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Living Well : Nutrition

Eat Smart

There's more to eating smart than just counting calories—healthy choices can mean the difference between a "quick-fix" and lasting, meaningful weight loss

IMPROVE YOUR HEALTHY EATING HABITS

Eating smart is one of the most important things you can do to keep weight off. Studies show that low-fat, low-calorie eating habits are key to keeping the weight off for the long haul. Cutting back on fats makes your body work harder to use the energy it gets from the foods you eat. That means more calories get used and fewer get saved as fat.

There’s more to eating smart than just counting calories; healthy, balanced meals are also important. An 8-year survey asked people who lost weight and kept it off what they ate in a typical day. The survey found that successful weight losers eat from all the food groups. It also found that they eat more vegetables than any other food group.

The eating habits of people who participated in this survey changed over the 8 years. At the end of the survey, people were eating more vegetables, meat, and beans than at the start. They also ate less dairy and less carbohydrates. Still, for the whole time period, successful weight losers ate more than one serving per day from each food group—with vegetables as the largest portion. In fact, by the end of the study, those who lost weight and kept it off were eating almost 4 servings of vegetables per day. That’s about twice as much as they ate from any other single food group.

WHAT ABOUT LOW-CARB DIETS?

You may have heard about low-carbohydrate diets. Low-carb diets are designed to reduce the main source of energy for your body and force it to burn fat stores instead. This approach can be useful for short-term weight loss; it may even work long-term for some people. Still, in a survey of people who lost weight and kept it off, only a few relied on a low-carb diet. What’s more, people who ate fewer carbohydrates were more likely to gain back the weight they lost.

In contrast, more than 3 out of 4 people in the survey ate the recommended fat intake or less. Your body processes different nutrients in different ways. Fats convert to body fat more easily than carbohydrates, so eating fewer calories and watching your fat intake is probably more effective long-term to keep your body fat from coming back.

Low-carb diets may have other problems as well. Because low-carb diets are fairly new, no one knows for sure if they have long-term health effects. The typical low-carb diet restricts you to less than half of the carbohydrates recommended by the United States Department of Agriculture (USDA). In the short term, cutting the necessary carbohydrates may make you tired, dizzy, or nauseous. It may also lead to headache or constipation. Some health experts are also concerned because long-term reliance on a low-carbohydrate diet may lead to eating more fat. Increased fats, especially saturated fats, may raise your risk of heart disease.

For most people, the key is to eat a balanced diet of healthy foods that are low in calories and low in fat. This is likely to be the most sustainable strategy for long-term weight loss. Consult with your healthcare provider to know what is best for you.

EAT AT HOME

Preparing your own meals can help you lose weight and keep it off. You know what goes into the meals you make and you control the size of the portions you serve. In previous months, we gave you some shopping tips for healthy eating and talked about how to serve food so you won’t be tempted to eat more than your healthcare provider recommends.

Many long-term weight losers eat most of their meals at home. In a study of people who lost weight and kept it off, the average person ate only two to three meals a week in sit-down restaurants. They ate fast food less than once a week.

Of course, it’s OK to dine out sometimes. Just remember to make smart choices when you do. You may want to revisit some of the tips we gave you for choosing a meal in a restaurant.

This month, you may want to try out some new healthy recipes. Many sites have search or index features, so you can find a recipe that’s right for you; such as recipes that fit with your prescribed meal plan, use your favorite foods, suit your special needs, or fit with the style of meal you want to cook. Some are organized by course, calorie count, or cooking time. Below are a few links that can give you a wealth of meal ideas:

  • Healthy recipes from the Centers for Disease Control and Prevention. This site is full of links to resources for healthy eating. These include heart-healthy recipes, easy meals, ethnic foods, and tips for adding fruits and vegetables. Some are designed by nutritionists or professional chefs.
  • Weight maintenance recipes from the Mayo Clinic.
  • Healthy recipes from AllRecipes.com. These recipes include low-calorie, low-fat, and high-fiber selections.
  • Find new recipes that fit with the meal plan outlined by your healthcare provider. Try to choose something that looks fun to cook and you could eat a few times a month and still enjoy. Try to prepare at least one home-cooked meal each week. By the end of the month you may find a number of new delicious, nutritious meals that you like making for yourself.

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INDICATION

Qsymia® should be used together with a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:

  • 30 kg/m2 or greater (obese) or
  • 27 kg/m2 or greater (overweight) in the presence of at least one weight-related medical condition such as high blood pressure, type 2 diabetes, or high cholesterol

Limitations of Use:

  • It is not known if Qsymia changes your risk of heart problems or stroke or of death due to heart problems or stroke
  • It is not known if Qsymia is safe and effective when taken with other prescription, over-the-counter, or herbal weight loss products

It is not known if Qsymia is safe and effective in children under 18 years old

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

Qsymia can cause serious side effects, including:

Birth defects (cleft lip/cleft palate). If you take Qsymia during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant. Women who are pregnant must not take Qsymia. Women who can become pregnant should have a negative pregnancy test before taking Qsymia and every month while taking Qsymia and use effective birth control (contraception) consistently while taking Qsymia. Talk to your healthcare provider about how to prevent pregnancy. If you become pregnant while taking Qsymia, stop taking Qsymia immediately, and tell your healthcare provider right away. Healthcare providers and patients should report all cases of pregnancy to FDA MedWatch at 1-800-FDA-1088, and the Qsymia Pregnancy Surveillance Program at 1-888-998-4887.

Increases in heart rate. Qsymia can increase your heart rate at rest. Your healthcare provider should check your heart rate while you take Qsymia. Tell your healthcare provider if you experience, while at rest, a racing or pounding feeling in your chest lasting several minutes when taking Qsymia.

Suicidal thoughts or actions. Topiramate, an ingredient in Qsymia, may cause you to have suicidal thoughts or actions. Call your healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying; attempts to commit suicide; new or worse depression; new or worse anxiety; feeling agitated or restless; panic attacks; trouble sleeping (insomnia); new or worse irritability; acting aggressive, being angry, or violent; acting on dangerous impulses; an extreme increase in activity or talking (mania); other unusual changes in behavior or mood.

Serious eye problems, which include any sudden decrease in vision, with or without eye pain and redness or a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma). These problems can lead to permanent vision loss if not treated. Tell your healthcare provider right away if you have any new eye symptoms.

Possible side effects of Qsymia include:

Mood changes and trouble sleeping. Qsymia may cause depression or mood problems, and trouble sleeping. Tell your healthcare provider if symptoms occur.

Concentration, memory, and speech difficulties. Qsymia may affect how you think and cause confusion, problems with concentration, attention, memory or speech. Tell your healthcare provider if symptoms occur.

Increases of acid in bloodstream (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. Metabolic acidosis can happen with or without symptoms. Sometimes people with metabolic acidosis will: feel tired, not feel hungry (loss of appetite), feel changes in heartbeat, or have trouble thinking clearly. Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with Qsymia.

Low blood sugar (hypoglycemia) in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus. Weight loss can cause low blood sugar in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus (such as insulin or sulfonylureas). You should check your blood sugar before you start taking Qsymia and while you take Qsymia.

High blood pressure medicines. If you are taking medicines for your blood pressure, your doctor may need to adjust these medicines while taking Qsymia.

Central Nervous System (CNS) side effects. The use of prescription sleep aids, anxiety medicines, or drinking alcohol with Qsymia may cause an increase in CNS symptoms such as dizziness and light-headedness. Do not drink alcohol with Qsymia.

Possible seizures if you stop taking Qsymia too fast. Seizures may happen in people who may or may not have had seizures in the past if you stop Qsymia too fast. Your healthcare provider will tell you how to stop taking Qsymia slowly.

Kidney stones. Drink plenty of fluids when taking Qsymia to help decrease your chances of getting kidney stones. If you get severe side or back pain, and/or blood in your urine, call your healthcare provider.

Decreased sweating and increased body temperature (fever). People should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition.

Common side effects of Qsymia include:

Numbness or tingling in the hands, arms, feet, or face (paraesthesia); dizziness; changes in the way foods taste or loss of taste (dysgeusia); trouble sleeping (insomnia); constipation; and dry mouth.

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects of Qsymia. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to VIVUS, Inc. at 1-888-998-4887 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please read the Qsymia Medication Guide and Full Prescribing Information.

The Q and Me Patient Resources and Education site is based on the LEARN® Program provided under copyright license (September 15, 2010). All rights reserved.

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

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