The authors state that weight loss surgery, particularly gastric bypass surgery, is currently the most effective treatment for inducing sustainable weight loss in morbidly obese patients. However, little research or follow-up intervention has been targeted at ensuring a nutritionally adequate weight loss diet following bariatric surgery. This has resulted in nutritional deficiencies becoming common among surgery recipients.

Additionally, weight loss surgery recipients tend to hit a plateau in their weight loss, after which they “become candidates for body contouring surgery” and other elective cosmetic surgeries. The present study aimed to highlight the nutritional deficiencies often found in the post surgery weight loss diet as they relate to subsequent body contouring operations. To accomplish this, the authors performed an extensive search of the literature on bariatric surgery procedures and attempted to compile that information into a cohesive review.

Nutritional deficits in post surgery weight loss diets

The authors report that the literature to date points to a pervasive protein deficiency in patients’ post surgery weight loss diets, as well as numerous vitamin and mineral deficiencies. These deficiencies are especially pertinent given the delicate nature of the surgeries and the need for adequate healing after the procedures.

They conclude that plastic surgeons working with patients who have undergone weight loss surgery need to be aware of the nutritional aspects of their patients’ overall condition at the time of consultation. The nutritional deficiencies seen in these patients can be minimized fairly easily by reinforcing post-surgical eating guidelines and by prescribing nutritional supplements.

Nutritional deficiency leads to slow healing times and poor quality of wound healing. While the optimal post surgery weight loss diet and nutrient densities cannot be established given the current literature, certain nutrient requirements can be ascertained.

Helpful nutrients in the period following weight loss surgery

The average patient who has received weight loss surgery will likely benefit from the following supplements:

• Protein
• Vitamin A
• Vitamin C
• Arginine
• Glutamine
• Zinc
• Selenium

The authors state that each of these nutrients has been solidly established as playing a significant role in promoting wound healing and on enhancing immune system functioning. Ensuring that each of these nutrients is obtained from a post surgery weight loss diet is essential for proper healing and maintenance of surgery-induced weight loss.

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This study aimed to compare the effects of two calorie-restricted weight loss diets on the subjects’ overall weight loss as well as their mitochondrial oxidative metabolism. The mitochondria are responsible for generating cellular energy, so the rate at which they consume fuel is thought to be a good measure of a person’s overall metabolic rate.

Comparison Of Two Low Calorie Weight Loss Diets

The diets that were compared in this study both restricted the amount of total food energy that participants were allowed to consume, and so both were low calorie weight loss diets. The difference between them was the macronutrient ratio, or the ratio of carbohydrate to protein. So one group of study participants followed a “traditional” high-carbohydrate, low calorie diet while the other group followed a high-protein, restricted carbohydrate diet.

To determine the differences in effect between these two diets, nineteen obese men were randomly assigned to follow one diet or the other for a total of eight weeks. The small number of participants and the relatively short duration of the study are limiting factors in the interpretation of the results. However, significant results were found within the context of these limitations.

Weight Loss Diet Results

Study participants who followed the high-protein, low carb weight loss diet lost significantly more weight than those following the “traditional” high-carbohydrate low calorie diet. The low carb group lost an average of around 8 pounds, while the high carb group averaged around 5 pounds.

In addition to the improved weight loss, the researchers found that mitochondrial oxidation was “activated” in the study participants consuming the high protein diet. The researchers propose that such a diet may actually be increasing the dieter’s metabolism, providing a metabolic advantage over weight loss diets that are higher in carbohydrate and lower in protein.

Effects of Very Low Carb Weight Loss Diets Not Addressed

An interesting consideration that is not mentioned in the study is the fact that the “low-carbohydrate” diet group was consuming a much larger amount of carbohydrate than is typically prescribed for individual following a low carb weight loss diet. Carbohydrates still accounted for 40% of this group’s total caloric intake. This means that “low carb” study participants were still eating approximately 150 grams of carbohydrate each day.

Additional research may reveal whether the increase in protein alone may have produced the metabolic advantage seen in these study participants, or whether further reduction in carbohydrate intake might enhance this effect.

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This study set out to compare the effects that various commercially available weight loss diets have on cardiovascular health. It focused its attention on known cardiovascular “risk factors” such as plasma lipids, plasma lipoproteins, and LDL cholesterol particle size. Larger LDL cholesterol particles in the bloodstream are associated with reduced risk of cardiac events. More importantly, a reduction in LDL cholesterol particle size has been associated with a decreased risk of heart attack.

Commercial Weight Loss Diets

Four commercially available weight loss diets were selected for the study:

• Dr. Atkins’ New Diet Revolution
• The Slim-Fast Plan
• Weight Watchers Pure Points Program
• Rosemary Conley’s ‘Eat Yourself Slim’ Diet

According to the authors, the Atkins Diet is the prototypical low carbohydrate weight loss program, and the Slim-Fast weight loss diet involves simple calorie reduction. Both Rosemary Conley’s ‘Eat Yourself Slim’ Diet and the Weight Watchers Pure Points Program aim primarily to reduce dietary fat.

Commercial Weight Loss Diet Study Design and Results

This was a fairly large study, conducted across five universities in the UK and including 300 obese adults between the ages of 21 and 60. Participants were randomly assigned to follow one of the four commercial weight loss diets for six months.

Each of the study groups showed an equal amount of overall weight loss. Study participants had maintained an average weight loss of five to nine pounds at six months. Participants who followed each of the two low fat weight loss diets, Weight Watchers and Rosemary Conley, showed a significant reduction in overall LDL cholesterol.

The Weight Watchers dieters also showed a reduction in blood triglycerides, as did participants following the Atkins diet. Also, both of these diets were associated with a reduction in LDL particle size.

The researchers conclude that weight loss through any diet should generally be expected to improve cardiovascular health. They noted also that no negative effects were seen in groups following a low carb diet, contradicting expectations that increased fat consumption would increase cardiovascular risk factors.

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The authors of this study note that a major problem exists with our ability to understand and compare the effects of various weight loss diets based on the studies we have available.

Most of these studies suffer from high dropout rates and short follow-up times. This means that the results of weight loss diet studies tend to only include people motivated enough to stick with the diet for the duration of the study, and excludes people who dropped out due to adverse effects such as weight gain. Also, because the followup times for these studies tend to be short, there is insufficient research into the long-term effects that each of these diets have on health and body composition.

The present study attempts to correct for this latter problem by including a two-year followup period, so that the long-term effects of each diet and also the likelihood of an individual being able to stick to the diet for a long period of time could be taken into account.

The researchers randomly assigned 322 moderately obese, mostly middle-aged people to one of three weight loss diets: a low fat diet with calorie restriction, a “Mediterranean diet” with restricted calories, and a low carb diet without any calorie restriction.

Weight loss diet results

The adherence rate, or the percentage of study participants who stuck with their assigned diet, were quite good: 95.4% of the people were still on their assigned diet at one year, and 84.6% reported that they were still sticking to the diet at the two year mark. However, these figures are based on self-report, and weight loss diet study participants are notoriously bad at accurately reporting their behavior, so these self-report rates are a limiting factor in our ability to interpret the other results of the study.

Regardless, a number of interesting trends showed up in the way people ate on these diets. The group assigned to eat a Mediterranean diet ate the most fiber and the most monounsaturated fat, while the low carbohydrate diet group ate the most fat, protein, and cholesterol. In spite of this, the low carb diet group realized the greatest improvement in their blood lipid profiles. This means that the low carb dieters ate more fat and cholesterol but had less fat and cholesterol in their blood.

Another interested trend that the researchers noticed was in the area of blood sugar control. Thirty-six of the study participants were diabetic, and of these, the Mediterranean dieters showed the greatest improvements in fasting blood sugar level and insulin level.

Average weight loss outcomes for each diet

• Low Fat Weight Loss Diet: 2.9kg
• Mediterranean Weight Loss Diet: 4.4kg
• Low Carb Weight Loss Diet: 4.7kg

So, while the Mediterranean diet and low carbohydrate diet were fairly similar in average weight loss, the low fat diet group fell way behind. The average low carb dieter in this study lost nearly twice as much weight as the average low fat dieter. Additionally, both the Mediterranean diet group and the low carbohydrate diet group showed improvements in measures of overall health that the low fat diet group did not.

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The authors of this case study explain that the epidemic of obesity in the United States has spurred the development and utilization of an inordinate number of new weight loss diet drugs to treat obesity and its numerous related health complications.

Motivations For Weight Loss Diet Drug Use

Desperate patients hear repeated messages from their doctors, families, and sociocultural outlets that they must lose weight in order to be healthy, vital, and socially acceptable. This desperation frequently causes patients to lose sight of or even ignore the serious and well-documented side effects of some of the most popular and widely-prescribed weight loss diet pills on the market.

Phentermine Diet Pills Induce Cardiac Arrest

The present case study describes one such patient, a 48-year-old woman. The patient was moderately obese, physically healthy, and taking no medications other than the common appetite suppressant medication phentermine. This medication acts as a central nervous system stimulant by facilitating the action of noradrenaline. In this case, as in previous cases with similarly acting drugs, a heart attack was caused by acute ventricular tachycardia thought to have been initiated by prolonged ingestion of the weight loss diet drug.

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The authors of this study note that one of the key factors in weight loss and weight maintenance following gastric bypass surgery is the amount of satiety, or fullness, a patient experiences during the post surgery weight loss diet period. They hypothesize that an effective method for controlling hunger and maintaining a feeling of fullness is to avoid carbohydrate intake and otherwise reduce the glycemic load of the diet foods consumed.

Macronutrient Consumption Following Weight Loss Surgery

The present study set out to test that hypothesis by measuring the macronutrient and micronutrient values of the foods that patients consumed in the period following gastric bypass surgery, and comparing those values with the weight loss and reported satiety of the study’s participants.

The researchers found a negative correlation between carbohydrate intake and average monthly weight loss. This means that weight loss surgery patients who ate the fewest total carbohydrates after the surgery lost the most weight. The bariatric surgery patients who ate the largest number of carbohydrates, conversely, lost the least weight.

Another significant correlation was found between the glycemic load of the patients’ post surgery weight loss diet and their total energy intake. Glycemic load is a measure of the total amount that a given food item will add to your blood sugar, so this finding essentially means that the patients who ate the greatest number of carbohydrates also ended up eating the greatest number of calories.

The authors conclude that carbohydrate intake and glycemic load are significant factors in the success of a post bariatric surgery weight loss diet.

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This study compared the effects of a variety of weight loss diets on obese teenagers. The diets were distinguished by their overall macronutrient composition, or the percentage of calories derived from any of the three macronutrients: protein, fat, and carbohydrate. Seventy one teens were randomly placed on one of the following diet plans for twelve weeks:

• Low Carb Low Fat
• Low Carb High Fat
• High Carb Low Fat

An interesting aspect of this study was its focus on a factor designated as “health-related quality of life.” This factor focused on the mental health of the teens in the study, including aspects of both psychological and social functioning. Measurements of health-related quality of life were taken before and after the completion of the diet programs in addition to all the standard measures like body mass index (BMI) and body fat percentage.

Effectiveness of Teen Weight Loss Diets

All three of the groups benefitted equally from their diets in terms of decreased body mass index and body fat percentage. However, only the groups assigned to low fat weight loss diets reported an improvement in health-related quality of life.

By analyzing the health-related quality of life reported by teens prior to beginning the study, the researchers also found a relationship between the pre-existing psychological functioning of the adolescents and their later success on any of the three weight loss diet programs. Teens who were more psychologically healthy before the study began tended to see greater improvements in body composition.

Teen Weight Loss Diet Conclusions

The researchers therefore conclude that psychosocial functioning is an important consideration in helping obese teens to lose weight. They also concluded that a low fat diet may be important to improving quality of life factors in this group.

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The authors of this study explain the underlying principle guiding the treatment of type 2 diabetes and metabolic syndrome patients with carbohydrate restriction. It is believed that the insulin resistance which characterizes these disorders is a natural response to the excessively high insulin levels which result from increase blood sugar. By chronically increasing the blood sugar and stimulating insulin release, carbohydrate consumption induces insulin resistance.

The authors argue that this theory is not only intuitively valid on its face, but also supported by a substantial body of experimental research. In spite of this, the theory has generally been opposed by public health agencies. The authors posit that this opposition has been due to a concern that the agencies’ discouragement of carbohydrate consumption would result in an increased level of fat consumption, which the agencies’ believe would result in increased incidence of cardiovascular disease.

The purpose of the present study is to bring together recent data which demonstrates that the substitution of dietary carbohydrate for dietary fat, even saturated fat, actually improves cardiovascular risk factors. In lieu of any evidence that increased fat consumption is dangerous when coupled with a low carb diet, the authors propose that a restricted carbohydrate diet should be thought of as the preferred treatment for individuals diagnosed with type 2 diabetes or the metabolic syndrome. A low carb diet, they say, improves blood sugar control and reduces the need for medication.

The authors go on to review evidence that low carb diets effectively produce the health-enhancing effects described here even when weight loss is ruled out as a confounding factor. This means that a low carb weight loss diet would tend to improve glycemic control and cardiovascular risk factors regardless of whether the dieter actually lost any weight on the diet.

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Traditional ayurvedic medicine used the resin of the guggul tree to treat a wide variety of complaints. These primarily included lipid disorders such as obesity and high cholesterol, and inflammation disorders such as arthritis and atherosclerosis. Since the first clinical study of guggul extracts demonstrated benefits in test animals, numerous additional trials have been performed for a variety of disorders.

The active constituents of guggul resin, called guggulsterones, have been isolated and found to have a number of bioactive effects. In particular, they produce strong hypolipidemic, antioxidant, and antiinflammatory effects.

It is known that guggulsterone compounds inhibit the activity of bile acid receptors, and it has been hypothesized that this is the way in which the compounds reduce blood cholesterol and induce fat loss. “Fat burning” products containing guggulsterone, such as Nutrex Lipo 6, have become increasingly popular on account of these purported benefits, although a search of the literature showed no trials in which guggul extracts were used for weight loss. The authors of the present review state:

Although differences in study design, methodological quality, statistical analysis, sample size, and subject population result in certain inconsistencies in the response to therapy, the cumulative data from in vitro, preclinical, and clinical studies largely support the therapeutic claims for guggul described in the ancient Ayurvedic text. However, future clinical studies with much larger size and longer term are required to confirm these claims.

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