Food Diaries: Vital to Success

We always think we eat less than we actually do. Many obese people claim that they eat like birds and cannot understand why they continue to put on weight. Ultimately, weight is gained if the number of calories consumed is greater than the number of calories needed for survival.

It is a fact that different food types have different calorie contents. Fat is more calorie dense than carbohydrates and proteins. Hence most people who are trying to lose weight avoid a high fat intake.

Simple sugars, although relatively low in calories, trigger off the release of insulin. This results in a crash in blood sugar levels and triggers cravings for more sugars.

We can unwittingly consume a huge number of calories through our beverage choices: carbonated sodas, coffee, juices. And wine and beer too!

The little snacks that just happen to be eaten: food off our childrens' plates (waste not, want not mentality), eating whilst preparing food, snacks in the office pantry.

So the only way to really find out what we are consuming is by creating a food diary. In it's simplest form, the columns to fill in are:

• Time
• Food Eaten
• Amount
• Calories consumed
• Current Activity
• Hungry?
• Stress Level/Emotional State

The last 2 items are the most important clues about why we eat or overeat. From there, we can identify triggers for our eating habits. Knowledge is power. If we know what causes overeating, we can go into that activity knowing the risk & avoid temptation more successfully.

A food diary done for an entire week will help in pattern identification. This can be repeated as needed, to ensure new habits have formed. Alternatively, if you feel it helps you stick on course, continue. It is a fantastic way to manage your eating habits.

Reductil

Reductil(Europe, also known as Meridia in USA) is another common anti-obesity medicine. It was approved by FDA in 1997. The active ingredient is sibutramine, and it comes in a 10mg capsule. Dosage is 10 mg once daily (usually in the morning). If this is insufficient the dose may be increased to 15 mg daily after 4 weeks.

So how does Reductil work?

It's main mechanism of action is by affecting neurotransmitters in the brain. Sibutramine prevents two of these neurotransmitters, noradrenaline and serotonin, from being reabsorbed back into the nerve cells. Noradrenaline and serotonin are responsible for moderating mood and various other processes in the brain.

It is thought that sibutramine helps people to lose weight by increasing the amount of noradrenaline and serotonin free to act in the brain. This enhances the feeling of fulfillment from eating, and so makes you feel satisfied after eating less food.

An appropriate diet and exercise programme should be started while taking this medicine, in order to maintain your new weight after you have stopped treatment. Please consult your doctor for a full customised weight loss programme.

Who cannot take Reductil?

You cannot take Reductil if you are/have:

• psychiatric conditions such as bulimia, anorexia, depression or preexisting mania
• a history of or a predisposition to drug or alcohol abuse
• taking a MAO inhibitor, antidepressant or other centrally acting drugs
• poorly controlled hypertension
• heart disease
  
• stroke or seizu
• hyperthyroidism
• closed angle glaucoma
• enlarged prostate with urinary retention
• Phaeochromocytoma
  
• pregnant, or breast-feeding a child

General Precautions with Reductil:

• Reductil capsules should be swallowed whole with or without food.
• This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.
• You should change your lifestyle in terms of eating habits and physical activity while taking this medicine, so that you are able to maintain your new weight after you have stopped treatment. Your doctor should advise you on the changes you need to make and continue to monitor your weight after you stop treatment. If you don't change your lifestyle you may regain the weight you have lost.
• Your weight should be monitored while you are taking this medicine. If you are not responding adequately to this medicine, ie if you have not lost at least five per cent of your body weight within three months, or if you put on more than 3kg at any stage after previously losing weight, you will need to stop taking this medicine. This medicine should not be taken for longer than one year.
• Your blood pressure and pulse rate should be monitored while you are taking this medication; every two weeks for the first three months, then once a month for the next three months, then regularly at maximum intervals of three months after that. Your doctor may ask you to stop taking this medicine if your blood pressure or pulse rate increase too much.
• Consult your doctor if you experience shortness of breath, chest pain or ankle swelling while taking this medicine.
• If you experience any mood changes, depression, or distressing thoughts or feelings while taking this medicine then it is very important to talk to your doctor.
• This medicine may be harmful to an unborn baby. Women who could get pregnant should use a reliable method of contraception to prevent pregnancy while using this medicine.

Some possible common side effects of Xenical

• Dry mouth
• Difficulty in sleeping (insomnia)
• Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
• Headache
• Pins and needles (paraesthesia)
• Lightheadedness
• Anxiety
• Sweating
• Alteration in taste
• Aggravation of haemorrhoids
• Hot flushes
• Awareness of your heartbeat (palpitations)
• Increased heart rate (tachycardia)
• Raised blood pressure (hypertension)
• Depression
• Menstrual cycle disorders
• Impotence
• Seizures
• Decrease in the number of platelets in the blood (thrombocytopenia)
• Kidney disorders

*Please consult your doctor for a full assessment before starting Reductil.
*Prescription-only medicine. Please buy from a reliable source.

Intra-Gastric Balloon

Procedure:

A silicone filled balloon is inserted into the stomach through the oesophagus via an endoscope. The volume the balloon is pumped up to depends on the patient's stomach size. At maximum, it is the size of your palm. The balloon takes up space in the stomach, so you'll feel too full to eat.

Duration:

15 minutes (under IV sedation)

Candidates:

Patients weighing 10-15kg above their ideal weight
Severely obese patients should consider gastric banding instead

Who Isn't Suitable:

Those who are pregnant, have ulcers, gastro-oesophageal reflux disease or who are anti-coagulated (taking Warfarin or Heparin)

Scars:

None

Recovery Time:

None

Weight Loss:

15-20kg. The balloon is removed after 6 months, by which time the patient has adjusted to eating smaller meals.

Risk:

1% risk of silicon leakage from the balloon