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MUSC weight center offers diet programs by Heather Woolwine Public Relations The onset of summertime translates into many images. Afternoon cookouts, early morning bike rides, hotter temperatures and less clothing to accommodate the infamous Lowcountry heat. This time of year also reminds people of added weight they’d like to lose.   MUSC’s Weight Management Center (WMC), based in the Institute of Psychiatry, offers four weight loss programs designed for various activity and diet aspirations.   “Once the weather gets nice again, people are not only reminded of added weight by the clothing that’s worn, but it’s also a time of year when people realize they are not able to participate in certain physical activities because of the fatigue and diminished heat tolerance due to added pounds,” said Pat O’Neil, Ph.D., psychiatry professor and WMC director. “The summer weather makes the burden of extra weight more apparent and people realize that they can’t do all the things that they want to.”   For those who are overweight, overall health and well-being is a serious issue. Obese or overweight individuals are at risk for many conditions including diabetes and cardiovascular disease, and especially metabolic syndrome, according to O’Neil. If a person has three of the following five risk factors, he or she should see a physician and consider a weight loss program immediately: elevated waist line of larger than 35 inches for women and 40 inches for men; blood sugar levels higher than 100; blood pressure higher than 130/85; “good” cholesterol (HDL) levels lower than 50 for women or 40 for men; and triglyceride levels above 150. When considering these risk factors, individuals must also keep in mind that “taking medication for any one of these risk factors automatically counts towards a person’s total,” O’Neil said.   The programs run by clinical staff at the WMC encourage participants not to adopt a quick-fix mentality when it comes to weight loss. Instead, these weight loss experts know that making a lasting change in diet and lifestyle is the only solution to weight gain and obesity. WMC’s specialists take an active role in coaching participants to execute behavior and lifestyle changes that not only keep the weight off, but ultimately affect overall health and well-being. “Our programs are designed for people with a little or a lot to lose,” O’Neil said. “Keeping weight under control involves a persistent effort to maintain a balance of nutrition, activity, and a healthy lifestyle. Weight loss is a complex task, but it can be attained through the compassionate approach our specialists use when providing our clients with reputable medical and lifestyle approaches.”   Called the First Step program, the 20-week, gradual weight-loss regimen offers assistance through individual weekly meetings. This program is appropriate for people of all weight ranges and helps participants make changes in activity level and habits related to weight control.   The second option, called Focus, is a 15-week lifestyle change program designed to induce larger initial weight losses than the First Step program. The program features a diet based largely on meal-replacement products (shakes and bars) during the first eight weeks. The diet then transitions to a  food-based meal plan which continues to promote weight loss. Participants attend a combination of individual appointments that address nutrition, exercise and behavior.   The third program is called Health Fast. It lasts 30 weeks and was designed for people who need to lose up to 50 pounds. Combining a medically supervised, supplement-based, very low-calorie diet with instructed lifestyle changes and techniques, the program consists of three dietary phases offering a more rapid, but safe rate of weight loss for people with more weight to lose.   In the fourth program, New Moms, new mothers are aided in reclaiming control of the post partum body by boosting energy, replenishing nutrients, and promoting weight loss. The initial program is four weeks long, and participants can revisit the program up to 12 months post partum. It includes meal replacement pudding shakes, meal plans, an exercise guide, and stress reduction techniques.    The WMC also offers nutrition, exercise and behavioral instruction on an individual basis and participates in clinical trials testing weight loss aids. All programs are offered at the WMC location downtown at the Institute of Psychiatry south building, located across the street from free patient parking in G-lot. First Step, and the New Moms programs are all offered at the WMC’s satellite office location on Daniel Island, 899 Island Park Dr. The Daniel Island office is open on Tuesdays only.   For more information on any of the programs call 792-2273 or visit http://www.muschealth.com/weight. MUSC employees can receive a discount for any of these programs. Those with the MUSC Options health insurance plan may also be eligible for reimbursement of up to 50 percent of program fees if participants complete the program and meet weight maintenance requirements. Why do people gain weight? People gain weight for a variety of reasons, but most can be further divided into one of two groups. Essentially the notion is an extension of the old nature versus nurture argument. Some people are genetically predisposed to weight gain and retention. “Most weight gain comes down to an embarrassingly simple concept of consuming more calories than are burned, but for some, genes play a role in susceptibility to a tempting and fattening world,” O’Neil said. “I don’t think researchers expect to find a single obesity gene, but so far at least a hundred loci related to gaining or losing weight have been found. Genes determine a person’s metabolic rate, his or her propensity to store or burn fat, the propensity to lose or utilize energy from fat cells, and they play an important role in determining the brain’s sensitivity to hormones involved in the regulation of body weight.”   In terms of the environmental, or nurture, argument, it’s a case of not burning what’s consumed, in addition to intense advertising and temptation. “Rates of childhood obesity have tripled in the last 30 years and adult obesity has also risen significantly, and certainly our genes have not changed during that time,” O’Neil said. “There is an enormous amount of highly tasty, inexpensive food and drink that is fast and virtually everywhere. The sheer number of calories that some people consume just in what they drink alone would be enough for a total daily intake. Food advertising is relentless. Humans are programmed to like and want to eat, and historically, that need has served us well in survival. Now we live in a very different society that is much more sedentary, and many of us were brought up as members of the clean-your-plate club. We’re also on the move and there are a lot of fast eaters out there, which makes it easy to miss the cues your body is sending to the brain that you’re actually full before you stop eating.”   Whether obesity is more aggravated by nature or nurture, O’Neil quoted prominent obesity researcher George Bray, M.D., of Louisiana State University, “genes load the gun, but the environment pulls the trigger,”     Friday, May 26, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island papers at 849-1778, ext. 201.