After seeing an overweight patient with a back problem, Dr. Robert Lamberts of Augusta, Ga., decided to blog about it. Last week, I linked to his blog and asked readers “Should Doctors Lecture Patients About Their Weight?”

More than 700 of you responded. Many readers were grateful that Dr. Lamberts seemed to understand their plight. Others offered their own stories of being lectured by doctors.

“If shaming and being a social pariah was sufficient to get people to lose weight, there would be no fat people,” wrote reader Jill. “The stress of dealing with fat-hatred is, I believe, a bigger threat to health than weight is.”

Dr. Lamberts thinks it’s counterproductive to “scold” patients about their weight. “It makes people not want to come into the office,” he said. “They don’t want to walk into scorn.”

To hear more from Dr. Lamberts and his views on helping patients with weight issues, listen to the podcast below.

Listen to the Podcast (mp3)

A recent study funded by the Atkins Foundation attempts to compare the Atkins low-carbohydrate eating plan against two other diets. Although none of the study participants lost much weight over two years, the research is being trumpeted by some as a victory for Atkins, because the low-carb group lost slightly more weight and posted better cholesterol numbers than the low-fat dieters.

But were the participants really following the Atkins diet? Read more…

As if we needed a reminder that diets mostly fail, The New England Journal of Medicine has published a new report on an intense, tightly controlled experiment involving more than 300 moderately obese people.

After two years of effort the dieters lost, on average, 6 to 10 pounds. The study, funded in part by the Atkins Research Foundation, seemed designed to prove that low-carb diets trump low-fat diets. But in the end, all it really showed is that dieters can put forth tremendous effort and reap very little benefit.

Dr. Dean Ornish, a proponent of low-fat diets, is critical of the study design, particularly the fact that the so-called “low-fat” diet group was really only a moderate-fat diet that included about 30 percent of calories from fat. He writes more about the issue in a Newsweek column here.

The New England Journal report also affirmed something many women have believed all along — that low-carb diets work better for men than women. Male low-carb dieters lost about 11 pounds, compared to about 9 pounds on a Mediterranean diet. Women low-carb dieters lost only about 5 pounds, compared to about 14 on the Mediterranean diet. To read more about the new research, click here.

Overweight people already know they are overweight. So should doctors keep nagging them to lose pounds?

No surprises here. (PictureNet/Corbis)

That’s the issue tackled recently by one of my favorite medical blogs, called “Musings of a Distractible Mind.” The author, who goes by “Dr. Rob,” is Dr. Robert Lamberts, an Augusta, Ga., physician who is board certified in internal medicine and pediatrics. On his blog, Dr. Rob muses about a variety of topics like llamas, twinkies and favorite patients. But I was particularly moved by a recent post, which was written after Dr. Rob’s encounter with an overweight patient who was clearly accustomed to being lectured about obesity. As Dr. Rob was about to discuss whether the man needed surgery for sciatica and back pain, the patient interrupted him, hanging his head in shame and blaming his weight for the problem. Read more…

Summer fun. (David Gonzalez/The New York Times)

Why is childhood nutrition tougher in the summertime than during the rest of the year?

That’s the question I explored in my Well column this week. Although schools often are blamed for contributing to childhood nutrition problems, some data suggest kids actually gain more excess weight during the summer. Researchers speculate that unstructured play, hot weather and camp junk food all may play a role.

What happens to your child’s eating and activity habits during the summer? Read the full Well column here and post your comments below.

Young, fit and feeling fat? (Janet Hostetter for The New York Times)

At a time when much of the Western world is focusing on obesity problems, even teens who are at a healthy weight may develop a distorted body image.

That’s what German researchers found after surveying nearly 7,000 11- to 17-year-olds, asking them to describe their bodies. Options included far too thin, a bit too thin, just the right weight, a bit too fat and far too fat.

About 75 percent of the kids fell into the normal-weight category. However, half the normal-weight girls and a quarter of the normal-weight boys still described themselves as being too fat.

When those teens were given quality-of-life and self-esteem tests, normal-weight children who believed they were fat scored as poorly as children who really were obese. And normal-weight children who felt fat actually scored worse on family relationship questions than obese children. The findings were published in the current issue of Deutsches Ärzteblatt International, a German medical journal.

Although the data come from Germany, studies in the United States also suggest body image concerns are prevalent among American teens and adolescents. A 1999 study from the American Dietetic Association found that 55 percent of 7- to 12-year-old girls said they wanted to be thinner.

The data suggest that efforts to address unhealthy weight gain and obesity among young people have the the potential for “collateral” damage in normal-weight kids, who may develop self-esteem problems. An accompanying editorial noted that adolescents are exposed to considerable social pressure to be thin.

Your waistline may be the best barometer of your health. (Susan Farley for The New York Times)

Imagine if your employer started measuring your waist as a measure of your health.

That’s what’s happening in Japan. As my colleague Norimitsu Onishi explains in today’s Times, a Japanese law that came into effect two months ago requires companies and local governments to measure the waistlines of Japanese adults. The government limits are 33.5 inches for men and 35.4 inches for women. Those who exceed the standard and also have another weight-related health concern are given “dieting guidance” to drop weight. (To read the full story, click here.)

While the Japanese plan seems onerous, it’s not without scientific basis. Studies clearly show a person’s health risks increase as waist size grows. Read more…

A 5-year-old leaving an exercise program for overweight children. A new study suggests that the epidemic of childhood obesity finally may be leveling off. (Matt Slocum/Associated Press)

The above photo appeared with a recent post I wrote about childhood obesity. Readers were critical of me not only for showing the picture, but for my later comment that I found the picture to be “sad.” I see a child who likely is teased by peers and is at risk for a lifetime of health problems. But readers disagreed.

“It’s also very unfortunate, TPP, that you felt the need to say a photo of a little girl having her hands held lovingly by two adults is ’sad,’” wrote reader Cathy W. “Yes, her weight is unfortunate and unhealthy, but you don’t know anything else about this little girl, so please refrain from judgments. I know it’s shocking to believe, but an overweight child can still be happy and loved!”

“I was an overweight child 40 years ago,” wrote reader Janet V. “But I was never sad, so I really am offended by your characterization of the child’s picture as such.”

I asked Dr. David Ludwig, director of the childhood obesity program at Children’s Hospital Boston, to talk about overweight kids and the controversial picture. To hear our conversation, click the link below. To read the original post and comments, click here.

Listen to the Podcast (mp3)

Certain ice cream flavors are packed with calories. (Francesco Tonelli for The New York Times)

Just in time for summer, Newsweek has weighed in with a list of the most-fattening ice cream flavors. In the past several years, ice creams have gotten more fattening than ever as premium brands like Häagen-Dazs and Ben & Jerry’s load up their ice creams with chocolate-coated nuts, fudge-laden pretzels, decadent cake and brownie batters and even candy bars.

The result is that a bowl of ice cream may contain as many calories as some people eat in a full meal. The good news is that not every ice cream is packed with guilt. Brands including Turkey Hill and Edy’s offer a number of fun-packed flavors, like their own versions of Moose Tracks and Fudge Chunk, that are typically far lower in calories. Here are the Newsweek selections for the most-fattening flavors as well as a few alternatives I have found that offer a similar taste experience, with far fewer calories, per half-cup serving. Read more…

A new study suggests that the epidemic of childhood obesity finally may be leveling off. (Matt Slocum/Associated Press)

A glimmer of hope has emerged in the battle against childhood obesity. As I wrote about in today’s Times, the Centers for Disease Control and Prevention is reporting that childhood obesity rates appear to have hit a plateau.

Nobody is celebrating just yet. Now health officials and families need to focus on helping the one out of three children in the United States who are already overweight or obese. Fortunately, the problem is potentially easier to battle in children than adults.

“Childhood is the ideal time to address this problem for a lot of reasons,” said Dr. David Ludwig, director of the child obesity program at Children’s Hospital in Boston. “The lifestyle habits that cause the problem haven’t been entrenched as long with children as they have with adults. And all but the most heavy children can basically outgrow their problem by holding their weight constant as their height increases or at least slow their rate of weight gain.”

Because kids are constantly growing, it can be tough to figure out how much your child should be eating. They key is to provide a ready supply of healthful foods and limit so-called “energy dense” foods — things like fried chicken nuggets or pastries that pack a lot of calories in each bite.

A number of Web-based tools can also help. The Children’s Nutrition Research Center at the Baylor College of Medicine provides an energy calculator that can help you determine how many calories your child should be eating each day. To use the calculator, click here.

To find out whether your child is at a healthy weight or at risk of being overweight, you should use a childhood body mass index calculator. The C.D.C. provides one here. And click here to learn more from the C.D.C. about using B.M.I. calculations in childhood health.

Is it possible to legislate against thinness?

Thin and beautiful? (Remy de la Mauviniere/Associated Press)

That’s what lawmakers in France are attempting to do. The French parliament’s lower house has approved a bill that would make it illegal for anyone — including fashion magazines, advertisers and Web sites — to publicly incite extreme thinness, The Associated Press reports.

The bill is the latest effort to address concerns surrounding the fashion industry’s use of ultra-thin models. In November 2006, 21-year-old Ana Carolina Reston, a top Brazilian model, died as a result of anorexia. At the time of her death she weighed only 88 pounds.

French politicians and fashion industry members signed a nonbinding charter last week on promoting healthier body images. And last year Spain banned ultra-thin models from catwalks.

But Conservative politician Valery Boyer, who introduced the proposed law, argued that efforts to promote “extreme thinness” should be punishable in court. One target is Web sites that promote anorexic behavior with such advice as eating little more than an apple a day.

Although it’s not clear how the fashion industry would be affected by the rule, Ms. Boyer says she believes the legislation would force changes in how fashion houses depict women. The law would give judges the power to imprison and fine offenders up to about $50,000 if found guilty of “inciting others to deprive themselves of food” to an “excessive” degree.

The legislation goes to the Senate in the coming weeks. To read today’s full Times story on the topic, click here.

More weight, fewer cavities? (Chang W. Lee/The New York Times)

Overweight children have healthier teeth than normal weight kids, a new study shows.

The surprising finding, published this month in the journal Community Dentistry and Oral Epidemiology, comes from researchers at the Eastman Dental Center at the University of Rochester Medical Center. They analyzed data from nearly 18,000 children who participated in two separate major surveys that were part of the large and ongoing National Health and Nutrition Examination Survey.

Among youngsters ages 2 to 5, there were no differences in rates of tooth decay. However, among children ages 6 to 18, those who were overweight or at risk for becoming overweight had fewer cavities than kids of normal weight. Read more…

Women’s weight discrimination. (Jodi Hilton/The New York Times)

It only takes a modest weight gain for a woman to experience weight discrimination, but men can gain far more weight before experiencing similar bias, a new study shows.

The notion that society is less tolerant of weight gain in women than men is just one of the findings suggested by a new report from the Rudd Center for Food Policy & Obesity at Yale University, published this month in the International Journal of Obesity. Read more…

Dieters are more likely to lose weight and keep it off if they have contact with a weight-loss counselor, a new study shows.

The report, led by researchers at Duke University Medical Center and published today in The Journal of the American Medical Association, shows just how difficult it is for dieters to maintain their weight loss. The study began with 1,685 overweight or obese adults who weighed on average 213 pounds. The group was successful at losing weight, with an average weight loss after six months of 18.7 pounds.

About 1,000 people who lost 9 pounds or more took part in the second phase of the study. Some used an Internet-based weight counseling tool, while others had regular personal contact with a weight-loss counselor. A third group received basic instruction on maintaining weight loss, and those dieters attempted to keep the weight off on their own.

Monthly personal contact meant the participants had telephone contact with a counselor for 5 to 15 minutes each month, except for every fourth month, when they had a 45- to 60-minute individual face-to-face session. The Web-based program gave participants unlimited access to a Web site designed to support weight loss maintenance, with interactive features allowing participants to set personal goals and action plans for the next week and to graph personal data over time.

More than two years later, most everyone had gained back some of their weight. The people who tried to maintain their weight on their own fared the worst, gaining back an average of 12.1 pounds. People who used the Web-based tool gained back 11.5 pounds. However, those people who took part in the personal contact group gained back the least — regaining 8.8 pounds.

Although personal contact only resulted in a 3.3 pound additional benefit, the study authors noted that even small losses can improve health. Every kilogram (2.2 pounds) of weight loss is associated with an average decrease in systolic blood pressure of 1.0 to 2.4 mm Hg and a 16 percent reduction in diabetes risk, the authors said. At the end of the study, more than 45 percent of those who had received counseling were still maintaining at least 9 pounds of weight loss, an amount with clear clinical benefits, they noted.

Does this counter make my kitchen look cluttered? (Susan Farley for The New York Times)

Most of us try to slim down our bodies. But a new book suggests the better strategy is to first slim down our kitchens.

Author Peter Walsh is best known for his role as a clutter expert and organization consultant on the popular television show “Clean Sweep.” His new book, “Does This Clutter Make My Butt Look Fat?,” focuses on how clutter in the home stands in the way of a more healthful lifestyle. One of his main suggestions is to clear clutter and toss out the useless appliances that get in the way of healthful food preparation in our kitchens.

Mr. Walsh says he started seeing the link between clutter and weight problems when readers of his first book on decluttering began telling him how they also had lost weight as a result of getting organized. Clutter and fat, he realized, are not so different.

“All of us deal constantly with the urge to consume more,” he writes. “We spend too much, we buy too much, and we eat too much. In the same way we surround ourselves with so much clutter, we overwhelm our bodies with caloric clutter consisting mainly of sugar and fat.” Read more…