When it comes to weight loss, most people look for the quick fix.
Americans try everything from liquid diets to hunger strikes to mummification-style wraps in an effort to take off a few extra pounds quickly.
Some programs or diets work in the short haul, but the results are temporary. Others can be harmful or potentially fatal, as the fen-phen prescription turned out to be.
This month, Taking Shape takes a look at three common weight-loss techniques seen as shortcuts. Each produces results — but what are the costs, physical and financial?
Stomach stapling isn’t something to be taken lightly — the guidelines recommended by the National Institutes of Health consider only people with a body mass index of 40 or above to be a good candidate for the surgery.
"This is a serious treatment for a serious disease," said Sandra Montelongo, program coordinator for Paradise Valley Comprehensive Weight Loss Center. "And some people have developed serious health consequences."
The recently developed center, part of Paradise Valley Hospital in Phoenix, specializes in a form of bariatric surgery that reduces the stomach to the size of a thumb and bypasses part of the small intestine.
Because the bypassed part of the intestine is where calcium, iron and folate are absorbed, patients who have the surgery will be on special supplements for the rest of their lives. And consuming any foods that have concentrated fats or sugars leads to "dumping," a phenomenon even less pleasant to experience than to read about.
Patients will lose weight with bariatric surgery — in a 14-year study, 95 percent of patients kept off at least 75 percent of their weight loss. And the results are relatively quick — 75 percent of the weight loss occurs in the first year.
The Paradise Valley center makes applicants go through a 10-week education and training program with a dietitian, fitness expert, psychologist and even a chaplain to prepare them for the changes ahead — think how hard it must be to go to a restaurant with friends and only be able to eat a quarter-cup of food total. The diet is high in protein for the first year, but trying to build muscle with weightlifting is not recommended.
Most programs cost about $25,000. And some people who lose large amounts of weight also require superficial skin-reduction surgery, which is cosmetic and not covered by insurance. The most important thing to remember, Montelongo said: "The surgery isn’t a cure, it’s a treatment. And the treatment goes on for a lifetime."
THE ATKINS DIET
High-protein diets leave dieters feeling full because protein has a satiating effect, even though they’re eating fewer calories than they would otherwise.
Carol Johnston, nutrition professor at Arizona State University East, reduced test subjects’ caloric intake by 25 percent; some subjects were on a high-protein diet, while others were on a highcarbohydrate version.
"The high-protein people couldn’t believe it was a restricted-calorie diet," Johnston said. "The highcarbohydrate people were starving. But they got the same number of calories, based on body weight and metabolism."
Johnston said the problem with the Atkins diet is its moratorium on carbohydrates, which can stress organs — including the brain — and muscles. The brain consumes 20 percent of the body’s energy at rest and can use only glucose, which is found in carbohydrates. Atkins dieters don’t store any carbohydrates for later use — but the brain still needs an energy source.
The body can break down proteins from muscle mass into amino acids, which can be turned into glucose for the brain. It’s called ketosis, and it’s breaking down body proteins, Johnston said.
"Even though Atkins says you’re metabolizing fat, you’re doing it in an unnatural way because of this lack of carbohydrate. It’s like a starvation state. Only if you literally were starving is ketosis beneficial. If you’re eating and in ketosis, it’s causing disregulation in body processes. You tend to tax your organs.
"You’re using a good majority of body protein to feed the brain," she said. "Will you die from that? Probably not, but your organs will probably get small. They won’t operate optimally."
Johnston said one of the things "that will kill you outright when you go into ketosis" is irregular heartbeat. She recalled a high schooler who had been on Atkins for two weeks and had a heart attack in school — not because of blockage from cholesterol, but because of her heart’s irregular rhythm.
Diet pills that claim to boost your metabolism may do so, but the moment you stop taking the pills, you’re right back where you started. And many contain ephedra, an herb that can cause hypertension and irregular heartbeat. (The U.S. Food and Drug Administration is considering banning ephedra because of the deaths associated with it.)
Consumers are easily swayed by words like thermogenic, bioavailable and metabolism.
"There’s just enough science in some of these pills that makes it hard to say, ‘No, it doesn’t do what it says it does,’ " said Andrea Hutchins, assistant professor of nutrition at ASU East. "It makes it hard to disprove."
Most pills such as TrimSpa contain caffeine, guaranine extract, cayenne and black peppers and other components that stimulate the metabolic rate.
"People with hypermetabolism tend to be really skinny," Hutchins said. "What these pills are trying to do is mimic that effect — up the metabolic rate. More of what you do eat is burned as energy instead of fat, yes, but it’s an outside effect."
That means most people haven’t cut back on eating or increased the amount of exercise they do, so the minute they go off the pills — and Hutchins estimates the cost prevents people from staying on them for more than three to six months — the weight comes back.
"It’s an easy fix, and you see changes quickly," Johnston said. "When most of us go to lose weight, we forget it took us months, if not years, to put the weight on. When we want to take it off, we want to see results now."
Most pills also contain diuretics — anything with caffeine or herbal supplements such as rosemary or fennel seed will lead to multiple trips to the bathroom, which results in a loss of water weight.
"These are more sophisticated versions of Dexatrim," Johnston said. "When you look at the ingredients, you’re getting the same effects."
THE TAKING SHAPE TEAM UPDATE
Four East Valley residents are on a yearlong challenge to get in shape with the help of a dietitian, trainer and membership at the YMCA. We’ll follow their struggles and successes each month — and report their progress.
It seems counterintuitive: Now that 15-year-old Lindsay Thurber is out of school for summer, she’s got a schedule that gets her out of the house most days by 7 a.m.
The Mesa student, who just finished junior high school, hits the YMCA almost every day for treadmill, biking and "a lot of crunches," she said. "It burns, but it’s good." She’s also started jumping rope for five minutes at a time, after she heard it burns more calories than jogging.
"I’ve toned up so much," she said. "I’m so happy. I’m ready for high school now. I’m not as self-conscious about the way I look. And I saw a friend yesterday I hadn’t seen since school got out, and she said, ‘Gosh, you’ve lost a lot of weight.’ Actually, I haven’t lost much, but I’ve toned up."
Because muscle weighs twice as much as fat, Thurber’s small drop in pounds belies her increased health and fitness.
Her trainer, Jan Hertzfeld, keeps the teen on a regimen of cardio and weightlifting; because Thurber’s looking to lose fat, not pack on muscle, Hertzfeld keeps the focus on cardiovascular health — even the muscle-building exercises have the goal of increasing Thurber’s metabolic rate.
The teen also eats "a lot more chicken, and I’m staying away from red meat," she said. "And I have fruit every morning, or a smoothie" she creates by whirling an instant breakfast packet and fruit or yogurt in a blender. It’s a change for the girl who used to start her day with sugary cereal.
"I‘m getting annoyingly boring," Steve Guss said of his progress in Taking Shape. But the Scottsdale man means it in the best way: His "boring" routine means five days a week at the YMCA in Scottsdale or downtown Phoenix, where he works.
The results speak for themselves: He’s down one size in shirts, and so pleased about it he’s been known to wear the shirt sizing tags around for a while.
His wife, Evelyn, shakes her head a little — her plantar fasciitis has acted up on one of her feet, and between the doctor’s appointments and waiting for the orthotics her gym attendance hasn’t been what she hoped it would be.
"Not being on a regular routine really hurts," Evelyn Guss said. "All the doctor’s appointments — when you come back, it’s like starting brand-new all over again."
But those doctor appointments have brought good news — her physicians are pleased about her weight loss, and her blood sugar levels are more consistent in the mornings now. On the whole, the numbers are lower.
The Gusses say food continues to be their Achilles’ heel.
"It makes me upset with myself that I’m not doing 100 percent with the food," Evelyn said. "Food is still a huge issue for me. I’ll think, ‘Hey, I’m having a salad,’ but I pick the salad with walnuts."
The couple said many of their friends still don’t sympathize, either.
"They’ll want to go to the regular places, and they’ll say, ‘Oh, you can order plain pasta or salad,’ and I’ll say, ‘No, I can’t order plain pasta or salad when everyone else isn’t,’ " Evelyn said.
But a dietitian recommended a little-known restaurant in Phoenix to the Gusses, who don’t stop singing its praises. "It’s called Soma, and they have a tequila lime cheesecake with like 137 calories," Steve said. "They bake their fries, and they have a turkey burger."
"And they have a kids’ meal that adults can buy," Evelyn said, "and it’s more than enough food for me."
The hardest part, for Steve, is when they’re out of town, as they were last month to watch their daughter pick up her master’s degree and their granddaughter’s dance recital in Las Vegas.
"It’s harder for me to restrict my food intake then," Steve said. "But I still got up and drove halfway across town to do cardio at the local Y."
"This was a rough month," Kindred Arvizu said, sighing as she looked back on the past four weeks of the Taking Shape challenge. "It’s the toughest month since we began.
"Life got in the way — or, I should say, it was a lot easier this month to
make excuses" , woman said. "And nobody was telling me, ‘You gotta go, you gotta go.’ I wanted someone to force me to do it."
Instead, Arvizu settled for going to the gym maybe once a week, down from her four-timesa-week routine, and there was a two-week period where she didn’t go at all.
"And you start feeling like you’ve blown it, what’s going to happen now, that everything you’ve done over the past six months is going to go down the tubes," she said. She stopped watching what she ate.
A Diamondbacks game proved the catalyst to recharge her incentive.
"We had to go up three flights of stairs and, as I was approaching it, I was kind of panicky," she said. "I was afraid I wouldn’t be able to catch my breath. But it was nice knowing that I ran up and down those stairs and wasn’t winded — it kind of proved that regardless of whether I’ve been screwing off for three or four weeks, the results were still there. I was proud of myself."
She returned to the gym the next day — and she still lost 2 pounds this month.
"I still wish I had someone that was doing it with me," she said. "But I’m back
to doing it again."