Many of us eat for emotional reasons. When you feel sad or depressed, you might eat in an attempt to make yourself feel good. Inactivity and the availability of copious amounts of "fast" and sugar-loaded food also contribute to the high number of overweight people in the United States.
Western (Allopathic) Medicine and Weight Control
The allopathic solution to weight control is simple: eat less and exercise more. The problem is that not all diets are the same in their ability to properly nourish the body. Many fad diets purposely eliminate one complete food group (the zero-carb or no protein diet), or focus on eating one food to the near exclusion of all others (the grapefruit diet). These diets work in the short run because the body cannot metabolize food for fuel when a complete spectrum of nutrients does not exist. This is like losing weight from malnutrition, and is a very unhealthy.
Restrictive operations make the stomach smaller. The theory is, with a smaller stomach, you will feel full a lot quicker than you are used to. This also means that you will need to make big lifelong changes in how you eat-including smaller portion sizes and different foods-in order to lose weight. The most common restrictive surgery is adjustable gastric banding. In this operation, a small band is placed around the upper part of the stomach, creating a small pouch. In stomach stapling (vertical banded gastroplasty), an incision is made in the abdomen. Surgical staples and a plastic band are used to create a small pouch at the top of the stomach.
Limitations and Risks
If you do not chew your food well or do not stop eating soon enough, you may feel discomfort or nausea and may sometimes vomit. If you drink a lot of high calorie liquid such as soda or fruit juice, you may not lose weight. If you continually overeat, the pouch may stretch. If the pouch stretches, you will not benefit from your surgery. You may also develop nutritional problems and need to take vitamins.
A review of studies on stomach stapling (vertical banded gastroplasty) notes that 60% of excess weight (the weight above what is considered healthy) was lost, although a large portion of people regained the lost weight after 3 to 5 years.
Risks common to all surgeries for weight loss include an infection in the incision, a leak from the stomach into the abdominal cavity (resulting in an infection called peritonitis), and a blood clot in the lung (pulmonary embolism). About one-third of all people having surgery for obesity develop gallstones or a nutritional deficiency condition such as anemia or osteoporosis.
Herbal Remedies
There is also a disturbing trend toward using so-called "herbal" remedies to lose weight. Remember, herbs are medicine, and you should never take herbs without first consulting an NCCAOM board-certified herbologist. There have been cases of dangerous and deadly results from misusing herbal ephedra that was chemically treated and highly concentrated, then sold as weight control supplements. A board certified herbologist would never prescribe herbal ephedra by itself and in large, chemically treated, concentrated doses. Ephedra in and of itself is not a dangerous substance. In the hands of a trained, board certified herbologist, it can be an effective and safe tool for treating disease.
Hoodia
Hoodia is another newly rediscovered herb that is currently being mass-marketed as a weight loss supplement. Hoodia is in the plant family Apocynaceae, stem succulents that can reach up to three feet high and present exuberant flowers, often with flesh color and strong smell. Hoodia is a protected plant that grows in the Namib Desert. Common names include "Bushman's Hat" and "Queen of the Namib." Bushmen from the area have purportedly been using hoodia for centuries to help ward off hunger, dehydration and starvation during long trips in the desert. Recently, Western companies have harvested hoodia, chemically treated it, concentrated it into pills and are marketing it as a "natural" herbal appetite suppressant and weight loss remedy.
Below are some questions and answers from the United States Food and Drug Administration (FDA) Center for Drug Evaluation and Research about the drug fen-phen. Keep in mind that fen-phen will probably not be the last pharmaceutical used by allopathic doctors in weight control and appetite suppression. Most all of these drugs have serious and sometimes deadly side effects.
Fen-phen was an anti-obesity medication (an anorectic) which consisted of two drugs: fenfluramine and phentermine. Phentermine has also been used in combination with dexfenfluramine ("dexfen-phen"). Fenfluramine ("fen") and phentermine ("phen") are prescription medications that have been approved by the FDA for many years as appetite suppressants for the short-term (a few weeks) management of obesity. Phentermine was approved in 1959 and fenfluramine in 1973. Dexfenfluramine (Redux) was approved in 1996 for use as an appetite suppressant in the management of obesity. Recently, some physicians have prescribed fenfluramine or dexfenfluramine in combination with phentermine, often for extended periods of time, for use in weight loss programs. Use of drugs in ways other than described in the FDA-approved label is called "off-label use." In the case of fen-phen and dexfen-phen, no studies were presented to the FDA to demonstrate either the effectiveness or safety of the drugs taken in combination.
Fenfluramine (Pondimin) contains dexfenfluramine and levofenfluramine. Levofenfluramine may have some activities not directly related to appetite suppression. Dexfenfluramine (Redux) contains only dexfenfluramine.
On July 8, 1997, the Mayo Clinic reported 24 patients developed heart valve disease after taking fen-phen. In five patients who underwent valve replacement surgery, the diseased valves were found to have distinctive features similar to those seen in carcinoid syndrome. The cluster of unusual cases of valve disease in fen-phen users suggested that there might be an association between fen-phen use and valve disease.
On July 8, FDA issued a Public Health Advisory that described the Mayo findings. The Mayo findings were reported in the August 28 issue of the New England Journal of Medicine, along with an FDA letter to the editor describing additional cases. FDA has received over 100 reports (including the original 24 Mayo cases) of heart valve disease associated mainly with fen-phen. There were also reports of cases of heart valve disease in patients taking only fenfluramine or dexfenfluramine. No cases meeting FDA's definition of a case were reported in patients taking phentermine alone.
Recently, additional information received by the FDA has raised more concern. Most of the cases previously brought to the FDA's attention were in patients who had symptoms of heart disease. Recently, FDA has received reports from five physicians who had performed heart studies (echocardiograms) on patients who had received fen-phen or dexfen-phen and did not have symptoms of heart disease. Of 291 asymptomatic patients screened, about 30 percent had abnormal valve findings, primarily aortic regurgitation. Based on these data, the manufacturers have agreed to withdraw the products from the market and FDA has recommended that patients stop taking the drugs.
At the present time, no cases of heart valve disease meeting FDA's case definition have been reported with phentermine alone. Analysis of the data points to an association of heart valve disease with fenfluramine and dexfenfluramine.
The type of valve disease that FDA believes may be associated with fenfluramine and dexfenfluramine is an extremely unusual type of drug reaction. Because valve disease is not usually associated with drug use, it is not normally screened for in human clinical testing of drugs. Since valvular heart disease is not screened for in clinical trials, it would usually not be detected unless patients developed symptoms. No cases were detected in 500 patients followed for one year in a clinical trial of dexfenfluramine. Furthermore, asymptomatic heart valve disease (heart valve disease without symptoms) would not likely be detected in patients taking the drugs as part of a weight loss program. The number of patients who have been reported to have symptoms of heart valve disease associated with recent exposure to the drugs has been very small, compared to the number of recent prescriptions, although there may be a delay in the development of symptoms. And even in symptomatic patients, the link between the symptoms and drug use may not be obvious because such a reaction is not common. These factors may explain why this problem was not discovered earlier.
During the last few years, there has been a marked increase in amount and duration of use of fenfluramine, as it became widely prescribed as part of the fen-phen regimen. In 1992, articles were published about study results suggesting that the combined use of phentermine and fenfluramine would result in significant weight loss when used over an extended period of time. The results of these studies were not reviewed by FDA, and the conclusion about long-term use of the combination of drugs has not received FDA approval. The increased magnitude and duration of use probably led to an increase in the number of cases of symptomatic heart valve disease, which may have contributed to the recent recognition of this association.
With respect to dexfenfluramine (Redux), which was approved on April 29, 1996, the labeling states that safety has not been shown for longer than one year of use. This reflects the length of the study upon which dexfenfluramine was approved. It was a one-year European study of 1,000 subjects, half of whom were treated with dexfenfluramine. The study population was 80 percent women with an average age of 41. Heart disease was not noted in the study. A follow-up study directed toward uncovering heart disease after termination of the study was not performed because there was no reason to believe at that time that the heart was affected. In addition, dexfenfluramine had been marketed in Europe for over a decade without detection of an association between dexfenfluramine and heart valve problems. FDA is currently trying to obtain such follow-up.
The heart contains four major valves that regulate the flow of blood through the heart and to the lungs and general circulation. Disease may cause excessive tightness (stenosis) or leakiness (regurgitation) of the valves. In the case of valve disease associated with fenfluramine and dexfenfluramine, leakiness is the problem. Valvular damage may ultimately produce severe heart and/or lung disease.
Patients who have taken those drugs may have changes in their heart valves that cause leakiness and backflow of blood. If this is severe, the heart has to work harder. This may cause problems in heart function. However, the full medical implications of this relationship, especially in the asymptomatic patients, is not fully understood.
The patient may have no symptoms. The physician may hear a new heart murmur (abnormal sound as the blood flows over a valve), or the changes may be detected with a painless, non-invasive special heart test called an echocardiogram. An echocardiogram is usually performed by a cardiologist. If the disease is severe, the patient may experience such symptoms as shortness of breath, excessive tiredness, chest pain, fainting, and swelling of the legs (edema).
It is not known at this time. One report has been submitted to FDA in which the valve disease appeared to improve. However, we encourage those people who have taken fenfluramine or dexfenfluramine to contact their physician and discuss the appropriate follow-up, even after stopping their medicine. The full medical implications of these findings are not known at this time, especially as they relate to the asymptomatic valvular changes. The FDA and other government agencies, the manufacturers, and medical researchers will aggressively follow this concern and keep patients and health care providers informed of what is learned about the natural history of the valvular disease caused by these medications.
Yes, this is the FDA's recommendation. Although we believe these drugs can be stopped at once for most persons, you should consult your physician about whether he/she advises you to taper the dosage over, for example, a 1 to 2 week period. The manufacturers of these drugs are withdrawing fenfluramine and dexfenfluramine from the marketplace, effective September 15, as the concerns about the effects of these drugs on heart valves continue to grow. The drugs will no longer be available in pharmacies. Though the potential long-term medical implications are not known at this time as there are still a number of unanswered questions, the FDA and the manufacturers believe it is in the best interest of the patients that they stop taking these medications. Please be aware that at present this recommendation does not apply to phentermine taken alone.
You should consult your physician about having an echocardiogram. Your physician's recommendation will depend upon your symptoms, if any, his or her examination of you and your history of exposure to these drugs.
You should consult your physician about having an echocardiogram. Your physician's recommendation will depend upon your symptoms, if any, his or her examination of you and your history of exposure to these drugs.
Herbal fen-phen is a product that does not contain fenfluramine, dexfenfluramine, or phentermine. Products called "herbal fen-phen" often contain a combination of ephedra (an ephedrine containing herb) and caffeine, but may also contain other herbal ingredients. FDA has not reviewed these herbal products for safety or efficacy. Ephedrine is pharmacologically different from fenfluramine and dexfenfluramine.
FDA has not reviewed the safety or efficacy of such combinations and has not approved their use. These drugs are active in serotonin metabolism but have somewhat different activity than fenfluramine and dexfenfluramine. No currently available weight-loss drugs have been studied adequately in combinations to permit a recommendation by FDA for combined use.
The citizen petition did not contain any additional medical information that was not already known. The FDA had taken appropriate actions based on the knowledge at that time. Since that time, more information has been obtained that raised enough additional concerns to warrant withdrawal of Redux from the market.
Though the majority of cases of which FDA is aware are women, there is no reason at present to believe that men are not also at risk. Most of the use of these products is in women, so what we have seen to date could be only a reflection of the usage patterns of the products. FDA advises that both male and female patients consult their health care professionals.
"Ear Stapling" is practiced by some medical clinicians who often possess an incomplete and rudimentary knowledge of acupuncture to promote weight loss. The "staple" is an actual staple made of metal, approximately one centimeter in length and three millimeters wide. It is crimped deep (approximately two millimeters, transversely) into the cartilage of the ear and leaves two exposed wounds per staple. It is left in the ear for one month or more at a time and may be constantly sore, painful, irritating and extremely tender to the touch. The chance for inflammation and/or infection is very high.
A licensed acupuncturist who has received a three to four-year Masters of Traditional Oriental Medicine or a Masters in Acupuncture does not learn ear stapling in graduate school and would never use this dangerous technique. Always consult a licensed and board certified acupuncturist before receiving "ear stapling." You will save yourself much pain and grief.
Dr. Hsu has always said: "There is no magical cure for weight loss!" Acupuncture and Chinese herbs are complementary therapies. An overweight or obese person must be willing to make a deep, long-term commitment to controlling their weight. Any therapy for weight control must be combined with a proper diet and exercise.
Acupuncture for weight loss works on different levels. Acupuncture can stimulate the body's production of serotonin and endorphins. Thereby relaxing the person so they can avoid stress eating. Acupuncture has also been shown to improve the muscle tone of the gut to decrease hunger. Furthermore, acupuncture affects the hypothalamus which among many other things, plays a large role in the mechanisms of hunger.
Some people are anxiety eaters. TCM is particularly helpful in these cases because of its centering, calming and balancing function. Once stress is relieved, the desire to eat for comfort is lessened. For another look at how stress can affect the body, visit our page on stress relief.
Traditional Chinese Medicine makes the following dietary recommendations:
Eat small meals
Eat warmed, fresh cooked food
Avoid cold drinks and frozen food
Avoid fried foods
Avoid alcohol
Avoid caffeine
Avoid anything with added sugar
Avoid fast food and junk food
Ear acupuncture, or auricular acupuncture, is very effective for weight control. Acupuncture stimulates the auricular branch of the vagal nerve and raises serotonin levels. Both of these actions increase the smooth muscle tone of the stomach, thereby suppressing appetite.
TCM also recommends daily brisk walking and swimming as gentle forms of exercise for effective weight control.
Lose weight and feel great with New York AcuHealth's Weight Control Program. Acupuncture is an effective method of appetite suppression that has shown to lead to weight loss. People report feeling full so that they eat less, and still have energy. Temporary side effects may include dizziness, headaches and nausea, but there are no permanent side effects.
After an initial consultation, the program includes of a series of 10 twice-weekly sessions. Treatment consists of the following:
Dr. Hsu creates a treatment protocol and chooses ear and body acupuncture points accordingly.
Dr. Hsu places small acupuncture ear needles in specific points chosen exclusively for a patient's condition. These needles are removed after the treatment.
Sterile, hair-thin intra-dermal needles may be placed in specific acupuncture points chosen exclusively for a patient's condition. These needles are attached and completely covered by adhesive tape. They are left in for a certain number of days and are easily, safely and painlessly removed by the patient at home or by Dr. Hsu on a subsequent visit.
Or, Dr. Hsu may use "ear seeds," which are small metal spheres or actual herbal seeds, approximately one millimeter in diameter, attached by adhesive tape onto specific acupuncture points. They are left in for a certain number of days and easily removed by the patient. The purpose of these seeds is so the patient can press and massage them when they feel an urge to overeat. Doing so can help to relax the patient and allow them to overcome these urges.
