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Like most people, Kevin Hall used to think the reason people get fat is simple.

"Why don't they just eat less and exercise more?" he remembers thinking. Trained as a physicist, the calories-in-vs.-calories-burned equation for weight loss always made sense to him. But then his own research--and the contestants on a smash reality-TV show--proved him wrong.

Hall, a scientist at the National Institutes of Health (NIH), started watching The Biggest Loser a few years ago on the recommendation of a friend. "I saw these folks stepping on scales, and they lost 20 lb. in a week," he says. On the one hand, it tracked with widespread beliefs about weight loss: the workouts were punishing and the diets restrictive, so it stood to reason the men and women on the show would slim down. Still, 20 lb. in a week was a lot. To understand how they were doing it, he decided to study 14 of the contestants for a scientific paper.

Hall quickly learned that in reality-TV-land, a week doesn't always translate into a precise seven days, but no matter: the weight being lost was real, speedy and huge. Over the course of the season, the contestants lost an average of 127 lb. each and about 64% of their body fat. If his study could uncover what was happening in their bodies on a physiological level, he thought, maybe he'd be able to help the staggering 71% of American adults who are overweight.

What he didn't expect to learn was that even when the conditions for weight loss are TV-perfect--with a tough but motivating trainer, telegenic doctors, strict meal plans and killer workouts--the body will, in the long run, fight like hell to get that fat back. Over time, 13 of the 14 contestants Hall studied gained, on average, 66% of the weight they'd lost on the show, and four were heavier than they were before the competition.

That may be depressing enough to make even the most motivated dieter give up. "There's this notion of why bother trying," says Hall. But finding answers to the weight-loss puzzle has never been more critical. The vast majority of American adults are overweight; nearly 40% are clinically obese. And doctors now know that excess body fat dramatically increases the risk of serious health problems, including Type 2 diabetes, heart disease, depression, respiratory problems, major cancers and even fertility problems. A 2017 study found that obesity now drives more early preventable deaths in the U.S. than smoking. This has fueled a weight-loss industry worth $66.3 billion, selling everything from diet pills to meal plans to fancy gym memberships.

It's also fueled a rise in research. Last year the NIH provided an estimated $931 million in funding for obesity research, including Hall's, and that research is giving scientists a new understanding of why dieting is so hard, why keeping the weight off over time is even harder and why the prevailing wisdom about weight loss seems to work only sometimes--for some people.

What scientists are uncovering should bring fresh hope to the 155 million Americans who are overweight, according to the U.S. Centers for Disease Control and Prevention. Leading researchers finally agree, for instance, that exercise, while critical to good health, is not an especially reliable way to keep off body fat over the long term. And the overly simplistic arithmetic of calories in vs. calories out has given way to the more nuanced understanding that it's the composition of a person's diet--rather than how much of it they can burn off working out--that sustains weight loss.

They also know that the best diet for you is very likely not the best diet for your next-door neighbor. Individual responses to different diets--from low fat and vegan to low carb and paleo--vary enormously. "Some people on a diet program lose 60 lb. and keep it off for two years, and other people follow the same program religiously, and they gain 5 lb.," says Frank Sacks, a leading weight-loss researcher and professor of cardiovascular disease prevention at the Harvard T.H. Chan School of Public Health. "If we can figure out why, the potential to help people will be huge."

Hall, Sacks and other scientists are showing that the key to weight loss appears to be highly personalized rather than trendy diets. And while weight loss will never be easy for anyone, the evidence is mounting that it's possible for anyone to reach a healthy weight--people just need to find their best way there.

Dieting has been an American preoccupation since long before the obesity epidemic took off in the 1980s. In the 1830s, Presbyterian minister Sylvester Graham touted a vegetarian diet that excluded spices, condiments and alcohol. At the turn of the 20th century, it was fashionable to chew food until liquefied, sometimes up to 722 times before swallowing, thanks to the advice of a popular nutrition expert named Horace Fletcher. Lore has it that at about the same time, President William Howard Taft adopted a fairly contemporary plan--low fat, low calorie, with a daily food log--after he got stuck in a White House bathtub.

The concept of the calorie as a unit of energy had been studied and shared in scientific circles throughout Europe for some time, but it wasn't until World War I that calorie counting became de rigueur in the U.S. Amid global food shortages, the American government needed a way to encourage people to cut back on their food intake, so it issued its first ever "scientific diet" for Americans, which had calorie counting at its core.

In the following decades, when being rail-thin became ever more desirable, nearly all dieting advice stressed meals that were low calorie. There was the grapefruit diet of the 1930s (in which people ate half a grapefruit with every meal out of a belief that the fruit contained fat-burning enzymes) and the cabbage-soup diet of the 1950s (a flatulence-inducing plan in which people ate cabbage soup every day for a week alongside low-calorie meals).

The 1960s saw the beginning of the massive commercialization of dieting in the U.S. That's when a New York housewife named Jean Nidetch began hosting friends at her home to talk about their issues with weight and dieting. Nidetch was a self-proclaimed cookie lover who had struggled for years to slim down. Her weekly meetings helped her so much--she lost 72 lb. in about a year--that she ultimately turned those living-room gatherings into a company called Weight Watchers. When it went public in 1968, she and her co-founders became millionaires overnight. Nearly half a century later, Weight Watchers remains one of the most commercially successful diet companies in the world, with 3.6 million active users and $1.2 billion in revenue in 2016.

What most of these diets had in common was an idea that is still popular today: eat fewer calories and you will lose weight. Even the low-fat craze that kicked off in the late 1970s--which was based on the intuitively appealing but incorrect notion that eating fat will make you fat--depended on the calorie-counting model of weight loss. (Since fatty foods are more calorie-dense than, say, plants, logic suggests that if you eat less of them, you will consume fewer calories overall, and then you'll lose weight.)

That's not what happened when people went low fat, though. The diet trend coincided with weight gain. In 1990, adults with obesity made up less than 15% of the U.S. population. By 2010, most states were reporting obesity in 25% or more of their populations. Today that has swelled to 40% of the adult population. For kids and teens, it's 17%.

Research like Hall's is beginning to explain why. As demoralizing as his initial findings were, they weren't altogether surprising: more than 80% of people with obesity who lose weight gain it back. That's because when you lose weight, your resting metabolism (how much energy your body uses when at rest) slows down--possibly an evolutionary holdover from the days when food scarcity was common.

What Hall discovered, however--and what frankly startled him--was that even when the Biggest Loser contestants gained back some of their weight, their resting metabolism didn't speed up along with it. Instead, in a cruel twist, it remained low, burning about 700 fewer calories per day than it did before they started losing weight in the first place. "When people see the slowing metabolism numbers," says Hall, "their eyes bulge like, How is that even possible?"

The contestants lose a massive amount of weight in a relatively short period of time--admittedly not how most doctors recommend you lose weight--but research shows that the same slowing metabolism Hall observed tends to happen to regular Joes too. Most people who lose weight gain back the pounds they lost at a rate of 2 to 4 lb. per year.

For the 2.2 billion people around the world who are overweight, Hall's findings can seem like a formula for failure--and, at the same time, scientific vindication. They show that it's indeed biology, not simply a lack of willpower, that makes it so hard to lose weight. The findings also make it seem as if the body itself will sabotage any effort to keep weight off in the long term.

But a slower metabolism is not the full story. Despite the biological odds, there are many people who succeed in losing weight and keeping it off. Hall has seen it happen more times than he can count. The catch is that some people appear to succeed with almost every diet approach--it just varies from person to person.

"You take a bunch of people and randomly assign them to follow a low-carb diet or a low-fat diet," Hall says. "You follow them for a couple of years, and what you tend to see is that average weight loss is almost no different between the two groups as a whole. But within each group, there are people who are very successful, people who don't lose any weight and people who gain weight."

Understanding what it is about a given diet that works for a given person remains the holy grail of weight-loss science. But experts are getting closer.

For the past 23 years, Rena Wing, a professor of psychiatry and human behavior at Brown University, has run the National Weight Control Registry (NWCR) as a way to track people who successfully lose weight and keep it off. "When we started it, the perspective was that almost no one succeeded at losing weight and keeping it off," says James O. Hill, Wing's collaborator and an obesity researcher at the University of Colorado. "We didn't believe that was the case, but we didn't know for sure because we didn't have the data."

To qualify for initial inclusion in the registry, a person must have lost at least 30 lb. and maintained that weight loss for a year or longer. Today the registry includes more than 10,000 people from across the 50 states with an average weight loss of 66 lb. per person. On average, people on the current list have kept off their weight for more than five years.

The most revealing detail about the registry: everyone on the list has lost significant amounts of weight--but in different ways. About 45% of them say they lost weight following various diets on their own, for instance, and 55% say they used a structured weight-loss program. And most of them had to try more than one diet before the weight loss stuck.

The researchers have identified some similarities among them: 98% of the people in the study say they modified their diet in some way, with most cutting back on how much they ate in a given day. Another through line: 94% increased their physical activity, and the most popular form of exercise was walking.

"There's nothing magical about what they do," says Wing. "Some people emphasize exercise more than others, some follow low-carb diets, and some follow low-fat diets. The one commonality is that they had to make changes in their everyday behaviors."

When asked how they've been able to keep the weight off, the vast majority of people in the study say they eat breakfast every day, weigh themselves at least once a week, watch fewer than 10 hours of television per week and exercise about an hour a day, on average.

The researchers have also looked at their attitudes and behavior. They found that most of them do not consider themselves Type A, dispelling the idea that only obsessive superplanners can stick to a diet. They learned that many successful dieters were self-described morning people. (Other research supports the anecdotal: for some reason, night owls tend to weigh more than larks.) The researchers also noticed that people with long-term weight loss tended to be motivated by something other than a slimmer waist--like a health scare or the desire to live a longer life, to be able to spend more time with loved ones.

The researchers at the NWCR say it's unlikely that the people they study are somehow genetically endowed or blessed with a personality that makes weight loss easy for them. After all, most people in the study say they had failed several times before when they had tried to lose weight. Instead they were highly motivated, and they kept trying different things until they found something that worked for them.

"Losing weight and keeping it off is hard, and if anyone tells you it's easy, run the other way," says Hill. "But it is absolutely possible, and when people do it, their lives are changed for the better." (Hill came under fire in 2015 for his role as president of an obesity think tank funded by Coca-Cola . During his tenure there, the NWCR published one paper with partial funding from Coca-Cola , but the researchers say their study, which Hill was involved in, was not influenced by the soda giant's financial support.)

Hill, Wing and their colleagues agree that perhaps the most encouraging lesson to be gleaned from their registry is the simplest: in a group of 10,000 real-life biggest losers, no two people lost the weight in quite the same way.

The Bariatric Medical Institute in Ottawa is founded on that thinking. When people enroll in its weight-loss program, they all start on the same six-month diet and exercise plan--but they are encouraged to diverge from the program, with the help of a physician, whenever they want, in order to figure out what works best for them. The program takes a whole-person approach to weight loss, which means that behavior, psychology and budget--not just biology--inform each person's plan.

"We have a plan that involves getting enough calories and protein and so forth, but we are not married to it," says Dr. Yoni Freedhoff, an obesity expert and the medical director of the clinic. "We try to understand where people are struggling, and then we adjust. Everyone here is doing things slightly differently."

In most cases, people try a few different plans before they get it right. Jody Jeans, 52, an IT project manager in Ottawa, had been overweight since she was a child. When she came to the clinic in 2007, she was 5 ft. 4 in. tall and weighed 240 lb. Though she had lost weight in her 20s doing Weight Watchers, she gained it back after she lost a job and the stress led her to overeat. Jeans would wake up on a Monday and decide she was starting a diet, or never eating dessert again, only to scrap the plan a couple of days, if not hours, later. "Unless you've had a lot of weight to lose, you don't understand what it's like," she says. "It's overwhelming, and people look at you like it's your fault."

A March 2017 study found that people who internalize weight stigma have a harder time maintaining weight loss. That's why most experts argue that pushing people toward health goals rather than a number on the scale can yield better results. "When you solely focus on weight, you may give up on changes in your life that would have positive benefits," says the NIH's Hall.

It took Jeans five years to lose 75 lb. while on a program at Freedhoff's institute, but by paying attention to portion sizes, writing down all her meals and eating more frequent, smaller meals throughout the day, she's kept the weight off for an additional five years. She credits the slow, steady pace for her success. Though she's never been especially motivated to exercise, she found it helpful to track her food each day, as well as make sure she ate enough filling protein and fiber--without having to rely on bland diet staples like grilled chicken over greens (hold the dressing). "I'm a foodie," Jeans says. "If you told me I had to eat the same things every day, it would be torture."

Natalie Casagrande, 31, was on the same program that Jeans was on, but Freedhoff and his colleagues used a different approach with her. Casagrande's weight had fluctuated throughout her life, and she had attempted dangerous diets like starving herself and exercising constantly for quick weight loss. One time, she even dropped from a size 14 to a size 0 in just a few months. When she signed up for the program, Casagrande weighed 173 lb. At 4 ft. 11 in., that meant she was clinically obese, which means having a body mass index of 30 or more.

Once she started working with the team at the Bariatric Medical Institute, Casagrande also tracked her food, but unlike Jeans, she never enjoyed the process. What she did love was exercise. She found her workouts easy to fit into her schedule, and she found them motivating. By meeting with the clinic's psychologist, she also learned that she had generalized anxiety, which helped explain her bouts of emotional eating.

It took Casagrande three tries over three years before she finally lost substantial weight. During one of her relapse periods, she gained 10 lb. She tweaked her plan to focus more on cooking and managing her mental health and then tried again. Today she weighs 116 lb. and has maintained that weight for about a year. "It takes a lot of trial and error to figure out what works," she says. "Not every day is going to be perfect, but I'm here because I pushed through the bad days."

Freedhoff says learning what variables are most important for each person--be they psychological, logistical, food-based--matters more to him than identifying one diet that works for everyone. "So long as we continue to pigeonhole people into certain diets without considering the individuals, the more likely we are to run into problems," he says. That's why a significant portion of his meetings with patients is spent talking about the person's daily responsibilities, their socioeconomic status, their mental health, their comfort in the kitchen.

"Unfortunately," he says, "that's not the norm. The amount of effort needed to understand your patients is more than many doctors put in."

In an August op-ed published in the journal the Lancet, Freedhoff and Hall jointly called on the scientific community to spend more time figuring out how doctors can help people sustain healthy lifestyles and less on what diet is best for weight loss. "Crowning a diet king because it delivers a clinically meaningless difference in body weight fuels diet hype, not diet help," they write. "It's high time we start helping."

Exactly why weight loss can vary so much for people on the same diet plan still eludes scientists. "It's the biggest open question in the field," says the NIH's Hall. "I wish I knew the answer."

Some speculate it's people's genetics. Over the past several years, researchers have identified nearly 100 genetic markers that appear to be linked to being obese or being overweight, and there's no doubt genes play an important role in how some people break down calories and store fat. But experts estimate that obesity-related genes account for just 3% of the differences between people's sizes--and those same genes that predispose people to weight gain existed 30 years ago, and 100 years ago, suggesting that genes alone cannot explain the rapid rise in obesity.

What's more, a recent study of 9,000 people found that whether a person carried a gene variation associated with weight gain had no influence on his or her ability to lose weight. "We think this is good news," says study author John Mathers, a professor of human nutrition at Newcastle University. "Carrying the high-risk form of the gene makes you more likely to be a bit heavier, but it shouldn't prevent you from losing weight."

Another area that has some scientists excited is the question of how weight gain is linked to chemicals we are exposed to every day--things like the bisphenol A (BPA) found in linings of canned-food containers and cash-register receipts, the flame retardants in sofas and mattresses, the pesticide residues on our food and the phthalates found in plastics and cosmetics. What these chemicals have in common is their ability to mimic human hormones, and some scientists worry they may be wreaking havoc on the delicate endocrine system, driving fat storage.

"The old paradigm was that poor diet and lack of exercise are underpinning obesity, but now we understand that chemical exposures are an important third factor in the origin of the obesity epidemic," says Dr. Leonardo Trasande, an associate professor of pediatrics, environmental medicine and population health at New York University's School of Medicine. "Chemicals can disrupt hormones and metabolism, which can contribute to disease and disability."

Another frontier scientists are exploring is how the microbiome--the trillions of bacteria that live inside and on the surface of the human body--may be influencing how the body metabolizes certain foods. Dr. Eran Elinav and Eran Segal, researchers for the Personalized Nutrition Project at the Weizmann Institute of Science in Israel, believe the variation in diet success may lie in the way people's microbiomes react to different foods.

In a 2015 study, Segal and Elinav gave 800 men and women devices that measured their blood-sugar levels every five minutes for a one-week period. They filled out questionnaires about their health, provided blood and stool samples and had their microbiomes sequenced. They also used a mobile app to record their food intake, sleep and exercise.

They found that blood-sugar levels varied widely among people after they ate, even when they ate the exact same meal. This suggests that umbrella recommendations for how to eat could be meaningless. "It was a major surprise to us," says Segal.

The researchers developed an algorithm for each person in the trial using the data they gathered and found that they could accurately predict a person's blood-sugar response to a given food on the basis of their microbiome. That's why Elinav and Segal believe the next frontier in weight-loss science lies in the gut; they believe their algorithm could ultimately help doctors prescribe highly specific diets for people according to how they respond to different foods.

Unsurprisingly, there are enterprising businesses trying to cash in on this idea. Online supplement companies already hawk personalized probiotic pills, with testimonials from customers claiming they lost weight taking them.

So far, research to support the probiotic-pill approach to weight loss is scant. Ditto the genetic tests that claim to be able to tell you whether you're better off on a low-carb diet or a vegan one.

But as science continues to point toward personalization, there's potential for new weight-loss products to flood the zone, some with more evidence than others.

When people are asked to envision their perfect size, many cite a dream weight loss up to three times as great as what a doctor might recommend. Given how difficult that can be to pull off, it's no surprise so many people give up trying to lose weight altogether. It's telling, if a bit of a downer, that in 2017, when Americans have never been heavier, fewer people than ever say they're trying to lose weight.

But most people do not need to lose quite so much weight to improve their health. Research shows that with just a 10% loss of weight, people will experience noticeable changes in their blood pressure and blood sugar control, lowering their risk for heart disease and Type 2 diabetes--two of the costliest diseases in terms of health care dollars and human life.

For Ottawa's Jody Jeans, recalibrating her expectations is what helped her finally lose weight in a healthy--and sustainable--way. People may look at her and see someone who could still afford to lose a few pounds, she says, but she's proud of her current weight, and she is well within the range of what a good doctor would call healthy.

"You have to accept that you're never going to be a willowy model," she says. "But I am at a very good weight that I can manage."

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Weight Loss: Why Your Diet Isn't Working | Time.com - TIME

Losing weight is tough, both mentally and physically. New science shows that when the body starts to lose substantial amounts of weight, it fights viciously to gain it back. But despite the biological roadblocks, plenty of people are successful at losing weight and keeping it off over the long term.

But how? As part of its recent exploration of the new science of weight loss , TIME asked 9 weight loss and obesity experts their best advice for people who are trying to lose weight. Here are their top tips for what works when it comes to slimming down.

Avoid all sugary drinks, as they provide 'empty calories' that don't fill you up. The sugar may uniquely act on the liver to produce belly fat.

Dr. Dean Schillinger, chief of the University of California, San Francisco Division of General Internal Medicine

The calorie in, calorie out approach fails, because it disregards how food affects our hormones and metabolism. Pay attention to food quality.

Dr. David S. Ludwig, professor of nutrition at Harvard Medical School

MORE: You Asked: Whats the Best Way to Lose Weight?

The simple message is to eat a healthful diet and to engage in more moderate-to-vigorous physical activity. The challenge is how to actually accomplish that in an environment that seems to push us constantly in the wrong direction.

Dr. Stephen R. Daniels, pediatrician-in-chief at Childrens Hospital Colorado

Aim to achieve and improve health and reach a psychologically 'happy weight,' not an unrealistic 'ideal' weight that may be impossible to reach for most.

Dr. Jaideep Behari, associate professor of medicine at the University of Pittsburgh School of Medicine

People need to have the mindset of someone who is ready and willing to make some permanent changes in the way they live. A number of treatments can create short-term weight loss without a great deal of effort from the person, but they dont allow for long-term weight loss.

Dr. Michael Jensen, obesity researcher at the Mayo Clinic

MORE: 'I Swallowed a Balloon For Weight Loss and Lost 40 Lbs.'

You need a program that satisfies hunger and has good food so it doesnt feel like a diet. Hunger erodes willpower, and thats the reason most diets fail.

Susan B. Roberts, professor of nutrition at Tufts University and founder of iDiet

Make small changes that stick, make changes as a family and keep it positive.

Dr. Stephen Pont, medical director of the childhood obesity center at Dell Children's Medical Center

The culprit is not bad choices by individuals. It is the toxic food environment in which calories are ubiquitous. Until the food environment changes, everyone must become aware of the calories they consume, especially those from beverages, sweets, and other calorie-dense foods.

Dr. Lawrence J. Appel, director of the Welch Center for Prevention, Epidemiology, and Clinical Research at Johns Hopkins University

MORE: If You Want to Lose Weight, Don't Eat Out

A person can eat almost anything they want, but the portion size has to be appropriate. For example, eat dinner on a salad plate rather than a dinner plate to cut the portion size in half.

Melinda L. Irwin, professor of epidemiology at Yale School of Public Health

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9 Weight Loss Tips From Doctors: Diet and Exercise | Time.com - TIME

Spring is in the air, and so are new diet plans. Everyone wants that certain body type or to get rid of a few extra pounds before its time to pull out their summer wardrobe, and there are hundreds of diets out there promising results.

Most focus on weight loss, but weight loss alone isnt always an indicator of health. And diets that call for extreme eating changes arent always healthy or palatable long-term. You may be able to eat only cabbage soup for a week, but not for the rest of your life!

IS LASER TREATMENT FOR VAGINAL ATROPHY SAFE?

And often the fast weight loss these diets promise is gained back just as quickly, a phenomenon thats well-documented andmay be the result of diets that are too restrictive.

It might be time for something new on the diet scene.US News and World Reporthas released their diet rankings for 2017, and a diet youve never heard of has taken the 4thslot in the overall rankings, is 3rdin heart-healthy diets, and ranks 18thin weight loss. Its called the TLC diet, and its initials stand for Therapeutic Lifestyle Changes. It doesnt sound trendy, and thats because its not. Though weight loss is often a by-product of the diet, it doesnt promise a supermodel body or results within a certain time frame. It was developed to combat heart diseasethe number one killer of Americansby tackling high blood cholesterol with healthy lifestyle changes, but by adjusting your caloric goals you can target healthy weight loss too.

TIPS TO BE LEAN FOR LIFE

Theres a lot of flexibility within the diet that allows people to eat things they enjoy. Like most effective plans for weight loss, the TLC diet involves counting calories and staying close to the range recommended for your height, weight, and activity level. You might have to get out your calculator for the first few weeks, but the guidelines are simple and quickly become habit.

Cut saturated fat to less than 7 percent of your calorie intake. For a 1500-calorie diet, thats less than 10 grams of saturated fat, which often means less full-fat dairy and fatty meats. Trans fat, found mostly as hydrogenated oils in products like margarine and packaged foods, should be avoided if at all possible and is one of very few ingredients the TLC diet tries to cut out entirely. Theres no limit on unsaturated fats, but keep in mind that foods high in fat tend to be high in calories, so keep that calorie limit in mind when choosing foods that are high in healthy fats.

Saturated fat actually has a bigger impact on blood cholesterol levels than dietary cholesterol, but cholesterol should still be kept under 200 mg a day. Full-fat dairy products, shrimp, egg yolks, and organ meats are all high in cholesterol. These foods arent forbidden though. A 3.5 oz. serving of shrimp contains 189 mg of cholesterol. Just ditch the cream sauce, and opt for olive oil and herbs instead to stay under your cholesterol limit.

WHY TEENS SHOULD AVOID DIET PILLS

The TLC diet also recommends getting a lot of soluble fiber, at least 5-10 grams a day but preferably 10-25 grams a day. While insoluble fiber passes through the digestive tract pretty much undigested (giving your colon a nice workout), soluble fiber dissolves into a substance that actually coats the walls of your intestines and keeps them from absorbing dietary fat and cholesterol. Cereal grains like oatmeal, whole fruits, and beans are all good sources of soluble fiber.

Because of research that shows heart benefits for omega-3 fatty acids, the diet also recommends two fish meals a week. It also recommends avoiding foods high in sodium and restricting alcohol intake to one drink a day for women and two a day for men.

The last key part of the TLC diet is an important oneget 30 minutes of moderate-intensity activity most days of the week, preferably every day. Gardening, golfing (without a cart), playing tennis, biking, and brisk walking are all examples of moderate-intensity activities, and its important to pick something you enjoy. Join a group, class, or club to stay motivated!

Always check with your doctor before starting a new diet, and you can check out the complete guide to the TLC diethere.

This article first appeared on AskDrManny.com.

Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. Click here for more information on Dr. Manny's work with Hackensack University Medical Center. Visit AskDrManny.com for more.

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Could this be the next great weight loss secret? - Fox News

BOSTON

Carolyn Mills has lost 45 pounds since December by taking the prescription diet drug Contrave.

"It's probably saving my life," she said.

Contrave is one of several new drugs that the Food and Drug Administration approved in the past few years to help patients struggling with obesity.

"The drugs work," said Dr. Caroline Apovian, director of the nutrition and weight management program at Boston Medical Center. "And they all help you lose, on average, between 5 and maybe 12 percent weight loss."

That's significant for people who are obese. Often, the hormones telling them, "I'm hungry," are too powerful. Diet and exercise alone don't seem to work.

"Most people don't see obesity as a disease," Apovian said. "And even the patient thinks, 'I can do this on my own. I can lose this 100 pounds.'"

At BMC, Apovian said patients eligible for prescription pills are at least 20 to 30 pounds overweight. They must have a Body Mass Index over 30 --- or a BMI over 27 if they have another complication.

"We have to know a lot about a patient to choose which drug to try first," she added.

For example, Apovian prescribed Qsymia for her patient Jodi Gold, a young woman without any major health issues who hoped to lose a significant amount of weight.

"Gives you really good weight loss," Apovian explained. "Could keep you up at night. Headache. Palpitations. But it's a very good drug."

Gold said she hasn't experienced any side effects since she started using the drug two years ago. In combination with diet and exercise, Gold said Qsymia has helped her lose more than 60 pounds.

"I'm able to kind of go through my day without making food a focus," she said. "So it's helped me created a different lifestyle."

Apovian said another drug, Belviq, offers more more modest weight loss, but with fewer side effects.

"So it's a great drug if you have a patient with high blood pressure or diabetes," she said.

If a patient is comfortable with needles, the drug Saxenda is a new option.

"Really good weight loss," Apovian said. "Small injection. The side effect for that is nausea."

The drug Contrave combines anti-addiction with anti-depressant medications.

"And this combination is fantastic for people who have bingeing and addictions to food like carbohydrates," she said.

Mills said Contrave is working for her. She already feels healthier and happier.

"You're just not dragging yourself around all day long going, 'When will this day be over?'," she said.

Apovian said if patients stop using the drugs, unfortunately the weight can come back, but she added that the FDA has approved most of the drugs for long-term use.

WEBVTT OR RESPONSIBILITY.IT IS STILL UNFOLDING.AND YOUR HEALTH, GETTING APRESCRIPTION TO LOSE WEIGHT.MARIA: MORE DRUGS ARE ON THEMARKET AND THE FDA SAYS THEYWORK NEWSCENTER 5'S EMILY RIEMEREXPLAINS THE OPTIONS.IT'S PROBABLY SAVING MY LIFE.>> EMILY CAROLYN MILLS HAS LOST: 45 POUNDS SINCE DECEMBER WITHTHE DIET DRUG CONTRAVE.>> THE DRUGS WORK.AND THEY ALL HELP YOU LOSE ONAVERAGE BETWEEN A 5 AND MAYBE12% WEIGHT LOSS.EMILY THAT'S SIGNIFICANT FOR: PATIENTS STRUGGLING WITHOBESITY.OFTEN, THE HORMONES TELLING THEMI'M HUNGRY ARE TOO POWERFUL.AND DIET AND EXERCISE ALONEWON'T WORK.MOST PEOPLE DON'T SEE OBESITY AS>>MOST PEOPLE DON'T SEE OBESITYAS A DISEASE, AND EVEN THEPATIENT THINKS, I CAN DO THIS ONMY OWN.I CAN LOSE THIS 100 POUNDS.EMILY AT BOSTON MEDICAL CENTER,: DR. CAROLINE APOVIAN SAYSPATIENTS ELIGIBLE FORPRESCRIPTION PILLS ARE AT LEAST20 TO 30 POUNDS OVERWEIGHT.THEY MUST HAVE A BODY MASS INDEXOVER 30, OR A BMI OVER 27 IFTHEY HAVE ANOTHER COMPLICATION.>> WE HAVE TO KNOW A LOT ABOUT APATIENT TO CHOOSE WHICH, WHICHDRUG TO TRY FIRST.EMILY FOR JODI GOLD, SHE: PRESCRIBED QSYMIA.>> GIVES YOU REALLY GOOD WEIGHTLOSS.COULD KEEP YOU UP AT NIGHT.HEADACHE.PALPITATIONS.BUT IT'S A VERY GOOD DRUG.EMILY IN TWO YEARS, JODI SAYS: SHE'S HAD NO SIDE EFFECTS, ANDWITH DIET AND EXERCISE, QSYMIAHAS HELPED HER LOSE MORE THAN 60POUNDS.>> I'M ABLE TO KIND OF GOTHROUGH MY DAY WITHOUT MAKINGFOOD A FOCUS, SO IT'S HELPED MECREATE A DIFFERENT LIFESTYLE.EMILY BELVIQ: OFFERS MORE MODEST WEIGHTLOSS, BUT WITH FEWER SIDEEFFECTS.SO IT'S A GREAT DRUG IF YOU HAVEA PATIENT WITH HIGH BLOODPRESSURE OR DIABETES.EMILY AND IF YOU'RE OK WITH: NEEDLES, SAXENDAIS A NEW OPTION.>> REALLY GOOD WEIGHT LOSS,SMALL INJECTION.THE SIDE EFFECT FOR THAT ISNAUSEA.EMILY CAROLYN'S DRUG, CONTRAVE: COMBINES ANTI-ADDICTION WITHANTI-DEPRESSANT MEDICATIONS.AND THIS COMBINATION IS>> FANTASTIC FOR PEOPLE WHO HAVEBINGING AND ADDICTIONS TO FOODSLIKE CARBOHYDRATES.EMILY CAROLYN SAYS IT'S WORKING: FOR HER.SHE ALREADY FEELS HEALTHIER, ANDHAPPIER.>> YOU'RE JUST NOT DRAGGINGYOURSELF AROUND ALL DAY LONGGOING WHEN WILL THIS DAY BEOVER.EMILY IF YOU STOP USING THE: DRUGS, YES, UNFORTUNATELY, THEWEIGHT CAN COME BACK.BUT DR. APOVIAN SAYS, MOST OFTHE DRUGS ARE APPROVED FORLONG-TERM USE.

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Patients losing weight with prescription drugs, injections - WCVB Boston

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May 22, 2017 01:00 ET | Source: Diet Doc

Salt Lake City, UT, May 22, 2017 (GLOBE NEWSWIRE) -- Finding a balanced diet to shed pounds in the short-run but also prevent long-term weight gain is challenging. With excessive hunger between meals, uncontrollable cravings for junk food, and lack of adequate physical exercise, millions of people find it difficult to establish and maintain a healthy diet. The prevalence of fad diets that offer immediate solutions but are neither sustainable nor healthy presents another obstacle. In practice, a balanced weight loss solution involves consistency, personal customization and professional health supervision. A healthy eating plan (consisting of nutritious foods that do not exceed ones daily calorie intake goal) should ideally be balanced with an active lifestyle and, in extreme cases, medical weight loss solutions. In general, a healthy eating plan involves:

The Keto Diet, or the Ketogenic Diet, is one example of a balanced diet that provides a healthy eating plan designed to promote weight loss by modifying the bodys utilization of the energy from food. It involves high levels of fat, moderate amounts of protein, and low amounts of carbohydrates. Generally, the human body burns carbohydrates before fats for energy; the ketogenic diet removes carbohydrates from the diet for bit so the body is forced to burn stored fat.

It must be noted that while the Keto Diet is widely praised and discourages the starvation approach that many fad diets endorse, it can still be challenging to maintain. Like any other diet, it requires consistency, customization and professional supervision to be effective. If not managed properly, the Keto Diet, like any other diet, can be unhealthy or even dangerous. Although ketone bodies are a sign of weight loss with the Keto Diet, they can also be a warning sign of serious issues like diabetes. Therefore, it is important for a medical professional to supervise any major diet.

At Diet Doc, a nationally recognized weight loss center, the unique dietary needs of each individual are considered in order to promote efficient, safe, and long-term weight loss. Instead of a one size fits all diet strategy, every Diet Doc patient receives guidance on individual diet macros (protein, carbohydrates and fats) and metabolism-boosting techniques to lose weight fast. In fact, all Diet Doc patients receive custom-designed weight loss programs and diet consulting. With a safe, doctor-supervised diet plan and guidance for life, Diet Doc patients gain the following benefits within the very first month:

For patients who struggle with portion control or emotional eating, Diet Doc offers solutions like Metwell, which helps balance metabolism and reduce appetite without harmful side effects.. Medical weight loss solutions like these, especially in combination with popular diets like the Keto Diet, have been shown to be effective when doctor-supervised and customized to an individuals dietary needs, according to Diet Doc Weight Loss Centers resident medical expert, Dr. Rao.

With a team of doctors, nurses, nutritionists and motivational coaches, Diet Doc products help individuals lose weight fast and keep it off. Patients can get started immediately, with materials shipped directly to their home or office. They can also maintain weight loss in the long-term through weekly consultations, customized diet plans, motivational coaches and a powerful prescription program. With Diet Doc Weight Loss, the doctor is only a short phone call away and a fully dedicated team of qualified professionals is available 6 days per week to answer questions, address concerns and support patients.

Getting started with Diet Doc is very simple and affordable. New patients can easily visit https://www.dietdoc.com to quickly complete a health questionnaire and schedule an immediate, free online consultation.

About the Company:

Diet Doc Weight Loss is the nation's leader in medical, weight loss offering a full line of prescription medication, doctor, nurse and nutritional coaching support. For over a decade, Diet Doc has produced a sophisticated, doctor designed weight loss program that addresses each individual specific health need to promote fast, safe and long term weight loss.

Twitter: https://twitter.com/DietDocMedical

Facebook: https://www.facebook.com/DietDocMedicalWeightLoss/

LinkedIn: https://www.LinkedIn.com/company/diet-doc-weight-loss?trk=biz-brand-tree-co-logo

CONTACT INFORMATION

Diet Doc Contact Information:

Providing care across the USA

Headquarters:

San Diego, CA

(800) 581-5038

Info@DietDoc.com

Homepage

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A photo accompanying this announcement is available at http://www.globenewswire.com/NewsRoom/AttachmentNg/d2ac3ae4-ccb8-410b-8d64-9a03b6403e3a

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Diet Doc's Personalized Ketogenic Diet Consultation Promotes Healthy Eating and Weight Loss Success - GlobeNewswire (press release)

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Waco Medical surveys show a correlation between quick weight loss diets and long term heart damage.

Summer is almost here, and some may be looking for last minute ways to shed unwanted weight, but studies show many trendy diets yo-yo weight, sometimes causing long term damage to the heart and other organs.

It took you years to put this weight on, its not going to come off in five minutes, Nurse Tracy Kramer said.

Every day I can guarantee you, I have a patient that comes in wanting to lose weight and needs to lose it fast, Kramer said.

They're tired of being big and they want the magic pill or the magic shot to get it done, and the really isn't one

She said dramatic weight loss from unhealthy diets causes long term heart damage, increases cholesterol, improves your chances for developing diabetes and even could result in you gaining extra weight in the future.

Kramer recommends traditional weight loss methods.

Small portions, portion control, doing exercise 30 minutes a day where you get your heart rate up and having a calorie intake of around 1200 a day, Kramer said.

Doctors also recommend replacing sugary drinks with fruit infused water.

Kramer also recommends getting a partner to keep your workouts and diet on track.

More here:
Quick weight loss diets linked to long term heart issues - KWTX

Within seven years of having Roux-en-Y gastric bypass weight-loss surgery, 1 in 5 developed an alcohol problem.

Getty Images/iStockphoto

After a popular type of weight-loss surgery, nearly 21 percent of patients develop a drinking problem, sometimes years later, researchers report.

The researchers followed more than 2,000 patients who had weight-loss surgery at 10 hospitals across the United States.

Over seven years, more than 1 in 5 who had Roux-en-Y gastric bypass weight-loss surgery developed a problem such as alcohol abuse or alcoholism, compared with around 11 percent of those who underwent gastric banding.

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Roux-en-Y gastric bypass is a surgical procedure that significantly reduces the size of the stomach and changes connections with the small intestine. Gastric banding, another weight-loss option, involves placing an adjustable band around the stomach to reduce the amount of food it can hold.

In recent years, Roux-en-Y gastric bypass has become more popular than gastric banding because it leads to greater weight loss, according to the study authors.

They said their findings indicate that weight-loss (bariatric) surgery patients should receive long-term follow-up to watch for and treat drinking problems.

The study results were published online May 15 in the journalSurgery for Obesity and Related Diseases.

"We knew there was an increase in the number of people experiencing problems with alcohol within the first two years of surgery, but we didn't expect the number of affected patients to continue to grow throughout seven years of follow-up," said study author Wendy King. She's an associate professor of epidemiology at the University of Pittsburgh's Graduate School of Public Health.

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"Because alcohol problems may not appear for several years, it is important that doctors routinely ask patients with a history of bariatric surgery about their alcohol consumption and whether they are experiencing symptoms of alcohol use disorder, and are prepared to refer them to treatment," King said in a journal news release.

The study doesn't actually prove that Roux-en-Y leads to alcohol abuse. However, other studies have shown that compared to banding, it's associated with higher and quicker elevation of alcohol in the blood, the researchers said.

Moreover, some animal research has suggested that Roux-en-Y may affect areas of the brain associated with reward, possibly increasing alcohol reward sensitivity, the researchers noted.

Although Roux-en-Y gastric bypass patients were nearly four times more likely than gastric banding patients to say they'd received treatment for substance abuse, few study participants said they'd undergone such treatment, the researchers found.

Overall, 3.5 percent of the Roux-en-Y patients reported getting substance abuse treatment, far less than the nearly 21 percent who reported alcohol problems.

"This indicates that treatment programs are underutilized by bariatric surgery patients with alcohol problems," King said. "That's particularly troubling, given the availability of effective treatments."

2017 HealthDay. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Popular weight-loss surgery linked to alcohol problems - CBS News

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Early Response to Liraglutide Resulted in Long-Term Weight ... - P&T Community

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