4.
Finding a Weight Loss Program That Works For You

It seems that every time you open up a magazine or newspaper, or turn on a TV or radio, there's another ad for a miracle product promising effortless weight loss. And most of them promise that their product makes it possible to lose weight while you eat all your favorite foods and without having to exercise. ("There now exists an all-natural, bioactive weight loss compound so powerful, so effective, so relentless in its awesome attack on bulging fatty deposits that it has virtually eliminated the need to diet.") They make healthy pursuits like balanced nutrition and an active lifestyle dirty words. And they hint that all you need to do to look like the bikini-clad model in the picture is to send away for a bottle of "miracle" pills.

Each year from January through May, many people start to think about how they'll lose weight before they try on their bathing suits and tank tops. This is the when companies advertise their weight loss products and programs to appeal to peoples' desire to look svelte and shapely for the summer months. Many companies advertise their products and services responsibly, but others promise effortless weight loss from "miracle" pills or gadgets. They inundate the media with ads full of hype and empty promises. It's enough to make you sick.

There are no weight loss miracles. Sensible weight loss and healthy weight management generally require eating less and exercising more. Any advertisement for a weight loss product or service that says you don't have to change your eating habits or increase your physical activity level to lose weight is selling false hope.

Many advertisements for weight loss products and services are scientifically groundless. Yet mainstream newspapers, magazines, radio stations, and broadcast and cable TV outlets run ads for weight loss products that routinely promise the impossible. And many people believe the ads because they appear in the media they trust.

To call attention to the media's responsibility to screen ads for weight loss products and services that promise far more than they can scientifically deliver, the Partnership for Healthy Weight Management is inaugurating Ad Nauseam, a new campaign.

bulletEvery year, the Partnership for Healthy Weight Management will publish a list of claims made in ads during the previous year for products or services that promise results so extravagant, any responsible media outlet should have demanded proof before accepting them for publication.
bulletMedia outlets that published or broadcast the ads will be identified.
bulletMedia indicating they have adopted strategies to screen out dubious ad claims for weight loss products also will be identified.

Ad Nauseam: The year 2000 Ads Nauseam include the following dubious claims: "`I lost 93 POUNDS! . . . Quickly, Easily & No Dieting.' New. Now Available Without A Prescription. . . . People have reported losing the first 10 pounds within a few days and up to 50 pounds the first month. Even if you want to lose 100 or more pounds [product name] can be your answer."

"Lose Up to 2 Pounds Daily. Without diet or Exercise."

I Lost 44 Pounds in 30 Days."

"NEVER be fat again with the [product name] . . . The [product name] eliminates fat for effortless weight loss. Same results as: Jogging 10 miles per week. An hour of aerobics per day. 15 hours of swimming or cycling per week."

"The Miracle of Body Fat Reduction. Where do you want to lose weight? It's the same for everyone. Body fat always gravitates to the stomach, the buttocks, that hips and legs. [Product name] will help to rapidly reduce the fat in all these areas. It does this by redirecting these problem fat cells to the muscles of the body where they can be burned off more easily. By taking just one tablet before every meal, the weight gaining process can be averted by simply maintaining that same plan."

"First Time in the U.S.A. The Sensational French Weight Loss Discovery. Watch Pounds Practically Melt Off Your Body From Day One. As excess Fat and Unsightly Cellulite Are Instantly Attacked! Eliminates 10-20-35-50 pounds with ease.
bulletNo Effort Required: eat everything you normally eat.
bulletNo Risk to Your Health: no fatigue, no side effects, no mood changes. A 100% natural method to lose weight.
bulletNo Dieting Ever: no food restrictions, or exercise programs.
bulletNo Constraints of Any Kind: your day to day activities do not change. The only change is how much better you will look."

"Imagine Losing As Much As 50% Of All Excess Fat In Just 14 Days! Not Even Total Starvation Can Slim You down and Firm You Up This Fast Safely!...Lose Up to 1 Full Pound Every 8 Hours. Lose up to 2 1/2 to 3 full pounds each day and you do it without counting calories."

"Amazing Fat Fighting Pill Ends Hunger - Guarantees Super Fast Weight Loss! U.S. Patent reveals weight loss of as much as 28 lbs. in 4 weeks and 48 lbs. in 8 weeks... There now exists an all-natural, bioactive weight loss compound so powerful, so effective, so relentless in its awesome attack on bulging fatty deposits that it has virtually eliminated the need to diet. . . . Eat all your favorite foods and still lose weight (pill does all the work.)"

"This extraction of sweet acids contained in tropical fruits will allow anyone, including those who have never succeeded in losing weight, to activate their metabolism and lose up to 14 pounds per week."

"New Medical Breakthrough! `Lose A Pound A Day Without Changing What You Eat' . . . You will get a risk-free opportunity to get the trim, sexy body you've always dreamed of in days or weeks, instead of months or years, without going through painful exercise and unbearable diets."

"Watch fat melt away with [product name]. No impossible exercise! No missed meals! No dangerous pills. No boring foods or small portions! Just fast and easy, effective weight loss! [Product name] is the easiest way to successfully lose weight you'll ever try. It doesn't require grueling exercise. There are no dangerous pills or tablets to take. Best of all, you continue to eat your favorite [sic] foods!"

"The new fat-fighter. Slimming capsules that soak up fat! . . . This brand new Swiss formulated high power diet-pill has been created and discovered by Dr. , M.D., for men and women to lose weight and bind fat from foods you have eaten. The idea is as brilliant as it is simple. Have you ever seen an overweight fish? Or an oyster with a few pounds too many? Everyone knows that sea animals never get fat. That's because their bodies contain [product name] which is now available as a diet pill for everybody who wants to lose unwanted fat. [Product name] reduces body fat deposits in the belly, thighs, and butt. It also makes sure that the fat from your last meal leaves your body before being digested."

"Now everyone can easily burn off excess weight without changing diet or taking exercise!.. . You do not have to change the food you eat. This is not a starvation diet and you do not have to take grueling pointless exercise. [Product name] starts incinerating your fat and slimming your figure from day one. It is 100% natural so it is totally safe. We guarantee that you'll lose between 2 and 8 pounds a week until you reach your target weight and sexy figure and you won't put the fat back on!"

"You lose weight even if you eat too much. These active pineapple [product name] tablets that you can now receive on a free trial basis force your body to dissolve all its excess fat. You should know that 8 tablets contain the weight loss power of 16 whole pineapples. Consequently, even if you continue to eat normally, even if you eat too much, you are literally forced to lose your excess pounds. You will lose at least 16 pounds in the first two weeks. And at least six pounds every week thereafter."

Media Culpa: This year's collection of dubious ad claims were published in the following magazines and newspapers during 1999 and the first two months of 2000:

Cosmopolitan Magazine
Esquire Magazine
McCall's Magazine
Redbook Magazine
Woman's Day Magazine
The Atlanta Journal - Constitution
The [Denver] Rocky Mountain News
USA Today

Source: Smart Source, a publication of News America, FSI, Inc.  

Nutrition Action Health letter Rates Diet Books

WASHINGTON-The best-selling diet book authored by talk-show self-help guru Dr. Phil McGraw is a "tough-love manual that relies more on Dr. Phil's opinion than on science," but it at least recommends mostly healthful foods, according to the nonprofit Center for Science in the Public Interest (CSPI). Dr. Phil's line of expensive dietary supplements, shakes, and nutrition bars, on the other hand, are high on quackery and aren't likely to help anyone lose weight, according to the cover story in the January/February 2004 issue of CSPI's Nutrition Action Health letter.

Dr. Phil's program encourages dieters to spend $60 a month on a 12-pill-a-day regimen. He offers one set of supplements and vitamins for what he calls "pear" body types and another for "apple" body types. In addition, he recommends spending an additional $60 a month to swallow 10 more so-called "Intensifier" pills each day. But according to CSPI, none of those pills' ingredients has been shown to promote weight loss.

"Dr. Phil's pills are certain to lighten your wallet, but not your weight," said CSPI senior nutritionist David Schardt.

Although Dr. Phil says his Shape Up! Shakes contain "scientifically researched levels of ingredients that can help you change your behavior to take control of your weight," CSPI says that they're just a run-of- the-mill powder made from milk, fiber, and vitamins. And his bars, made from sugars, oil, soy protein, fiber, and still more vitamins, seem formulated without the help of Dr. Phil's book, The Ultimate Weight Solution, which declares sugars and fats "off-limits if you want to successfully control your weight."

In its article about popular diet books, CSPI called The South Beach Diet by Arthur Agatston a "healthy version of the Atkins diet that's backed by solid evidence on fats and heart disease." Despite an unwarranted restriction on perfectly healthful foods like carrots, bananas, pineapple, and watermelon, CSPI says South Beach is the first popular weight- loss book in a long time to recommend a healthy diet.

CSPI criticized Dr. Atkins' New Diet Revolution for promoting diets heavy in red meat, long-term consumption of which may raise the risk of cancer and heart disease. Other diet books, including The New Glucose Revolution recommend mostly healthy foods, but overemphasize the importance of the glycemic index on weight loss, according to CSPI. "The glycemic index is much more complicated than most books pretend," writes CSPI nutrition director Bonnie Liebman.

Another book, Eat Right 4 Your Type recommends different foods depending on one's blood type and is "about as scientific as a horoscope," according to CSPI. (For example, the book recommends that women with a family history of breast cancer consider eating more snails.)

The Fat Flush Plan, which like Dr. Phil's book recommends a useless and expensive pill regimen, recommends reducing fatty deposits in thighs and arms by "cleansing your lymphatic system with a bouncing action or by moving your arms while walking briskly." CSPI is all in favor of brisk walking, but says The Fat Flush Plan is a "kooky mishmash of old detox lore and new good-carb theory."

Barry Sears' Enter the Zone and Dean Ornish's Eat More Weigh Less also recommend mostly healthy foods, but CSPI had some caveats with each.

Source: Center for Science in the Public Interest
www.cspiner.org

Weight Loss

Before you begin a weight loss program, see your primary health care provider for advice about your overall health risks and the weight loss options best for you. Health experts agree that the best and safest way for most adults to lose weight and improve their health is to modestly cut calories, eat a balanced diet and be physically active each day. Depending on your health and weight, your primary health care provider may recommend additional methods, such as medication or surgery, which carry greater risks. Consider all your choices seriously.

When you start shopping for a weight loss program, ask providers whether they follow the Voluntary Guidelines for Providers of Weight Loss Products or Services from the Partnership for Healthy Weight Management.

If a program provider doesn't know about the Guidelines, suggest they contact the Partnership at the Federal Trade Commission's address.

Participating programs will answer important questions about how their product or service works, how much it costs, how well it works and any risks involved in following the program. You'll find a detailed Checklist for Evaluating Weight Loss Products and Services. Copy this to use as a discussion guide when speaking with representatives from weight loss programs, whether or not they follow the Guidelines.

What's involved in following the program?

Ask for details about what foods and how many calories you'll eat each day, and whether the program includes regular physical activity. A weight loss program that claims you can lose weight and keep it off without changing the foods you eat or increasing your physical activity is selling a fantasy.

A sensible program encourages you to follow advice from the Dietary Guidelines for Americans, such as eating at least five daily servings of fruits and vegetables, and choosing grains (including whole grains), lean meats and low-fat or fat-free dairy products.

People usually do best when they reduce their usual calorie intake or increase the calories they use by about 500-1000 calories per day. This allows you to eat enough for good nutrition and, if followed daily, helps you lose about 1 to 2 pounds a week. For diets under 1500 calories, be sure to check with your health care provider to make sure you meet all your nutrient needs. Including low-calorie snacks in your meal plan may help prevent you from becoming so hungry that you end up overeating or binging.

What are the staff qualifications?

If a program includes assistance from staff members, ask about their training, experience and credentials. Find out what type of attention you'll receive (for example, individual counseling or group support) and how often.

What are the risks of using the product or services?
Some methods for losing weight are riskier than others. Diets that require drastic food restriction should be under the supervision of a physician. Get details about side effects or risks that can occur from using the product or service. Check with your primary health care provider before you take prescription or over-the-counter weight loss drugs or other products that are part of the weight loss program. Steer clear of harmful "self-help" weight loss tactics, such as smoking, fasting, purging, or abusing laxatives.
What are all the costs of this program?

Ask for an itemized price list that includes membership fees, fee for weekly visits, and costs for items, such as diagnostic tests, food meal replacements, dietary supplements, or other products in the program.

How can I improve my chances for keeping the weight off?

The Guidelines require participating programs to give you information about difficulties that many dieters experience with keeping weight off and how you can increase your odds for success.

How successful are other people who follow this program?
Ask whether the program can provide studies that document its success. If so, ask what percentage of all customers have completed the program, how much weight they lost, and how successfully they've kept the weight off over a one-year period or longer. Although the Guidelines do not require providers to disclose detailed program results, providers may give you some of this information. Remember, information based on only some of the people in the program probably reflects those most successful at meeting their weight loss and maintenance goals.
What if a provider claims to follow the guidelines, but won't answer my questions?

No law requires providers of weight loss products or services to give you the information the Guidelines call for. However, a provider that claims to follow the Guidelines must give you all required information and it must be truthful and accurate.

If a provider claims to follow the Guidelines, but does not give you all required information, or if you suspect the information is not truthful or accurate, call the the Federal Trade Commission's (FTC) toll-free help line at 1.877.FTC.HELP, use the FTC's online complaint form at www.ftc.gov/ftc/complaint or contact the Partnership at the address below:

Federal Trade Commission
Bureau of Consumer Protection
600 Pennsylvania Avenue N.W.
Washington, D.C. 20580
Attention: Partnership for Healthy Weight Management

Being Overweight: A Risky Business

People choose to lose weight for many reasons looking better and feeling more energetic are two popular reasons. Improving or keeping your health is the most important reason.

Being overweight, eating poorly, and being physically inactive all increase your risk for high blood pressure, heart disease, stroke, diabetes, and some forms of cancer. Other factors affecting your disease risk include your family and medical history, and lifestyle factors such as whether you smoke or drink too much alcohol.

If you are overweight, losing just five to 10 percent of your weight and keeping it off lowers your risk for developing most of these diseases. For example, an overweight 200-pound person who loses 10 to 20 pounds may reduce risk for disease and improve health problems, such as high blood pressure or high blood cholesterol. Adopting more healthful eating habits and daily physical activity can better your health, even if you don't lose weight. This section helps you rate whether your weight puts you at risk for health problems.

Rate your risk

The number you see on the scale doesn't necessarily tell you whether you need to lose weight. That's because two people of the same height and weight can have different bone structures and carry different amounts of muscle and body fat. For most adults, determining your Body Mass Index (BMI) and waist size are reliable ways to tell whether you are overweight and to estimate your risk for health problems.

Your BMI uses your height and weight to estimate how much fat is on your body. A BMI of at least 25 indicates overweight. A BMI of 30 or more indicates you are obese. Generally, the higher your BMI, the higher your weight risk.

Your waist size indicates whether you have an "apple" shape and tend to carry fat around your midsection. Your health risks increase even further with increasing waist size. A waist measurement greater than 40 inches for men or 35 inches for women indicates a significant increase in health risk.

To tell whether your weight is a health risk, locate your BMI in the "Find Your BMI" chart on the next page. Then, measure your waist at the point below your ribcage but above your navel. Use your BMI and waist size to determine your risk using the Weighing Your Risk chart.

If your weight puts you at increased risk for health problems, talk with your primary health care provider about safe and suitable options for improving your health. Use the Checklist for Evaluating Weight Loss Products and Services on the next pages to gather information about different programs so you can choose the best one for you.

Find your body mass index (BMI)

Find your height in the left hand column. Then, move across the row to your weight. The number at the top of the column is your BMI.

Use this chart to see whether your weight puts you at increased risk for health problems. Find your BMI in the left-hand column. Then, locate your waist size in one of the top columns. The box where the two meet shows your level of risk.

Body Mass Index (BMI)   Waist less than or equal to 40 in. (men) or 35 in. (women) Waist greater than 40 in. (men) or 35 in. (women)
18.5 or less Underweight - N/A
18.5-24.9 Normal - N/A
25.0-29.9 Overweight Increased High
30.0 -34.9 Obese High Very High
36.0 -39.9 Obese Very High Very High
40 or greater Extremely obese Extremely High Extremely High

Personal Health Profile Evaluation Checklist

Complete this profile with your primary health care provider to help you choose a weight loss program that's best for you.
My weight in pounds is: __________________
My height in inches is: __________________
My BMI* is: __________________
My weight puts me at an
increased high
very high extremely high
risk for health problems.
Using the Weighing Your Risk chart to calculate.

Information from my primary health care provider:

My Blood pressure is: __________________
My blood cholesterol is: __________________
My BMI* is:  __________________
My HDL cholesterol is: __________________
My LDL cholesterol is:  __________________
My blood triglyceride level is:  __________________
My fasting blood sugar is: __________________
* If your health care provider says these values are outside healthy ranges, you can improve them by losing and maintaining a moderate weight loss goal of five to 10 percent of your body weight, and increasing your physical activity level.

Checklist for Evaluating Weight Loss Programs and Services

Use this checklist to gather and compare information from all weight loss programs you're considering

Make several copies of the blank form so you can fill out one for each program. A provider's willingness to give you this information is an important factor in choosing a program. If you need help to evaluate the information you gather, talk with your primary health care provider or a registered dietician.
Program Name:  ______________________________________________
Address:  ______________________________________________
______________________________________________
Phone: ______________________________________________
In this program, my daily caloric intake will be: ______________________________________________
I will will not be evaluated initially by program staff.
The evaluation will be made by (check all that apply):
Physician Nurse Registered Dietician Other company trained employee

My progress is supervised by (check all that apply):

Physician Nurse Registered Dietician Other company trained employee
I will  will not be evaluated by physician during the course of my treatment.
During the first month, my progress will be monitored:
Weekly Biweekly  Monthly Other ________________________
After the first month, my progress will be monitored:
Weekly Biweekly  Monthly Other ________________________
My weight loss plan includes (check all that apply):
Nutrition information about healthy eating At least 1,200 calories/day for women
Keeping food diaries or other monitoring activities Suggested menus and recipes or 1,400 calories/day for men
Liquid meal replacements Portion control
Dietary supplements (vitamins, minerals, botanicals, herbals) Prepackaged meals
Help with weight maintenance and lifestyle changes Prescription weight loss drugs
Surgery
My plan includes regular physical activity that is (check both if both apply):
Supervised (at the program site) _____ times per week ____ minutes per session
Unsupervised (on my own time) _____ times per week ____ minutes per session
The physical activity includes (check all that apply):
Walking Aerobic dancing Strength training
Stationary cycling Swimming Other_______________
The weight loss plan includes (check all that apply):
Family counseling Group support  Lifestyle modification advice
Weight maintenance advice
The staff explained the risks associated with this weight loss program. They are:
____________________________________________________________________
____________________________________________________________________
The staff explained the costs of this program. (Check all that apply and fill in the blanks.)
I will be charged a one-time entry fee of $ _________
I will be charged a $ _________ per visit.
Food replacements will cost about $ _________ per month.
Prescription weight loss drugs will cost about $ _________ per month.
Vitamins and other dietary supplements will cost about $ _________ per month.
Diagnostic tests are required and will cost about $ _________.
Other costs include ________________________ at $ _________.
Total cost for this program $ _________.
The program gave me information about:
The health risks of being overweight. The difficulty many people have maintaining weight loss
The health benefits of weight loss How to improve my chances at maintaining my weight.
Other information to ask for:
Participants in this program have lost an average of ___lbs. over ___months/years.
Participants in this program have kept off ___% of their weight loss for ___year(s).
This information is based on the following (check one):
All participants.
Participants who completed the program.
Other _______________________________________
Notes:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

Membership List

The Partnership for Healthy Weight Management was organized in 1998 to promote reliable methods for healthy weight management. The partnership is composed of organizations and individuals from industry, public advocacy organizations, government agencies, scientific associations, and universities.

The Partnership issues Voluntary Guidelines for Providers of Weight Loss Products and Services to encourage weight loss programs to provide consumers with basic program information. Providers of weight loss products or services that choose to follow these guidelines will give you information to help you make sound weight management decisions.

To receive a copy of the Voluntary Guidelines for Providers of Weight Loss Products and Services, go to the Partnership for Healthy Weight Management Web page at www.consumer.gov/weightloss or write:

Federal Trade Commission
Consumer Response Center
600 Pennsylvania Avenue, NW
Washington, DC 20580
Attention: Partnership for Healthy Weight Management

American Association of Lifestyle Counselors
Dallas, TX
Lindora Medical Clinics
Costa Mesa, CA
American Dietetic Association
Chicago, IL
Maryland Department of Health and Mental Hygiene
Division of Cardiovascular Health and Nutrition
Baltimore, MD
American Obesity Association
Washington, DC
Medical University of South Carolina Weight Management Center
Charleston, SC
American Society for Clinical Nutrition
Bethesda, MD
The National Heart Lung and Blood Institute
National Institutes of Health
Bethesda, MD
American Society for Bariatric Physicians
Englewood, CO
The National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
Bethesda, MD
American Society for Bariatric Surgery
Gainsville, FL
The New York Obesity Research Center
New York, NY
Center for Bariatric Medicine
Roanoke, VA
North American Association for Study of Obesity
Silver Spring, MD
Centers for Disease Control and Prevention
Atlanta, GA
Novartis Nutrition Corporation, St. Louis Park, MN
Chapman & Company
Charlottesville, VA
Pharmacists Planning Services, Inc.
San Rafael, CA
Comprehensive Weight Control
Rockville, MD
Shape Up America!
Bethesda, MD
Council on Size & Weight Discrimination
Mt. Marion, NY
Slim-Fast Foods Company
West Palm Beach, FL
Department of Nutrition Sciences
University of Alabama at Birmingham
Birmingham, AL
Society for Nutrition Education
Bethesda, MD
Division of Nutrition Research Coordination
National Institutes Of Health
Bethesda, MD
Tanita Corporation of America
Arlington Heights, IL
eDiets.com
Deerfield Beach, FL
The Theodore Vanltallie Center for Nutrition
and Weight Management
St. Lukes-Roosevelt Hospital Center
New York, NY
Federal Trade Commission Bureau of Consumer Protection
Washington, DC
University of Colorado
Center for Human Nutrition
Denver, CO
The George Washington University Obesity Management Program
Washington, DC
U.S. Food and Drug Administration
Center for Food Safety and Applied Nutrition
Washington, DC
Health Management Resources
Boston, MA
Weight Watchers International, Inc
Woodbury, NY
International Food Information Council
Washington, DC
Wheat Foods Council
Parker
Jenny Craig, Inc.
Del Mar, CA
Knoll Pharmaceutical Company
Mt. Olive, NJ

The Partnership for Healthy Weight Management

Federal Trade Commission
Bureau of Consumer Protection
601 Pennsylvania Avenue, NW
Room 4302
Washington, DC 20580
www.consumer.gov/weightloss

International Food Information
Council Foundation
1100 Connecticut, NW , Suite 430
Washington, DC 20036
http://ifcinfo.health.org

Read Chapter 5