Ask the doctor - weight management

DIET DRUG

I’ve been prescribed Rimonabant for six months to help me lose weight, but I feel miserable and I’ve hardly lost any weight. Is this really a miracle drug?

Rimonabant, which is sold under the brand name Acomplia, is an appetite suppressant that should help you stick to a low-calorie diet. It is not, however, a miracle pill and most people lose only a small amount of weight while they’re taking it. It sounds to me that this treatment isn’t right for you and, whether it is the drug that is making you miserable or its failure to work, I think that you should probably come off it. Talk through alternative options with your GP. But remember that there is no such thing as a quick fix in the fight against obesity. A healthy diet plan combined with regular fat-burning exercise is your best bet and, with a little willpower and some expert advice, there is no reason why you should not be able to reach your goal. You’ll find plenty of helpful tips on losing weight at weightconcern.com.

Dr Louise Selby, SHE 

Weight gain and the Pill

I’ve been in a new relationship for the last six months. To begin with we used condoms, but then I decided it would be a good idea if I went back on the contraceptive pill as I didn’t want to take any chances. However, since I’ve been taking it, my weight has gone up by over half a stone. I’m 36. Would swapping to another form of contraceptive help?

It's true that you can put on a few pounds when taking the combined contraceptive pill. However, have you considered whether it's your new relationship that's to blame? Many women start taking the Pill because they've met a new partner. But just think about the early stages of a relationship - you've probably been going out for more meals and cooking more elaborate recipes for you both, and you may also have less time to exercise. So before you automatically blame the Pill, have a careful look at your changed lifestyle.
Dr Sarah Jarvis, Good Housekeeping
 

Contraceptive injections and weight gain

Last year, I used the depot contraceptive injection for nine months. At first, I noticed that I’d put on a few pounds, but then my weight suddenly started to balloon. I stopped using this form of contraception nine months ago, but my weight is still going up. What’s causing it and what can I do to stop it?

While excessive weight gain with the depot (slow-release) form of contraception isn't common, it can happen. And while it's normal to put on some weight - the average is about 5½lb a year - it can be much more than this for a few women. The fact that your weight has continued to go up, however, even though you're no longer using it, suggests that there might be another cause, such as an underactive thyroid gland, that needs to be investigated. I suggest that you make an appointment to see your GP and ask if you need to have a blood test to rule this out. Dr Sarah Jarvis, Good Housekeeping

Weight loss

Recently I switched to a healthier diet, and lost about half a stone. But my practice nurse says I’m a little underweight. Is it dangerous?

It depends just how underweight you are. Being very underweight (usually measured by a body mass index - BMI - of under 17) can increase the risk of osteoporosis, or thinning of the bones. But if you're within seven pounds of the ideal range, you're highly unlikely to have problems. Unless you are seriously underweight, low weight is, generally, much healthier than being obese.
Dr Sarah Jarvis, Good Housekeeping

Can a pill help me lose weight?

According to an article I read recently, there is a new slimming drug you can buy over the counter. I've been trying to lose weight for a year without success. I'm too busy running my own company to spend any time in the gym and I often eat ready-made meals, which doesn't help. How do I get hold of this drug – and is it safe?

You are referring to the Alli tablet made by GlaxoSmithKline. It's expected to be approved for use in the UK next year, but it's not a wonder drug – it's only effective when combined with a healthy diet and willpower, and side effects include diarrhoea. Trials suggest that once people stop taking the drug they regain all the lost weight.

Being overweight means you're at risk from health problems including diabetes, heart disease and some cancers, so it's important to make a long-term healthy-eating plan a priority. It is difficult, but if you're organised and committed, it is possible.

Cut out ready-made meals and junk food and stick to a balanced diet with fresh fruit and vegetables. Think about joining a dieting group – it's easier when others are spurring you on. Regular brisk walking will help control your weight – and reduce stress! For further advice, visit www.weightconcern.org.uk.
Dr Louise Selby, SHE
 

Help me with my diet!

I have irritable bowel syndrome and need to lose weight. How do I find a qualified dietician for expert advice?

The term dietician is protected by the Health Professions Council (HPC) in the UK, and only people who are properly qualified can register with the HPC. Your GP can refer you to a dietician or you can contact the HPC (www.hpc-uk.org or 0845 300 4472) to ensure your dietician is registered.
Dr Sarah Brewer, Prima
 

My waist is thickening

I drink lots of water during the day, but have noticed that I’m gaining weight around my waist. I only have one kidney. Could this be the reason?

Drinking fluids will not cause weight gain in the form of fat around the middle, although it can cause fluid accumulation – for example, around the ankles. As you are concerned, do see your doctor to check your kidney function. Weight gain around the middle is usually due to excess fat, and ‘middle-age spread’ is a possibility. The good news is that fat stored on the abdomen seems to be easier to shift through diet and exercise than fat stored on the hips.
Dr Sarah Brewer, Prima

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The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk