Obstacles to Weight Loss with David Katz, MD

What's standing between you and a healthy weight?

WebMD Weight Loss Clinic - Live Events Transcript
Event Date: Jan. 16, 2003

If this year is not the first time you've made a resolution to shed some pounds, you already know the kinds of obstacles that stand between you and a healthy weight. We discussed the hurdles and pitfalls of weight management when David Katz, MD, co-author of The Way to Eat, joined us on as part of WebMD's New Year's Challenge.

The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome, Dr. Katz. Your book is called The Way to Eat. That's a subject of great debate these days, especially when it comes to weight loss. The low-carb versus low-fat argument continues to rage. Where do your book and your medical opinion fit in this fight?

Katz: I think the goals for weight control must include life long health as well. I am unapologetically opposed to fad diets. They are about short-term weight loss but not long-term health. Health and long-term weight control can and should be pursued together. I think people's common sense guides them in the right direction. We all do really know that a balanced moderate diet rich in grains, fruits, and vegetables is good for us. It's worth noting that some very bad diseases like cancer, cholera, tuberculosis, and AIDS produce rapid weight loss and lower your cholesterol. Clearly these are not good for you. And what that points out is that not just any approach to rapid weight loss is good for you, either.

In my view, learning the skills and strategies for lifelong nutritional health and weight control is like learning to ride a bicycle. Until you know how, it's scary. If you try it without knowing how, you will tend to fall down and get hurt. And by that I mean failed attempts at controlling weight -- which really are painful for people. In response to epidemic obesity, many nutrition experts are unfortunately fussing about which bicycle you should ride or which bicycle you should buy without stopping to consider that you don't know how to ride. Fad-diet authors say forget about learning to ride a bike; come take a ride in my limo instead! The Way To Eat teaches you to ride that bicycle. Once people know how to pursue a healthy lifestyle and diet for lifelong weight control, the appeal of quick fix fad diets dissipates.

Moderator: Of course, exercise is part of that equation, and we have a question about that:

Member: So how long should we exercise daily? Is it OK to exercise two hours daily?

Katz: In terms of how long you should exercise for weight control, there are several considerations. I won't bog down in math now, but unless you work out very intensely, usually the number of calories consumed in exercise is limited. Most of our calories are spent on basal metabolism. But the benefits of exercise go far beyond control of weight. Exercise certainly contributes to weight control, improves cardiac health, seems to reduce cancer risk, is clearly good for mental health, and is associated with longevity.

If you are not fit, starting intense exercise abruptly can, of course, be dangerous. But if you build up your physical activity level gradually, there probably is no amount of exercise that's too much. Frankly, I wish I could find the time every day for two hours of exercise. The one caveat is that some exercise is very stressful to joints. Listen to your body. If you are producing aches and pains as a result of your workout you are either overdoing it, or doing it wrong. But most of us would benefit from more physical activity as part of our daily routine.

Member: I don't have a sweet tooth; I have a salty tooth. I crave things like chips and cold cereal and popcorn. It seems that's all I eat sometimes. I'm not terribly overweight for my age (mid-30s) but I think my diet may catch up to me one day. Is it unusual to crave foods like this, and am I on course for health/weight issues later?

Katz: It's not at all unusual to crave salty food. For the most part, human beings are born liking sugar. Salt is more of an acquired taste. But we are predisposed to like salt. Salt is relatively hard to find in natural foods. That's part of the reason, for example, that deer will come to a salt lick. In our case, the more salt we eat, the higher it tends to raise our threshold for tasting and appreciating salt in our food. It seems likely that you would indeed benefit by trying to break this cycle.

Here is what I suggest: Identify lower-salt alternatives to those foods you mentioned. A good example would be health-food brand cereals, such as Nature's Path, as alternatives to the commercial brands. Taste buds are creatures of habit, but they can be re-trained. When you first taste the lower-salt foods you will miss the salt. Stick with them anyway for one to two weeks. By that time, your taste buds will already be acclimating. If you keep making such substitutions, you will gradually shift downward your affinity for salt.