DEAR DR. ROACH: I am 60 years old, with high blood pressure and history of TIA. I stopped smoking five years ago and gained 50 pounds. I eat healthy and am on the treadmill 30 minutes five times per week. I am fairly active otherwise, but am not losing weight. My doctor says vigorous cardio exercise is a no-no for me because of the TIA. My friends and family say yoga is good for high blood pressure and anxiety. Would it be a good weight-loss program for me as well? — C.B.

ANSWER: Yoga has many benefits, but there are two important points I need to make. The first is that there are many different ways to do yoga, and some of them are intensive cardiovascular exercise. It would be good to get your doctor to give you an idea of how intense an exercise he or she wants you to avoid. Even less-intensive yoga practice can have significant benefits for overall health, and possibly for blood pressure and anxiety.

The second point is that exercise alone is unlikely to get you to lose significant amounts of weight (such as 50 pounds) without reducing caloric intake. Fortunately, increasing exercise somewhat while decreasing calorie intake somewhat can lead to significant weight loss. More importantly, even moderate exercise and healthy eating can reduce risk of a stroke, which must be a big concern in someone with a history of TIA (transient ischemic attack, a frequent precursor of stroke).

Weight gain after quitting smoking is common, but it usually amounts to 10 or so pounds, not 50. Your doctor should evaluate whether there are any other reasons for your weight gain (especially medications, but also other medical conditions) and discuss with you dietary programs to help. Remember: The health benefits of quitting smoking are much more important than the accompanying weight gain in almost everybody.

DEAR DR. ROACH: I took your advice on exercising, and switched to lighter weights and more repetitions. I now have no more strains or pulled muscles. I do nine exercises, 30-40 repetitions two to four times a week. My primary doctor won’t prescribe steroids for me. Are there any over-the-counter artificial steroids available? I would like to add a little bulk. I’ll be 75 next month. — J.B.

ANSWER: I agree completely with your primary care doctor, and recommend strongly against the use of anabolic steroids for the purpose of performance enhancement or to gain muscle bulk. Testosterone and other anabolic steroids are used for men who can’t make adequate amounts, especially those with symptoms. They also are used in cases of muscle wasting from various medical disorders. Unfortunately, they are used very commonly (6.4 percent of men worldwide have taken steroids, with 18 percent of recreational and 13 percent of professional athletes having done so). They have the potential for serious side effects, and when purchased from Internet suppliers, the quality, amount and even the type of steroids are unknown.

Most of the OTC supplements sold as nonsteroid performance enhancers (there are many) probably are ineffective -- with a few exceptions, such as creatine (which has some benefits in men under age 36) and caffeine (which helps a little in endurance events). If you really want to increase muscle bulk, I suggest you earn it the old-fashioned way: through gradual increase in resistance training. More resistance tends to lead to larger muscles, but it’s important to build up slowly to avoid injury.