Tag Archives: weight-loss

Carvings March 1, 2026

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In the news

Our diet is our destiny

                Full credit for that statement goes to Dr. William G. Wilkoff in his column of September 10, 2025. Dr. Wilkoff points out quite clearly that “Food — not lack of exercise – fuels obesity.” That was the title of an article on National Public Radio.

                To be sure, exercise does matter. When we cut back drastically on calories it’s important to exercise regularly – meaning a minimum of four times a week, with moderate intensity, for at least one hour. The reason? When we cut back significantly on calories it’s not the fat that the body draws energy from. First, energy comes from glycogen, the carbohydrate stored in the liver and muscles. Next, the body begins to burn protein – almost entirely from muscle – as well as from stored fat. Without exercise, almost half of the pounds lost during a weight-loss regimen come from muscle.

                If you have worked out on a treadmill or stationary bike at your local gym you may have already noticed a distressing fact: roughly one hour on one of these machines burns only about 300 calories – about as many as you will get in two scoops of ice cream.

                The ideal rate of weight loss is about two pounds per week. Losing more than that leads to fatigue, cravings and irritability. Two pounds of fat is equivalent to about 7,200 calories, or about 24 hours (!) on that treadmill!! On the other hand, you can reduce your calorie intake by 7200 calories a week by eliminating a daily dessert (which average 300-500 calories per serving – see below), replacing pasta, rice, or potatoes with a fiber- and nutrient-rich vegetable like broccoli, peas, cauliflower, beans, etc., and limiting your wine intake to only one small glass (four ounces) instead of two five-ounce glasses.

                By losing only two pounds per week even a morbidly obese person (more than 100 pounds over standard weight for height) will be back to normal in two years or less. That will likely reduce high blood pressure, lower the risk of complications of diabetes and certainly improve self-image. 

Lifestyle

Thoughts on desserts

                From what I have observed over the years, most of us have at least one dessert a day, typically with the evening meal. There is no need to give up desserts forever – a highly unrealistic goal – but a few relatively minor changes can significantly lower one’s total weekly caloric intake.

                There are three things to consider: type, size and frequency.

                Outside of the tourist areas, European desserts often consist only of a piece of fruit – not a whole one, mind you – with a small slice of hard cheese. If it is a sugary kind it’s about the size of your thumb, gone in a mouthful, or at most, two. The desserts served in our restaurants average about 500 calories; some of our most popular establishments offer1500 calorie desserts. As an example, a slice of apple pie a la mode has 400-600 calories.

                Don’t go cold turkey on desserts if you are used to having one every day. Do without dessert just one day a week for a month, then two, then three. At the end of three months that’s 1500 calories a week, or two pounds a month. Right on target for a healthier lifestyle!

Carvings January 1, 2026

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Happy New Year!

In the news

Is a pill the answer?

                The new year is going to see a surge in the oral forms of Ozempic and similar drugs for control of type 2 diabetes and for weight loss. The injectable forms of GLP-1, in spite of their inconvenience compared to oral medications, have been very popular because they are effective and they have relatively few serious side effects.

                The availability of a new class of drugs for the control of type 2 diabetes is welcome. That disease, which is entirely lifestyle related with very few exceptions, is a threat to the financial stability of the healthcare system. If the CDC projection is correct, more than half the U.S. population will be burdened with this disease by 2050 and the cost will reach over one trillion dollars per year.

                What are the practical aspects of the new pills in regard to weight loss? Some studies show a weight reduction of 10-15 percent; the best that I have seen in one trial was 27 pounds. That degree of fat loss does matter. It lowers the risk of coronary artery disease, stroke and the complications of type 2 diabetes.  That’s not the end of the story. A 250-pound person who loses 27 or 30 pound is still obese. They have lowered their risk but they have not eliminated it. The benefits are not permanent. Approximately two-thirds of users will regain their weight within only one year after stopping medication.

                There is nothing easy about trying to lose weight. The new pill has not changed that.

                The hardest “pill” for Americans to swallow is a change in lifestyle. Prescription drugs will help along the way, but only a reduction in caloric intake will eventually eliminate a decades-old accumulation of fat. Nor is exercise the answer. To exercise without cutting food intake is folly. However, it is extremely important to exercise regularly when on a calorie-reduction diet in order to prevent the loss of muscle mass that would otherwise result.

                The holidays are a lousy time to cut back on calories, but the holidays are over. Consider just throwing away all the goodies that were foisted upon you by loving friends and relatives. (A confession: I will not throw away my daughter’s fruit cake! Everything else goes.)

Carvings   August 1, 2025

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In the news

Walking is great – but it’s not enough.

            I commend all those who walk several times a week. Besides improving heart and lung fitness, it strengthens the core muscles (back and abdomen) and adds to the bone strength of the legs, which includes the hips. But if you fall while walking (!) and land on your outstretched hands, it could result in a fracture of one or both wrists or elbows or collarbones. We need resistance-type exercises that provide numerous health benefits, including stronger bones for the upper body.

            When you exercise your biceps, for example, it puts stress on the bones of the arm where the muscle is attached. The bone reacts by becoming thicker and stronger, thus resistant to breakage. But there’s more.  A beneficial by-product of using barbells, dumbbells, elastic bands and exercise machines is maintaining the health of specialized nerve endings attached to each muscle cell that help us to retain balance. One reason why seniors are prone to falls is that when they lose muscle cells because of inactivity they also lose those nerve structures that maintain balance.

            Although a fitness center is ideal, a home exercise program is a good start. Any household item that fits comfortably in your hand, e.g., a can or jug that holds food or juice, will do. Gym memberships are often available for less than $25 a month and some senior insurance programs will cover the cost.

            For persons with a chronic illness such as arthritis or heart disease, a physical therapist can provide a suitable, safe program. Four or five hours a week of regular, moderately intense physical activity, at any age, results in greater energy and a feeling of well-being. You’ll never go back to being a couch potato!

Lifestyle

“Don’t be a spectator, don’t let life pass you by.” Lou Holtz

            Lou Holtz, the famous Notre Dame football coach, is an outstanding motivational speaker. I have modified one of the elements of his repertoire as follows:

            For a meaningful life, have:

                        Someone to love

                        Something to believe in

                        Something to hope for

                        Something to give

                        Something that brings you daily joy

Carvings June 15, 2025

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In the news

Wither goest Ozempic?

            Ozempic and Wegovy, made by the same company, are the trade names of the GLP-1 drugs known as semaglutides. Although they are chemically identical, the dosage, the packaging and their intended uses are different. Such is the way of marketing!

            These medications are intended to improve the health of obese, diabetic persons. They have several actions, including decreasing the appetite, providing a feeling of fullness, slowing digestion, decreasing glucose production in the liver and increasing the release of insulin. Ozempic is intended to slow the progress of type 2 diabetes while Wegovy is designed to aid in weight management, i.e., weight loss. 

            In clinical trials they were helpful in managing both problems, although the regimen used also included reducing calories and increasing physical activity, fundamental measures in any weight loss program.

            Patients taking Wegovy lost 15 percent of their body weight in a 16-month trial period. Those taking Ozempic lost 7 percent. If we can assume that the average weight of the participants was approximately 225 pounds, both groups would still have been overweight or obese at the end of the trial. To be sure, even such modest weight loss is beneficial in managing type 2 diabetes and in lowering the risk of cardiovascular disease. In fact, among study subjects, those taking these drugs showed a significant decrease in cardiovascular disease, and in slowing of the progression of kidney disease.

            Is this the best solution to the national epidemics of obesity (42 percent) and type 2 diabetes (12 percent). Consider the following challenges.

            The cost of Ozempic is nearly $1000 per month; Wegovy costs about $1350. Few patients will pay that much because of insurance, or pricing plans offered by the company.

            This is a weekly injection, not a pill. Side effects are not common, most being in the range of ten percent or less, including nausea, vomiting, diarrhea and constipation. Infrequent but serious side effects include inflammation of the pancreas and gallbladder; allergies, temporary hair loss, vision problems and mood changes have been reported.

            Losing weight is frustratingly difficult, as most overweight persons are aware. Drugs are convenient; lifestyle changes are not. Some of the current generation of weight-challenged persons may find some success with prescription drugs. The long-term hope is that coming generations will be encouraged to avoid excess weight gain in the first place, but that will probably require draconian governmental intervention. The combined cost of obesity and diabetes is more than a half-trillion dollars annually. I’ll discuss what might be a real solution in a coming post.

Lifestyle

Preventing falls: things we overlook

            Falls, especially among the older generation, are a serious problem, often resulting in death. The frailty that accompanies aging is only part of the problem and one that can be postponed for decades if we are committed to a lifetime of regular, moderately intense physical activity. In addition, there are some steps, especially as we get older, that will lower our risk.

            How safe is your flooring? Secure or remove loose rugs.

            Some shoes don’t belong in your wardrobe. Get rid of those that are too slippery (smooth leather soles) or too clingy (crepe soles).

            Bare feet and socks increase the risk of falls.

            Improve lighting with night lights and lighting strips. They are cheap insurance.

            Move frequently used kitchen items to a lower shelf. And never stand on a chair!

            If you wear bifocals or transitional lenses you just might have to move more deliberately.

            Face it! You can’t hold your liquor like you did at 20. Adjust.

            On a new medication? Be extra careful. Some cause dizziness.

            It’s worth getting a consultation on fall prevention from an occupational therapist. Discuss this with your physician. Things like grab bars in the shower can be literal lifesavers. And they increase resale value!

Carvings April 1, 2025

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No April Fool: It’s time to put an end to nutritional pornography.

            In a few months we will reach the end of the first quarter of the 21st century with no end in sight of the three epidemics that threaten to overwhelm our health system and our economy: obesity, type 2 diabetes and osteoporosis. The first two were almost non-existent at the beginning of the preceding century. The obesity rate in 1900 was approximately 5 percent; it is now 42 percent. Diabetes was almost entirely type 1, the juvenile form, a totally different disease from type 2 diabetes. The latter now affects 12.2 percent of the general population, more than one-third of people over the age of 65 and increasing numbers of children below the age of 18, some as young as six years! Type 2 diabetes was so uncommon in the pre-World War One era that it wasn’t clearly distinguished from type 1 diabetes until the 1950s.

Osteoporosis, the Third Epidemic, is going to crash down on us with a vengeance in about 30 years, as today’s young people fail to build a strong skeleton during the bone-building window between ages five and twenty-five. They transport themselves on electric bikes, scooters and skateboards, and replace childhood sports and games with screen-watching, eliminating the muscle stresses that nature intended to form a strong skeleton.  

            Someone recently sent me an insightful post: “Ninety percent of today’s supermarket food didn’t exist a hundred years ago. Neither did ninety percent of today’s diseases. Think about that.”

            Government edicts will determine what supermarkets will offer us in the coming decade. Trans fats have already been outlawed. Food coloring restrictions are imminent; the sugar content of processed foods is probably next; saturated fat and salt mandates will reach us in a few short years. SNAP (welfare) recipients are not allowed to use those funds to purchase alcohol or tobacco. It’s likely that they will see junk food added to that list during the current administration. Legislation is pending now in Tennessee to disallow the purchase of candy and soft drinks with SNAP funds. Other states will follow suit, and so will the federal government.