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DIET IN OBESITY: ALTERNATIVE ADVICES AVAILABLE

There are countless commercial diets thrust upon the public in newspapers, bookshops, on TV, the internet and on the coffee morning circuit. Many of these may have benefits and others remarkable, or alarming, ramifications.

To succeed and make money for its inventor, any commercial diet must have a unique and novel aspect or idiosyncrasy that makes it different to those which have gone before. It is exactly this idiosyncrasy that should make us treat the diet with suspicion. There has been no great evolutionary advance in the human digestive or metabolic systems, or major breakthrough in the science of nutrition, to necessitate brand new diet theories. On the contrary, new diets either repackage what we already know in different, easily understood words and phrases - which should be encouraged - or else are fad diets without scientific basis - which shouldn't. There is a growing body of opinion, especially in the US, known as the 'undieting' lobby, which takes the argument one step further and is opposed to any sort of structured diet programme. The National Eating Disorders Association in The US describes dieting as a dangerous eating disorder, defining it as:

Any attempt in the name of weight loss, 'healthy eating', or body sculpting to deny your body of the essential, well-balanced nutrients and calories it needs to function to its fullest capacity.

Its literature spells out the dangers of yo-yo dieting (including 'negative impacts on the metabolism'), psychological problems (including depression) and progression to other eating disorders. It reports that 40-50% of women in the US are dieting at any one time, 40-60% of high-school girls are dieting and that 46% of 9- to 11-year-olds are dieting 'sometimes or very often'.

Although extremely eloquently put and vigorously argued, these views are rather extremist and overlook the simple fact that reputable weight-loss diets save lives, particularly in the case of diabetics and sufferers of coronary heart disease.

A sensible approach is to treat 'dietary change' as one thing, by educating patients on good and bad nutrition and giving them the skills to permanently alter their own feeding habits, but to treat 'Diets' with caution. Patients have the ability to choose their preferred method of losing weight, be it through primary care or buying a book, attending a private slimming clinic or accessing help on the internet. Primary care has neither the time nor the resources to cope with each and every obese person without outside help.

Although today's commercial diets have a more scientific basis, there are still some slightly unusual concepts being promoted, which may not entirely fit in with what we learnt at medical school. It is part of the job of the primary care team to tiptoe through the minefield of the modern commercial diets and to encourage patients to follow a path that is not only clinically acceptable but also suits the individual's taste, social circumstances, working environment and family life.

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Hoodia gordonii (pronounced HOO-dee-ah) is also called hoodia, xhooba, !khoba, Ghaap, hoodia cactus, and South African desert cactus.Hoodia is a cactus that's causing a stir for its ability to suppress appetite and promote weight loss. 60 Minutes, ABC, and the BBC have all done stories on hoodia. Hoodia is sold in capsule, liquid, or tea form in health food stores and on the Internet. Hoodia gordonii can be found in the semi-deserts of South Africa, Botswana, Namibia, and Angola. Hoodia grows in clumps of green upright stems and is actually a succulent, not a cactus. It takes about 5 years before hoodia's pale purple flowers appear and the cactus can be harvested. Although there are 20 types of hoodia, only the hoodia gordonii variety is believed to contain the natural appetite suppressant.Although hoodia was "discovered" relatively recently, the San Bushmen of the Kalahari desert have been eating it for a very long time. The Bushmen, who live off the land, would cut off part of the hoodia stem and eat it to ward off hunger and thirst during nomadic hunting trips. They also used hoodia for severe abdominal cramps, haemorrhoids, tuberculosis, indigestion, hypertension and diabetes.In 1937, a Dutch anthropologist studying the San Bushmen noted that they used hoodia to suppress appetite. But it wasn't until 1963 when scientists at the Council for Scientific and Industrial Research (CSIR), South Africa's national laboratory, began studying hoodia. Initial results were promising -- lab animals lost weight after taking hoodia.The South African scientists, working with a British company named Phytopharm, isolated the active ingredient in hoodia, a steroidal glycoside, which they named p57. After getting a patent in 1995, they licensed p57 to Phytopharm. Phytopharm has spent more than $20 million on hoodia research.Eventually pharmaceutical giant Pfizer (makers of Viagra) caught wind of hoodia and became interested in developing a hoodia drug. In 1998, Phytopharm sub-licensed the rights to develop p57 to Pfizer for $21 million. Pfizer recently returned the rights to hoodia to Phytopharm, who is now working with Unilever. What you need to know about hoodiaHoodia appears to suppress appetite Much of the buzz about hoodia started after 60 minutes correspondent Leslie Stahl and crew traveled to Africa to try hoodia. They hired a local Bushman to go with them into the desert and track down some hoodia. Stahl ate it, describing it as "cucumbery in texture, but not bad." She lost the desire to eat or drink the entire day. She also didn't experience any immediate side effects, such as indigestion or heart palpitations. Stahl concluded, "I'd have to say it did work."In animal studies, hoodia is believed to reduce caloric intake by 30 to 50 percent. There is one human study showing a reduced intake of about 1000 calories per day. However, I haven't been able to find either study to actually read for myself and am going on secondhand reports.

Information on this site is provided for informational purposes only. It is not meant to substitute for medical advice provided by your physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disease, or prescribing any medication. You should read carefully all product packaging and labels. If you have or suspect that you have a medical problem, promptly contact your physician or health care provider. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease. *With purchase of 4 bottles.

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