Helping grandson who weighs 311 pounds requires expert help

advice alone rarely leads to sustained significant weight loss. There are many reasons that people gain weight and others that make it hard to lose weight. Simply receiving the advice is probably not going to work. Very few people successfully lose 100 pounds and keep it off.

Given how serious his issue is, your grandson should be seeing an expert in weight loss. In addition to diet advice and exercise, he certainly should consider other treatments, including medication and surgical procedures. These increase the likelihood of long-term significant weight loss.

Some procedures to help people lose weight can be done endoscopically with minimal risk. This is especially relevant for people who are not good candidates for traditional surgery, such as people with heart problems.

Dear Dr. Roach: I like to research my various conditions online so that I can have discussions with my physicians. The internet is wonderful for that, but I am increasingly frustrated with the plethora of pseudoscience sites/ articles. What tips can you suggest in order to find accurate, scientific information for health concerns? —

A: My first place to start is the National Library of Medicine at www.medlineplus. gov. The information is reliable and written at different levels of sophistication to match the type of question. Some institutions, such as the Mayo Clinic, have very robust and reliable information written for the public. UpToDate, a continuously updated medical textbook for professionals, has a patient-education library with well-written information.

There are sites that rate health information as to reliability. The Health On the Net Foundation, for example, certifies websites as to trustworthiness with its HONcode.