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Anti-obesity medication, Diet and exercise for weight loss - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Weight Loss
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1775 Questions
Doctor :   hi, how can I help you
User :   hi doc
Doctor :   please proceed with your query
User :   my problem is my weight
Doctor :   wats your height and weight
User :   height is 6ft and weight is 114 kgs
Doctor :   ok
Doctor :   do yu have family history of obesity
User :   actually weight is 114 ti 122 kgs which fluctuates to and fro
User :   *to
User :   no
Doctor :   ok
Doctor :   do yu have any medical illness
User :   so actually some more thing i'll like to tell u here
Doctor :   please proceed
User :   no medical history of illness as such, but u see i have been struggling with my weight ever since
Doctor :   ok
Doctor :   as per your ht and wt the body mass index is 34
Doctor :   which indicates obesity
User :   i have tried everything from exercise to gym to dieting to eating right, but the thing is that i am an emotional eater and sticking to a plan for a long duration is really tough
Doctor :   the ideal wt for your ht is 73- 75 kgs
User :   especially with the amount of input expected of you in an Indian industry
User :   now going to gym has actually distributed fat evenly across my body, this has led to a problem, that i have developed huge breasts.
Doctor :   ok
User :   now i need to reduce weight at some fast i am changing my job...which needs me to be an extrovert as it is customer facing.
Doctor :   ok
User :   till now i was more towards internal side of the company and didnt had many meetings..
Doctor :   ok
Doctor :   i will help u in this
Doctor :   can i ask few Q
User :   so now u can say....please go ahead..
User :   sure..
Doctor :   wat exercises did yu do in gym
Doctor :   for how many days
Doctor :   in a week
User :   5 days a was for 2 months back in 2001 and a month in 2004, basically all chest that i could get rid of the fat on my chest but it all had counter effect and i now have a very broad structure.....looks really awful..
Doctor :   ok
Doctor :   did yu do any cardio exercises like
Doctor :   tread mill and cycling
Doctor :   or cross runners
User :   yeah i did....i still do it.... on and off....only today i burnt 255 calories on treadmill...and 226 calories yesterday.....
Doctor :   ok
User :   but again see...this has a no. of problems.....and this is why I keep failing...
User :   not practical to spend 1 hr everyday on treadmill....
User :   makes me less productive in all other aspects
User :   increases my metabolism.....i eat more and eventually when leave excersise...gain more that what i lost
Doctor :   ok
User :   i really dont want to do it....its just the pressure, the looks which makes me do it..
User :   and a am eventually going to leave it anyways...
Doctor :   ok
Doctor :   regarding the diet
User :   its not my thing
Doctor :   are yu on a good diet control
User :   yes
Doctor :   ok
User :   breakfast and lunch....yes..
Doctor :   not taking fatty and oily foods
Doctor :   ok
User :   a very good control throughout the day...but night no.....
Doctor :   ok
Doctor :   did yu check your cholestrol levels
User :   see i give u todays example.....
User :   i consumed some 500 calories till evening....
Doctor :   ok
User :   but consumed some 1200 at dinner....
User :   cholestrol is under control
Doctor :   OK
Doctor :   did yu take any medications for obesity
User :   no
Doctor :   ok
Doctor :   as per your history
Doctor :   exercise is not regular and complete
Doctor :   and diet control in the nite in not there
Doctor :   so the weight redcution is not achived
User :   yep
Doctor :   i will give yu few medical tips to over come the obesity
User :   k
Doctor :   Exercise
Doctor :   do yu wat aerobic exercise is
User :   yes...but i have treadmill at home so basically walk at a speed to 5 and above at home only
Doctor :   ok
Doctor :   yu need to do brisk waking daily for 40- 45 mins
Doctor :   outside
User :   k
Doctor :   brisk walking speed less than jogging, and more than normal walk
Doctor :   for 40-45 min
Doctor :   4-5 days in a week
User :   k...but just 1 ques
Doctor :   with free movements of shoulders and arms
User :   why outside???
Doctor :   its the environmental factor
Doctor :   its proved that the exercises done in home has given less benefit
Doctor :   compared to exercises done outside
Doctor :   tread mill is fast walk in one place
Doctor :   but brisk walk involves more movements
Doctor :   brisk walk should be done on plain surface
User :   k........but i told u the problems in this...
Doctor :   yes i understand
Doctor :   but to reduce the wt
Doctor :   yu need to follow it strictly
User :   k....what next
Doctor :   next is regarding diet
Doctor :   yu have good control on diet in break fast and afternoon
Doctor :   but the dinner part is not
Doctor :   so divide it as 4 times a day
Doctor :   take short and frequent meals
Doctor :   foods to avoid
Doctor :   Fatty (saturated) foods- butter, cheese, curd, ghee and others
Doctor :   Junk foods (oily and spicy foods) and carbonated drinks
Doctor :   Red meat (lamb and beef) and yellow portion of boiled egg
User :   i am veg so...u can skip the non veg part
Doctor :   concentrate more on these foods
Doctor :   ok
User :   also i dont drink alcohol
Doctor :   Green leafy vegetables and others (carrot, pumpkin, garlic, and others)
Doctor :   carbonated drinks like coke and pepsi
Doctor :   carbonated drinks to be avoided
Doctor :   concentrate more on these foods
Doctor :   Fat free skimmed milk
Doctor :   non fat yogurt
Doctor :   Vegetable oil- canola, olive oil for cooking
Doctor :   is that ok
Doctor :   so wat ever yu eat yu need to burn it in the form of calories,
Doctor :   so to burn the calories yu need do more exercises
Doctor :   do burn the fat into calories
User :   k....but u know i have already been there i have done that... i have read every single article on internet about this.....i have done VLCC and I am doing....what u just told me....but it will not last.....
User :   whatever u told me......thax....but i know that much.....
Doctor :   i will advice yu go for ANTIOBESITY medications
Doctor :   and even the newer SURGICAL procedure
Doctor :   this combination will be ideal for yu
User :   can u give me some pill to reduce fat or give me some pill to stick to the plan u just gave me....because...i just can stick to damn 16 yrs....
Doctor :   as your BMI is 34
Doctor :   these pills are not over the counter
Doctor :   it requires medical prescription and signature of the doctor
Doctor :   i can say the newer drugs
Doctor :   If diet and exercise are ineffective alone, anti-obesity drugs are a choice for some patients
User :   k
Doctor :   recommended only for short-term use,
Doctor :   its should not longer than 12 weeks treatment
User :   k
Doctor :  
the drug treatment has to stopped if 5% of wt reduction has not happened even after 12 weeks
Doctor :   the newer drugs inlcude
Doctor :   Orlistat
Doctor :   Sibutramine
Doctor :   Rimonabant
Doctor :   Metformin and
Doctor :   Pramlinitide
Doctor :   any one drug intially
Doctor :   or combination of 2 drugs at later stages is advised
Doctor :   these medication have some side effects also
User :   r these medicine names or the ingredients?
Doctor :   like irregular bowel movements, dry mouth, constipation, headache, increased blood pressure
Doctor :   these are the pharmacological names
Doctor :   i will say the trade names also
Doctor :   Orlistat -Xenical
Doctor :   Sibutramine - Reductil or Meridia
Doctor :   Metformin- Glucophage
Doctor :   Rimonabant - Acomplia
Doctor :   Pramlintide - Symlin
Doctor :   are yu intrested any surgeries
Doctor :   ???
Doctor :   there are newer laproscopic surgeries which has gained more importance and also helped a lot to reduce the weight with less complications
User :   i have read a lot about surgeries but i think they r really expensice and results are not that satisfactory....
Doctor :   yes i agree they are expensive but the results are satisfactory
Doctor :  
the newer procedure in a expert hand is good
User :   i saw the pictures of people operated for gynocomastia and some were really not that.....well natural
Doctor :   ok
Doctor :   thats right
Doctor :   after the opertive procedure it cant look like natural
User :   it cant???
Doctor :   its operated right
User :   i was planning to go for it once i reach a weigh of 85 and couldnt reduce my breasts
Doctor :   it can gain the natural shape
Doctor :   ok
Doctor :   i am also insisting surgery for obesity
User :   one doubt and then i'll ask more questions on surgery...
User :   k....and do i have to follow the diet plan and exercise routine along the pills.
Doctor :   yes
Doctor :   pills supplement diet and exercise
Doctor :   first line of treatment is diet and exercise
Doctor :   after that pills come
User :   k....
User : i go in for gynocomastia surgery....which will include lyposuction and reduction of aereoles also.....what will be approx cost for that.....and would you suggest it right now or after i reduce some weight with help of pills first
Doctor :   do yu have any insurance
User :   i think insurance doesnt cover it...
Doctor :   where do yu stay
User :   delhi, India
Doctor :   ok
Doctor :   if its government hospital its 8- 10 K
Doctor :   if its private hospital or nursing home its 30- 40 K
User :   would you suggest it right now or after i reduce some weight with help of pills first ???
Doctor :   let me explain it to you
User :   please....
Doctor :   even if you go for a liposuction now
Doctor :   if the wt is not controlled then the fat can accumalte again in the breast lobules
Doctor :   so ideal would be to reduce the weight and then go for a breast reduction or liposuction
User :   k.....
Doctor :   pills are secondary
Doctor :   primary is diet and exercise
Doctor :   i can understand your problems and issues sunny
Doctor :   not to worry
Doctor :   be relaxed
Doctor :   have good control on diet
Doctor :   and do regular exercises
Doctor :   along with medications
Doctor :   be mentally relaxed
Doctor :   not to get stressed and tensed
User : do you have any idea that does medical insurance cover gynocomastia and lyposuction procedures in delhi, India???
Doctor :   medical insurance does not cover gynecomastia
Doctor :   it covers only male breast cancer surgery
User :   k....i dont know how does it work...but do u operate for gynecomastia or may be i can vist you persnally for pills prescription???
Doctor :   first go for pills
Doctor :   this anti obesity pills will redcue your wt
Doctor :   then it will be easy for liposuction
Doctor :   and surgery success is also good
User :   k....
Doctor :   and recurrance of gynecomastia is also less
Doctor :   please fill the feed back form
User :   i just did...
Doctor :   thanks
Doctor :  
yu can come to chat with me
Doctor :   and ask for me
Doctor :   i will be there for yu 24/7
User :   k....but i needed that pills prescription...
Doctor :   yu can go for hospital near by your place
Doctor :   and doctor can prescribe for you
Doctor :   with sign
User :   what kind of doctor should i ask for physisian or dietician??
Doctor :   its general physcian
Doctor :   dietician is only for diet issues not for medications
User :   k...thanks...
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please refer your friends to our service.
User :   good night
Doctor :   good nite
Doctor :   It shows you have moved away from the chat, so I close the window. Please log in again for 24/7 medical help.
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