Veggie Blog

Weight loss tablets and safety

What side effects can weight loss tablets cause?

It depends on the product. Even carefully tested prescription medicines can cause nausea, diarrhea or constipation, headache and other mild problems, and the National Institute of Diabetes and Digestive and Kidney Diseases says most side effects are mild and often improve with time, while serious ones are rare. Stimulant-type ingredients found in many over-the-counter products, such as caffeine, are another story. They can raise your heart rate and blood pressure, cause jitters and make it hard to sleep, and in some people they have been linked to chest pain, a racing heart and even heart attack or stroke.

Taking more than the recommended dose is dangerous. Overdoses of stimulant diet products can cause tremors, confusion, hallucinations, seizures and heart rhythm problems, and they need emergency care. If you have taken a product for a while and want to stop, some people report tiredness, low mood, irritability and trouble sleeping. If you are taking a prescription medicine, ask your doctor before you stop.

Are over-the-counter products held to the same standard?

No. In the United States, dietary supplements, including weight loss supplements, do not need FDA approval before they are sold. The manufacturers are responsible for their safety and label claims. The National Institutes of Health Office of Dietary Supplements points out that weight loss products sold as supplements are sometimes tainted with hidden prescription drugs. Of the dietary supplements that were subject to the most serious FDA recalls between 2004 and 2012, 27% were weight loss products. Ephedra, once a common ingredient, was banned from US supplements in 2004 because of safety concerns. The same office concludes that the evidence for supplements helping with weight loss is inconclusive and unconvincing.

Who should be extra careful?

Talk to a doctor before using any weight loss product if you have heart disease, high blood pressure, thyroid, kidney or liver problems, diabetes or a history of seizures or stroke. The same applies if you are pregnant or breast-feeding, under 18, or older, and if you take other medicines, including cold remedies, antidepressants and herbal products, because they can interact. Do not combine weight loss products with each other unless a doctor has prescribed it.

What should you ask your doctor or pharmacist?

Before you start, it helps to ask a few questions. Is this product approved by the FDA for weight management? What are the likely side effects, and which ones mean I should stop? Does it interact with my other medicines? How long should I take it, and what happens when I stop? What should we do if I am not losing weight after 12 weeks? Buy only from a pharmacy or supplier that your doctor or pharmacist trusts, and keep the original packaging so that you can follow the instructions.

Does a tablet work without diet and exercise?

No product does the work for you. Clinical tests show that weight loss tablets only work when they are combined with a lower-calorie diet and an exercise plan. Check with your doctor before starting to exercise, and aim for a mix of cardio and strength training. Adults need at least 150 minutes of moderate activity a week plus two days of muscle-strengthening, according to the CDC. Keep the plan realistic and steady, as we explain in our post on natural weight loss through eating right and keeping moving. For safe-use tips and who should avoid them, see our guide to what to know about diet pills.

To see what doctors can prescribe, and who qualifies, read our post on tablets to help with weight loss. For the ingredients in over-the-counter pills, see what is in a weight loss diet pill.

Questions about the sun salutation

What is the sun salutation, and why is it so popular?

The sun salutation is a flowing sequence of yoga poses that includes forward folds, backbends, lunges, a plank, a cobra-like lift and a downward-facing V, all joined by your breath. It is popular because it works the legs, arms, shoulders, spine and abdomen in one smooth routine, so it makes a short, all-around practice for people with little time. You can find the full instructions in our step-by-step guide to the 12-step sun salutation.

What are the benefits?

Mostly the benefits of gentle, regular movement: stretching tight muscles, improving flexibility and balance, and building a little strength in the arms and legs. The US National Center for Complementary and Integrative Health says that studies of yoga in general suggest possible benefits for stress management, mood, sleep and balance. There is little research on the sun salutation itself, so do not expect miracles. A few rounds do not replace the 150 minutes of moderate activity and two days of muscle strengthening a week that health authorities recommend for adults.

When is the best time to practice?

Whenever you can do it regularly. In the morning, a couple of rounds can loosen stiffness and wake you up. In the evening, a slower pace with longer breaths is a pleasant way to unwind. Avoid practicing right after a big meal, and give yourself a few minutes to warm up if the room or your body is cold.

How many rounds should I do?

Two or three slow rounds are plenty at first. As your strength and stamina grow, you can work up to six or even twelve rounds, but quality matters more than quantity. Keep your breathing smooth, and take a rest between rounds if you need one.

Can it help me sleep?

Some people find that slow rounds in the evening help them settle down, and research on yoga and sleep looks promising, although it is not conclusive. Pair it with a regular bedtime and a dark, quiet room. If you struggle to sleep for weeks, speak to a doctor.

Who should be careful?

Yoga is generally considered safe for healthy people when it is done properly and with a qualified teacher, but injuries do happen. The most common ones are sprains and strains, often in the knee or lower leg. Take extra care, and ask a doctor or teacher first, if you have problems with your back, neck, wrists, shoulders or knees, if you have high blood pressure or feel dizzy easily, or if you are pregnant. Never push into pain.

How can I make it easier?

You can bend your knees in the forward folds if your hamstrings are tight. In the plank, rest your knees on the floor. Skip the deep backbend and keep your elbows bent if your lower back complains, and shorten the holds. If your wrists hurt, ask a teacher about alternatives. Over time you will find the version that suits your body.

Yoga has a long history, and you can learn more about where it comes from in our post on what yoga is and our introduction to hatha yoga.

Home exercise machines are easy to buy and easy to stop using. The old version of this post gave sound advice in broken English: ask yourself a few questions before you reach for your wallet, and do not believe everything a commercial tells you. Its questions were whether you will like the equipment, whether you can afford it, whether you have room, and whether it is safe for you. I have kept those and added what the research says about safety. Much of the buying advice here is common sense and not a result from a study, and I say so where that is the case.

Will you actually enjoy using it?

This was the first question in the old post, and it is the most important: the best machine is the one you will use. If the equipment is new to you, try it first, for example at a gym or a store with a demonstration model. Starting with small, inexpensive items such as a mat or resistance bands is a lower-risk way to find out what you enjoy. Our guide on how to choose a gym and get started explains how to try things out first.

Can you afford it, and is the price a sign of quality?

The old post warned that an expensive item is no guarantee that you will use it or that it works for you. Decide on a budget first, then check quality: a very low price can mean weak construction, and a high price does not always mean a better machine. Read the warranty and return policy, and add delivery and assembly to the cost. These are general shopping tips, not rules from an official source.

Should you consider used equipment?

The old post suggested used equipment, which can cost far less if it was barely used. Check it carefully: a treadmill belt should run smoothly and bolts should be tight. Another option the old post gave is to join a gym that already has the machine, and our post on everyday activities that count as moderate exercise shows that you may not need any machine at all.

Do you have the space?

Many buyers forget this one. Measure the room before you buy a treadmill or exercise bike, and leave clear space around the machine and a path to get it into the room. Planning ahead avoids the hassle the old post described, where equipment that does not fit gets in the way.

Is it safe for you and for the children in your home?

The old post told readers with health problems to check with their doctor and to try equipment before buying. There is data behind that advice. A study in the journal Injury Prevention used national emergency department data for 2007 to 2011 and estimated about 70,000 injuries in the United States linked to mechanical home exercise equipment, 66 percent of them involving treadmills. Children aged 0 to 9 accounted for 35.2 percent of injuries, and adults aged 25 and over for 52.8 percent. The authors concluded that injury awareness and prevention are important complements to active lifestyles. Read the study here: Emergency department-reported injuries associated with mechanical home exercise equipment in the USA. In practice, keep young children away from running machines and follow the maker’s instructions. If you have a heart or joint condition, talk to your doctor first.

Do you need equipment at all?

Often you do not. The Physical Activity Guidelines for Americans advise adults to get at least 150 to 300 minutes of moderate aerobic activity a week, plus muscle-strengthening on two or more days. Brisk walking, climbing stairs and body-weight exercises can meet those goals for free, and our post on moderate exercise for fitness lists five easy ways. If you do want equipment for strength work, our guide to full-body workouts shows what two or three sessions a week can look like.

What was the old advice about asking an instructor?

The old post ended by telling you not to buy on impulse and to ask a professional gym instructor first. A qualified trainer can tell you whether a machine suits your goals and your body. Sleep on the decision, compare at least two options and only then buy.

Vitamins and your health

How do you choose a vitamin supplement?

If you and your doctor have decided that a supplement makes sense, there are hundreds of products to choose from, in pharmacies, supermarkets, health stores and online. A higher price or a bigger bottle does not mean better quality. Look for a product made for your age, sex and life stage. Read the label and compare the amounts with the Daily Value. The NIH Office of Dietary Supplements warns that some high-potency products contain far more of certain vitamins and minerals than the recommended amounts, sometimes even more than the upper limit, and that is the risk with megadoses.

Check the expiry date, and look for a seal from an independent testing organization, such as USP or NSF, which shows that the contents match the label. Buy from a reputable seller.

What is the difference between vitamins you can store and vitamins you cannot?

Vitamins A, D, E and K are fat-soluble, which means the body stores them, so too much can build up over time. Vitamins C and the B vitamins dissolve in water, and the body gets rid of the extra in your urine, but very high doses still cause problems. For example, vitamin C above 2,000 milligrams a day can cause diarrhea and stomach upset. Women who are pregnant or planning a pregnancy should ask their doctor before taking any vitamin A, because too much preformed vitamin A can harm the baby.

When and how should you take them?

Take supplements as the label says. Many people take them with a meal, which is easier on the stomach, and fat-soluble vitamins are absorbed better when the meal contains some fat. Choose a time you will remember and make it a routine. Some vitamins and minerals can interact with medicines. Vitamin K, for instance, affects blood thinners such as warfarin, and calcium and iron can reduce the absorption of some medicines. Ask a pharmacist if you take any regular medication, and read our post on taking calcium supplements safely for a good example.

Which supplements are worth discussing with your doctor?

The shortlist is usually short: vitamin B12 for vegans and for some older adults, vitamin D if you get little sun, folic acid before and during pregnancy, and iron or calcium if a test shows you are low. If you eat a varied diet and are healthy, a basic multivitamin with amounts close to the daily recommendations is generally safe, but it is not a must. You can find out more in our posts on vitamin supplements and on taking supplements.

Will vitamins keep your energy at its best?

Only if you were low in a vitamin to begin with. Taking more of a vitamin than your body needs does not raise your energy. Sleep, regular exercise, a balanced diet and managing stress make far more difference. If you feel tired all the time, see your doctor, because there are many possible causes, and a supplement could hide the real reason.

What should you remember?

Supplements are an add-on to a healthy diet, not a substitute. Choose products carefully, stay within the recommended amounts, tell your doctor and pharmacist what you take, and keep them away from children. To think through whether you need one at all, see our post on whether you need a vitamin supplement, and for a look at how too little affects you, read about a lack of vitamins.

Atkins diet basics

The idea behind Atkins

The Atkins diet is not a new phenomenon. It first appeared in the early 1970s and has grown in popularity in recent years in response to the low-fat diet craze. As dieters had trouble with low-fat plans, they searched for a new solution, and Dr. Atkins’ New Diet Revolution book found a new audience.

A lot of people have jumped on the Atkins bandwagon, and there has been a lot of hype as a result. But what are the basic facts of the Atkins diet?

The Atkins diet is based on a theory about why we gain fat. According to Dr. Atkins, over-consumption of carbohydrates and sugars leads to weight gain. He argued that the way your body processes the carbohydrates you eat has more to do with your waistline than the amount of fat or calories you consume. In his book, Atkins describes a condition called insulin resistance. He theorizes that many overweight people have cells that do not respond properly to insulin.

When you eat carbohydrates and sugar, your body notices that your blood sugar level is elevated. Insulin is released from the pancreas to help store the sugar as glycogen in the liver and muscles for extra energy later on. However, your body can only store so much glycogen at once. As soon as your body reaches its limit for glycogen storage, the excess carbohydrates are stored as fat. This happens to anyone who eats more energy than they use.

According to the theory, people who are insulin resistant have an even harder time using and storing carbohydrates. The more insulin the body is exposed to, the more resistant it becomes. Over time, the pancreas releases more insulin and the cells become more insulin resistant, which creates a cycle that favors fat storage.

As a result, Atkins held that insulin resistant people gain weight easily, because the carbohydrates are converted into fat instead of energy. Other effects he linked to it include fatigue, brain fog (the inability to focus, poor memory, loss of creativity), low blood sugar, intestinal bloating, sleepiness, depression and, over time, high blood sugar. There is much more than weight at stake when you are insulin resistant, so see your doctor if you suspect insulin resistance or diabetes.

What the diet restricts

The diet for people who are insulin resistant is a diet low in carbohydrates. The core of the Atkins diet is the control of carbohydrates in all their forms. The foods restricted on the Atkins plan include simple sugars (like cookies, sodas and sweets) and starchy carbohydrates (like bread, rice and grains). Even carbohydrates that are considered healthy, such as oatmeal, brown rice and whole wheat bread, are restricted in the early phases of the program.

Ketosis

In the first phase of the plan, you limit your carbohydrate intake to about 20 grams of net carbohydrates a day. This puts your body into a state of ketosis, in which it burns fat as fuel. According to Dr. Atkins’ research, the state of ketosis also affects insulin production and prevents more fat from being formed. Your body begins to use stored fat as an efficient form of fuel, and you lose weight. Another claimed benefit is that ketosis reduces carbohydrate cravings. If you have been living on a carb-heavy diet, you may have found that you simply cannot get enough carbohydrates. People who have been on the Atkins diet for some time report that they do not crave carbohydrates as they once did.

Although the first phases of the Atkins diet are fairly strict, the plan teaches you to find balance in the long run. People who follow the diet slowly reintroduce small amounts of carbohydrate into their eating until they find a comfortable balance between their health and carbohydrate use.

The basic principles of the Atkins diet have been adopted by many other low-carb plans. Studies that compare low-carb diets with other diets generally find similar weight loss after a year, but Atkins remains popular as a low-carbohydrate solution. If you have diabetes, kidney disease or any other health condition, talk to your doctor before starting.