From a MD nutritionist, I had hoped for a more progressive approach to obesity than drug therapy.

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I am 40 years old, 5 feet 4 inches tall and weigh 267 pounds. I have been extremely overweight since youth and have made many weight loss efforts. One particularly “effective” diet was a high protein/low carbohydrate diet. Ten years ago, I lost 120 pounds in about 14 months but it took less than 8 months to regain the entire amount.

I recently consulted a nutritionist (MD) at a medical college who offered me 3 diet choices: (1) Carnation Instant Breakfast Diet (5 servings/day) (2) High Protein/Low Carbohydrate Diet (NO STARCHES /Fruits at all) (3) Balanced-Deficit (1200 calorie diabetic exchanges). The only diet that makes sense to me is (3) and I became VERY skeptical of an MD who would advocate diets such as (1) and (2). Because I chose (3), what advantage to I have to continue to see this nutritionist over, say, a program such as Weight Watchers?

From a medical college nutritionist, I had hoped for a more progressive approach to obesity treatment that included a program of drug therapy (Phen/Fen, for example). She told me that she couldn’t prescribe long-term therapy with these drugs because FDA (Food and Drug Administration) has not approved them. This seems to be contrary to the press that I have read recently. If these drugs can be prescribed, what kind of doctor do I need to see?

A bariatric doctor specializes in weight control. If what your nutritionist doctor told you is true about drug therapy for weight control and Phen/Fen has been taken off the market by the FDA. Not anyone can call themselves a nutritionist as the title is licensed in 44 states. I would check out a person’s credentials which you can find online.

Your instinct was good in choosing the 1200-calorie diet based on the diabetic exchanges. Weight Watchers uses a similar system of exchanges with different levels. An important question to ask is what is the nutrition counselor’s education and experience to provide nutrition counseling. A Registered Dietitian has the education and national certification to provide nutritional counseling.

FYI One Instant Breakfast packet has 123.55 calories and 8 ounces of skim milk has 80 calories. Five servings of Instant Breakfast with 40 ounces of skim milk has 1045 calories. Four packets would give you 100% of the Recommended Dietary Allowance (RDA) for all nutrients except vitamin E and fiber.