Saturday, February 28, 2009

Easy vs. Hard

It is easy to sleep in on a cold winter morning...it is hard to wake up and go to work. It is easy to read an engrossing novel...it is hard to read a techincal manuel for work. It is easy for Posner to watch a Giants football game on a Sunday...it is hard for him to watch Meet The Press.

It is Easy to gain weight and hard to lose weight.

To quote a line from Tom Hanks to Gena Davis in a movie also starring Madonna (Name the movie for a free bottle of Serotonin Multivitamins) "If it was that easy, everyone would do it."

Counting calories, choosing low caloric foods over high-caloric ones, exercising more...all of these are difficult to do. But, allm of them are necessary to achieve significant weight loss. But remember the reasons as to why you want to lose weight. Being healthier, happier, looking younger, having higher self esteem, looking better in your clothes...all of these are great endpoints. It is easy to go back to old life-style patterns that put that weight back on. Choosing to be healthier and happier is an easy choice...it is getting there that is hard.

Friday, February 27, 2009

Being a Role Model and Inspiration

As you are working through your weight loss efforts, others are watching you and hoping you succeed. Along the way, there also may be a number of people for whom you are providing inspiration. Perhaps you have children who have weight issues...or a spouse. Maybe it is a friend or coworker who need to lose weight but have not yet found the fortitude to embark on a weight loss effort.

To feel that your weight loss initiative may motivate a significant person(s) in your life to follow suit almost puts even more pressure on you to be successful. But it is reality that when you lose a significant amount of weight and become healthier/look younger etc, you will serve as an inspiration to others around you. Not only are you helping yourself, but others may be positively affected as well. Kind of like that movie "Pay it Forward".

Okay, game time...I brought that movie up...Pay it Forward. If you e-mail me with the correct answer, you get a free bottle of serotonin. Here is the question: Can you name the actor who played the teacher and the actress who played the mother of the kid? My e-mail: serotab@aol.com and NO LOOKING ANSWERS UP ON THE INTERNET!!!

Thursday, February 26, 2009

alcohol and weight

Yesterday in the Washington Post there was a lead article about a study that came out of England showing an association of alcohol usage in females and an increased cancer risk. The amount of alcohol intake in the study was minor...one drink a day of wine or beer. This study was conducted in 1.2 million women!

Wow..lots of people drinking that red wine because of other reports that this is "good for your heart". Now, ONE drink a day can cause a risk of cancer???

A few thoughts here: ONE: please, always take newspaper or internet "study reports" with a high degree of skepticism. As a practicing physician, I remember the entire estrogen controversy: studies showing less heart disease in females taking estrogens...then studies that showed MORE heart disease. So, now studies that show cancer risk mixed with older studies showing healthy heart issues?

Okay, so why is this issue in my weight loss blog? Here is the reason: Alcohol derails weight loss efforts. It markedly interferes with weight loss. When I advise patients to "knock it off" sometimes I get the counter argument that "I heard wine is healthy for me". Well, now I have some more ammo to refute that comment.

Alcohol slows metabolism down and if you are trying to lose weight and having trouble, assess your alcohol intake. If you are doing any weekend drinking or "only one glass of wine a night", strongly consider cessation.

Wednesday, February 25, 2009

Keeping Focused

Your physician (me) has become quite militant in the last few weeks hounding people as to whether they are reading this blog. When I ask my patients, much less than 10% say they read this daily. I then pull the guilt thing on them by saying.."Hey...I am getting up 7 days a week to write this thing; shouldn't you take the time to read it (30 seconds or less)?"

Obviously the words you are reading are not earth-shattering revelations that will proel anyone putting their eyes on this to never gain a pound ever again. What I am trying to do is to whisper in your head daily things that may help you focus on your weight loss efforts. To gain weight? No focus needed...just do what is fun and follow old behavior patterns. To lose weight? CONSTANT vigilance, thinking, planning etc.

When you are in the formal program and see us weekly, you are paying money, we are talking weekly face to face, and your weigh-in produces a psychological accountability factor that helps you maintai focus. When you leave your formal visits, this all changes...now it is self-accountability and it is so easy to lose focus. I am trying to help people at least once a day think about their weight loss efforts because as soon as we stop thinking about it, we find ourselves right back into the old behavior patterns, and trust me, those behavior patterns aren't conducive for weight loss.

Obviously I am preaching to the choir, because you are reading these words today..but try to make this a daily meeting with me. The more you can keep thinking about your weight loss efforts, the more focused you will be, and success will be yours.

Tuesday, February 24, 2009

weight loss and fighting boredom

Chicken/vegetables....chicken/vegetables.....tuna fish/salad....BORING!!!

Many people, as they are avoiding the food sources that would be detrimental to their weight loss efforts, feel a huge boredom factor set in. The "fun"foods are no longer part of the plan. High protein/low carb meal plans can become quite mundane.

This weekend we bought a crockpot and it came with a book with many recipes. Many of these recipes did not involve high-caloric foods.

Finding innovative choices for foods is difficult at times, but search for recipes, cook books and other help that may open up some interesting food choices for you, yet allow you to follow your goals to lose weight. If you know of people in your circle of friends or workplace who are similarly trying to lose weight, exchange recipes and ideas. Try to make the effort more fun.

When boredom sets in, we are more apt to stary off course

Monday, February 23, 2009

Academy Awards and Weight

Was it just me or was the show last night really boring???

Actresses and actors on the red carpet....the cameras are flashing and clothes and looks are being scrutinized. Lots of pressure on these actresses to look fabulous. These people make their livings by having a certain "look". There is especially more pressure on the females to not be overweight. Some of these actresses look waif thin...at times almost sickly. As you watch the "aging" of certain actresses that were well known for their beauty, many resort to multiple plastic surgeries in the quest to look younger. The puffed lips and stretched faces are a distortion in many cases and what was once a beautiful woman is now a caricature.

Okay, let's leave Hollywood and return to "normal" people. We are not paid millions of dollars to be in pictures and our work performance is judged not by how thin or how beautiful we are, but rather on our professional contribution to the company. We want to be at an improved weight not because we want to look better than the other people around us, but rather, to be healthier and happier with ourselves. Our reasons for wanting to be at a healthier weight are much more grounded than the Hollywood stars we see on the big screen.

Losing weight will allow you to live longer, be happier and have a higher self-esteem. You are losing weight for "you" ...not for your "fans".

Sunday, February 22, 2009

weight loss and exercise

Certainly a topic we have covered before, but I wanted to let people know of a new resource we have for our program.

Face it...for most people (including me) "exercise" is not fun. I run pretty much daily and DO NOT like it. During the weekdays when it is 0-dark-thirty and freezing outside, as I am running Tanner the dog on our usual 4.5 mile route, I am NOT enjoying it. When I play a tennis match, I do enjoy that, but on a daily basis, I cannot get a tennis game. If I am going to exercise, it will need to be a run or a machine such as a stairclimber or a treadmill. Reality: what feels better??? sleeping in, getting up for a nice breakfast or getting up and running? We all know the answer.

However, for a long term weight loss/maintenance strategy, exercise is a key component. The trick is to find an exercise that is NOT that negative for you (some people despise treadmills, so therefore this is NOT a good exercise to force yourself to do) and SCHEDULE your exercise as part of your weekly plans. But you MUST keep that appointment to exercise almost as you would treat an important business meeting.

We have a new arrangement with a trainer at The Washington Sports Club to see our patients initally for a FREE visit. Joanne will also be forming a monthly walking group for our patients and other events to help raise the consciousness of our Serotonin-Plus patients to the role of exercise and how it can be made "fun".

Please call us in about 1 week for the details.

On a non-weight loss note, I saw Slumdog Millionaire last nite. A very good picture but I do not think it will win Best Picture. (Having said that I also thought the stock market bottomed out with the Dow at 9000). Have a great Sunday!

Friday, February 20, 2009

weight loss and "the last straw"

Yesterday I had two patients who described their reason for entering our program was they hit "one last straw". For one person, it was being placed by her internist on a blood pressure medication. The other person said that she put a dress on that was one of her favorites, and it did not fit. In one case, it was a health issue that caused the patient to make a definitive move to help her lose weight. In the other, it was an aesthetic/vanity motivator.

Psychologically, often when it comes to confronting a weight problem, many people take the road of denial/avoidance. The weight does not get checked, the person avoids looking in the mirror, and in general, thoughts of addressing the weight problem are blocked out of the mind. However, when something very "real" happens, such as a medical problem requiring medication or other intervention, or a social situation calls for the wearing of a gown or a bathing suit, the person is forced to confront their weight issue.

For many, it will take a "last straw" to become motivated and begin a healthier lifestyle. For some, the "last straw" may come too late...a serious heart attack, a major diabetic complication, etc. NOW is the time to do something about your weight...do not wait for a last straw!

Thursday, February 19, 2009

weight loss and sabotage

Yesterday I was thrilled to have 2 patients come in and refer to chocolate as "saboteurs".

Sabotaging of your weight loss efforts by friends or family can be disruptive to meeting your goals. Yesterday I had a patient tell me that she told her mother, before February 14, NOT to give her candy as a holiday recognition. It would seem intuitive for people around you to respect your weigth loss efforts and not do anything to try to derail your plans. However, nurturing being what it always has been, parents and friends will provide calories as a form of love and recognition. Taking a step back, providing this to an overweight individual would be akin to handing an alcoholic a drink, but society does not look at this action in the same vane.

Please be upfront and direct with your friends, family and co-workers and explain that you are on a weight loss mission so you can be happier and healthier and you would greatly appreciate their help along the way. That "help" can be nothing more than NOT tempting you with food sources that will make you fail in your efforts to be healthier and happier. When framed this way, there is no way that anyone in your sphere who cares about you would do such. This will in fact make it easier for you.

Do not "hide" from people your intentions to lose weight...make it known. You will get support along the way which can be of great help!

Wednesday, February 18, 2009

weight loss vs. resculpturing

We are expanding our weight loss program to medspas outside of our area. These spas perform procedures such as liposuction, "tummy tucks", fat injections and other body resculpturing procedures. The physicians at these spas tell me that often people confuse these procedures for weight loss surgery. Ethically, physicians are not supposed to do liposuction on people above a certain body weight. It is more dangerous to do this in obese people.

It is important to distinguish between losing weight and body resculpturing. Obviously, losing weight most definitiely resculptures the body in amazingly good ways. But more importantly, losing weight makes you HEALTHIER! Sucking fat out, injecting fat cells, etc. may improve the aesthetic look, but will do ZERO for improving your health.

There is certainly nothing wrong with wanting to look your best and procedures such as liopsuction can make you happier with your "look". Losing weight will help you look younger, have better self-esteem and confidence , but also make your internal organs healthier at the same time.

Tuesday, February 17, 2009

Keeping Track

A number of my patients have found websites that allow, for no cost, the ability to track caloric intake, progress, etc. These sites provide graphs and analyses about your efforts. You input your meals, exercise etc. and you get feedback as toyour progress and other data.

These are great vehicles for people to track progress and keep journals of their efforts. When people eitgher journal their food intake or track their progress through these types of sites, psychologically, the person better stays in the "zone" to focus and maintain their efforts.

If you are interested in finding out more about these free websites, please call us at: 703-866-4144.

Monday, February 16, 2009

300th Post

I noticed that today's entry is my 300th posting on this site. Every day I ask my patients if they are reading this and I think it is a somewhat embarrassing question, because if they are not (and well over 75% are not reading this daily) they feel awkward in that perhaps they will be hurting my feelings.

Why am i writing daily entries? Clearly, it is somewhat difficult to find new/interesting topics to cover about weight loss. Moreover, it does take time daily to do this.

Answer: I truly believe that when people do not think about their weight loss efforts, they are doomed to failure. If your goal was to gain weight, you do not have to think about this for one second...do what is fun and do what your body tells you to do. However, if your goal is to lose weight, that requires constant mentation/planning/focus etc. As soon as we lose this focus, we start losing the battle. I am trying to put a voice in your head daily urging you to keep "in the zone" and maintain your focus. While you are in our program, we see you weekly, you are paying money, you are getting prescription meds, etc...not as important to get these daily messages. However, when you leave the weekly visits, it is a much more vulnerable and perilous time as this relates to losing weight. I am hoping to be that voice in your head (other than your own) to help you maintain focs and direction.

On to the next 300 posts...please join me for the journey.

Sunday, February 15, 2009

weight loss and boredom

I hope your Valentine's night was fun. After we saw the movie Australia last nite (great film! and...why is Hugh Jackman NOT the new James Bond....he is sooo much more fitting for the role than Daniel Craig) we found ourselves at Wegmans shopping for a late nite dinner. Restaurants tend to be crowded and not as good on holidays such as Valentines Day, New Years Eve, etc....they tend to rush the meal and food not as good. We found some great steaks, lobster tails and prepared a really fun dinner.

I have not been in that store for a really long time and I forgot how many diffeent and unique itmes they have compared to the regular supermarkets. The point here is that if a person is in a weight losing mode, a place like this offers a wide array of food choices that would make it less "boring" to eat the same "chicken and vegetables" every day. One of the things that makes losing weight very difficult is that the "smart" food choices to enable the weight loss are not "fun" choices. Trying to make the meal preparations fun and different but yet still stay on a course of low caloric foods is difficult. Make it a challenge! Find different foods and let your mind be creative to try to make this more fun and less boring.

Saturday, February 14, 2009

weight loss and Oprah

I must admit that I have never watched the Oprah show. I see many news items involving her and the show/magazine/appearances etc. Her great popularity must be secondary to her ability to "connect" to her audience on many levels. Although I do not follow the show, when checking out of grocery stores it seems as if every magazine chronicles her weight conrol struggles.

One of the groups now doing the Serotonin Plus Weight Loss Program is running television commercials for the program in the Massachusetts/Rhode Island area and they are running the tv spot during the Oprah show. I spoke to the marketing person from the group and she told me that they are getting an excellent response from that commercial. (You can see the commercial at: www.spdiet.com ...look under "See us on TV" on the home page. We run the commercial locally on newschannel 8 and the Mass. group dubbed the end with their numbers/contacts.)

Oprah Winfrey is a very successful woman and has resources beyond all of our wildest imaginations. She can, if she so desired, have personal training sessions hours per day, chefs to customize meals for her, personal assistants who can shop for her and plan her meal schedules, other assistants to handle other mundane daily tasks, etc. So how is it possible for a person with these vast and limitless funds not be able to control her own weight? Furthermore, if someone like her cannot do it, how is it possible to control weight for the person whose day begins at 530, gettng kids off to school, then to work for an entire day, then to the children's soccor practice, then home to make or pick up dinner, then helping with homework, then to an exhaustion-induced sleep then the alarm rings again to begin the cycle again?

The answer is that we are all humans and we share a number of similarities no matter what our resources are. People who are prone to chemically-induced carb cravings, stress eating and other behavior patterns that lead to excessive weight have a very difficult time changing these behaviors. Intellectually we know that eating high-caloric food sources does not "solve" anything, but we find ourselves at times in the midst of compulsive behavior patterns that are somewhat self-destructive. Whether it be a person with a billion dollars or one who lives from paycheck to paycheck, breaking deleterious eating patterns is very difficult. By thinking about these issues, reading this blog, recording your food intake in a diary, finding a support buddy trying to lose weight also, coming into our formal program when you need the help of the medications and weekly visits...there are many ways you can make your weight loss a high priority and win the war over instinctual/chemical imbalances/learned beahaviors that sabotage our goals to be healthier and happier.

Friday, February 13, 2009

Weight, appearance and employment

Yesterday I saw a patient who has been coming to our clinic off and on over several years. When he focuses and places high priority on hiw weight loss efforts, his achieves aggresive weight loss. However, when he becomes distracted with work and home issues, he starts returning to old behavior patterns and the weight goes back on.

He was telling me that his company is unfortunately undergoing layoffs and he is very concerned that his weight may play a role in whether he is retained or not. The patient is in the sales division and he lamented to me yesterday that he feels his weight problem places him in a competitive disadvantage compared to his colleagues that maintain a healthier weight. The reasons are several: 1-perhaps the management will fret that an overweight employee may lose more time at work secondary to medcial conditions 2- if the overweight employee has several health issues already such as hypertension, diabetes, etc. health insurance premiums will go up for the company as a whole and 3- perhaps clients are more apt to "buy" from aesthetically "more in shape" salespeople as opposed to overweight ones.

The above rationale, as hurtful as it seems, is not too far off base. In this very challenging economic period, it can only help your job status to maintain as healthy an appearance as possible. Yet another great reason to keep in the zone and reach your weight loss goals.

Thursday, February 12, 2009

weight loss and medspas

After work today, I am traveling to Philadelphia to meet a medpsa owner that is interested in bringing a weight loss component to their spas in PA, DE and MD. At thier spas, they do body sculpting procedures such as liposuction, injection therapy, etc. Sometimes, people make the mistake of thinking that liposuction and mesotherapy injections are weight loss procedures. This is just not the case. As a matter of fact, ethically, liopsuction should not be performed in people above a certain body weight. A number of cosmetic surgroens will ethically turn away potential clients for liposuction if the person weighs too much.

Once again, I am pointing out that there is no "easy" way to weight loss. Sometimes I have patients make jokes about having the plastic surgeon "suck the fat away" but in fact, this is NOT a weight loss procedure. On a daily basis we are bombarded with so-called "simple" solutions to weight loss...acai berry supplements, belly fat cortisol blockers, etc. If it sounds too good to be true, it will be. To lose weight successfully and for long term, you must commit yourself to changing life-style. Do not be fooled by procedures/products that make it sound easy. But the hard work is very worthwhile.

Wednesday, February 11, 2009

weight loss and less talked-about health issues

Yesterday in the Washington Post Health section there was a study cited about the increased incidence of urinary leakage in females who are overweight. When we think about the medical consequences of obesity, most of us immediately think heart attacks, diabetes, and stroke. However, there are many other serious, life-altering health problems related to obesity. Sleep apnea, arthritis, chronic back pain and urinary leakage are several. Also, it is important to remember that certain cancers, such as breast, colon and pancreatic cancers are seen with increased prevalence in the obese population.

We often focus on the aesthetic need for weight loss..wanting to look younger, better in our clothes, etc. However, the health implications can be many.

Tuesday, February 10, 2009

Choosing Health

Personal story: Last week my brother was admitted to a hospital in New Jersey for treatment of a leg infection which was extensive. He has had a history of diabetes and when he was admitted, laboratory testing showed that the diabetes was under very poor control. Due to lots of work stress and other issues, my brother was not as vigilant as he should have been, thereby allowing the diabetes to worsen, predisposing him to such a severe infection.

Weight control has always been a problem for him and in his fifties, he had an angioplasty.

Controlling diabetes is essential to warding off the end results of organ damage attributed to poor sugar control. Heart attacks, stroke, kidney failure, blindness, peripheral vascular disease, and ncreased risk of infection are all at increased risk in a diabetic. It is estimated by the year 2030, 35% of the American population will have diabetes mellitus. Why? The answer is obesity. If this trend is not reversed, if we think that now healthcare expenditures are way out of control and threatening the already burdened economy, then in 20 years, the system will indeed collapse. We can all do our part...and that is to choose health over foods that make us overweight. Choosing health over immediate gratification is a difficult choice, but it is the smart one for many reasons

Monday, February 9, 2009

weight loss and salad bars

I was out at a Ruby Tuesdays last night for dinner and I had, as part of my meal, their famous salad bar. What an array of "stuff"! Lots of weight-friendly choices such as lettuce, tomatoes, cucumbers, carrots and other vegetables. Lots of unweight-friendly choices such as high-fat appearing cheese, raisons, croutons, chocolate pudding, very rich dressings, and other stuff that would definitely not be compatible with a weight losing strategy. The other issue is that if you order a meal, this delectable salad bar only costs $2.99...a deal!

The point here is there are "salads" that can be helpful to your weight loss plans and "salads" that you are fooling yourself with if you think it is a compatible choice. One could easily, at that salad bar heap over 2000 calories on one plate. And that would be on top of the meal that is coming afterwards. One could most definitely mix together a salad at that bar, with a very low fat dressing, that would be a good strategy, but thought must prevail, not impulsive picking at an "all you can eat" bar.

Have a great Monday!

Sunday, February 8, 2009

weight loss and putting others first

This week I had a several new patients who entered our program and a common lament was that work related obligations completely consummed them to the point where there was absoultely no focus on their own health. The eating patterns were sporadic, no thought involved at all, and these patients entered the program over 100 pounds their ideal body weight. The work was so important to them, that they let their own health suffer and put them in grave health risk.

Last night we were out to dinner with dear friends, and one of them is an internal medicine physician in Massachusetts. We did our residencies together in Portsmouth Naval Hospital and we have remained close friends for 28 years. He is truly the "town doctor" where he practices. I visited him once there and wherever we went, people said "hi Doctor____" to him, and I could tell he is held in the upmost reverance in that community. Why? By knowing his work ethic and caring, empathetic nature, he clearly has touched the live of thousands and I am certain has saved the lives of countless.

He is now very overweight and has a strong family of heart disease. On a daily basis he sees and helps so many people but his devotion to his work has put him in grave health risk as well.

The point here is that I implore you to follow the airlines' advice (no, not to read the safety card for the upteenth time) to "in the event the cabin loses pressure and the oxygen masks fall, place it on you before your children". Why? if you stay healthy you are much better positioned to help the important people in your lives. If you were to become very ill, you are not in any position to help others. So, it is not at all "selfish" to focus on your own health...your own weight issues, and then turn around to help others. So if your boss makes you feel that the work he/she is throwing at you is more important than your impending heart attack, then time to have a sitdown with the boss. It is not worth it to succumb to a serious medical problem because work or other peoples issues became a higher priority.

Saturday, February 7, 2009

SP Weight Loss to New Jersey

Good morning....this morning we have Dr. Linda Cho, a GYN physician from Bergen County New Jersey visiting with us with her staff and they will be implementing the Serotonin-Plus Weight Loss Program at their offices in Bergen County. They will be seeing some patients with me and learning more about how our weekly patient encounters are used to help people achieve their maximal weight loss.

It makes me very, very happy to see other physicians starting to get more proactive in helping their patients lose weight. EVERY physician has overweight patients in their practices, and those patients have health issues BECAUSE of the weight problem. Most physicians (not all) will advise their patients to lose weight, but very very few get more aggressive than just simply telling their patients to "eat less and exercise more". Overweight people know this already...this is not some type of earth-shattering revelation. Enacting a strategy as to how to navigate the stressful obligations of life..family, business , etc and focus on behavioral changes is very difficult, if not impossible for many. This is where the physician needs to come in and offer a comprehensive solution for their patients. Not just handing them a 1200 calorie dietary sheet.

Personally, I feel a great sense of pride that the SP Program, which I started out of my Burke office in October, 2001, is now appearing in different parts of the country...Rhode Island, Massachusetts, Southern Maryland, and now New Jersey. Helping people lose weight changes their lives, and as physicians, there is no better feeling than helping someone be healthier and happier. I want to thank all of you for allowing me to help you.

Friday, February 6, 2009

Family and friends..a sensitive issue

If you saw a family member, friend or loved one about ready to eat a food source that you knew was tainted with salmonella, you would quickly yell or get their attention immediately to stop them from getting harmed.

If you see a family member, friend or loved one with obesity, and intellectually you knew that their health was being significantly jeopardized by their weight, would you figure out a way of getting their attention and trying to stop them from being harmed?

The two examples above are very different, yet bear this similarity: you never want any illness, or even worse, premature death occurring in the people who are so very dear to you. Yet, in the first example, without hesitation, you would move swiftly and aggressively to get the person's attention but in the latter example, you find it very difficult to broach the subject. This is very common, meaning that it is a highly sensitive issue to bring up in conversation someone else's weight problems. You fear hurting the person's feelings, invading their privacy, and otherwise risking your friendship or relationship with that person. I had two patients yesterday who told me that their own doctors never told them they needed to lose weight. Physcician's are supposed to be objective medical professionals, and if some find it uneasy to bring up weight issues to a person, all of us can imagine how difficult it is to bring these issues up to our friends or loved ones.

Please consider a tactful approach to people in your lives who are important to you. Your intervention is only out of love and caring...not hurtful. You may be saving the life of a loved one.

Thursday, February 5, 2009

weight loss and set points

I have had many patents ask me whether we are born with some type of predetermined, genetically mandated weight "setpoint". These patients have told me that no matter what they do, how much weight they have lost, what diets they have tried, they seem, over time, to drift back to the same weight.

I do not believe this is true at all. What I do believe is that people develop certain behavioral tendencies as this relates to eating and exercising behaviors. At times, people will purposefully change their behavior patterns to lose weight (a "diet"), but then over time, will resume old eating and exercising behavior patterns. The weight then goes back to what they feel is some "setpoint". Yes, it is a setpoint, but it is NOT predetermined by some third party...it is determined by people's behavior patterns. Now, if we are to believe that people cannot change their behavior patterns, then there is , in fact, a setpoint. However, I believe that behavior patterns CAN be changed permanently. This is not easy of course, but most certainly possible. YOU are in control of your behavior patterns, not some unknown entity that has "preprogrammed" you. TAKE THIS CONTROL and prove to yorself that there is no such thing as a "setpoint".

Wednesday, February 4, 2009

weight loss and finish lines

Okay...I know I have covered this before but I need to do this again...the concept of a "finish line" when it comes to your weight loss efforts. I had a patient reenter the program yesterday and the main motivation was a wedding that will take place in several months. The person wants to lose 30 pounds for the wedding. Motivation? Obviously to look younger and better in the gown. Pictures will look much better, the person will feel much better about herself and others will look at her and give lots of compliments. All of this is great....BUT.....what happens the day after the wedding??? Will it be perceived that the "job is over" and now back to the same behavior patterns that caused the weight gain to begin with??? I tried very hard yesterday to have the patient see that the reason for the weight loss is a good short term one, but there are long term reasons that necessitate no "finish line" being perceived on the date of the wedding. If that finish line is visualized, the patient will in fact gain all the weight back. It is very important to look at the long term as well and regarding weight control, there is no "finish line".

Tuesday, February 3, 2009

weight loss and choices

Every day we are confronted with choices. At work, it may be a case of choosing between which project is more important and requires your attention that day. At home, you may need to choose which parent drives which child to practice that day. Personally, you need to choose where and how you spend the money you work so hard to make. Choices....every day you need to make choices and your work performance, parenting responsibilities and financial status will affected by these choices.

Some of the most important choices you can make are those that will affect your health. Right now, by virtue of you being in our program or simply reading this blog, you clearly are thinking about your dietary choices and how those may affect your weight. By focusing on losing the weigth you want/need to lose, you are making the choice to be healthier and live longer. You will look younger, feel more energy and wear those clothes impressively. This is the choice you are making. You are choosing health over the immediate gratification of high caloric food sources. You are balancing the "fun" of drinking alcohol and eating high-carb foods vs. the desire to be healthier and look better. You are making an excellent choice. Keep with it!

Monday, February 2, 2009

Superbowl....Penalty???

Great game last night...I know there are so many Steeler fans out there...congratulations!

I know that although you all watched to game in different venues...friends' houses, a bar, your house, restaurants, etc...there was most definitely one thing in common: LOTS AND LOTS of high-caloric foods and drinks. The temptation abounded and although you went into it with the best of intentions, you may have found yourself succumbing to the "mob" mentality. Then you get on the scale this morning (for those of you who garner up the courage to face the music) and say "oops".

For those of you in our program, there is an urge to cancel your appointment this week because you are fearful of the negative results of stepping on the scale. Although you inherently know that no one here gets upset or angry with you, and contrarily, we are here to support you in a very positive way, there still is the feeling of embarrassment. Those who are not in our program currently may not even step on the scale to see the bad news.

These weeks are the EXACT time to come in for your appointment or, if doing this alone, step on that scale...see the results and then formulate a plan. We get into weight trouble when we do ot monitor the weight or have no plan as to what to do if the weight goes up. Denial is a very big factor in people not doing anything about weight gain.

For those of you who stood up to Superbowl week and were successful in your weight loss efforts: CONGRATS! For those of you who had a difficult week...NO PROBLEM! Let's make it up this week with some more rigorous exercise and more careful, planned out dietary intervention.

Sunday, February 1, 2009

Why is America becoming more overweight?

Last nite we went to see an Irving Berlin musical review in D.C. a GREAT show with so many tunes recognizable from old movies...Fred Astaire and Ginger Rogers, Annie Get Your Gun, White Christmas and others. The guy was a pretty prolific song writer and I started thinking lots about my parents (both deceased) who would have just loved the show. My parents died prematurely from smoking related diseases. That was their generation...many smoked. That generation also knew little about the risks of cholesterol. As a matter of fact, when I first became a physician (this was some long time ago in between the dinosaurs and the development of rap music) the "normal" cholesterol was listed as up to 300. 300???? didn't we have any idea how detrimental this type of cholesterol number was? So, in the World War 2 generation, they smoked, they ate all the wrong foods, there was no Pilates classes, spinning classes or Washington Sports Clubs. But yet, we are heavier than them. Why??? We all know much better about the risks of obesity....we know much more about the benefits of eating low cholesterol diets, we have many more work out facilities at our disposal. How can this happen???

Multitude of answers....from the dual working parents that our generation has spawned, leaving little time for meal preparation, to the use of high-fructose sweeteners that became a mainstay in the 1950s, to the growth of fast food restaurants, to the advent of the internet which puts too many people on their asses instead of moving them...there are countless other reasons as to why America is becoming more and more overweight despite knowing more and more about the risks. Fred Astaire and Ginger were "dancing cheek to cheek" as opposed to eating high-caloric foods in front of a computer.

Last thought....pretty fascinating that a Jewish immigrant wrote the most popular American Christmas song, White Christmas. The show is great so any of you out there who have as much gray hair as me, you have 2 weeks to get to see it...Lincoln Theatre downtown.