.

>> Good evening.

Thanks so much for watching HealthLine on PBS Fort Wayne I'm your host Mark Evans tonight we're going to be talking about something that's going to be very topical during the holiday season.

>> We're talking about weight loss, maintaining weight or gaining weight and I believe our physician on hand tonight our friend Dr. Ryan Syngman will agree that what is it about seven to ten pounds each holiday season the average person gains.

>> Absolutely and there's no need for that.

So we're going to talk about that and we're also going to talk about some of the most famous and most heard weight loss myths and I think you're going to be surprised by a good number of these.

>> So all we're talking about that I want you to give us a call at 866- (969) 27 two zero any time in the next half an hour we'll take your call regarding weight loss weight management basically because Dr. Ryan Singleman is a weight management specialist on top of that prefacing that you're actually adio it's there and that's a little bit different from them and it's a little bit different in our country.

>> You've got two different kinds of physicians.

You got your M.D.

or medical doctors and get your ideas who are doctors of osteopathy.

I won't bore you with minutia but back in the early eighteen hundred there was a split like the way he was an M.D.

at the time the way doctors doing things and thought well is there a better way with a more holistic approach and he founded Osteopathy with this idea of being a bit more holistic from the outset from like a medical school standpoint.

And so you find that between NB's and more Deo's tend to be like in the primary care more preventative medicine, maybe more of a pediatrician or family medicine which is where I hail from as a family medicine background in the medical doctors generally attack the problem the current situation.

But I mean they also well obviously qualified to help prevent absolutely it's the same thing.

>> So as a physician we do the surgeries, we do the medical prescribing, the diagnosis and everything like that.

>> It's just really a bit of a difference of initial philosophy.

Not that there aren't MDs who don't practice holistically, not that there aren't docs who practice super laser focus on the problem.

>> It just feels off of them by a little bit different approach being different and that's interesting.

Most of the doctors I've had in my life I've been deo's so you know, I think I've been pretty good hands.

>> We're going to talk about this weight loss thing weight thing.

We've talked about this before.

I've been a weight loss yo yo my during my life I've lost lots of weight and I put some of that weight back on.

>> Luckily now I'm in a very happy place.

I've lost about forty pounds in the last year and a half.

Want to continue doing that so I'm sure I'll be learning some things as well as our viewers tonight on how to do that.

>> So let's talk about some of these myths.

I when I was sent these this list by you earlier this week I was laughing because I don't know how many times I've asked these questions myself and also heard them but the first one right off the bat and again he's going to straighten me out if this is not a fact but I'm not eating enough to lose weight.

>> Yeah, I hear that one a lot and I think it's it's a struggle because when you want to try to lose weight there's all these different fat ideas that are out there.

But when people say I can't eat enough to lose weight, they're saying is that there's this idea that you put your body into starvation mode and then it hoards calories and doesn't lose weight.

Well, what they really are talking about is if you don't eat enough then you get this overwhelming hunger and then you can go and do like bingeing episodes which is not what you want but from a very high level if you don't consume the proper amount of calories then you will start to have your body burned the stored energy and you will lose weight.

If it was actually true that you could not eat enough and then you would not lose you would not be to lose weight then the idea would be that if you had someone who is lost on a desert island or somebody who was in a jungle somewhere and they've been out there for weeks and because they can't find proper nutrition, food is really true that you can't under eat and you wouldn't lose weight then you come to these people they'd be massive but no, they have completely pulled out all their calories, their bodies burned off all of their body fat.

The body is burning down even their muscle to sustain itself.

>> So the reality isn't that you have to eat more than you think to try to lose weight.

>> That's not the way it works.

You have to make sure you're getting that calorie deficit.

So oftentimes what we see are people who are eating three, four, six times a day maybe even more than they normally would with this idea of I can't lose because I'm not eating enough when actually what they're doing is they're over feeding themselves and actually perpetuating the problem.

>> And on the other side of the coin there's a ketogenic diet out there and you're burning your own storage fat and that could even be dangerous because you can get in you can be dabbling in to using your muscle fibers.

>> As for energy, so it's a balance any time you're trying to lose body weight the trick is losing body weight.

>> You've got to have proper nutrition all together.

If you put yourself too far into a calorie deficit then what can happen is you can actually disrupting your vital organs and so you want to have their physician who's trained in a registered dietitian help you find out what is an appropriate calorie balance for you so that you're eating in a healthy manner.

You want to be a lose weight and preserve as much muscle mass as possible.

So making sure you're still getting your fruits and getting your vegetables and getting a proper protein so you can keep up that body mass when you do start burning fat, whether it's the ketogenic diet or a different type of one, then what happens is over time you start burning off these energy cells and you're not getting the same energy burst you would if you're eating a piece of fruit or a brownie or a piece of bread because you're burning it from your fat cells.

So that's where you get this kind of achy feeling that can come by.

>> That's how you can get the the lack of energy that usually doesn't last for too long.

But if you work under eating tremendously the amount that you should be, you can actually put yourself in a little bit of danger.

You'd be messing up your electrolytes.

>> You could be messing with your heart rhythm.

So the things you've got to be careful with yeah.

Yeah it's tricky stuff.

>> OK, here's another one BMI and you'll probably have to explain what BMI is but BMI is the best way to measure my health .

>> Yeah so BMI is a old measurement that we've had around really since about the nineteen forties it was even before that but it became popularized by the American military because we were trying to figure out how does our country who's about to send a bunch of people to World War Two how do you feed an army and BMI or body mass index was this calculaion it looked at your high end your weight with a little bit of a mathematical formula and says OK, here's a normal BMI range between let's say twenty to twenty five of twenty twenty four twenty five to twenty nine is overweight and anything that is thirty and over are differing degrees of the disease of obesity.

>> OK well that unfortunately doesn't work great for a couple of different reasons.

The BMI we classically look at was really only developed for your eighteen to twenty four year old and so as you age out of that the body fat does redistribute in your body burns less calories as you get older which is frustrating but I didn't write the script.

>> It just is what it is.

So the older you're going to have some changes to what's considered a healthy environment for your body.

>> But if you take just a look at the BMI, this struggle is the BMI.

>> You classically someone has unhealthy body weight if their BMI is over thirty but we now know that unhealthy body weight is better defined as excess body fat that puts a risk to your health which really takes away that number of a BMI.

Yes, technically you can have the disease of obesity at a BMI lower than thirty depending on your age, depending on your demographic fix what your genetic background is like an island and eastern island Pacific origin or looking at somebody who is maybe of a Asian descent or a African-American descent or even a Hispanic descent because of the different genetics that's expressed, you could technically develop the disease of obesity at a BMI lower than thirty because of how the unhealthy body fat starts to accumulate.

>> So in essence BMI itself also does not take look at differences in body fat and muscle.

You can be very muscular and have very low body fat and still have to have a BMI but that doesn't mean that you are unhealthy.

>> So actually BMI is an OK measure for health but this single best measure for health that you can do just home is actually a true waist circumference measurement.

>> OK, if you were to get like a tape measure preferably a cloth one and you were to measure yourself two inches above your belly button and take that diameter, the more narrow that is the better your health is.

>> And here's why.

When we gain body fat it's not just under our skin.

>> It's not just here in the belly.

pIt's actually deep inside too and it's around your kidneys.

It's around your pancreas.

It's around your liver.

And that deep tissue we call it the viscera are the visceral fat tissue.

>> That measurement is a much more accurate indication of your health and so if you have let's say your big strong arms are big strong legs in your exercise and get great exercise capacity but your body fat is getting too high.

>> Yeah, you may have great exercise capacity but overall health is at risk.

So the one measure I'd recommend if you're really curious about it isn't necessarily what your weight is but what is this waist measurement.

>> OK ok good good point.

I want to remind our viewers that we are taking calls Dr. Brian Singleman who is a weight management specialist also he is answering questions about some of the weight loss myths we've heard and also we're talking a little bit about how to keep that weight off during the holiday season.

>> Here's one for you.

It's kind of in the realm of the magic pill.

>> I heard supplements will help me lose weight.

The supplement industry is always a challenge.

>> The biggest thing that the industry is the fact that it's not regulated.

>> There are about 700 to one trillion dollars worth of supplements that are bought a year in the United States is a massive, massive industry and it's completely unregulated by the FDA.

>> That's not right or wrong.

But the challenge is is that you're really taking the company's word for it that every bottle has what it says and every pill has what it says in it.

The thing that is interesting there was an FDA study in consortium with the was the not Merck Medical Group.

They'll come to me out of Boston.

I'm blanking on the name of it but it was a massive studies that were done with the Mayo Clinic.

There we go.

So what happened was they looked at the supplements that were being put on the over-the-counter are being sold as natural herbal remedies and found that 90 percent of them had off label medicines that were in it that were not listed on the label at all.

So they had things like old weight loss medicines that were pulled off the market in the United States because they were found to be deadly.

They had things like blood thinners in it.

They had psychotic medications in it and they had even medicines that were diuretics and make you urinate more right now.

So you take these things and you think, oh, I'm feeling effect.

Do you think oh, it's because of this natural blend of herbs and spices or whatever they say in there and it turns out the reason to feel that way is because they actually had adulterated it with these medicines that they were getting from China, from Russia and now that's not to say all supplements are wrong or supplements do that.

But you have to be really careful when you go to take a supplement if it's given you the effect that you think it and it's really working, you may want to take a step back going OK, what's what's really in this?

>> And that's why if you're going to use diet are you going to use exercise?

Are you to use nutritional supplements?

Always want to talk to your doctor about it first and make sure that we're monitoring blood pressure, monitoring your lab levels, make sure there's nothing in that thing that you know you don't know is there?

>> And it could be causing problems.

Yeah, it could be something that you never dreamed would happen.

>> Absolutely.

What about the old I can't lose weight because my hormones so that is a yes and a no.

OK, so one of the biggest things that we often hear and I'm going to get when I leave the studio tonight is that exactly people going to throw stones at you?

Here's why because we often hear especially from from women is I can't lose weight because I'm menopause or I hear that you gain weight because you're going through menopause.

>> Well, actually the lowering of your estrogen and lowering your progesterone in a woman when you look at the comparison and large studies does not cause weight gain and that's where I'm when it's done.

>> It's it's so hurt even physicians report this over and over again.

The menopause is what causes weight gain, right.

Menopause shifts where body weight is stored.

>> So with women we're gaining more weight in the periphery when you go through menopause tends to shift it more centrally.

So it may seem like well I'm getting away because I'm getting more of a belly but actually pound for pound it stays about the same.

What does cause weight gain in menopause is actually a couple of different factors which was really interesting.

Some great studies done in Europe and some in Australia that help prove this.

The first thing is we alluded to this earlier as we get older we just burn less calories as we get older it's easier and easier to gain weight and you know, as someone in my forties I'm already recognized I can't get away with what I did when I was in my twenties and as someone who is maybe a little bit older than that, you probably could get away with as much as you could either.

>> And it takes it's harder to burn that off anyway, right.

That's just normal human physiology.

So one just being older and most and going through menopause in their fifties you're starting to see that cascade effect the second thing is for many people in our culture around the time that women are going through menopause they're usually going through some socioeconomic changes.

>> Maybe they're getting close to retirement or maybe they're more financially viable.

>> They can go eat out more or take more vacations.

Maybe their kids are no longer in the house and have to cook as much as they were.

>> So they're more likely to do fast food.

Maybe there's you know, it's empty nesters may be more day drinking.

You know, there's things that happen that culturally shift it so you start seeing this calorie creep that goes along side of reduced calorie burning on a day to day basis because of aging.

>> So in that sense it's not just those hormones like the estrogen progesterone for menopause.

>> The other hormone that people often blame for not being able to lose body weight is having an underactive thyroid.

>> I'm sure you've heard similar oh, I can't lose weight because of my thyroid.

Yeah, I struggle with that one is the weight loss associated with correcting and underactive thyroid has nothing to do with body fat.

>> Hmm.

So if you have a floridly underactive thyroid the issue you're dealing with is that the body shifts fluid and you get this condition called mix edema.

I'm going to bore people out there tonight but there it is.

Mix edema is where you have fluid that builds on the front of your legs and it can be pounds of fluid that build up there.

So when you correct that what you have happen is the body weight goes down not because you're losing body fat ut because that fluid is going away.

So really when you look at an underactive thyroid, the data shows very clearly that you have an associated lower body hungar with it so that the net effect from a body fat percentage is about neutral.

>> So although you can say hey I can't lose it because my thyroid actually it's not that is the key piece that people tend to think it is.

>> Yeah yeah yeah.

Here about thyroid from time to time.

Absolutely.

All right.

We are going to go ahead much in the know that number at 866- (969) to seven to zero we have about roughly about ten minutes before the program ends and we have a call coming in right now and it looks like James and James is asking us to ask the question for him do people with drug addiction gain weight when they beat their addicton?

>> That's a really great question, James.

>> So let me answer that in a couple of parts.

Let's start with some illegal drugs and then let's also then talk about things like nicotine and marijuana and other drugs that people may use and even use alcoho in there as well.

>> So for many illegal straight street drugs, it depends on how they were beating that addiction.

There are some medicines that are used that can help blunt the effect of those illicit drugs but then can make you overall hungrier.

>> There are some therapies that can do the same and in many cases we say that people who are using drugs of abuse of any kind are self medicating .

That might be something that you're familiar with and when you're trying to treat a maybe a psychiatric issue, maybe you're trying to treat a hormonal issue, maybe trying to just get to the emotional struggles that you're dealing with and you're using these substances to take care of that.

But if you no longer use that substance, what is there for you that you can turn to?

And when you look at this hormone in our brain called dopamine the the feel good hormone, it's the stuff that makes you feel good when you are gambling or when you are having sexual relations or the other big plays you gift.

This is like bungee jumping risk taking behavior.

You get these big dopamine surges but one of the biggest places humans get dopamine surges is from food and it makes sense then that if you were using a substance well now you've got food that can give you that pleasure and so yeah, you're going to hit those Ding of the Oreos are you just love to eat chicken and you're eating more chicken and or wings you can easily find that that becomes a replacement.

>> There are some drugs though whether they're things like the methamphetamines, OK, where they do some kinds of speed, whether you're abusing the ADHD medicines as some people can get into there are things like even nicotine or cocaine , those kinds of things when you use those regularly it actually elevates makes you burn more calories.

>> And so if you are stimulating your body and burning all these calories and then you stop, well then of course that body is going to start to pick back up after it's longer burning the same amount.

>> Sure.

That's one of the reasons why smoking cessation is really, really challenging I think is one of the missing by the fact that I was going to slide right into that.

>> Yeah.

So that's that's a great topic.

The reason why I can be so hard to quit smoking and not gain weight is for a few reasons.

One, you're not getting those dopamine hits anymore from the cigarets you're likely to turn to something else.

>> The second thing is is that dopamine inside of a nicotine is a stimulant.

>> It's like taking caffeine.

It's like taking well like some methamphetamine.

It's one of the reasons people like to smoke.

>> Yeah.

It keeps you awake.

It suppresses your appetite.

It makes you more energetic.

There there is an old saying this turns I did some diving into just recently because I wrote a blog article about nicotine weight loss.

It turns out it's not true that doctors ever recommended women to smoke back in the nineteen fifties to keep their weight down.

But I've heard that enough.

I thought that was real so I had to go see if that was a myth and I know it's not actually true.

I had aunts who actually said right right.

>> It turns out it was actually a an advertisement from one of the tobacco companies that showed a woman smoking while carrying a baby in that kind of morphed into a myth that doctors recommended although I did actually see a old newspaper clipping that said something like Marlboro is the brand most preferred by doctors to smoke and I thought that was funny.

But going back to why it's such a hard thing so if you were having something that you're smoking that's keeping your hands occupied, that's pushing down your appetite, that's bringing more calories because of the effect of the nicotine, what's going to happen that stops with higher metabolism?

The higher calorie burn is going to drop back down.

Your hunger levels are going to also go up and you're no longer getting that dopamine.

>> So where you can do you're going to pick up things.

You're going to start exactly right.

And so that's why I can be such a challenge to keep the body weight down.

You're not only having the physiologic changes of no longer smoking but now you have the neuropsychiatric kind of addiction pathway that is feeding you.

You find something else to grab that?

>> Well, yeah, yeah.

It all kind of links together.

It does.

Well, we have about five minutes left.

Dr. Sangamon and I was wondering if we could talk a little bit about how to survive through the holidays.

I think that it's the time of the year.

>> Let's talk about that some tips from you and yeah, so I think a couple of things.

The first one would be really be mindful of drinking your calories.

There's always something out there whether it's alcohol or juices or pops or sweets.

You're all this different stuff that's out there.

>> So if you're going to have that glass of wine, you're going to have some eggnog.

It's going to have this fully loaded with calories.

Maybe don't also have that piece of pie or that cookie alongside of it or make that choice make that exchange because if you have both you be doubling or tripling the amount of calories you're getting all at once.

>> And I think it's a good point because when we think about registering in our mind what we've eaten, the calories we've consumed, are we actually taking into account what we're drinking as well?

>> Many people don't.

Yeah, and that's something that we as a society need to wake up to a little.

>> But that's a whole other conversation next time you come back.

Sure.

That'd be my pleasure.

The other thing is when you are having that that Christmas meal or the big get together and you have all these great options out there, I encourage you not to take a whole portion of each of those things but maybe just take a tablespoon foretaste of everything they can really see what you want to spend your calories on and that way you're going to try a little bit of everything without overindulging into it.

>> Right.

And I even saw I did a little research on top of the things that you sent me but we talk about fast food isn't always fattening.

>> Right?

You got to make good choices on that.

But here it is to lose weight you have to give up all your favorite foods.

>> No, no, that's not true at all.

No, I'd be pretty miserable.

I think most people would be pretty and happy about that.

But what we're trying to help you understand is if you're going to try to lose body weight and be healthy, have somebody help you find out what would be a healthy calorie balance for your day to day life and then treat that like you would an account shoot a budget.

>> OK, I want to have that glass of wine later.

I want to have the piece of pie later.

That means I can't have this handful of chips and I need to only have half the bread with this sandwich or whatever in exchange is going to be to help get you into a healthy place.

>> But there are people out there who have difficulty with eating healthily or they have a hard time with mindset with it and so even making those exchanges can put them to a place where maybe triggers some anorexia or bulimia, things like that.

So if that is someone if you're one of those people and you're out there, please make sure you're reaching out for appropriate help so we can get you that care that you need because everyone deserves a chance to be healthy.

>> Oh, absolutely.

Sometimes we just don't know how to be healthy.

We're using old habits and we were talking about food and a little bit about preparation there.

>> We also have to keep in mind how we're preparing the food right deep frying it or we frying in the skillet or are we doing it through the air fryer where we're not having a whole lot of grease?

>> We better get to a call before we run out of time.

Becky is on line five.

She's asking us to ask this question.

I'm diabetic and I'm on a strict diet.

>> What other ways could I lose weight?

So that's a great question.

One of my favorite things to do and help people get healthy with body weight is helping get people off insulin, helping them get to a place they don't need to take more medicine.

So being on a strict diet can be difficult depending on what you're looking at.

So the first question is is even with me on a strict diet are your calorie yes.

You're getting here.

Is this your goal?

Can you get that in line if you're eating what you should be is your body not treating it right?

It's treating it like it's too many calories and we need help get that body to burn its things appropriately.

So what I would encourage you to do is if you're trying to lose body weight you're on a strict diet and things don't seem to be working.

Last thing I want you to do is to blame yourself the first thing you should sit down and go OK is my nutrition where it should be?

If it is then you sit down the doctor and say what else my missing if you don't even know what your nutrition is supposed to be then you sit down with the doctor.

You need to sit down with a regular dietitian and have that information given to you so that you can be set on the right path for many people you can walk the right path if you're given the rulebook to do it and that's what we're here to help you to do.

>> And of course we talked about this before or fad diets don't work and you did suggest the last time you were here that any time that you're really considering going on a diet or on a weight loss plan you should advise your doctor about absolutely.

>> And I'm sure the doctor would have plenty of advice for you as well.

And if not, there's plenty of people out there who are available who can help out.

I just found two seconds here.

I was on a long journey to help people learn how to lose body weight and I had to go through a lot of training myself to how to do it.

And so it's not something that all physicians are taught to do.

Right.

But there's more and more of us out there learning to do this and I'm so glad that is the case because I do remember there was that rumbling rumor that physicians just don't know anything about weight loss and diet and so good to have people like you getting into the trenches.

Thank you very much, Dr. Ryan Syngman, thank you so much for being here.

>> It's always a pleasure to have you on the show.

It's my pleasure as well.

And let's have you back again sometime after the first of the year.

That sounds great all thank you.

>> Good.

We thank you for watching.

Thank you for your questions.

We wish you a very happy holiday season, a safe one and a healthy one at that until next time.

Good night and good