Dr. Weil's Rx for Guys

Andrew Weil, the controversial M.D. who prescribes herbs, pollens and a wide range of alternative therapies, wants to help. He is inundated with appeals for medical advice--sometimes thousands a day, delivered via mail, phone calls and e-mail. His books are best-sellers. His seventh and most recent, 8 Weeks to Optimum Health, is a prescription for mental, spiritual and physical changes. It put him on the cover of Time. He lectures, does PBS specials and has a flooded Web site on the Internet--Ask Dr. Weil (www.drweil.com) receives 2 million hits a month. But still he has a problem. His message has been slow to catch on with the half of the population that may need him most: men.

Weil, 55, is the founder of the Center for Integrative Medicine at the University of Arizona Medical School in Tucson. A Harvard graduate with degrees in medicine and ethnobotany, Weil eschewed a traditional medical practice and took off for South America, Asia and India, where he studied with shamans, herbalists and osteopaths. Unlike most alternative medicine gurus, however, Weil also refers to conventional medicine when needed. But he is still criticized by many doctors for prescribing drugs and therapies that haven't been tested or approved by the Food and Drug Administration. He has millions of admirers who are now swallowing herbs such as ho shou wu and ashwaganda, bypassing filets mignon for soybeans, and even having their skulls massaged. Weird stuff, but many people say it works. Some claim it has saved their lives.

[Q] Playboy: Are men and women equally skeptical about alternative medicine?

[A] Weil: Men are more likely to dismiss it.

[Q] Playboy: Is it that men simply require more proof?

[A] Weil: I don't know, but men are more resistant. In general, they're much less likely to ask for help in matters of health. I'm not sure if there is some correlation between men not being willing to ask for directions when they're lost and their not wanting to go to health professionals if they have symptoms, but there may be. I know they're more likely to deny what's going on.

[Q] Playboy: Do men have a less healthy lifestyle than women?

[A] Weil: Definitely. They are more likely to be stuck in unhealthy patterns of eating and stress. They are subject to particular kinds of stress that women aren't: the need to perform, achieve, compete in the workplace. Women have more of it than they used to, but men still have the most. Men even exercise in ways that can be damaging.

[Q] Playboy: We thought exercise was good.

[A] Weil: But a lot of men get caught up in forms of exercise that aren't good for them. They push themselves too hard and damage themselves. It's common. Men are often very athletic in the early part of their lives and then become sedentary in middle age because they did too much damage. For example, they run and ignore pain in their knees until they can't run at all. It's much better to have moderate habits of exercise that hold up into old age. It's important that men learn to listen to their bodies. When you exercise, don't ignore pain. Men may dismiss walking as a wimpy form of exercise, but it is excellent.

[Q] Playboy: Are intensive workouts good if we keep them up?

[A] Weil: It depends. It's clear that for many people who go to fitness clubs it's all about appearance, about attractiveness. That should not be the primary reason for exercise, though I recognize that it can be a motivator. But if they are exercising for reasons of vanity and not health, they could actually harm themselves.

[Q] Playboy: How do you feel about the workouts men are doing to produce washboard stomachs?

[A] Weil: First of all, that can dissolve instantly if you stop doing it. It's not real change in the body; it's not rooted in anything physiological. Washboard stomachs aren't something to strive for. Sure, they look good on slick magazine paper and the TV screen, but they're not healthy. A flat abdomen with tight, rippling muscles will restrict the motion of the intestines during digestion. It will also crimp the action of the diaphragm, which of course needs to move easily for you to breathe. It's OK to be trim, but the well-toned abdomen should be yielding, not rigid. Abdominal crunches in moderation can be helpful. They can strengthen the back as well as the abdominal muscles. They're a good antidote to back pain because they balance and tone the muscles that support the spine. And they may help some people shape their midsections. You don't need to buy an expensive apparatus to work your abdominal muscles--your basic stomach crunch will do. Lie on the floor with knees bent, palms on your legs or on the floor, and your feet comfortably apart. Keep your chin up, focus your eyes on the ceiling and curl your body forward until your shoulders are a few inches off the floor. Hold and repeat. And keep breathing. Remember: Spot reduction isn't the answer, whether you use those devices or not. The secrets to losing weight won't cost you anything: Eat less (especially less fat), change your diet, get regular aerobic exercise. If you want to crunch your abs, that's great, too.

[Q] Playboy: How good are Stair Master, Nautilus machines and all that time at the gym?

[A] Weil: Used wisely, they can be fine. When the weather is bad and I can't bicycle or walk, I use the Stair Master. But if I go to a club, I see people, especially women, working out on Stair Masters like madwomen. There's a certain grim look about them that doesn't look healthy to me. It's much better if you can find something fun and easy that you can incorporate into your life. Most very healthy old people didn't do intensive workouts. They were moderately and sensibly active throughout their lives.

[Q] Playboy: But we also hear about some of the oldest and healthiest people who smoked, drank, had diets you would disapprove of and didn't exercise.

[A] Weil: Overriding everything may be something we rarely consider: the social connectedness that we don't have in our culture. One of the most unhealthful things in modern America is our increasing social isolation. Community connectedness is protective against ill health. A study looked at a community of Italians in Pennsylvania, in which the older generation had very low rates of heart disease, though they were smoking and eating a lot of meat. The younger generation had heart disease rates that are comparable to those of other Americans. The main thing that changed was the loss of the community. The younger generation lived in nuclear families, isolated from one another.

[Q] Playboy: Hasn't feminism managed to close the gap between men and women, particularly regarding stress? Why are men more susceptible to stress-related illness?

[A] Weil: Men in our culture have shorter life spans than women do, and they're more prone to violence, accidents and heart attacks. Men tend to ignore emotional problems and are unlikely to ask for help. Men tend to be stuck in bad diets and are less likely than women to eat enough fruits and vegetables. They still die younger.

[Q] Playboy: That's cheerful.

[A] Weil: Men can change. I suggest they look at their lives carefully. They should consider the sources of stress that have to do with being a man. Do they feel compelled to achieve? Are they the sole wage earner in the family? Is it difficult for them to express their feelings? I recommend individual or group psychotherapy to help them know and express their feelings. Many men have difficulty controlling anger. Yoga may help some men. Anger expressed outwardly and anger turned inward can both be destructive to the body. There's increasing evidence that anger can put you at risk for coronary heart disease and sudden death, especially men. Studies on the hard-driving type-A personality found that high energy and ambition weren't the key factors in determining a high risk for heart attacks. Instead, they were type-A characteristics combined with anger.

[Q] Playboy: Monks in monasteries may not get angry, but that's not the real world.

[A] Weil: So it becomes a question of how you handle anger. As a man becomes conscious of his anger, he should begin to distinguish between the mildly annoying and the infuriating. With the things that anger you most, try to figure out what they're really about: Are you feeling powerless? Guilty? Once you've learned to recognize anger and identify its roots, it will be easier to express it constructively and lessen it.

[Q] Playboy: Lessen it how?

[A] Weil: Just being aware of what causes it can help. Also, you can learn other ways to communicate your emotions. It's important to learn to say exactly what you're feeling and why, rather than just lashing out. The goal isn't to suppress your anger but to express it in a nonaggressive way. Psychotherapy, hypnotherapy and counseling can all be useful. Exercise is also an excellent way to cope with stress. Studies have found physical activity eases anger and tension. Meditation, relaxation and breathing techniques help a lot. Also, since isolation can increase feelings of anger and often leads to substance abuse and general ill health, men should work hard to develop meaningful connections with their families and friends. Finally, of course, is diet. There's no getting around it. Meat and cheese are key to the Western diet, but they are very bad. The prescriptions are obvious: Eat lots of fruits and vegetables, fish and whole grains, and have lots of variety.

[Q] Playboy: Are there other for-men-only prescriptions?

[A] Weil: Men should be careful with dietary supplements. If they take a multivitamin, it shouldn't contain iron. Men can't eliminate iron except through the loss of blood, and too much iron may promote cardiovascular disease and cancer.

[Q] Playboy: How does male sexual dysfunction relate to physical health?

[A] Weil: Sexuality is a reflection of one's general state of health, and it can be used to monitor both mental and physical well-being. It's an area in which many physicians are not well trained. Most doctors aren't very comfortable with taking sexual histories from people or giving them advice about sexuality. It's an area where there's a lot of room for improvement.

[Q] Playboy: We're all ears. How do you approach sex differently?

[A] Weil: I've looked at a lot of herbal and natural approaches to enhancing sexuality in men.

[Q] Playboy: You mean aphrodisiacs?

[A] Weil: Yes.

[Q] Playboy: Everyone has heard tales of aphrodisiacs, but we've always assumed they don't really work. First, what about Spanish fly?

[A] Weil: It's actually a beetle. It's a strong irritant of the genital and urinary system; it causes inflammation of the lower urinary tract, which can lead to erection and sexual excitement. But it's dangerous and not the way to go.

[Q] Playboy: What are safer choices?

[A] Weil: Asian ginseng and ashwaganda, two tonics described in my books, are especially useful for men. They make men more interested in sex, bring increased erections and prolong the duration of erections. They make for more satisfying sexuality. I mean, there's a lot of stuff out there. It's not even clear why they work. They may work on hormonal pathways. They are having specific effects on sexual physiology.

[Q] Playboy: Exactly how?

[A] Weil: The compounds in ginseng, called ginsenosides, are known to increase resistance to stress, improve hormonal balance, benefit metabolism and aid skin and muscle tone. I recommend an extract in capsule or liquid form that has been standardized for ginsenoside content. Oriental ginseng is a stimulant, so use it with caution, if at all, if you have high blood pressure, insomnia or anxiety.

[Q] Playboy: What is ashwaganda?

(continued on page 158)Dr. Weil(continued from page 148)

[A] Weil: An Ayurvedic herb. The word means "smells like a horse."

[Q] Playboy: That ought to get us far....

[A] Weil: It works for many people. It is sold in capsules in health-food stores. Just follow dosage recommendations on the product. There are many other Chinese herbal formulas thought to increase male sexual function. You can ask a practitioner of traditional Chinese medicine about them. The tonic ho shou wu, from the root of Polygonum multiflorum, is said to be a powerful sexual tonic. It is believed to increase sexual energy, improve sperm production in men and promote fertility in women. Paradoxically, a proven sex-drive enhancer for women is the male hormone testosterone. Women produce their own testosterone, and reputable scientific studies show that tiny additional amounts can increase libido dramatically. An herb that may increase a woman's interest in sex is the Mexican plant damiana, though not that much is known about it. I recommend that people try one of these for a few months and see what happens. Another important thing is that both physical and mental well-being are essential to healthy sex. Hypnotherapy and guided imagery therapy can help you make the most of the mind-body connection in overcoming sexual problems. We've all heard that the greatest aphrodisiac is the human mind.

[Q] Playboy: Do you have nontraditional treatments for impotence?

[A] Weil: All these sexual enhancers are useful for that. In general, with impotence or reduced sexuality in men, I would certainly try these alternative approaches before getting involved in urological workups and implants--machines that cause erections and all that. There are often simple solutions to impotence. One of the more common physical problems, reduced blood flow to the area, can be caused by smoking. Also, sexuality is heavily influenced by emotions and psychology. Impotence is much more likely to have a psychological cause than a physical one. Men spend lots of money on products that claim to boost male potency, but few of them actually work.

[Q] Playboy: How are those different from the aphrodisiacs you mentioned?

[A] Weil: There's a lot of stuff out there, from vitamin E preparations to rice bran oil to something called gama arisonal. The only drug currently listed in the Physicians' Desk Reference as a sexual booster is yohimbine, derived from the bark of an African tree and long rumored to be an aphrodisiac. Yohimbine is a stimulant that sometimes appears as a street drug. Users report distinctive and pleasurable tingling sensations along the spine and in the genitals. Manufacturers say it increases erections in men. Currently it is a prescription drug, available under the brand names Yocon, Yohimex and Aphrodyne. Yohimbé bark and extracts are sometimes sold in health-food stores. Yohimbine is relatively safe, with minor side effects in recommended dosage, but little scientific research exists to back up the claims made for it. The drug increases sexual arousal and performance in male rats. Whether it does the same in male humans is unclear. It does not appear to increase human sexual desire but may boost erectile and ejaculatory ability, which would make it worth trying in cases of physical impotence. A doctor must prescribe it.

Of all the categories of products recommended to increase male potency, hormones have the strongest biological effects. Testosterone is our principal androgen. Recent research has shown that testosterone is an attractive sexual booster, but oddly enough, women may benefit from it more than men. Getting the dose right is critical. Unless men are deficient in testosterone, taking extra is not going to do too much. At the same time, it can be a miracle cure for men who have suffered injuries to their testes or who were born with insufficient testosterone or who have little free testosterone in their blood as the result of aging. Even in these cases the manner of administration is important. The testosterone patch delivers the hormone in amounts and rhythms that closely mimic the natural state. But unusually high levels of androgens may hurt men physically or emotionally, causing a higher risk of heart attacks, for example, or increased aggressiveness.

[Q] Playboy: How can men avoid prostate cancer?

[A] Weil: More than any other cancer, this one seems preventable through diet. For one thing, men should make sure to include tomatoes and tomato products in their diet. Clinical studies show that the red pigment in tomatoes, lycopene, reduces the risk of prostate cancer. One large study reported in the Journal of the National Cancer Institute showed that men who ate just two servings of tomatoes a week--raw as well as cooked, even in sauces--had a 34 percent lower risk of developing prostate cancer.

[Q] Playboy: Does ketchup count?

[A] Weil: Yes.

[Q] Playboy: So, in fact, President Reagan was right--ketchup is a vegetable.

[A] Weil: Yes.

[Q] Playboy: Do you recommend anything other than tomatoes?

[A] Weil: Soy offers tremendous protection. It reduces the risk of both prostatic enlargement and prostate cancer.

[Q] Playboy: Now you're saying we have to eat tofu?

[A] Weil: Not if you don't like it. I try to interest people in the fresh green soybeans you get in sushi bars. They give you all the protective isoflavalins you need. I also recommend the usual: less red meat, more fish, more fruits and vegetables. The most important thing is to get plenty of water, because dehydration stresses the prostate. Also, you should avoid prostate irritants such as coffee, alcohol, tobacco and red pepper. Zinc deficiency can lead to prostate problems, so make sure you get enough, either by eating pumpkin seeds or taking supplements. A good preventive dosage is 30 milligrams once a day, which would give men great protection against prostate cancer. If you experience prostate enlargement, I'd advise taking saw palmetto, an herbal remedy made from the partially dried berries of Serenoa repens, a small palm native to the southeastern U.S. Saw palmetto protects the prostate from the irritating effects of testosterone and promotes shrinkage of the gland. The best form is a standard extract, taken as 160 milligrams twice a day. Another herb, Pygeum africanum, is also beneficial to the prostate and is sometimes added to saw palmetto formulas.

[Q] Playboy: How about testicular cancer?

[A] Weil: Testicular tumors are the most common type of cancer in men 25 to 35 years old, though men from 15 to 45 are at risk. The fact that testicular cancer occurs at a relatively young age suggests that it has an origin different from the cancers that commonly occur in older people. Generally, cancers in younger people result from a rapid development of embryonic cells left over from fetal development. Other sorts of cancers arise from malignant transformation of cells. Anything that increases cell division is going to increase the risk of cancer. DES (diethylstilbestrol) is suspect, as are other synthetic hormones. DES is an estrogen that was (continued on page 176)Dr.Weil(continued from page 158) given to millions of women from the Forties through the Sixties as a way to prevent pregnancy complications; it was banned in 1972 because it was found to cause birth defects. Daughters of women who were given DES have a higher risk of vaginal cancer. DES is also believed to be linked to cancer in men, though the evidence is less clear. Sons of women who were given DES definitely have a higher risk of an undescended testicle, which in turn carries a greater risk of testicular cancer even after it has been surgically brought down. A warning sign of testicular cancer is a lump in one of the testicles. If you notice any unusual lump or mass or hardness in your scrotum, you should have it checked by a doctor. At the same time, you should know that many irregularities you might find if you check yourself aren't tumors, but you want to make sure. And the cure rate for testicular cancer has improved dramatically in the past two decades. Twenty years ago it was about 25 percent, but now it's close to 90.

[Q] Playboy: Does it bother you that some people lump you in with quacks, charlatans and faith healers?

[A] Weil: Yes. It's unavoidable, I guess. I hope people will be more discriminating and recognize that the methods I'm advocating are much more balanced.

[Q] Playboy: Yet you've been called the "guru of alternative medicine."

[A] Weil: I don't like that, either. First of all, I'm not an uncritical proponent of alternative medicine, certainly not all alternative medicine. And I'm not a guru. I'm not looking for devotees.

[Q] Playboy: Do you view yourself as a healer?

[A] Weil: I think healing comes from within. I'm not laying hands on people. I'm giving them information that enables them to unblock and activate the body's natural healing processes.

[Q] Playboy: At times you advocate some pretty strange remedies. Do you understand the problem many people have with New Age medicine?

[A] Weil: The truth is that a lot of New Age stuff really turns me off. So of course I understand the skepticism. It's why I feel strange when I get lumped in with all of that.

[Q] Playboy: Well, you're the one who talks about the "energy" of food and prescribes cranial massages.

[A] Weil: One main difference between me and the traditional medical community is that I'm not closed to speculation about many things the medical world ignores. I'll consider anything, though I too want scientific proof if I can get it.

[Q] Playboy: But the difference is that you don't insist on it. Your harshest critics worry that you are pushing cures that are unproved.

[A] Weil: Well, I don't insist on proof if a treatment seems to help people and definitely won't harm them.

[Q] Playboy: But unless treatments are tested, they may harm people over the long run. You just don't know.

[A] Weil: The things I work with, including herbs and healing techniques, diet and exercise, breathing and meditation, can't hurt anyone. But I would like them to be studied. That is one of the things I push for.

[Q] Playboy: One of the more unusual things you advocate is animal venom. How does that work?

[A] Weil: I'm interested in bee venom therapy, in particular, which has a history of use for rheumatoid arthritis and multiple sclerosis.

[Q] Playboy: How about shark cartilage? Tiger bone?

[A] Weil: There's some evidence that there are things in shark tissue that inhibit the growth of new blood vessels on which tumors depend, but it's not clear that putting shark tissue in your mouth gives them to you in a usable form. It wouldn't be my first choice of a treatment for cancer. I know nothing about tiger bone. It's not good for tigers, of course. This is a bad area of Chinese medicine that has been extremely destructive to endangered species and other animals.

[Q] Playboy: Is it worth killing tigers or other animals if it helps people?

[A] Weil: I would prefer to look for a plant that had similar properties.

[Q] Playboy: Where did you come across cranial massage?

[A] Weil: Almost 20 years ago I met a doctor named Robert Fulford, who had a busy osteopathic practice in Tucson. He's now 92, and he teaches physicians to do cranial therapy. Rather than working on a symptom, he works on the entire body, exploring past injuries, diet, exercise, even the way someone breathes. Cranial therapy is part of traditional osteopathic medicine, which heals by using hands to manipulate the skeleton and connective tissues. I've found cranial therapy to be extremely useful for a wide range of problems, including headaches, hyper-activity in kids, disturbed sleep cycles and asthma. Gentle pressure is applied with the hands to the head. The aim is to free up restrictions in the movement of the cranial bones and allow the subtle natural rhythms of the central nervous system to express themselves in a balanced fashion.

[Q] Playboy: It sounds pretty quacky to us.

[A] Weil: I've seen brilliant clinical successes with it. It's a great technique, and it's one we're going to be emphasizing in our training at the university.

[Q] Playboy: Where do you draw the line? What in the New Age healing world is nuts?

[A] Weil: There are some therapies that look dangerous to me: oxygen, ozone and hydrogen peroxide therapies as well as other therapies that use strong chemicals. I wouldn't let anybody put them into me. I'm turned off by people who use devices such as electronic acupuncture machines with vibrating needles. And I'm extremely turned off by all the multilevel marketing of products such as colonial minerals, super blue-green algae and Tahitian no-ni. It seems there's one a month, a miracle cure that you can't live without. All the parametal stuff is suspect and the claims made about them are ridiculous. The other kind of medicine that turns me off is chelation therapy and the people giving intravenous this and that. The near-religious fervor that goes along with the distribution of a lot of this stuff really turns me off. It gives alternative medicine a bad name.

[Q] Playboy: You said that people don't get hurt, but haven't people died from some alternative medications? There have been deaths from a remedy called herbal ecstasy.

[A] Weil: I certainly don't advocate that. It isn't an herbal remedy. It is a stimulant that's sold as a legal alternative to illegal psychoactive drugs. The active ingredient, ephedra, is not a dangerous drug. If it's used moderately and occasionally, it's not a problem. But it's dangerous when people take it in such large doses and combine it with caffeine or with other stimulants.

[Q] Playboy: What does garlic do? In the article about you in Time, a scientist from UCLA criticized your claims and said, "There's no evidence that garlic does anything but make your breath smell."

[A] Weil: That is plain old ignorance. There's now an academic textbook out on the medicinal effects of garlic, in addition to many scientific articles about its therapeutic effects. The data are there, but most American medical doctors just don't know it. Of course, there are medicinal herbs that people use without supporting evidence. And it's true that, in general, there aren't enough double-blind clinical trials to satisfy Western medical needs. Oftentimes there is insufficient information on natural remedies because there's no incentive to study them. With no patentability to protect profits, there's little reason for a company to invest in research. Over the past few years, the National Institutes of Health has funded 42 research projects on alternative treatments ranging from acupuncture for attention-deficit hyper-activity disorder to guided imagery for asthma to Chinese herbs for hot flashes. Much of the data will be available to the public soon. The NIH also has given $10 million to ten specialty centers, including Bastyr University in Seattle and Beth Israel Hospital at Harvard Medical School, for such research.

[Q] Playboy: Do people who take vitamin C get fewer colds?

[A] Weil: I tell people who get five, six colds a year to take 3000 to 5000 milligrams of vitamin C a day. Most find that that dramatically reduces their frequency of colds. I am less convinced that vitamin C treats colds, but I think it definitely can be a preventive.

[Q] Playboy: Dr. Linus Pauling was emphatic about vitamin C. Was he right?

[A] Weil: I'm very interested in his work, though I think he became a monomaniac about vitamin C toward the end of his life. I usually take 1000 or 1500 milligrams three times a day. He was taking 18,000 mg a day. But I'm a strong proponent of antioxidant therapy. Antioxidants are a group of vitamins and minerals that block oxidation reactions, and I think they give tremendous protection against cancer and heart disease, and they slow down aging. The ones I use are vitamin C, vitamin E, selenium and a mixed carotene supplement. I think everybody should. There are studies backing it up. You can't pick up a medical publication these days without seeing an article about new research on antioxidants.

[Q] Playboy: At what point did you give up vegetarianism?

[A] Weil: I began eating fish about ten years ago, but that's all. I don't eat red meat or chicken or eggs. I eat a little bit of cheese. I like parmesan on pasta and a little mozzarella here and there.

[Q] Playboy: Have you ever been to a McDonald's?

[A] Weil: I have never eaten a McDonald's hamburger. I think I am one of the few Americans who can say that. However, I have, when on the road, gone into a McDonald's to get a Coca-Cola. Once in a while I'll drink a Coke, and that's the only thing I've ever had in a McDonald's.

[Q] Playboy: The fact that you drink Coke is surprising.

[A] Weil: Once in a while. I like drinking a Coke in front of people for shock value.

[Q] Playboy: What do you have against coffee?

[A] Weil: Coffee can contribute to migraine headaches, anxiety, heart palpitations, insomnia, coronary heart disease and stomach disorders. If you need caffeine, stick to green tea.

[Q] Playboy: Why green tea?

[A] Weil: It protects against cancer, lowers cholesterol and doesn't have the toxins coffee has.

[Q] Playboy: How about decaf coffee?

[A] Weil: It's not safe. First of all, decaf retains enough caffeine to affect sensitive people. It also contains other substances naturally found in the coffee bean that can have irritating effects on the body. Decaffeinated coffee can be just as tough on the stomach as regular coffee.

[Q] Playboy: What is your opinion of some of the popular diets? How about the Zone?

[A] Weil: It's a curious one. I don't think it is unhealthy, and it works for some people. The discussion about fats in the book is good, and Barry Sears is right to call people's attention to the fact that there are classes of carbohydrates that turn easily into blood sugar and might stress the pancreas: sugar, white flour, white breads. There are two things I don't like about the diet, though. Encouraging people to regard food as a drug is not healthy. Seeing food as a drug is what contributes to unhealthy ways of dealing with it. The other thing is that he notes, in fine print, that this diet applies to 25 percent of people and doesn't apply to another 25 percent of people, while the rest of us are somewhere in the middle. But the implication of the book is that it is the way everybody should be eating. It's not. It only works for some people.

[Q] Playboy: How about popular diet pills?

[A] Weil: I don't like them. There's nothing new in them; they're a variation on the old theme of using stimulants to suppress appetite. It works temporarily, but you're certain to gain back the weight when you stop taking the drugs. And the side effects can be significant. The only use I see for them is to get someone started on a weight-loss program, if the person is committed to follow that with a healthy regimen to maintain the weight loss without drugs.

[Q] Playboy: Which diets do you recommend?

[A] Weil: Everyone is different. For some, the Dean Ornish diet is going to work: very low fat, vegetarian. It's another of the latest fads out there and we'll see what happens. Pritikin's diet is good for some people. It's also very restrictive--good for people with heart disease, to reverse the blockage--so it's hard to follow. My problem with most diets is that people don't stick to them. I try to help people learn how to eat better in an ongoing way, a way that can become part of their lives.

[Q] Playboy: You've also expressed concern about the effects of water and air on health. What can people do about that?

[A] Weil: You can do something about water: Use bottled water when you are on the road and get a water purifying system for your home. Air is tougher. Certain house plants are effective at removing pollution. You can also take antioxidants, which give you protection against problems that come from the environment.

[Q] Playboy: In general, is the American diet and lifestyle a disaster?

[A] Weil: Yes, and we are pushing it all over the world now. But people are figuring out how to have less-stressful lives, and the American diet is getting better. People are much more sophisticated about food than when I was growing up. There is a big sushi restaurant in Tucson, where I live, and it seems to be most frequented by rednecks and cowboys. The sight of cowboys eating sushi is amazing. Who would have thought? At the same time, there is much, much greater consumption of fast foods and processed foods, and Americans eat enormous portions of food. So we are eating more of worse foods. There are McDonald's restaurants in hospitals now. The McDonald's corporation is inducing hospitals to put them in by giving them grants. That's a terrible trend. The love of beef is dangerous. Of all the animal foods, beef is probably the least healthy. At a restaurant in Texas, if you eat a 72-ounce steak by yourself, you get it for free. And people do it. It's the essence of the worst of the American diet. The fat in meat is the worst fat for hearts and arteries. In addition, cows are big animals at the top of a food chain, so they are likely to concentrate all the environmental toxins, plus they are given all these drugs, hormones and growth promoters. Steamed vegetables and fresh fruit, on the other hand, are not only nutritious but also can protect you against serious illness. Is that big steak worth it?

The drug increases sexual performance in rats. Whether it does the same in humans is unclear.