Friday, October 31, 2008

Candy and Elvis

Happy Halloween....for those patients of ours that choose to wander by our office this morning, be prepared to see Elvis come to life....in the form of a middle aged male doctor thinking he looks great in the jumpsuit....Viva Las Viagra...oops..I mean Viva Las Vegas....Don't worry, if you cannot make it in for this spectacle, we will take pictures and have them prominently displayed at our VERY SPECIAL Patient Appreciation Nite scheduled for Friday, December 5 from 5-7pm. (Autographed Elvis pictures will be on sale).

Okay...please remember that the nation's largest health concern is childhood obesity and if you plan on giving our Reeces Pieces, Butterfingers, etc. tonight, you are not exactly helping the problem. PLEASE consider non-caloric treats...such as party favors or some other "treat" that children will perceive as fun, safe but yet not high-caloric. Or, perhaps, some lower calorie "treat", such as a packaged fruit.

Also, as I have made my case previously, do NOT decide to either ingest your left-over candies or partkae of your own cildren's collection from your neighbors. These smal high caloric sources will completely wipe out all the hard wotk you have done this week. If you are going to do a chocolate, go out and buy some expensive Godiva...do not do the cheap stuff.

At all times, rememeber your quest to be healthier, happier, look younger etc...these are the reasons WHY you want to lose weight....do not let the little saboteurs we call "treats and goodies" take us away from this great mission.

Thursday, October 30, 2008

weight loss and family

I had a new patient come in yesterday who told me that her major motivation for weight loss was that her young daughter was starting to become overweight and as her mother, she felt obligated to be more of a "role model". She told me that at night, upon returning from work, to relax, she would have several glasses of wine, and her daughter commented on that. This struck a nerve, and the mother decided it was time to eliminate alcohol and show her daughter a healthier way of eating as well.

To an extent, we are all role models to our family, friends, students, patients etc. No matter what your profession or area of specialty, there are people in this world who "look up to you". Does this mean you have to be "perfect" in your eating behaviors, clothes choices, the way you conduct your life? Of course not. But, isn't it a good feeling when your children, family, co-workers, etc. positively comment on your "healthier" appearance? Isn't it a great feeling to know that you are setting some sort of "example" in a positive way? Obviously, as this relates to weight, it is our own self esteem, health, appearance etc. that are affected by our own eating/drinking choices, and we truly are not responsible for other peoples actions. But, very very cool to know that someone decides to become healthier by following our example!

Wednesday, October 29, 2008

weight loss and credibility

Yesterday I was asked by a patient why I ran daily, and I honestly asnwered that when I run daily I can eat more and not put on weight. I further explained that for credibility purposes I feel it is important for me to not be dispensing weight loss advice to my patients if I was overweight. I then thought back to the first year we had the program (2002) and Linda and I went to our first meeting of the American Society of Bariatric Physicians. This is the organization of physicians whose specialty is medical weight loss. Linda and I were aghast to see that over 75% of the physicians there were overweight. We both thought how weird that is to have a specialty in weight loss, yet the physician could not control his/her weight.

When I was an internal medicine resident at Portsmouth Naval Hospital from 1981-1984, 4 of the 5 staff cardiologists and 3 of the 4 oncologists were cigarette smokers. These were physicians whose patients lives were ruined by cigarette smoking, yet the physicians themselves did the same lethal behavior pattern.

By no means am I a "model" for my patients...I eat too much pizza, I sometimes skip meals, I eat lots of carbs sometimes...any of you out there that have bumped into me at a restaurant and have seen my plate can certainly tell stories! But, I do get up early every day and run 5 miles...I do avoid alcohol...I rarely will order a dessert after dinner...and most definitely part of my motivation to keep my weight stable is that when I am in front of you, I do not want you to think to yourself: "yeah, you tell me this doc, you tell me that, you dont practice what you preach!!"

Tuesday, October 28, 2008

Your weight loss as a "threat" to others

I have had a number of people tell me as they are successfully losing a lot of weight that spouses and friends will almost intentionally try to sabotage their efforts to lose even more weight. The person is told, even when he/she clearly has many more pounds to lose, "you don't need to lose anymore!" and then the spouse or friend attempts to lure the person into eating high-caloric food sources.

Is it possible that your weight loss threatens some peeople around you? Does yor spouse fear that you will become much more attractive to others? Do your friends feel that you will get much more positive attention and they will get less? How is it possible that the people closest to you and love you the most will try to derail your efforts to look/feel your best?

I truly do not think it is intentional sabotage. To an extent, your efforts to lose weight, showing control and discipline along the way, does, in fact, make other overweight people feel embarrassed that they cannot do the same. When that dessert comes at the end of a meal, if EVERYONE partakes of a high-caloric dessert, it must be okay, right? However, if one or several people profess that they are in a weight losing mode and need to not eat dessert, than others around them will not have as much fun ordering the double chocolate cake. Concerning spouses, to some extent, a number of people will feel threatened when their spouse draws positive attention from the opposite sex when walking into a room.

I am not certain much can be changed about people's emotional response to your weight loss efforts, except to point out that it probably is not intentional, and you should not become angry at anyone. Calmly, but firmly, telling those around you why it is important for you to lose the weight, and your gratitude for having them help and support your efforts may help them chnage their behaviors and therefore make it easier for you to progress in your efforts.

Monday, October 27, 2008

Setting short term and long term weight loss goals

When someone enters our weight loss program, we ask them on their entry sheets to list a "goal" weight loss in total and then a separate 12 week goal. I have discussed this previously, but I will do so again: Make sure your total weight loss goal is reasonable and practical and most importantly, MAINTAINABLE. We will have great difficulty getting back to our college weights (I weighed 155 pounds, had Neil Diamond hair and drove an AMC Hornet) so that is not a reasonable goal. There is no question that if someone were to pay you a million bucks to get to your college weight, you could do that. But, once the money was delivered, there would be little chance of maintaining that weight.

Concerning a short-term goal, challenge yourself to reach that, meaning that you must take into account your gender, age, height and previous "low" number. Obviously, being male, younger, more obese, etc. will result in more weight loss in the short term. Patients that weight over 300 pounds coming into our program can lose over 40 pounds in 12 weeks with us, but if someone was 5 feet 2 inches, 170 pounds and 60 years old, a mch more reasonable expectation would be 20 pounds in those same 12 weeks.

We can help you establish goals in the short term and long term, and this does not require coming back into our program or entering the program if you have never been here. We do offer free consultations and we would be happy to help you establish realistic and maintainable goals for yourself.

Sunday, October 26, 2008

Weight loss and sleep apnea

Over the past several weeks, I have seen several patients that have told me that their snoring at night has markedly decreased as they have lost weight. Snoring is an obvious annoyance to the person you share a bed with, but medically, this could be a sign of a potentially dangerous disease. i.e. sleep apnea.

Sleep apnea patients experience many episodes of oxygen desaturation at nighttime which can lead to serious heart disease and/or cardiac dysrhythmias. The patients will also experience significant daytime somnulence. For the patient that complains of snoring and daytime fatigue, a physician will order a sleep stuyd that demonstrates the oxygen desaturation that occurs, confirming the diagnosis of sleep apnea. A continuous positive airway pressure machine ("CPAP") is then prescribed.

Excessive soft tissue around the neck can cause this obstructive sleep apnea and weight loss can greatly improve the situation. Yet another great reason to lose weight!

Saturday, October 25, 2008

eating and boredom

A rainy saturday...events cancelled, activities postponed...lots of home time. Boredom sets in (hey, you can only watch just so many reruns of Friends) and you find yourself wandering over to the fridge to see whats begging to be eaten. Hmmm..how about the Halloween candy that is in your cubbard not opened yet??? Is it calling you by your first name?

Whether it be a snow day, a rainy day or any other adverse weather condition that places us for long periods of time in our homes, we must be careful not to give in to the temptation of treating our boredom with eating high caloric food sources.

If you have exercise equipment in your house, try to use this "down" time for more caloric burn-off. Do not venture over to the refrigerator for snacks in bewteen meals. Certainly, avoid small repetitive food sources such as nuts, popcor, trail mix, etc.

And if you go out to a movie theatre, NO POPCORN!!!

Have a great Saturday

Friday, October 24, 2008

Building "wiggle room"

Another weekend upon us...Friday nite party??? Saturday college football gathering??? Sunday NFL football party or tailgating??? Lots of opportunities to reach for high-caloric food sources and derail all the efforts you put in this week. Remember: Thanksgiving, Christmas, New Years almost upon us!!! The holiday season is probably the most difficult time of the entire year to lose weight. You know the "usual" drill...you put on 8-10 pounds over the holidays, January rolls in, you get on the scale and say to yourself."New Year's resolution..I am going to lose weight". Start now!!! be EXTRA aggressive in your efforts over the next several weeks so when the holidays are upon us, we will be able to eat a bit extra and not worry too much that we destroyed months of good weight loss work. Do NOT get into that Halloween candy you may have already bought on sale. Also, remember for next week that childhood obesity is probably the most important national health issue at this time, so was it really a good choice to buy Three Musketeer bars to give out to any overweight kids ringing your doorbell???

On another note..PLEASE put on your calenders Friday, December 5th, 2008 from 5-7. We are celebrating our 20th anniversary of providing medical care to the area! This is a very special day for the staff and me. Please join us for some really great holiday fun...and yes, there will be some high-caloric stuff there but also healthier stuff. We are bringing karioke in again which was way too much fun last year. I certainly hope that you are able to stop by that evening!

Thursday, October 23, 2008

Weight loss and Libido

A very senstive subject that is very difficult for patients to bring up to their physicians is sexual dysfunction. For males. there is a distinct difference between the desire for intimacy (libido) vs. the inability to achieve an erection (erectile dysfucntion or "ED"). Medical problems such as diabetes, athersclerotic heart disease, and adverse medication side effects may cause either or both sexual difficulties.

Obesity in and of itself is a very large contributor to both problems as well and we have found that when male patients lose significant weight, both libido and performance improve dramatically. Perhaps some of this is psychological, as our self-esteem, confidence and ego improve tremendously with weight loss.

On the female side, we have had many reports of libido increase on the serotonin supplement, and it is not clear to me as to whether it is the weight loss itself or serotonin enhancement that provides the libido increase. Perhaps it is both.

In any event, whether female or male there is no doubt that weight loss can enhance and enrich sexual performance and desire. Yet another reason to count those calories and realize that those "treats and goodies" such as cookies and chocolates can be sexual milk-DUDS.

Wednesday, October 22, 2008

Exercise and weight loss

This week it has been very apparent to me that the change in season to a darker, colder time period adversely impacts on caloric burn-off for many people. In the program, a number of patients tell me that "walking" is their exercise, but they do this outside. On a balmy morning in the summer, it is easy to set your alarm early, put on shorts and enjoy the birds singing as the sun rises while you are walking. Now, it is dark, cold and the birds are packing their bags for points south. Who wants to walk outside? A warm bed sounds much better.

The point here is that equipment for your house in the form of a treadmill, rower, exercise bike or elliptical machine can be very helpful to allow you to still get up early and get some exercise in. Place the equipment in front of a tv set and watch the morning news (oops..forget that...stress eating may result...put on AMC and watch a good old picture instead). Climate control, lights and a distraction in the form of a tv show allows you to still burn off calories during these darker/colder months. Getting up, getting dressed, bringing a change and going to a gym is lots more work. Please do not get me wrong...gym membership and utilization is great. However, I have had some patients recently who have told me that they have gym memberships but never use the gym.

Yes, equipment for the house costs precious $$$, but remember our new theme here: "INVEST IN YOURSELF". We all will need to work years longer now, and need to sustain our health. Investing in the stock market was a loser. Investing in yourself is a winner. An exercise program will go a long way in keeping us healthy.

Tuesday, October 21, 2008

Holiday Season Approaching

Probably the time period from Haloween through New Year's is the fastest time perioed of the year. So many events..gaterings. From Halloween parties to Thanksgiving celebrations, office Christmas paarties, friends holiday parties, our own family gatherings and then New Years Eve festivities. All of these will be taking place in basically an 8 week period. There is no bigger challenge to your weight loss efforts than this time of year.

How do we approach this holiday season and not gain 10-15 pounds? First and foremost, try to keep alcohol as minimal as possible. Also, although gratiously accept thje gifts to you of brownies, cookies, holiday candies, etc., turn around and give these bac to someone who does not have a weight issue. Take these next several weeks to really work hard on your weight loss efforts to build in some "cushion" for those few pounds that may sneak on during the Thanksgiving thru New Years time period. Always try to pay attnetion to your hunger signals, and when ata large Thanksgiving or Christma feast, stop eating when you in fact feel "full". Take very small tastes of the very high-caloric foods as opposed to larger portions.

Linda has generated some holiday mealplans, so please check our websites and stop by the office.

It would be great to get to January 1, step on the scale and smile as opposed to saying "oh, no..New Years resolution time!"

Monday, October 20, 2008

Halloween and Weight Loss

First issue: My staff and I all dress up for Halloween even during the work day so Friday, October 31, we will be here in from 730 am till 12 noon so if you want to see Elvis come back to life in the form of a middle aged doctor, please feel free to stop by.

Did you buy the candy yet to give out to your trick or treaters? If so, my question to you is: "WHY?" Keeping food items of temptation around the house for prolonged periods of time is not a great idea. If it is in the house and we feel stressed out, we will feel an urge to open one of the bags and indulge in the very food sources that perhaps caused the weight problem to begin with.

Also, are there perhaps "healthier" snacks to purchase to give out on Halloween? With the childhood obesity rate climbing to alarming proportions and the life expectancy of the younger generation being less than their parents, our decision to give out less caloric sources of "treats" is a very socially-conscious decision.

As opposed to looking at high-caloric, low nutritious food sources as "treats and goodies" but rather as saboteurs and killers will hopefully help you avoid purchasing them and giving them out.

Sunday, October 19, 2008

weight and "set points"

I often have patients ask me whether there is some predetermined "set-point" that a person's weight will go to no matter what they do in the short term. If that person "diets" the weight will go down but then over time, the weight seems to drift back up to the number that has been present previously. No matter what that person does in the short term, the weight always seems to go back up to that overweight number that prompts the person to feel frustrated.

I propose to you this: Behavior patterns are the "set point", not the number on the scale. What I mean by this is that people develop behavioral patterns that become ingrained and although in the short term many people can alter these behavior patterns, the long term change in behavior is difficult. As this relates to weight, if in the short term, a person lowers carbs, exercises more, reduces alcohol consumption, etc, the weight will drop. However, if over time, the person reverts to old behavior patterns as that relates to eating, the weight goes back up.

So the point here is that there is no weight"set point", but rather there are behavioral "setpoints" that are difficult to change. For long term weight loss, it is the behaviors that must change permanently. Easy to do? Of course not. Can it be done? ABSOLUTELY

Saturday, October 18, 2008

Back from Boston

Okay....I was there for several days so I now find myself saying.."Paaaahhhhk the caaaahhhhh"

Had a book signing at the Natural Products Expo yesterday and it was fun. Lots of people from overseas were at this convention and there was much interest in our serotonin technology.

As I was talking to people who came by for a book, I started thinking again about how our body chemicals can contribute greatly to our health and conversely to disease states. Specifically concerning weight issues: metabolism, cravings, the need for food when we are under stress, the feelings of when we feel "full" (satiety) vs. hungry...all of these have a chemical contribution. We inherit these chemicals just like we inherit the genes that dictate eye color, height and hair color. When we come from families that seem to have many overweight people, there clearly is a genetic predisposition for this to occur in us and our children.

We do have to "play the hand we are dealt" and when it comes to weight issues, if we inherit a genetic predisposition to be overweight, we are forced to be that much more aggressive in our efforts. By no means is it a predestined outcome that the obesity is going to be present regardless of what we do. Balacing the chemicals that contribute to some of this issue (sucha s serotonin of course) can be helpful in our efforts. It was lots of fun for me yesterday to meet new people and explain the development of our serotonin technologyu and the formulation that Linda and I developed.

Have a great weekend!

Friday, October 17, 2008

Last Day in Beantown

Yesterday I attended a conference in Boston called the Natural Products Expo. This is the second largest trade meeting of the natural products industry. This is a very large conference and many of the booths are from companies that sell dietary supplements, natural foods, etc.

As I was walking up and down the aisles of the display booths, it became apparent again to me yesterday how many companies sell "weight loss " supplements making it seem that just by taking their pill or powder, one is able to easily lose weight. At the booths, I would engage an employee of these companies and innocently ask questions (I did not identify myself as a physician who practices weight loss for fear of having them not do their usual shpiel) about how their "miraculous" product works. The explanations I received were often ridiculous from a scientific standpoint.

I know I have written this theme before, but it struck me so hard yesterday that I felt the need to bring this up again: To lose weight and keep the weight off, there is NO SUCH PILL ALONE THAT WILL MAKE THIS HAPPEN WITHOUT A LIFESTYLE CHANGE. Not our Sertonin-Plus, not the myriaqd of pills I saw being sold yesterday, not anything already on the market.

As you are all doing this effort, you of course realize that planning your meals, limiting your portions, reducing your carb intake, avoiding alcohol and snack foods...all of these aforementioned activities are not in a pill form. Supplements (of course our Serotonin-Plus is the VERY BEST!!!) can be an adjunct to these efforts, but stand alone, do not be duped into believing there is a magic pill out there. Yesterday I saw too many companies that made it seem this way.

Thursday, October 16, 2008

New England and Cookie Diets

We visited a medspa in Massachusetts yesterday that was interested in implementing the Serotonin-Plus Weight Loss program into their spa. Seems that they have tried a number of "weight loss programs" that have not worked very well. The owner was lamenting that his most recent venture was a "Cokkie Diet" program in which patients would buy 75 dollars a week worth of special cookies. They would also pay 80 dollars a week for their visit. Most of the patients were dissatisfied and left the program . The owner is now stuck with 10000 dollars worth of inventory of cookies that have a 35 day shelf life.


Once again, it is our strong feeling that meal replacements, fad diets etc. are NOT a long term strategy. To lose weight and keep that weight off, one needs to learn how to behavior modify with "real" food...not prepackaged meals, bars, shakes or cookies.

By the way, New England for seafood??? The restaurants in our area are MUCH better than here,

Wednesday, October 15, 2008

Hi From New England

Thanks to Linda for providing a great blog ths morning...Your Doc is meeting with a hospital today in Fall River, Mass. to discuss implementing our Serotonin-Plus Weight Loss Program in their bariatric center. They offer surgical procedures but not a medically managed program.

Surgery is the answer for some but not many. We have many people that enter our program who have a surgical procedure and then gain back lots of weight. Why? The answer is that surgery truly does not provide beahvioral modication. Over time, people revert to old eating behaviors and the weight goes back on.

The long term success for weigth loss requires behavioral modification and life style changes. With any type of bariatric surgery you must still provide behavioral guidance and support.

Cold up here!!! Brrrrrr! (This ex-Nuuu Yooorker has developed southern blood!)

Dining Out-To Cheat or Not to Cheat?

Dining out can be a challenge for anyone whether we are watching our weight or not. There are so many choices. Americans dine out more than ever. And portions are larger than ever. Restaurants, however, are more accommodating to health and diet needs than they were in the past. Really think about the food you are going to choose and ask yourself if the calories and setback are worth it. Here are some tips that might help you in making choices when you do eat out.

• If you are busy and eat out often, avoid considering dining out a special occasion. When we think of dining out as a special occasion or celebration, we tend to overeat and indulge in foods that we may not otherwise eat.

• Budget your calories throughout the day: if you know that you are going out to eat for dinner, try to reduce your intake at breakfast and lunch so you can "save" some of your calories for when you dine out.

• However, you may want to have a small snack to help curb your appetite before dining out to help you avoid eating too much at your meal.

• If you know where you will dine out, look up the menu (and nutrition information, if available) online and decide what you will eat before you get to the restaurant. This way you are in control to choose a lower calorie, lower fat meal option and are not overwhelmed by the menu options and careless about eating healthy when you arrive at the restaurant hungry.

• Split your meal with a friend or family member. Most restaurants serve portions that are two to three times what we need! Otherwise, have the serving staff put half of the meal in a to-go box before it is brought to the table.

• Avoid all the extras, as these calories add up quickly: bread and butter on the table, sweetened drinks, appetizers, side items and desserts. Instead focus on a healthy balance of lean proteins, low fat carbohydrates and fruits and vegetables.

Tuesday, October 14, 2008

"Taking a Break"

On a number of occasions, we have had patients that have spent many months with us doing a great job in losing much if not all of the 100-plus pounds that they needed to lose. At a certain point in their efforts, especially when the weekly loss slows down on the scales, patients will sometimes say 'I need a break". The question is "break from what?"

The answer is that mentally, the choice to lose weight necessitates a constant need to plan meals, count portions, consciously give up the food and drink items that put us in a weight problem to begin with, and focus your attention and efforts on your weight efforts. All of these requirments are not easy at all ; especially when we feel stressed from other personal or business matters. Food and alcohol is a form of treatment for these stresses and at certain points, your efforts to lose weight become stressful as well. There is just so much stress anyone can handle at one time, and when you are dealing with many issues at once, sometimes we feel the need to "take a break" from focusing on weight loss.

At times like these, I ask my patients to sit down and write out on a ledger the important reasons as to why they want to lose the weight and then on the other side, write down the culprits that derail their weight loss efforts. Are the two glasses of wine at nite really more important than developing diabetes and risking kidney failure or blindness? Does the popcorn nuts or ice cream after dinner rate a higher priority than looking older than your age?

These are the mental machinations that one needs to go through when the mental fatigue sets in and you are thinking about "taking a break" from your wonderful goal to lose weight and be happier and healthier.

On a completely different note, the Giants were dismal last nite and the first patient that teases me this morning about that ugly game last nite will get the largest needle we have for the blood test.

Monday, October 13, 2008

Exercise and weight issues in females

The following article: http://news.yahoo.com/s/hsn/20081010/hl_hsn/mentalbarriersblockobesewomenfromexercise

shows in a study that overweight females avoid exercise for several reasons including self-consciousness, fear of injurt, minor aches and pains.

A viscious cycle is set up when a person is overweight...lack of exercise because of the obeisty worsens the weight problem further, resulting in even lesss ability to exercise. Conversely, when one starts losing weight, a positive cycle is set up: when the person starts losing weight, there is less pain when exercising, less self-consciousness about being seen in work-out garb etc. This increasing exercise will alloow the person to lose even more weight.

Please do not hesitate to contact us for recommendations for exercise no matter what yourweight is. Embarking on an exercise program will pay off huge health dividends for you.

Changing topics: Football..no gloating from me about the Skins....their two wins on the road were amazingly surprising ...yesterday was a trap game...they will be okay...Tonight...GO G-MEN!!!!

Sunday, October 12, 2008

weight control and brain chemicals

This week I am going to Boston to do a book signing for a company that will be distributing our Serotonin-Plus product thru GNCs and other retail vitamin stores. The book I wrote several years ago was about serotonin and how imbalance of serotonin can affect a number of body systems.


It is amazing how the slightest imbalance of a chemical that is present in such small amounts in the body can have such life-altering affects. The total body content of serotonin as about 10 mg (the size of a small claritin tablet) and the majority of this is found in the GI tract. In the brain, concentrations of serotonin are minutes, yet the most subtle imbalances may lead to severe depression, anxiety, OCD and a number of other significant mood disorders.

We inherit brain chemical imbalances, so the chances are high that if depression and other mood disorders run in your family, your chances greatly increase. Similarly, with weight control, metabolism issues, cravings and other factors that result in weight issues are often inherited.

Recognizing that we often have to play the hand that is dealt to us, when obesity seems to run rampant in our families, the question comes about as to whether this is "environmental" vs. true genetics. Some families, more than others, base their family gatherings and shows of nurture by providing more high-caloric foods than others. This is the environmental component. The slow metabolism, tendency toward addictive behaviors, etc is more the chemical contribution.

I feel that both play a large role in the tendency to familial obesity. The solutions involve changing the customary routines in "feeding" family members way beyond reason and consciously counting calories/portions or in some other way limiting caloric intake. Certainly, a program such as ours can help focus people on these issues. That is why I constantly tell people that "pilss" are a complete adjunct to any long term strategy for weight loss. Changing behaviors and finding adaptive ways to mitigate negative brain chemical contributions to eating patterns are the necessary components for long term weight loss.

Off to a tennis match! Have a great Sunday.

Saturday, October 11, 2008

self-accountability

When people decide to that it is time to stop coming for their weekly visits to our program I implore that there has to be a strong sense of self-accountability. When patients come here weekly, we weigh them, discuss the week's challenges, make suggestions as to how to navigate around the difficult stressful times and not allow those food sources in that will damage our weight loss efforts.

When there are no weekly, visits, the person is then "in charge" of their own accountability systems. Psychologically, when people know they have a weigh-in in front of a physician or nutritionist, there is a bigger push for success. Fear that if there is no success will have the professional "disappointed" in that person's efforts? Spending very valuable money on a program and not achieveing success? These may be the psychological factors involved with outside "accountability".

Make contracts with yourself: Reward yourself for success, establish goals and reward yourself (non-calotic) for reaching those goals. Stop by here for weigh-ins (no cost!!) and please read my blog daily to stay connected with me.

Friday, October 10, 2008

Another weekend.....

The weekends present unique challenges to us in our quest for weight loss. Why? Well, one reason is that at the end of a long, difficult week, there is an internal "push" for some type of reward for enduring the hardships of the workweek. How do we tend to reward ourselves? Usualy food sources. Another reason is the social events that occur on the weekends as opposed to the weekdays...whether it be a gathering of friends/neighbors on a Saturday nite or a football sunday with tailgating, the bountiful supply of high-caloric foods and alcohol will most definitely impact negatively on our weight oss efforts.

Take the time to sit down and pencil out on paper the weekend challenges that occur and what solutions you can come up with to stave off the damage that may occur to your weight loss efforts. Concernng the football/tailigating issue, try very hard NOT to get into the "herd" mentality of imbibing on lots of alcohol and carbs. At social gatherings, similarly, remember at all times that alcohol is a very damaging item in your weight loss efforts.

Have a great weekend...enjoy the last vestiges of warmth...

Thursday, October 9, 2008

No Finish Lines!!!

Over the past several weeks we have seen a number of people who have come back to us having put a significant amount of weight back on months/years after leaving our program. The first thing I tell these patients is: Do NOT feel embarrassed about this. The losing/then gaining of weight is very common because as we discussed when you entered our program, it is much easier to gain weight than it is to lose it. To lose weight and keep it off requires constant, and I mean constant vigilance, planning, thinking, etc. As soon as life's issues (work, home, etc) take over and we stop concentrating on our weight loss or maintenance efforts, then we regress to our old behavior paterns. These behaviors usually revolve around making quick choices for food (sure is easy to drive thru a Burger King) as well as seeking rewards for stressful times. Such rewards involve high-caloric food sources, alcohol, etc.

There is no "Finish Line" to our efforts...to lose weight and keep it off requires that change of life style that we constantly talk about. Is this easy? Of course not. Over a number of years we all build up pattenrs of behavior and ofetn when it comes to food choices, these patterns involves taking in food sources that taste good to us. Unfortunately, these types of food sources are often very high caloric.

Hey, I need to apologize to my Redskins fans out there. Your team's performance has been incredible. Seeing them in preseason and in the first game agianst my G-men, I thought you guys would go 3-13. Campbell is playing GREAT and Coach Zorn's systems are working incredibly well. SO MUCH FUN seeing you guys beat Dallas and the Eagles in their home stadiums. Will be a GREAT game when the Giants play them later in the year in D.C.

Wednesday, October 8, 2008

weight gain and depression

I think that many of you, including me, are getting quite upset at the never-ending bad financial news that we are being barraged with daily. Two trillion dollars of retirement monies have been lost, many people nearing retirement are now looking at working (if there is work to be had) for years more, and yet, AIG execs were in some retreat last week spending over 400K dollars on lavish spa treatments, meals, exotic rooms, etc. Their CEO is now receiving a million dollars a month as a consultant...the same CEO who oversaw the demise of this huge insurance conglomerate.

As we absorb this type of news, first there is an element of disbelief, followed by anger and then depression may set in. During depressive phases, we often start reaching for high-caloric food sources as some sort of "treatment" strategy. I implore everyone reading this to recognize this pattern, and stop it in its tracks. "Destress" by trying to get more exercise or writing your congressman, senator, or whomever and tell them what you think about all of this. Do NOT allow the gloomy news to impact adversely upon your health, because as I mentioned in the past, right now your BEST investment is in YOU. Keeping your health intact will be your best response to all of this. There are things we cannot control...such as the government's complete ineptitude in having staved off this recession. You and I cannot control the greed that resulted in this lending debacle. What we can control is what we put in our mouths.

Tuesday, October 7, 2008

weight loss and the economy

The newspapers and television news channels are inundating us with bad economic news; almost unprecedented for most of us, as we have always been able to rely on Wall Street and the financial institutions for good news on most occasions.

Many of us who have most of our "retirement" monies in 401Ks have seen paper wealth diminish dramtically and the values of our real estate assets are also nosediving. Clearly, we all see the need for working a number of more years past when we planned on hanging it up.

We must remain healthy so I implore everyone to try to focus on your health and well being...get those physical exams to make sure everything is okay and certainly if you are carrying more weight than you should, have a plan to take those pounds off. Keeping healthy is going to give you the opportunity to keep working longer if you need to, which may be a necessity for many.
Try to avoid that stress eating as best as possible...the extra pounds brought on by the high-caloric stress foods will further damage our overall health.

Monday, October 6, 2008

The Doctor Is Back from Vegas

First, I want to thank Linda for keeping the blog up while i was Viva-ing it in Las Vegas. I know Linda is very proud of Ryan's accomplishments and devotion to our country and I loved her blog this morning.

Okay...the data is in from Vegas: Posner up....(drum roll please...) 1.5 pounds.

i did exercise every day...did one buffet (Plant Hollywood), drank more than usual (i hardly drink cause it makes me smiloe but I had probably 2 drinks a day. I didn't do afternoon snacks..tried to stay on high protein choices.

My plan: this week....reduce carbs to 2 portions a day....pump up exercise recheck weight in 1 week...if down to my previous, resume the normal...if still up, do more aggressive caloric restriction..

By the way....want to know what happened in Vegas???? sorry..........remember: what happens in Vegas stays in Vegas!!! (okay....here goes: I did surrender my 16s against the dealers "10" in blackjack)

Marine Update

Many of you know my son, Ryan, is a Marine. Many of you have also wished him and I well as he serves our country and as I persevered to get through boot camp in the spring. I certainly appreciate that very much! I just wanted to let you all know that he got his first promotion last week and is now a PFC! He is so pleased and tells me his goal is to get a perfect PFT and move up to Lance Corporal within the next 3 months. He is in aviation candidate school and has to qualify physicially to be able to be part of an air crew before he can even attend the technical school. He must be able to swim with his 75 pound pack on, swim 1 mile, as well as do 36 laps in their pool utilizing a variety of strokes in less than 80 minutes. Every day he spends 4-5 hours swimming and also runs 8 miles per day in the Pensacola sand. Although I am having a hard time adjusting to being a Marine Mom, he is an inspiration to me. How tired must he be at lap 26, 28 or 33? But he continues on to finish. I think about that when I am at the gym after a long hard day of work and feel tired on my last 10 minutes of the elliptical and want to stop. I think of his persistance and convince myself, "Hey if he can do that, I can certainly spend a little more time on the elliptical trainer to burn more calories." It's all about perspective.

Keeping Your Calories In Check

All of us at one point or another agonize over food choices especially if it is hard to manage our weight. For example, if you work hard to control your weight, you may get pleasure from your appearance, but you may also feel sorry for yourself each time you forego a favorite food. There is a balance to be struck between the immediate gratification of indulgent foods and the long-term pleasure of maintaining a desirable weight and good health.

Yes, a donut looks good and it will taste good but we have to think about the effect on our bodies. Is it worth the 500 calories it contains? That becomes a personal decision. Then, we have to ask, if I eat that can I burn that off with my exercise? Then, we have to determine, “well if I don’t exercise what will that do to me?” When we are watching our calories, we have to prioritize our foods so we get what we want in our diet without overdoing it, if our appearance and health are important to us.

As most of you know, I don’t ever suggest that any foods are going to be off-limits for the rest of your life. Throughout your life you will again eat ice cream, potato chips, cookies, cake, donuts, etc. It is portion control and moderation that is the key. Successful weight management involves 3 steps: 1)Knowing that you can give yourself a treat that you want 2) Engaging in more activity to burn off those calories associated 3) Giving up something else in the diet that wasn’t important to balance out the calories. When you have that balance worked out, you have identified your own personal dietary pleasure "point of preference." This is where you want to stay.

Sunday, October 5, 2008

What Does the Serotonin Formula Do?

In our program, we use the Serotonin Formula which is a natural patented serotonin supplement. We get many questions on just what is in it and what it does. It is a fabulous product and does many great things for us. Please rest assured that the Serotonin Formula has been tested thoroughly for safety. It contains vitamins and minerals as well as pure serotonin that has been extracted from the stinging nettle leaf. It does not contain any animal by-products.

So what does it do for us? First, it boosts metabolism. The effects of the Serotonin Formula were studied in a variety of clinical trials. For weight loss, it acts as a mild appetite suppressant, significantly reduces carbohydrate cravings and the tendency to binge/stress eat and is a thermogenic agent that helps burn calories. It also acts as a natural mood enhancer and elevates mood as it naturally normalizes serotonin levels. It is a great tool to be used when you are stressed, it can help to reduce the feeling of being overwhelmed. Many patients tell me that when they take the supplement, little tings don’t bother them anymore and they are able to cope easier. Thirdly, it increases your energy level. Other clinical trials were done with the supplement and it was found that in there are other ancillary health benefits such as reducing the severity and frequency of migraine headaches and reducing the pain associated with Fibromyalgia.

Many of our patients stay on it after they get to their goal weight because it is an aid to help with carb and appetite control. Many have been on it for years and I have been taking it for nearly 6 years. It gives me the energy to keep going and deal with Dr. Posner everyday.

Saturday, October 4, 2008

How Much Exercise Do We Need?

I have many patients that ask me, “How much exercise is necessary?” Well it depends upon what you want to accomplish. If you are in a weight loss mode then you want to burn more calories than you take in. If you are in a weight management mode then you want to burn off exactly what you take in to maintain your weight.

The American Institute for Cancer Research’s (AICR) expert report, "Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective," recommends at least 30 minutes of moderate physical activity a day to protect against cancer. This is exercise will also help you burn calories. Moderate physical activity is defined as activity that causes the heart rate to increase and breathing to deepen, such as brisk walking. A brisk walk, swim or bike ride will work well, as will some household chores, provided they get the heart pumping. It doesn't matter what activities are chosen and the exercise does not have to be done all at one time. It can be broken up in 10 or 15 minute intervals. The question becomes will 30 minutes per day be enough for weight loss? It will of course depend upon your metabolism and your food intake. The AICR recommends that 60 minutes per day of exercise is associated with the prevention of weight gain. It is also recommended that for maximum calorie burn, a blend of cardio and weight resistance training is necessary.

So, what if you don’t have 60 minutes per day to exercise? Do some sort of formal exercise for as long as you can. Then keep your body moving, the more you move, the more calories you burn. Cleaning and normal chores around the house can burn calories. Incorporate more walking into your daily life. Make yourself walk up stairs instead of taking an elevator or an escalator or park farther away from the store or your work place so you have to walk more.

Friday, October 3, 2008

Tips To Help You Stay in Control

As the nutritionist of the program, it is my mission to help everyone that has the desire to lose weight. I will do whatever I can do to help. Life is crazy here in the D.C. area and although we may consciously want to do well to stick to our routines to lose weight, sometimes life gets in the way. We need to realize that every week will not be perfect and that is ok. All we can do is try our best.

I feel we can all use any help we can get to help us stay on track. Here are some simple things that you can do to help you stay on track with your diet and weight loss efforts:

1. Think about this, have you ever seen restaurants of any kind decorated in blue? Chances are you haven’t. Why? The color blue functions as an appetite suppressant and will cause you to eat less. So look to add blue napkins or tablecloth, use blue plates or even wear blue when you eat. Try it. Studies show it will suppress your appetite and you will eat less. Conversely, avoid red, yellow, and orange in your dining areas. Studies find they encourage eating.

2. Hang a mirror opposite your seat at the table. One study found that eating in front of a mirror slashed the amount people ate by nearly one-third. It seems having to look yourself in the eye reflects back some of your own inner standards and goals, and reminds you of why you're trying to lose weight in the first place.

3. Reduce your portions. Whether you eat at home or in a restaurant, immediately remove one-third of the food on your plate. The explosion in portion sizes in America has been an issue for about the last 20 years. We eat far, far more today than our bodies need. Studies find that if you offer greater portions, people will eat more food, regardless of their hunger level. This may go back to the “Clean plate syndrome” that many of us grew up with. We had to clean our plates to please our parents or to get dessert, etc. We do no longer have to clean our plates. Any excess food that we don’t eat on our plated does not have to be wasted, we can save it for tomorrow. The converse is also true: Serve yourself less and you'll eat less.

Thursday, October 2, 2008

Should I take a multivitamin?

As the nutritionist for the program, many patients ask me if they should take a multivitamin if they are taking the serotonin supplement. I believe a multivitamin is necessary. The serotonin has some vitamins and minerals to help the body and the mind through the stress of weight loss but it is not a complete multi. In this crazy world we live in, we sometimes don’t get the nutrients we need depending upon our eating habits. And if we are very stressed (which who isn’t today), our bodies need more nutrients such as the B vitamins, Vitamin C, Calcium and Magnesium. Also if we are on a reduced calorie diet as in our program, we will naturally get in less nutrients.

It is recommended that you take a multivitamin if you are in one of these groups:

•Women of childbearing age: They need 400 IU daily of folate (the form in supplements is called folic acid). This B vitamin helps prevent neural tube birth defects; women need to build up their folate stores at least several weeks before becoming pregnant. The folic acid in supplements and fortified foods is better absorbed by the body than the folate found naturally in food (this is also true of vitamin B12). In addition, many pre-menopausal women do not consume enough iron and can benefit from the amount in a basic multivitamin.

• Over 60 years of age: Most don’t get the nutrients they need, for a variety of reasons. For instance, aging itself may make it more difficult to absorb and utilize certain nutrients. The major problem nutrients for older people are vitamins D, C, B6, B12, and folic acid, as well as minerals such as zinc, calcium, and magnesium.

• Strict vegetarians: Those who eat no animal products, may not get enough vitamin B12, zinc, iron, and calcium.

• Those on weight-loss diets, as well as heavy drinkers or smokers: Are likely to have a shortfall of vitamins and minerals.

• Those not eating a balanced diet (at least five fruits and vegetables a day, as well as whole grains, low-fat dairy, and small servings of lean meat, poultry, or fish) may not be getting enough folic acid, B6, and B12. These B vitamins play a role in lowering homocysteine levels in the blood and thus may help reduce the risk of heart disease and, recent studies suggest, Alzheimer’s disease and osteoporosis. Folic acid may also help prevent cervical and colon cancer.

There are a variety of multivitamins out there from One-A-Day to Centrum to store brands. Just look on the label and be sure you are getting 100% of the Daily Value for the major vitamins and minerals that have daily requirements. We also have a multivitamin that I formulated that has a little bit of serotonin in there that was developed to be used with our Serotonin Formula. The extra serotonin gives it a nice kick to enhance mood and energy.

Wednesday, October 1, 2008

Travel and Weight Control

Okay, your Doc is leaving for Las Vegas this morning for some business meetings and some fun. What is the guy's strategy for not putting weight on??? Here goes:

1- NO AIRPORT FOOD! I will eat breakfast before i go
2- NO MIRAGE BUFFET! Buffets test the very fabric of the human condition.."All You Can Eat" is how they advertise any buffet and the Vegas buffets compete with each other in terms of how opulent their food spreads are. I have never been to a buffet when I persoanlly have not gone up at least three times for different foods or desserts. If I do not go to a Buffet, I can't stuff it in, right???
3- Limit the Carnegie Deli trip to once! Okay, as an ex-Nuu Yooorker I LOVE corned beef, knishes, etc, and with the offense intended, any place in Northern VA that calls itslef a "New York Deli" is blatantly lying. The Mirage hotel houses a real Carnegie Deli...like the one in New York. I will allow myself that indulgence once.
4-LIMIT ALCOHOL! When you stroll the streets in Vegas you see lots of people walking around with these huge Pina Coladas in glasses that resemble the Eiffel Tower. These high-caoric drinks can really damage weight control so at the most, I may be good for 1 or 2 light beers during the 5 days.
5- NO EATING IN BETWEEN MEALS! Every hotel has food courts, snack shops etc...I will not be tempted by the Gelato bar
6- EXERCISE DAILY! I will go to the gym first thing every morning to run

Anyway, these are my strategies to limit the weight gain from a trip such as this. Also, when I get back on Monday, I will check my weight and if it does go up, then next week I wil be that much more vigilant.

I bought a new laptop so I will be posting blogs from Sin City! If I hit a major jackpot, then we are moving our second office from Bethesda to Las Vegas Blvd. Nah teasing...I would miss all of you too much!