Reader ponders best weight loss rate

Dear Dr. Roach: I have had fatty liver for the past 10 years. To reverse it, I am trying to lose weight. Now I am 116 kilograms. I have heard that if someone has fatty liver and wants to lose weight, they should not lose more than 1.5 kg per week. This week, I lost 3 kg. What is your advice?

A.A.

Answer: The advice against too much weight loss too quickly was based on an observation that some people rebounded their weight after losing it. Newer studies have not confirmed that. In fact, people with large amounts of weight loss (more than 2 kg in the first four weeks) have been shown to have a better chance of keeping the weight off. If you are losing weight due to healthier diet and exercise, I would advise continuing those behaviors and not worrying about losing too much too quickly.

Any kind of weight loss can temporarily increase the risk of gallstones. Having some sources of healthy fat in the diet (such as nuts or avocados) will decrease this risk.

Dear Dr. Roach: What is an epiretinal membrane? My doctor says I have this but it is not bad enough to be treated. I am 86 years old, and my vision is blurry. How would this be treated?

T.V.

Answer: An epiretinal membrane is a thin layer that forms over the retina at the back of the eye. It can cause loss of vision or visual distortion. Most of the time, they do not require treatment. An epiretinal membrane can form after certain eye conditions, especially retinal detachment. It’s possible for it to attach to and pull the retina, causing distortions in the vision.

The only treatment is surgery. The decision to perform surgery is made by how much the vision is affected. Although surgery is usually effective, there are possible complications. Most eye doctors do not rush to surgery, except in cases where there is swelling in the most critical part of the retina for central vision. People whose epiretinal membrane gets worse, or who have the kind that can pull the retina out of shape, may also require surgery.