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Weight loss gimmicks (or how to slim your wallet without really trying)

Are these new low-carb diets the miracle solution that various authors and entities claim?

These diets are generally considered low carbohydrate and high protein, but usually are also high fat. Before we go further, let's discuss a few facts about basic nutrition.

Foods are composed of three classes of compounds -- carbohydrates ("carbs"), protein, and fat. Carbohydrates, commonly found in fruits and vegetables, tend to have a low energy density (fewer calories per ounce) because they usually contain water. Both carbohydrates and proteins contain 4 calories per gram (a gram is 1/28 of an ounce). Fats, on the other hand, contain 9 calories per gram, or more than twice as many calories as carbohydrates.

However, since carbohydrates tend to contain water, which doesn't add any calories, you can:

• Consume much larger quantities of carbohydrates than fats (which don't contain any water) or proteins (which tend to contain less water).
  
• Be satiated (feel "full") while consuming a larger volume with less calories.

Carbohydrates and proteins have been shown to be much more effective in leading to a feeling of fullness than do fats and lowering the total number calories consumed at a meal compared to a high-fat diet.

Whenever people go on a diet, especially a low carbohydrate diet, they experience a diuresis (loss of water) from the body. Most people associate this transient loss of water with true fat loss, which it isn't. This water comes back later when the weight stabilizes.

Everybody overeats at times. The effect of overeating on carbohydrates, fats, and proteins is very different. Excess carbohydrates and proteins lead to an increase in metabolic rate (you may feel warm because of this), but excess fat intake does not. Fat consumed that is in excess of immediate needs is immediately stored; whereas carbohydrates and proteins must undergo extensive metabolic conversions utilizing some of the energy in these compounds in order to be stored as fat.

By avoiding some food groups (like vegetables), one can develop deficiencies of vitamins, especially vitamin A, the B group, C, and occasionally K. Since these diets are generally high in fat, serum lipids (cholesterol and triglycerides) tend to be higher.

Finally, high fat intake has been shown to promote obesity, not just in humans, but also in laboratory animals.

A balanced calorie-deficit diet that includes carbohydrates is safer and more likely to promote weight loss for a longer period of time.

Herbal "Phen/Fen" or what do I have to lose?

Herbal "phen/fen" (St. John's Wort and ephedrine, soon to be banned in the U.S.) has been promoted as a "safe" alternative to phentermine combined with fenfluramine ("phen/fen"). Most people are aware of the disastrous complications of "phen/fen," including valvular heart disease, PPH (primary pulmonary hypertension), heart attacks, strokes, and the significant neurologic complications of depression and memory loss.

Some individuals and companies are now promoting the combination of ephedrine and St. John's Wort for weight loss. Ephedrine is a non-prescription stimulant medication that increases heart rate and blood pressure. It causes a slight decrease in appetite and an increase in metabolic rate. St. John's Wort is an herbal product that has some antidepressant activity. Many people incorrectly believe that fenfluramine was an antidepressant similar to Prozac, Zoloft, or Paxil (it wasn't). Thus, the combination of ephedrine and St. John's Wort has the (inappropriate) designation of "herbal phen/fen." from these mistaken assumptions. The major problem with this herbal combination is that ephedrine can result in heart attacks, strokes, and other fatal complications (there have been a number of recently reported deaths in previously healthy, young individuals taking ephedrine). Thus, you have a lot more to lose than you may think and extreme caution is warranted.

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Last modified: May, 2004.

Copyright © 1996-2004 Michael D. Myers M.D. Inc.
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