::TRISTAR CLINIC NEWS
2008-06-12
Losing Weight - Again
-Lesley Ward
The hard truth is: weight loss is not a one-time deal. It's never "over." There is no "cure" for being overweight. There is only paying attention to what you eat, every day, for the rest of your life.
It is not an easy pill to swallow, and it's why there IS no easy pill that will take the weight off permanently. Maintaining weight loss long-term takes constant effort and vigilance, and an acceptance of this reality.
This is why, every year, many people find themselves having to lose weight - again. Because even though they did lose weight, and they felt all the benefits of losing weight, and they vowed they would not put it back on again-they did. Somewhere along the way the old habits crept back in, and the weight came back on.
So, now what? Well, you've done it once, you can do it again.
Sometimes, in our experience, when a person has lost a lot of weight--say, more than 50 lbs--the second time can be harder. There was something about the initial weight loss that was so dramatic and exciting-what we call "the honeymoon phase"-that it kept you going. The second time around, there is a sense of familiarity that may not be altogether pleasant, especially if you have a lingering sense of failure over the fact that you did this before, and you regained every pound and more.
You can't let those feelings stop you! You can lose the weight again, and you can keep it off. It just means doing the work, and working a little bit differently this time, focusing more on the long-term.
Here are some things to keep in mind:
Get Support - We all know it is very difficult to lose weight on our own. You need someone to give you some outside accountability and perspective. Otherwise, it is all too easy to get caught up in the tiny fluctuations on the scale, or give in to the kind of temptations that spring from our rationalizing self-talk. If you do not have access to a supervised program such as the one at TriStar Medical Clinic, consider joining a weight loss group, starting a pool with co-workers, or signing up for an online tracking system. Find some structure outside yourself, and make your commitment that much stronger.
Self-Monitoring - Keep track of your food intake and physical activity. It can be a little notebook you keep in your bag, or a spreadsheet on your computer, but writing down what you're actually doing is the best way for you to see things as they really are. People who do this are much more successful long-term!
Eat More Protein and Restrict Carbohydrates - You know that eating more protein helps you feel more satisfied, which is a good reason to eat plenty while you are losing weight. Even more important, it also helps ensure that while you are losing weight, you are losing fat, not muscle. When dieters lose muscle mass because they're eating less but not paying attention to protein or resistance activity, they are in effect slowing down their metabolism--which makes it that much easier for you to regain your weight.
Set Boundaries - Sure, we like to say that in Maintenance, you can eat anything you want; it just has be portion-controlled. The trouble is, most people have some foods that they simply cannot eat in a controlled way. Whatever that is for you-it's probably flashing through your mind right now. And that may mean that, in order for you to keep your weight off, you really have to decide that you're never going to eat a Krispy Kreme, or a Double-Double, or whatever it is, ever again, because to even go there is to fall right back into all the habits that keep you heavy.
Think Forever - It's scary to realize-"You mean I have to watch what I eat all the time, for the rest of my life?!"
But the reality is-yes, you do. If you are going to stay at a healthy weight, you do have to be aware of what you are putting in your mouth every day. It doesn't mean that you will not occasionally choose to have a piece of birthday cake, or a slice of prime rib. The key word is "choose." You have it, not because everyone else is, or it's expected, or you're hungry, or it looks good, or it's there, but because you've thought about how you're going to feel two hours from now, and tomorrow, and next week, and you choose to have it. Because you know you're in control. And you're NOT gaining your weight back AGAIN.
2008-01-31
Carbohydrate-Restriction May Improve Weight and Blood Sugar Control In Type 2 Diabetics
-Dr. Anton Steiner
Many diets that have become popular since the late 1990s advocate limiting the amount and type of carbohydrate consumed as a way to modulate blood insulin levels and improve weight loss. In theory, keeping blood sugar and insulin levels in a moderate range reduces the amount of carbohydrate converted to fat thereby aiding weight loss as well as diabetes control.
The effect of carbohydrate-restricted diets on the health of people with type 2 diabetes was recently investigated by researchers who reviewed 56 studies on the subject and combined data from 13 of them for further analysis.
Low-carbohydrate diets led to greater improvements in the percent of hemoglobin A1c (a measure of blood sugar control in people with diabetes), the level of fasting blood sugar, and some blood fats such as triglycerides than did typical weight loss diets. However, the effect of carbohydrate-restricted diets on weight loss was inconsistent. Additional properly designed and controlled studies examining the effects of low-carbohydrate diets in people with type 2 diabetes are needed to confirm the safety and long-term effectiveness of these diets and clarify the impact on weight loss.
2008-01-31
What Causes People to Underestimate Their Calorie Intake?
-Dr. Anton Steiner
According to the National Weight Control Registry Data, self-monitoring skills such as routinely weighing oneself, counting calories consumed, and tracking exercise help people achieve and maintain a lower body weight. However, several well-regarded studies have shown people underestimate the number of calories they eat each day by as much as 30% which can dramatically affect their success. A new study has identified some of the factors that contribute to miss-estimation of calorie consumption by overweight women.
Years of education, degree of athletic skill, body weight goals, and body image were identified as factors that contribute to routinely underestimating the number of calories eaten and the amount of exercise performed. Inaccurate estimation probably accounts for the confusion that people often express over failure to lose weight even though they believe they are exercising more and eating less.
Learning methods for portion size estimation and tracking food and exercise in a diary or log can make instant improvements in reporting accuracy. Knowing how many calories you consume and use each day, is a crucial skill for weight management.
2007-12-31
Number of Obese Americans Leveled off, but Didn’t Fall
-Dr. Anton Steiner
The Centers for Disease Control (CDC) recently reported some progress in the nationwide battle of the bulge. Although the number of American adults classified as obese remains alarming high, the latest national health survey found that the number of new cases of obesity seems to be leveling off. During 2005-2006, 33% of men and 35% of women were obese. This is equivalent to 72 million obese Americans and represents roughly the same number found to be obese during the 2003-2004 survey.
The CDC began formally tracking obesity rates 20 years ago as part of the state by state Behaviors and Risk Factor Surveillance System (BRFSS). Each state collects a variety of health-related data and passes it on to the CDC for compilation and analysis. The BRFSS data demonstrates that about 15% of American adults were obese in the early 1990s. That rate grew rapidly until 1999 and has been slowing since then.
While examining the latest BFRSS data, the CDC researchers noted other important trends. Specifically, the percentage of obese people aged 40-59 hovered around 40%-a rate significantly higher than was found in younger adults. Also, there are large racial/ethnic differences in the obesity rates. About 53% of non-Hispanic black women and 51% of Mexican-American women ages 40-59 are obese, compared to about 39% of non-Hispanic white women of the same age.
The latest BFRSS data is a good news-bad news situation. True, the increase in the rate of obesity is slowing, but, it's also not falling. Also, the percentage of severely obese Americans is continuing to climb. The latest BRFSS data can help the CDC and other health providers target audiences that are most at risk for developing obesity, or who are already obese and need the greatest degree of treatment. Clearly new and more dramatic efforts are needed to reverse the body weight trend. Interventions such as reducing the cost of lean proteins, fruits, and vegetables through government subsidies, and offering people cash or benefit incentives to lose weight are examples of such interventions.
On a personal level, you should have a good understanding of where your body weight falls on the BMI scale, the repercussions of your body weight and, if necessary, how to take action to improve your weight status. Taking charge of your weight is a smart investment in your future health and happiness.
2007-10-10
An Intensive Weight Loss Program May Help People Lose Over 100 Pounds
-Dr. Anton Steiner
With soaring obesity rates and increasing interest in bariatric (weight loss) surgery to provide long-term solutions, many people are frustrated that, while they are significantly overweight, they are not eligible for surgery based on the currently accepted criteria. One aspect of surgical procedures that is often overlooked is that many bariatric surgeons will use a meal replacement formula diet in combination with behavioral therapy in preparation for surgery. This meal replacement program serves a variety of functions. The first is that it reduces the complication rate of bariatric surgery by reducing pre-surgical weight and liver size which, in turn, makes the surgery easier. Secondly, your ability to conform to a pre-surgical diet may be a predictor of your ability to conform to the post-surgical diet restrictions that you will face.
Considerable weight loss is possible on the same diet that many surgeons use preoperatively. In fact, when patients are able to lose over 100 lbs on a meal replacement formula and maintain the weight loss through behavioral therapy, the need for surgery diminishes.
In a recent study of 118 morbidly obese people with an average starting weight of over 370 pounds, an average of 145 lbs was lost after 44 weeks. That's less than one year using a meal replacement formula, medical monitoring and behavioral therapy.
These results compare very favorably with bariatric surgery and have minimal risk when monitored by an appropriately trained physician. People who do not qualify for bariatric surgery, are financially unable to afford surgery or are not prepared for the additional risk, this research shows that a comprehensive weight loss program is an extremely viable alternative.
2007-10-10
Large hip-to-waist ratio linked to early CVD
-Dr. Anton Steiner
For many years, the accepted way to establish weight-related risk was to use Body Mass Index (BMI). BMI is a measure of body fat based on height and weight that applies to both adult men and women. Last year, a study from the Mayo Clinic that used the BMI of patients with heart disease to calculate their risk of death shocked many people when their results appeared to indicate that overweight individuals were less likely to die from heart disease and that there was even a measure of protection gained by being overweight. The researchers indicated that the cause of the unexpected results more likely originated from the BMI calculation than from an actual protective quality of obesity.
The study questioned the accuracy of BMI when applied to an individual rather than when used as a calculation for a large population. Since most people are more concerned with their own risk rather than the risk of an entire population, an alternative measurement which provided a more accurate assessment of risk for the individual was required.
The hip-waist ratio appears to be the leading candidate for this more accurate measurement, and its position is strengthened even further by a recent study that showed the hip-to-waist ratio was a more accurate predictor of heart disease than several other standard measures, including BMI.
The hip-to-waist ratio is easily measured with a tape measure:
- For your waist, measure around the narrowest part of your waist or, if this is difficult to find, just above your belly button.
- For your hip size, measure around the widest part of your hips.
Then simply divide the waist measurement by the hip measurement.
The risk of heart disease is considered high if your ratio is higher than 0.8 for women or 1.0 for men. In other words, if your stomach protrudes further than your hips, it is time to consider a serious weight loss program.
