Commonsense rules to manage your weight properly

Obesity is a disease, and like any disease, it must be treated, according to Dr. Kamal N. Tolia. As a gynecologist, Dr. Tolia found that often her patients' health problems were weight-related, and many of them spoke to her about their struggles to lose weight. She decided to learn more about weight reduction and became certified by the American Board of Bariatric Medicine.
 Dr. Tolia recently spoke about the consequences of overweight and obesity and her commonsense approach to proper weight management.

Q: How great a problem is obesity in the state of Texas?
A: In 2005, more than half of Texans aged 18 to 29 were overweight or obese, according to the state comptroller's office. Those aged 30 to 44 were much more likely to be overweight or obese, with a prevalence of 67.3 percent. Those 45 to 64 were heavier still; 71.3 percent were overweight or obese. Texas ranked tenth among states in its share of overweight or obese adults.
 We shouldn't think, however, that the problem is specific to Texas or even to the United States. It's a worldwide epidemic.

Q: What caused this epidemic?
A:  Especially for those of us in the United States, life is easy. It's far easier to get into a car and go somewhere than it is to walk or ride a bicycle. Food, especially high-calorie, high-fat food, is cheap and easy to get.
Also, we tend to center our lives on food. Most people gain weight during the holiday season. We need to find other ways to celebrate.
It takes a great deal of awareness and motivation to change our lifestyle habits and overcome obesity.

Q: What are some of the consequences of being overweight or obese?
A: There are many. The tendency for developing adult onset (Type 2) diabetes has risen dramatically in this country, even among teen-agers. Besides diabetes, obesity can lead to hypertension, high cholesterol and triglycerides, and eventual heart attacks. Beyond that, obesity can lead to back and knee problems, sleep apnea, and even sterility and infertility.
   Simply losing weight can improve your health, your looks and your self-confidence. With proper diet and exercise, people with diabetes can even control their insulin levels so that they no longer have to take pills or shots. When people walk into my office with high lipid cholesterol and triglycerides and find the numbers to be significantly lower after three months, they feel good about themselves.

Q: Is there any particular diet that you recommend?
A: There are thousands of different diets - just turn on your television to see the commercials. But I don't believe you can make a one-size-fits-all diet. Fad diets that advise you not to eat after a certain time in the afternoon, for example, or diets that restrict you from eating certain types of food, cannot be maintained.
 Also, many of us tend to put too much emphasis on the Body Mass Index (BMI). The system is based on a person's height relative to his or her weight. But if you are well-muscled, the BMI may not apply to you.
In general, however, there are four steps to my diet plan:

1. Drink water. And I do mean water, not soft drinks. I recommend six to eight glasses of water a day.
2. Spread out your calorie intake. Eat five small meals a day totaling 1200 to 1500 calories. Of course, calorie counts may vary according to your individual needs.
3. Concentrate on high protein, low fat. Many types of foods including beans, nuts and certain types of vegetables can help you raise the protein to fat ratio in your diet.
4. Exercise! All of us can find half an hour each day to maintain our health. Walking is the form of exercise I recommend most highly. Walk three miles a day seven days a week to start until you've reached your goal weight. After that, you can cut back.

Q: What is the role of medicine in treating obesity?
A: Obesity is a disease, and, as with any disease, it needs to be treated - urgently, in some cases. Different types of pills including appetite suppressants and fat blockers have their role in treating obesity, in getting people started and in giving them the self-confidence they need to continue their weight loss.
 The problem is that people often want a quick fix. Women will come to me and say, "I'm getting married in two months, and I need to lose 30 pounds before then." My answer is No! Don't do that to yourself! Don't abuse your body that way!
 Whether or not you use medicines or surgery to treat obesity, you still need to make a lifestyle change that involves less food, the right foods, more exercise and more water.

Q: How can a medical doctor help you treat obesity?
A: A qualified doctor can help you make a plan and keep you motivated to stick to it. I give my patients the information they need, then have them write their own diet plans.
 Maybe a patient travels a lot and has to eat in restaurants. I advise the patient to order a salad and share the entrée. Most hotels now have workout rooms to help you keep your weight loss commitment. If you don't have time for breakfast, a protein bar may be the answer. The point is to make a diet that suits your lifestyle.
 It's far easier to lose weight than it is to maintain your weight. A doctor can help you sustain and maintain what you've gained.

Dr. Kamal N. Tolia's clinic is located at 6005 East Ridge Road, Suite 110. For more information or to make an appointment, call (432) 362-3626.