When we think of the word "stress", most often we envision the emotional/physical response to untoward life events. The emotional components may include anxiety, a sense of panic, depression and a global sense of worry and doom. Physically, our "fight or flight" hormone response may cause us to feel palpitations, headaches, chest pains and poor sleep patterns.
Frequently, when we are under stress, we find ourselves reaching for food as a "treatment". Unfortunately, the food sources we seek during periods of stress are termed "comfort foods" and they tend to be very high in calories. Chips, cookies and other sweets are the most commonly sought out foods. Alcohol consumption may also be a response to stress for a number of people. A few beers or glasses of wine may seem to temporarily make the stress seem more bearable. But once again, the calories we consume with the alcohol will make weight problems even worse.
Linda and I have developed a quiz to allow someone to see just how much stress plays a role in his/her eating behavior. Check out: www.stresseaterquiz.com Invite your friends and family to go that site as well to perform an assessment as to whether stress is contributing to any weight issues they may have and to what extent.
Tomorrow I will discuss more about the chemical responses to stress as that relates to eating behaviors and what solutions we may have for you.
On a non-medicine note: I was at Wolf Trap Saturday night to see the musical "Rent". One stethoscope up for me...my daughter loved the show. Must be a generational thing...if I took her to see the old classic Guys and Dolls, I think she would have demanded to leave at intermission.
Monday, June 30, 2008
Sunday, June 29, 2008
WEIGHT LOSS AND EXERCISE
I was out running around Burke Lake Park the other day and paid attention to the faces of people who were running by me in the opposite direction. (I didn't mean people running past me because they were faster than me, so please stop the age jokes going through your mind). For a number of people, there was a look of anguish on their faces. It was hot, humid, and not easy to run in this environment. I started thinking about other venues in which you see people, and my first thought was that you almost NEVER see a look of anguish on the face of a person at a restaurant. Everyone appears to be happy, smiling, enjoying the moment.
Point here is that the reason why so many people avoid exercise is because it is not really a "fun" activity. We know it is healthy for us, will help in our weight loss efforts, and globally produces more energy, but while we are doing the exercise, it is not all that much fun. Least you doubt that statement, next time you are at a gym, look around and you will see most people with IPODS, headsets, watching tv, etc...all meant to distract themselves from the activity being performed. Now think of a restaurant...no one seems to want to be distracted from that activity.
For me, when I am playing tennis, I do not realize that I am "exercising" because I am into the competition, enjoying the activity (if I win), etc. Running for me is much more boring and I constantly seek diversion through listening to music or watching a sports event on TV.
Try to find activities that are not things you loathe. For instance, a number of people despise running on a treadmill. Obviously, if that was the only exercise available to them, they will find every excuse in the book why NOT to do it: "I have been working so many hours on the job." "The kids are so busy with soccer." "My knees hurt when I run." For those people who hate running, explore other activities that burn calories that you may find more fun. Certainly during the summer, swimming is a great sport. Hiking, rowing boats, "boot camps" that personal trainers run may all be activities that you will find more fun. Everyone of course is different, so individually, if you are not exercising at all right now, explore the activities that will allow your heart rate to go up, yet you enjoy doing that activity.
Point here is that the reason why so many people avoid exercise is because it is not really a "fun" activity. We know it is healthy for us, will help in our weight loss efforts, and globally produces more energy, but while we are doing the exercise, it is not all that much fun. Least you doubt that statement, next time you are at a gym, look around and you will see most people with IPODS, headsets, watching tv, etc...all meant to distract themselves from the activity being performed. Now think of a restaurant...no one seems to want to be distracted from that activity.
For me, when I am playing tennis, I do not realize that I am "exercising" because I am into the competition, enjoying the activity (if I win), etc. Running for me is much more boring and I constantly seek diversion through listening to music or watching a sports event on TV.
Try to find activities that are not things you loathe. For instance, a number of people despise running on a treadmill. Obviously, if that was the only exercise available to them, they will find every excuse in the book why NOT to do it: "I have been working so many hours on the job." "The kids are so busy with soccer." "My knees hurt when I run." For those people who hate running, explore other activities that burn calories that you may find more fun. Certainly during the summer, swimming is a great sport. Hiking, rowing boats, "boot camps" that personal trainers run may all be activities that you will find more fun. Everyone of course is different, so individually, if you are not exercising at all right now, explore the activities that will allow your heart rate to go up, yet you enjoy doing that activity.
Saturday, June 28, 2008
Goal-Setting Is the First Step to Fitness Success
If you haven’t set goals for yourself, now’s the time to start. Research shows that people who set fitness goals are more likely to stick with their exercise routines and perform at a higher level than those who don’t. This simple process can invigorate your program whether you’re new to working out or simply want to tweak you current fitness objectives.
So why spend time setting goals? First, because it works. Setting goals also helps keep you motivated, especially at the beginning of a fitness program. Goals help us adhere to the exercise program and once we’ve succeed, even if it’s just a little, it motivates us throughout the program.
Goals should be realistic, for instance, look at your body type, fitness level, your available time to exercise and don’t forget your food intake. As you’re setting your goals, remember to make them specific and measurable. An objective of "I want to run two miles under 25 minutes" is more effective than "I want to increase my running speed." This way, you have a way of measuring and tracking your success. Define your goal so you have a way of measuring it.
Often we focus on the overall achievements we’re aiming for, but don’t forget to break down that goal into smaller objectives that you’ll work toward over time. If you want to increase your bench press max by 50 pounds, break that into segments—increase your max by 10 pounds in six weeks, and build from there. Hitting those smaller goals helps keep you motivated to reach the larger ones.
Simply setting your goals is not enough. You’ve got to figure out how you’ll achieve them. How often will you train? For how long? When will you go to the gym? How much cardio will you do? How will you modify your diet? The more specific you are with your plan, the better. After you’ve developed your plan, track your progress. The easiest way to do this is with a training log where you record your workouts and other information like your nutritional intake, hours of sleep, and other factors that may affect your training. Check in with your goals occasionally—this may mean sitting down once a week with your training log to perform a mini-review of how you did over the past week. As you review your progress, make appropriate adjustments to your training plan to keep you on track. Once in a while, take a look at the big picture—are you still motivated about your overall objectives? Are your goals still realistic or do they need to be tweaked? Your exercise log will help you review and evaluate your progress. If you’ve hit a plateau, for example, you may find that you need to mix up your routine—or it may be that you’re not getting enough rest between workouts. Your log can also serve as a trophy of sorts—it’s a constant reminder of how far you’ve come and how hard you’ve worked.
And don’t forget to celebrate your achievements! When setting goals, you may also want to build in a reward system for yourself. Made it to the gym four days a week, despite a busy work schedule? Finally hit 225 on the bench press? Treat yourself to a manicure and pedicure at the spa, buy a new book or shoes or 18 rounds on your favorite golf course. Do not reward yourself with food. That too will help keep you motivated. The bottom line is goal-setting should be an integral part of your workout routine if it isn’t already. It makes sense in the business world and in the gym as well. Remember, too, that deciding what you want isn’t enough—you must determine how you’ll get it. People confuse dreams and goals, whereas a dream is a fantasy; a goal is a dream, but has a plan to motivate you and help take you there.
So why spend time setting goals? First, because it works. Setting goals also helps keep you motivated, especially at the beginning of a fitness program. Goals help us adhere to the exercise program and once we’ve succeed, even if it’s just a little, it motivates us throughout the program.
Goals should be realistic, for instance, look at your body type, fitness level, your available time to exercise and don’t forget your food intake. As you’re setting your goals, remember to make them specific and measurable. An objective of "I want to run two miles under 25 minutes" is more effective than "I want to increase my running speed." This way, you have a way of measuring and tracking your success. Define your goal so you have a way of measuring it.
Often we focus on the overall achievements we’re aiming for, but don’t forget to break down that goal into smaller objectives that you’ll work toward over time. If you want to increase your bench press max by 50 pounds, break that into segments—increase your max by 10 pounds in six weeks, and build from there. Hitting those smaller goals helps keep you motivated to reach the larger ones.
Simply setting your goals is not enough. You’ve got to figure out how you’ll achieve them. How often will you train? For how long? When will you go to the gym? How much cardio will you do? How will you modify your diet? The more specific you are with your plan, the better. After you’ve developed your plan, track your progress. The easiest way to do this is with a training log where you record your workouts and other information like your nutritional intake, hours of sleep, and other factors that may affect your training. Check in with your goals occasionally—this may mean sitting down once a week with your training log to perform a mini-review of how you did over the past week. As you review your progress, make appropriate adjustments to your training plan to keep you on track. Once in a while, take a look at the big picture—are you still motivated about your overall objectives? Are your goals still realistic or do they need to be tweaked? Your exercise log will help you review and evaluate your progress. If you’ve hit a plateau, for example, you may find that you need to mix up your routine—or it may be that you’re not getting enough rest between workouts. Your log can also serve as a trophy of sorts—it’s a constant reminder of how far you’ve come and how hard you’ve worked.
And don’t forget to celebrate your achievements! When setting goals, you may also want to build in a reward system for yourself. Made it to the gym four days a week, despite a busy work schedule? Finally hit 225 on the bench press? Treat yourself to a manicure and pedicure at the spa, buy a new book or shoes or 18 rounds on your favorite golf course. Do not reward yourself with food. That too will help keep you motivated. The bottom line is goal-setting should be an integral part of your workout routine if it isn’t already. It makes sense in the business world and in the gym as well. Remember, too, that deciding what you want isn’t enough—you must determine how you’ll get it. People confuse dreams and goals, whereas a dream is a fantasy; a goal is a dream, but has a plan to motivate you and help take you there.
Friday, June 27, 2008
Understanding Portion Control
Most people consume far more calories than they realize. Why? They don’t rationally estimate portion size.. According to a survey conducted by the American Institute for Cancer Research (AICR), most Americans (78 percent) still believe that the kind of food they eat is more important in managing their weight than the amount of food they eat.
People wonder why they're gaining weight. Americans are concentrating too much on cutting fat, or relying on fad diets that cut intake but lower the metabolism. Studies reveal that these strategies fail to address the issue of total calories consumed, as well as overall good nutrition.
Experts say that understanding the concept of standard serving sizes is essential to good nutrition and weight maintenance. Standardized serving sizes help consumers, health professionals, and food manufacturers find a common language.
Although serving sizes are "standardized," individual portion sizes will vary, because people have different caloric requirements. Portion size also depends on a person's specific weight management goals and health needs.
The problems of obesity and lack of nutrition awareness also seem to have a societal and cultural component. Take a look at fast food restaurants. Most of these restaurants offer "super-size" or "value" meals, which often contain an entire day's worth of calories and fat. In addition, full service restaurants offer large portions to provide value to customers in a competitive environment. Similarly, with today’ hectic pace and more women in the workforce, it is easier for many to grab ready-made or easy to prepare foods like pasta that contain more carbs.
Statistics from the U.S. Department of Agriculture reveal that Americans' total daily caloric intakes have risen by 148 calories per day since 1980. This amount adds an extra 15 pounds to weight every year.
Interestingly, the same studies show that the amount of fat in the average American diet has decreased from 40 percent of total calories to 33 percent during the same period. So although calories from fat have decreased -- at nine calories per gram of fat versus only four for a gram of carbohydrate or protein -- Americans have more than made up for their lower fat intakes with larger portion sizes of other types of foods. Larger portion sizes equal more calories. And more calories lead to weight gain, regardless of the source of the calories -- fat, protein, or carbohydrate.
Fat provides a feeling of fullness, which can help some people avoid eating to excess. By cutting fat out of their diets, people may lose this signal to stop eating. In addition, many "low-fat" and "no fat" foods can be just as high in calories compared to the regular versions as fat is replaced with sugars or high calorie sweeteners to beef up flavor.
Use These Portion Guides
What's a portion size? According to the American Dietetic Association, you can use the following "models" to approximate portion sizes:
People wonder why they're gaining weight. Americans are concentrating too much on cutting fat, or relying on fad diets that cut intake but lower the metabolism. Studies reveal that these strategies fail to address the issue of total calories consumed, as well as overall good nutrition.
Experts say that understanding the concept of standard serving sizes is essential to good nutrition and weight maintenance. Standardized serving sizes help consumers, health professionals, and food manufacturers find a common language.
Although serving sizes are "standardized," individual portion sizes will vary, because people have different caloric requirements. Portion size also depends on a person's specific weight management goals and health needs.
The problems of obesity and lack of nutrition awareness also seem to have a societal and cultural component. Take a look at fast food restaurants. Most of these restaurants offer "super-size" or "value" meals, which often contain an entire day's worth of calories and fat. In addition, full service restaurants offer large portions to provide value to customers in a competitive environment. Similarly, with today’ hectic pace and more women in the workforce, it is easier for many to grab ready-made or easy to prepare foods like pasta that contain more carbs.
Statistics from the U.S. Department of Agriculture reveal that Americans' total daily caloric intakes have risen by 148 calories per day since 1980. This amount adds an extra 15 pounds to weight every year.
Interestingly, the same studies show that the amount of fat in the average American diet has decreased from 40 percent of total calories to 33 percent during the same period. So although calories from fat have decreased -- at nine calories per gram of fat versus only four for a gram of carbohydrate or protein -- Americans have more than made up for their lower fat intakes with larger portion sizes of other types of foods. Larger portion sizes equal more calories. And more calories lead to weight gain, regardless of the source of the calories -- fat, protein, or carbohydrate.
Fat provides a feeling of fullness, which can help some people avoid eating to excess. By cutting fat out of their diets, people may lose this signal to stop eating. In addition, many "low-fat" and "no fat" foods can be just as high in calories compared to the regular versions as fat is replaced with sugars or high calorie sweeteners to beef up flavor.
Use These Portion Guides
What's a portion size? According to the American Dietetic Association, you can use the following "models" to approximate portion sizes:
- One deck of playing cards equals one serving (three ounces) of meat, poultry, or fish (can also use the palm of a woman's hand or a computer mouse).
- Half a baseball equals one serving (one-half cup) of fruit, vegetables, pasta, or rice (can also use a small fist).
- Your thumb equals one serving (one ounce) of cheese.
- A small hand holding a tennis ball equals one serving (one cup) of yogurt or chopped fresh greens.
Weight loss and "healthy" Choices
I was at a Ruby Tuesday's restaurant last nite for dinner and ordered a combination that included their salad bar. Pretty cool salad bar....lots of "stuff"...aside from the classic vegetables, there was quite an interesting array of things like eggs, cheese, hot croutons, ham, pudding, fruits, many types of great looking salad dressings. By the time I finished loading up my plate, I realized that the amount of calories on the plate exceeded most likely the calories on their double cheeseburger. What started out as a foray into a "healthy" choice turned into a caloric disaster.
Point here is this: sometimes we are lulled into thinking we are making a "good" choice for a weight loss-friendly food source. Whether it be a McDonalds premium salad, a yogurt parfait, a salad bar at Ruby's etc., these items can be incredibly damaging to our weight loss efforts. Take some time to analyze the things you are eating (such as that great energy bar which is loaded with calories) that you feel are "good" and see just how many calories you really are consumming with that choice.
Another anecdote about Rubys....apparently at one point they had this Mega Burger of some sort that had an insane number of calories, and in the spirit of trying to contribute to the health of America, they removed that menu item for awhile. Turns out the public clamored to have it back, and they succumbed to the pressure. Kind of like that commercial for BK when they "secretly" tape the response of their customers to being told the Whopper is off the menu. Outrage!!! Those commercials are hilarious because I can't help but wonder if they choose the people to be in that commercial from the studio audience of the Jerry Springer show.
Weekend: EXERCISE!!! hot and humid so morning exercise or indoors....
Point here is this: sometimes we are lulled into thinking we are making a "good" choice for a weight loss-friendly food source. Whether it be a McDonalds premium salad, a yogurt parfait, a salad bar at Ruby's etc., these items can be incredibly damaging to our weight loss efforts. Take some time to analyze the things you are eating (such as that great energy bar which is loaded with calories) that you feel are "good" and see just how many calories you really are consumming with that choice.
Another anecdote about Rubys....apparently at one point they had this Mega Burger of some sort that had an insane number of calories, and in the spirit of trying to contribute to the health of America, they removed that menu item for awhile. Turns out the public clamored to have it back, and they succumbed to the pressure. Kind of like that commercial for BK when they "secretly" tape the response of their customers to being told the Whopper is off the menu. Outrage!!! Those commercials are hilarious because I can't help but wonder if they choose the people to be in that commercial from the studio audience of the Jerry Springer show.
Weekend: EXERCISE!!! hot and humid so morning exercise or indoors....
Thursday, June 26, 2008
Maintaining/Losing Weight and Vacation Choices
I have had several patients that have come back from their vacations and the scales were a stark reminder of how quickly weight can go back on easily when "focus" is lost. A large % of the patients who gained significant weight while gone had something in common: They all stayed at "all inclusive" resorts, i.e. places where all the food and alcohol was included in the price of the vacation.
"All You Can Eat/Drink" mantras test the very fabric of human nature. We are paying one price, whether we eat a small amount of food and drink water, or eat large portions of foods and consume enough alcohol until we find ourselves singing Barry Manilow karioke. Often, at these all inclusive spots, buffets are offered with the quality of food being marginal at best. The dessert bars are laden with a tempting array of choices that ulitmately taste no better than a twinkie.
A few thoughts: NO ONE at our clinics, especially me (Dr. Las Vegas Mirage Buffet) expects people to go on their well earned vacations and not partake of the food and other dietary choices that make us smile and feel good. We all work very hard and part of the fun of any vacation is living life a bit more hedonistically. However, if you are in a weight loss mode, perhaps when you consider a vacation spot, you may want to steer away from places that test your resolve. If you are at a nice beach resort with a fine restaurant that will make you pay more $$$ for a second plate of food or a great dessert, you may be more apt to pass it by than if those came at no additional cost on a buffet spread. Especially the alcohol consumption, which more than anything, will derail weight loss efforts.
If you have been recently successful at going on a vacation and NOT gaining weight, please e-mail me your "secret to success". Serotab@aol.com
"All You Can Eat/Drink" mantras test the very fabric of human nature. We are paying one price, whether we eat a small amount of food and drink water, or eat large portions of foods and consume enough alcohol until we find ourselves singing Barry Manilow karioke. Often, at these all inclusive spots, buffets are offered with the quality of food being marginal at best. The dessert bars are laden with a tempting array of choices that ulitmately taste no better than a twinkie.
A few thoughts: NO ONE at our clinics, especially me (Dr. Las Vegas Mirage Buffet) expects people to go on their well earned vacations and not partake of the food and other dietary choices that make us smile and feel good. We all work very hard and part of the fun of any vacation is living life a bit more hedonistically. However, if you are in a weight loss mode, perhaps when you consider a vacation spot, you may want to steer away from places that test your resolve. If you are at a nice beach resort with a fine restaurant that will make you pay more $$$ for a second plate of food or a great dessert, you may be more apt to pass it by than if those came at no additional cost on a buffet spread. Especially the alcohol consumption, which more than anything, will derail weight loss efforts.
If you have been recently successful at going on a vacation and NOT gaining weight, please e-mail me your "secret to success". Serotab@aol.com
Wednesday, June 25, 2008
Weight Loss and Discretionary Spending
I had a patient yesterday tell me something that made me kind of stop in my tracks yesterday. As a primary care physician, there is very little that someone can tell me that would make me pause wordless for a bit. In my role as a family physician for now over 24 years, I have heard many stories that would be considered "shocking" to most laypeople, but yet, my role is to be completely non-judgemental, provide sound medcial/psychological insights, and help the person through their medical or psychological crisis.
Okay, back to the story, which will not be shocking, so sorry for those readers out there who are now waiting with baited anticipation. Anyway, a very nice nurse patient in our weight loss program, told me in the course of our visit: "Dr. Posner, you were my birthday present and mother's day present". I guess I have been to Las Vegas once too often, so this initially sounded like some sort of Vegas-ian (new adjective coined by Posner) themed movie script. Quickly however, she laughed and explained that as opposed to her spending money on a clothes outfit, vacation, jewelry, or other, she elected to spend the money on our weight loss program. She was not happy with her aesthetic look, felt low energy, didn't like how she looked in her clothes, and noticed her blood pressure creeping higher. She then made the decision to spend the monies she would have spent on "pleasurable" things on our program instead.
This anecdote gave me a somewhat different perspective on how some people view making a decision to get some jump-start help in losing weight. Making your self healthier and happier with your appearance is probably one of the best expenditures one can make on themselves. Being healthier and looking more fit will allow you to have much greater fun on your vacations, take different types of vacations,allow you to feel a boost in self-esteem and pride, make you want to be around others, etc. So, if any of your loved ones are experiencing weight issues and their health or psychological condition is faltering because of that, suggest that Dr. Posner be their present to themselves! (And I am NOT available on E-Bay!)
Okay, back to the story, which will not be shocking, so sorry for those readers out there who are now waiting with baited anticipation. Anyway, a very nice nurse patient in our weight loss program, told me in the course of our visit: "Dr. Posner, you were my birthday present and mother's day present". I guess I have been to Las Vegas once too often, so this initially sounded like some sort of Vegas-ian (new adjective coined by Posner) themed movie script. Quickly however, she laughed and explained that as opposed to her spending money on a clothes outfit, vacation, jewelry, or other, she elected to spend the money on our weight loss program. She was not happy with her aesthetic look, felt low energy, didn't like how she looked in her clothes, and noticed her blood pressure creeping higher. She then made the decision to spend the monies she would have spent on "pleasurable" things on our program instead.
This anecdote gave me a somewhat different perspective on how some people view making a decision to get some jump-start help in losing weight. Making your self healthier and happier with your appearance is probably one of the best expenditures one can make on themselves. Being healthier and looking more fit will allow you to have much greater fun on your vacations, take different types of vacations,allow you to feel a boost in self-esteem and pride, make you want to be around others, etc. So, if any of your loved ones are experiencing weight issues and their health or psychological condition is faltering because of that, suggest that Dr. Posner be their present to themselves! (And I am NOT available on E-Bay!)
Tuesday, June 24, 2008
Weight Loss and Relationships
I am writing a book about weight loss which wil be released in January, 2009 (okay, enough shameless self-promotion!) and one of the chapters of the book will be devoted to people who achieved incredible weight loss, meaning close to 100 pounds if not more. How did they allow themselves to become so obese? What psychological or environmental factors were involved? What made them decide to finally do something aggressive about their weight and how did they do it so sucessfully?
I am interviewing a number of our patients who have achieved incredible success and agreed to be a part of this chapter. This past weekend I interviewed a husband and wife who are in their 50s and combined, they have lost well over 200 pounds. Their entire lives have changed, but one of the most poignant examples of how life has changed was this: Because of the morbid obesity, subsequent sleep apnea, snoring, taking up large amounts of space, etc., they had not slept together in years. Now, they both are in the same bed at night again and the smiles on both of their faces told me just how much they loved this benefit of the weight loss.
As I have mentioned many times before, the obvious benefits of weight loss are the medical pnes...improved health. But, there are also some major benefits to relationships. If you have a story about how your weight loss has positively impacted on your relationship, and are willing (no names of course!) to share the general nature as to how that relationship has changed, please feel free to e-mail me at: serotab@aol.com
I am interviewing a number of our patients who have achieved incredible success and agreed to be a part of this chapter. This past weekend I interviewed a husband and wife who are in their 50s and combined, they have lost well over 200 pounds. Their entire lives have changed, but one of the most poignant examples of how life has changed was this: Because of the morbid obesity, subsequent sleep apnea, snoring, taking up large amounts of space, etc., they had not slept together in years. Now, they both are in the same bed at night again and the smiles on both of their faces told me just how much they loved this benefit of the weight loss.
As I have mentioned many times before, the obvious benefits of weight loss are the medical pnes...improved health. But, there are also some major benefits to relationships. If you have a story about how your weight loss has positively impacted on your relationship, and are willing (no names of course!) to share the general nature as to how that relationship has changed, please feel free to e-mail me at: serotab@aol.com
Monday, June 23, 2008
Big Breakfast with Chocolate to Help weight loss?
An article last week, http://www.washingtonpost.com/wp-dyn/content/article/2008/06/19/AR2008061901659.html?referrer=emailarticle detailed a study which concluded that a very large breakfast, including lots of carbohydrates, actually helped obese women lose weight as opposed to the women who ingested a much lesser breakfast with less carbs.
The article referred to higher levels of serotonin in the morning causing less carb cravings resulting in people not wanting to eat as much breakfast, but as the day progresses and serotonin levels drop, people start reaching for more food sources. If they were to satisfy their carb requirments in the morning, there would be less food ingestion later.
My feelings on this? Not sure yet. Clearly, I am not quite certain we should be encouraging our patients to eat Captain Crunch in the morning with the donut as a way of losing weight. The article sure makes it seem it is a simple as this. IT IS NEVER SIMPLE.
I will try contacting the lead article writer to get some more info. In the meantime, PLEASE always take internet articles/study summaries for what they are: PRELIMINARY data to be looked at with interest pending more data.
The article referred to higher levels of serotonin in the morning causing less carb cravings resulting in people not wanting to eat as much breakfast, but as the day progresses and serotonin levels drop, people start reaching for more food sources. If they were to satisfy their carb requirments in the morning, there would be less food ingestion later.
My feelings on this? Not sure yet. Clearly, I am not quite certain we should be encouraging our patients to eat Captain Crunch in the morning with the donut as a way of losing weight. The article sure makes it seem it is a simple as this. IT IS NEVER SIMPLE.
I will try contacting the lead article writer to get some more info. In the meantime, PLEASE always take internet articles/study summaries for what they are: PRELIMINARY data to be looked at with interest pending more data.
Sunday, June 22, 2008
Being in the "Zone" for weight loss
Every week we have patients come back to our program who have been with us previously. Each and every one of them did very well in their first program with us, losing weight aggressively and leaving quite happy. However, over a period of months or years, for a significant number of people, weight will start going up again. In a perfect world, our program or anyone else's for that matter would help people lose weight permanently.
Unfortunately, lifestyle changes as that relates to food consumption, alcohol usage and exercise (or lack thereof) are very difficult to accomplish permanantly. Temporarily, we can go on "diets"...meaning for a period of time we change our behavioral patterns, but a very common psychological factor is our desire to "cross a finsh line". This means that when we have reached our goal or close to it, we then are able to start going back to old behaviors.
Truly, to lose weight and keep the weight off requires life style changes and permanant behavior modification. When people decide to start a weight loss effort, they are in a mental "zone" of sorts, meaning they are geared up mentally to alter their lifestyles. Whether it be the health issues, cosmetic appearance, or whatever reasons, the person is "psyched up" to mke weight loss a priority and that person is willing to change their current lifestyle.
How do we stay in this "zone"? We have offered up several ideas such as keeping a card with the five major reasons as to whyyou want to lose weight and look at that card daily. Another way is to keep "pre" and "post" pictures prominently displayed in places wehere you will see them daily. Coming to our office and use our scale for a "weigh-in" will not cost you one penny, yet may psychologically allow you to feel the "accountability" that is an important part of any weight loss program. I am certain that our patients who have successfully maintained their weight loss have other concepts/ideas as to how to maintain the lifestyle changes. PLEASE feel free to offer those hints/suggestions up! E-mail me at: serotab@aol.com
On a non-medical note: I am playing a tennis match this morning. This sport is really puttering out for some reason. I think it is a great sport for people because you can still play ata decent level when you get older unlike the real "jump and run" sports such as basketball and football.
Unfortunately, lifestyle changes as that relates to food consumption, alcohol usage and exercise (or lack thereof) are very difficult to accomplish permanantly. Temporarily, we can go on "diets"...meaning for a period of time we change our behavioral patterns, but a very common psychological factor is our desire to "cross a finsh line". This means that when we have reached our goal or close to it, we then are able to start going back to old behaviors.
Truly, to lose weight and keep the weight off requires life style changes and permanant behavior modification. When people decide to start a weight loss effort, they are in a mental "zone" of sorts, meaning they are geared up mentally to alter their lifestyles. Whether it be the health issues, cosmetic appearance, or whatever reasons, the person is "psyched up" to mke weight loss a priority and that person is willing to change their current lifestyle.
How do we stay in this "zone"? We have offered up several ideas such as keeping a card with the five major reasons as to whyyou want to lose weight and look at that card daily. Another way is to keep "pre" and "post" pictures prominently displayed in places wehere you will see them daily. Coming to our office and use our scale for a "weigh-in" will not cost you one penny, yet may psychologically allow you to feel the "accountability" that is an important part of any weight loss program. I am certain that our patients who have successfully maintained their weight loss have other concepts/ideas as to how to maintain the lifestyle changes. PLEASE feel free to offer those hints/suggestions up! E-mail me at: serotab@aol.com
On a non-medical note: I am playing a tennis match this morning. This sport is really puttering out for some reason. I think it is a great sport for people because you can still play ata decent level when you get older unlike the real "jump and run" sports such as basketball and football.
Saturday, June 21, 2008
Weight Loss and Sensitivity Issues
I had two different patients in yesterday who provided some interesting thoughts about talking to others about weight loss. One patient is a female, mid thirties in for a sinus infection. She was an ex-model who has no weight problems at all, and she saw the literature in the office about our weight loss program. The patient asked me whether I give out brochures and other marketing materials to my medical patients who are overweight. I told her that it is a fairly senstivie issues to bring up in discussions whe someone is not in for a general wellness visit. Obviously, if a patient comes in for a physical examination , part of the exam is a weight measurement, and then if the number is not optimal, I have a very easy time bringing up weight control to help overall health. However, when an overweight person presents for a sore throat, especially when the person is not a chronic patient, it is somewhat awkward to start talking about our fabulous weight loss program. The person only has to look in the mirror to see he/she is overweight...they know it already. The ex-model patient, being in great shape, beautiful, etc. thought it was odd that I would not tell every overweight patient about the program directly as opposed to just having literature around the office.
Another patient who joined our program said her motivation was her husband making a comment to her to the effect of "hey...you have gained a little weight since we got married a year ago...". The patient was taken somewhat aback by the statement, felt hurt a bit, but then decided to do something aggressive about it.
These examples highlight the relative sensitivity that we all have approaching others about weight issues. We fear hurting their feelings, making them self-conscious, having them be angry with us etc. However, as a physician, am i not being a bit negligent, even if the person is not here for that reson, to not bring up their weight problem from a health standpoint? As a relative, friend, lover etc, are you really being a cruel person to encourage a loved one to lose weight for health reasons?
I would be greatly interested in your comments on this...if you cannot post to the blog, feel free to e-mail me at: serotab@aol.com
On a non medical note,...Get Smart picture...2 Stethoscopes up!!!! GREAT, FUNNY picture...Anne Hathoway and Steve Carrell are hilarious. Mel Brooks , original creator was involved. If you can pinpoint exactly in the moveie when his infliuence on this film occurs, I will give you a certificate for a free movie for two.
Another patient who joined our program said her motivation was her husband making a comment to her to the effect of "hey...you have gained a little weight since we got married a year ago...". The patient was taken somewhat aback by the statement, felt hurt a bit, but then decided to do something aggressive about it.
These examples highlight the relative sensitivity that we all have approaching others about weight issues. We fear hurting their feelings, making them self-conscious, having them be angry with us etc. However, as a physician, am i not being a bit negligent, even if the person is not here for that reson, to not bring up their weight problem from a health standpoint? As a relative, friend, lover etc, are you really being a cruel person to encourage a loved one to lose weight for health reasons?
I would be greatly interested in your comments on this...if you cannot post to the blog, feel free to e-mail me at: serotab@aol.com
On a non medical note,...Get Smart picture...2 Stethoscopes up!!!! GREAT, FUNNY picture...Anne Hathoway and Steve Carrell are hilarious. Mel Brooks , original creator was involved. If you can pinpoint exactly in the moveie when his infliuence on this film occurs, I will give you a certificate for a free movie for two.
Friday, June 20, 2008
weight loss and portion control
I had a very nice gentleman yesterday tell me that his major revelation about success in losing weight has to do with portion control. This patient, who has lost over 50 pounds in 6 weeks, informed me that he never used to measure or even think about his portions. Since starting the program, he has become much more cognizant of the size of the food sources that are appearing on his plate. Especially at restaurants, he is being very careful not to always eat what is put in front of him.
Weekend and alcohol: Once again, recurrent theme...alcohol delays weight loss efforts...before you put that beer in your hand, think twice about it...if you want the weight to come off aggressively, mimimize that alcohol.
On a non-weight loss note: Michael Myers film was panned. Give me a break. You and I know that we will all laugh at his stupid fart jokes. And if you don't think the Three Stooges are funny, then I must question your sense of humor. (Now this will get me lots more comments than my weight loss advice!)
Weekend and alcohol: Once again, recurrent theme...alcohol delays weight loss efforts...before you put that beer in your hand, think twice about it...if you want the weight to come off aggressively, mimimize that alcohol.
On a non-weight loss note: Michael Myers film was panned. Give me a break. You and I know that we will all laugh at his stupid fart jokes. And if you don't think the Three Stooges are funny, then I must question your sense of humor. (Now this will get me lots more comments than my weight loss advice!)
Thursday, June 19, 2008
Realistic Goals
Had a new patient come into my office yesterday and we were discussing her goals for weight loss. She told me that in high school she weighed 125 pounds..she was about 5 feet five inches...to reach this goal she needed to lose about 40 pounds.
Often, we refer to "the charts" as to what our weight should be....100 pounds for the first five feet and 5-8 pounds for each additional inch. However, I strongly believe that the goals for weight loss should be realistic and not based on some hard and fixed chart number. We are all built differently and what may be a good goal for one person at a cetain height is not realistic for another.
I went off to college at 155 pounds...5 feet nine inches...If I weighed 155 now, my patients would ask me if I was very ill, because I would look gaunt and unhealthy.
Please remember that as we get older, it becomes more and more difficult to maintain "ideal" weights, and even if we can get there, mauintenace would be far too difficult.
Set a realistic goal/expectation and that also psychologically sets you up to be successful as opposed to thinking you failed in your efforts.
On a non-weight subject: I wish I wasn't a Mets fan...this has been one ugly season.
Often, we refer to "the charts" as to what our weight should be....100 pounds for the first five feet and 5-8 pounds for each additional inch. However, I strongly believe that the goals for weight loss should be realistic and not based on some hard and fixed chart number. We are all built differently and what may be a good goal for one person at a cetain height is not realistic for another.
I went off to college at 155 pounds...5 feet nine inches...If I weighed 155 now, my patients would ask me if I was very ill, because I would look gaunt and unhealthy.
Please remember that as we get older, it becomes more and more difficult to maintain "ideal" weights, and even if we can get there, mauintenace would be far too difficult.
Set a realistic goal/expectation and that also psychologically sets you up to be successful as opposed to thinking you failed in your efforts.
On a non-weight subject: I wish I wasn't a Mets fan...this has been one ugly season.
Wednesday, June 18, 2008
Night at the Movies....
Okay....Saturday nite...you plan on going to see one of the new movies that have been released...you buy your 11 dollar ticket (anyone out there besides me remember the 3 dollar picture???) and then you pass that concession counter...you know, the one that charges you the same amount of money for one soda as you can buy an entire case for at Costgo...the smell of the popcorn weakens your resolve....alright...just go for the small popcorn...but...that really nice kid behind the counter gives you a deal that, to quote Marlon Brando from the Godfather.."You can't refuse"...for a quarter more you get the LARGE bucket....and..a free refill! or...perhaps you dont feel like popcorn but that nachos and cheese snack looks great....oops..they also gave you a coupon that tells you that if you buy that large popcorn and soda...you get a box of Whoppers for a buck...thats a steal!
as you are watching that exciting movie...you find yourself going repeatedly from hand to mouth..hand to mouth....hand to mouth..not even thinking about it...
here are the damages: the popcorn: 1263 calories...nachos 1440, whoppers 680.
OOPS!!!!!!!! your scale that week is not a pretty site....
Bottom line: eat before you go to a movie and bypass that concession counter...eating in a distracted manner will cause you to consume far more than you intended..
on a non-weight loss note: i watched the movie Juno on the flight last weekend...two stethoscopes up...fun picture (even without the airline peanuts)
as you are watching that exciting movie...you find yourself going repeatedly from hand to mouth..hand to mouth....hand to mouth..not even thinking about it...
here are the damages: the popcorn: 1263 calories...nachos 1440, whoppers 680.
OOPS!!!!!!!! your scale that week is not a pretty site....
Bottom line: eat before you go to a movie and bypass that concession counter...eating in a distracted manner will cause you to consume far more than you intended..
on a non-weight loss note: i watched the movie Juno on the flight last weekend...two stethoscopes up...fun picture (even without the airline peanuts)
Tuesday, June 17, 2008
Boredom
Several of our patients have expressed boredom with eating the "same things". Chicken, vegetables, more chicken, more vegetables....BORING!
Creatiivity is the name of the game here. Write out lists of foods that would be conducive in floowing a prudent dietary plan..proteins, fruits, vegetables, carbs that make sensxe, fruits.....then, start putting the creative part of your brain on formulating some fun meals that are anything but boring. Linda has a bunch of recioes she could share with you and we have some posted on : www.sweight.com. For those of you who have done our program, we have lots of bunches of ideas and recipes. We are developing a new website which we will release shortly that will have even more creative choices.
Boredom in eating will lead to poor choices eventually. Try to pump more excitement into this by using the creative chef-wanna=be part of your brain!
Send us your favoirte weight-friendly recipes...e-mail them to : lhlivka@serotonin-plus.com Okay..let me take this one step further...we will evaluate al recipes coming in and this will be a contest....winner will receive....hmmmm...let me think about this one and post tomorrow....
Creatiivity is the name of the game here. Write out lists of foods that would be conducive in floowing a prudent dietary plan..proteins, fruits, vegetables, carbs that make sensxe, fruits.....then, start putting the creative part of your brain on formulating some fun meals that are anything but boring. Linda has a bunch of recioes she could share with you and we have some posted on : www.sweight.com. For those of you who have done our program, we have lots of bunches of ideas and recipes. We are developing a new website which we will release shortly that will have even more creative choices.
Boredom in eating will lead to poor choices eventually. Try to pump more excitement into this by using the creative chef-wanna=be part of your brain!
Send us your favoirte weight-friendly recipes...e-mail them to : lhlivka@serotonin-plus.com Okay..let me take this one step further...we will evaluate al recipes coming in and this will be a contest....winner will receive....hmmmm...let me think about this one and post tomorrow....
Monday, June 16, 2008
Vacation weight gain..the Doctor is Baaack!
Good morning and I am glad to be back. Scale told me 2.3 pounds of weight gain...i ran 5 miles every day while away but still gained weight? Why? Wasn't alcohol...I am a complete lightweigth with alcohol..one drink I am laughing...2 i am asleep. It was more carbs and portion issues...
Posner's plans to get those pounds off this week? Extra vigilance for watching portion control and not allowing any of the little things that I will sometimes allow myself such as a saoft pretzel at night, a small piece of cake that sometimes gets through.
Point is that there must be a plan..when you return from a vacation....face the music: weight yourself, see what gain may have occurred and formulate your strategy to get it down to the level you want. When you get in trouble is when you either do not weight yourself or do not have a plan.
Thanks to Linda Hlivka for writing some great helpful stuff the last few days.
Another point: sometimes there are some comments at the end of this blog pushing a website for commercial purposes. We are trying to rid these but I wanted all to understand that we are NOT supporting/recommending any of these companies that are trying to leach on our blog for their own purposes.
Posner's plans to get those pounds off this week? Extra vigilance for watching portion control and not allowing any of the little things that I will sometimes allow myself such as a saoft pretzel at night, a small piece of cake that sometimes gets through.
Point is that there must be a plan..when you return from a vacation....face the music: weight yourself, see what gain may have occurred and formulate your strategy to get it down to the level you want. When you get in trouble is when you either do not weight yourself or do not have a plan.
Thanks to Linda Hlivka for writing some great helpful stuff the last few days.
Another point: sometimes there are some comments at the end of this blog pushing a website for commercial purposes. We are trying to rid these but I wanted all to understand that we are NOT supporting/recommending any of these companies that are trying to leach on our blog for their own purposes.
How to lose weight or maintain during the summer vacation and BBQ season
Summer is a very busy time of year for many of us. We have vacations and graduation parties, barbeques and weddings to name a few. How can we lose weight or even maintain with so many things going on? Here are some tips that might help.
1) If you are going on vacation pack some healthy, low calorie, portable snacks like veges, cheese, yogurt, cottage cheese, etc. whether you are driving or flying so you're less likely to be tempted by unhealthy options.
2) Exercise more often and longer to expend more calories if you know you will be taking more calories in. If you increase your exercise during this time period, you'll reduce the damage of increasing your caloric intake during the same time. The more you exercise the more you can eat without gaining weight. And exercise is a great stress reliever and you will feel better.
Eat sensibly BEFORE you go to parties and barbeques. You'll be much less likely to be tempted by goodies if you're already full.
3) Eat slowly and savor every bite. It takes 20 minutes for the stomach to signal to your brain that you are full.
4) IWhen you do eat out on vacation, order a dinner salad, pass on the bread and munchies served and split an entrée with someone.
5) When heading off to parties, volunteer to be the designated driver. Alcohol provides many extra "empty" calories that you don’t need. If you must drink try a wine spritzer or, for example, a rum and diet coke. Avoid sweet frozen drinks and the sugars of regular sodas.
Whenever you encounter plates of food buffet-style, snack on fresh raw vegetables and lean protein, and avoid sweets and high calorie selections. When possible, move away from the food table… you will be less likely to be tempted to eat more.
6) Choose water or low calorie beverages whenever possible. Avoid the empty calories of alcohol, regular soda, punch, and other fruit juices. Drink water before your meal so feel full sooner.
Eat slowly, and if socially acceptable, chat often. If your food is eaten slowly and you talk longer, you'll be full sooner. At meals, fill up on low calorie appetizers, if possible, like salads with low calorie dressing, raw vegetables and some soups.
7) When on vacation still get your low calorie snacks in. and drink your water Avoid skipping meals before a big meal.
8) Eat dessert in moderation, have a small piece or just a bite. Pass up peanuts, chips, and other everyday snacks. Spend your calories on the special treats you really want. If you do need to snack choose a few pretzels or unbuttered popcorn.
9) When attending a party or barbeque wear a form-fitting outfit, with a belt if possible to remind you to not overeat.
10) Make socializing, rather than food, the focus of the event. Keep your portions in check -- to keep calories under control.
11) Practice saying "no, thank you." It's okay to turn down invitations or tell a pushy host you don't want seconds. Stop eating when you are no longer hungry. Bring fat-free or low-fat dishes to parties. Encourage others to do the same.
12)Arrive at mealtime for a dinner party and avoid before-dinner drinks and appetizers.
13) Attend only the parties you really want to go to. You'll save a lot of calories - and time.
14) If you are tempted by the frozen margaritas, make your own low calorie frozen drink using Crystal Light, water and crushed ice.
Hopefully some of these tips will help you to save you calories as you enjoy your summer.
1) If you are going on vacation pack some healthy, low calorie, portable snacks like veges, cheese, yogurt, cottage cheese, etc. whether you are driving or flying so you're less likely to be tempted by unhealthy options.
2) Exercise more often and longer to expend more calories if you know you will be taking more calories in. If you increase your exercise during this time period, you'll reduce the damage of increasing your caloric intake during the same time. The more you exercise the more you can eat without gaining weight. And exercise is a great stress reliever and you will feel better.
Eat sensibly BEFORE you go to parties and barbeques. You'll be much less likely to be tempted by goodies if you're already full.
3) Eat slowly and savor every bite. It takes 20 minutes for the stomach to signal to your brain that you are full.
4) IWhen you do eat out on vacation, order a dinner salad, pass on the bread and munchies served and split an entrée with someone.
5) When heading off to parties, volunteer to be the designated driver. Alcohol provides many extra "empty" calories that you don’t need. If you must drink try a wine spritzer or, for example, a rum and diet coke. Avoid sweet frozen drinks and the sugars of regular sodas.
Whenever you encounter plates of food buffet-style, snack on fresh raw vegetables and lean protein, and avoid sweets and high calorie selections. When possible, move away from the food table… you will be less likely to be tempted to eat more.
6) Choose water or low calorie beverages whenever possible. Avoid the empty calories of alcohol, regular soda, punch, and other fruit juices. Drink water before your meal so feel full sooner.
Eat slowly, and if socially acceptable, chat often. If your food is eaten slowly and you talk longer, you'll be full sooner. At meals, fill up on low calorie appetizers, if possible, like salads with low calorie dressing, raw vegetables and some soups.
7) When on vacation still get your low calorie snacks in. and drink your water Avoid skipping meals before a big meal.
8) Eat dessert in moderation, have a small piece or just a bite. Pass up peanuts, chips, and other everyday snacks. Spend your calories on the special treats you really want. If you do need to snack choose a few pretzels or unbuttered popcorn.
9) When attending a party or barbeque wear a form-fitting outfit, with a belt if possible to remind you to not overeat.
10) Make socializing, rather than food, the focus of the event. Keep your portions in check -- to keep calories under control.
11) Practice saying "no, thank you." It's okay to turn down invitations or tell a pushy host you don't want seconds. Stop eating when you are no longer hungry. Bring fat-free or low-fat dishes to parties. Encourage others to do the same.
12)Arrive at mealtime for a dinner party and avoid before-dinner drinks and appetizers.
13) Attend only the parties you really want to go to. You'll save a lot of calories - and time.
14) If you are tempted by the frozen margaritas, make your own low calorie frozen drink using Crystal Light, water and crushed ice.
Hopefully some of these tips will help you to save you calories as you enjoy your summer.
Saturday, June 14, 2008
Alcohol and weight loss?
Successful weight loss is all about burning, more calories than you take in. In an effort to save calories when we go on a diet, many of us choose lower-calorie alcoholic drinks, mainly because they contain fewer alcohol calories than their regular counterparts.
However, drinking too much has a far more damaging effect than you can imagine by increasing caloric intake but also by reducing the number of fat calories you burn. Alcohol can increase your appetite for up to 24 hours after you finish drinking.
Research reported in the American Journal of Clinical Nutrition studied the effect on metabolism in adult men. Each was given two drinks of vodka and sugar-free lemonade separated by 30 minutes. Each drink contained just under 90 calories. Fat metabolism was measured before and after consumption of the drink. For several hours after drinking the vodka, fat metabolism dropped by 73%.
The way your body responds to alcohol is very similar to the way it deals with excess carbohydrate.
The combination of alcohol and a high-calorie meal is especially fattening, mainly because alcohol acts as a potent appetizer. A Canadian study shows that an aperitif increased calorie intake to a greater extent than a non-alcoholic beverage.
Researchers from Denmark's Royal Veterinary and Agricultural University report similar results. When a group of men was given a meal and allowed to eat as much as they wanted, they ate more when the meal was served with beer or wine rather than a soft drink.
Alcohol suppresses the number of fat calories your body burns for energy much more than meals rich in protein, carbohydrate, or fat. While an occasional drink isn't going to do much damage, consistent alcohol intake will reduce overall lean muscle mass having a significant effect in lowering the metabolism
However, drinking too much has a far more damaging effect than you can imagine by increasing caloric intake but also by reducing the number of fat calories you burn. Alcohol can increase your appetite for up to 24 hours after you finish drinking.
Research reported in the American Journal of Clinical Nutrition studied the effect on metabolism in adult men. Each was given two drinks of vodka and sugar-free lemonade separated by 30 minutes. Each drink contained just under 90 calories. Fat metabolism was measured before and after consumption of the drink. For several hours after drinking the vodka, fat metabolism dropped by 73%.
The way your body responds to alcohol is very similar to the way it deals with excess carbohydrate.
The combination of alcohol and a high-calorie meal is especially fattening, mainly because alcohol acts as a potent appetizer. A Canadian study shows that an aperitif increased calorie intake to a greater extent than a non-alcoholic beverage.
Researchers from Denmark's Royal Veterinary and Agricultural University report similar results. When a group of men was given a meal and allowed to eat as much as they wanted, they ate more when the meal was served with beer or wine rather than a soft drink.
Alcohol suppresses the number of fat calories your body burns for energy much more than meals rich in protein, carbohydrate, or fat. While an occasional drink isn't going to do much damage, consistent alcohol intake will reduce overall lean muscle mass having a significant effect in lowering the metabolism
How to help overweight teens
An interesting article came out on the issue of overweight teens. Childhood and teen obesity is an epidemic in this country right now. There are potentially many reasons for this. If you are a parent you know there are many sensitive issues for teens and it is at times difficult to talk to them. This recent article finds that most parents are not helpful in helping their overweight teens address their weight issues. Just talking about it will not engage them to the point where they want to change their behaviors or habits. Having a role model that can teach them what and how to eat and to help them exercise will certainly begin a transformation in which they will begin to embrace a lifestyle change. Weight loss is a participatory activity and one needs to be psychologically ready to engage in it. If you as a parent can be their coach on the journey they will succeed.
http://www.cbsnews.com/stories/2008/06/04/health/webmd/main4152902.shtml
http://www.cbsnews.com/stories/2008/06/04/health/webmd/main4152902.shtml
Friday, June 13, 2008
Increase the metabolism with weight training
Everyone who sees me knows what I proponent I am of exercise and weight resistance training. Weight resistance is the quickest way to increase the metabolism and increase lean muscle mass plus it will help tone and tighten the skin. The muscle in our bodies burns many more calories than our fat cells. So the more muscle we have, the more calories our bodies will burn. Also for us, as women, the resistance training is important as we age and help with delaying onset of arthritis and osteoporosis.
Adding in some weight training to your existing exercise routine for 20 minutes, 3-4 days/week can truly make a difference. This can be done at a gym with resistance machines, free weights or resistance bands. If you need a routine to follow at home, I found one that I love: Gilad's Express Workouts are great to help add muscle (not bulk) and strength. There are 15 express workouts each under 10 minutes that you can do whenever you have a few extra minutes to spare. Each workout targets a different area. The 2 DVD set is available online at www.BodiesinmotionwithGilad.com for $29.95 or on Amazon.com for $26.99.
Adding in some weight training to your existing exercise routine for 20 minutes, 3-4 days/week can truly make a difference. This can be done at a gym with resistance machines, free weights or resistance bands. If you need a routine to follow at home, I found one that I love: Gilad's Express Workouts are great to help add muscle (not bulk) and strength. There are 15 express workouts each under 10 minutes that you can do whenever you have a few extra minutes to spare. Each workout targets a different area. The 2 DVD set is available online at www.BodiesinmotionwithGilad.com for $29.95 or on Amazon.com for $26.99.
Thursday, June 12, 2008
Does Weight Affect Your Overall Health?
We all assume that if we are overweight (BMI = 25-29.9) or obese (BMI= 30+) we will more likely develop health problems. But just how much does it matter? Actually increased body weight does take a toll on the body and the mind. The benefits of weight loss are profound. Here are several examples of how losing just a few pounds can alter your risks. Losing just 5 to 15 percent of your weight can lower your chances for developing heart disease or having a stroke. Weight loss also improves blood pressure, as well as triglyceride and cholesterol levels. Regarding diabetes, a weight gain of 11 to 18 pounds increases the risk for developing type 2 diabetes to twice that of those who maintain a healthy weight.
Recent research shows that a 5 to 7 % weight loss can prevent type 2 diabetes. Research also shows that overweight and obesity are associated with an increased risk for some types of cancer including endometrial, colon, gallbladder, prostrate, kidney, and post-menopausal breast cancers. Also, women who gain more than 20 pounds between age 18 and midlife double their risk of post-menopausal breast cancer, compared to women who do not gain weight. For every 2-pound increase in your weight, the risk for developing arthritis increases by 9 to 13 percent.
Also pre-menopausal women who are overweight can experience irregular menstrual cycles and infertility. Extra pounds can cause complications during pregnancy, too such as increased risk for death in both the baby and the mother and increases the risk of high blood pressure. Women who are obese during pregnancy also are more likely to have gestational diabetes and experience problems with labor and delivery. Moreover, obesity can negatively affect quality of life, earning potential and promotions as well as self-confidence, pride and energy. Did you also know that as we get older and apply for that all important life insurance, your premium is partially determined by your BMI along with your health history and age. The lower your BMI, the lower your premium assuming your health is good.
Recent research shows that a 5 to 7 % weight loss can prevent type 2 diabetes. Research also shows that overweight and obesity are associated with an increased risk for some types of cancer including endometrial, colon, gallbladder, prostrate, kidney, and post-menopausal breast cancers. Also, women who gain more than 20 pounds between age 18 and midlife double their risk of post-menopausal breast cancer, compared to women who do not gain weight. For every 2-pound increase in your weight, the risk for developing arthritis increases by 9 to 13 percent.
Also pre-menopausal women who are overweight can experience irregular menstrual cycles and infertility. Extra pounds can cause complications during pregnancy, too such as increased risk for death in both the baby and the mother and increases the risk of high blood pressure. Women who are obese during pregnancy also are more likely to have gestational diabetes and experience problems with labor and delivery. Moreover, obesity can negatively affect quality of life, earning potential and promotions as well as self-confidence, pride and energy. Did you also know that as we get older and apply for that all important life insurance, your premium is partially determined by your BMI along with your health history and age. The lower your BMI, the lower your premium assuming your health is good.
Wednesday, June 11, 2008
Why Sleep Is So Important to the Weight Loss Process
Here is an article on why sleep is so important to the weight loss process. Essentially according to the Wayne State University of Medicine, as we become sleep derrived, "hormones that process appetite begin to get disorganized." "There's a decrease in the amount of leptin, an appetite-suppressing hormone, when a person gets too little sleep. At the same time, ghrelin -- a hormone that stimulates appetite -- increases with a lack of sleep." It is recommended that we get not less than 6 hours of sleep per night and ultimately 7 or 8 to be at our peak. http://health.msn.com/health-topics/articlepage.aspx?cp-documentid=100205002
Tuesday, June 10, 2008
Vacations and weight gain
During their time in our weight loss program, many people will go on a vacation or business trip that will involve much socializing. "Control" of the dietary intake is often lost and it is virtually impossible to follow a defined dietary plan while of of your usual environment. When our patients come back to us after their trip, there is often the lament that controlling weight while on vacation is impossible.
Here are some thoughts: There is no question that part of the fun of any vacation is eating some great foods and perhaps drinking some good wine or the drinks with the whip cream, cherrie on top and an umbrella. Purposefully counting portions, not touching a dessert or alcohol beverage, etc. can actually take away from the fun of the vacation. Can you imagine spending thousands of dollars on a great cruise and NOT going to the midnite buffet? At the Serotonin-Plus Weight Loss Centers, Linda and I never expect our patients to not partake of some of these food sources.
Some suggestions: 1-Perhaps provide yourself some "wiggle room" before leaving, meaning that for several weeks before a known, upcoming vacation, purposefully be extra-vigilant on your dietary intake so as to lose more weight than usual, expecting that vacation week will be difficult to lose weight, and odds may even be a weight gain. 2- Choose vacation spots where your food/alcohol are paid for ala carte. The "all inclusive" resorts that provide food and booze in the "all you can eat and drink" mode challenges the very fabric of human nature. 3-Limit your alcohol intake...it is amazing what damage alcohol does to your weight loss efforts. 4-Log onto the business center's internet everyday and read this blog...envision Posner's face saying "when you get back you won't be happy if you step on that scale and see that you gained weight you worked so hard to lose." (laughing...kidding you about this one) 5- "taste" desserts as opposed to eating the entire thing..6-exercise daily...every hotel/resort/crusie ship etc. has a workout facility..no excuses!!!
time for my morning run...hey...anyone interested in a "Serotonin-Plus' run sometime on a weekend? Informal gathering of our patients, staff, friends, etc? can be a walk/run...pick a park in Northern VA or D.C.
Here are some thoughts: There is no question that part of the fun of any vacation is eating some great foods and perhaps drinking some good wine or the drinks with the whip cream, cherrie on top and an umbrella. Purposefully counting portions, not touching a dessert or alcohol beverage, etc. can actually take away from the fun of the vacation. Can you imagine spending thousands of dollars on a great cruise and NOT going to the midnite buffet? At the Serotonin-Plus Weight Loss Centers, Linda and I never expect our patients to not partake of some of these food sources.
Some suggestions: 1-Perhaps provide yourself some "wiggle room" before leaving, meaning that for several weeks before a known, upcoming vacation, purposefully be extra-vigilant on your dietary intake so as to lose more weight than usual, expecting that vacation week will be difficult to lose weight, and odds may even be a weight gain. 2- Choose vacation spots where your food/alcohol are paid for ala carte. The "all inclusive" resorts that provide food and booze in the "all you can eat and drink" mode challenges the very fabric of human nature. 3-Limit your alcohol intake...it is amazing what damage alcohol does to your weight loss efforts. 4-Log onto the business center's internet everyday and read this blog...envision Posner's face saying "when you get back you won't be happy if you step on that scale and see that you gained weight you worked so hard to lose." (laughing...kidding you about this one) 5- "taste" desserts as opposed to eating the entire thing..6-exercise daily...every hotel/resort/crusie ship etc. has a workout facility..no excuses!!!
time for my morning run...hey...anyone interested in a "Serotonin-Plus' run sometime on a weekend? Informal gathering of our patients, staff, friends, etc? can be a walk/run...pick a park in Northern VA or D.C.
Monday, June 9, 2008
More on serotonin
Check this out....Here is another article on the benefits of increased serotonin. http://www.sciencedaily.com/releases/2008/06/080605150908.htm It certainly makes the point for continuing on serotonin well after your weight loss is achieved.
weight loss and marketing scam
I was running around Burke Lake Park yesterday morning (kind of slow...this age thing really sucks...not much fun being passed by young mothers jogging and pushing their strollers with babies in them) and heard on the radio a commercial that made it sound like a study: 'We are recruiting people now who want to lose signifcant weight for a "risk-free" trial of _____." The commercial went on about this miraculous new supplement that produces outstanding weight loss. The tenure of the commercial made it sound as if they were soliciting study participants for a trial of this. In fact, this was nothing more than playing words to make it seem as if this was a study, but in reality, this was nothing more than a scam to get people to call. Once on the phone, I have no doubt that the "operators on duty" would try to extract the credit card from the caller...shipe the product and not ding the credit card for 30 days..hence the "free trial". These companies know full well that many people will not bother to return the bottle of bogus pills and their credit card will be charged.
I have brought this up before but will do so again: anything that sounds too good to be true always is too good to be true, as this relates to claims for "easy" weight loss. To lose weight effectively and for the long term, lifestyle changes are required. There is no such thing as the magic pill . (Except our serotonin products....okay...teasing here...even our great pills are an ADJUNCT to what is really required for long term weight loss)
I have brought this up before but will do so again: anything that sounds too good to be true always is too good to be true, as this relates to claims for "easy" weight loss. To lose weight effectively and for the long term, lifestyle changes are required. There is no such thing as the magic pill . (Except our serotonin products....okay...teasing here...even our great pills are an ADJUNCT to what is really required for long term weight loss)
Sunday, June 8, 2008
weight loss...human sabotage?
You are out to dinner with friends enjoying an excellent meal. You have probably had a cocktail, a salad or an appetizer, some of that warm bread and butter, a very tasty steak or seafood dish with some type of potato as a side dish. Great food, great talk, great time. The waiter than comes over with the dessert tray showing incredibly tempting desserts ranging from cheesecake to the double chocolate cake to the apple pie with vanilla ice cream. Everyone at the table smiles, looks at each other, and almost like the critical, time constraint decision making of the teams' general mamagers at the NFL Draft, couples make decisions as to what desserts to "share". Now, if someone at that table expresses the following: "I really do not want anything...I am full.", this is followed by a virtual lambasting from everyone else at the table. "Oh, come on, you can have a little." The collective consensus basically makes us feel like an outcast if we decide to forego more calories. So, we give in and say that we will have a few tastes.
The point here is that when the dessert tray comes, no one at that table truly feels anything approaching the sensation of "hunger". Every person there, ESPECIALLY the overweight ones, know full well that the dessert should not be eaten. But, if everyone around the table is eating it, then eating the dessert is okay, right?. However, if one or more people express the sentiment that because of feeling full, trying to fight weight issues, or for other reasons, they won't order the dessert, the ones who do will feel somewhat deflated and not feel as good about eating the high caloric item. You have taken their fun away and make them a bit self-conscious.
Please do not be one of the saboteurs, meaning do not "push" food on people, especially overweight friends, relatives or coworkers. Also, do not allow yourself to be "bullied" by a saboteur who tries to force food on you. Very nicely, but clearly explain that you are trying to lose weight to be healthier and the person can feel free to do what they would like, but they need to respect your mission.
On the non-weight loss front: 2 stethoscopes up for the new Sandler picture: Don't Mess With The Zohan...very silly, lots of New York humor.
Another issue: Record high temps for the D.C. area....please do your workout indoors.
The point here is that when the dessert tray comes, no one at that table truly feels anything approaching the sensation of "hunger". Every person there, ESPECIALLY the overweight ones, know full well that the dessert should not be eaten. But, if everyone around the table is eating it, then eating the dessert is okay, right?. However, if one or more people express the sentiment that because of feeling full, trying to fight weight issues, or for other reasons, they won't order the dessert, the ones who do will feel somewhat deflated and not feel as good about eating the high caloric item. You have taken their fun away and make them a bit self-conscious.
Please do not be one of the saboteurs, meaning do not "push" food on people, especially overweight friends, relatives or coworkers. Also, do not allow yourself to be "bullied" by a saboteur who tries to force food on you. Very nicely, but clearly explain that you are trying to lose weight to be healthier and the person can feel free to do what they would like, but they need to respect your mission.
On the non-weight loss front: 2 stethoscopes up for the new Sandler picture: Don't Mess With The Zohan...very silly, lots of New York humor.
Another issue: Record high temps for the D.C. area....please do your workout indoors.
Saturday, June 7, 2008
weight loss and attention
Sensitive subject: several female patients in our program have told me that a byproduct of their weight loss has been a very marked change in the attention they get in their professional worlds. When giving lectures or leading a meeting, before their weight loss they noticed that a relative lack of attention from their audience, especially men. When significant weight loss occurred, then it seemed to be the case that the audience was hanging on every word. There was a bit of anger in this realization, because professionally, whether overweight or not, the same person was giving the same talk...but yet, only because of a physical appearance change, the message was being attended to.
It is clearly not "right" or "fair" but it is reality that often we are judged by our physical appearance. When I went to my first meeting of the American Society of Bariatric Physicians, I was surprised to see that over 75% of the physicians were overweight. How much credibility can an overweight phsyician have in trying to help people lose weight?
I know this is a very sensitive subject because we deserve to be judged by what is "inside" of us, not the external package. But, truth is what people first see is the external part. Professionally, career progression is probably influenced to some extent on our ability to present a healthy look.
Please feel free to post comments on this issue. It is a very, very sensitive one for many people.
It is clearly not "right" or "fair" but it is reality that often we are judged by our physical appearance. When I went to my first meeting of the American Society of Bariatric Physicians, I was surprised to see that over 75% of the physicians were overweight. How much credibility can an overweight phsyician have in trying to help people lose weight?
I know this is a very sensitive subject because we deserve to be judged by what is "inside" of us, not the external package. But, truth is what people first see is the external part. Professionally, career progression is probably influenced to some extent on our ability to present a healthy look.
Please feel free to post comments on this issue. It is a very, very sensitive one for many people.
Friday, June 6, 2008
Serotonin, weight loss and worms
A study summary was released on Reuters yesterday which demonstrated the affects of serotonin on fat metabolism and weight loss. http://news.yahoo.com/s/nm/20080603/hl_nm/obesity_eating_dc
The issue of brain chemical balance on appetite/eating behaviors has been well documented previously but this study supports the serotonergic mechanisms involved in weight loss. As we have the only patented oral serotonin supplement in our program, we found this study very interesting.
Brain chemicals modulate many behavioral patterns in humans, and eating behaviors are certainly affected. Why do most people turn to food in times of stress? Why do some people stop eating when confronted with stress?
Just as we inherit eye color, height, etc. from our family, we also inherit brain chemical imbalances. That is why depression, anxiety, OCD, panic disorder and other "psychiatric" conditions seem to occur more commonly in families. Similarly, at least part of the weight problem you notice in a family unit has some basis in inherited chemical issues. Of course, environmental factors plays a large role as well.
Weekend coming up..set up some exercise time for yourself!
The issue of brain chemical balance on appetite/eating behaviors has been well documented previously but this study supports the serotonergic mechanisms involved in weight loss. As we have the only patented oral serotonin supplement in our program, we found this study very interesting.
Brain chemicals modulate many behavioral patterns in humans, and eating behaviors are certainly affected. Why do most people turn to food in times of stress? Why do some people stop eating when confronted with stress?
Just as we inherit eye color, height, etc. from our family, we also inherit brain chemical imbalances. That is why depression, anxiety, OCD, panic disorder and other "psychiatric" conditions seem to occur more commonly in families. Similarly, at least part of the weight problem you notice in a family unit has some basis in inherited chemical issues. Of course, environmental factors plays a large role as well.
Weekend coming up..set up some exercise time for yourself!
Thursday, June 5, 2008
weight loss and exercise
As I was running this morning listening to my IPOD (okay...i know you are curious as to what the 52 year old doctor listens to on his IPOD....here goes: show music, James Taylor, Carol King, Barry Manilow, Neil Diamond...yeah, I said it..Neil Diamond....stop laughing!!!) I started thinking about a conversation I had with a patient yesterday when I asked her about exercise. The patient told me that she "walks alot at work".
W alking is great of course, BUT, a "good" exercise is getting your heart rate to about 75-80% of the maximum heart rate for age (220-yourage=maximum heart rate) and keeping it there for about 20-30 minutes. Unfortunately, for most people, walking at work maybe brings your heart rate to no greater than 90.
PLEASE try to find dedicated time for real exercise...setting aside 30-45 minutes 3-4 times a week to do dedicated exercise. Make it like a business appointment, meaning that you will keep your scheduled time/date as important as you would keep a business meeting. Find activities that are considered "fun" for you as opposed to a burden. Some people HATE treadmills....they will find every reason in the world then not to exercise if the treadmill is their only recouse.
Sorry for the late entry today..storms messsed up schedule..but..I did find the time to run and listen to Forever In Blue Jeans on my IPOD!
W alking is great of course, BUT, a "good" exercise is getting your heart rate to about 75-80% of the maximum heart rate for age (220-yourage=maximum heart rate) and keeping it there for about 20-30 minutes. Unfortunately, for most people, walking at work maybe brings your heart rate to no greater than 90.
PLEASE try to find dedicated time for real exercise...setting aside 30-45 minutes 3-4 times a week to do dedicated exercise. Make it like a business appointment, meaning that you will keep your scheduled time/date as important as you would keep a business meeting. Find activities that are considered "fun" for you as opposed to a burden. Some people HATE treadmills....they will find every reason in the world then not to exercise if the treadmill is their only recouse.
Sorry for the late entry today..storms messsed up schedule..but..I did find the time to run and listen to Forever In Blue Jeans on my IPOD!
Wednesday, June 4, 2008
Weight loss is easier with a partner!
I had a husband/wife team come into my office yesterday and they have been very successful, in their weight loss efforts. I was talking with them and probing as to how they have been able to be so successful. They almost simultaneously said "doing this together makes it much easier".
It is definitely the case that when a person embarks on an initiative to lose weight, having the support of a family member, friend, co-worker or other can be incredibly helpful. When two or more people decide together to lose weight, each person becomes a "support group" to the other. Friendly challenges such as bets on who reaches goals quicker can even make this more fun.
There is nothing fun about the act of losing weight. It is viewed mostly as sacrifice and deprivation. Giving up "fun" food sources is not an enjoyable act. Counting portions/calories is work...lots of work. Having the support of someone who is doing this alongside of you can be a great motivator. If you are considering a weight loss effort, try to find someone in your world who is willing to roll the sleeves up and get to work with you on this.
On a non-weight loss issue: Please help me understand this one. So we have people running for President...three senators who are currently in office. Each is flying around the country campaigning...millions and millions of dollars being raised for this effort. And if they do make it to be President, fortunes of money are in their future for speeches, books, etc. Why are they still being paid to be senators? Are they working for the people who elected them or are they just running for a higher office 100% of their time? I think all of us still have to do our work that we were hired for in order to be paid. Okay, rant is over. Back to weight loss tomorrow!
It is definitely the case that when a person embarks on an initiative to lose weight, having the support of a family member, friend, co-worker or other can be incredibly helpful. When two or more people decide together to lose weight, each person becomes a "support group" to the other. Friendly challenges such as bets on who reaches goals quicker can even make this more fun.
There is nothing fun about the act of losing weight. It is viewed mostly as sacrifice and deprivation. Giving up "fun" food sources is not an enjoyable act. Counting portions/calories is work...lots of work. Having the support of someone who is doing this alongside of you can be a great motivator. If you are considering a weight loss effort, try to find someone in your world who is willing to roll the sleeves up and get to work with you on this.
On a non-weight loss issue: Please help me understand this one. So we have people running for President...three senators who are currently in office. Each is flying around the country campaigning...millions and millions of dollars being raised for this effort. And if they do make it to be President, fortunes of money are in their future for speeches, books, etc. Why are they still being paid to be senators? Are they working for the people who elected them or are they just running for a higher office 100% of their time? I think all of us still have to do our work that we were hired for in order to be paid. Okay, rant is over. Back to weight loss tomorrow!
Tuesday, June 3, 2008
Weight Loss and Word Associations
Okay....fill in the blank: "hamburger and________" "Fish and _______" Hot dog and a _____" "Apple pie and _____"
answers: fries, chips, beer, ice cream
we are sooo used to ordering food sources in these type of combinations...and with it comes excessive calories on top of the high calories of the first food source.
point here is when/if you decide to order the burger, go to the ball game and have the hot dog, etc, you don't HAVE TO also have the accompanying food-association item. Think about what else you tend to eat in combinations and if you cannot avoid one of the high-caloric sources, how to ensure you don't do the other.
answers: fries, chips, beer, ice cream
we are sooo used to ordering food sources in these type of combinations...and with it comes excessive calories on top of the high calories of the first food source.
point here is when/if you decide to order the burger, go to the ball game and have the hot dog, etc, you don't HAVE TO also have the accompanying food-association item. Think about what else you tend to eat in combinations and if you cannot avoid one of the high-caloric sources, how to ensure you don't do the other.
Monday, June 2, 2008
Beware of Marketing Hype
Atkins Bars, sugar-free ice cream, no sugar cookies....all of these sound like very healthy choices that will help keep you on the road to your weight loss goals....
Oops...about ready to burst your bubble (fun reading this on a Monday morning, huh?).
At our weight loss centers, we frequently see patients whose weight loss goals for that week are not being met, and when questioned, we find out that they have been using some of the above mentioned food sources. The advertisement of a "high protein" bar bearing the name of a doctor who was famous for a radical approach to weight loss or dessert sources that purport to not harm weight loss efforts can be quite effective. If we are made to think that we are consumming something that is "healthy" we are more apt to want to do it...and over and over.
I would caution you about reaching for these sources of snacks/desserts because even though they are advertised as something that sounds non-derailing, we find this is not true.
On a non-weight loss note: A tennis win for the old Doctor guy yesterday! After my match I was watching some of the golf guys walking the course drinking a beer as they were walking and I thought of this one: Aerobic golf! winner is not the one who finishes the 18 holes with the least strokes...it is the person who finishes the 18 the quickest...no carts allowed...whack the ball./.run to it....hit it again..etc...this would be a contest of both skill in golf and aerobic conditioning. Okay, maybe ESPN wouldn't carry this...sorry.
Oops...about ready to burst your bubble (fun reading this on a Monday morning, huh?).
At our weight loss centers, we frequently see patients whose weight loss goals for that week are not being met, and when questioned, we find out that they have been using some of the above mentioned food sources. The advertisement of a "high protein" bar bearing the name of a doctor who was famous for a radical approach to weight loss or dessert sources that purport to not harm weight loss efforts can be quite effective. If we are made to think that we are consumming something that is "healthy" we are more apt to want to do it...and over and over.
I would caution you about reaching for these sources of snacks/desserts because even though they are advertised as something that sounds non-derailing, we find this is not true.
On a non-weight loss note: A tennis win for the old Doctor guy yesterday! After my match I was watching some of the golf guys walking the course drinking a beer as they were walking and I thought of this one: Aerobic golf! winner is not the one who finishes the 18 holes with the least strokes...it is the person who finishes the 18 the quickest...no carts allowed...whack the ball./.run to it....hit it again..etc...this would be a contest of both skill in golf and aerobic conditioning. Okay, maybe ESPN wouldn't carry this...sorry.
Sunday, June 1, 2008
Nothing Wrong With The "V" Word
When I ask people who enter our weight loss program why they want to lose weight, the politically correct answer is usually: "I want to be healthier and I know my excessive weight puts me at risk for heart disease, diabetes, etc."
Let's be honest though. Very often the major reason we want to lose weight is so that we can look younger, look better, have others think we are more attractive and look much better in clothes that now fit again. We hesitate to admit to these reasons because they sound "VAIN".
Re-establishing a higher level of self-esteem, not feeling we have to hide from cameras, attracting more positive attention: all of these are great reasons as well as the health ramifications as to why we should lose weight. Never feel ashamed about these reasons.
On a related, but non-weight loss issue: I had a medical patient from Brazil who came in looking about 15 years younger than her age, and when I asked her what her secret was she mentioned the name of a local prominent plastic surgeon. This was defintiely not the case in its entirety because this person exercises regularly, does not smoke, eats very healthy and is very active with her chidren. Aside from weight control, clearly these other factors (and I dont mean the plastic surgery!) can play a large role in looking younger than your years.
Let's be honest though. Very often the major reason we want to lose weight is so that we can look younger, look better, have others think we are more attractive and look much better in clothes that now fit again. We hesitate to admit to these reasons because they sound "VAIN".
Re-establishing a higher level of self-esteem, not feeling we have to hide from cameras, attracting more positive attention: all of these are great reasons as well as the health ramifications as to why we should lose weight. Never feel ashamed about these reasons.
On a related, but non-weight loss issue: I had a medical patient from Brazil who came in looking about 15 years younger than her age, and when I asked her what her secret was she mentioned the name of a local prominent plastic surgeon. This was defintiely not the case in its entirety because this person exercises regularly, does not smoke, eats very healthy and is very active with her chidren. Aside from weight control, clearly these other factors (and I dont mean the plastic surgery!) can play a large role in looking younger than your years.
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