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Is Vinegar An Appetite Suppressant?
Dr. Katz
Photo: Mackenzie Stroh
Q: I read that drinking a glass of water with a teaspoon of vinegar in it will suppress your appetite. It seems to work. Why? And is it safe?
—Barbara Manning Lee's Summit, Missouri

A: Some research indicates that vinegar, which provides a diluted dose of acetic acid, slows stomach emptying and thus potentially prolongs the sense of fullness after a meal (presumably, this is true even if the meal is nothing but vinegar). Of perhaps greater interest, vinegar lowers the glycemic index of foods such as white bread and pasta, making them more filling, possibly because the carbs enter the bloodstream more slowly. Also, by giving the appetite center a flavor—astringent—vinegar makes the brain feel as if it were being fed. Evidence that vinegar helps with weight loss or self-control is hard to find, but these mechanisms do make the idea plausible. As for safety, because vinegar is acidic, it may irritate the esophagus and stomach. Over time too much acid may leach calcium from bone and damage tooth enamel. Generally, though, up to three tablespoons of vinegar a day—at only 9 to 15 calories total—should be fine. 
As a reminder, always consult your doctor for medical advice and treatment before starting any program.

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    Dieting Myths
    Dr. Oz and Pamela Serure
    With a medical philosophy that focuses on functional medicine, Dr. Mark Hyman says he treats people's symptoms based on how the body works, rather than creating a diagnosis and treating the diagnosis. In his latest book, Ultra-Metabolism: The Simple Plan for Automatic Weight Loss, Dr. Hyman says he uses functional medicine to debunk many weight loss myths. Dr. Oz talks with Dr. Hyman about seven common weight loss myths that could be keeping you from losing weight.

    • Starvation Myth: Restricting calories or not eating will help you lose weight.
      Dr. Hyman says this myth is one of the biggest pitfalls in weight loss. Starving yourself and restricting needed calories turns on your body's survival mechanism, causing you to eat more and gain back weight you may have lost, Dr. Hyman says. "You cannot control the primitive urges and hormones that drive your eating behavior," he says.
    • Calorie Myth: All calories are created equal.
      Drinking 140 calories of soda versus eating 140 calories of kidney beans is going to have a dramatically different effect on your body, Dr. Hyman says. The beans offer fiber, vitamins, protein and minerals. "Calories from protein affect your brain, your appetite control center, so you are more satiated and satisfied," Dr. Hyman says.
    • Fat Myth: Eating fat makes you fat.
      Dietary fat restriction does not lead to weight loss, Dr. Hyman says. "We need fats to regulate our metabolism, and the right fats can help us lose weight."
    • Carbohydrate Myth: Eating low or no carbohydrates make you thin.
      "Carbohydrates are the single most important foods for long-term health and weight loss," Dr. Hyman says. Eating the right carbohydrates is necessary and essential for health. Dr. Hyman advises staying away from processed foods or refined carbohydrates and instead focusing on good carbs, such as whole grains, beans, nuts, seeds, vegetables and fruits, to help you lose weight.
    • Sumo Wrestler Myth: Skipping meals helps you lose weight.
      Dr. Hyman says many Americans are in danger of following the same diet Japanese sumo wrestlers follow. Japanese sumo wrestlers gain weight by skipping breakfast and engaging in exercise, eating large meals for lunch and supper, and then sleeping soon after eating. Dr. Hyman says eating a breakfast high in protein, spreading out your food intake throughout the day and avoiding sleep for two to three hours after eating will aid you in losing weight.
    • French Paradox Myth: French women are thin because they drink wine and eat butter.
      French women are statistically thin, but not because of anything magical, Dr. Hyman says. He points to their lifestyle—they eat small meals, shop more frequently for fresh foods than American woman typically do and they eat slowly. Dr. Hyman says their food intake and choices, coupled with the fact that their towns are built for walking, changes their metabolism.
    • Protector Myth: Government polices and food industry regulations protect our health.
      Dr. Hyman says our economy profits from people being sick and fat. "The food industry profits from providing poor quality foods with poor nutritional value that people eat a lot of," Dr. Hyman says.
    The information provided here is for entertainment and informational purposes. You should consult your own physician before starting any treatment, diet or exercise program. The opinions expressed by the hosts, guests and callers to Oprah Radio are strictly their own.

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      America's Next Great Diet Craze

      Dieting on nuts, wine and olive oil
      Before you buy another book or throw out half your groceries, get the skinny on three of the hottest diet contenders.

      Popular diet plans have always played musical food groups: no carbs, more protein, low fat, high carbs.

      Today, having been there and done 'em all, Americans are heavier than ever, which is why the newest approaches are taking a different tack, claiming to manipulate the body in some way—say, by "flushing" fat or "revving" metabolism. The question is: Do they work? "The golden rule with weight loss is always 'calories in versus calories out.' No matter what the gimmick is, if fad diets lead to weight loss, they operate by making you take in fewer calories," says Donald Hensrud, MD, associate professor of preventive medicine and nutrition at the Mayo Clinic in Rochester, Minnesota.

      We asked some of the country's top nutrition experts to help evaluate the high-concept diet books making the rounds.
      PAGE 1 of 4

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        Chapter 6 from What Would Susie Say
        Chapter 6: The "Pause"
        You know Susie Essman as the sassy Susie Greene on HBO's Curb Your Enthusiasm. Now, she's turning her hilarious bouts of withering sarcasm into a book that delves into love, life and comedy.
        What Would Susie Say by Susie Essman
        I'm perimenopausal, and I know that I am because I have the symptoms, and I know I have the symptoms because I spend 80 percent of my free time checking out the myriad of medical sites online. I spend the other 20 percent looking for lumps.

        I feel so blessed to live in an age where medical information is available on the internet. Internet info is a hypochondriac's wet dream and a doctor's worst nightmare. I spend a lot of time on these websites checking symptoms for illnesses and conditions I'm certain I have. So far, this month alone, I've had Lyme disease, hysterical blindness, and an enlarged prostate. Whenever someone I know, or someone I know knows someone who has an illness—minor, major, or terminal—I immediately assume I have it too and plan accordingly. Much to my delight and chagrin, almost all of the commercials on TV these days are for some kind of pharmaceutical treatment for diseases I've never heard of but am sure I've contracted. One after another, fifteen-, thirty-, and sixty-second spots for pills and ointments that must be taken at your own risk. I know I'm not alone in this. Otherwise there wouldn't be so many goddamn commercials for this stuff. I've even thought of starting a symptoms checkers support group. I'll call it Dead by Tuesday Anonymous.

        The beauty of the internet is that there are so many choices. There's WebMD, MayoClinic.com, MedicineLine.com, Medicine.net—plus hundreds of specialty sites, too numerous to mention. Let's say I go on WebMD to check a symptom of a disease that I suspect I have, and they inform me that I'm in good health and have nothing to worry about. Needless to say, that prognosis doesn't sit well with me, so I can simply dismiss it and check out the other sites until I find one with an outcome that pleases me, one, that if not fatal, will certainly be very dramatic. The sheer volume of medical websites gives me hope that somewhere, somehow, I can find a site that lists my symptoms and will reinforce my belief that I have something that I most probably don't have a chance in hell of having. A lot of symptoms are universal. So many diseases have symptoms I can easily have. Fatigue. Who's not fatigued? Lethargy? Isn't she the twin sister of lazy? Or bloating? I'm bloated twenty-nine out of thirty-one days of the month! And you can fake yourself out on some symptoms and convince yourself that you have them even when you don't. Dizziness, for example. Dizzy is my middle name. I can easily convince myself that I felt dizzy because I lifted my head up too quickly the other day.


        I don't mean to trivialize the pain and suffering of people who are really sick, and it's not that I really want to be sick, but the hypochondria is something that is out of my control. Illness is frightening. If I gain weight I'm convinced it's because I have a tumor growing inside of me that weighs a few pounds. If I lose weight, it's because the tumor is causing a diminished appetite. I can't win. To ease my fears I tell myself that if I'm vigilant about my health, then I'll remain healthy. But there is anecdotal evidence everywhere I turn that proves that this approach doesn't necessarily work.
        PAGE 1 of 8

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          The Big Pang: Why You Can't Stop Eating
          Who's in charge—you or your appetite? Eating right would be a piece of cake if it weren't for that overpowering urge called hunger. But where do those "feeeeed me!" signals really come from? Your genes? Our culture? The mysterious hunger hormones leptin and ghrelin?
          Hungry
          Photo: Thinkstock
          Like the insatiable houseplant in Little Shop of Horrors our bodies send a message to our brains: "Feeeeed me!" The monster within us makes its relentless demand, we comply, and soon enough it rears its ugly head yet again and roars for more.

          We're supposed to feel hungry when we need fuel, but hunger has become so fraught, so linked to our collectively ballooning girth, that it often seems less like a finely tuned bodily function and more like a beast in need of taming. Who's in charge—our appetites or our brains? And is there really such a thing as willpower?

          The answer to the second question is yes, of course, but if we try to live by willpower alone—to eat less than nature intended us to eat, to be thinner than our genes meant for us to be—we're in for a struggle. The sad truth is that for some people, staying thin means going hungry. The much happier truth is that scientists are beginning to understand much more about how we know when, and how much, to eat. Millions of people, from the clinically obese to those struggling with an extra five pounds, stand to gain (and lose) from the researchers' insights.

          A major advance in Big Pang theory came in 1995, with the discovery of leptin, the first recognized hormone that regulates body weight. "Since then, the pace of change in understanding appetite control has been exponential," says David E. Cummings, MD, associate professor of medicine at the University of Washington in Seattle. Two years ago, Cummings himself reported that surges of another hormone, ghrelin, prompt hunger before meals. Both breakthroughs have brought us much closer to figuring out how, when, and why the creature must be fed.

          In a perfect world, two to three and a half hours after eating breakfast, your empty stomach secretes ghrelin, which travels to the brain and triggers your appetite. You begin to feel physically hungry, you think about lunch, and pretty soon you're eating. The food then signals your ghrelin levels to drop off, decreasing your appetite.

          As you eat, other molecules and hormones—including PYY, which was recently found to have a role in hunger—tell your brain to stop eating: Your stomach expands, and nerve impulses from the stretch receptors there, as well as hormones stimulated by food in the intestine, alert the brain that you're full. Together, ghrelin and PYY are part of a tag team of hunger, turning appetite on, then off.

          Leptin also turns your appetite off, but in a longer-term way than PYY: It lets your brain know how much fat you've stored in your body. Leptin is made by the fat cells, and as fat stores rise, more leptin is secreted, traveling to the brain with the message You're fat enough—stop eating so much. If fat levels fall, so do leptin levels, and appetite increases. Mice that are genetically unable to produce leptin grow enormously obese because they never get the word to stop eating.
          PAGE 1 of 4

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            Is It Possible to Lose Weight on Antidepressants?
            David L. Katz, MD
            Photo: Mackenzie Stroh
            Q: I was a healthy weight and had a normal appetite when I began medication to treat my depression. Since then, I've gained 40 pounds. These pounds seem to be quite attached to me despite all the dieting and exercising I do. Is it possible to take weight off while on antidepressants?
            — Louise Muckle
            Dundas, Ontario

            A: There's no question that certain medications may make it tough to lose weight, but I believe you still can. The most commonly prescribed antidepressants, SSRIs like Prozac, affect the levels of serotonin in the brain, which in turn has a direct effect on appetite. Other classes of antidepressants such as tricyclics can also lead to weight gain, although the mechanism is unclear. For some people, easing depression causes weight gain because their appetites are revived.

            First, try building some lean body mass through strength training—say, with light dumbbells or resistance bands. Aim for roughly 20 minutes, three times a week. This offers two advantages: Muscle requires more calories to maintain than fat, and having more muscle will make activity easier and more pleasurable, which translates into additional calories spent.

            If medication is increasing your appetite, try using what I call nutrition skill power to satisfy yourself with the fewest calories possible. Choose foods that will take up a lot of space in your stomach but aren't calorie-dense, such as fresh fruits and vegetables, soups, and stews.

            Eat plenty of fiber, which will fill you up but is calorie-free; get it from whole grains, beans, and lentils. Some research shows that calcium and vitamin D may direct calories to muscle rather than fat storage, so take 500 milligrams of calcium and 300 IU of vitamin D twice daily (check with your doctor first).

            Finally, if both you and your doctor are willing, consider switching medications. Not all antidepressants have the same weight-gain effect in every patient. You may be able to find a drug regimen that relieves your depression without adding pounds.

            As a reminder, always consult your doctor for medical advice and treatment before starting any program.

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