Saturday, May 2, 2015

Does Alli Work for Weight Loss?

I've been overweight for most of my adult life, I'm 44 now, and I've tried every diet you can think of. The weight always comes back by the end of a year, and I'm at the end of my rope, thinking I'll never be able to weigh a normal amount. I'm way too nervous to ever try weight loss surgery, but I'm ready to think about some of the prescription weight loss pills. I know even some of the ones prescribed can be dangerous, but I haven't heard anything terrible about Alli. What is your opinion on this weight loss drug?
Melanie C.

Hi Melanie,
Alli is a diet aide sold over the counter that is approved in prescription strength as the pill "orlistat".
Unlike many diet pills, which are appetite suppressants, this pill works by preventing some of the fat you eat from being absorbed. If you don't absorb fat into your system, you won't get the calories it provides. Over time you can lose weight through this method of reducing your caloric intake. And if you maintain a relatively low-fat diet (50-60 grams per day) there's a good chance you can keep the weight off.

If you visit the Alli website you'll see they have a lot of support to offer. They provide tips for a healthier lifestyle and tools to help you plan proper meals. They give you access to chat boards and answer your questions. There are quizzes and articles and skills to help you change your eating habits for good.

The weight loss plan itself? Alli is, alas, not the magic pill that dieters are still waiting for. They factually inform you that, "For every 2 pounds you lose, Alli can help you lose a third pound". This means YOU have to change how you're eating now and be able to lose weight by eating less in order for Alli to help.

"Success" is described as losing 5-10% of your body weight. For a 300-pound person, losing 30 pounds is equal to 10% of their body weight. Most people who weigh 300 pounds probably have a goal weight quite a bit lower than 270 pounds.

The facts are, Alli blocks the absorption of 25% of the dietary fat you eat. In order to be on the Alli program, the suggested fat intake is less than 50 grams of fat per day. Fifty grams is the amount of fat that can be found in half a Domino's pepperoni pizza, or a Burger King Breakfast Biscuit with sausage, egg and cheese, OR a Mc Donald's Quarter Pounder with cheese and a medium order of fries. Again, the 50-gram fat recommendation is for the entire day. So a typical 300-pound person is going to have to drastically change their lifestyle to drop their fat intake probably to one-quarter of what they are used to.

An example of 10 grams of fat would be found in less than 1 Tablespoon of butter or oil, about 1 cup of whole milk, or a small hamburger---just check some of the food labels on candy bars or chips you have in your pantry. You'll need to skip almost every fat-containing junk food (chips, donuts, cookies, biscuits, milkshakes, candy bars, ice cream) to leave way for healthy foods that contain fat, such as an egg, a chicken breast, avocado, nuts, and fatty fish. If you can adopt the habit of limiting fat in your diet, you can lose weight with or without Alli.

Here's the kicker: If you eat additional fat and take Alli, the medication blocks the absorption of 25% of the fat you eat, and guess where the fat goes? It comes straight out the other end of your digestive tract. That's going to be the equivalent of a tablespoon of oil dribbling out each day, with nowhere else for it to go.

In fact, this side effect is one of the factors that keeps Alli users on track: They quickly find out what will happen when they over-eat fatty foods, so they avoid these foods and keep their fat intake low.
In reality, Alli is only going to keep 250 calories from fat out of your system when you stick to the 50-gram daily intake; this is just enough to lose 1/2 pound each week. But lowering your fat intake from 100 grams to 50 grams (even without the aid of a diet pill) will reduce your calorie intake by at least 450 calories--enough to lose nearly a pound each week. I say "at least" because the foods we eat that contain fat usually contain calories from carbohydrates, too, like donuts and cake and candy bars and ice cream.

The bottom line: If you are used to eating large amounts of fat on a daily basis, try reducing the fat in your diet. You can lose weight by doing this alone. If Alli helps as a gentle reminder to avoid extra fatty foods, then it may be the diet pill you've been looking for after all.

Friday, May 1, 2015

Should I Take B12 Shots?

Hi Laurie,
I'm a 58-year old man in good health. I don't take any medications, I eat relatively healthy, and stay active. Recently I've been getting tired easily and I wonder if B12 shots would help. I've heard people say they give you energy, but is this just another myth of a vitamin magically making you feel better? Do B12 shots really help?
Thanks, Jim S.

Hi Jim,
Good question, since vitamin B12 shots actually do help some individuals--those who can no longer absorb vitamin B12 when taken orally.

Vitamin B12 has a complicated absorption process. The acid normally present in the stomach is necessary for absorption of this vitamin, as is a healthy portion of the small intestine. So if a person has certain intestinal diseases or specific surgical procedures, they may not be able to absorb B12 from food, and they require monthly B12 shots to prevent a deficiency. 
Reduced stomach acid can occur from a long regimen of antacids, required by some people with GERD, reflux, or peptic ulcer disease. People with this set of circumstances may also require B12 shots. Normally, as people age they also produce less stomach acid. You may be approaching the age where there just isn't enough acid present to do a good job of absorbing B12.

If someone has a diet poor in Vitamin B12, such as a vegan (B12 is found only in animal products and vegans are vegetarians who consume no flesh, eggs, or dairy products), they could simply take a pill containing vitamin B12, so they would not require the vitamin in injectable form.

The first step to take is to see your doctor and describe your symptoms. There are different kinds of anemia (iron-deficient anemia is the most common) and other conditions that can cause fatigue (thyroid imbalance and other hormone level changes). Vitamin B12 will only help correct a B12 deficiency. If you are deficient in B12, aside from taking injections your physician may perform a series of diagnostic tests to find out why. These begin with a simple blood test, so it can be easy to determine whether B12 is involved or not.

Either way, a noticeable change in your usual physical condition warrants a check-up to rule out anything that might be serious, and to fix any number of conditions that can be easily treated to get you back to your usual active life.