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A doctor visit before DIY weight loss

Some with heart, diabetes or weight issues may need tests before they can rely on exercise and diet.

April 20, 2009|Jeannine Stein

If you don't have that much weight to lose, are relatively young, don't have a disability and are in overall good health, you can probably safely skip the doctor's visit. If you're severely overweight or have diabetes or a family history of heart disease, you should check in with a doctor before getting that heart rate too high.

A trip to see a general practitioner will probably result in tests for cholesterol, triglycerides, blood pressure and blood sugar -- all linked to heart health, a key component of exercise. If the numbers are out of the normal range, medication might be in order. The ultimate goal is to manage conditions with exercise and diet, eventually lowering or getting off medication altogether.

A doctor might recommend mild to moderate workouts if your numbers aren't in a danger zone, but he or she may also want to stabilize some conditions before letting you lace up your sneakers. To be on the safe side, begin an exercise regimen slowly -- maybe with a walk around the block, some light pool workouts, or low-resistance pedaling on a recumbent bike (best to do it with a buddy to be safe). If you experience shortness of breath, weakness, dizziness or chest pains, stop immediately and seek medical care.

To get the most out of a visit, it's good to know what to expect, what to discuss, and what questions to ask to fast-track you on your way to fitness. Dr. Adrienne Youdim, medical director of the Cedars-Sinai Center for Weight Loss, and Dr. Sasha Stiles of Tufts Medical Center-Weight and Wellness Center in Boston offer some advice:

* Don't feel compelled to go overboard with every test under the sun. A doctor will likely start with the basics: screening for cholesterol and triglycerides, blood pressure, body fat and diabetes, giving a clearer picture of overall health. Plan for follow-ups to see if numbers are heading into the normal range and to adjust treatment accordingly. Some of the tests may be available at free or low-cost community health screenings, but if results are out of the standard range, you'll likely need to see a doctor to manage conditions with lifestyle changes or medication. More serious tests, such as a cardiac stress test done on a treadmill, are usually prescribed if coronary artery disease is suspected to guard against severe exercise repercussions such as a heart attack.

* Be upfront with your doctor about the reason for your visit, explaining your weight gain as best you can -- yo-yo dieting, stress, emotional eating, etc. If you can't account for the underlying cause, Youdim says, your physician may request additional tests for conditions such as low thyroid.

But don't expect your physician to outline a daily exercise routine or hand you a customized meal plan. Although some offer specifics, such as a list of heart-healthy foods, most will probably suggest a more generic route -- change your diet and exercise regularly.

If so, it may be time to seek help from fitness and nutrition pros who can better guide you.

* When there's no end to the lose-gain-lose-gain roller coaster, consider seeking more intensive help elsewhere, such as a comprehensive obesity center. "People come to a point," says Stiles, "where they say, 'I need to keep it off, and I need to know more about why I blow it when I blow it.' They need a program that's not only a nutritional plan but something that will help them with their triggers, so that they never have to do this again."

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jeannine.stein@latimes.com

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