Thank you for your wonderful articles.

A: As a general rule, Namenda is prescribed to treat moderate to severe dementia such as is seen with Alzheimer’s but it may be used for other purposes, as well. The recommended starting dosing is 5 mg a day and advancing to 20 mg which you are on. Side effects can include confusion, hallucinations, fainting, easy bruising, difficulties concentrating, elevated blood pressure readings and more. Less serious side effects noted include fatigue, and weight loss (not gain) from having a diminished appetite.

Norvasc is a calcium channel blocker that treats high blood pressure, angina and other conditions caused by coronary artery disease. Side effects can include edema of the extremities, chest flutter, and less commonly fatigue, abdominal pain, headache and a drowsy feeling.

Pantoprazole decreases esophagitis and other conditions caused by excess stomach acid production. Side effects can include a rapid heart rate, muscle cramps, headache, memory problems, loss of appetite, fainting, hallucinations, insomnia and weight changes.

Clonazepam is prescribed to treat symptoms of anxiety or panic, seizure disorders, and other purposes. This drug is produced in doses as small as 0.125 and as strong as 2 mg. Initial dosing should not exceed 1.5 mg per day, divided into three doses; however, to reduce the effect of drowsiness, this drug may be ordered as one dose at bedtime. Side effects can include fatigue, loss of appetite, diarrhea/constipation, confusion, pounding heartbeats and weight changes.

So, as you can see, except for your Namenda, the balance of your medications can produce relatively similar side effects but are not likely linked with your weight gain. Further, if you admit to being tired, I wonder if you are less active than you once were, are more sedentary sitting to watch television or reading, and if you may be retaining fluids. As such, I recommend you speak with your prescribing physician to determine if you can reduce the dosing on any or your meds (one at a time) under his or her direction and can simultaneously initiate a plan of exercise. I’m not referring to working out on an elliptical machine but you might begin by joining a friend for a walk around the block once or twice a day. If you’re not a walker, consider other activity you might have enjoyed a few years ago and, if appropriate and again, only with your doctor’s approval, initiate it once more. Reduce your consumption of sodium (salt) in your daily diet by reading labels when you shop. As an example, the ingredients in processed foods may contribute to your high blood pressure. Modifications may allow you to reduce or eliminate one of your medications. Then request a referral to a dietitian for direction on what foods would help you lose your 10 pounds and ultimately maintain a desired weight. You shouldn’t have to be “stuck with the discomfort” of weight gain.

Other readers who would like related information can order Dr. Gott’s Health Report “A Strategy for Losing Weight: An Introduction to the No Flour, No Sugar Diet ” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Gott’s Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.

A: I can already envision countless individuals who will respond with “boy, I wish I had her problem”. We are so focused on losing weight that we forget to consider those individuals who cannot gain weight and this is a major issue for those involved. The rate at which people burn energy has a great deal to do with body weight. Those with a high metabolism might discover they burn energy from the foods they consume very rapidly, preventing weight gain. While exercise is extremely important, you might consider strength training that will increase your muscle density and your appetite.. This form of exercise can be as easy as adding weights to an exercise routine. And, while the thyroid gland is one consideration, you have already ruled that out. Considerations for this inability can include having liver disease, infection, or a metabolic disorder. While it appears extremely easy to eat more in an effort to gain weight, it’s important to consume the right foods such as peanut butter, eggs, avocados, nuts, cheese, and pastas – the very items overweight individuals should avoid. The trick here is to eat the proper foods and add to muscle tissue rather than fat deposits in the abdomen, thighs and buttocks. If you currently eat three meals a day, you might consider increasing healthy snacks between those meals, or eating four to six meals each day. If you find yourself otherwise involved in doing laundry or vacuuming, you might consider setting a kitchen timer that will be a reminder to snack. There are cases where malabsorption is to blame for an inability to gain and maintain weight. This can be the result of inflammatory intestinal conditions, ulcerative colitis, a parasitic infection, or even gluten intolerance. In many instances, malabsorption can be determined through blood tests that can determine proper levels of zinc, beta carotene, vitamins B and D, and more.

Exercise is vital to our health, as long as it isn’t taken to extremes. You don’t specify other than being a mother (which is gigantic in the big picture) what your work entails. If you are physical at your place of employment, you may actually burn more calories than you consume.

You appear to be healthy and I wouldn’t worry, especially because this has been a life-long issue but I would be remiss if I didn’t point out that such conditions as an autoimmune disorder, specific forms of cancer, chronic obstructive pulmonary disease and other conditions should be investigated as a possible cause for your inability to gain weight. Therefore, a visit to your primary care physician is the place to begin. He or she can take a history, examine you, order appropriate testing and be assured nothing is amiss. You might then be referred to a nutritionist and/or dietician who will review your meal plans and make appropriate recommendations.

Other readers who are interested in learning more can order Dr. Gott’s Health Report “Eating Disorders” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.

I have been unable to work steadily, except as a retail shop clerk. I’ve had a college degree since 1981. My family (brothers, nieces, nephew and cousins) are all very successful. My parents are 88 and 90 years old and have been helping financially. When they are gone I don’t know what I’ll do.

Do you have any advice for me?

DEAR READER: Clinical depression is a medical illness that affects how a person feels, thinks and acts. He or she has likely lost interest in things that were once enjoyable. This condition cannot be taken lightly. It is a serious illness that can last from weeks to years. Sadness and depression can be a normal reaction to a rather stressful situation for all of us on occasion. We feel bad one day and, to a degree, feel better shortly thereafter. For the individual who is clinically depressed, he or she becomes unable to cope, sleep is interrupted, irritability sets in and the person finds him or herself withdrawing from life. Each person may have reasons to feel this way – problems with finances, work, loss of a loved one, every day demands, family, etc., or there may be no obvious source for the depression such as in the case of pure medical depression or secondary to certain health problems such as hypothyroidism.

Schizo-affective disorder is a mental condition that causes a loss of contact with reality as well as mood problems. Symptoms vary from person to person. The disorder may manifest with cycles of severe symptoms, improvement, and ultimately reverts back to severe symptoms. A person may have difficulties sleeping, may have hallucinations, delusions, be paranoid, and more. The paranoia and mood swings can result when an individual abuses cocaine and other drugs, has a seizure disorder, takes steroid medications and for other reasons. Control begins through psychotherapy and drugs to include anti-psychotics and antidepressants.

The clozapine you have been prescribed treats severe schizophrenia. Cymbalta treats depression plus anxiety. Bupropion is an anti-depressant. Levothyroxine is a replacement for a hormone ordinarily produced by the thyroid gland. Omeprazole treats gastroesophageal reflux disease (GERD). Mirapex treats the symptoms of Parkinson’s disease, restless legs syndrome and for other conditions as determined by a physician. Therefore, in summation, you are on three drugs for your disorder but also appear to have hypothyroidism, GERD and perhaps RLS or tardive dyskinesia (from your clozapine). So, you are dealing with several issues that can be rather debilitating. Clozapine has a specific side effect of weight gain, as does bupropion; however, I do not feel your 120 pound weight gain can all be attributed to the meds you are on. Rather, I believe it is in part, a manifestation of your disorder. Because a therapist cannot prescribe medication, I recommend you speak with your psychiatrist or prescribing doctor to determine if there are other satisfactory drugs that don’t have weight gain as a side effect. Another interesting fact is that Cymbalta can cause hallucinations. If your depression came first, perhaps the treatment is the cause of your schizo-affective disorder. If this is the case, you may be able to switch to another medication and discontinue the clozapine. And, while it is easy for me to say and perhaps extremely difficult for you to tackle, you are a college graduate. I must, therefore, urge you to get your drugs stabilized, join a support group and take the initial steps necessary to get your life back on track. I wish you well and know you can improve your life. Good luck.

Readers who would like related information can order my Health Report “Consumer Tips on Medicine” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.

DEAR READER: For other readers who may be unaware, ESRD stands for end-stage renal disease, a condition that signifies the almost complete failure of the kidneys to work efficiently. It is likely your kidneys may have begun slowing down 10 or even 20 years before you entered this stage. The most common causes for this to occur are high blood pressure and diabetes.

There are many symptoms of ESRD, to include fatigue, bone pain, tingling of the extremities, insomnia, loss of appetite, excessive thirst and weight loss (not gain). So, we cannot blame your weight gain on your kidney failure.

Side effects of metoprolol can include diarrhea, fatigue, flu-like symptoms, headaches and sudden weight gain. And, here it seems, you may have your answer. You don’t mention any other medications so I cannot determine (should you be taking any) if they may be to blame. I recommend you speak with your nephrologist about this issue to determine if another medication, perhaps in a different class, can be substituted for the metoprolol. You certainly have enough problems on your plate as it is without adding 20 pounds to the load.

Treatment for ESRD consists of two possibilities – dialysis or kidney transplant. For the purposes of this discussion, I will discuss hemodialysis, a process whereby blood from the body is filtered, harmful substances are removed, and the “purified” blood is then pumped back into the body again. This routine takes about three hours and is performed about three times each week. There are dialysis centers in many hospitals today although, a nightly home program is another possible option. The advantage to this is that the waste products are removed every evening which is easier for the heart as well as for the access site. And, blood pressures appear to be reduced to the degree medication is no longer required. This process involves training by a dialysis nurse to teach a patient and care givers how to handle equipment, insert a needle into the access site and more. There are risks of dialysis; however, it is literally lifesaving.

Kidney transplant is very common in our country. A donor may even provide a kidney through a laparoscopic technique that simply requires small surgical cuts into the skin, allowing for faster recovery. If you were to undergo transplant, the surgeon will place the new healthy kidney inside the lower abdominal area. The damaged kidneys will ordinarily be left in place unless they are causing hypertension, infection, or other problems. The entire procedure takes about three to four hours. As with any surgery, there are risks. In this instance, they can include bleeding, infection, heart attack or stroke, and blood clots. You will be on medication for the rest of your life once the procedure is completed – a small price to pay for beating ESRD.

Readers who would like related information can order my Health Reports “Kidney Disorders” and “Hypertension” by sending a self-addressed, stamped number 10 envelope and $2 US or money orders (for each report ordered) to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) when writing or print out an order from my website www.AskDrGottMD.com.

I have had testing. My appendix was removed because it was misshaped and there was a concern about a possible tumor. During the CT and colonoscopy, it was discovered that they couldn’t put the scope into me and had to do a virtual colonscopy.

It turned out that the appendix was filled with endometriosis. My abdomen is filled with it as well. I am fortunate in that I experience no pain because of it; however, my colon is obviously crushed and I no longer empty my bladder in one sitting.

The diagnosis is that the endometriosis has also attached itself to my lymph system which is why I have the fluid gain. I am taking a diuretic and wear compression socks during the day. I have between five and 10 pounds of extra weight (after the diuretic) that I have gained in only a couple of months this spring. I exercise daily by jogging and playing soccer but it does not help the leg swelling.

Is there something I can do to help my lymph system so that I do not have all the extra weight? My clothes do not fit, even shirt sleeves and bras cut into my skin) and I do not want to buy new. How much extra stress is there on my body with this extra weight?

DEAR READER: In my opinion, your primary concern should be the endometriosis. This has clearly been identified as the cause of your weight gain and you appear to have an extensive case that is obviously causing problems. Unless something is done to ease the pressure it is placing on your vital organs, you will likely begin experiencing further problems.

My advice to you is to seek out the help of a gynecologist familiar with the treatment of endometriosis. Perhaps surgical removal of portions (as it is likely too far-spread to be removed completely) may be beneficial. In addition, you should also likely be on a permanent form of birth control or other hormonal/medical therapies to stop your menstrual cycle because each cycle causes the abnormal tissue to swell, putting further pressure on your organs. In some instances, the lining may even shed, such as your uterine lining does. This means that some of your fluid retention is actually endometrial tissue and blood, rather than lymph fluid retention. By suppressing your cycle, you are also suppressing the activity of the errant endometrial tissue.

You know the cause, yet your physician is only treating the symptoms and not doing very well at that. Find a physician willing to help you get to the root of the problem, rather than simply trying to cover it over.

DEAR READER: My first thought for your weight gain was menopause. In the peri-menopause phase leading up to menopause, symptoms can include vaginal dryness, decreased fertility, irregular periods, mood swings, thinning hair, loss of breast fullness, hot flashes, sleep disturbances, and increased abdominal fat. As we age, our metabolism also tends to slow down, causing weight gain despite unchanging diets.

That said, increased exercise and proper diet can often control weight gain. You appear to have a very healthful, balanced diet and get plenty of exercise already. Unless you are eating copious quantities of these healthy foods or regularly snack on fatty or sugary foods, I cannot see that your diet is to blame.

My suggestion to you is to make an appointment with your physician for a full physical to include blood work. You should review your exercise routine and a typical weekly diet including snacks and drinks. Your hormone or thyroid levels should also be checked in the event that one or both is abnormal and contributing to your weight gain.

In the meantime, consider reducing your caloric intake by about 200 calories daily while maintaining your exercise levels. Eat low-fat or fat-free dairy items, fresh fruits and vegetables, whole grains, and lean protein. Avoid luncheon and processed meats and sugary, fatty or fried/greasy foods.

While you already do so, it is important to attempt to exercise at least 30 minutes each day. Unless you have difficulty breathing or joint problems, consider jogging or running for part of your daily three-mile walk. This increases the heart rate and burns more calories which may be beneficial in boosting your weight loss and/or metabolism.

Readers who are interested in learning more can order my Health Reports “Menopause”, “Thyroid Disease”, and “Losing Weight: An Introduction to the No Flour, No Sugar Diet” by sending a self-addressed, stamped number 10 envelope and a $2 (for each report) US check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print an order form from my website, www.AskDrGottMD.com.

Since going off Nardil in 2009 I have had low energy and sleep disruptions. My weight has dropped to 210, fluctuating occasionally between 205 and 215. Despite my best efforts, I cannot drop my weight any further, though adding vitamin B has helped with my energy. Hormone tests have come back normal, so there is not an issue there.

I have a desk exerciser under my desk at work that I typically manage to use for about two hours a day — little resistance but continuous — as well as doing high impact cardio at the gym two to three times a week.

My average daily diet consists of one chocolate doughnut during the workday and in the evening, one dry deli sandwich and a small bag of baked potato chips. From time to time I’ll get frustrated and stop exercising and start eating more. At those times my weight will only increase by about five pounds.

My question is, has the Nardil permanently affected my ability to lose weight? Do I have any hope of getting down to my pre-Nardil weight?

DEAR READER: Let’s begin with the drug you discontinued three years ago. Nardil is generally prescribed to treat symptoms of depression, fear and anxiety and is generally dispensed after other anti-depressants have been tried without success. It is not recommended for severe depression or bipolar disorder. There are several conditions that would preclude you from having taken this drug, to include being on diet pills, medication for asthma, having ADHD, and being on over-the-counter cough and cold solutions, or diet remedies.

While on the drug, you should have avoided foods high in tyramine, to include aged and smoked meats, beer, wine, yogurt, fava beans, sauerkraut, liver and a great deal more.

Side effects, in part, include rapid weight gain, agitation, chest pain, cardiac arrhythmias, dizziness, drowsiness, impotence, dry mouth and insomnia. You admit to weight gain a relatively well-known effect of the medication that your physician should have paid careful attention to.

I am going out on a limb here because I simply do not know and cannot guess what the long-term effects of Nardil are. However, I do not feel the drug is presently affecting your ability to maintain an acceptable weight three years later. Rather, I feel your entire diet is horrendous. You do not indicate what you take in for fluids. Do you drink lots of coffee, high-fructose juice drinks, or excessive amounts of sugar alternatives in diet sodas? Regardless of your answer, I feel you would definitely fare better and feel better if you modify your meals to include fresh fruits and vegetables, lean protein (meats, or vegetarian alternatives), whole grains, and low-fat dairy products. Remember to eat a balanced, wholesome breakfast each morning as it is the most important meal of the day. Include snacks during the day if you feel the need, which might include fresh carrots, celery, broccoli and cauliflower with a low-fat dip for flavor. Forfeit those chips or save them for an occasional treat. Hide the salt shaker and use alternative seasonings. Concentrate on the quality of foods you consume rather than the caloric count and you just might be pleasantly surprised.

Coupled with your present exercise program, you are an excellent candidate for reducing your weight to the 180 pound range. In fact, if I can be so bold, I challenge you to stick to a more healthful diet for a month or two while maintaining your exercise regimen and report back to me. I will print your findings regardless of the reading on your scale. Hopefully I won’t end up with egg on my face because of an unanticipated weight gain.

Readers who would like related information can order my Health Report “A Strategy for Losing Weight — An Introduction to the No Flour, No Sugar Diet” by sending a self-addressed, stamped envelope and $2 (US check or money order) to my attention at P. O. Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.

Twenty years ago, I would run three or four miles every morning right after I got up, consuming nothing but water, and it seemed to work fine.

DEAR READER: The key words here are “twenty years ago.” Unfortunately, our metabolism changes as we age, and what worked then for most of us probably won’t work as easily now.

You should match your energy intake to your energy needs. If you awaken in the morning and plan a rigorous schedule of exercise, you should eat prior. I’m not speaking of loading up on pancakes and bacon before jogging, but I am recommending a lighter meal to give you the energy to partake in the physical activity. Keep in mind that your body customarily burns about 100 calories an hour at rest and while you are sleeping. So, if you sleep eight hours at night, you have already expended 800 calories on awakening. To avoid major fluctuations throughout the day, you might consider what I call grazing — eating small to moderate meals every three to four hours. In that way, you should match your energy intake and output.

To provide related information, I am sending you a copy of my Health Report “A Strategy for Losing Weight: Introduction to the No Flour, No Sugar Diet.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

I swam competitively in high school with up to four hours per day of heavy training, ate as little as possible, and still gained. I continued to swim in college and met with doctors, trainers and nutritionists who claimed I had a healthful and appropriate diet and got plenty of exercise despite my ever increasing weight.

Today, I continue a steady routine of exercise — a minimum of two hours each day doing both strength and aerobic activities. I mix up the routine so my body won’t get adjusted to doing the same thing every day. During weekends and vacations, I increase my activity levels.

I’ve studied to become a trainer, read anything I can get my hands on about how to exercise properly and tried many, many ways to lose weight. I started with the basic expend more calories than you consume. I used a weightlifter’s competition diet of 1,000 calories a day for three weeks and gained six pounds. I’ve weighed, measured, and kept a food journal in order to keep my calories at a minimum.

My doctor has ordered all sorts of blood work that always comes back normal. It was discovered that I have an airway-obstruction issue (apparently my tongue is too big for my mouth), and my physician told me that the sleep issue caused my weight issues and that a CPAP machine would help. I started using this in November and have put on 10 pounds since then.

I continue to question my doctor, but he maintains that if I reduce my calories enough, I will lose weight. I don’t drink soda or alcohol, nor do I eat white flour or sugar. At one point in a depressed, desperate mood, I consumed 500 calories per day for two weeks, kept up my workouts, and gained four pounds. Needless to say, I was crabby.
I’m sad, depressed, and at my wits’ end. I’m seriously disappointed with my ability to conquer this hurdle. What is wrong with me?

DEAR READER: It certainly appears you have done all the right things and even some “not so right” things to keep your weight down .

There are several reasons why individuals can experience difficulty losing weight, including the consumption of too many calories without expending them, hypothyroidism, alcohol use, certain medications, emotional factors such as depression, slow metabolism, Cushing syndrome and more. Some individuals may even be weight-loss intolerant.

Based on your letter, I don’t believe you are weight-loss intolerant. The fact that you continue to gain weight despite drastic calorie cuts is a concern to me. It indicates that either you are not being truthful about your diet and exercise habits or there is some underlying medical problem causing the unintentional weight gain. For the record, I would like to say, that I do not believe you are being untruthful and the sheer desperateness of your letter is proof of that.

You claim to have had blood work but because you did not elaborate, I do not know what you were tested for. Because of this, I will again review some of the testing you should undergo or perhaps have repeated.

First, a complete blood count and work-up should be done. Several endocrine disorders such as hypothyroidism and Cushing syndrome can lead to unwanted weight gain and difficulty losing weight as well as other problems. Hypothyroidism is often easy to resolve with inexpensive prescription hormone replacement. Cushing syndrome is more complex. It often results from a benign pituitary-gland tumor, a benign adrenal gland or an ectopic adrenocorticotropic hormone (ACTH) secreting tumor (typically found in the lungs, thyroid, thymus gland or pancreas).

Alcohol use, quitting smoking, depression and certain medications may be contributing factors. I believe your current issues with depression are stemming from the persistent weight gain, not the other way around.

In my opinion, your physician is being negligent about your situation. Despite your repeated attempts to get help, he has essentially ignored the situation. Now is the time to find a new physician who will take you seriously and work with you to get to the bottom of this very frustrating problem.

To provide related information, I am sending you copies of my Health Reports “Thyroid Disorders” and “A Strategy for Losing Weight: An Introduction to the No Flour, No Sugar Diet.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order for each copy to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

I am a 50-year-old male, 5’9” tall, somewhat well muscled yet, have a 36” waist, and weigh 190 pounds. I drink alcohol on occasion, never smoked, have no health problems and take no medication. My daily diet consists of coffee and one cookie in the morning, water and a sandwich with mustard for lunch, and a well-balanced supper.

I don’t use sugar in my coffee or tea. I don’t drink soda or sugary juices and don’t eat iced cream, baked goods, chips, junk or fast food.

I work at a seasonal job doing turf maintenance from April until the end of October. In that time, I will lose ½ to ¾ pound each week until I get laid off in October. During November my weight loss levels off and is maintained easily because I am quite active outdoors hunting and the like. Sometimes I’ll lose a pound or two during that time. Then comes December! I’ll gain a pound per day (almost all belly fat) for the first two weeks and then will gain between two and five pounds more the last two weeks. The weight gain then stops and I have to work like heck to get it off. This has been going on for almost ten years and only happens in December. Nothing in my diet changes. In fact, the only change in my lifestyle is that I do not get up every day at 4:30 AM. Otherwise, I’m just as active as when I’m working.

Is it possible that a genetic or chemical trigger is set off in me because of the shortness of daylight or could it be something else? I’m ready to explode because I’m so frustrated. I wish I could skip December altogether or go into hibernation.

DEAR READER:
A person will ordinarily gain weight when the caloric input exceeds the caloric needs. Your conscientious approach to a healthful lifestyle is remarkable; in fact, your caloric intake is far from being extreme. I’m tempted to blame your “belly fat” on stress, a condition that causes increased waistlines for most of us. With your obvious concern about your end-of-year annual weight gain, you may enter December with trepidation and your system may adversely react and cause you to store excess fat despite your diet and activity level.

Do you attend many family or community parties during the holidays that might provide empty calories? If not, perhaps something as simple as additional coffee ingested daily during the winter months might slow your calorie consumption. To explore this possibility you may want to write down everything you eat and drink in December, as well as your exercise habits, to determine if there is an alteration in your daily routine. Perhaps you are consuming more or are less active than you think. By keeping a journal you can go back and review it. You may even find a pattern of which you were completely unaware.

I recommend that you address your concerns with your family physician. For instance, you may want to have your metabolism checked with a thyroid blood test. In fact, after taking your history, your physician might consider other blood tests that may provide the missing pieces to your puzzling weight gain. At the very least, your doctor can follow your weight loss/gain to identify any reasonable cause for it.

It appears that you are healthy. Your weight depends on calories. This relation can have a genetic basis. Were either of your parents or your siblings troubled by inexplicable weight alterations? If so, treatment for your pattern would be different. Maybe it’s time to relax and not be perturbed by your modest winter alterations. What you gain in December is basically what you are losing in the summer. I don’t believe you need to worry about your loss/gain pattern. However, your family physician can help you.

To give you related information, I am sending you a copy of my Health Report “A Strategy for Losing Weight”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.