How much are you willing to pay per pound to lose weight?


The Food and Drug Administration (FDA) recently approved two new medications for weight loss.

Qsymia, is actually a combination of two older drugs – topiramate (Topamax), an anticonvulsant that helps increase satisfaction after eating, and phentermine, a psychostimulant and appetite suppressant. Using Qsymia combined with diet and exercise for a year led to an average weight loss of 8.4% of total body weight, or about 20 pounds.   

Qsymia is a controlled medication because it has a potential for addiction. Like other psychostimulants (think Adderall and Ritalin), it can cause a fast heart rate and a tingling sensation in the limbs. Other side effects include memory impairment and decreased concentration. Topiramate can cause birth defects as well.   

Belviq, is an entirely new class of medication called a serotonin 2C agonist.  It helps patients feel full sooner and eat less. Belviq was even less effective than Qsymia in helping with weight loss; it led to an average annual decrease of just 5% of total body weight, or about 7 pounds. The side effects from Belviq are minimal, but because older serotonin agents were associated with heart problems, everyone is keeping a close eye on it. 

Information about cost is hard to pin down exactly, but the best guesstimates are that Qysimia will cost about $6 a day and Belviq $8 a day.   

This made me wonder if we should approach these medicines as if they were in a refrigerator case at the grocery store and ask ourselves, “What am I paying per pound?”

When you look at it this way, these two new wonder drugs don’t look so great. Qsymia will run you about $109/pound of weight lost while Belviq will cost you about $417/pound.

To give you an idea of how that compares to other methods that have been around for a while:

  • Weight Watchers = $ 97/pound
  • Nutrisystem = $130/pound
  • Jenny Craig = $131-237.56/pound
  • Weight loss surgery = $235 – 400/pound
  • Diet and exercise = $0/pound!

As you can see, none of them are cheap, and the only one that doesn’t cost you any money costs you a little more in time and effort.  Unfortunately, it’s the only one that really works.  In fact, it’s the main ingredient in those super expensive drugs we’re talking about.  Read that description again – “using Qsymia combined with diet and exercise led to weight loss…”  The problem with diet pills is that not only do you gain the weight back as soon as you stop taking them, but without diet and exercise, they barely make a dent in your waistline.

Because of all of this – the cost, the side effects, the potential for addiction and the lack of any proven long-term benefit – we don’t even prescribe these medicines at the Student Health Center. We’d rather work with you one on one and help you take advantage of the resources available to you here at Ohio State.    

At Student Health Services, we can offer a “well person” exam with any indicated laboratory tests and refer you to one of our registered dieticians. Dining services offers some great online resources to help you keep tabs on your nutritional intake and Rec Sports has many facilities and programs to help you participate in any kind of exercise that you are interested in. 

We want you to succeed at getting to and maintaining your optimal healthy weight. As soon as it is as easy as taking a pill, we’ll let you know.  In the mean time, we’re here to help you do it the right way.

Jo Hanna Friend D’Epiro, PA-C, MPH
Student Health Services
The Ohio State University

How Healthy are Healthy Foods?


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A recent WebMD report cited 23 “Food Frauds” that are suggested by advertising as being healthy food choices, but really contain lots of hidden bad stuff:

  • extra calories
  • fats
  • sugar
  • salt

or, they are just misleading:

  • 2% milk does not mean 2% of the fat in whole milk, but actually about 50%
  • “Zero trans-fat” may not truly mean there is no trans-fat in the food

Here are some of their list of frauds – are any of these on your menu for today?

  1. Fresh Smoothies
  2. Energy Bars
  3. Chicken Burrito
  4. Sugar-free Drinks
  5. 2% Milk
  6. Turkey Hot Dogs
  7. Low-fat Granola
  8. Added Omega 3
  9. Iced Tea
  10. Trans-fat Free Foods

Want to learn more about your diet and healthy food choices?  Both Student Health Services and the OSU Student Wellness Center have nutritionists on staff to assist you. 

Healthy Eating!

Roger Miller, MD (OSU Student Health Services)

Source: WedMD (Copyright ©2009, WebMD, LLC. All rights reserved)

501 pounds of inspiration!

My brother- and sister-in-law flew out from Portland, Oregon for the holidays last week and my brother-in-law, an avid cyclsist (which I’m pretty sure is a requirement for citizenship in Portland) told me about an unbelievable story he read in Bicycling Magazine.

The story is about a 38-year-old man who tipped the scales at 501 pounds!  He was so obese that he couldn’t even leave his house to work or watch his daughter play in the park.  Doctors told him that his only option was to have bariatric surgery – there was no way he could lose the weight on his own – but that he had only a 50% chance of surviving the surgery because of his weight.  His despair became so ovewhelming that he tried to kill himself by cutting his wrists, but he had so much fat on his arms that the blood kept clotting off.  

I’ll let you read the story, but through a discovery of bicycling and a commitment to healthy eating – no medications or surgery – he got his weight down to 185 pounds and is doing well now.

There are a million weight loss stories and testimonials this time of year, and they’re usually being used to sell us a diet plan or a gym membership or a weight loss supplement while we’re still pumped up about our New Year’s resolutions.  The reason I’m sharing this particular story with you is that there is none of the BS and oversimplification that typically goes into those stories.  Anyone who has ever tried to lose weight (and keep it off!) will sympathize with this man’s plight.  It’s often hard, embarrassing, futile and even painful – this story shows what it’s really like without pulling any punches.

I hope you get as inspired from reading it as I did.  And I hope you have a healthy and happy 2010!

John A. Vaughn, MD (Ohio State Student Health Services)

Twinkies Really Are Like Crack!


Hitting the press this week, results of a peer-reviewed study from the Scripps Institute contending that Ho-Ho’s and junk food in general are food heroin.

The headline in Science News: “Junk Food Turns Rats into Addicts” made me want to pull up a Nutty Bar and read more. Investigators contend that if you give a rat bacon, a Ho-Ho or cheesecake, he’ll soon be knifing his fellow rats in the alley for more money for the vending machine.

To prove the addictive powers of junk food, researchers went to the grocery store and picked up a bunch of bad-for-you-but-oh-so-tasty foods like sausage, cake, bacon and Ho-Hos. They divided rats into two groups: unlimited junk food versus yummy “high nutrient, low calorie” chow.

What they found was the Ho-Ho rats started eating with abandon. They become compulsive about ingesting cheesecake, and they would even endure an electric foot shock to get their fix. Standard chow-fed rats who were allowed to have only the occasional nibble of something tasty and were not as willing to be shocked for the sake of a Frito.

As Ho-Ho rats continued eating, it took more and more junk to achieve a “high”. And once the junk food was removed and the rats were offered only the high nutrient, low calorie chow, they simply stopped eating; as I might if offered edible cardboard after cheesecake and Doritos.

Researchers suggested that this study was “the most complete evidence to date” suggesting that both obesity and drug addiction have similar neurologic causes.

Perhaps. These findings are certainly compelling, but it is important to remember that humans aren’t rats. Our brains are similar, not identical. Most humans won’t ever be addicted to anything. While rats are clever, humans are capable of informed, learned, nuanced behavior.

Are these studies a fair fight? There’s no question – at least in humans – that most would choose to eat something tasty versus something pasty, and that has nothing to do with addiction. Nevertheless, as I reach for another Tootsie Roll, I am unsettled. Am I an addict?  Are you?

Victoria Rentel, MD (Student Health Services)

How can I avoid the “freshman 15”?

Q: Am I really going to gain 15 pounds during my freshman year!? 

A: Ah, the infamous “freshman 15” – every college student’s nightmare, right?  15 pounds is a little bit of an exaggeration, but there actually is some truth to that urban legend. 

A recent study showed that while the average weight gain during the first semester (obviously, the study wasn’t done here) of college is only about 3.3 pounds, about 1 in 4 freshmen actually gain around 5% of their initial body weight – about 10 pounds! 

So why does this happen? Moving away from home and adjusting to college life is a very stressful transition.  And just when all of this stress hits you, you’re thrown into a world where you’re surrounded by fast food restaurants, late night study sessions and parties.  So you don’t have time (or a kitchen) to cook for yourself; you don’t have your parents making you eat your vegetables; you’re stressed out from adjusting to college life; you’re sleep deprived because of late nights and early classes; and you have 24-hour instant access to tasty, high-calorie snacks.  It’s practically impossible to not gain weight in this situation!

So how can you prevent it? Try to stick to healthier choices in the dining halls; even a salad can pack a big punch if it’s topped with high fat toppings and dressing. Load up on whole grains, fruits, vegetables, and low fat dairy instead of burgers and fries. Watch your portion sizes and skip the seconds. Keeps late night snacking to a minimum; that pizza might sound good when you’re pulling an all-nighter but it can really pack on the pounds. And don’t forget that alcohol has calories! Even a light beer can have 100-125 calories so a couple of big weekends can do a lot of damage.

Make sure you’re getting 7-8 hours of sleep a night – yes, even during finals week – and don’t forget to exercise. Not only will a good workout relieve stress, it will keep off the weight as well. Remember, the RPAC is your friend, but only if you make it past the coffee shop and into the exercise area.  You’re already paying the recreational fee so you might as well use it! 

Now is the time to start healthy habits that will last a lifetime!

Angela Walker, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

Medical Mythbusters – Eating late at night makes you fat!

TRUE OR FALSE: Late night snacks make you fat


Weight loss is one of those topics on which medical myths abound – in fact, one stroll through Barnes and Noble will show you how many people are making a mint by promoting them. One of the ones we hear all the time is that eating late at night makes you fatter than eating earlier in the day.  Fortunately for those of us midnight snackers, new research has shown that this is total bunk. While technically speaking our metabolism slows down a little bit at night, the simple truth remains: if you eat more calories than you burn, you’ll gain weight and if you eat fewer calories than you burn, you’ll lose weight – no matter what time of day it is.  

Granted, if you find yourself taking a big bowl of ice cream to bed every night, or indulging in nightly wine & cheese, you’re going to pack on some pounds, but no more so than if you had that bowl of ice cream for breakfast.  

It’s probably still a good idea to avoid eating late at night.  Eating right before you lie down puts you at an increased risk for acid reflux, a condition in which food contents and digestive acids from the stomach splash back up into the esophagus causing an uncomfortable burning sensation in the chest (“heartburn”).  If that occurs, be sure to let your health care provider know.  And leave the Oreos alone unti the sun comes up…

Angie Walker, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS) 

Is the Biggest Loser Really a Winner?

As I watched Helen win the grand prize of $250,000 on the seventh season of “The Biggest Loser” for losing 140 pounds in 20 weeks, I was thinking about the messages that this “reality” show sends to all of us.  I get why it’s so popular: the drama, the competition, the personalities and life stories of the contestants, and of course the “can you believe someone could weigh that much and lose that much weight!” shock value. 

I’ll even admit that The Biggest Loser does show you what is possible with very hard work and determination combined with a tremendous amount of support.  And there’s no doubt that the contestants’ lives change in a positive way over the 20 weeks of the show; not only do they lose the weight, but you see their confidence and self-esteem increase as they discover that they can do things they never imagined.  In many ways, it’s a great “feel good” story.

But the problem is that the story is more fiction than fact.  The weight loss that the contestants experience over the 20 weeks is unrealistic, unhealthy and un-maintainable.  Unfortunately, without a focus on sensible and realistic nutrition goals, truly effective weight loss is just not possible.   

If you are trying to lose weight and get in better shape this summer, what positive messages can you incorporate into your program from the Biggest Loser contestants?   

  • If they can workout for hours each day, I can find time for 15 to 30 minutes to be more physically active.
  • Gradual but consistent changes work over time. You gained your extra weight one pound at a time and will lose it in the same way.  Be patient. 
  • Get positive support from friends and family.  Let people know what you need from them and what is helpful.  A workout friend can be very motivating.
  • Set challenging but flexible and achievable goals.  For example:  I will eat breakfast five to seven days each week and have two to three food groups/meal.
  • Making a commitment to changing my eating and exercise patterns will help me feel better about myself, give me more physical and emotional energy and help me feel I have some control over my life.

They’re not as glamorous, or as quick, as winning The Biggest Loser.  But in the long run, they’re worth their weight in gold!

Maureen Latanick, Dietitician – Ohio State Student Health Services