Diet & Weight Loss Archive

If you want to keep your New Year’s resolutions, you need to approach them as a process of behavior change, make your goals realistic, and have a specific plan for how you will reach them.

Ask the doctor

Q. I'm very overweight, and my doctor has been urging me to consider bariatric surgery. I'm worried that, like the diets I've tried, it will work for a while and then stop working. Am I being too cautious?

A. Bariatric surgery involves any of several different surgical procedures on the stomach and intestine designed to reduce the calories your body absorbs from the food you eat. It also helps quell appetite. That's because, in all of us, when our stomach becomes empty following a meal, it starts to make a hormone (called ghrelin) that travels to the brain and stimulates appetite. Bariatric surgery seems to diminish the amount of that hormone.

It's called "weight bias," and even health care providers aren't immune.

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If you've ever delayed a doctor's appointment so you could lose a few pounds before your annual weigh-in, or hesitated to exercise in public because you felt self-conscious among a sea of hard-bodied gym goers, your weight may be affecting your health — but not in the way you might think.

Even if you're otherwise healthy, sometimes excess pounds bring increased health risks, especially if they keep you from following recommended health practices that offer protection over the long term.

Research we're watching

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Noshing on a handful of nuts on most days of the week has been linked to a lower risk of obesity and heart disease. New research may help explain why: walnuts appear to activate a brain region involved in appetite and impulse control.

For the study, nine people with obesity drank a smoothie that contained about 14 ground walnut halves or a placebo smoothie (identical in taste and calories) for five consecutive days. After a month on their regular diets, the participants returned for another five days, during which the placebo group drank walnut smoothies and vice versa. On day five of both periods, they underwent brain imaging tests while looking at pictures of desirable foods (such as burgers and cake), less desirable foods (vegetables), or neutral pictures of rocks and trees.

You've tried different diets — and have even been exercising regularly — but those extra pounds won't budge. Don't give up. It may be that you haven't yet found the weight-loss strategies that work for you.

"Everything works for some people, but no treatment is equally effective for everyone," says Dr. Lee Kaplan, director of the Obesity, Metabolism and Nutrition Institute at Massachusetts General Hospital. "No method is fundamentally better than any other. The key is finding out which therapy is best for you, and that takes trial and error."

You may be storing unhealthy amounts of visceral fat even if your weight appears normal.

For decades, the body mass index (BMI) has been the gold standard for gauging obesity-related heart disease risk. But this handy tool doesn't always tell the whole story. It extrapolates your body fat percentage based on your height and weight (see www.health.harvard.edu/bmi-calculator). But the formula can't assess how or where your body stores its excess fat — a distinction that is crucial for cardiovascular health. By some estimates, the BMI misclassifies nearly 50% of people who are at higher disease risk from excess fat, meaning that you can be overfat even when you're not overweight.

The secret life of belly fat

Some people are genetically programmed to have a lot of fat tissue under the skin, which is deployed to store extra food energy during times of scarcity. But other people have very few of these designated fat cells, explains Dr. Christos Mantzoros, professor of medicine at Harvard-affiliated Beth Israel Deaconess Medical Center.

Research we're watching

People who carry excess weight but have normal blood pressure, blood sugar, and cholesterol values are sometimes dubbed "fat but fit." But they're still more likely to develop heart disease than people who aren't overweight, a new study suggests.

Researchers analyzed more than 7,600 cases of heart disease that occurred over a 12-year period in 10 European countries. They also used data from 10,000 healthy people without heart disease as a comparison group. Compared with people at a healthy weight, those who were overweight or obese had up to a 28% higher risk of developing heart disease.

Research we're watching

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Close to a third of Americans say they use artificial sweeteners on a daily basis. Popular examples include aspartame (Equal, Nutra­Sweet), sucralose (Splenda), and stevia (Truvia, Pure Via). They're all available in packets and are also added to soda, yogurt, and other foods.

But do these sugar substitutes actually help you lose weight? New research suggests they do not. In fact, these zero-calorie additives may have the opposite effect — and possibly even increase the risk of high blood pressure, diabetes, and heart disease.

News briefs

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If you haven't been good about eating a healthy diet, take heart: A Harvard study published July 13, 2017, in The New England Journal of Medicine found that changing to one of three scientifically developed healthy eating programs was associated with longer life. The healthy diets included the Alternate Healthy Eating Index, the Alternate Mediterranean Diet, and the Dietary Approaches to Stop Hypertension (DASH) diet. Scientists looked at self-reported diet and health data from nearly 74,000 healthy men and women who significantly improved their diets and maintained them for 12 years. Scientists then looked at participants' risk of death for another 12 years. The results: people who improved their diet the most were up to 17% less likely to die, whereas those whose diets worsened the most were up to 14% more likely to die. This study strongly indicates that improving your diet, even if you start in middle age, can add years to your life — and vice versa. If you're re-evaluating your diet, check out the Harvard Special Health Report Healthy Eating for a Healthy Heart (www.health.harvard.edu/HEHH).

Research we're watching

Not only is obesity a risk factor for flu complications, but it might actually make the flu vaccine less effective, says a study published online June 6, 2017, by the International Journal of Obesity. Scientists at the University of North Carolina at Chapel Hill found that the flu shot provides less protection in people who are obese.

The study compared flu rates in 1,022 people during two recent flu seasons. All participants were vaccinated against the flu. The researchers looked at immune response to the vaccine and also tracked who went on to get the virus. They found that nearly 10% of obese participants got the flu, compared with 5% of their healthy-weight counterparts. This is bad news, because individuals with a body mass index of 40 or higher are also more prone to flu complications.