Leane Manurung: Being slim needs discipline

Leane Manurung: Being slim needs discipline

By Primastuti Handayani

JAKARTA (JP): Leane Manurung was the country's best archer
from 1971 to 1983. Now a dedicated nutritionist, she chairs the
nutrition department of the School of Medicine at the University
of Indonesia.

Born on Feb. 4, 1948, she was more popularly known as Leane
Suniar, who finished ninth at the 1979 Olympics in Montreal.

Together with teammate Donald "Robin Hood" Pandiangan, they
represented the country in international events, including the
1981 World Championship in Italy.

Leane was in the fourth year of medical school when she was
picked as a national team member. She completed her studies in
1983, after abandoning them for 12 years.

The mother of one son and two daughters who resides on Jl.
H.O.S. Tjokroaminoto 38 in Central Jakarta, she receives around
30 patients three times a week -- mostly housewives and young
female professionals wanting to be slim and attractive.

Leane chose to study applied nutrition after being appointed
as one of the doctors to the national athletic team by Suprayogi,
former chairman of the National Sports Council.

She was offered a chance to study abroad but declined because
of her responsibilities toward her husband and children.

Leane talked to The Jakarta Post on the slimming business in
her small practice room one evening.

Question: Everyone wants to be slim now. What is the main
motivation -- health care or physical appearance?

Answer: If we look at the trend, people want to be slim to
change their physical appearance. But many also realize the older
they get, the greater the chances they have of becoming ill. Many
of my patients are young people who want to look slim, especially
professionals, who are between 20 to 30 years old. Only a few are
men. I think men want to be slim because they already have aged-
related ailments.

Q: There are many slimming services now. What is the situation
regarding these services?

A: I think they are using shortcuts and sometimes do not
consider the side effects. Many non-medical experts are
involved ... It's easy to reduce weight, they only give a
diuretic to remove body fluid.

Q: Will it cause dehydration?

A: Yes, it will. Foolish people ... only focus on losing
weight. They're very happy to lose four to five kilograms per
week. The medical standard of reducing weight is only one to one-
and-a-half kilograms per week. That's good enough. There are many
side effects of slimming programs.

Q: Could you mention some?

A: If people reduce their weight by removing body fluid, then
they will suffer dehydration. They will be very weak. Sometimes
they have to be hospitalized ... and need to be infused. They're
lucky if they don't suffer kidney disorder.

I had a patient who went to a general practitioner, a
consultant on a weight reducing program. The doctor gave the
person medicine to remove body fluid. Some time after, the
patient had to be hospitalized.

The people at the slimming center refused to reveal the name
of the medicine, the more so when they realized the client was
hospitalized. But we traced the medicine by observing its
effects.

Sometimes the practitioners do not even give prescriptions.
Some of them sell drugs which could be their own productions in
their offices.

When we raised complaints, they came up with names of
different medicines instead of those they gave to the clients.

Generally they give a diuretic, which produces more sweat or
urine. This reduces the size of our cells and reduces weight.

Another way is to speed up metabolism is by using laxatives.
What we consume is not absorbed by the body, but is immediately
removed. This can also cause dehydration.

Many doctors give medicine to stimulate metabolism. This
forces the heart to beat faster. Even at night, the heart cannot
rest. It still works hard. Automatically, the food consumed is
spent to keep the heart working, and this can reduce weight.

We should consider whether it is right to treat people like
that. I only give such medicine to patients if they suffer from
hypertension, which requires a diuretic, or if they have
constipation problems.

Q: What about the effectiveness of slimming cream and its side
effects?

A: I can't say whether the cream is effective or not. I don't
know how it works. The cream is only scrubbed on a certain area
of the skin's surface. It's difficult to study how effective the
absorbency is to increase metabolism, which can reduce weight.

In slimming centers, a similar procedure is used. They wrap
clients with magnetic belts and remove body fluid. Clients lose
weight temporarily. But after they eat, or even drink, they gain
it back again. The results are not effective because they still
have to go on dieting. They have to change their habits of food
consumption.

Q: Is acupuncture effective in a weight-reducing program?

A: Well, acupuncture, as people say, is good for the program.
An acupuncture patient I know said it's not very effective. But
it's people's minds convincing them they can be slim that forces
them to go on dieting.

Q: Is it relatively safe because they change their eating
behavior?

A: Yes, but it's not from the acupuncture itself, but from
their conscience telling them to change diets and that is what
reduces weight.

If we design a program to lose weight, from six to eight
kilograms in two months, the regularities from dieting and
discipline make people unable to eat more.

Q: Is the latest technology of liposuction popular here?

A: There are several liposuction programs here. It's a
difficult method that is applied only on certain parts of the
body. It is very dangerous because after the fat is sucked,
clients have to undergo skin surgery to lift the skin, which
loses fat underneath. Every three to six months, the patient
requires skin surgery to make the skin look good and young. A
young client may only require surgery once every six months. But
if she's older, she might require surgery every three months.

Q: What is the most effective way to reduce weight?

A: Dieting and doing physical activities. What makes us fat is
eating between meals. Maybe we can't eat much during main meals.
But eating between meals makes us forget how much food we've
consumed. Snacks usually consist of sugar and flour, which are
easily processed into energy. Unused energy becomes fat.

Q: Is dieting without exercising effective?

A: It is possible, but results will appear slower. If we only
diet, we can reduce one or one-and-a-half kilograms per week. But
by combining dieting with sports, we can reduce one-and-a-half to
two kilograms per week.

We have to consider a client's physical condition. If a client
has a heart problem, we can't urge him to do weight lifting.

The most effective way is when somebody is already engaged in
activities of high intensity. For normal people, when their heart
beats faster, it means the extra fat is already being processed.
They have to keep increasing their exercise (to achieve results).

Q: What are the most effective sports to help a diet?

A: Every physical activity which can increase the heart rate
can help to reduce weight. It depends on age. Young people can
jog or swim with ease. People accustomed to exercise must
increase the level of its intensity. Old people, especially the
overweight, cannot be told to run. The safest way is walking or
exercising lightly.

Q: What percentage of your patients succeeded in losing
weight?

A: Almost 80 percent managed. Maybe 10 to 15 percent failed.
Most of those who failed lacked high motivation ... or they could
have reduced two kilograms per week easily. They would have to
work hard to cut out tasty food from their diets, including those
with sugar and flour.

Q: Do you also give medicine to your patients?

A: I give them medicine to help dieting ... Usually they use
the medicine in small doses. The medicine I use is to reduce the
will to eat.

There are two kinds of drugs. One is to reduce weight, which
requires a large dose. Low-motivated people can still reduce
weight by taking the medicine because the metabolism process goes
on in the evening.

The second kind of drug reduces the will to eat. If people are
undisciplined and keep eating, they can't lose weight.

Q: Does it mean they feel full after taking the drugs?

A: Yes. If people don't want to take the shortcut, they are
happy to come to me because they don't have to starve because of
medical treatment. After they have stopped taking the medicine,
they can still go on with their diet program. They won't be
addicted. The drugs are administered in gradual steps, from small
to large doses. Then I reduce the dose to observe the
stabilization process, then add more, and gradually stop
administering the drugs.

Q: How long does the process take?

A: About two to three months. My program is to reduce six to
eight kilograms in two or three months. Every week, only one to
one-and-a-half kilograms is lost.

Q: How do you measure the ideal proportion between height and
weight?

A: It depends on one's age. For people above 35, the height
minus 100 is the ideal weight. For the young, the height minus
100 minus 10 percent. Sometimes people want to lose more.

Q: What is your suggestion for people who want to reduce
weight without joining a fitness center?

A: I never suggest to my clients to join fitness centers. If
they are young, it's okay. But housewives or mothers can follow
aerobic programs on TV every morning at home.

Q: What is your advice to those who want to be slim?

A: Stop eating between meals and engage in more physical
activities. Go on a diet. Stop going to parties.

We should not refer to our culture. The more we respect
people, the more we serve food to show our respect. For example,
if we have relatives or superiors, we automatically serve them
food or ask them to fancy restaurants.

The best place to spend our time is always accompanied by
food, like in coffee shops. It's very different abroad where we
can spend time in parks to chat without eating. Here, pleasant
places always serve good food.

Q: Does it help to only skip dinner?

A: Skipping dinner means reducing intake. But the proper way
is dieting with a nutritious menu, and consuming more vegetables
and fruits. Look at the Sundanese. They look good because they
consume more vegetables.

Q: Should the Ministry of Health sanction slimming services
due to the complaints which have come up?

A: In Indonesia, people still consider life cheap. I had a
patient who died of dehydration. She was treated by a Chinese
medicine man. After being treated by the sinsei, she lost six
kilos in the first week, but died in the second week.

I told her mother to file charges against the sinsei. But she
was ashamed because her daughter died of dehydration. She seemed
to prefer losing her daughter than having her around, but fat. I
said to myself: "How cheap life is here."

Many patients are treated at hospitals for dehydration. They
tend to blame themselves for going to certain doctors.

Many Indonesians prefer to go to doctors who offer quick
slimming programs. Then if the unwanted happens, they blame
themselves.

Q: Have any of these doctors been punished by the Indonesian
Medical Association?

A: I think we still reserve respect for our colleagues.
Although we know who is behind certain cases, we only complain
without taking action.

Q: Is there any consultation with the doctors within the
organization?

A: There should be, but we don't have any. We consider the
problem solved when one doctor wants to help to cure another
doctor's patients. It's unethical, but it still goes on here.