and good evening.

Thank you so much for watching HealthLine on PBS Fort Wayne I Mark Evans, your host.

>> And tonight we're going to talk about something that people really don't want to talk about and that's dieting.

Of course, you know, tis the season to be jolly.

A lot of food in sight.

>> They'll be eating everything except the holly.

Oh maybe.

Anyway, our special guest tonight is Dr. Ryan Sigmon.

>> We had you on what about a month and a half ago or so we're talking about this and we said we need to get you back especially during the holidays to give people ideas about how to not only keep the weight off ,not gain more, but once they do, what's the right direction?

>> Sure.

And tonight we're going to be talking about fad diets and you may not want to hear about some of this stuff.

>> Of course we want you to listen.

I want you to view and if you happen to have a fad diet that you're on or considering why don't you give us a call?

>> The number is on your screen.

It's 866- (969) 27 two zero.

We'll answer all your questions about dieting tonight as Dr. Ryan Singleman is a weight management and family medicine physician so he knows all about that numbers on your screen give us a call any time during the next half an hour we won't be stopping down for commercials because we are public television.

>> Very proud of that.

>> So Dr. Singleman, we're going to reveal some of the truths behind the fad diets and I thought this was very interesting subject.

>> We talked about this a little bit the last time you were on but are there advantages to fad diets?

>> Are they actually helpful in losing weight?

Well, that's a really good question for many people.

If you are trying to lose body weight, any change up in what you are doing will allow you to maybe get some of the weight down if you are taking someone who's eating a lot of food and your cramming it down to something smaller because you're going to a low carb diet or you're trying to cut gluten out of your diet or you're wanting to maybe eat mostly meat and so you're cutting out a portion of the calories normally concerned you're going to find that you can lose some body weight by reducing those calories.

So it's possible that you will lose weight with a fad diet and there's so many of them out there.

>> The challenge however is to take a fad diet and make it into a lifestyle and make it sustainable and that's where a lot of people may fall down.

You can you can do the chopstick diet.

>> You've heard of the chopstick.

Don't eat anything that you can with a chopstick sort of it's you eat soup with two chopsticks if you still gain weight then you go just one chopsticks.

>> OK, but what are sustainable long term and that's really where the fad diets can can fall apart because it's not something that people necessarily are ready to do for the long haul so it can be helpful short term but is it really something that's sustainable and a tricky part about fad diets and this is what my Britza dietitians and I work with a lot is you can get to a point where you're so controlling what you're eating that you're not getting proper nutrition.

>> OK, so just because you could maybe lose weight eating oatmeal all day long means you're missing out on massive food groups or just eating chicken all day or whatever.

>> You've got to be very careful about some of these fad diets will direct you to because you may be nutritionally falling apart.

Well, and we also need to look at as we discussed in the last show, it's all about balanced.

You know you don't want to just stick to one thing even though it might work.

But bottom line, why do people often gain weight after a fad diet?

>> And I kind of know because I've been there done that.

I've been a diet yo yo all my life .

>> But why is that so it's important to understand how your body works.

>> The typical axiom is you eat less, move more, lose weight and what we've all been doing most of us are we here culturally it's a little more complicated than that we've talked about before in the show there's about fifty seven different types of obesity and roughly four hundred hormones that contribute to how your body operates.

Now if you cut out a portion of your calories for a while then your body will slow down your metabolism a little bit trying to help prevent weight loss because that's the way we're programed.

So you go to a fat diet, you drop calories, you drop body weight and some of these hormonal slowing occurs and then what happens is you would start losing weight and then you hit plateau and once you hit that plateau it's because your body is found a way to balance the activity and your nutrition to keep you at that constant weight even though you want to go lower.

It's found a way to kind of cheat, if you will, to keep you safe, stable place and then you keep going at it.

You get frustrated because what you were doing was working.

Now it's not working anymore.

So you say to heck with this diet, it's not working anymore.

>> I'm going to go back to eating like I was.

But if you were eating here and you were down here with your calories but your body was treating it like this then it's like taking that and doubling it up again because your body's kind of rebound back into that body weight and so you can see people who yo yo diet or crash diet for a while go back to what they are doing in crash site again they keep not only not going as low as they were with each diet each time they regain that weight they regain higher than they were and they keep going ever higher with these cyclical dieting types.

>> Well, you know, if you don't mind me sharing something personally here as far as what I've been going through since April, I've Austin I think a considerable amount of weight more than twenty five pounds.

My goal is at least thirty but I have stayed at the same weight now for probably going on for weeks and my particular diet is not a fad diet.

It's what we have talked about a couple of times.

It's the portion control and increasing the exercise movement and so forth and that worked out famously for me.

>> So I have locked in at a particular weight and it's just like today just getting dressed to go to work.

>> I thought you know, these pants are fitting really nice and loose.

>> I just wore them not too long ago and I said I bet you I've lost some more weight.

I get on the scales.

>> I'm at the same weight.

So is there something about that?

Does your body catch up like losing the inches versus the pounds?

>> How does that work?

So there were actually multiple questions then they're OK with each and every one of them feel like well start with the last one which was how can you wait stay the same but the same time then you're actually feeling clothing fitting differently.

Yeah you can through activity for doing more exercise and controlling how you're eating.

>> You can actually lose body fat but put on muscle muscle and because muscle is denser it takes up less space than body fat does so your weight can be the same but your body proportionally be changing so your shirts fit differently your pants fit differently.

>> Oh yeah.

And then that's how you can you can put on these clothes and go well my weights the same but this feels so much more comfortably.

>> Yeah.

Now to go back to the other question that you asked in there is what's going on with this plateau and what do I need to do to maybe get out of a plateau?

>> Yes, So initially if your body is plateauing one of three things that's happening either on a calorie balance side you're hitting where you need to drop that calorie balance out more so you need to maybe cut back on some of that what you're eating or change up what you're eating.

>> What I mean by that there are three major groups of calories.

You've got your proteins, you've got your fats and then there's those carbohydrates.

>> Well, each one of those in different portions is what we get all of our nutrition from and there are some body types takes some experimentation to figure out which one your body prefers.

There are some body types that prefers more fat in the diet.

There are those who prefer the more carbs or those who prefer more protein in trying to figure out what that ratio mix is can help your body to get out of those plateaus to be able to lose again.

The other thing is it may be that you're eating exactly the amount of calories you're supposed to be but your body may be treating it like too much the different disease states that affect body weight your genetics, the metabolism, the medications may or may not be taking all those different things contribute and can make it a challenge.

>> OK, so there's there's a lot involved there and of course going a different direction you wouldn't suggest in my particular situation portion control versus and of course increased activity I should not change.

>> I just need to maybe change up my diet a little bit.

Do you think that possibly in incorporate more exercise is that going to perhaps kick things in again?

It certainly wouldn't hurt but I would say for the most part when people are looking to make lifestyle change and to get healthier with their body weight, the key isn't always exercising more because exercising more can actually make you hungrier and it can give you that excuse to go well I exercise today so I can have that little thing over here.

>> And the other issue is we often will misjudge how many calories we burn with that exercise and so we might actually overindulge more than intended to try to make up for that balance.

>> OK, very we'll get back into weight loss but we have a question here about James who I think we're going to go quite the dichotomy here which is fine because we're still talking about nutrition and weight.

>> But James is asking do you have any advice for a cancer patient struggling to gain weight asking that?

>> Yeah, and that's a phenomenal question.

Unfortunately we hear these kind of concerns very frequently and it's a struggle between the ravages of cancer itself, the therapies for chemotherapy.

It can make it very difficult to lose body weight.

So a couple are to gain body weight excuse me.

So a couple of things to do with that.

The big key is pushing protein the the way cancer attacks the body, the way chemo therapy agents work on the body.

It's very easy to lose healthy amounts of protein and when that happens you start reducing your baseline amount.

You actually get to a point where your body can't absorb nutrition as well and I won't go into major detail with it.

But essentially your small intestine has a certain amount of surface area and that is beholden to how much protein you have in your body.

The lower your protein level drops, the lower surface area drops and the less you're going to be able to absorb.

>> So the real key if you're just struggling to keep weight up is really try to pack into the protein whether it's drinking protein shakes, whether you're making your cells or buying some name brand over the counter, whether it is trying you eat lots of tuna, lots of soy, those types of things will help it to tell you to build that back because your protein levels go too low.

>> You're not going to absorb anything else as well.

OK, and that's something James should definitely be talking to his doctor.

Absolutely already doing that.

You know, that's very important for cancer patients to keep that weight on and sometimes as you mentioned put some weight on.

>> Absolutely.

All right.

Now I did preface a question earlier, but are there any beneficial fad diets?

>> Are there any fad diets that you would advocate so broadly?

>> Yes.

And then specifically no.

Right.

So what happens with any type of diet plan?

There are scientific reasons why you might choose one type of a diet over another depending on a person's health status, depending on their lifestyle, depending on their budget.

There are certain things to consider.

Some of the ones that are a bit more more common right now are things like the Kyoto diet you may have heard of free or low gluten diets are kind of a fad right now there is the Mediterranean diet.

>> People have heard about the dash diet and many others.

So each one of those may have specific reasons why someone may want to choose them.

The tricky part about them is that they can take a long time to not only adhere to but it can create a lot of life change that makes hard to stick to it long term.

As an example, we do not live in an area that typically has a lot of fresh fish so we have people who can import it.

>> People do go out to fish but if you want to live a true Mediterranean diet which is a lot of green leaves, a lot of fish and some oils that make up a big part of that diet type, it's going to be a little hard to find that that constant supply of good healthy fish in this area.

Conversely, if you are somebody who is an animal lover doesn't want to think about eating animal proteins or if you have certain religious affiliations that mean you can't eat certain types of proteins, then things like a ketogenic diet or an Atkins diet are not necessarily going to be the right thing for you to choose because it's not going to agree with that lifestyle.

>> However, if you look at the Mediterranean diet it shows phenomenal ability to help reverse heart disease, to help reverse diabetes.

>> You look at things like the ketogenic diet and the Atkins diet, the Atkins shows similar things where it can help actually to reverse the effect of diabetes, help people lose extra body weight.

So in those instances you can say well, if you have some of these issues then taking some of these diets on might be beneficial for you.

OK, we're talking to Dr. Ryan Singleman who is a weight management and family medicine physician and will answer your questions as you call those in 866- (969) 27 two zero.

>> Of course it is the season that we start grazing at the tables of various parties even at home special treats that come in and I think from what I've been preached by physicians and even weight loss counselors over the years, moderation is the key.

>> Isn't that isn't that true?

>> I think it is to the extent that when you start to deny yourself and and just keep saying no, no, no, sometimes those those yearnings, those cravings just start to get larger and larger and when that happens you can get to a point where it almost becomes overwhelming.

>> And so instead of being just a little bit it's now I mean the whole sleeve of cookies if it's doglike Oreos or instead of having a small piece of the pie, I'm having half the pie and of course that's that pretty devastating.

>> So I'm having a little bit may help prevent you from having too much.

There's still those people too who having a little bit will actually promote you into having more and more like you can't just stop at one nobody can eat just one.

>> Well, there are certain foods in my household too.

>> They're my kryptonite.

I will absolutely adhere to that.

But so moderation I think is key but there are people that if they even have a little taste it's going to put them over the edge and you know who you are.

>> You know that you're more likely to have one struggle versus another.

So it really helps to sit down with a dietician, with a therapist, with your physician and help kind of talk to you what your barriers are to being healthy so you can identify because if you can identify where you're going to struggle then you're going to have a easier time of planning for success.

>> True.

That makes sense.

All right.

Let's go to the phone lines.

>> Line three we have Rosano Rossana, what is your question for Dr. Sangamon?

Yeah, I have three questions.

I would like to know which blood pressure medications are most likely to cause weight gain and have I lost my gallbladder if that had caused me to cause weight gain and also can going on a Spanish diet happy to lose weight.

>> OK now those are some great questions.

Thank you very much for asking them.

I'm going to start with your last question first and that is can going on a spinach diet help you to lose weight?

Well certainly if that's all you're eating the likelihood is yes that it's going to help you lose a lot of body weight.

But that's not necessarily a healthy diet to just eat nothing but spinach.

You need to make sure that we're actually getting all of your full nutrition in there and it would be hard I think to consume thousands of calories worth the spinach and when sitting.

So I think it most likely yes, you could lose weight with that for your second question, the middle question regarding the gallbladder having your gallbladder removed does not by itself cause you to lose or to gain body weight.

In fact, for many people they find that because not having that bile that was sitting in the gallbladder as much you didn't have more loose bowel movements and may have a little harder time keeping weight on.

And so if that is something that is starting to affect you, definitely talk to your doctor about that because there are ways you can circumnavigate that and have a normal bowel system again.

And for your your first question, it was about the medicines for blood pressure that cause weight gain there are a whole class that tend to be more damaging than others and that's what we called the beta blocker class.

There are some things called propranolol metoprolol attend the Lall Lavetta lolled that class can cause you to be more likely to gain weight which doesn't mean you necessarily stop them.

>> There's usually very good reason why we choose those medications for you as a patient.

So before you would even come close to stopping one of those definitely talk to your doctor about it.

There may be alternatives that are appropriate but you don't just ever want to stop one of those because they could be very important for your heart health .

>> That's good advice, Valerie has a question.

>> Well, read that she's preferring not to be on the air and that's quite all right.

So she's saying what would you suggest to someone that needs to lose weight for surgery but have hit a standstill?

>> I've known people who have had that situation well and I actually see that pretty regularly as well as a lot of the patients that I work with professionally are either on weight management journey with medications and lifestyle changes as an adjunct to actually going for bariatric surgery or who are kind of in a dual program with or who've had bariatric surgery and then need further support.

We also have patients who need to lose access body weight so they can safely have a hip surgery or safely have a knee surgery or something like that.

So if you're at a standstill, one of my my biggest recommendations is sit down and do a real inventory and be honest with yourself.

What am I doing for breakfast?

What am I doing for lunch?

What my doing for dinner?

Am I doing snacks?

Am I eating at night?

Am I snacking throughout the day?

Do I do great five or six days out of the week but then on a weekend I kind of blow it up because I'm going out to eat with friends or I'm indulging in more alcoholic beverages or whatever it might be.

And speaking of beverages really take a look at what you're drinking.

You know, if you are drinking multiple cups of a Starbucks coffee that is three or four hundred calories a day if you're putting lots of creamer and things if you're drinking milk or juice or sweets or regular pop any of that stuff, we don't usually think about it but it starts to add calories to what you're doing.

I was kind of joking with my my youngest son the other day we were at a family member's house.

We were visiting them.

It's the holidays and my son was very excited because he had root beer and don't get a lot of beer in my household and so he was drinking root beer and I said Hey buddy, take a look at that root beer because that's your dessert.

He said What do you mean is that how many calories are in that cup of root beer?

And he looked at it and he's like There's one hundred eighty calories and yeah.

And I said How many calories do you do that you have for dessert.

He says Two hundred is a and he got frustrated.

>> Yeah but it's and we would be nice he didn't deny dessert but the point is that when you drink your calories is the easy way to start keeping your weight up or gaining weight you don't intend to do doing well I think that's the next and of course you're a physician you're going to be preaching that to your children.

>> But but even when I was on going to talk about this a couple of minutes in fact time is flying by during the show but I was on the ketogenic diet.

>> You're I did very, very well with and we're talking twenty years ago when all of this was a big buzz and I think that during that time and I can mention these two particular weight loss companies because they're no longer in business but one is physicians weight loss centers and the other was Neutra bollix.

It seems like what you just drive by street corners?

Oh, there's another Neutra bollix going.

>> So that was quite the rave at that time.

Now I participated in the physicians weight loss centers process and I lost forty pounds in ten weeks.

I thought that was great and of course I was a walking testimony of people so my gosh how are you losing the week where I tell them where I lost it?

>> Well the thing about it is Dr. you're them and I put that forty pounds and then some back within two years and I was even trying to watch what I eat and this particular program that I was in they taught you how to eat healthy portions, make sure you have the balance but it was also very protein ginner and we had to do we check we would actually check our urine.

>> Sure.

With these sticks Quito's sticks to see where we're as they would call it burning as far as the fat process and you know, if you were too low you weren't sticking to your diet or if you didn't show any type of that burn or it could go really hot.

>> Right.

And so if you're really hot it's like they would say you need drink more water, get those ketones flushed out of your system and I think they even promoted more protein at that time.

>> So all in all out of business over the years and then of course we have Dr. Atkins coming up with his diet and the ketogenic diet seems to have still stayed around.

>> But is is that is that a dangerous diet or I mean should that be medically supervised any type of diet ought to be medically supervised.

But when it comes to things being dangerous, especially when you're looking at ketones and too much catalysis, you can actually be burning a lot of fat, putting lots of ketones into your body which can actually be very challenging for your kidneys.

So if you're making massive shifts in your body weight with that and you can be successful at losing a lot of body weight in fact it can show data that helps reverse things like diabetes.

>> But if you don't do it effectively or do it appropriately and you're on Mezzeh medications for diseases ,you could actually be shifting things so quickly that those medicines stop being beneficial.

It can actually be harmful.

>> So things where they're trying to check your urine to make sure you're in the right range and make sure you're drinking enough water to trying to monitor you because they don't want you to cause harm and the struggle is you gain the weight back.

But my guess is it was not because you weren't trying to be careful but also because you weren't just doing that same ketogenic diet to the same degree anymore.

And that's where trying to find the right balanced approach for your lifestyle is so important.

>> It's not just about I'm going to do this for six weeks or eight weeks or ten weeks.

What am I going to find that I can do for really the rest of my life to be successful at losing excess body weight and being and being healthy?

>> I'm OK and we can talk about other fad diets but we're running out of time.

We have three minutes but I want to make sure we get this question since we're talking about people pondering whether or not they need to lose weight, you know, and I know a lot of people I won't say a lot but a few that are saying yep, suicidality is over.

>> I want to start a diet.

Yes.

And when they found out I was doing this program, we got some good information for me.

>> But you know, you mentioned you know, as a physician you're going to figure try to figure out what type of diet would be best for an individual or weight loss program.

So the question is if someone strictly wants to lose weight and get healthier, what do they need to do first?

>> The first thing I would recommend doing if you strictly want to lose body weight and try to get healthier, this is what you want to tackle on average the average American gets eight hundred more calories a day than they need.

>> So here's what I would start with eliminate anything you're drinking with calories.

>> Get rid of the soda.

Get rid of the alcohol, get rid of juice, get rid of milk.

We drink so much milk and then get hung by the dairy lobby on this but it's not healthy for us so we need to eliminate a lot of the liquid calories we get.

In fact have had people who get two times their regular needed calories day and just what they're drinking get people who are drinking gallons of Kool-Aid or Mountain Dew or look at Gatorade all that good stuff is full of sugar and it just leads to extra body weight.

So that'll be the first place I'd look at second of all not to pick on any specific restaurants but especially for fast food.

Stop getting the side dishes.

Stop getting the tater tots, stop getting the French fries.

Just get one sandwich not two , three or four only eat one piece of the bread, not both of them.

And then if you're looking at going out to eat sometime get half the meal box before it even comes to the table and eat out for lunch the next day.

Let's start reducing the portions coming in and if you will do this consistently you're going to start seeing some changes.

However, work with your dietitian, work with your physician, get this a bit more structured because for a lot of things that are out there it can be beneficial.

>> But if you don't know the rules to the game that you're playing, you're not going to be successful at winning it so someone can tell you a little bit of rule year to a little bit of rule there and you think you picked it up by watching someone else play it.

But until we address it right for yourself, you're going to have a hard time winning.

>> All right.

And then of course you know there's the yo yo yo yo cycle and my last question for you and we have about thirty seconds how can someone stop the Fed or of the yo yo diets so yo yo dieting is dangerous and that what you're doing is you're constantly going up and down your diet.

You drop weight, you come back and you keep doing it back and forth, back and forth.

The key is getting consistent and if you hit a plateau reach out to your doctor.

Don't stop doing what you're doing because it's worked so fast is you stop you're going back up.

Keep doing what you're doing and reach out for help.

>> Consistency is the consistency.

All right.

Dr. Ryan Zimmerman, by the way, if you'd like to go to Google and Google Ryan Zimmerman blog, you'll see a lot of this information and more for your holiday losing weight.

>> Pleasure.

All right.

Thank you so much for being with us today.

My pleasure.

And you got to have you back we'll have you back after the holidays some time.

We'll see how everybody did.

Sounds great.

OK, we'll be back next week.

We have a very special subject is called Minimally Invasive Surgery.

Jennifer Blomquist will be here to host that.

>> Until then, thank you for watching.

Good night and good