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Last week I discussed the distribution of fat as a risk factor. I pointed out that upper body fat is more dangerous than lower body fat and showed you how to use the "waist-to-hip" ratio to determine this risk. This week we'll evaluate some of the more popular approaches to weight loss currently on the market and make a recommendation based on the latest research.

1. Rotating periods of high and low calorie intake. Several books advocate rotating periods of high and low caloric intake to avoid the slowdown in metabolism associated with a simple low-calorie diet plan. Although this sounds like a good idea, there is little research to support the claims that this approach really does work. In fact, a study at Vanderbilt University compared four different caloric levels, ranging from 600 calories to 1,500 calories a day, with a constant 1,200 calorie diet, and found no difference in weight loss, fat loss or metabolic rate.2. Eating certain combinations of foods. Some authors have suggested that certain foods should never be eaten with other foods and that weight loss occurs best if certain combinations of foods are eaten together. Since these authors do teach readers to eat a better quality of food, their approach does seem to work. However, there is little evidence that combining foods as they suggest is valuable by itself.

3. Very low calorie diets. Many hospitals and medical clinics offer a very low calorie diet plan for rapid weight loss. Although this approach may be recommended for morbidly obese patients under medical supervision, these very low calorie diets are not recommended for those not significantly overweight.

Low calorie liquid diets sold in the supermarket or drug store can be even more dangerous if not used correctly. Few of these diets are designed to serve as the sole source of daily calories, and using them in this manner can be risky. In addition, losing weight too fast can be dangerous because of the possibility of dehydration, electrolyte imbalance and more serious complications such as gall stone formation. Another problem relates to the lack of a backup program to help people learn how to eat properly when their weight has reached a more normal level. Without a change in lifestyle, most will gain back to their original weight or higher.

4. Commercial weight loss programs. Some commercial weight loss programs are quite helpful and teach proper principles of weight control to their customers. Others are a little too aggressive and advocate procedures that are not only unsafe, but may be dangerous. Most sell some type of product as part of their treatment program.

Mostly because of complaints from a group of clients, and partly because of the amount of money spent each year on weight loss, a congressional committee has been formed to look at the whole area of commercial weight loss.

Next week, I'll review the latest scientific information about weight control from a seminar at the recent American College of Sports Medicine meeting held at the Salt Palace.