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Living Well : Nutrition

Eat Breakfast

You've probably heard that breakfast is the most important meal of the day. But did you also know that a healthy breakfast can help lead to meaningful weight loss?

DON'T BE FOOLED BY A "QUICK-FIX" TACTIC

We know that it can be hard to keep weight off, and that you’ve worked hard to change your lifestyle and improve your health. It can be a challenge to keep up the good habits you may have built. At times the hard work of staying on track may make you want to try a quick fix. But all too often, a short-term solution can lead to a long- term problem.

One quick fix that has grown too common is skipping breakfast. It can be tempting to cut calories by leaving out a meal, but skipping breakfast may do more harm than good.

Your body responds to the way you eat. If you skip a meal, your body may hold on to more fat to make up for the meal you missed. So when you skip a meal, you train your body to keep your fat. To learn more about  planning meals that are healthy and filling, read the Q and Me article about structuring meals.

Breakfast may be the meal people skip the most–but breakfast can be very important.

THE ENERGY YOU NEED TO MAKE THE MOST OF YOUR DAY

Breakfast is often called the most important meal of the day. When you wake up in the morning, you’ve probably gone about 8 to 12 hours without food. This can cause your energy to lag. A healthy breakfast gives your body the energy it needs to start your day, which can help you stay active. People who eat breakfast tend to be more active than those who skip it. A good breakfast also provides the nutrients you need to maintain better health.

Eating breakfast can help you feel full in the morning, making you less tempted to eat too much later in the day. Making smart breakfast choices also helps: you could choose eggs or a high-fiber cereal, and you’ll probably feel full longer; if you pick a Danish and coffee, you may get a boost of energy at first, but this could then be followed by a midmorning energy slump.

What’s more, if you start your day with a healthy breakfast, it can help your mind stay focused. An alert mind can help you make good decisions during the course of your day and be more productive at work.

Still, many people skip breakfast.

It’s easy to believe that doing without a meal will help you lose more weight. Skipping breakfast may not lead to fewer calories in a day, but it can make you less active. Eating breakfast can help you stay on track. People who eat a healthy breakfast are also more likely to maintain a healthy weight; skipping breakfast can raise your risk of obesity and high cholesterol.

You may want to try following these tips to avoid skipping breakfast:

  • Breakfast can be quick. Stress or a busy day can make you rush. Some people skip breakfast in their hurry to get out the door. If this sounds like you, you may want to try some ready-to-eat foods that you can take with you, such as yogurt, fresh fruit, and high-fiber breakfast bars; or you might prepare your breakfast the night before.
  • A light breakfast for a small appetite. Some people don’t like to eat when they first wake up. This is more likely if you ate a late dinner or a large late-night snack. If you don’t want to eat at the start of your day, try cutting out the late-night eating, or choose something light you can take with you and eat a bit later.
  • Interesting choices for breakfast. Some people may get tired of the same food day after day. It’s true that some breakfasts are better for you than others, but there’s more than one way to get what you need from your breakfast. You could try different kinds of fruit or grains. Eggs can be a good source of protein, but so can yogurt, turkey, or smoked salmon. You can think of other interesting options; be creative. Start your day with hummus and sprouts, if it falls in line with your diet and that’s what you feel like eating. A good breakfast doesn’t have to be standard breakfast food. As long as you follow your healthcare provider’s recommendations, what you eat day to day is up to you.

WHAT MAKES A GOOD BREAKFAST?

A healthy breakfast is rich in fiber and nutrients, but low in fat and calories. Importantly, it should be something you enjoy and can prepare quickly. A good breakfast usually contains three or more food groups.

Fiber can give you lasting energy and help you feel full for a longer time. Fruits and whole grains are good sources of fiber, which has important health benefits.

Protein can also help you feel full. Good sources of protein can include eggs, nuts, lean Canadian bacon, milk, and yogurt. Protein also helps your body keep its lean muscle mass that can help you stay active and support your long-term weight loss.

BREAKFAST CHOICES

Fruit and cereal. Fruit and whole-grain cereal with skim milk can be a very good choice. This combination includes three vital food groups: fruit, grains, and dairy. The fruit and grains provide fiber and vitamins; milk can give you protein and calcium. These nutrients can help you feel full and give you long-lasting energy.

In a survey of long-term weight losers, fruit and cereal were both popular choices: 3 out of 5 people ate cereal most mornings of the week, and more than half ate fruit. Other studies have shown that people who eat more breakfast cereal tend to be thinner than those who eat less.

Of course, you might not like cereal; or you might like it but not want to eat it every day. There are other good choices.

Eggs. There’s a reason eggs are a popular choice for breakfast: eating eggs can be a great way to get protein. As we’ve said, the protein in eggs can satisfy your hunger and make you feel full until lunch.

In one study, 2 groups of overweight women ate almost identical low-fat, reduced-calorie meal plans for 8 weeks. The one difference was that 5 mornings a week women in one group ate 2 eggs for breakfast while women in the other group ate a bagel. Both meals were the same size and had the same number of calories. The women who ate 2 eggs lost almost two-thirds more weight than the ones who ate bagels. They also had more energy and a much greater change in the size of their waistline.

You might be worried that eggs may have too much cholesterol, but adding eggs to a low-fat diet is not likely to raise your risk of heart disease. Blood tests at the end of the study found that the women who ate eggs had about the same cholesterol and triglyceride levels as the women who ate bagels. If you are actively trying to manage your cholesterol levels, you may want to skip on the yolk and just eat the egg whites. Please discuss this subject further with your healthcare provider.

Another study investigated whether a little more protein would help people trying to lose weight. One group of women ate an egg sandwich with lean Canadian bacon, the other group ate a breakfast without as much protein. In this study, both groups lost the same amount of weight, but the women who had the extra protein felt less hungry in the 4 hours after breakfast. They also kept more of their lean muscle at the end of the study.

Other choices. Of course, there are many ways to eat a healthy breakfast. Some other choices can include:

  • A fruit smoothie made with low-fat yogurt.
  • Smoked salmon and light cream cheese on half a whole-grain bagel.
  • Toasted whole-grain bread spread with fruit and a cup of low-fat milk or yogurt.
  • Get more ideas for eating smart.

See what your healthcare provider thinks!

ACTIONS

  • Choose a healthy breakfast you can fix in a typical morning.
    • Try to make it rich in fiber and nutrients, without too much fat or calories.
    • Try to make it something you enjoy and can prepare easily and quickly.

< Back to Nutrition

INDICATION

Qsymia should be used together with a reduced-calorie diet and increased physical activity for chronic weight management in:

  • Adults with an initial body mass index (BMI) of:
    • 30 kg/m2 or greater (obese) or
    • 27 kg/m2 or greater (overweight) in the presence of at least one weight-related medical condition such as high blood pressure, type 2 diabetes, or high cholesterol
  • Pediatric patients aged 12 years and older with an initial BMI in the 95th percentile or greater standardized for age and sex

LIMITATIONS OF USE:

  • It is not known if Qsymia changes your risk of heart problems or stroke or of death due to heart problems or stroke
  • It is not known if Qsymia is safe and effective when taken with other prescription, over-the-counter, or herbal weight loss products

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

QSYMIA CAN CAUSE SERIOUS SIDE EFFECTS, INCLUDING:

Birth defects (cleft lip/cleft palate). If you take Qsymia during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant. Patients who are pregnant must not take Qsymia. Patients who can become pregnant should have a pregnancy test before taking Qsymia and every month while taking Qsymia and use effective birth control (contraception) consistently while taking Qsymia. Talk to your healthcare provider about how to prevent pregnancy.

If you become pregnant while taking Qsymia, stop taking Qsymia immediately, and tell your healthcare provider right away. Healthcare providers and patients should report all cases of pregnancy to FDA MedWatch at 1-800-FDA-1088, and the Qsymia Pregnancy Surveillance Program at 1-888-998-4887.

Qsymia may slow the increase in height in children 12 years and older.

Increases in heart rate. Qsymia can increase your heart rate at rest. Your healthcare provider should check your heart rate while you take Qsymia. Tell your healthcare provider if you experience, while at rest, a racing or pounding feeling in your chest lasting several minutes when taking Qsymia.

Visual field defects (independent of elevated intraocular pressure) have been reported in clinical trials and in postmarketing experience in patients receiving topiramate. In clinical trials, most of these events were reversible after topiramate discontinuation. If visual problems occur at any time during treatment, consider discontinuing Qsymia.

Suicidal thoughts or actions. Topiramate, an ingredient in Qsymia, may cause you to have suicidal thoughts or actions. Call your healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying; attempts to commit suicide; new or worse depression; new or worse anxiety; feeling agitated or restless; panic attacks; trouble sleeping (insomnia); new or worse irritability; acting aggressive, being angry, or violent; acting on dangerous impulses; an extreme increase in activity or talking (mania); other unusual changes in behavior or mood.

Serious eye problems, which include any sudden decrease in vision, with or without eye pain and redness or a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma). These problems can lead to permanent vision loss if not treated. Tell your healthcare provider right away if you have any new eye symptoms.

Qsymia may cause a severe rash with blisters and peeling skin, especially around the mouth, nose, eyes, and genitals (Stevens-Johnson Syndrome). Qsymia may also cause a rash with blisters and peeling skin over much of the body that may be life threatening (Toxic Epidermal Necrolysis). Call your healthcare provider right away if you develop a skin rash or blisters.

COMMON SIDE EFFECTS OF QSYMIA IN ADULTS INCLUDE:

Numbness or tingling in the hands, arms, feet, or face (paraesthesia); dizziness; changes in the way foods taste or loss of taste (dysgeusia); trouble sleeping (insomnia); constipation; and dry mouth.

COMMON SIDE EFFECTS OF QSYMIA IN CHILDREN 12 YEARS OLD AND OLDER INCLUDE:

Depression, dizziness, joint pain, fever, flu, and ankle sprain.

POSSIBLE SIDE EFFECTS OF QSYMIA INCLUDE:

Mood changes and trouble sleeping. Qsymia may cause depression or mood problems, and trouble sleeping. Tell your healthcare provider if symptoms occur.

Concentration, memory, and speech difficulties. Qsymia may affect how you think and cause confusion, problems with concentration, attention, memory or speech. Tell your healthcare provider if symptoms occur.

Increases of acid in bloodstream (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. Metabolic acidosis can happen with or without symptoms. Sometimes people with metabolic acidosis will: feel tired, not feel hungry (loss of appetite), feel changes in heartbeat, or have trouble thinking clearly. Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with Qsymia.

Low blood sugar (hypoglycemia) in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus. Weight loss can cause low blood sugar in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus (such as insulin or sulfonylureas). You should check your blood sugar before you start taking Qsymia and while you take Qsymia.

High blood pressure medicines. If you are taking medicines for your blood pressure, your doctor may need to adjust these medicines while taking Qsymia.

Central Nervous System (CNS) side effects. The use of prescription sleep aids, anxiety medicines, or drinking alcohol with Qsymia may cause an increase in CNS symptoms such as dizziness and light-headedness. Do not drink alcohol with Qsymia.

Possible seizures if you stop taking Qsymia too fast. Seizures may happen in people who may or may not have had seizures in the past if you stop Qsymia too fast. Your healthcare provider will tell you how to stop taking Qsymia slowly.

Kidney stones. Drink plenty of fluids when taking Qsymia to help decrease your chances of getting kidney stones. If you get severe side or back pain, and/or blood in your urine, call your healthcare provider.

Decreased sweating and increased body temperature (fever). People should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition.

Qsymia capsules contain the inactive ingredient FD&C Yellow No. 5 (tartrazine) which can cause allergic-type reactions (including bronchial asthma) in certain people, especially people who also have an allergy to aspirin.

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects of Qsymia. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to VIVUS LLC at 1-888-998-4887 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please read the Qsymia Medication Guide, Full Prescribing Information and Risk of Birth Defects with Qsymia Patient Brochure.

The Q and Me® Patient Support Program is based on the LEARN® Program provided under copyright license (September 15, 2010). All rights reserved.

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

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