Prescription Weight Loss
 

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I certainly don't think that a perscription medication will do the trick. In my experience people lose weight in the short run but are never able to keep it off in the long term. As you grow older, your metabolism slows so it may be harder to lose this weight than it was 8 years ago. A diet in which you eat several times a day, as well as your bike riding may help. Overall, you are already far more healthy than you were 4 months ago. You have already improved your cardiovascular health and hopefully made fitness a long term part of your life.

I tend to disagree with the pharmaceutical method as well, as most of the compounds have long term risks and given the short time they've been in use, their long term effects haven't really been evaluated. The Prednisone messed up your metabolism for a bit, OK, but it's not unlosable. In my opinion, pharmacological or surgical weight intervention should be reserved for morbid obesity situations where there's loss of the ability to exercise, or a metabolic disease mechanism contributing to the weight gain.

You are already doing it the American way and it isn't working!

Here is a secret weight loss trick: Become a vegan for the rest of your life!

Just kidding, kind of. Your diet is probably not as good as you think it is. You know what you are doing wrong, you just aren't trying hard enough. Stop eating red meat. Stop eating cheese. Stop eating white bread, stop eating dessert. If you would rather let drugs do the work for you, why don't you try methamphetamine? Its cheap and it works!

Weight loss drugs work just like crash diets-- as soon as you stop artificially bolstering your metabolism, you will gain weight back fast. If you stay on the drugs or a grapefruit juice fast for a long time, it will make you sick.

You have to figure out a change you can make and keep up with for the rest of your life. Its your choice! if you would rather eat 3 cheeseburgers a week than be healthy, you better do a lot of cardio to work them off, or get used to being fat. Maybe you can live with only ONE cheeseburger a week, and do a moderate amount of exercise, and eat other healthy foods to balance your diet. You just have to make it a priority.

I'll third the opinion, to stay away from the chemicals, the problem with the pharmaceutical approach, is that it is an appetite suppressant, but it doesn't fix the underlying problem, and that is knowing how to eat properly. So, once you have lost the weight you want, to go off the meds, your appetite comes back, you start eating again, and all the weight you lost finds you again, problem is, it brings a few new pounds it found along the way, so you end up heavier then before.

I think, really the first step, is to learn to respect yourself, would you expect someone you respect to visit a home full of garbage, probably not, so you need to realise your body is your home, and if you respect yourself, then you don't want your home full of garbage. so quit eating it.

So what should you eat? Highly nutritious, low calorie foods, so you meet your nutritional needs with the fewest calories. The recommended weight loss, is 2lbs a week, 2lbs is 7000 calories, so you need to make sure that what you use, exceeds what you consume by 1000 calories per day. You can either cut back on what you eat until your 1000 calories short, add 1000 calories worth of additional physical activities, or a combination of both. Realise that processed foods, usually have the nutritional value processed out, leaving just the calories, you don't want this....

Oh well, I need to actually go to work now, so more tomorrow.....

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weight watchers. its a lifestyle change

Of course standalone pharmacological management of a lifestyle disease won't work by itself.

That said, there is nothing wrong with a multi-factoral approach to lifestyle change and subsequent weight loss, and pharmacological treatment can certainly be an effective part of that approach.

There is an incredible volume of medical literature available within the public domain, most of which focus on interventions with efficacy at a population level. Exercise and diet are both proven modifiable risk factors for obesity (amongst many other diseases with high levels of morbidity and mortality). There are also many pharmacological treatments that, while they have not proven to be significantly efficacious in isolation, can provide an important pillar to a comprehensive approach to obesity and weight management.

Yes, there certainly are risks involved with any pharmacological treatment which is why there is the important piece of advice that should always go with this kind of discussion. Go see a doctor. A good doctor.

If you want to lose weight, diet. If you want to keep the weight off, you need to be comprehensive in your approach. If all else fails, get a healthy illicit drug addiction going.



(also ^^^^ +1 Weight Watchers)

Here is the deal - if he is unable to loose weight despite being active and having a proper diet then he may need medical help. I'm not going to suggest weight loss pills, but I am going to suggest that he sees a doctor about this issue.

Get checked out by a doctor at a health & wellness center. They can calculate your metabolic burn rate and see if everything is OK. An example of an issue they may find would be that you may have slow metabolism from an underactive thyroid or some other common medical reason. The treatment for that is to take a synthetic thyroid pill every morning to get you back to where you should be. Or they may find that everything is OK and then give you a special diet based on your personal needs.

So oddly this is exactly what I did, I cut out all white bread, no fried sides when we eat out. That made a huge difference. Then I cut out all the Soda pop, (Diet and everything) any added salt and anything that is fried. Like it has been said before, you have to make changes that you have to be able to live with for the rest of your life, it's not a diet it's a life style change. So in 4 months I've lost 22 lbs, I had a bit of a set back when I had to lay off the biking heavy for 2 weeks due to injury. But I am back at it now and over the time I was off I was able to at least maintain my weight and didn't gain.

You know now that I think about it, it's been nearly 4 months since I had a cheese burger :).

Pills and chemicals are a bad idea, not only because they usually don't work and may be harmful, but because they foster the idea fat people are helpless victims. OK, rant over before it began. :-)

Unless you have a medical condition that causes weight gain or slows metabolism, you should lose weight with the simple rule that if you burn more than you take in.... etc. My guess, and this is not a flame nor an attempt to troll, is that you are overstating the calories burned and underestimating the calories taken in. This is easy to do. Take it from me. I've been there. In fact, I am living there now, since recently my eating habits haven't been conducive to weight loss.

I would recommend to start counting those calories.. Get a date book and write down everything that you eat or drink that has calories.. Go online and find a BMR calculator.. For men, you should be shooting for 2300 calories or less per day. Once you start having deficit calorie days and add some riding you will see the weight coming off slowly but surely. Another great item to have is a pocket calorie book, 8.00 at any book store, it has many fast food places listed as well.. This will give you a better judge of how many calories you are taking in each day.. The Calorie King book is seen as the best one on the market.. The book has many national fast food places so you can see what is calorie dense and what is not..

http://www.amazon.com/Calorie-King-C...3493975&sr=8-1

Great advice so far.

I "though", I had done a pretty good job of modifying me diet. I did all the classic things that are associated with eating "healthy". Yet I never lost any weight in a year of "eating healthy". I finally started journaling EVERYTHING I ate or DRANK(very important) and the numbers didn't lie. Despite the "healthy" foods, I was still taking in way to many calories. I wanted a life style change not a crash diet. Therefore I didn't cut out every single junk food, fast food, or take out or any of the classic "unhealthy" foods, I just learned to incorporate them into my diet of healthy foods. Therefore I wouldn't get burned out and didn't felt like I was missing out on many of the foods that I enjoyed. I tailored my diet to have a 1500 calorie goal. I was amazed at how much food you can consume and still only take in 1500 calories if you pay attention to what you are eating.

I did the same for my exercise. I started out walking/hiking so I bought a pedometer and journaled my steps and miles every day. Then I'd figure out how many calories, I burned. Again I wasn't burning nearly as many calories as I thought. Therefore I figure out how big of a calorie deficit I wanted and made sure I walked enough each day to burn that many calories. Then I added in bike riding, which allowed me to cut back on the walking/hiking. As I've lost weight, I've added things like jogging or leg squats to my to my walks/hikes and pushed my bike rides farther and longer to increase the calorie burn.

+1, This is the way to do it.

I also read a web book that really got me thinking about this http://www.fourmilab.ch/hackdiet/e4/, it's called the hackers diet. Despite the name it is quite serious and a good start to a lifestyle change. If you get a chance read it.

+1. The biggest reason that people assume weight loss doesn't work is that they don't work at it. Instead, they talk about 'eating light', which is a sort of catchall phrase meaning "I'll not make any lifestyle changes." It makes them and their friends/enablers feel good without causing them to give up any part of the lifestyle that made them fat.

I had a hard time losing weight just by changing a few eating habits so I started Weight Watchers and it worked great.

+1 This really is the "right way" to do it.

Get a book called "Eat To Live" by Dr. Joel Fuhrman. It will revolutionize what you "think" is a healthy diet. The book isn't even truly about "weight loss", it's about being healthy (and weight loss is a big part of that). Essentially the book describes the perfect diet as being "mostly vegan". He doesn't tell you to completely stop eating meat, but explains (in cold hard facts) why your meat (and all animal product) consumption should be very low - not just for weight loss, but to help prevent cancer, diabetes, and LOTS of other potential issues.

I will part from popular opinion here for a minute.

Pills can play a PART of the solution. For me, phentremine has been a huge help...

1.) It helps build the habit of eating less. Your less hungry, and the pill making you less hungry all the time helps you get into the habit of eating less.

2.) It gives you alot of energy. You get in the habit of doing more. Now, after getting used to doing more, even without the pills, I am much more "bored" just sitting around, and end up doing more because I got used to keeping myself busy...now inaction just bugs the hell out of me.

Now, I still take them...but its rarely....and less often. With just a month or so of them, I've gotten myself into better habits, and I don't need them to keep it up...

As far as the "almost vegan" thing...not for me.

For me I did what was above....

I did not actually write it down but I could see how it would help. I think for me the best thing I had going was a heart rate monitor and it showed calories burned....That really helped me get an idea of what 100 calories was and how hard it was to counter act that 100 calories...

I learned that Fruits are the devil....they make you think they are all good for you and it is healthy to eat them but you can eat so much of them that you might as well be eating a Big Mac.....

When you start looking at Calories out and calories in then there is no doubt why you are not loosing weight..

I think the Journal idea is a good one.....it will give you a basis of when you are taking in....post up your Journal, it would be intresting for us to see and hear opinions on what your eating....

:)

Really? I usually try to eat at least one and sometime two peices of fresh fruit daily. If I eat two peices this only amount to a couple hundred calories and little or no fat. Compared to 700 calories and 30 grams of fat in a Big Mac with cheese.

+1 for journaling your food. Write down everything! I am using Fitday.com...works like a champ. Plus the graphs are fun!

+1 to this - unless you have some undiagnosed medical condition you are probably eating more than you think and burning fewer calories than you think.

What has worked for me

1. Start keeping a log of EVERYTHING you are eating and be honest with yourself. You can be eating a very healthy diet but eating too much (this was largely my problem). Buy an el-cheapo scale to check quantities especially on meats. Watch out for hidden calories and calorie dense foods. For example when eating out a lot of restaurants slather butter on everything. Also try to maintain a proper balance between carbs, protein, and fat. Note I try to do this with every meal.
2. Read the label on everything processed that you eat. Be very careful of high fat or high sugar in processed foods. This seems to hit me personally really hard so I've become a dedicated label reader.
3. Start keeping log of your exercise as well. Be careful most online resources overstate calories burned ,some of them excessively. It take a long time and a lot of work to burn off 100 calories.
4. Don't use exercise as an excuse to over eat or as an excuse to eat something bad. I have a friend that does this and has a hard time losing weight off. Personally one "bad" meal with stall my weightloss for several days.
5. Make sure you are getting enough calories. I went to a wellness center and had them measure my metabolism then set a number 1000 calories less than that and have been following that.
6. Figure out if you have any triggers that make you eat wrong or improperly. It might be a food, it might be a stressor, boredom, etc. If you have triggers once you are aware of them you can start to deal with them.
7. In addition to weighing yourself take some body measurements. When your weightloss stalls, and it will, chances are your measurements will continue to change. I've found this to be a positive motivator.

Most of all keep a positive attitude, you are going to have ups and downs. Work for the lifestyle changes that you need to maintain your weightloss. It took you a long time to put it on and it's going to take a long time to take it off.

Scott

+1 to journaling. I started journaling my food intake as well. In the morning a light breakfast (oatmeal or a little cereal). Then around 10am I munch a banana or some other fruit.
I hardly go out during lunch and always bring a sandwich packed with salads, cucumber, mustard, avocado and turkey to work. Eat some tomatoes and pickles with it. Then around 3-4pm when the little hunger strikes again I eat a lowfat yogurt with some granola. Before the exercise bike ride in the evening I munch on a slice of bread with either peanut butter/banana or some ham or turkey. Or maybe a very small dish of dinner.
Then I hop on my bike for an hour or two every night.

I'm down 15lbs to 196lbs since I started Jun 10th with serious exercising and change in eating habits.

Oh.. and I drink only water, or natural fruit juice when there is no water available at work. But I'm trying to keep the juices to a minimum as they are alot of calories.

Thomas

My doctor had me lose weight starting 2.5 years ago (went from 365 lbs to 190 lbs and have kept it off for one year so far), and the doctor and my dietician prescribed a food and exercise program much like what I see above. I feel that those issues are mostly mechanical, however, and that losing weight and keeping it off is not a mechanical issue at heart. It is also a mental and emotional issue for me. My doctor and dietician had me attack the problem from 3 directions.

1. Food and Exercise.
2. Mental/Accountability.
3. Emotional Aspects of Behavior.

The food and exercise parts were by far the easiest. They had me eat a balanced diet and plan my meals, which includes planning emergency foods that you can eat at most fast-food places and restaurants when something like real life comes up, such that I NEVER went more than 5 waking hours without a snack. The goal is to not have BIG MEALS or LONG SKIPS between meals (ALWAYS EAT BREAKFAST, NEVER SKIP A MEAL!!!). The idea here is to even-out your blood sugar as much as possible the entire time that you are awake. You don't want any big spikes in blood sugar (like when you eat too many carbs at one-sitting), and you don't want any big dips in blood sugar (either from not eating often enough, or the big crash following a previous spike in blood sugar earlier). Big drops in blood sugar can make some people have binge cravings, and if it happened to me late-in-the-afternoon, I used to pretty much eat until I went to bed. I was unable to control myself with willpower at that point, and learning how to avoid letting it happen was HUGE in helping me control my behavior. At first, they had me on a balanced diet consisting of around 1800 calories a day. There are lots of decent food plans out there that work. Just don't pick one that severely restricts carbs, fat, etc. because you can't keep that up for the rest of your life. You eventually want to be eating in a way that you can eat and be happy with for the rest of your life. Forever.

You already exercise, and there is plenty of good advice here on BF about that.

The mental part centered around accountability. This is not the same thing as blaming myself for what I did wrong. I wrote down everything that I ate, and took it into the dietician twice per week for face-to-face review of what I ate. They also weighed me at each of those visits. They did not admonish or yell at me, we just went over what I ate in a clinical way, they asked me how I felt on the days that I ate too much, etc. Looking at it dipasionately that often along with a third party really opened my eyes. I could easily lie to myself and/or overlook the amount of food that I was really eating (especially when I did not eat and was hungry all day, and then pigged out at night, but had no idea how many calories were involved until I wrote it down), until I was forced to face it dispasionately twice per week for a while. What is really happening with your body sinks in, and sticks. You don't need a dietician to do this. There are free programs, support groups, and some online weight loss blog communities that do this for each other.

You may not have emotional issues with food, but I did and still do. I used food to calm myself down. I never considered myself very emotional, until I started seriously losing weight. Then I figured out that I used food to elevate my blood sugar to the point where I was artifically calmer almost every day. I used to eat to stay alert and calm at work (sometimes boring yet meticulous job), and basically to calm myself down whenever I experienced any strong emotion (anger, hurt, even too happy, etc.). I used to think that the intensity of my daily emotions was...sort of childish and unacceptable for an adult man to have to deal with. Without food, I had to re-learn how to deal with these perfectly natural strong emotions on a daily basis in a socially acceptable way. I went into counseling to deal with these issues, but many other people deal with these issues on their own, or with the help of family, friends, support groups, etc.

I just thought that I would chime in with some less-mechanical advice. Sorry so long, and have a great week.

I think it's worth getting a doctor's opinion to find out if there is some underlying medical condition that affects how you need to go about changing your lifestyle. Re: drugs, if you care about your health at all (as opposed to just getting skinny for the beach and damn the consequences), you really want to make them the tool of last resort -- for any condition. Drugs aren't free, and they're not without side effects, and they often force you into other restrictions on your life (must take at x time, can't eat/drink this, must eat that, whatever). Perhaps worst of all, even though a drug is effective for you now, that doesn't tell you that it will continue to be so in the future.

As for lifestyle changes, I agree with others that it's supersupersuper important to get away from vague and meaningless phrases like "eating light" or 'exercising regularly", and starting to quantify what goes in and what goes out. This is a step that you must take and a skill that you must learn if you're to become and stay healthy. I have a brother who's recently lost quite a bit of weight on Nutrisystem, and while I am happy to see him at a much healthier weight, I know that he doesn't have the skills to do it on his own. Nutrisystem, for those who don't know, is a program that provides your food. They give a nod to exercise, but it's pretty much all about getting people to lose weight through calorie and portion control. Calorie and portion control is great, but not if someone else is doing all the counting and thinking for you, because as soon as you're not eating their food, you have to make decisions that you don't have skills for. So last week there we are, on a family vacation, and I got to observe that my brother still will eat whatever's in front of him, however much it is, that he'll graze on unhealthy snacks, that he doesn't have any realistic idea of how many calories he's burning through exercise, and that even when he's eating healthy food he's eating too much of it. It's a great example of how someone can have a very mistaken impression of how healthy their eating habits are and how vigorous their exercise is.