that from anyone before, and I thought it was brilliant. The result of following that pattern over a number of months was that he had lost 45 pounds and still had about 15 pounds to go to get to his normal weight for height.

When a couple do things together, it can make things so much easier, but it doesn’t have to be a couple. If you can observe people who appear to be lean and a normal body weight, just watch the amount of food they eat as well as the types of food they eat. It always comes down to eat less, eat better, move more. As I said when I started, we just have to figure out how to do that for ourselves to find out what works best. Next story on Saturday.

What are you prepared to do today?

        Dr. Chet

Will Carbonated Water Aid Weight Loss?

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In the next few Memos, we’re going to talk about several studies out of the mainstream. Today we’re starting with adding carbonation to water.

If you walk the aisles of a grocery store, you can’t help but see 100 feet of shelves full of water—not just the regular purified or distilled, but flavored with every fruit and herb imaginable with a net of no added calories. I admit that I have my favorite: Liquid Death Severed Lime.

Earlier this year, a research group published a paper that asked the question, “Can carbonated water support weight loss?” They compared the rate of glucose metabolism in the red blood cells of people who drank carbonated water with data from those who undergo dialysis. While the process is complicated, the carbonated water increased the bicarbonate levels of the blood making it more alkaline. That stimulated the rate of glycolysis in the cells, and theoretically, increasing metabolism.

Would drinking carbonated water all day have an impact on body weight long term? The researchers made it clear that nothing replaces a healthy diet and increasing exercise, because the number of calories used in the process is low. However, drinking water before a meal may help you eat less, and making it carbonated water may also help. Unless you have an issue with carbonated water, maybe it will give you a slight edge in your efforts.

What are you prepared to do today?

        Dr. Chet

Reference: BMJ Nutrition, Prevention & Health 2025;:e0011082.

The Ridiculous: Obesity and Weight Loss Scams

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As I planned this series of Memos, I wrestled with using the word “obesity” because everyone appears to hate that term—especially when directed at themselves. I decided to stick with it because it afflicts close to 40% of us in the United States. Before I get to ridiculous weight loss plans people are hawking, how did we get here?

Obesity is the product of success. We’ve been successful in creating so many labor-saving devices, we can’t burn enough calories in everyday activity anymore. We’ve successfully produced so much food, available just about everywhere, and made to appeal to all our tastes—sweet, salty, fatty, and umami. They’re hard to resist. The U.S. and Canada have worked hard to produce so much food. But with that success comes overconsumption. Pure and simple.

I question whether obesity is a disease. The dieticians and nutritionists have tried health education without success. Now the medical community has taken over with surgery and pharmaceuticals. And we’re still getting fatter, not because we’re failures but because we’re reaping the rewards of success. We have to change our approach to how we treat food if we’re going to be successful in changing the outcome.

In this series, I’m going to cover recent ads, commentaries, and research on obesity and weight loss. Let’s begin with a Facebook ad my daughter-in-law sent Paula the other day.

The Ridiculous

Paula got a text from Kerri that showed the benefits of MagnaGermanium earrings; these magnetic earrings will activate your lymphatic system, drain away toxins, detox your body, and allow you to lose weight naturally. I had to check it out—after all, it was FDA approved!

It was just a bunch of testimonials. No science, even though the ad referred to it. Claimed to be made in an FDA-approved facility, but there’s no such classification. It’s a pure scam but reasonably priced: just $22.97 a pair in the ad I reviewed. Look around a little, and you can find them for one cent; that tells you all you need to know about the quality.

I don’t think I have to say anything else. By the way, those Kelly Clarkson “ads” for Keto-ACV Gummies? Worst artificial intelligence effort I’ve seen so far. They’re also in the ridiculous category.

We’re just getting started. Next week, a look at fish oil and the potential for overweight children. You don’t want to miss it.

What are you prepared to do today?

        Dr. Chet

Find Your Way

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How are you doing with your 2024 weight loss efforts? Or your fitness regimen? Eating more vegetables and fruits? Taking your supplements regularly? Is it going smoothly at about three weeks in, or not so much? I know I’ve slipped up. Based on Dr. Barabási’s research, that doesn’t mean you’re doomed to failure. Remember what he found: it isn’t your age that determines your productivity, it’s your creativity.

Not Your First Rodeo

If you’ve been successful at changing a health habit, losing weight or getting fit, particularly when you were younger, you found a way to do it. Over the years, especially with weight loss and fitness, life happens, and your body changes; you go back to old habits and gain back weight or lose fitness.

There’s a tendency to try to recreate that experience again. In other words, you’re going to try the same workout routine, the same way to lower calories, whatever helped you achieve that goal. But life isn’t static and maybe it doesn’t work the same way. You decide to try another type of diet, such as the ketogenic diet, and that worked great—for a while. But you slowly returned to your old habits and gained back the weight. Because you’re older and with the change in metabolism that seems inevitable, you lose the passion for trying.

You just get tired of trying. You may be saying something like, “You’re just not into it,” or you make up some other excuse. But whatever the reason, you quit trying.

Never Stop Trying

At the end of his TED talk, Dr. Barabási’s said: Creativity has no age; only productivity does. What that means applies as much to health as it does to being a successful scientist or attaining any goal. Keep trying to find that one thing, that one way that will work for you. It doesn’t matter what diet you use, what aerobic workout you try, or what method you use to gain strength. The only thing that limits you is not your age but your willingness to keep trying until you figure it out. No matter your age, no matter your limitations, that way exists. You just must find it and make sure it’s sustainable for life.

The Bottom Line

Near the end of the movie “City Slickers” the character played by Jack Palance tells Billy Crystal’s character he knows the secret to life. Billy says, “Well, what is it?” Jack tells him that’s what he must figure out. Find that one thing and nothing else matters.

Whether it’s changing your weight, getting fit, lowering your blood pressure, or any other health goal you want to attain and maintain, that’s what you must figure out. No gimmicks, hacks, or short cuts. Find your way. I remain committed to helping you find it.

What are you prepared to do today?

        Dr. Chet

Reference: Ted Radio Hour. Late Bloomers. 9-1-2023

The Cause of Obesity

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On Tuesday, I said that I couldn’t get past the word disease in the statement from CDC Head of Disease Prevention and Health Promotion: “Obesity is a disease caused by many factors, including eating patterns, physical activity levels, sleep routines, genetics, and certain medications.” While we can agree that there may be a genetic or medication contribution to obesity, there is only one real cause.

The definition of disease is a disorder of structure or function in a human, animal, or plant, especially one that has a known cause, and a distinctive group of symptoms, signs, or anatomical change. There’s no question that obesity has anatomical changes that result in symptoms.

But understand the numbers of obesity. Not everyone is massively oversized; the average height for a man in the U.S. is 5’9” and over 202 pounds to be considered obese, while for the average height of a women is 5’4” and over 173 pounds. There are many people who can hide that weight well. My point is that it’s not the largest individuals who are tipping the scales in the increase in obesity; it’s all of us above normal weight contributing our share.

The disorder part of the definition is one that is clear.

The Cause of Obesity

The cause of obesity is the systematic overconsumption of calories, usually taking years, if not decades, to manifest itself.

The Evidence for the Cause

There are two examples I’ll cite, both related to World War II. The first was the Minnesota Starvation Experiment. Male conscientious objectors had to lose 25% of their body weight in six months. They were normal weight when the study began, and their caloric intake was adjusted weekly to maintain the required weight loss. The result was a linear loss of 25% of their weight in six months.

This one is extreme but applies nevertheless. No one walked out of concentration camps overweight after being liberated—no one. They were systematically starved until they no longer had the energy to work.

In both cases, there was not a change in structure or function; the people were simply starved. The result was weight loss. There’s no change in structure or function when we systematically overeat. However, once we’re overweight and obese, there are changes in the structure and function of our bodies that must be dealt with. But it still comes down to this: a calorie is a calorie. No matter what genetics we have or what medications we take or how little we move, we won’t get fat if we don’t overeat.

The Bottom Line

We are obese because we consistently eat too many calories. We can reduce our weight if we systematically eat less. Yes, there are challenges to overcome because of those structure and function changes caused by chronically overeating. You just have to find the way to reduce your caloric input that works for you. Eat less. Eat better. Move more.

I frequently am asked which calorie-counting app is best, and I don’t have an answer. Do you? Have you found one that’s easy to use? Drop me an email and let me know which app you like and why. I’ll give them a try and let you all know which ones perform best.

What are you prepared to do today?

        Dr. Chet

Reference: https://www.cdc.gov/obesity/data/prevalence-maps.html

Is It Worth It?

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At an obesity conference, the report on the clinical trials for a pre-diabetes and diabetes medication left the crowd on their feet and cheering. There are reports of well-known personalities who’ve used the drug with great results. But the ultimate question about a pharmaceutical approach to obesity has to be this: is it worth the money? Let’s start by looking at the pharmaceutical and then the return on investment.

How It Works

The body makes proteins called incretins which can stimulate the release of insulin. One incretin hormone, GLP-1 (glucagon-like peptide-1), is manufactured in the upper digestive system in response to carbohydrate intake. In subjects with type 2 diabetes, this hormone effect is diminished or no longer present.

The ability to stimulate the production of insulin and prevent the release of glucose by glucagon can be stimulated pharmacologically by semaglutide, a receptor agonist—that means it turns on the glucagon. In subjects with type 2 diabetes, semaglutide stimulates GLP-1 receptors significantly, thereby reducing blood glucose and improving glycemic control. In addition, it has multiple effects on various organ systems; most relevant are a reduction in appetite and food intake, leading to weight loss in the long term. Since GLP-1 secretion from the gut seems to be impaired in obese subjects, it was logical to test it in obese populations. Those were the study results I reported on Tuesday.

All in all, this sounds like it might be a potential solution to our obesity crisis, but there are some unanswered questions. What is the long-term safety of regular use of the drug? How does the microbiome impact the effectiveness of the drug? But more than that, everything comes with a price, which begs the question: is it worth it?

The Price

The price of using semaglutide for obesity is really two-fold. First is the actual cost of the weekly injections which is about $1,400 per month at retail. If your insurance will cover it, I’ve seen prices as low as $25 per month. We know that people lost an average of 18% of their starting weight at 68 weeks—the length of the longest study to date—but the rate of weight loss declined near the end of the study. How long will insurance cover it beyond that, and will a person continue to lose weight? We don’t know.

After using the drug for 20 weeks, the placebo group was switched to a placebo and immediately began to gain weight. By the end of 68 weeks, they had regained all but 5% and were still gaining. Would an investment of close to $17,000 to lose about 20% of your weight be worth it if you began to gain it back? There are many questions around whether people can take this drug for the rest of their lives; every pharmaceutical intervention must have an end strategy. The researchers did not address the issue.

The Bottom Line

The research into this pharmaceutical intervention was well done. However, unless the intervention includes an exit strategy, it could be a waste of money. Perhaps a lower carbohydrate diet may be a partial solution because this drug impacts carbohydrate metabolism. But we don’t know whether the weight loss would be enough to have the body take over and do the same thing on GP-1 by itself.

I think this shows a hopeful approach and it may turn out to be a boost to someone who is absolutely willing to change their lifestyle or someone who needs to lose weight for a specific purpose, such as joint replacement surgery or preparing for IVF. But for most of us, maybe it’s better to save the time and money and do what we know works: Eat less. Eat better. Move more.

What are you prepared to do today?

        Dr. Chet

References:
1. JAMA. 2021;325(14):1414-1425. doi:10.1001/jama.2021.3224
2. JAMA. 2022;327(2):138-150. doi:10.1001/jama.2021.23619

Happy New Year!

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It’s good to be back talking to all of you again. The New Year is a time of optimism, everything seems possible, and there’s an enthusiasm for achieving health goals. One thing many people want to do is to lose some weight. It seems appropriate to cover a couple of drugs that were recently approved by the FDA to treat obesity. They’re a pharmaceutical approach to weight loss, and they’ve gotten so much press I have to cover them.

You’ve probably seen the commercials for a pre-diabetes and diabetes medication called Ozempic. It also has a sister drug called Wegovy that was approved for use in teens. In at least two clinical trials, subjects who had weekly injections of the drug lost at least 15% or more of their body weight in 68 weeks. Those who were switched to placebo injections started to gain back the weight they lost. All subjects were supported with monthly consultations with dieticians to induce a 500-calorie reduction in food intake and to increase exercise levels. Markers for type 2 diabetes improved such as HbA1c and blood glucose.

Is this the be-all and end-all to the obesity epidemic? And exactly how does this drug work? I’ll cover that on Saturday.

What are you prepared to do today?

        Dr. Chet

References:
1. JAMA. 2021;325(14):1414-1425. doi:10.1001/jama.2021.3224
2. JAMA. 2022;327(2):138-150. doi:10.1001/jama.2021.23619

Aging Stressor: Excess Body Weight

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The last major stressor that comes with age is excess body weight. The first book that I ever bought in grad school was about obesity. In it, there was a chart of almost 100 health issues that were linked by research to carrying extra body fat and one that was not. In the 40 years since then, the list of negative effects of obesity has grown.

If you remember my answer to the question from last week’s Memo about what one thing would I do differently in my life, that’s the reason I chose getting to a healthier weight and staying there. Pick a body system, any system, and you’ll find the deleterious impact of excess fat on that system. Immune system? Yes. Joints? Yes. Liver? That too. Pancreas? Yes—and on and on and on. That’s why it’s important to get to a healthy weight as young as you can and stay there.

But what about now? It’s been a 50-year fight for me, and I still have not succeeded to the extent I would like. Getting to a healthy weight is not about a specific diet or foods or anything other than one thing: the quantity of food we eat.

I’m going to give you the simplest approach to losing excess body fat I can with two ways to do it.

  • Use a smaller plate when you eat meals and fill it only once. Moving from a dinner plate to a salad plate will cut off about 20 to 25% of the calories you eat. You can use the same logic with smoothies or cereal or soups. Smaller portions yield fewer calories.
  • As an alternative, reduce your caloric intake by 250 to 500 calories per day if you already track your food intake. That’s it.

Can you work on the quality of food? Sure. How about fewer carbs or less fat? If you want. What I’m saying is that to attack the excess body weight you carry, you have to attack your number of calories and eat fewer of them. Start with the sledgehammer to break down the wall. You can get to the chisel later on to fine-tune your lifestyle.

That one benefit of being overweight? It reduces the risk of osteoporosis. I don’t think that’s worth the hundreds of other risks it increases.

Aging with a Vengeance

The first Aging with a Vengeance webinar will be on Super Bowl Sunday; the topic will be increasing muscle mass. I’ll be covering a specific strength training program together with nutrition approaches including diet and supplements. The approach is based on the practical application of the most recent research. The first Memo of 2023 will give details on how to sign up for the webinar and the materials you’ll get.

Have a Very Merry Christmas from all of us at DrChet.com! Talk to you again on January 1, 2023.

What are you prepared to do today?

        Dr. Chet

Worst Stressor: Split Decision

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I intended to talk about the single most negative stressor that we face as we age, but I couldn’t pick just one. When I say stressors, I mean things we have to deal with every day, not a singular event such as an auto accident. Smoking would be the easy choice, but it doesn’t impact as many people as it used to. Here are my two choices.

Too Much Weight

Someone asked me a simple question before an Insiders Conference Call: if you could do one thing differently when you were young to improve your health, what would it be? Without hesitation my answer was I would have gotten to a normal body weight and maintained it. Being overfat impacts you as soon as you try to get out of bed: you have to overcome gravity. And it doesn’t stop there.

Every system, every organ, and every cell in your body is impacted by excess fat. Some effects are worse than others, but every cell is impacted in some way. If you can avoid gaining the weight to begin with, that’s ideal. If you’re like me and you didn’t, it’s a lifetime challenge to get to a normal weight and maintain it. I’m still working at it.

If you’re still a youngster in your 20s, 30s, or 40s, don’t postpone weight loss. Do whatever it takes to get to a normal weight (short of drug abuse or eating disorders), then develop a healthy lifestyle to keep your weight down. Even if you’re older, you can still lose weight just as my mother-in-law did in her 80s.

Chronic Pain

There are some people who don’t know what it’s like to face pain every day, but the majority of people face the daily challenge of having their lives impacted by pain as they get older. It may be joint pain in the knees. Lower back pain afflicts many. It may be nerve damage from prior accidents. But as we age, pain is the stressor that may be present all day, every day.

There is no magic wand for this stressor. For some people, if they didn’t have to think about pain, they could do so much more. Instead, it’s trying to find the right everyday changes that can make life bearable.

The Bottom Line

I think you can understand why it was a split decision. In addition, these two stressors affect each other: being overfat can make the pain worse, and having pain can prevent us from exercising to help with weight loss. It doesn’t mean there are no stressors of aging we can deal with—there definitely are. That’s what we’ll talk about in my upcoming program Aging with a Vengeance.

On next week’s Insiders Conference Call, I’ll talk more specifically about the stressors of aging and what we can do about them. Become an Insider by 8 p.m. Wednesday, December 14, and you can join the Insider call at 9 p.m.

What are you prepared to do today?

        Dr. Chet