4 quick weight-loss fixes

Source: Best Health Magazine, Summer 2009

Quick-fix weight-loss measures can make the doctor-endorsed gold standard’losing a couple of pounds per week by reducing calories and increasing exercise’seem, well, old-fashioned. But in the often unregulated world of quick-fix weight loss, it’s buyer beware. Some of the approaches outlined in this article are better researched and safer than others, so read on to find out the bottom line. Before trying any of these methods, discuss the options with your doctor.

1. Laparoscopic gastric banding

The fast fix
This procedure is meant for those who are obese. In a same-day surgery (done under general anesthetic with a camera and a few small incisions), an adjustable silicone-based ring is placed around the top part of the stomach, creating a gastric pouch the size of a golf ball and restricting food intake. As you eat, the upper part stretches, causing you to feel full quickly. The band controls the rate at which ingested food empties into the lower stomach, helping to stave off hunger.

The vast majority of gastric bandings are done in private clinics. The Surgical Weight Loss Centre in Mississauga, Ont., for example, is one of the highest-volume lap-banding surgery facilities in North America, says Dr. Chris Cobourn, a surgeon and the clinic’s medical director. ‘We conducted 800 such procedures last year,’ he says. Cobourn estimates that up to 1,500 lap-banding procedures were done in Canada in 2008. Laparoscopic gastric bypass, a more invasive surgery with greater risk of side effects and a longer recovery period, is the most widely performed surgery for obesity.

Potential benefits
The average loss is 50 to 60 percent of excess body weight after three years, says Dr. Nicolas Christou, director of bariatric (weight-loss) surgery at McGill University Health Centre in Montreal. (Gastric bypass averages a weight loss of 70 to 80 percent of excess body weight.) A study by Christou showed that permanent weight loss after bariatric surgeries can reduce the risk of developing cancer by up to 80 percent in morbidly obese patients.

Possible downsides
The band may slip and, in rare cases, erode, requiring its removal or replacement. Three to five adjustments may be needed in the first year, and patients must adopt good eating habits (such as eating slowly and chewing their food well) for life. As with other gastric procedures, there is a risk of weight regain, particularly if there is no long-term care. Lap-banding is reversible, but that is almost always followed by regain of the lost weight. The average wait time at the nine hospital-based bariatric centres across Canada is more than five years, and the procedure isn’t covered by provincial health­care plans. Private clinics don’t usually have a waiting list. If you are considering this surgery, ask how many lap-bandings the physician has performed. It should be at least 100 to ensure the minimum level of skill required, advises Cobourn. Also, pick a clinic with a long-term support plan. ‘Lap-banding is only the first step,’ says Cobourn, who adds that patients also need counselling about new ways to eat.

Bottom line
Lap-banding doesn’t work miracles, says Dr. Raj Padwal, a physician specializing in obesity, and assistant professor in the department of medicine at the University of Alberta. ‘Most patients who have bariatric surgery are still clinically obese when they reach their major weight-loss target.’ Bariatric surgeries are reserved for Class II patients (a body mass index [BMI] between 35 and 40, plus medical complications such as type 2 diabetes or high blood pressure) and Class III patients (BMI of 40-plus). Private clinics perform the procedure starting with a BMI as ‘low’ as 30.

Cost

$17,000-$20,000

2. The Dr. Bernstein Diet

The fast fix
This fat-free diet plan limits dieters to 850 to 1,350 calories per day (to put that in context, 2,250 calories are recommended for active women 31 to 50). Patients visit a Dr. Bernstein clinic three times a week to consult with a registered nurse, and every two weeks with a physician, and get vitamin and mineral supplements. Since the diet was founded 35 years ago, more than 400,000 dieters have been treated at 60 Canadian clinics. A mainten­ance plan is also offered.

Potential benefits
Average weight loss is 35 to 40 pounds in two months. ‘About 75 percent of the patients lose all the weight we suggest they take off, and 75 percent of those keep it off long term,’ says Dr. Stanley Bernstein, founder of the Toronto-based program. According to Dr. David Lau, an endocrinologist specializing in obesity in Calgary and president of Obesity Canada, ‘the Dr. Bernstein method is effective primarily because of the close monitoring of
its low-calorie diet.’

Possible downsides
Bernstein says there are no risks. Lau agrees the risks of sudden metabolic changes are small, but ‘when you partially starve a person, vital signs’such as blood pressure and mineral and electrolyte balance’need to be monitored.’ Plus, Lau points out that it’s not optimal nutrition to eliminate fats entirely: ‘The best diet is really a nutritionally balanced hypo-caloric diet.’

Bottom line
Physicians specializing in obesity are not proponents of speedy weight loss. They recommend a reduction of one to two pounds a week.

Cost
Can vary; about $1,400 for average weight loss of 35 pounds over seven to nine weeks. A one-year maintenance plan including a weekly office visit costs $750.

3. Hoodia

The fast fix
The extract of a rare succulent plant found in the Kalahari desert of South Africa, Hoodia gordonii is currently sold in pill form as a non-prescription appetite suppressant online and in many health food stores.

Potential benefits
The U.K.’s Phytopharm, which owns the patent to hoodia extract, says it conducted at least one unpublished clinical trial that showed users reduced their daily caloric intake by 1,000 after 15 days. The company has partnered with Unilever in the U.S. to eventually market an OTC weight-loss supplement.

Possible downsides
Although there are no known short-term risks of taking hoodia, more studies are needed to rule out long-term dangers as well as interactions with other supplements or with medications. Tests by Phytopharm of so-called hoodia supplements currently on the North American market showed that most contained only trace amounts of (or no) hoodia.

Bottom line
Health Canada’s Natural Health Products Directorate has not approved any products containing hoodia. Padwal says supplements have not been studied for their potential effect on weight loss. If you want to try a herbal product, look for a Natural Product Number (NPN) or a Homeopathic Medicine Number (DIN-HM) to ensure it is authorized for sale.

Cost
Ranges from 60 cents to $1.25 a pill; usually sold as bottles of 60 or 90.

4. Non-surgical fat removal

The fast fix
Two new types of technology are now available: One sends painless high-frequency ultrasound waves through the skin to liquefy fat calls (similar to shattering kidney stones); another sends infrared laser and radiofrequency electrical energy through the skin to shrink fat cells. Brands such as UltraShape and VelaShape have been available at Canadian dermatology and plastic surgery clinics for the past year.

Potential benefits
Both procedures claim to remove a one- to two-inch (two- to five-centimetre) ‘circumference’ of fat in a targeted area of the body (including the belly, hips, thighs and upper arm) after a few quick and painless sessions (neither procedure changes body weight). It takes up to six weeks to notice a difference as the disrupted fat cells are excreted or absorbed as energy, according to the manufacturers.

Possible downsides
Dr. Stephen Mulholland, a cosmetic plastic surgeon at SpaMedica in Toronto, combines both procedures. He says there are no risks; however, some patients are dissatisfied with the results because they may expect dramatic weight loss. ‘It’s about contour re-correction’a change in centimetres and shape,’ he explains. Obesity experts point out that these procedures (and liposuction) are not accepted ways to treat obesity. Studies show that having fat removed in these ways does not result in improved health outcomes, such as reduced blood pressure, explains Padwal. ‘It is purely cosmetic.’

Bottom line
These technologies are best suited for people who have achieved their desired weight, and wish to spot-reduce resistant areas of their bodies, according to Mulholland. Cosmetic weight-loss pro­cedures do not affect the fat deposits that are most detrimental to our health. Says Padwal: ‘They may affect subcutaneous [under the skin] fat, but we want to reduce the fat in the liver, pancreas and muscles. Only diet and exercise will do that.’

Cost
Between $800 and $1,200 per treatment (several may be required for each targeted zone).

This article was originally titled “Drop Pounds with Caution,” in the Summer 2009 issue of Best Health. Subscribe today to get the full Best Health experience’and never miss an issue!’and make sure to check out what’s new in the latest issue of Best Health.