Overall, humans are very well evolved and adapted to be able to withstand famine. This is a good thing if you get lost in the woods, but in normal day to day life, it can make it challenging to maintain a healthy body weight.
In the last month or two, several interesting things have come out.
First off, is the confirmation based on large studies that food journals work. This is not surprising in many respects since keeping a daily record of what you eat and how many calories it amounts to would be very helpful in staying within a calorie budget and also seeing where the most effective improvements could be made.
The problem historically has been that keeping a food journal has been really tedious: booklets, paper records, calculators and so forth. Admittedly this is also tough to even get started with if you are worried that you are going to see "too much information".
Happily, the Internet can help with this. Free applications are now widely available which allow you to state your gender, height and current weight, and then develop a daily calorie budget based
on how much you would like to weigh and over what amount of time.
The concept of a calorie budget refers to a daily net calorie intake that should allow you to succeed, based on calories eaten minus calories burned off.
Lose It! and myfitnesspal are both web-based applications that allow you to select from a large variety of fresh and pre-prepared and restaurant foods, and an extensive variety of activities and exercises. Both of these are free, and both are available as free iPhone and Android apps as well. Personally, I like Lose It! because it has an exhaustive list of exercises and activities including household walking, vacuuming, housecleaning and about ten different levels of yardwork as well as athletic activities ranging from running to archery to skiing. My wife prefers myfitnesspal because it has a better selection of fresh foods and scratch meals.
For those of you who find daily fixed work-outs a bit boring, Sworkit is a pretty cool circuit training application that allows you to set up and follow a series of exercises from 5 to 60 minutes focused on specific body areas or whole body. It allows you to vary your work-out day to day, and even includes yoga sequences and core strengthening! This is also available as an iPhone app (I don't happen to know if it's also in the Android Market).
Another big study seems to link low-carb diets with being helpful and keeping weight you've lost from coming back. (Atkins had a point after all?) Lots of people have had the frustrating experience of working hard to lose weight, and then have it come back over the next months even though they are continuing to diet and exercise regularly. Apparently, decreasing calorie intake and increasing activity and exercise helps to reduce weight, but your body quickly responds by reducing metabolic rate. This means your body burns off calories at a lower rate and stores more of it as fat even though you are not doing anything differently. The study looked at diets where 60%, 40% or 20% of the dietary calories came from carbs and found that the 20% calories as carbs diet was the best at keeping the weight off. This seems to work by countering the aforementioned down-regulation in metabolic rate. Interestingly, fat intake was not restricted in this study. The weight loss apps I described above could also allow you to regulate carb intake for both weight loss and weight maintenance purposes.
Last, but not least, one of three new drugs in the pipeline recently obtained final FDA approval. Qnexa is actually a combination of low doses of two already existing generically available drugs, phentermine and topiramate.
Phentermine has been used as an appetite suppressant for decades. Topiramate started as a drug to prevent seizures, has also been found to be highly effective at preventing migraines and its most common side effect has been weight loss.
Please do not hesitate to ask about healthy weight reduction: I am very happy to discuss it and am delighted to see patients succeed in their efforts and also reduce their need for medicines for high blood pressure, heartburn or joint pain!
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