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Thursday, 22 March 2001

My Diet Isn't Working!

Written by  Dr. Oscar Taube, M.D.

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QI was wondering if you could help me out with a problem. I have tried and tried to go on a diet - I even tried diet pills and they just don't work! I work out sometimes, I play basketball all the time, but it never seems to help any!!! All my friends are really skinny and pretty and I feel like I shouldn't even be friends with them 'cause of what they look like. I have a lot of friends but I have also been made fun of. My friends are always looking at their stomachs and showing them to people, and I can't do any of that stuff cause of what people will think! I really need your help. Thanks!



AFirst of all, we need to determine whether you really need to go on a diet and lose weight. In the United States (and in many industrialized nations) there are many young people (particularly females) who have an unrealistic desire (from a health standpoint) to lose weight.

If you haven't been to your doctor or other health care provider for over a year, it would be a good idea to make an appointment for a check-up. Your doctor can check your height, weight, blood pressure, (and perhaps some other measurements) and figure out whether you are at a healthy weight for your age and height.

Sure, we all have a "standing in front of the mirror after taking a shower" opinion of our bodies ("my stomach is too flabby, my butt's too big," etc., etc.) but when it comes time to consider a weight loss program, the key question to ask ourselves is: "from a Medical Health standpoint, am I at a good weight for my height?"

If you are at a normal healthy weight, and you're terribly concerned, all the time, with losing weight, do you have an eating disorder, such as anorexia nervosa? Discussing this possibility would be another reason to see your health care provider for a check-up.

O.K., let's assume that you really are overweight for your age, and that it would be a good idea to consider a weight loss program. The rest of the answer will be based on the assumption that you are overweight.

First of all, most of the nationally known, responsible diet plans all focus on the same thing -- eating a healthy diet and getting regular exercise. It sounds as if you get a fair amount of exercise if you play basketball regularly. It is important to exercise hard enough that you are sweating by the end, and these periods should last at least 20-30 minutes. Ideally, one should exercise like this daily, but the minimum is 4-5 times per week.

The only way to effectively burn calories is with prolonged, aerobic exercise. Diet pills are a health hazard, and should not be a part of a weight loss program.

The second part of weight loss involves your diet. Many adjustments can be made to one's diet to facilitate weight loss, and not all of them should be made at one time. Limiting fast food to no more than once a week is of the utmost importance. It is also a good idea to limit fried foods and replace them with broiled and baked foods. Be bold and try to eliminate at least one major vice from your diet, such as potato chips or ice cream, and replace it with fruit.

If you're really not sure where to start on making changes in your diet, keep a diet diary. You can do this simply by stuffing a few pieces of paper in your pocket, along with a pencil. For about 5 days write down everything you eat. Once you've completed 5 days of an ACCURATE, and COMPLETE diary, do two things with it: one, make believe that you're a nutritionist, and this diary belongs to a friend, and you're reviewing it - what do you think of the diary? Does it represent a good healthy approach to eating? Would you make any changes in the meals and snacks that are listed? Two, review the diary with your health care provider or a nutrition expert.

Another very important aspect of weight loss is when to eat. Do you eat breakfast? Many people who are trying to lose weight will skip either breakfast or lunch. This is exactly the opposite of what you should do. It is important to eat 3-4 small meals a day rather than 1-2 large meals. The reason is this: When you skip a meal, your body gets nervous and wonders where the food is. Then, the next time you eat, your body tries to conserve as many of those calories as possible because it doesn't know when the next meal is coming. This actually leads to weight gain.

When you eat frequent, smaller meals your body trusts that it will be fed regularly and it burns calories faster. If you have the argument that you aren't hungry in the morning for breakfast, then you may have eaten too much the night before! Everyone should be hungry after an overnight fast.

One suggestion for weight loss might strike you as odd, because it doesn't have anything directly to do with eating or with exercise: Cut down on television! If you are overweight, ask yourself if you watch an excessive amount of television. There's a lot of excellent research that shows that children and teens who watch too much television are at increased risk for obesity. It really does make sense, when you think about it: watching television is an activity that doesn't burn off any calories, and most of the food commercials advertise high fat foods!

One final note: You should be doing what is right FOR YOU - not for you as you compare to your friends. Make sure that the way you see yourself is realistic, and that your diet and exercise plan are healthy, effective and not excessive. Again, seeing your doctor is a great idea.

Best of Luck.

Dr. Taube

Also see: Crisis Center/ Eating Disorders

Last modified on Sunday, 03 July 2011 09:30
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Dr. Oscar Taube, M.D.

Dr. Oscar Taube, M.D.

Dr. Oscar Taube is the Clinical Director and Director of Medical Education at Greenspring Pediatric Associates (Sinai Hospital Pediatric Outpatient Department) in Baltimore, and the Coordinator of Adolescent Medicine at Sinai Hospital's Department of Pediatrics. He is also an Assistant Professor of Pediatrics at Johns Hopkins School of Medicine and at the University of Maryland School of Medicine.

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