Dear Dr. Gott: A few weeks ago, I started your diet to lose weight by eliminating flour and sugar. Initially, I lost 20 pounds, but lately I have not lost any additional weight. Could you please let me know what I can do to lose additional weight? I am 87 years old and do not walk. The only exercise I get is riding a recumbent bike four times a week. Each time I ride the bike, it takes approximately 20 minutes.

Anything you could suggest I would willingly try and appreciate.

Reply: As I have written before, my no-flour, no-sugar diet is not as restrictive as it sounds. Rather, its prime thrust is to help overweight people choose more sensible alternatives.

In the book, I remind folks that to lose weight they have to moderate portions and get regular exercise. Also, I emphasise that the rate of weight loss isn't consistent. An individual may lose two or three pounds a week and then, for no reason, stop losing for a while. Stick with the diet, weigh yourself weekly, and be patient. Your age is an important factor in your weight-loss pattern because your exercise level is compromised.

Dear Dr. Gott: I am a middle-aged man, and I recently went for a general physical exam. I was treated by a new doctor. He checked my ears, heart and lungs. Then he asked me a few questions and said I was fine. The entire exam took fewer than five minutes. Was this really sufficient? Do I need to go to a specialist just to get a check-up?

Reply: Perhaps. Most family physicians are comfortable performing annual exams on their patients. Such an exam should include a thorough review of any symptoms followed by a complete examination that includes poking and prodding various body parts ¿ including the prostate gland in men. Further testing, such as blood work, a cardiogram and other analyses ¿ should be performed depending on the doctor's recommendation.

I agree that you were short-changed, and I suggest that you share my response with your physician.

If he seems unreceptive to change, switch doctors. Remember that a colonoscopy is recommended for everyone over 50 years of age, with repeats every five to ten years. Also, an ultrasound of the abdomen to identify an abdominal aortic aneurysm should be considered as a one-shot method to identify swelling of the major artery supplying blood to the lower body.

You may not need to see a specialist for a routine annual exam providing your doctor is willing to give you an appropriate examination and attention.