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    Weight Management Program
    West River Center
    146 West River Street
    Suite 11A
    Providence, RI 02904


  • Ask Vincent Pera, MD: Questions About Losing Weight

  • I gained 10 pounds during the holidays and now my clothes don't fit. If I go back to my regular eating habits will the weight come off or should I start a diet?

    A gain of 10 pounds certainly is not uncommon during the holiday season. This, however, represents the equivalent of 35,000 calories that are now being stored as fat. Going back to "normal eating" for most people would not ensure that these additional 10 pounds will come off in a reasonable amount of time. To lose this extra 35,000 calories of fat it would be best to cut back on calories and increase activity to account for a deficit of about 500 calories per day (compared to "normal eating"). If this is done it should take less than two months to lose the excess weight.

    I was 30 pounds overweight in my twenties. I dropped the pounds in my early thirties and have kept them off but I can't put a bite of apple pie or a piece of candy in my mouth without feeling guilty. Is this normal?

    Being accountable for food intake is an essential component of losing weight and keeping it off. Feeling "guilty" about eating high calorie foods is one way to maintain control if the "guilt" is not obsessive or extreme. When applied to eating a bite of pie or a piece of candy rarely, this might raise concerns about behavior suggestive of an eating disorder, especially if it leads one to think about purging or using laxatives to "relieve the guilt." If this is the case, intervention with a professional trained in the evaluation and treatment of eating disorders is recommended.

    Diabetes runs in my family. I'm about 45 pounds over my ideal weight and worried that I'll get diabetes, too. If I lose weight, will I lessen my chances of getting this disease?

    Diabetes and weight are strongly linked. The bad news is as weight goes up, the likelihood of developing diabetes (especially with a history of diabetes in the family) goes up dramatically. Severely overweight individuals are at a 10 to 15 times greater risk of developing diabetes than normal weight individuals. The good news is as weight comes down, the risk of developing diabetes also comes down --and for those who have diabetes, the ability to control it improves dramatically as weight comes down. For someone 45 pounds overweight with a strong family history of diabetes, losing weight would, without a doubt, be most helpful is lessening the risk of developing diabetes in the future.

    I'm a woman with thin arms and legs but I'm putting on weight around my waist. To lose the excess around my middle, should I do a particular kind of exercise, in combination with dieting?

    There are no diets that have been shown to alter weight (fat) accumulation in certain specific areas of the body. It has been shown, however, that fat cell distribution is, to a degree, under genetic influence--hence the pear-shaped body seen more commonly in females and the apple-shaped body seen in men. There are special exercises that can focus on toning and building muscle in certain areas of the body. An exercise physiologist is the best resource for learning about these exercises.

    There's so much in the media about low-fat and no-fat diets. I read somewhere that everyone needs to eat some fat so certain nutrients can be absorbed. How much fat should a person have every day?

    There are a number of vitamins and nutrients that are important nutritionally and come from fat. Recommendations for calorie-restricted diets typically suggest limiting fat to approximately 20 percent of the caloric intake and up to 30 percent for eucaloric (maintenance) diets. There are many sources of and types of fat. The health circumstances of each individual (hyperlipidemia, heart disease, diabetes and others) must also be considered in determining the most appropriate amount and types of fat for the individual's diet. A nutritionist is the best resource for determining specific dietary needs.

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