Each issue of our popular Health After 50 newsletter includes House Calls, a lively question and answer column in which Johns Hopkins doctors answer readers’ questions. Here’s a sample.
Q. I’m 72 and reasonably healthy, but I have never lifted weights. Should I start now?
A. Absolutely. Resistance training, which refers to weight lifting and other strength-building exercises, is essential to good health for both men and women at any age and despite many existing medical conditions -- but always talk to your doctor before starting an exercise routine.
If you are healthy, you can partake in a fairly vigorous strength-training program. One example comes from a small study in the International Journal of Sports Medicine. Researchers analyzed the effects of strength training on 24 healthy men and women who were over 75. Participants used a combination of weight machines, dumbbells, and exercise bands to work a variety of muscle groups twice a week for the first three weeks. Then one workout was added per week until exercisers were up to four weekly workouts. After three months, participants lost an average of 8 lbs. of body fat, increased their oxygen uptake by 12%, and increased their strength up to 37% in some muscle groups.
Q. I am about 15 lbs. overweight. Do you recommend the new over-the-counter diet pill Alli?
A. Alli is FDA approved and therefore safe to try to lose weight, but be aware of several things. Alli is made of the same ingredients as prescription Xenical (orlistat), only at half the dose. Orlistat prevents the enzyme lipase from breaking down fat within the intestine, thereby blocking the absorption of approximately 25% of the fat you consume.
However, unpleasant side effects can result when fat lingers in your digestive tract, including frequent, loose bowel movements, foul-smelling stools, flatulence, urges to rush to the bathroom, and oily discharge. Thus, people taking orlistat must also eat a low-fat diet in order to keep undigested fat at a minimum. In stopping the breakdown of fat, orlistat also blocks the absorption of essential, fat-soluble vitamins, which must be replenished by taking a daily multivitamin. And there is the potential for drug interaction with the blood-thinner Coumadin (warfarin), diabetes medications, and immunosuppressant drugs.
Owing to its possible side effects, orlistat may not be ideal for you or others who are otherwise healthy and are looking to drop a small amount of weight -- in those cases, reduced caloric intake and regular exercise will do the trick. Doctors therefore usually recommend orlistat only for people with body weight indexes (BMIs) greater than 30 -- which is considered obese -- or for those who risk weight-related health problems due to diabetes, high blood pressure, or heart disease.
