[I received the following email several weeks ago; my response at
the time follows, along with the more detailed one promised. **Kitty]

My question is simple, where are the genuine solutions to the
epidemic of obesity? I have been overweight all my life (I am
currently 58 years old). I'm tired of hearing about diets,
lifestyle changes, and exercise fads. I have done them all and they
simply don't work for me. I have repeatedly lost over sixty pounds
only to gain it all back. I need a miracle, and I know in my gut
that there's one lurking somewhere in the shadows of fringe
medicine. Maybe not in this country, but somewhere somebody has the
answer to controlling hunger and metabolism. I keep hearing about
discoveries from LEF and a dozen other sources, but they have yet to
run the FDA gauntlet and be approved (if they ever succeed).
Frankly, I'm running out of time -- unless I can shed my extra
weight and keep it off (and I am determined to be among the few who
live long enough to annoy the hell out of the Social Security
system). I do not believe that death is inevitable or necessary if
the human body's systems can be rejuvenated and maintained (I am
working on that with unbridled optimism).
Can you offer help of any kind or point me in a direction that will
put me on the right track to real and lasting weight loss?

Unfortunately I suffer from obsessive compulsive disorder and my
compulsion is not so easily overcome. Knowing a lot of information
about a subject is not the same as being able to actually do
something about it. I am a college graduate, a published author and
a member of Mensa 4 Sigma, so it's not like I haven't got a brain.
I've studied nutrition, health and fitness for twenty years. That
is obviously not my problem. I still contend that there is a
botanical or pharmaceutical solution somewhere in the world. Unlike
most people of my age, I still believe in magic.

[My private response:
"Please post your message to MoreLife Yahoo
http://groups.yahoo.com/group/morelife/ . I will be glad to respond
to it after we complete our drive to AZ and settle into our house
down there; that will be soon after ~ 1/10. Both Paul and I prefer
to respond to questions in a public forum (MoreLife Yahoo and
sci.life-extension the most common) since we are sure that others
will benefit from the exchange. You can do so anonymously if that
is an issue for you.

"In the meantime, I strongly suggest that you keep a journal of
*all* your intake (type and amounts of both solid and liquid) and
what you were doing and feeling at the time. Keeping records is an
essential tool for further evaluation." **Kitty]

[To continue the response to this writer:
Being intelligent and successful in several areas, does not prevent
someone from having problems that underlie a compulsion to eat more
than one's body needs. Unless a complete physical work-up with
blood tests shows that you have a metabolic disorder, your problem
is in how you psychologically approach food. (Even if you do have
such a disorder, you are not without the ability to manage it.) You
are not a "victim" of compulsive eating; you *can* gain control of
your eating, but you must determine when and how you lose control.
Under what conditions does this occur? What is food "providing" you
in some warped manner? Keeping a journal allows you to gather the
facts - if you are complete and honest in the data collection. How
you interpret it is the next step.

A few words on this subject of overeating is the link from the
Practice Index section on Use of Foods going to Michael Hurd's site:
http://www.drhurd.com/news_289.html Although I haven't read these 2
books myself, I am familiar with the premises and conclusions from
other works; both sound very good and I expect I will obtain copies
in the near future for part of our personal library:

The Art and Science of Rational Eating by Albert Ellis, Ph.D.

Albert Ellis applies the principles of rational-emotive
therapy to the problem of compulsive eating. He asserts, with
evidence, that overeating is due to a complex interplay between
psychological factors (distorted thinking, irrational beliefs) and
physiological factors. Humorous, educational case vignettes are
included.

Breaking Free From Compulsive Eating by Geneen Roth

Practical, sensible methods for coping with compulsive
eating (including binge-purge syndrome)--but it goes deeper as well.
Insightful and original points on issues such as being judgmental
with oneself, self-forgiveness, and trust. The author speaks from
experience with eating compulsions. She knows which rationalizations
to fight, and how to fight them.

Both of the above books are included on
http://www.drhurd.com/booklist/compulsive.html

Psychologist Nathaniel Brandon "became convinced that low self-
esteem was a common denominator in most, if not all, of the
varieties of personal distress [he] encountered in [his 40 year+]
practice. [He] saw low self-esteem as both a predisposing causal
factor of psychological problems and also as a consequence." Most
of his numerous published works, which explain self-esteem including
its need and attainment (with examples of his methods), are
available in bookstores and online. His website
http://www.nathanielbranden.net includes several essays and and also
self-esteem building tools that he uses in his practice, seminars
and workshops ( http://www.nathanielbranden.net/content/psy.html ).

You may not like to hear that losing and keeping excessive weight
off requires work on your part and is *not* achievable by magic, but
that is the fact of the matter - unless you truly have a metabolic
disorder. (But even with such a disorder, one does not lose complete
control.) These disorders, however, are not common and the vast
majority of cases of obesity are a result of eating far more than
the person biologically needs. It is discovering and controlling
the psychological needs that food also provides that is the
challenge you must face if you truly want to live even to the
average life span in a relatively healthy manner - let alone far
longer, and in vigor. Accept that challenge, understand it fully,
create a plan, implement the plan, and maintain it. Assistance is
beneficial in this process via non-victim oriented books and tools
like the above, a psychological therapist, and/or a coach.

In addition to working on the issues of self-esteem, anyone who
truly wants to achieve and maintain a healthy body frame
can make good use of the examples provided on MoreLife of a
nutritious low calorie approach to eating
(http://morelife.org/personal/health/dietregimen.html ) and
methods of incorporating physical activity into one's daily life
(http://morelife.org/personal/health/physacts.html ).

To make it clear to those reading this message, the writer of the original email
to me has a BMI of over 40, compared to mainstream medical (NIH defines Obesity
= BMI of 30 or greater ) acceptance of 18.5-24.9 as normal weight. This person's
physical well-being is greatly at risk. **Kitty]