FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

EAT LESS, EXERCISE MORE KEYS TO WEIGHT LOSS

Question: My older son and his wife and their two young sons are overweight. At last they have decided to do something about it. I am interested in finding them a menu plan they can all follow. Do you have any suggestions?

Answer: I know you will get conflicting recommendations for your family's weight loss plan if you ask neighbors, friends and the health food store's expert. Each group has reasons, including financial reward, for supporting their proposed method as the best. I'm going to give you advice, too. My advice, while not free of bias, is supported by objective scientific research. I think that gives it added credibility.

Obesity is a serious health problem. Overweight individuals have increased risk for developing high blood pressure, heart disease, diabetes, gall stones and other liver problems. Obesity also dramatically worsens some chronic conditions such as back pain, arthritis particularly of the knees and hips sleep apnea and gout. Another serious complication of obesity is the emotional and social stigmata of being overweight.

Information from a recent study shows that obesity is increasing in our society. Now one-third of individuals are overweight, and 37 percent of these individuals are severely overweight. "Normal" weight is usually defined by the Metropolitan Life Insurance Height-Weight Tables with categories for age, sex and height. Weight problems are classified as percentages of your ideal weight: overweight, 110 to 120 percent; moderate obesity, 120 to 150 percent; severe obesity, 150 to 200 percent; and morbid obesity, greater than 200 percent or 100 pounds, which ever is the lowest number.

People can be overweight for a variety of reasons. It is possible to have "slow metabolism" that allows the individual to gain weight despite eating an apparently normal amount of food. It is possible that your family suffers from one of these metabolic problems, since they are usually inherited. However, the most common cause of being overweight is simply eating more food than is required either due to habit or as a learned response to stress.

The human body is efficient. Food that is consumed in excess of that needed to fuel the "metabolic fires of life" will be converted into fat and saved! Therefore, there is only one way to lose weight eat less than is needed. This requires the body to draw upon the stored fat to meet the caloric needs.

Regardless of our age, we all need vitamins, minerals and proteins to stay healthy. The vitamins and minerals come from fresh fruits, vegetables and grains. Proteins also come from these foods, but they are more abundant in fish, meats, milk and cheese. Unfortunately, these last foods are also quite high in fats a major contributor to obesity. You, your extended family, and the rest of us should restrict fat so that it constitutes no more than 30 percent of the calories in our diets. Carbohydrates should make up 55 to 60 percent of the diet and proteins should make up 15 to 25 percent.

Children and adults can lose weight by increasing their physical activity while holding their eating at the same level, by decreasing their eating, or by a combination of the two. In reality, diets, particularly fad diets, rarely result in lasting weight loss. The same is true of diet pills. The only way to have sustained weight loss is to change the underlying behaviors that produced the original overeating. This often involves education about eating a more healthful selection of foods, some behavioral counseling to learn to cope with life's stresses in more effective ways, and an exercise program.

It would be a wise move to encourage your family to look into this combined approach instead of hoping for a miracle weight reduction by following a fad diet or by using one of the low-calorie meal replacements.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.