DR. HOOK- Blowing smoke? Trying anything to lose weight

Rosie O'Donnell and Donald Trump need to hash it out more so they can continue to irritate America!  C'mon, Donald! You're a rich successful man and, yes, your last name is "Trump, but you're acting more like Donald Duck.

Lionel Ritchie needs to hash it out with his daughter, Nicole. Personally, I wouldn't give her an allowance until she cleaned up her act with drugs and alcohol. She was just arrested again for a DUI and admitted to smoking marijuana. Hmm, maybe he doesn't need to hash it out but make some tough decisions with her instead. What she really needs is some corned beef hash because girlfriend isn't eating.

On the flip side of anorexic Hollywood celebrities, two-thirds of Americans are eating too much and not exercising, and therefore are overweight or obese. And to my surprise, a lot of people are using cannabinoid products, including hash brownies. Why would people eat a hash brownie when it makes them fat?

Cheech and Chong brought marijuana into my vocabulary as I was growing up in small-town Ohio. I had never smelled marijuana until my freshman year in college. When I asked my friend Andy, "Why does your hallway smell funny?" he shook his head in disbelief at my naivete.

Cannabinoids are chemicals in marijuana that bind to CB receptors of the brain. One side effect is hunger. When the CB receptor is activated by cannabinoids, the brain tells the person, "Ready, set, eat! You aren't filled up yet, so gobble that twelfth donut, finish up the rack of lamb, and there's still room for jello! Yes, of course you can eat that wafer-thin mint."

Well, as always, experts are trying a new angle to help people lose weight that doesn't involve exercise. And as we all know (I sound like an LP stuck in the same groove), exercise is the only effective way to lose weight and to keep it off.  Almost all people (97 percent) who lose weight with pills, diet fads, or weight loss programs will regain all the weight within three years. Ba da ba booooom: and half of those people will weigh more than they did when they started. Don't kill the messenger— i.e. me. I'm just reporting the facts.

Endocannabinoids (EC) are being studied right now. They are cannabinoid-like chemicals that the central nervous system makes on its own. (See, you don't have to inhale after all!) Studies are going on, including here in Charlottesville, to see if anti-cannabinoid receptor drugs will combat EC. The end result–- will people feel less hungry and know when to stop eating?

One drug in Europe is rimonabant, a CB1 specialized antagonist. I don't have the study to critically appraise, but the review articles have shown in animals, rimonabant decreases eating as well as the preference for sweets, narcotics, and nicotine. Talking about three blind mice!

In humans, though, the weight loss is not really all that much: maybe ten pounds. And, as mentioned above, probably in three years they will have regained it all and will likely weigh more. However, when it comes to obesity, the majority of people will tackle anything that "promises" that they will lose weight. That's dangerous, because what are the long term side-effects? We know some weight loss drugs have caused major harm.

Exercise is hard, but playing a sport is fun. I recommend to my patients to join some fun activity to get cardiovascular exercise. There is some physical activity out there for almost everyone– after all, every pot has its lid.