The Battle For Minimum Weight – Blacks and the Obesity Epidemic

Caught up in the frenetic grind of her fashion industry job, Allison Ferrell, 41, paid little attention to her increasing waistline. As Manager of Product Operation and Logistics for Abaete, a New York-based luxury apparel line, lunch was a luxury she couldn’t afford. She said she was crazed and I couldn’t spare the time so If I didn’t eat by 1:00 p.m. that was it for the rest of the day.After a 2005 surgery left her stomach upset, she routinely avoided a litany of foods and routinely skipped meals. Her erratic eating habits kicked her body into pre-starvation mode. Believing it was starving, her body stopped burning calories and began to store food reserves causing an increase in body fat. I’d had a good run, but my negative habits were catching up with me and now it was time to take care of myself.”According to the American Council for Exercise, acceptable essential fat is 25-31% and obese is 32%; Ferrell measured almost 39%. Accustomed all her life to being thin, she was flummoxed by 23 pounds of extra fat.Ferrell is hardly alone in her struggle to manage her weight. Plus sized women and strapping men are a celebrated norm within Black culture – the tacit acceptance of which is inhibitive to weight loss. From Thanksgiving and Easter dinners to barbeques and ho-downs, cooking and meal-sharing have been time-honored means of familial and communal bonding. Meals laden with fat, sugar, salt and cholesterol have long been cornerstones of traditional African American cuisine. While these foods are gastronomically appealing, they are detrimental to healthy living. It’s difficult to change habits that are ingrained in our history, explains, dietician and nutritionist and co-owner of living Proof in New York.Some of the culturally defining foods in Europe, Asia and the Mediterranean, such as olive oil, grains and vegetables are heart healthy. What is natural for African Americans is further down the food chain of nutritious. The American Obesity Association estimates that approximately 127 million adults are overweight, 60 million are obese and 9 million are morbidly obese. The escalating phenomenon of obesity has become a national crisis and is nowhere more evident than in African American communities. Recent statistics from the Center for Disease Control and Prevention show nearly 51% of black women are obese and a whooping 78% are overweight – the highest of all ethnic groups – almost 30% are obese and 67% are overweight.Considering body type and height variations, the standard scale fails to provide an accurate measurement of body weight. The Body Mass Index (BMI) is a widely used formula which uses weight and height measurements to assess total body fat and provides healthy weight ranges for all ethnicities. BMI is also an indicator of heightened risk for developing diabetes, heart disease and other obesity-related illnesses. A BMI of 19-24 is considered healthy. However, a BMI of 25-29.9 is overweight and 30 and higher is obese. The waist circumference measurement calculates abdominal fat and is often used in conjunction with BMI to determine weight related conditions. Despite glaring evidence, many blacks have a poor perception of weight and fail to recognize their weight as problematic. Dr. Ian Smith, medical and diet expert for VH1’s Celebrity Fit Club and ABC’s The View explains that this speaks to the core concept of self-definition and what we think we look like. To change the tide, he insists, the imperative is to change the cultural mindset that promotes and sustains the behavioral habits cause obesity. The curvaceous, full-figured body is the feminine ideal in Black culture.Many Black women are resistant to weight loss because they equate maintaining a healthy weight with losing their curves and by extension their attractiveness. Dr. Ian says, “There is a tendency to sexualize weight. You can be on the plus side but still be healthy. We shouldn’t be defined by a condition that is damaging to our health, but instead by our courage, inner and outer beauty and our vigor for life.” Dr. Leggett offers another perspective. There is no conflict between being sexy and physical fitness. Because individuals are resistant to exercise, they convince themselves that being overweight is a paradigm for sexy.While a variety of factors contribute to obesity and overweight, the root causes remain the same: lack of exercise and poor nutritional choices. Dr. Christopher Leggett, Director of Cardiology for Medical Associates in Georgia and one of the country’s foremost interventional cardiologist says that people enjoy sedentary lifestyle and the lack of dietary discretion in what, when and how much they eat, none of which is tempered by balance. Moreover, larger food portions, dependence on fast food and the barrage of media marketing by the food industry have played a major role in the erosion of overall health. Today’s historic numbers are also largely attributed to the double-edged sword of technological advancement.The ease and simplicity of modern living made possible by computer and digital technology discourages physical activity and permeates every aspect of society: food delivery, surfing the internet, computer-based office jobs and play station. Dr. Ian explains that people are less inspired to move and this means calories sit on their bodies and become fat. In addition, relentless work demands – commuting, long hours, working through lunch – requires that the basic necessities of self-preservation are cast aside. As the singular head of the household, black women are often responsible for balancing home, work, childcare and sometimes education with little time to squeeze in exercise. Dr. Leggett refutes this claim saying that many women spend hours on beautifying their external appearance when they set aside thirty minutes each day for exercise. Until individuals become actively engaged in healthy living the medical consequences of obesity will continue to escalate.The consequences of obesity present a smorgasbord of debilitating illnesses including diabetes, heart disease, stroke, hypertension and certain cancers and have a domino effect on the body’s physiology. What has been commonly considered “a little sugar” has morphed into a runaway epidemic affecting an estimated 18 million Americans, with Blacks at a 1.6 greater risk of developing the disease than whites. It also has consequences of stroke, kidney failure, amputation and blindness, and ranks first in direct healthcare costs, consuming $1 of every $7 spent on healthcare. Dr. Leggett explains Obesity is the primary cause of Type II diabetes which increases the occurrence of cardiovascular disease, resulting in an 80% death rate from heart attacks. Excess abdominal fat is highly active. It expands, releasing chemicals that ensure its continued existence. This in turn creates a resistance to the hormone insulin, which controls blood sugar. Increased insulin-resistance exhausts the pancreatic gland resulting in high blood sugar levels, which sets the stage for diabetes.The cardio-vasculature of the body is impacted by elevated cholesterol and lipids in the blood. A build-up of Low-density lipoprotein (LDL or “bad” cholesterol) and other food slush form plaque within the coronary arteries, the vessels that supply blood to the heart. This deposit eventually narrows the opening of the blood vessels that supplies organs with oxygen and nutrients. Dr. Leggett says that rupture of the arteries causes kidney and spinal chord stroke, in the coronary arteries causes heart attacks and in the carotid arteries, stroke or thrombosis, an obstruction of blood flow throughout the circulatory system. Blockages in the lower extremities often cause poor circulation, joint pain and even amputation.With 45% of women and 42% of men twenty years or older suffering from the condition, African Americans have the highest rate of hypertension in the world. Research conducted by the National Obesity Association indicates that hypertension occurs 9% more frequently in obese individuals. Poorly controlled hypertension leads to stroke, which is the third cause of death and the primary reason for disability. As fat increases, so does the demand for oxygen and nutrients. The upsurge of blood circulating throughout the body adds pressure to the artery walls causing them to narrow and stiffen, resulting in an enlarged heart, stroke and kidney disease.An American Cancer Society study shows that up to 90,000 cancer deaths annually can be attributed to obesity and overweight. Increased production of insulin and estrogen stimulates the growth of cancer cells. In women, obesity is related to elevated risk of uterine, breast, cervix, ovarian, renal cell and endometrial cancers; in men, with colon and prostate cancers. The high incidence and virulence of obesity-related diseases are exacerbated by lack of preventive care and appropriate health screenings. Dr. Ian posits that Blacks tend to visit the doctor later and by then these illnesses are less treatable and curable and the body is weakened. That’s why whether it’s talking to your physician or going to a free clinic, we must become more proactive about our own health.An unspoken consequence of obesity is the double jeopardy of weight discrimination within the healthcare industry. Doctors’ subjective opinion and prejudice negatively impacts medical treatment, care and outcome. A recent study by the New England Journal of Medicine shows discrimination in treatment of kidney failure, cancers and heart disease, despite the fact that these illnesses are more egregious in blacks than in whites. A physician may withhold treatment or a procedure, which may be optimal, based on latent feelings that the obese patient is lazy, lacks discipline and self-respect or will not follow the prescribed regimen.With a distressing 30% of children ages 6-19 overweight and 15% obese, the prevalence of childhood obesity has skyrocketed over the past twenty years, ensuring a future wave of chronic, obesity related diseases, diabetes, hypertension and other ailments. According to the American Academy of Pediatrics, the probability of an obese child becoming an obese adult increases approximately 20% at four years old to 80% by adolescence. Alarmingly, African American girls across all socio-economic levels have the highest incidence: of ages 6-11, 38% are overweight and 22% are obese; ages 12-19, 45% and 27% respectively.The calamitous combination of super-sized fast foods, video game culture and physical inactivity, enabled by parental complicity has swept the tide of childhood obesity to unprecedented heights. The typical adolescent diet is comprised of fats, cholesterol, sugar, Trans fat and devoid of fruits and vegetables; beverages are carbonated and loaded with high fructose corn syrup. Nutritionist Lisa Jubilee maintains there are numerous ways parents can set better examples for children. She says if you must eat fat food, skip the fries sometimes, get a smaller size or choose a salad. Instill the habit of eating a fruit as an after-school snack or have one with cereal in the morning.”Today’s children are the most inactive in history, largely owing to the pervasiveness of stationary entertainment such as Play station and X box games and video television. Urbanization and the reduction of physical education in schools have resulted in the frequency and decline of exercise. The American Academy of Pediatrics report shows that 25% of children 8-6 years watch at least four hours of television daily and having a television in the bedroom is a strong indicator of obesity development, even in preschool-aged children. Inner city children are purportedly hindered by the inability to walk or bike safely to school or play outside later. Moreover, many lack the means and the inclination to venture outside the familiar confines of their neighborhood and into suburban or rural environs.Children are becoming fatter at a younger age, Dr. Leggett observes. Some are presenting early sign of heart disease and blood vessel damage. But you can’t blame them when parents are supposed to be in charge of the food environment. The list of obesity-related illnesses in children is comparable to adults’. Hypertension occurs 9% more frequently in obese children and doctors have also observed signs of heart disease. In 1997, the growing number of children with environmentally-influenced diabetes prompted a name change from adult-onset to Type 2 diabetes. Excess weight also triggers bronchial spasms, the hallmark of asthma. Other consequences include sleep apnea, orthopedic complications and delayed menstruation in girls. The psychological effects are immensely damaging and often persist into adulthood. Obese children experience social alienation and teasing which become catalysts for depression, eating disorder and high risk behaviors.Make no mistake – being fat costs. Obese and overweight individuals can expect higher medical expenses and insurance premiums, tend to earn less and create less wealth in their lifetime. As the country faces a burgeoning healthcare crisis, the medical cost of obesity-related illnesses is an estimated $93 billion, 85% of which is covered by government programs such as Medicaid and Medicare. The cost to each tax payer is $180 annually. Routine care for preventive, diagnostic and treatment services can reach $7,000 in yearly out-of-pocket expense. Decreased productivity, absenteeism, sick days, disability and restricted movements are costly to both workers and employers. Weight penalty is also exacted through social stigmatization and impediments to career advancement. Many experience difficulty finding employment, securing a promotion or a coveted assignment based on the belief that they are lazy and weak-willed.Is it possible to halt the upward trend of obesity? Healthcare experts agree that education and moderation are keys to incorporating healthy habits into daily living. Despite the promises of diet pill pushers and the growing popularity of bariatric and gastric bypass surgeries, the surest solution to weight loss remains diet and lifestyle changes. Jubilee, who requires clients to keep a food journal, formulates eating plans tailor-made for the lifestyle and needs of the individual. She suggests that individuals begin by walking every day and introduce new, wholesome foods into your diet so you can live longer than your forefathers. For Ferrell, she suggested different ways to prepare old favorites such as baking instead of frying and minimizing the amount of batter used to make biscuits. Small steps are necessary to make the big changes that will sustain weight loss. Ultimately, African Americans have the means and opportunity to overcome the tide of obesity and overweight by setting new, grander examples of healthy living for this generation and the next.

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Fighting Obesity Through the Centuries – A Weight Loss Doctor Reveals Some Old Secrets

Without A Plan Permanent Weight Loss is Impossible.The top resolution for 2010, just like it has been for every year is shedding weight and becoming physically fit. It also can become the hardest to do: changing the way we eat and exercise in a few days or even in a few months can overwhelm just about anyone. The first step is always to prepare a plan, weight loss without a definite plan is impossible. Whether you try low carb, count calories, points or eat specially prepared meals, you still need a plan. Before you jump on the first plan you hear about, take a long look and see that the task of losing weight is nothing new. It goes back to 5000 years to early Egypt. Take a look through the centuries and find a plan that is best for you.Obesity and Dieting is Nothing NewThe earliest indications of obesity can be traced back to the first modern humans in Europe about 35,000 years ago. In those days, efficient storage of energy (i.e., fat) in times of plenty was paramount to surviving the next famine. Times have changed and famine does not exist in our part of the world any longer. Therefore, our once lifesaving ability to store energy (i.e., fat) efficiently has since turned against us. It now shows up in our society as the constant concern of too much weight and ultimately, as obesity. For thousands of years, being overweight and obesity were exceptionally rare phenomena and were almost never studied.The perception of obesity varied among cultures.In ancient Egypt, obesity was considered a disease. Egyptians depicted their enemies as obese individuals. Obesity was certainly not the Egyptian beauty ideal, which instead featured long, slender legs, narrow hips with high breasts, and golden skin. Concerned that diet maintained their health, the ancients recognized that the quantity and quality of food were equally important. Their method of portion control was rather primitive. TheyVomited and purged themselves three times a month.Ancient China was aware of obesity and the dangers that come with it. The texts tolled Gobi berries for strengthening the liver, preventing obesity, and fortifying the-Qi-(chi) or life force. The Aztecs believed that obesity was supernatural, an affliction of the Gods. They had a sophisticated vocabulary for obesity and locations of specific fat deposits, including a double chin and a -beer belly.The ancient Greeks first recognized the dangers of obesity. Hippocrates, considered the Father of Medicine,believed that obesity led to infertility and even death.
Hippocrates was aware of sudden deaths being more common among obese men than lean ones. He correctly identified the energy balance equation:
Energy cannot be created or destroyed.
Energy is either used or stored.
When -calories in- are greater than -calories out- then body weight increases.
When -calories in- are less than -calories out-then body weight decreases.
After Hippocrates laid the foundation for understanding energy and weight management within the human body, another two thousand years went by before the general public in Europe, in the early 1600s, began to recognize diet and exercise as means to preserving one’s health.Around the 17th century, links between diet, disease, and health were clearly acknowledged.Study after study emphasized the benefits of leanness and the dangers of corpulence. beginning in the 17 the century. The term obesity was first used in 1650 by the English physician and medical writer, Dr. Tobias Venner. With the industrial revolution of the 19th century, England saw a growing abundance of food coupled with an increasingly sedentary lifestyle. The result was a vast increase in obesity among the middle and upper classes.Unfortunately, as the medical society and the public in general began to look at obesity and its complications as serious health problems, knowledge on how to reverse it, especially permanently, remained unclear! Surprisingly, most 19th century doctors had no idea about its cause. Many thought obesity was due to sin or diseases.Physicians of the time did not believe that what you ate had a direct impact on your body and on your general health. People typically ate bread, potatoes, pastry, puddings and cakes, and served their meat with thick gravies. Alcohol was part of daily life. Basically, people of that time ate as much as they could afford! After all, a big belly was a sign of prosperity. Lights Begins to Shine in the early 1800’s with Graham Crackers in AmericaDuring the early 1830s, Reverend Sylvester Graham was the first American to relate food choices to health. He condemned the sin of gluttony,advocating a bland, vegetarian diet as the cure. Dr. Graham developed a recipe and encouraged people to eat flat bread made of coarse whole wheat flour. However, people who ate his Graham Cracker were described as -pale and sickly. Reverend Graham became known as Dr. Sawdust-not a very good start to reversing obesity, but these were the first efforts made to remediate the conditionRevelations Appear in early 19th Century London:Across the Atlantic Ocean, in the early 19th century Dr William Wadd, a physician of the English Court, finally touched the heart of the matter. He connected overindulgence at the table with the dangerous conditions that resulted from an excess of fat deposits in the body.Dr. Wadd’s first principle of treatment was taking food that has little nutrition in it.Was he describing eating food with less fat or carbs? He pointed out that many physicians refused to treat obese patients because they did not recognize the growing obesity epidemic of the early 1800s as a real and dangerous disease. That was in 1800. Sounds familiar?In 1850, the medical profession in Europe had accepted the theory of German chemist Baron Justus von Liebig that carbohydrate and fat supplied the carbon which, combined with oxygen in the lungs, produced body heat. In terms of this theory, carbohydrate and fat were respiratory foods and the cause of obesity was believed to be an overindulgence of them.Dr. Liebig’s patients were cut off from food for as long as possible and almost starved themselves to death. He exhorted establishing an hourly watch over the instinctive desires of his patients. Although this was only the first organized attempt to reverse obesity, a more humane treatment was needed. Nevertheless, the importance of limiting food intake to treat obesity became fairly well accepted by the mid 1800s. The challenge was then, as it still is today, the unbearable hunger that always accompanies the reduction of food consumption.4 London Doctors Uncover the Secrets of Weight Loss: (Much of which we then forgot)During the 19th century, three English doctors-Horace Dobell (1826-1916), Isaac Burney Yeo (1835-1914) and John Ayrton Paris (1785-1856)-turned their attention to the growing problem of obesity, researching methods and assisting obese individuals in overcoming their weight-related issues. They concluded that the excess food and increasingly sedentary lifestyle of 19th century England conflicted with the body’s biological need to efficiently store energy (i.e., fat) in times of plenty to survive the next famine. They recognized that quick fixes and miracle solutions offered no answer to this problem.Jean Anthelme Brillat-Savarin, alerted his readers in 1825 to the dangers of fad diets. He warned against the common use of so called venagar to lose weight and was one of the first advocates of limiting carbs. His book, The Physiology of Taste is one of the first important books on food.Dr Burney in 1842 Unravels the Secret to Successful Weight Loss:Humans-like animals-are motivated by four basic drives: hunger, thirst, sex, and the need for security. Hunger and sex are the strongest, being necessary for the survival of our species. Dr. Burney-famous for his Yeo’s Treatment(treatment of obesity by giving large amounts of hot drinks and withholding carbohydrates)-noted that the sensation of hunger, although involving mainly the stomach, originates in the brain. Additionally, as this sensation is one of the most basic of the human emotions, its regulation must occur slowly and with the greatest care.Hunger that is not satisfied creates morbid cravings,as Dr. Burney wrote. Probably the main reason why so many diets fail is that they ignore what Dr. Burney calls-our most basic of all drives-hunger.Before we even started to count calories, points, fat, carbs or protein, and other metrics we use to help us regulate our food intake, Drs. Dobell and Burney had already concluded that all of these methods were too complicated. Both doctors noted that dietary changes should be based on the individual’s unique requirements concerning age, gender, and activity level. However, 1865 was the age of vapors, elixirs, potions, and liniments. Telling an upper class, overweight lawyer that his excessive eating caused the fat around his belly and that he had to physically exercise-like a farm hand-was problematic and almost drove Dr. Burney out of practice.Diet is related to age, sex, occupation… and should correspond to what a person likes. Avoid any unnecessary changes in the number or variety of food and always give a patient what he likes, unless there is an unquestionably good reason for not doing so, writes Dr Burney in 1842.You might think recognizing that overeating will make us fat is pretty obvious and was not at all a significant discovery. In reality, most weight loss plans today fail to take into consideration that not everyone can eat the same food, the same amounts of food, or react the same way to foods. This is why none of these generic diet concepts work. We are all different and every person requires personalized plans of action to achieve long-term success in managing sustainable and healthy weight levels.How many diet plans even consider what the individual actually likes to eat? Drs. Dobell and Burney stressed that a successful weight loss plan depends on making as few changes as possible and then tailoring the food to the individual’s age, sex and occupation and, especially, to personal likings. This advice is even more relevant today than it was 175 years ago. Finding the real causes for your weight problems and then selecting foods based on these personal factors-including what you like to eat-was fundamental back then and is just as important today.Keeping Weight Loss Plans Simple is Nothing New:-Interference with a diet, like all good things, is particularly open to abuse for nothing is so easier than to lay down a complicated code of restriction and rules as to what to eat and what to drink and the patient is very apt to think that the skill of the doctor increases with the number and variety of the orders. But those who understand the principle of a diet know that the reverse is true…instead of meddling with unimportant details, seize the few essential points for which a diet generally will be found to turn. Those that are best off are those that abstain from all attempts to meddle-writes Dr Horace Dobell in 1865.William Bunting, a London Undertaker Writes About His Experiences Fighting Obesity, Some PracticalIdeas from the First Celebrity Dieter:In 1860, in what is considered one of the first diet books, a famous London undertaker and coffin maker William Banting, revealed how to lose and-most importantly-maintain, weight loss for years. At 5 feet 5 inches in height and weighing more than 202 lbs., Banting experienced rapid weight gain beginning at age 30. He was so overweight that he had to walk down the stairs backwards to avoid jarring his knees. He was unable to ties his shoes or pull up his pants. Despite vigorous exercise, spa treatments, self -induced vomiting, drinking gallons of water, low-calorie and starvation diets, he only kept gaining weight.For many years, he went from one doctor to another in vain-They took my money but they failed to make me thinner. He was hospitalized twenty times for weight reduction, only to fail again. One of his physicians noted that putting on weight was perfectly -natural-; the physician himself had being gaining a pound a year for years. Fed up with physicians and failures, he created his own plan, bearing many similarities with the findings of Drs. Dobell, Burney and Paris and described it in his famous Letter of Corpulence, first published in 1864.Amount of Food: People of larger frame and build require a proportionally larger quantity of… food… and foods that are beneficial in youth are prejudicial in aged.
Kind of Food: Starch, sugar and fatty meats tend to create fat and should be avoided all together. Experimentation is needed, to establish which foods cause weight gain for that individual and which do not. No attempt to restrict all carbohydrates — but sugar, potatoes, and some breads… Vegetables and fruits of all kinds are permitted freely.

Food Changes have to be gradual and kept to a minimum so as not to cause feelings of loss and… return to former habits.

Number of Meals -Four meals a day are preferred. (The fourth is a late evening snack.)-

Exercise- The rules of diet you found so beneficial have been long forced upon men who are under training for running or prize fights… most overweight people are unhealthy or lacking time and are unable to exercise and sweat-

Mr. Banting successfully lost more than 50 lbs. and kept it off until he died at age 80. Inadvertently, he incorporated the basic findings of the English doctors, including tailoring the amount of food for his age and activity level. He made only a few important and gradual dietary changes and ate three meals a day, along with a bedtime snack. His emphasis on eliminating starch, sugars, and fatty meats in his diet preceded Dr. Atkins by more than 100 years. Banting concluded that exercise was not as important as changing the food that he ate. As successful as it was, Banting’s plan seemed too obvious and simple. As much as his name became synonymous with slimming, he was ridiculed and denounced as a charlatan. The British Medical Society vilified his diet system as -humbug- and the basic principles on which it was based were ignored for another century.Basic structure of daily foods revealed by Dr Paris in 1826!Despite all controversy, some headway against obesity was made when Dr. John Ayrton Paris revealed the basic framework for moderate food distribution throughout the day in his book, Treatise on Diet (1826). His daily food framework includes the importance of breakfast, light lunches, and small evening meals. Dr. Paris also emphasized the importance of snacks and was the first to introduce the idea that eating a larger dinner after a day’s work may be more advantageous than eating large lunches.–Everyone’s diet depends… upon the degrees of exercise, age and rapidity of growth. Usually, one large meal a day, the other light and small in bulk… again depends upon occupation. A light lunch is preferable to two large meals a day. Often a patient arises in the morning without inclination for breakfast but because of his occupation, he is compelled to force down food in order to protect himself against exhaustion latter in the day from lack of food. At least have a biscuit, eggs or toast for breakfast. Snacks become necessary in civilized life. Dinner, the large meal of the day, in this manner may be postponed to 7 PM- writes Dr Paris in 1826.Obese Individuals Turn to Quackery beginning in the 1890’sIn the last half of the 19th century, both obese people and their physicians turned away from the newly discovered -secret– a big belly was the consequence of excessive eating. Instead, they desperately turned to the use of all kinds of medical quackery, including water, vibration and massage therapy, laxatives, purgatives, electrical and non-electrical corsets and belts, Epsom salts, various tonics, creams, liniments, and pills.What We Can Lean From the Past:During the 20th century, science revealed more and greater details about the human body, but some of the most fundamental and simplest truths about weight management seemed to have been lost or have faded into oblivion. Instead, modern-day weight loss methods such as calorie counting, weighing and measuring portions, points, phases, only protein, no carbs, as much fat as desired, no fat at all, whole wheat, natural, light, organic, pre-portioned, frozen meals– along with complicated recipes, diet schemes and specialty foods– took the place of common sense. Diets became restrictive, fundamentalist, ideological, and sometimes even contradictory. Clich├ęs and myths do not help to clear up the issues related to obesity and what to do about it.Maybe the ideas of the early 19th century London physicians can help you design a successful weight loss plan for 2010. Give their ideas a try. They Work!