Fat trapping in perspective Part 3

Which to my mind is one of the greatest travesties ever! And I shall use this platform to say my say and hope that some really bright medical aid official reads it and tries to do something about it: you guys pay for the treatment of all diseases which may be caused by obesity, right? That includes the effects of diabetes mellitus II as well as heart bypass surgery, right? Plus all those expensive tablets to help control blood pressure, cholesterol and depression, right? Then why in the world would you not be willing to pay for the prevention (by controlling obesity) of any of these diseases, which would cost you much less than all the long-term medications? And the same goes for birth control pills. You pay for all the expenses related to pregnancy and birth, but you won't pay for a tablet to prevent all these expenses. Add to that the fact that you don't pay for nutritional supplements. But you do pay for the treatment of diseases caused by a lack of these nutrients such as fractures caused by osteoporosis! The treatment of these diseases is far more expensive and longer lasting. But you go on forking out year in and year out, right?

Just thought I'd ask. Use it, don't use it ...

But back to the reason why Xenical achieves such remarkable results. Being on the program also qualifies you to enjoy the support of a dedicated help line, excellent dietary advice in the comprehensive and free reading matter provided, as well as the fact that the manufacturers work closely with physicians to monitor and support their clients.

Don't get your hopes up too high, though! Xenical is not prescribed as a matter of course. Your doctor will have to do an evaluation to see if you fit the criteria for use They are based, inter alia, on your BMI (Body Mass Index) and your cholesterol and glucose levels.

There also happen to be a few possible side effects. They usually only come into play if the product is abused: if you eat too much fat, you will experience excessive flatulence, as well as an urgent (and usually inconvenient) need to go to the toilet and if you don't get there in time, you may well soil your pants! You could also have orange-coloured, oily and runny stools that stain your toilet bowl. As far as I'm concerned, this is excellent, because it will hopefully prevent you from abusing fat in your diet!

What are the other points to watch out for? If you are pregnant or lactating, have nutrient deficiencies, are under 18 years of age or have gallbladder complaints, you are advised against taking the product. You should also inform your medical practitioner if you are allergic to or list at or any other medicines, foods or food additives.

But here is the proviso I mentioned earlier: If you plan to use any product that inhibits your body's uptake of fat, please realise that every single one of these products (as well as other diet products such as metabolic boosters and so on) only help you lose weight provided you fulfill your side of the bargain. Yes, you still have to follow a healthy and balanced eating plan. Above all, you still have to restrict your fat intake to around 33 g per day (in other words, no more than 30% of your dailykilojoule intake should be fat kilojoules).

Then what is the point of taking it, you may ask. The point is that these products, especially Xenical, are serious medications and they or any other supplements should never, ever be abused. If you take them without addressing your lifestylehabits and existing diet, which in itself will mean you are not that serious about your weight and health issues, you will not lose weight or become healthier, for thatmatter. You will merely lose your good money, possibly harm your body and end up giving the product a bad name by saying it doesn't work. Or, if you are the decenttype, you will do the right thing and blame yourself, which will simply make you feel worse about your weight than you already do.

In the end, you have to evaluate your motivation, your intentions and your dieting history in order to establish whether you are a perpetual dieter or a desperate dieter. Radical honesty will help you arrive at the right conclusion. If the answer is yes, you are a perpetual or desperate dieter and you want to stop that syndrome permanently and you are willing to take the responsibility, then and only then should you invest in one of these products. If you are going to do it for the wrong reasons (such as having an unrealistic expectation of the products efficacy or wanting instant gratification), believe me, you will merely perpetuate your past history to your own detriment. Without any of your old habits changing, your weight will most definitely also not change. In fact, wanting these products to help you lose weight without wanting to bring your side, is a guaranteed way of ensuring that you will end up weighing much more in the long run than you weigh today. And emotionally you will feel far, far worse than you ever thought possible. So bad in fact, that you will spend the greater part of your waking moments trying to pretend that you are fat and happy!

Using these products is supposed to enhance your dieting efforts but not constitute them, regardless of what the cute and cleverly worded advertisements and infomercials may claim!

Sooner or later you will have to believe and trust your common sense.

Fat trapping in perspective Part 2

Finally confronted with this reality, many dieters start despairing. And just when they are ready to give up and sink further into the_ir obesity, another product comes onto the market with new, intriguing and exciting claims: fat trappers or -binders.

Here with some facts about these products.

'Fat binders' or 'fat trappers' usually contain chitosan, derived from the shells of crustaceans such as prawns, shrimps and lobsters. Taken before a meal, a certain part of the fat consumed during the meal binds with the chitosan, travels through the intestine as freeloading passenger and passes out of the body, bound to the waste products. Some have a time-release action and some claim to 'trap' up to 15 times their own weight in fat. These products are available without prescription from chemists, health stores and mail order companies.

On the surface there is nothing 'wrong' with these products and in fact, Kitobind, available over the counter, is a product I respect. As I do Xenical, which contains orlistat. The latter is a schedule 3 product for which a prescription from your doctor is required. Many myths surround diet products, and Xenical and Kitobind are no exception. Xenical in particular is likened to a 'fat binder', but this is about as far from the truth as can be. As to the safely of these products, I can only vouch for the two that I know. I am not familiar with any of the other products and can therefore only caution you to buy a familiar and well-tested product. What I can mention though, is that I have been involved in clinical trials of some of these fat trapper diet products that proved to be totally ineffective. Volunteers who took the tablets had less fat in their stools after a fatty meal than those who had taken placebos or 'blank' pills!

It just goes to show how we can be fooled.

It is wise to remember that over-the-counter diet products are not required to conform to any stringent health laws and lately many rumours have been doing the rounds that certain fat trappers can cause severe and permanent intestinal problems. So, safe is the word if you do not want to be sorry when you buy this, or any other kind of supplement or medication.

Of these, the prescription product Xenical warrants discussion, since it does not work as a fat trapper. The active ingredient in Xenical, namely orlistat, inhibits the activity of the lipase enzymes in the stomach. Their function is to split the ingested fat in the stomach into smaller molecules in order to be fully absorbed by the body. Orlistat therefore prevents this from happening, leaving some of the molecules large, which means they cannot be absorbed into the body. The balance of the fat - the larger molecules - passes through the stomach and intestines without being digested and therefore without being stored as a source of energy. This logical, simple process will help you reduce your weight, maintain the lower weight and minimize the possibility of regaining it again. As always, there is a proviso attached here, but more about that later,

At the school we have seen amazingly positive results in the students who use Xenical. They lose weight at a faster rate and maintain what they have lost more readily than those who do not use the product. This does not mean that no chitosan-based product can produce good results, but I suspect that, because Xenical is marketed as part of a holistic weight management package, it instils a greater sense of dedication and determination in patients who are on the program. That, plus the fact that it is more expensive and not subsidised by medical aid schemes.

Labelling - 'preventing deception and fraud' continue...

Labelling and current legislation

At present under South African food law, certain terms are already ⁴prohibited. For example, no foodstuff may be labelled with the words 'recommended by doctors' or 'medically recommended' or imply the same; nor may the words 'health', 'healthy', 'heal', 'cure' or 'restorative' be used, implying that the food has health-giving properties.

The law also requires food producers to list ingredients in order of the _quantities in which they are present in a product. Hence, a product labelled as containing 'meat and soya' in that order would have more meat than soya. Nutritional content is not required by law, but if a producer wishes to state this on a package, it must be headed 'Nutritional Information'. The producer must indicate what percentage of the RDA (Recommended Daily Allowance) of the specific nutrient is present per serving and the order in which the nutrients are listed is stipulated. There must also be an indication of the energy content of the food to the nearest kilojoule per serving. Even the word 'serving' is prescribed by the legislation and 'means the mass, volume or number, as the case may be, which is recommended by the manufacturer as the amount to be taken on its own or as part of a meal ...'.

Perhaps this is where some consumers may have a difference of opinion with the manufacturers: the consumer sees the purchase as a meal, whereas the manufacturer regards it 'as part of a meal'. Either that or there are a lot of not-so-hungry manufacturers out there!

By law, the weight or volume of all packaged foods has to be stated on the package and this must refer to the actual usable quantity of food; for example, a 250 g pack of teabags must literally contain 250 g of tealeaves when weighed without the individual bags or box in which they are packaged. Another example of this type of legislation is applicable to eggs, which are graded and labelled according to strictly controlled weight regulations.

'Negative' claims

It is generally accepted that a manufacturer may extol the virtues of his product or the method of its manufacture, provided that the information given can be justified. However, any claim that denounces food ingredients, whether outright or by innuendo, deserves intense scrutiny. Over the last few years, some irresponsible promotional campaigns have stated or implied that foods containing certain permitted additives are less wholesome, less safe or less healthy than those without these additives. Conversely, it has been stated or implied that foods without certain permitted additives are more wholesome and safer, or healthier, than those with additives.

Admittedly, it is sometimes important to draw the consumers' attention to the fact that a foodstuff does not contain a substance, particularly if this fact could change the consumer's attitude to the product. For example, canned foods generally do not contain preservatives; evaporated milk does not contain added sugar (sucrose), yet in both cases, many people believe that they do. Because of the trend towards 'naturalness', more and more consumers are opting for additive-free foods and so of course manufacturers want to let the buying public know if their products conform to this 'ideal' - that's simply good marketing and the words 'contains no preservatives or additives' on a label don't necessarily imply that a product is any better than one with additives.

Then there are those ambiguous expressions, 'sugar free' and `no sugar added'. What most people don't realise is that the 'sugar' referred to here is sucrose (cane sugar) and that these products may well contain other types of 'natural' sugar - for example the milk sugar, lactose, present in an ingredient such as skim milk powder. These and similar expressions should only be used if the information is followed closely by an equally clear statement indicating which sugars are present or have been added to the food.