George L. Blackburn, M.D., Ph.D. is Associate Professor of Surgery and Nutrition and Associate Director of the Division of Nutrition at Harvard Medical School. He is the Director of the Nutrition Support Service, Chief of the Nutritional/Metabolism Laboratory, Director of the Center for the Study of Nutrition and Medicine, Program Director for Surgical Treatment of Severe Obesity, all of which are affiliated with the Beth Israel Deaconess Medical Center in Boston, Massachusetts.

He received his medical degree from the University of Kansas in 1965 and completed his internship and residency at Boston City Hospital, Harvard Medical School. In 1973, he obtained his doctorate in nutritional biochemistry from Massachusetts Institute of Technology.

He has published more than 400 publications to date and is on the editorial board of and reviewer for several journals, including, the Journal of the American Medical Association and New England Journal of Medicine.

In 1988, Blackburn was awarded the Grace Goldsmith Award by the American College of Nutrition and was made an honorary member of the American Dietetic Association in 1992. In 1998 he was the recipient of the Joseph Goldberger award in Clinical Nutrition from the American Medical Association.

5.10.01 Salene asked:
My sister is thinking about having her stomach stapled to lose weight. She has been extremely overweight most of her life and is a borderline diabetic. She has tried many diets to lose weight and they work for a while but then even though she stays with the diet, the weight stops coming off. She had just started taking Fen phen when it was taken off the market. It was the only medication that helped her lose weight. I have heard all the horror stories about what this drug can possibly do to your heart, but without it her health is in jeopardy because most of her problems are caused by her being over weight.

She was told once that there was a chemical imbalance in her brain that made her over eat. If that's the case why can't someone find a way to cure this problem. What are the pros and cons of having your stomach stapled and do you think it is a good solution to her problem? Thank you! Salene

Blackburn's response:
We call medications and "stomach stapling"/Gastric Bypass Surgery tools or helping hands to develop a healthy lifestyle that uses of a healthy diet and physical activity. These tools can only be safely and effective used in conjunction with a physician or surgeon knowledgeable in their use.

There are many Internet Web sites to gain the information you and your physician need. You can be confident that safe medications and Gastric Bypass surgery are available when indicated. However it all begins with proper food selections and energetic lifestyle.

Web sites:

• American Society of Bariatric Physicians
• American Society of Baratric Surgeons
• Centers for Disease Control - NHANES Surveys
• Independent tests of herbals, vitamins + supplements
• Center for Science in the Public Interest
• On-line weight management consumer resources
• American Dietetic Association
• U.S. Food and Drug Administration
• International Food Information Council
• Government's health Web site
• International Association of Eating Disorders
• International Association for the Study of Obesity
• Mayo Clinic site for healthy eating and healthy weight
• Resource Centers (Cardiology) for wgt mgt news + info
• National Association to Advance Fat Acceptance
• North American Association for the Study of Obesity
• Food and Nutrition Information Center
• Nutrition Navigator
• Weight Control Information Network
• Boston Obesity/Nutrition Research Center
• Aim for a Healthy Weight
• The American Society for Nutritional Sciences
• Comprehensive site for government information and materials
• American Obesity Association
• Centers for Obesity Research and Education

5.10.01 Beatrice asked:
I am a 24 year old black woman who has been struggling to lose weight for over 2 years now, but I never succeed. I've tried some weird fad diets of my own, but I gain more weight. I want to know is there a way you can lose weight and not spend so much money on diet foods? Because I work part time, I have very little funds. I would like to live as long as God will allow- but how? Can you please help me, I'm crying out to become normal again. Thanks

Blackburn's response:
Step 1 is to get to a healthy diet and activity program. That involves writing down what you eat, when you eat, how much you eat and how fat you eat. That is a structure of your daily food selection and dietary pattern.

Next, identify those high calorie foods that you can eliminate or substitute for low calorie foods. Try to be successful 10 out of 21 meals per week (7 BKft; 7 lunches; 7 dinners).

The same is true for daily activity-how many minutes are you involved in brisk activity like walking. The minimum is 30 minutes most if not every day. For appetite control you will probably need 60 minutes.

Any change you make should not be a fad. If you cannot do it for the rest of your life then don't do it at all. You have to ask yourself, how important is it to eat healthy and be physically active to stop gaining weight and when you lose weight keep it off.

Next, what is your confidence (on a scale of 1-10) that you can sustain the changes in lifestyle? Finally, you need to find a group (family, church, and weight control group) to work with. Be faithful and you'll get control of your body weight.

P.S. the best nutrient-dense, low-calorie foods cost less than most cakes and snacks or meals.

5.10.01 :Lisa asked:
Does taking 1000 milligrams of calcium a day help women lose weight? Are there any other vitamins or minerals that do?

Blackburn's response:
No and no. Your body weight is determined by your total calories in versus your total energy expended. There are plenty of reasons to get the daily requirement of vitamins and minerals, but weight control is not one of them.

5.10.01 Sharon Bender asked:
What is your response to the work on "addiction" in obesity? There is some evidence that there is a problem with dopamine and the yo-yo effect. I get to a point I would kill for chocolate, and lie, steal cheat for food when I lose too much. No one has ever addressed this in any diet I've been on. Why?

Blackburn's response:
Low dopamine is a new hypothesis. There are many reasons to love chocolate. The skill is to learn to eat or taste a small serving each day so you won't feel deprived. Take it with glass of milk and get a good bout of exercise and you'll control your weight without feeling deprived.

It is very important not to gain weight as it is very difficult to lose weight-more that 5-10 percent of your body weight.

5.10.01 Kim asked:
Dear Dr. Blackburn: I watched the PBS special "Fat & Happy", and I am more confused than ever. I have a book that advocates High Protein, Low Carb, and no mixing of either. I have also read all the other high protein books, which say that caloric intake does not matter. I AM MORE CONFUSED THAN EVER, NOW!

My husband and I are bouncing back and forth between books, just when we think we have it right something else comes our way to show us differently.Please put this into perspective.

Thank You
Kim Dean

Blackburn's response:
One size does not fit all. There are many types of food selection. The one that gives you satiety/fullness, good taste with right size portions is the one for you. Often the diet for a women is different that a diet for man. There are many ways to achieve weight control. The most successful diets use a variety of foods and lots of exercise.

5.10.01 Sara Shapiro asked:
What are the effects of prozac or other anitidepressants with weight loss? It seems that since I have started taking antidepressants I have continuously gained weight.

Blackburn's response:
Antidepressent effect on appetite and body weight control vary. Further, while one works for a while, often you need to change meds. Work with your physician on adjustment of medication and a good nutritionist to develop food selection that is not associated with weight gain.

5.10.01 Chris asked:
Where did you get the "Empathy suits"? What is the name of the company and how much did they cost? Thanks very much for the information.
Chris

Blackburn's response:
Manufacturer: AJR Services 4 Daintry Terrace Macclesfield Cheshire, SK10 1JP England Ph: 011-44-1625-615-090 Email: roy@AJR.u-net.com Approximately $1000 US dollars, plus estimated textiles import tax of $300

5.10.01 Mike asked:
I used the BMI calculator and for me (5'-9")I should have a weight of 162 lbs for a BMI of 23.9. I look ill when I go below 180 lbs. I have what I consider a large frame and am muscular though not as toned as I was 20 years ago. I know people as tall as me where I can get my thumb and fore finger around their wrist. I can't on me and I have large hands. How can every 5'-9" person have the same weight? Very informative show on nutrition. Thank you, Mike

Blackburn's response:
They can't. There is 10 percent range around each height. Thus while ideal BMI of 21 is a weight of 160+, there is no health difference in a range close to your weight. Further adjust for body type mesomorph, ectomorph and endomorph.Also adjust for waist thickness
See this document for reference.

Women with 35 inch waists and men with 40 inch waists or greater are at increased risk. As a general rule, any 1-2 inch increase in waist size poses a risk.

Healthy eating and physical activity are your goals. Be sure not to gain anymore weight unless it is muscle. Good luck.