6 B SIUSLAW NEWS ❚ SATURDAY, OCTOBER 1, 2016 TO YOUR GOOD HEALTH Taking the next step in weight-loss journey DEAR DR. ROACH: I have been trying to lose weight, with no results. I have cut back on carbs and sugar. In general, I watch what I eat. I also go to the YMCA and work out — in the water mostly, because my legs hurt so much. I weigh 286 pounds. I would love to lose 100 pounds, but I am not having any luck. When I go to my primary-care doc- tor, he tells me that I need to lose weight. When I tell him what I have been doing to try to lose weight, he doesn’t believe me. I think I need more help with my weight problem. I don’t know if I should find a new doc- tor, or what! — J.S. ANSWER: I have heard variations of this story so many times from my own patients that I am sure you are trying. However, losing weight is a SALOME’S STARS ARIES (March 21 to April 19) Someone from your past could arrive with welcome news concerning your future. Meanwhile, avoid taking sides in a workplace confrontation until you have more facts to go on. TAURUS (April 20 to May 20) A decision about a relationship could have longer-lasting consequences than you might imagine, so be sure of your facts before you act. A trusted friend can help. GEMINI (May 21 to June 20) A strained relationship could be restored with more personal contact between the two of you. Letting others act as your go-between only adds to the ongoing estrangement. CANCER (June 21 to July 22) New very difficult thing to do. Once your body has reached a certain weight, it is incredibly hard to get things turned around. Fortunately, it is possible for everyone to lose weight. But you cer- tainly do need some help. So does your primary-care doctor. As an alter- native to getting a new one, I think it might be worthwhile to see an expert in weight loss, since this is a field requiring knowledge of new medica- tions, as well as potentially using medications approved for other condi- tions in an “off label” way to help you lose weight. One of the first things to look at is the medicines you already take. Most primary-care doctors don’t know (and I mightn’t have, if I didn’t work at an institution where research and teach- ing about this goes on) how many medications for blood pressure, depression, epilepsy and diabetes (among others) can cause weight gain as a side effect. Sometimes switching medications can help a great deal. Most primary-care doctors are uncomfortable prescribing medica- tions for weight loss, especially after the disaster caused by the combina- tion of dexfenfluramine and phenter- mine (fen-phen). There are newer and safer medications now. Metabolic conditions such as Cushing’s disease and hypothy- roidism need to be looked for. Careful evaluation of the diet — using food diaries and often enlisting the expertise of a registered dietician nutritionist — is of paramount impor- tance. Since there is so much misin- formation, I almost always find peo- ple eating unhealthy foods and avoid- ing healthy ones, to their detriment. You should be congratulated on finding an exercise that you can do, and be encouraged to do so every day. Finally, since you are 100 pounds or so overweight, your doctor also should consider the risks and benefits of bariatric surgery, the most effective way (and only reliable one for most people) of losing that much weight. DR. ROACH WRITES: After I wrote about essential tremor, several people who suffer from this condition, as well as several clinicians, wrote to tell me about a product called Liftware that helps many (but not all) people with hand tremor eat with less difficulty. It’s a handle that you can attach a fork or spoon to, and it reduces the amount of shaking. It’s available at liftlabsdesign.com. facts could mean taking a new path toward a goal you’ve been hoping to reach. However, be sure all your ques- tions are answered before you under- take to shift directions. LEO (July 23 to August 22) This is a good week for all you fine Felines to turn your attention to some important considerations, such as your health, your job situation and the status of important relationships. VIRGO (August 23 to September 22) Avoid making a quick decision about a matter that needs more study. Keep your mind open for possibilities, even if they don’t seem plausible — at least not yet. LIBRA (September 23 to October 22) You might welcome the emphasis on openness in relationships that mark this period. But it’s a good idea to avoid sharing personal secrets with people you hardly know. SCORPIO (October 23 to November 21) There are still some questions that need to be asked and answered before you can feel confi- dent enough to make a potentially life- changing decision. SAGITTARIUS (November 22 to December 21) Some lingering effects from a now largely resolved work- place confrontation could make things difficult for you. Act on this before it becomes serious. CAPRICORN (December 22 to January 19) You feel you’re finally in control of your own life after months of making compromises and conces- sions you never felt comfortable with. Congratulations. AQUARIUS (January 20 to February 18) No sooner do you decide to pass on one job offer than another suddenly turns up. This one might not have everything you’re looking for, but it’s worth checking out. PISCES (February 19 to March 20) Congratulations. With Jupiter’s strong influence dominating this week, don’t be surprised to get some good news about a troubling financial matter. Siuslaw N ews ! 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