In other words, if you don't exercise, you WILL gain the weight back. How much is enough? We recommend shooting for a minimum of 3 hours a week, which is 30 minutes 6 days a week, or 45 minutes 4 days a week. What kind of exercise do you need to do? Brisk walking or something equivalent is all that's required. If you do something more vigorous, even better. But you have to do it. I have found that most people who just say "I need to exercise and I will try to do it"  generally fail. Those who make it a part of their schedule are much more successful. As Yoda said, "Do or do not. There is no try."

What dietary change has the greatest positive effect on insulin levels? Reducing carbohydrate intake. Carbohydrates come in 2 main categories: simple carbohydrates (sugars) and complex carbohydrates (starches). By reducing our intake of this macronutrient, we can reduce our insulin levels and end up losing weight. There are two great books on the subject that I highly recommend: "The New Atkins for a New You", and "Why We Get Fat, and What To Do About It" by Gary Taube.

In addition to the weight differences, male antihistamine users had a greater waist circumference, body mass index, and fasting insulin levels, while female users had higher waist circumferences and BMIs.

In case you don't know which meds we're talking about, they include Claritin (loratadine), Zyrtec (cetirizine), and Allegra (fexofenadine).

So, you are left with a dilemma: do you take care of your runny nose and sneezing or do you gain 10-20 pounds? Hmm. Which will it be? Thankfully, there are other options for treating allergic rhinitis (nasal sprays) that don't lead to weight gain.

At MD Weight Loss, I constantly stress the importance of regular exercise to maintain weight loss. I ask all patients to aim for 3 hours of exercise per week, which is a little more than the study noted above. And I've seen it over and over again............if you refuse to exercise, you WILL regain all of your weight. All of that hard fought weight loss will have been for naught. And this study is just more supporting evidence for the benefits of exercise.

 In a recent study, participants had their caloric intake restricted to 90% of their resting metabolic rate, and were assigned to 5.5 or 8.5 hours of sleep for 2 weeks. A few months later, they crossed over to the other sleep schedule for another 2 weeks. The amount of fat lost, fat-free body mass, and some hormones were monitored. Both groups lost about 6 and a half pounds. But the people who slept for 8.5 hours lost 56% of their weight as fat, and the people who slept for 5.5 hours lost 25% of their weight as fat. The sleep deprived patients also had lower resting metabolic rates and were more hungry.

So what does it mean? If you're in the process of losing weight, you will lose more of your weight as fat if you get enough sleep. If you stay up late, get up early, run on fumes all day, and try to caffeinate yourself through the day, you will lose less fat. And if you're losing less fat, it means you're losing more muscle, which is something you want to avoid.

In this study, there were 120 patients. About half went on a VLCD (very low calorie diet) averaging 900 calories per day. These patients were taken off of regular food and placed on high-protein meal replacement shakes for about 3 months. The other half went on a standard caloric reduction diet and lost weight more gradually. 83% of the rapid weight loss patients lost at least 15% of their starting weight , compared to only 48% of the slow weight loss group. That's a pretty significant difference.

At MD Weight Loss, we offer a VLCD that has been highly successful in helping people lose a lot of weight in a relatively short time. And the studies are showing that it is successful and safe.

Some sugar cravings are due to a low blood glucose level, otherwise known as hypoglycemia (hypo = low; glycemia = glucose in the blood). Most diabetics know what this feels like. You feel weak, you get shaky, you get clammy, you've got to get something to eat RIGHT NOW!!!!!!! So what do we usually do about it? Eat an entire quart of ice cream. Eat 10 chocolate chip cookies. Sure, that takes care of the problem, but it is WAY overboard. Something equally effective, but less damaging  would be to have a couple Tic Tacs, a half glass of OJ, or one piece of toast. In order to stay out of trouble with hypoglycemia, an easy strategy is to have more frequent, small meals (5-6 per day) and increase the amount of protein and decrease the amount of sweets in the diet.

Some sugar cravings are just that: cravings. There isn't anything wrong with your blood sugar level. You just have a hankering for a Little Debbie snack cake. There are some specialists that think this is due to the overgrowth of yeast in the stomach (although this isn't proven, by any means). Treating this with probiotics can help. Probiotics give you "healthy" bacteria to wipe out the yeast.

Another type of sugar craving is due to low serotonin levels in the brain. This leads to moodiness and depression. Having an ounce of dark chocolate can help restore the serotonin levels.

As a general rule, when you're craving something to eat, but you aren't actually physically hungry, try having a glass of water and/or go for a walk.

Well, fenfluramine, the second generation, a drug called lorcaserin, has been studied extensively, has been found to be effective, and so far ---------- no heart or lung problems. And here's why. Fenfluramine was an activator of serotonin receptors in the part of the brain that affects appetite, but it also had an effect on serotonin receptors located in heart valves and pulmonary arteries. But in contrast, lorcaserin is highly selective for serotonin receptors in the brain, thus avoiding effects on the heart valves and pulmonary arteries.

In a trial, 3182 obese or overweight adults received either lorcaserin or placebo. Those receiving lorcaserin had greater weight loss, and longer maintanence of weight loss than those receiving placebo. And over a 2-year time period, there were no heart valve problems.

Lorcaserin has been submitted for FDA approval. If approved, it could be on the market within the next year or two, which would add another weapon in the arsenal against fat!!!!!!