Weight Loss

Slimming - that magic word synonymous with grace, slenderness, and beauty, for which millions of people are ready to follow any approach, any gimmick, as long as it promises they will lose ten pounds or one inch from their thighs in one week. Yes, it may involve a little dieting - and sometimes it may promise no dieting is needed at all.

We are long past the age when matronly women ruled the social world, when curves denoted health or wealth, or provided inspiration for artists (from Rubens to Fellini). On the contrary, we live in a period in which slenderness, if not actual thinness, rules, and we are tyrannized by magazine covers showing a succession of skinny models. This makes women feel constantly guilty and leads them into a permanent battle with their weight, which may be unreasonable or even unjustified, but is certainly never easy.

Women patients want not only to lose weight, but to lose it from 'certain areas', fuelling the increasing demand for meal replacements, the ever-popular reducing creams, and the use of all possible topical treatments to try to lose the 'hateful' saddle bags. The capsule, tablet, or herb that will bring (or bring back) a slender, firm, or muscled body with no effort simply does not exist yet, any more than a 'miracle solution' to banish forever unsightly rolls of flesh on the stomach, buttocks, or thighs. What is required is a common­sense and gentle approach, a healthy, balanced diet, and some nonaggressive remedies to bring about long-term weight loss that also allow the weight to stay off. It is important to avoid 'yo­yo' dieting, which is not only discouraging, but also seems to become more unavoidable with each successive attempt to lose weight.

What is the ideal weight?

There is no mathematical formula - it is the weight at which you 'feel well' in both body and mind, and at which the doctor has no complaints.

Being overweight is a significant public health problem: the list of health complications stemming from being obese is so lengthy, it explains why doctors have for so long focused on this aspect of the condition. But obesity is also a real social handicap, both in its aesthetic aspects and simply in the every­ day difficulties it adds to moving about, travelling, or getting dressed and undressed.

The body that is generally apple­shaped (the upper body is well developed, the abdomen protuberant, and the lower body also tends to bulge) presents more risks to the heart than a pear-shaped body (slender upper body, heavy lower body). Moreover, over. weight men are more prone to cancers of the prostate and colon, and over­weight women to breast, ovarian, and uterine cancers.

An obesity update

"All men are not created equal. .. when it comes to the ability to eat anything, at any time, in any way. . . "

In fact, we are all very unequal when it comes to the question of weight. Some of us are more 'prone' than others to weight gain, whether for hereditary reasons (20 per cent of cases) or due to environmental factors, such as lifestyle, education, eating habits, and inclination (or not) to exercise. For some of us, dieting consists only of putting a little less jam on one's toast, or of eating cake only every other day. For the less fortunate, it means tightening one's belt in drastic fashion for the rest of one's life, or taking a whole week to lose a 'few' extra ounces gained after only one small lapse - "two seconds on the lips, a lifetime on the hips", as the saying goes.

Recent studies have reportedly shown that calories consumed in the evening 'count double' - so it is particularly important to try to curb dietary excesses after 5pm.

Energy expenditure

An Individual's weight depends on the balance achieved between the calories consumed and the energy expended. This second factor is itself linked to three others:

- The basal metabolism regulates the body's functioning, which is what burns up the greatest number of calories. The metabolic rate is influenced by heredity, but is closely related to muscle mass. The metabolic rate may slow down when food is restricted, or under chronic stress - we all know people who actually gain weight when they go on a diet, simply because they are preoccupied

- The production of heat by the body, and consequently the expenditure of energy, depends very much not only on food eaten but also on the quality of the nutrition. Out of 100 calories from protein, 25 to 40 are used to produce heat. These figures are much lower for calories from sugars and very low for fats, which explains how these latter substances tend to be stored up rather than consumed, promoting weight gain.

- Only 20 per cent of calories are burnt up in physical activity in a sedentary person. Exercise should be encouraged, but its role in the overall consumption of energy, and therefore in weight loss, is only partial

Why is it so hard to keep to a diet?

- Willy Pasini, the famous Italian psychiatrist, explains humorously that women are trapped in a hopeless dilemma because, "they are more attractive when they weigh two or three pounds less, but feel more sexual when they weigh two or three pounds more"

- Dr. Chiva, a professor at the University of Nanterre, explains mischievously why it is we are doomed to failure in advance: "The pleasures of the table are the first ones we are given, and the last ones left to us when all the others have abandoned us"

As if these two explanations were not already enough reason for patients to have doubts about following their diets, here are (unfortunately) a few more.

The dangers of weight-loss treatments

The risks of traditional medicines are well known. Four categories of medicines were used for a long time in slimming treatments, but are rarely used now:

- Thyroid extracts do bring about weight loss, but unfortunately it is only muscle mass, not fat, that vanishes. These medicines also cause not just nervous disorders involving palpitations, anxiety, and heightened emotionalism, but especially hormonal disruptions, thus lowering the basal energy expenditure, and causing the patient to gain weight as soon as he or she returns to a normal diet.

- Diuretics do not cause fat to be lost from the body, only water and mineral salts (mainly potassium), which has never brought about long-term weight loss. The skin becomes wrinkled, and this is followed not long after by cramps, itchiness, and malaise of various kinds. Any water lost is, of course, immediately replaced, ounce for ounce, by drinking

- Appetite suppressants, while certainly effective, can sometimes be dangerous. They are now banned

- Tranquillizers may ease the early days of a diet, but often make the patient sleepy. They may also cause dependency, and reduce basal energy expenditure, all of which makes long-term success unlikely

Since conventional weight-loss medicines have now been largely abandoned by most doctors, patients are quite justifiably looking to complementary therapies for help.

Acupuncture, auriculo therapy, electricity and mesotherapy

• Acupuncture's calming effects are helpful in the initial stages of the diet, and ease the later period of stabilization. Sessions may range from two per week to one every fortnight.
• Auriculotherapy has the advantage of leaving small 'semi-permanent' needles in place for several days, which can help reduce the hunger pangs during the difficult first days of the diet.
• Electrolipolysis, a combination of acupuncture and electrical stimulation, seems to be effective in stimulating local micro circulation and in reducing cellulite on the abdomen and upper thighs
• Mesotherapy remains the leading beauty treatment in France. It consists of injecting small doses of remedies into areas affected by cellulite, in order to reduce the appearance of 'orange­peel skin' .

Topical treatments

Lymph drainage, or massage to the areas of the body where lymph fluid circulates, is a gentle, effective, and pleasant treatment. It improves local circulation, and helps reduce swelling in the thighs.

• Caffeine applied topically has a direct effect on minor vein problems that may be causing cellulite, and thus helps reduce it.
• 'Reducing' creams soften, smooth, and tone the skin, and may help reduce some of its orange-peel appearance but, unfortunately, do not cause spectacular weight reduction. These products contain three active elements: substances that promote drainage and strengthen the veins, in order to improve micro-circulation; lipidreducing molecules that help break up and disperse fats in the cells; and toning ingredients. They are easy to use, and are risk-free, but they require enormous patience because these are very, very long-term treatments. They do improve the skin's appearance, even if they are not ultimately that effective against cellulite

Homeopathy

Anacardium orientale

- Four 5c tablets to be sucked slowly like sweets, two or three times a day when you feel hunger pangs

Anacardium orientale

- Vegetable origin: the Malacca bean tree, originally from the American tropics, and grown in India for its nuts
- The homeopathic appetite suppressant

• You could also try Strumeel@ (Heel), which include Fucus D4, Spongia D3, Acidum silicicum D4
  - Available in packs containing 50 and 250 tablets
  - 1 tablet to be dissolved under the tongue 3 times daily.
• It is also very important that you combine this treatment with a constitutional remedy, to be chosen after consultation with a professional homeopath. Some likely choices are Calcarea carbonica, Sulfur, or Thuja

There is no miracle homeopathic remedy that can make anyone lose seven pounds easily in a week or two. Anyone who tells you they have lost several pounds in no time, with almost no effort, has almost certainly not taken homeopathic remedies alone, whatever they might think or say.

Herbal remedies

Pink sage, hawkweed, and dandelion are diuretics.

Green tea eliminates water and fats.

Ispaghula and konjac swell up in the stomach and give a feeling of fullness.

Bladderwrack and laminaria, which are both rich in iodine, stimulate the metabolism.

Possible Prescription: Ask your herbalist to prepare a 30ml bottle of mother tincture of pink sage or hawkweed. Add 75 drops to one litre of mineral water,which is to be drunk regularly throughout the day.

Pink sage

The leaves of the pink sage, or Java tea, are used in that region for their detoxifying and diuretic effect. They also help bring cholesterol down slightly, and stimulate bile secretion.

Hawkweed

This plant is also known as 'mouse-ear hawkweed' because of the white hairs that cover its leaves, In the past it was believed to strengthen vision and heal wounds because of its unquestionable infection-fighting properties, Nowadays, it is mostly used to encourage the elimination of water, salt, and urea.

• You could also ask your herbalist to make up a 60ml bottle of dandelion in a whole fresh-plant suspension (this formulation's cold stabilization process restores the full natural therapeutic effect of the plant), Take half a teaspoonful in a little water morning and evening .

Dandelion

Dandelion leaves contain high levels of potassium, and also act as a diuretic. Use them in salads, along with spinach. Dandelion root is a powerful depurative that is as effective for the liver and gall bladder as for the kidneys.

Seaweed

Seaweed is very good for your health as long as it is not eaten too often or in large quantities. Bladderwrack contains high levels of iodine, which can very easily build up to toxic levels after only a few weeks. You should therefore limit your treatment to less than three weeks' duration, and to between 200 and 300mg per day.

• You could also try Bioforce Kelp:
  - Available in containers of 240 tablets
  - Two capsules to be taken twice daily before meals. Not to be taken before bed
• Another alternative is Konjac fibre (Health Plus), which contains 500mg per capsule of Konjac flour, in order to reduce your appetite: - Available in boxes of 70 capsules
  - Two capsules to be taken before breakfast, three capsules before lunch and five capsules before dinner. Make sure that you drink plenty of water throughout the day

Konjac

The flour derived from the konjac root, originally from Japan, consists of a dietary fibre (glucomannan) capable of absorbing 100 times its own volume of water, forming an indigestible, viscous gel that suppresses appetite.

Wild chicory acts as a depurative, a mild laxative, and a diuretic; it is a useful supplement to any reducing diet.

- You can prepare your own decoction by boiling three tablespoonsful of chopped, crushed chicory root in half a litre of water. Leave the mixture to steep for an hour, then drink one cup before each meal

Chicory

Chicory roots encourage the elimination of urine, as dandelion does, but they also act as a detoxifier and tonic.

Celery and watercress are also diuretics and depuratives.

• You could also try Watercress powder (Phyto):
  - Available in 500g packs

A substance is said to be a depurative when it helps purify the body through the elimination of toxins and poisons.

Oligotherapy

Zinc, nickel, and chromium for their role in regulating the endocrine system.

These trace elements are usually found n a varied and high-quality diet. In cases of deficiency, they can be given as ledicinal supplements.

Dietary sources of zinc, nickel, and chromium

These are mainly to be found in some vegetables (beetroot, broccoli, mushrooms, cabbage, spinach, beans, and lentils), whole-grain cereals, wheat­germ, brewer's yeast, meat (liver and dneys), seafood, pepper, thyme, black a, and parsley.

Possible Prescription: one dose of zinc-nickel-cobalt treatment to be taken in the morning, and one dose of chromium treatment to be taken in the afternoon, for one month. This is designed to supplement your diet, not replace it!

You could take these trace elements in combination such as Organic Minerals (Colloidals) which contains 70+ trace minerals:
- Available in 946ml bottles
- Take 1-3 caps just before breakfast and/or evening meal
- Children 1 teaspoon daily for each 20lbs of body weight

Or Maximol (Ionized colloidals):

- Available in 500ml bottles
- Take 1/2 capful once or twice daily on an empty stomach

Psychological treatments

There are three different possible approaches to psychological management of weight loss:

- traditional psychotherapy for support
- relaxation methods, as these help to control the inevitable tension caused by dieting
- other, more recent behaviour modification approaches, such as 'neuro-linguistic programming' (NLP), which does not address the diet itself, but rather the mental image the patient has of his or her goal to lose weight

It is most important for the therapist to:
- identify the patient's real wishes and desires
- evaluate his or her level of motivation
- get the patient to identify, in his or her own words, the positive elements or the arguments that from the outset allow him or her to justify failure
- identify anything that may undermine the patient's goal of keeping the weight off in the long term

Muriel Robin: "I've been on a diet for a fortnight now, and I've already lost... two whole weeks."