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Dear Dr. Roach: My family members drink mega amounts of diet pop, including the kids, ranging from age 3 to age 10. All the adults have serious weight problems. They say they have to drink something besides water. What comments do you have?

A.H.

Dear A.H.: There remains a controversy about the effect of diet soda and nonsugar sweeteners on weight loss. Observational studies (those that correlate behaviors with outcomes) suggest that greater consumption of diet sodas is associated with a higher risk of obesity. There are several possible explanations for this, including that overweight people are more likely to drink diet soda to try to lose weight. However, there also is evidence that drinking diet soda increases appetite and changes the way we perceive taste.

Some interventional studies, generally considered the strongest evidence, show people whose diet is changed to include diet sodas experience weight loss. Unfortunately, there is evidence of bias in these kinds of studies, possibly related to support by the industry.

Given that the information is unclear and even conflicting, I recommend a common-sense approach. If what you are doing isn’t working, you need to change it. If your family consumes large amounts of diet sodas and they have weight problems, changing from diet soda to water (or another unsweetened beverage, like tea or herbal beverages) may help.

By itself, though, it is probably not the answer. Losing weight requires a more comprehensive evaluation of the diet. Regular exercise is important, as well. Even if a change to a healthier diet does not promote weight loss, it does help with many other issues, including risk of heart disease, cancer and diabetes.

Dear Dr. Roach: In a column, a 63-year-old woman complained about her eyebrows starting to disappear at the outer edges. The same thing happened to me (I am about the same age). My blood tests were normal. I think for many, it’s simply aging. I disliked it so much that I tried Latisse, which many people use for eyelashes. One drop each night, and my eyebrows are back, as though I were a 20-year-old.

A.K.M.

A.K.M.: As an internist, I think of what skin, nail and hair problems may mean for diagnosing medical problems. That’s why I recommend evaluation of the thyroid gland — loss of the outer part of the eyebrow can be a clue to this important problem. However, I recognize that it can be a cosmetic issue, as well.

Bimatoprost (Latisse) is a prescription medication indicated for people with decreased eyelash volume. I have found case reports and anecdotal evidence that it is effective for eyebrows, as well. This is an off-label use of the medication. It is expensive, on the order of $140 per bottle at the time I write this, and might not be covered by insurance for this purpose. Any improvement in eyebrows is likely to go away when the use of the product is stopped.

Email questions to ToYourGoodHealth@med.cornell.edu.

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