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A morbidly obese woman has shared her 35st weight loss journey after doctors were forced to cut off her tongue because she was too large for surgery.

Jen Costa put on 25st over 14 years by gorging on takeaways every day after she suffered a horrific car crash.

The 35-year-old was so large that she was unable to stand up in the shower and had to have her partner wash her with a sponge as she sat on a chair.

Then one day when she went to complete a takeaway order on the phone, she noticed a pain in her mouth which was a tiny white lump on her tongue.

Jen, then 46st and wore size 9XL, was diagnosed with stage 4 cancer of the tongue but was told she was too fat for surgery and radiation.

Refusing to let her health take over, Jen visited a dozen hospitals across New York, US, before a doctor agreed to help.

Following a 19 hour operation to remove most of her tongue, Jen was unable to eat solid food which forced her on a liquid diet.

She said: I was handed a death sentence and it's ended up saving my life.

"What started as the darkest period of my life soon revealed itself as my biggest blessing in disguise. I used to be addicted to food. I abused the privilege to eat.

"After the car accident I was completely bed-bound and ordered a takeaway every single day. Now I have no choice. I can't eat anything but it's a blessing. I've lost 35st.

"God allowed me to battle cancer and to make me appreciate all that I took for granted in my life. Beforehand I was obese, sad, miserable, depressed and angry.

"But the cancer has made me strong and humble. I have no taste in my mouth it's just a lump in my mouth which is just there.

"I miss pizza, I miss ordering a Chinese and I miss the taste of my Grandma's chicken. But despite that I'm just so much happier."

Despite always being a bit chubby, Jen was still an active person during her teenage years.

But everything changed for her when she was hit by a car on a public highway which saw her left knee snap and ligaments tear in half.

She lost movement in her lower half for a year and then struggled with putting weight on her leg, placing her into depression and making her turn to food for comfort.

For the past two and a half years, Jen has been on a liquid shakes diet which has seen her weight drop from 46st to an impressive 12st.

She continued: I just know if I wasn't told I had cancer, I wouldn't be here today. I would have just continued sitting there eating my life away.

"I've lost the ability to taste and chew things properly. But I took advantage of that when I had it. Because I'm not eating as much, I have so much excess skin.

"I've had a few skin removal surgeries which has helped me lose the weight. The diagnosis just turned my life completely around.

"I had to die a little in order to learn to appreciate how it felt to be truly alive. I'm alive for the very first time in my life."

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Obese womans 35st weight loss transformation success saved her life - Daily Star

Intuitive eating is a hot topic right now. Im guessing that someone in your circle sent or shared with you the popular New York Times op-ed titled, Smash the Wellness Industry. (If not, READ. IT. NOW.) The author talks about how she was sick of seeing powerful, smart, feminist-identifying womenincluding herselffall for pseudoscientific wellness claims that are, ultimately, the author argues, really just about weight loss. She talks about her own journey with dieting and wellness culture while deconstructing the problematic diet industry and ultimately concluding by talking about her discovery of intuitive eating, which she credits with changing her life for the better.

For those not familiar with this concept, intuitive eating is an evidenced-based approach to eating that was originally designed to help chronic dieters get back in tune with their bodies unique needs, rather than rely on external food rules to determine what, when, and how much they eat. If youve ever dieted, you probably know that getting some of those rules out of your head is tough, even when youre no longer actively trying to lose weight.

If we are using an intuitive eating framework, then the ultimate goal is to use your internal wisdom to decide what, when, and how much to eat, not external rules like no eating after 8 P.M. or refined carbs arent allowed. When you first learn about intuitive eating, it can sound like its solely about eating when youre hungry and not eating when you are not, but it's a lot more nuanced than that. For example, maybe its 11 A.M. and you aren't hungry for lunch yet, but you know that this is your only opportunity to eat a meal before 5 P.M. Should you listen to your lack of hunger and skip that opportunity to eat? The intuitive eating argument would likely be no. Similarly, maybe its 9 P.M. and, even though youve had more than your estimated calorie needs for the day, youre still hungry. Do you just go to bed and ignore your bodys hunger signals? I would say no, as would the intuitive eating approach.

In other words, intuitive eating is definitely about listening to bodys hunger and fullness cues, but its not only about that. Its also about the practicality of eating when youre not hungry because you might not have a chance to eat for several more hours. And its also about satisfactionthat is, having a thing you really want to eat simply because it will satisfy you to do so. For example, society tells you that chips are unhealthy, but for you they are a good satisfying snack, and you may feel deprived if you don't get to have them. With intuitive eating, you can choose to have the chips and not feel guilty about it, even though diet culture says that we should. The idea here is that by paying attention to what your body and mind are asking you for, you will feel satisfied, not deprived, hungry, hangry, or craving foods that you arent allowed to eat because of a diet youre following.

If youre like so many people, including clients I work with daily, youre thinking this sounds great; Id give anything to have a less fraught relationship with food. But I also want to control my weight, and for that I do have to follow rules about what I eat. Its a dilemma I hear a lot: Is it possible to practice intuitive eating and have a healthier relationship with food, while also wanting to lose or maintain your weight?

The short answer: Not really, to be honest. Now, let me explain how I got there.

When I first heard about intuitive eating I was working as a registered dietitian in an outpatient community clinic, focusing on chronic disease management. Yes, I still took an individualized, patient-centered approach to care, but my primary intervention for my clients in larger bodies was weight loss. So, when I first learned about intuitive eating, I was resistant.

Part of this was due to what I learned in school: the more weight you lose, the more you can manage your symptoms. Another part of my resistance had to do with many doctors orders: almost every patient referred to me had an overweight or obese diagnosis that the medical provider wanted me to address via diet. Another part had to do with the patient themselves. Because we live in a diet-focused culture, patients, like so many of us, often hold the belief that thinner equals better and healthier.

So, sure, intuitive eating sounded great, but how could I square its principles and goals with my work in the clinic?

It was my social worker colleague who gave me my first copy of Intuitive Eating: A Revolutionary Program That Works, written by registered dietitians Evelyn Tribole and Elyse Resch. After reading the book, doing more research, and taking Ebelyns Triboles intuitive eating course for health professionals, everything clicked. I realized exactly what intuitive eating was, what it wasnt, and why body respect was paramount when adopting this philosophy around food.

Still, whenever I take on a new client, I do a consultation call with them to make sure that my weight-inclusive approach is a good fit for what they need and want. Almost inevitably, clients say they want to take an intuitive eating approach to their wellbeing, but are also not 100 percent happy with their bodies, and they hope that working with me will help them address that.

Heres the thing: One of the core principles of intuitive eating is to respect your body, or at the very least, learn to be more neutral about it. Proponents of intuitive eating would argue that intentional weight loss is contradictory to body respect, because if you unconditionally respect your body, you wouldnt go to so much trouble to make it smaller. Ive heard Evelyn Tribole give the example of shoe size when explaining this concept. We wouldn't try to squeeze a size 10 foot into a size 6 shoe, right? For the most part, we accept our shoe size as something neutral and move on. Why, then, do we expect anything different of our bodies? We are sold that idea that a size 6 is somehow better than a size 10. A size 10 is better than a size 12. A size 12 is better than a size 24...and so on. Diet culture also sells us the idea that smaller isnt just better, its healthier. The reality is that, even when it comes to health, a size 10 person isn't inherently healthier than a size 12 person. Weight is one marker of health, but it is far from the only one.

The main reason that the dual pursuit of intentional weight loss and intuitive eating is tricky is because of this: When my clients start to focus on losing weight, at some point, they have to make a food or fitness decision that overrides their bodies natural cues. In other words, the very act of pursuing weight loss means that there will likely be a restriction of some kind. This contradicts multiple core principles of intuitive eating, including reject the diet mentality and make peace with food. According to the intuitive eating website, making peace with food involves giving yourself unconditional permission to eat. [Because] If you tell yourself that you cant or shouldnt have a particular food, it can lead to intense feelings of deprivation that build into uncontrollable cravings and, often, bingeing. Ive seen this happen time and time again with clients. When we are trying to lose weight, we often have to micromanage our food intake, which is essentially the opposite of intuitive eating.

So, my answer to the question is: no, intuitive eating and weight loss arent really compatible. This is because intuitive eating and weight loss are not answers to the same question. They are, in and of themselves, their own distinct goals. Can you work towards two different goals at the same? Often, yes. But when one goal requires behavior changes that the other goal requires you to forgo, the answer is no.

The truth is, intuitive eating is its own journey, and it takes a lot of work to get to a place where you can really let go of the diet mentality. But before getting there, you have to make a huge emotional leap along with a massive behavioral change, which is to let go of the desire to control your weight. Most of my clients find it helpful to just talk about these concepts and explore their eating and dieting history. Some questions I may ask include: Has the pursuit of weight loss worked long-term? What did you have to give up in order to get to a lower body weight? Did it take an emotional toll? Did you feel good physically? Theres no one-size-fits-all approach here, but digging deeper and helping clients connect some of the dots for themselves is usually a good place to start. If a client is really struggling, I always recommend working with a licensed therapist who is well versed in the concepts of health at every size, intuitive eating, and body respect (Ive worked with a lot of amazing psychologists who have helped my patients tremendously).

Of course, making the argument for forging a neutral and respectful relationship with our bodies is easy for someone living with thin privilege, as many dietitian-proponents of intuitive eating are. I consider myself curvy but I still have an incredible amount of thin privilege. Because of weight discrimination (which I assure you is real) Im treated better in this society than someone in a larger body would be. This means that I dont have to worry about being harassed by ignorant people on planes or scolded about my weight by my doctor during a pap smear. So even though research supports the idea that we can pursue health at every size and that most weight loss diets fail, we still live in a reality where people with thin bodies are privileged over those who dont.

Not to mention, its hard to scroll through Instagram and be bombarded with thin women in bikinis getting all the love. Or to witness women being publicly shamed for gaining too much weight during pregnancy only to be praised for their snap back when they lose it quickly. Going against that grain can be exhausting. Which is why, If you have done your research, and decided that the pursuit of intentional weight loss makes sense for you, then thats your prerogative. At the end of the day, your body is your business. Im a big advocate of bodily autonomy, which means that you have the right to decide what is best for your own body.

My point is to say that intuitive eating is not something one would do in order to pursue a specific body-related goal. In fact, the only goals its meant to serve are a) having a less fraught relationship with food (which some studies suggest may lead to improvements in health) and b) improved mental health.

If you are someone who is looking for expert-led, evidence-based advice for losing weight for a health-related reason, I would say that intuitive eating may not be the best approach for you at this time, though there are parts of it that you might still adopt.

If you, like many of my clients, feel like weight loss will solve all of your problems, my challenge to you is this: consider shifting your perspective from wanting to change your body, to changing how you feel about your body. It takes time, but its worth it.

Jessica Jones, R.D.N., C.D.E., is a registered dietitian nutritionist who helps people improve their health while healing their relationship with food. Shes also the cofounder of Food Heaven, an online resource for delicious and nutritious living. To sign up for virtual nutrition coaching with Jessica, visit Jessica Jones Nutrition.

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So, You Want to Try Intuitive Eating But If Youre Being Honest You Still Want to Watch Your Weight. What to Do? - Self

If youve grown up obese or struggled with weight related issues as a child or even a teenager, you probably already know that weight loss cannot be achieved by taking a magic pill. Weight loss can only be achieved (and sustained) by a prolonged lifestyle change. 23-year-old Jay Dalwadi tells us that he learnt this the hard way after he followed a crash diet for few months, and then ended up gaining more weight than he had actually lost to begin with once he stopped following the said crash diet.

I was an overweight teenager, who always wished to have a healthy and fit body. I started working on this wish during my college days. I moved away from my home to pursue my graduation and was living in a hostel. And, I am sure youre already aware that a students life in a hostel is a life without any structure with no fixed timing or even proper food available for breakfast, lunch and dinner. So, I decided to make the best of this situation and started following a crash diet by skipping meals on purpose to lose weight. Id also walk a lot everyday, he says.

So naturally, I ended up losing weight. In around 50-55 days, Id lost 10-11 kgs weight, and was so happy about it! Before starting this crash diet, I weighed 105 kgs and after it, I weighed 94-95 kgs, he adds.

While the initial weight loss boosted my spirits when I returned home after completing my graduation, I resumed a normal routine and gained twice the weight I had lost. And by this time I had also started working. Factoring the new 9-5 job in, I now weighed 115 kgs.

I tried many things to lose this weight again but none of them were successful. But one day, I met a senior from my office, who is a gym freak. Hed always talk about eating healthy and a lot of other stuff related to leading a healthy life, and just by listening to him and talking to him, I got inspired to kickstart a proper journey to not just weight loss but also get fit. I also happened to meet an old friend during this period. He used to be very skinny earlier but now he had built a good physique and transformed himself from a skinny guy to a fit guy I asked him, how did you do it?" He said to transform yourself you have to change your diet and also start working out. He also helped me understand the importance of nutrition and fitness better to support my journey.

Consequently, I made the below weight loss plan to trim from 115 kgs to 88 kgs in 12-14 months.

To lose weight, the first thing I did was stop eating junk and packaged foods. I also shun white sugar and oily foods from all my meals and increased my water intake.

QUICK READ: Here's how drinking water at regular intervals can help you lose weight and increase your metabolism

Then, I charted a basic home workout routine and weight loss diet plan that included a good amount of protein, healthy fats and complex carbs to create a calorie deficit to help burn fat.

A calorie deficit is a specific diet pattern that revolves around the number of calories you consume in a day. According to Healthline, the concept is based on the idea that as long as you eat fewer calories than you burn, youre bound to lose weight.

This diet pattern requires you to calculate the number of calories your body needs to consume to function smoothly without feeling hungry, and how much deficit you need create without harming your health. Keep in mind that the number of calories required to create a deficit is different for different body types. You can calculate yours online via a calorie calculator.

QUICK READ: How many calories should you eat every day to lose weight?

Early morning (pre-workout): A cup of black coffee and one banana

Breakfast (post-workout): A bowl of masala oats and 3-4 boiled egg whites

Mid-day snacks: A bowl salad (spinach, cabbage, carrots, tomatoes, beetroot, etc.)

Lunch: 2 rotis + a vegetable preparation + 80 gms of curd

Evening snacks: A bowl of sprouts/peanuts

Dinner: A bowl of rice + boiled dal + 4-5 boiled egg whites

Post-dinner: A cup of skimmed milk with Proteinex (2 tbsp)

My weight loss workout routine comprised basic cardio and bodyweight exercises - walking, push ups, squats and jumping jacks at home for 6-7 days. This is the weight loss workout program that I followed:

1

Pushups Started from knee push-ups and then moved on to the standard push ups (10-10-10-10)

2

Burpees (10-10-10-10)

3

Squats (15-15-15-15)

4

Jumping Jacks (30-25-20-15)

5

High Stepping (30Sec - 30Sec - 30Sec)

6

Skipping

7

Crunches (15-15-15)

8

Planks (30sec - 30sec - 30sec)

After doing these 8 exercises, Id walk for 4-5 kms. Also, I kept increasing the rep counts, every week, according to my strength."

Right now, I am in a muscle building phase so I am following a calorie surplus diet. But to manage my new weight, I do high intensity workouts at the gym."

Weight loss isnt magic, it wont happen in a few days or weeks. You need to be patient and also stay consistent. Also, dont ever follow a crash diet and make the same mistakes I made. Just keep making small changes to your lifestyle, they end up making a huge difference in your body and mind. Lastly, believe in yourself.

Disclaimer: The diet and workout routines shared by the respondents may or may not be approved by diet and fitness experts. GQ India doesn't encourage or endorse the weight loss tips & tricks shared by the person in the article. Please consult an authorised medical professional before following any specific diet or workout routine mentioned above.

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How to lose weight like this guy who lost 27 kgs following a calorie deficit diet & exercising at home - GQ India - What a man's got to do

You can live the rest of your life without knowing how much you weigh.

Does that sound radical and maybe even unfathomable?

The statement comes from registered dietitian Christina Frangione, who suggests we all can say no weigh to measuring your health with diet cultures ruler: the scale.

While we may believe health is manipulating our bodies to an ideal weight and maintain that weight throughout our lifetimes, that belief is false. In fact, its making many of us less healthy.

Created by the $72 billion dollar diet industry, healthy-as-thin has infiltrated the nutrition and fitness industries, duping far too many of us into a lifetime filled with food preoccupation, exercise obsession and body dissatisfaction.

Ideal weight is a fallacy

As a culture we are obsessed with the number on the scale and the belief that we have an ideal weight.

You know, that number the number you weighed when you were 22, pre-baby, on the ski racing team, when you were restricting gluten, dairy, sugar on your 21-day detox, after your fitness contest. Or maybe that number is simply one youve been told you should attain but have never weighed.

We get that one number stuck in our heads and believe we cant like our bodies or be happy and healthy until the scale sings it. Whatever pops up on the scale sparks joy or utter despair, all in a matter of seconds.

Again, thats not healthy.

As a body image and redefining wellness ambassador, I must remind you that weight doesnt necessarily indicate your best health because bodies are born different sizes and shapes.

Some bodies are naturally small, and others are naturally big. Small bodies may be healthy or unhealthy. Big bodies may be healthy or unhealthy. Every body is different.

Its understandable that we focus on scale weight, as thats all weve ever been taught: Lose weight, get healthier.

But thats not the case for every body. For some, attaining and maintaining a thin body comes with relative ease. If youre thin or have lost weight and kept it off by honoring your bodys needs, thats wonderful. But it doesnt mean every body can do it.

As a former eat this, not that nutrition coach and fitness professional, I had that false belief because, frankly, I live in a body thats naturally thin.

But for many, focusing on attaining an ideal weight is a full-time job and a struggle. It takes an incredible amount of time and energy to force your body into a size it was never meant to be. In many cases, it cant be done.

You are not failure when that happens. Its diet culture thats failing you.

If you need to maintain a strict eating and exercise regime to maintain your ideal weight, thats not a healthy weight for you. We normalize restrictive eating and obsessive exercise and call it healthy. Its not.

Perhaps you do attain your goal weight. At what cost, and is it sustainable? For most, that success is fleeting, leading us into a life of yo-yo dieting and a desperate hunt for the next eating and exercise plan promising to fix our bodies.

Even more distressing, when you focus solely on an ideal weight and see little to no change, you may give up on healthy behaviors despite dramatic improvements in health markers, like improved cholesterol, blood sugar and cardiovascular health.

And, finally, diet culture doesnt tell you that your body is meant to change naturally throughout lifes stages. Scale numbers naturally fluctuate, daily and throughout your lifetime.

But I have to lose weight

I can hear you pushing back: But what if I am trying to lose weight for my health, not my appearance?

Youre told to lose weight as the sole solution to having health challenges such as diabetes, thyroid conditions, knee pain.

People in thin bodies have those health problems too. But only people in heavier bodies are told to lose weight to solve them.

As a mind-body-nutrition coach I have respect for every body, regardless of weight. Together we focus on the healthy behaviors that your unique whole body needs, and we allow your weight to be where you feel nourished, not punished or controlled.

Dont worry: Not focusing on weight loss doesnt mean youre giving up on your body or your health. It means that you are prioritizing whole health and feeling good over a number on the scale. It means that you are enhancing your overall health by freeing up precious time and energy mental, emotional and physical.

So if youre not focusing on scale weight, then what?

When weight loss is the goal, intuitive eating counselor Krista Murias said, depriving and restricting the body become more important than listening to and nourishing it.

Listen to your body. Diet culture has convinced us to tune out.

Stop forcing yourself to eat kale if you hate it. Stop forcing yourself to trot in the Turkey Day 5K to earn your holiday dinner. As clinical psychologist Dr. Coleen Reichman said: Sometimes its healthier to skip the workout. Your soul probably needs more attention than your glutes today.

Focus on healthy behaviors, not the number on scale. When you do, you can let the weight stigma against yourself go and finally find real freedom and intuition with food and fitness to live your best life.

Be a rebel. Dump your scale.

In addition to truly healthful behaviors like intuitive eating and pursuing movement that makes you feel good, listen for your other needs like:

more sleep

counseling

meditation

a job change

saying no unless its a, "hell yes!"

more frequent vacations

learning to communicate more effectively

connecting with your partner

Tanya Mark is a mind-body nutritionist and body image movement global ambassador. Contact her via tanya@tanyamark.com; follow her on Facebook.com @TanyaMarkMindBodyNutrition or Instagram at @TanyaMark.

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Say 'no weigh' to the scale | Health - Jackson Hole News&Guide

It would be like studying an intensive exercise program including long runs, calisthenics and strenuous sports among sedentary volunteers for just six days. The investigators might find that the program made the volunteers sore, tired and weak. However, a six-month trial, allowing adequate time to adapt to the new regimen, would reach the opposite conclusion, revealing the real benefits of physical activity.

Despite their greater difficulties, diet trials receive far less funding than drug trials, especially considering that poor diet is the leading risk factor for premature death. Few big companies stand to profit directly from dietary treatments for chronic diseases. Consequently, typical diet trials must get by on shoestring budgets, rarely exceeding a few hundred thousand dollars, compared with drug trials that may cost several hundred million dollars. Without adequate support, quality inevitably suffers. Diet trials of adequate size, duration and intervention strength rarely get done.

This problem has special relevance now, as the Dietary Guidelines Advisory Committee reviews the science in preparation for new Department of Agriculture recommendations to the public in 2020. Among thousands of scientific articles initially screened, only a small proportion so far have passed strict quality criteria for inclusion in committee deliberations. And ultimately, recommendations to the public can be no stronger than the science on which they rely.

Which doesnt mean that all nutrition research is unreliable. High-quality observational studies and clinical trials provide strong evidence for the benefits of whole carbohydrates (nonstarchy vegetables, fruits, legumes, minimally processed intact grains) over highly processed, fast-digesting carbohydrates (refined grains, potato products and added sugar). We also know that nuts, olive oil and avocado protect against chronic disease, contrary to dietary recommendations during the low-fat diet era, as embodied by the 1992 Food Guide Pyramid.

We need a sort of Manhattan Project to find definitive answers to the epidemics of diet-related disease. Nutrition research to prevent disease must have the same quality and rigor as pharmaceutical research to treat disease. Building the necessary scientific infrastructure will require sustained investment by government and philanthropic organizations, but the amounts involved would total a fraction of a cent for every dollar spent treating diet-related conditions like obesity, Type 2 diabetes and cardiovascular disease.

Study authors and the media can help by avoiding the tendency to overstate the results of weak research, contributing to public confusion. And the public has a critical role to play, not only demanding government action but also volunteering for diet studies.

No other factor approaches the importance of diet for public health. To reduce the human toll of chronic disease, we must upgrade the quality of nutrition research. The financial investment required will yield huge returns in medical cost savings.

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Why It Is So Hard to Figure Out What to Eat - The New York Times

spukkato/Getty Images A healthy diet, more exercise, more sleep, and better stress management are often the keys to weight loss. But what if youre doing all that and not seeing a difference? Unfortunately, theres no magical weight loss pill that will help you keep pounds off forever, but there may be one out there to give your body the jumpstart it needs.

After appropriate nutrition and physical activity, drug therapy to promote weight loss in patients who are overweight or obese can often improve a patients metabolic healthas proven by controlled, randomized, clinical trials, says Harold Bays, M.D., F.O.M.A., F.T.O.S., F.A.C.C., F.A.C.E., F.N.L.A., medical director and president of Louisville Metabolic and Atherosclerosis Research Center and chief science officer for the Obesity Medical Association. What is perhaps most exciting is the number of investigational anti-obesity agents in development. The prescription medications mentioned below are all FDA-approved, but they can come with side effects and arent right for everyone so youll want to discuss your unique situation with a physician who specializes in weight loss to figure out the best weight loss plan for you.

Liraglutide

This drug is actually an injection, not a pill. However, patients using liraglutide (Saxenda) may lose 5-10% of their bodyweight. Its also available in a lower dose (Victoza) to treat type 2 diabetes.

Lorcaserin

Lorcaserin (Belviq) acts on the serotonin receptors in your brain to trick you into feeling fuller than you normally would after eating smaller servings. The medication can help patients lose 5-10% of their bodyweight.

Naltrexone-bupropion

A mix of these two drugs (available as Contrave) may curb hunger and help you feel full. Traditionally, naltrexone is used to treat drug addictions and bupropion is used for depression and smoking cessation. Patients taking a naltrexone-bupropion prescription may shed 5-10% of their bodyweight.

Orlistat

Available in a higher dose as a prescription (Xenical) as well as over-the-counter in a lower dose (Alli), orlistat is a lipase inhibitor that helps reduce the amount of fat your body absorbs from food. Some people lose about 5% of their bodyweight while taking orlistat.

Phentermine

Phentermine is a stimulant that helps suppress your appetite and could lead to a drop of about 5% of your bodyweight. However, its only approved for short-term use (up to 12 weeks). Phentermine is also part of a combination drug called Qsymia that contains topiramate (which is used to treat migraines and seizures). That formulation can help some patients lose 5-10% of their bodyweight.

Most supplements that tout weight-loss benefits dont have enough robust research on humans to support their claims. The FDA also considers supplements (which can be formulations of nutrients like vitamins, minerals, or amino acids, or ingredients derived from herbs or botanicals) more like foods than drugs so theres no regulation. That means its up to individual manufacturers to make sure their products live up to the claims on their labels.

If youre interested in taking a supplement to boost your weight loss efforts, make sure you talk to your doctor first, especially because some can interact with medications you may already be taking. Below, weve compiled a list of popular ones.

Caffeine

We all love coffee because of the way it energizes us. The same way coffee stimulates our central nervous system, caffeine as a supplement can also kick our fat oxidation process into gear. Studies are mixed, but it may have a small effect on bodyweight and help prevent weight gain in the long run. Youll just want to be on the lookout for nervousness, vomiting, and a rapid heart rate.

Chitosan

Derived from the exoskeletons of crustaceans and arthropods, chitosan is a starch that binds fat in the digestive tract. Some small, poor-quality clinical trials show minimal effect on bodyweight, and side effects can include indigestion, bloating, and constipation.

Conjugated linoleic acid

Some clinical trials show that conjugated linoleic acid may work on a number of bodily processes including lipolysis, lipogenesis, and apoptosis to cause small reductions in bodyweight and body fat, but results are mixed. Unfortunately, it can cause quite a few digestive issues and throw off your glucose homeostasis.

Forskolin

Extracted from a plant in the mint family, forskolin is said to reduce a persons appetite. The problem is that it hasnt been studied very much on humans so its hard to say if it actually works. Side effects may also include indigestion, hypotension, blurred vision, pale skin, and fatigue.

Garcinia Cambogia

This is an extract from a tropical fruit that contains hydroxycitric acid. While some research has found it might promote small amounts of weight loss in the short term, side effects can include nausea as well as liver toxicity in rare cases.

Glucomannan

Glucomannan is an ingredient extracted from the roots of the elephant yam. Older studies suggest that taking glucomannan with meals may help keep you fuller longer to help you lose weight. However, more recent research shows that it doesnt really help with weight loss. Not only that, it can leave you with bloating, gas, and soft stools.

Green coffee bean extract

This extract may work by preventing the accumulation of fat and regulating the metabolism of glucose. Some research points to small amounts of weight loss, but few high-quality clinical trials have been completed. Headaches and urinary tract infections have been reported as side effects.

Green tea extract

Theres not enough research to say green tea definitely helps you lose weight, but some studies say it may help by boosting calorie burn and fat oxidation and lowering fat absorption. The bad news is it theres the potential for unpleasant side effects like constipation, nausea, high blood pressure, and liver damage.

Hoodia gordonii

This succulent from Africa is said to reduce appetite, but theres very little published research on humans and it can trigger higher blood pressure and a faster pulse.

Irvingia gabonensis

Irvingia gabonensis comes from the seed of an African mango tree. Its purported to interfere with adipogenesis and help reduce leptin, a hormone associated with obesity, but few clinical trials have been done. It can also cause gas, headache, and sleep disturbances.

Raspberry ketones

As you probably suspect, raspberry ketones come from raspberries. Some studies point to various raspberry components as helpful weight-loss aids, but there is very limited research specific to how raspberry ketones work on the human body, and some of it is funded by the National Processed Raspberry Council. While theres potential for success, a lot is unknown.

Steer clear of any supplements containing these ingredients, which can pose serious health risks:

Gallery: These 40 fit celebrities over 40 will inspire you to hit the gym

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The Latest Weight Loss Pills That WorkAnd the Ones That Don't - msnNOW

BRIGHTON The choice of treatment for obesity depends on a number of factors but should primarily be based on understanding the patient and their needs and goals, addressing barriers and avoiding stigma if meaningful and sustained weight loss is to be achieved, says a UK expert.

Talking at Society for Endocrinology BES 2019, Dr Abd Tahrani, a National Institute for Health Research clinical scientist at the University of Birmingham, said that the patient should be treated "holistically" and placed at the centre of decision-making.

He said that the underlying causes of obesity need to be addressed to choose the "right treatment for the right patient needs," considering the severity of the disease, the magnitude of weight loss required and the timescale overweight to achieve that.

Moreover, "long term support, like any other chronic disease, is absolutely mandatory", with the input of a skilled multidisciplinary team.

Dr Tahrani began by stating that it is not him, as a clinician, who chooses the weight loss intervention, rather it is the patient who chooses with the help of the multidisciplinary team.

To achieve that, you have to "know your patient very, very well" and avoid stigmatising them, he said.

The was underlined by data from the 2018 All-Party Parliamentary Group on Obesity survey revealing that just 26% of people with obesity reported having been treated with dignity and respect by healthcare professionals when seeking advice or treatment.

Dr Tahrani said that clinicians therefore need to work with their patient, collaborating to motivate them and encourage self-efficacy, all delivered with compassion.

He characterised this as listening to the patient's "internal music", respecting their rhythm and timeframe, and, ultimately, guiding them.

This then informs the process of choosing the right treatment, Dr Tahrani said, as clinicians need to understand the underlying causes of the individual's obesity.

"The common concept is that they have obesity because they eat too much and they don't move," he said, but "this is a symptom".

"This is like saying you've got anaemia. If you have anaemia, I don't treat you with a blood transfusion, I want to know whether iron deficiency, or B12 or folate deficiency. Then I give you specific treatment."

Dr Tahrani added: "Obesity is exactly the same."

He said that obesity is a chronic, relapsing disorder that involves two stages:

Sustained positive energy balance, where intake exceeds expenditure over an extended period of time; and

Resetting the body's weight "set point" at an increased level, in which physiological processes then work to regain any weight following weight loss.

However, there are a multitude of factors that feed into this process, as outlined by the government's attempt to create an obesity system map.

This highlighted that social, psychological, economic, infrastructural, developmental, biological, medical, food- and activity-related, and even media-related factors, all play a role in the wider causation of obesity.

Within an individual, obesity can be related to genetic or syndromic causes, hypothalamic alterations, endocrine alterations, medications, mental health disorders, and lifestyle changes, all of which have their own signs and symptoms.

This still begs the question, however, of what to do about obesity.

Dr Tahrani said that this can be seen at the level of societal change, through alterations in the food and activity environments and addressing stigma, and on the individual level, through lifestyle and behavioural changes, as well as the use of medications and surgery.

He believes that first, the barriers a person has against tackling obesity need to be identified. These can be explored using the 4M approach, which looks at mental, metabolic, and monetary factors, as well as mechanical factors, such as osteoarthritis, pain, and oesophageal reflux.

In addition, the clinician should take into account the patient's expected treatment outcomes, working with them to develop realistic aims and expectations and align the treatment and patient outcomes.

For example, patients may want to lose weight for body image reasons, in which case rapid weight loss will be desired, while those wanting to lose large amounts of weight will require interventions that may take longer but have a more sustained effect.

Dr Tahrani said that lifestyle changes, as recommended by the National Institute for Health and Care Excellence (NICE), should result in a sustained weight loss of 35 kg in people with obesity.

However, he warned against placing too much faith in very low calorie diets, such as those used in the DiRECT study, as the evidence suggests that patients typically regain all the weight they lost over the next 2 years or so.

He continued that drug treatments tend to be associated with a weight loss of around 3%5%, which is additive to any weight loss achieved with lifestyle changes but is only sustainable "as long as the patient continues to take it".

Dr Tahrani pointed out, however, that the greatest and most sustained weight loss is achieved with bariatric surgery, with gastric bypass associated with reductions of 25%30% maintained up to 20 years, although it takes up to 2 years to see the full effect.

Most important is to understand previous successes and failures in managing obesity, and to address clinical inertia.

While treatments can be escalated, depending on the response, he underlined that there is no point in exposing patients to repeated cycles of ineffective treatments.

Dr Tahrani explained: "OK, you've tried a lifestyle intervention. You couldn't do it. Let's do it again...If it hasn't worked, it hasn't worked.

"There's no point in repeating the same thing again, which also demoralises the patient and sets them up for failure."

Finally, the clinician needs to be surrounded by a skilled multidisciplinary team, and to listen to them, he said.

To illustrate his point, he said that before his presentation, he asked Twitter for advice on how to choose between weight loss interventions.

He received responses from academics, physicians, nurses, surgeons, epidemiologists, dieticians, pharmacists, medical writers, and patients, incorporating their ideas and acknowledging them all by name in his slides.

Following the presentation, session co-chair Dr Annice Mukherjee, a consultant endocrinologist at Spire Manchester Hospital, said: "I just want to play the devil's advocate.

"You said, if lifestyle measures don't work for weight loss, don't tell them to keep up their lifestyle measures, but surely lifestyle measures are good for many other aspects of health not just weight loss."

She added: "Why don't you say keep going. It doesn't matter that you haven't lost weight, it's still going to be beneficial."

Dr Tahrani agreed, saying that, "you need to align your agenda with the agenda of the patient".

He said that clinicians need to take a "holistic approach to the patient", and "health is not only about weight loss".

He explained: "They can continue with the lifestyle intervention for the rest of the benefits, but for weight loss you need to add another treatment on top of that.

"Physical activity in particular is overrated for weight loss...but for the rest of metabolic health, it's fantastic."

Dr Tahrani reports research contracts, consulting and other support from Sanofi Aventis, Eli Lilly, BMS, BI, Novo Nordisk, AstraZeneca, MSD, Janssen, Resmed, Philips Resporinics, ImpetoMedical, ANSAR, Aptiva.

Society for Endocrinology BES 2019: HDI1.6. Presented 11th November.

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Holistic, Patient-Centred Approach Needed to Tackle Obesity - Medscape

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Newswise Toxic man-made chemicalssuch as polychlorinated biphenyls and organochlorine pesticidesthat are absorbed into the body and stored in fat may be released into the bloodstream during the rapid fat loss that follows bariatric surgery, according to a study from researchers at the Johns Hopkins Bloomberg School of Public Health. The finding points to the need for further research to understand the health effects of this potential toxicant exposure.

For the study, published online November 5 in Obesity, the researchers examined 26 people undergoing bariatric weight-loss surgery, and found evidence of post-surgery rises in the bloodstream levels of environmental toxicants that are known to be stored long term in fat, including PCBs, organochlorine pesticides, and PCB-like polybrominated diphenyl ethers. The study also revealed that participants born before 1976when most of these chemical compounds were still widely usedtended to have much higher bloodstream levels of the chemicals, compared to younger participants.

The fact that this increasingly popular type of surgery may be causing these compounds to be released into the bloodstream really challenges us to understand the potential health consequences, says study senior author John Groopman, PhD, the Edyth H. Schoenrich Professor in Preventive Medicine at the Bloomberg School.

About 16 million people in the U.S. are morbidly obese, defined as having a body mass index (BMI) of 35 kg/m2. Their extreme overweight condition confers a relatively high risk of type 2 diabetes, cardiovascular disease, hypertension, and many cancers. For almost three decades, the U.S. National Institutes of Health has recommended weight-loss surgeries called bariatric surgeriesincluding stomach stapling and gastric bypass proceduresfor people who are morbidly obese and have serious obesity-related conditions such as diabetes, as well as for anyone with a BMI over 40. More than 200,000 bariatric surgeries are now performed in the country every year.

Although bariatric surgeries are known to have potential adverse side effects, including micronutrient deficiencies, the release of environmental toxicants from fat storage isnt one that has been studied before. Recently, though, Groopman and other researchers from the Bloomberg School and the Johns Hopkins School of Medicine realized that as these surgeries were becoming common, and, since they involved rapid fat loss, they could potentially release toxicants such as PCBs into the bloodstream of patients.

A large set of environmental toxicants, including carcinogenic PCBs, are oily, lipophilic compounds that tend to be absorbed intoand persist indefinitely inthe fat molecules that are stored in fat cells. In general, they are considered persistent organic pollutants (POPs) because they are not broken down quickly in animals, plants, soils, or bodies of water.

The researchers enrolled 27 patients who were morbidly obese and scheduled for surgery at the Johns Hopkins Center for Bariatric Surgery. Of these, 26 patients went through with the surgery and were included in the analysis. Each patient had a blood sample taken at the time of surgery and on four follow-up visits over six months. The analysis, aided by experts at the U.S. Centers for Disease Control and Prevention, focused on the bloodstream levels of 41 POPs, including 24 PCB compounds and 5 organochlorine pesticides, that were detectable in the initial samples. The researchers also classified the patients into two groups: the 17 born before 1976 and the 9 born after. People born before the mid-1970s generally have had greater exposure to POPs. Bans on the U.S. manufacture of PCBs and the organochlorine pesticide DDT took effect in 1979 and 1973, respectively.

The results showed that the patients born before 1976 started the study with roughly 5 times higher serum levels of most of the PCBs, as well as higher levels of organochlorine pesticides, compared to the patients born after 1976. During the six months of weight loss after surgeryin which the patients lost an average of 23 percent of their initial weight, or nearly 30 kg eachboth groups of patients tended to show increases in serum levels of fat-stored POPs. For example, in the older patients, serum levels of most PCBs went up by 15 to 25 percent for every 10 kg of lost weight. The older patients, who started with higher baseline serum levels of most POPs, and presumably had much greater fat stores of these compounds, tended to have higher rates of increases in serum levels of the POPs per unit of lost weight, especially for PCBs.

The researchers note that studies with larger populations need to be done to verify the findings in this small-sample study. Further research, say the researchers, could also determine if there are any biological effects, especially on sensitive, fat-rich organs such as the liver and brain, of the toxicant doses involvedwhich were mostly on the order of billionths of a gram per gram of serum lipids.

There is remarkably little information in the literature that relates blood levels of these compounds to effects in tissues, says Groopman. It would be great if we determine that its not a problem, and it might turn out not to be. At the same time, the data might suggest that people should lose weight more slowly, or that we should somehow find ways to trap these compounds as they are released into the blood. We also need to recognize that the compounds released from the fat represent lifetime accumulation of toxicants, and we need to address these life course exposures to determine health risk.

Mobilization of Environmental Toxicants Following Bariatric Surgery was written by Robert Brown, Derek Ng, Kimberley Steele, Michael Schweitzer, and John Groopman.The research was supported by the Maryland Cigarette Restitution Fund and the CDC Foundation.

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Study Suggests Weight-Loss Surgery May Release Toxic Compounds From Fat Into the Bloodstream - Newswise

The afternoon slump

If your daily lunch consists of a shop meal deal including a sandwich, crisps and a fizzy drink, then you are more likely to hit a wall in the afternoon.

Also known as the carb crash, which is another warning sign of pre-diabetes and type 2 Diabetes.

Dr Rathurs advise is to reduce the amount of carbohydrates and sugars you consume, such as bread, potatoes, pasta, rice, starchy root veg and swap for apples, nut butter, hard-boiled eggs, pistachios, or hummus with celery sticks.

Aches and pains

Even if pain is the result of trauma from an injury, your symptoms may be prolonged by the consumption of foods high in sugar, which can cause joint inflammation and or pain - a sure warning sign that you are at risk of type 2 diabetes.

Dr Rathur advises that whether youre trying to get fit or simply enjoy the gym, getting your exercise right, alongside better dietary management, is key to ensure a faster recovery of pains.

Excerpt from:
Type 2 diabetes: Five main symptoms to look out for - have you experienced any of these? - Express

A DUBLIN woman who lost more than half her body weight has lifted the lid on the radical diet overhaul that saw her shed those excess pounds.

Wendy Deacon was named Slimming Worlds Woman of the Year for 2019 after losing an astonishing 12st 4.5Ibs.

She was inspired to change her eating habits after discovering her daughter had expressed concern to her grandmother that Wendy would eventually eat herself to death.

"Hearing that broke my heart and I knew I needed to change. The thought of my daughter being so worried about my health really spurred me into action," she said.

Wendys incredible journey saw her go from a dress size of 32 to an astonishing 10.

She achieved it with a combination of regular Slimming World meetings and a major shift in diet that saw her ditch takeaways and chocolate in favour of fruit and salads.

"By far the best thing about losing weight though is seeing the pride in my family's faces, especially Amy's. I've finally started to feel proud of myself too - I've got my whole life back, she said.

Now planning her wedding and about to celebrate her 50th birthday, the Dubliner has now shared an example of the kind of food she now eats during the average day.

Breakfast: Nothing

Lunch: Hot chicken roll with crisps

Mid-afternoon: A couple of chocolate bars

Dinner: A takeaway

Evening: More chocolate

Breakfast: Scrambled eggs with grilled tomatoes, or yogurt and fruit

Mid-morning: Fruit

Lunch: A big home-made salad with turkey or ham

Dinner: Chicken stir-fry or spaghetti Bolognese

Evening: Fruit or a Slimming World hi-fibre bar

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Dublin woman reveals diet that helped her lose over 12 stone - Irish Post

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