Tuesday, March 31, 2009

Weight Loss and Recognition

Yesterday I was informed that WUSA, Channel 9, will be doing a story about our weight loss program on their news in April. We have been asked to provide a person who has lost lots of weight and is almost at his/her goal. The staff and I started thinking about all of our patients who may fit the criteria. We started jotting down lots of names but then we started discussing the concept of who would be happy to be in front of a camera and who would probably be shy.

I started thinking about how we are all different as this relates to wanting to be "noticed" about our weight loss effort or wanting complete confidentiality. Clearly, some of us are more "outgoing" in our personalities, and we have no problem sharing with the world our stories and adventures along the way of weight loss. Others are very private and do not want to discuss it.

When I started the program over 7 years ago, I was amazed that we were not getting more "word of mouth" referrals. We were sending so many people back to their workplaces, familiy etc losing so much weight , yet, they were not telling people how they were doing it. Reason? fear of failure! Although successful, they wanted to make sure the weight would stay off. If they were to gain weight back, they woiuld feel embarrassed. Moreover, some also felt they would look "weak" if they confessed they were getting help in their weight loss efforts.

Be proud of your efforts....this does not mean you need to go in front of a tv program...but please pat yourself on the back for becoming healthier, happier and taking control.

Oh, by the way, if you want to be a star and interested in the Channel 9 story, please e-mail us at: srangbar@spdiet.com

Monday, March 30, 2009

weight loss and infomercials

Yesterday before leaving for the airport, I was flipping thru Sunday morning tv and there are a plethora of "infomercials" spanning subjects from how to become an internet millionaire to how to make lots of $$ on foreclosures to how to lose weight EASILY.

One of the infomercials I stopped to marvel at was one that was all about the "SKINNY SWITCH". Seems that the spokesperson (some weight loss guru complete with blonde tipped hair and no degree behind his name) developed the "secret" to truning on the "skinny switch" that we all have inside of us that allows us to eat EVERYTHING that we want and lose weight. It had to be true! They had "real" people telling their story about how they allowed this guy to help them find the switch and some of them lost well over hundred pounds while eating their favorite foods. During the infomercial, they showed very overweight people eating spaghetti, meatballs and garlic bread, others eating cupcakes, while still others smiling and eating pizza. All of the testimonial people looked as happy as could be. They did show one woman trying to lose weight the old fashioned way...they showed her on a treadmill looking sooo miserable.

I know that my patient population has a very high intellect, so I guess you do not need to hear from me about the falsities and scamming that goes on with television infomercials. I did want to point out that people trying to lose weight are often vulnerable, and at times, we all wish there was a "magic pill" to help us lose weight. However, effort is required, meaning the conscious counting of calories, bypassing high-caloric foods, exercise etc. But the work is really worth while. And along the way, do not be tempted to spend money on "shortcuts" that you see advertised on television that make it sound simple.

Sunday, March 29, 2009

Advances in Medical Knowledge and Weight

Last night in Florida we saw a show called "Beatlemania". This was a tribute to the Fab Four, and the stars were really good...especially the Paul McCartney character. In the background at various points, there was video footage from the 60s and early 70s...the Ed Sullivan Show, Woodstock, etc. The old black and white videos were very nostalgic, and it is amazing how society has changed...the types of clothes, the style of the hair, what people would have rallies about etc. Also, there seemed to be sooo much more cigarette smoking back then. Obviously, the advancement of medical knowledge over the year as this relates to the association of cigarette smoking and early death resulted in a much less smoking society.

Our medical knowledge has adanced dramatically in other areas as well..infertility and cancer treatment, the development of new antidepressants and antihypertensives....aggrssive cholesterol control, etc. So, if our medical knowledge and product development is so much more advanced than the 60s, then why is obesity rate rising? We all know the association of weight issues with early heart disease, diabetes, etc, and data since the 60s have clearly demonstrated the association with cancers of the breast, pancreas and colon. So again, why, if we, as a society has greatly lessened the smoking rate, can we not turn the tide on obesity? Lots of reasons...to be continued tomorrow.

Saturday, March 28, 2009

Eating and addiction

I am in Ft. Lauderdale for the weekend and last night we wandered into the Seminole Hard Rock Casino. Despite the recession, the place seemed packed with eager people willing to throw hundreds onto the blackjack tables, roulette, slot machines etc. The place was really smoky...at the end of the night, my clothes smelled like I took a tour of the Winston tobacco company.

Gambling is one of those things wheree going into it, you know the odds are strongly in favor that you are going to lose money to the casino. You may win a hand, hit a good slot machine, ot throw the dice well for awhile, but if you stay there long enough, you will give back every dime, and more to the casino. They will win and you will lose. So, why do we do it?

I was thinking about this last night also in terms of all the major addictions...drugs, alcohol, gambling and eating. These are activities that can be quite detrimental, but we still persist. Obviously, for each individual, not every addiction occurs and a number of people have no addictions at all. For others, they can partake of these activities in small amounts without being "addicted" at all.

The "thrill" of a winning streak in the casino, the thrill of feeling high. the thrill of feeling a good piece of chocolate go into our mouths: all of these share some chemical basis. The neurochemical dopamine has been impicated as one of the chemicals involved in the addictive pattern. I am certain there are many other brain and body chemcials involved as well. As individuals, we are all subject to a unique admixture of these chemcials and that is why, aside from the environmental component, why some of us are more prone to addictive behaviors than others.

As this relates to your weight loss efforts, try to identify when you make the "wrong" food choices and under what circumstances this action occurs. Perhaps by identifying this, you can avoid the behavior pattern.

Oh, by the way, I was really hot at the tables!!! My dopamine levels were raging!!!

Friday, March 27, 2009

Weight Loss and airplanes

Sometimes I feel that I need to address some relatively sensitive subjects in this blog. It is not very fun for an overweight person to be confronted with situations that point out to he/she how others around them react to them. Last nite, I took a Southeast airlines flight to Florida, and this airline has "open seating", which means that the people who enter the plane first choose their seats and then the later people fill in. Of course, the window and aisle seats fill up first leaving the middle seats for those people entering the plane last. I was watching this situation carefully last night, as I was one of the first people on the plane. It was obvious that the later people boarding, would walk by the rows that had overweight people in either the aisle or window seat in that row. As the plane was a full capacity flight, only at the end would those middle seats fill in, and you could almost see some angst on the faces of the people having to squeeze into that middle seat between the overweight people on the aisle and window seats.

I believe at one point this same airline was discussing making it mandatory for a person above a certain size to purchase 2 seats.

We think about our weight issues only affecting us..meaning that the increase risk of heart disease, diabetes,, cancer, etc., lower self=esteem etc. However, at times, we get into situations when it is painfully obvious that people will react to us differently, not knowing one thing about the "inner" part of us, just based on weight. This doesn't mean that our goal to lose weight is that some person we will never see again will be happier sitting next to us on a Southeast airlines flight. It does point out though that reality is that people who do not know us at all will often make a quick judgement as to whether they want to be near us based on our weight.

Thursday, March 26, 2009

How Much Do You Want It?

I like watching movies...a great escape for me. Last night I was watching a picture and there was a scene where a football coach was rallying his team and he was asking them "How much do you want to win it all?"

What does this have to do with weight loss and this blog? Hmmmmm....well, here goes: Everyone trying to lose weight has a certain priority of reasons as to why it is so important to them. Perhaps the person was just started on blood pressure medication or was recently diagnosed with Type 2 Diabetes Mellitus, and their desire to lose weight is fear of early death of disabling medical conditions. For other people, they start realizing that many clothes in the closet do not fit anymore or they see themselves in a picture and are not happy with what they see. Some people are hitting the job market and realize that their prospects for employment woul be better if they presented themselves in a healthier fashion. Whatever the reason(s) to get that weight off, you must give up certain "fun" things that are part of your lifestyle. Maybe it is that nightly 2 glasses of wine or the nighttime snacks. Alternatively, maybe you need to set the alarm 45 minutes earlier to get up and exercise. Proverbially, there is no "free lunch" here. To lose weight, you need to plan and take control. This is work...lots of it. So, let's ask the question: How much do you want it? "It" meaning being healthy, living longer, looking younger and feeling higher levels of confidence and self esteem. I hope your answer is that you "want it" very much!

Wednesday, March 25, 2009

weight loss and the enviroment

Many of my patients have occupations that require them to travel frequently. This means hotels, airports, business dinners, etc. In essence, they feel that they lose control of the environment. When at home, thjey can shop for their food, prepare and plan meals, bring lunch, and have a schedule that is condicive for following all of the elements of our transitional dietary plan. However, when in the airport, the choices become Cinnabons or Sbarros pizza. At the nighttime business meeting, everyone is drinking cocktails. The patients feel that the environment is controlling them.

Reality: The environment will NOT conform to your desire to follow a high protein/low carb dietary plan. YOU need to take control of this environment. At every airport there will be a restaurant where, in fact, you can get a steak, chicken or seafood meal without having to do the Burger King or Sbarros choice. If you get to the airport early enough, you have the time to sit at this retaurant. Consider planning the trip, bringing our approved protein bars as snacks. At the hotel, there is that nice fitness center that requires you to get up 45 minutes earlier to use before your meetings. Take a step back and mentate as to how you can navigate around this difficult environment of travel and still follow the dietary plan that will help you lse the weight you desire. YOU have to adjust to this environment and take control

Tuesday, March 24, 2009

The Dangers of Red Meat

Today in the Washington Post main section, front page, there was a report of a study published in the Annals of Internal Medicine showing that people who eat 4 or more ounces of red meat per day have a 30% more risk of dying in the 10 years they were followed compared to those who did not. The study was performed in middle age and elderly people and the causes of death seen in the red meat eating group were attributed to cardiovascular and cancer causes. Of note, sausage, cold cuts and other "processed" meats seemed to be more causally related to the mortality.

I am not certain this news is a shocking revelation...I think we all pretty much knew going into this that chicken,turkey and fish were "healthier" proteins than a big piece of prime rib. However, this study did follow 500,000 people and 30% increase in mortality is a number that is eye-opening for sure.

How does this news interface with weight loss efforts? Clearly, if someone ate pasta and carbs and did not eat proteins, and that diet put the person in a morbid obesity range, I can assure you that the risk of that obesity would be more than the risk of eating red meat and being at an appropriate weight. We have many people who enter our program that never touch red meat at all. Obesity results in a much higher risk of heart disease, cancer, diabetes, etc...all of which will of course lower the life expectancy.

So...here are Posner's thoughts: A high protein/low carbohydrate dietary intake will help you attain your weight loss goals. The more poultry and fish/seafood you can use as part of your high-protein strategy, the better off you will be. For variety purposes and not having boredom set in, occasional red meat usage is fine.

Hmmmm...have not thrown a trivia question out there for awhile, so here goes: get the answer correct and stop by for a FREE bottle of our Serotonin Health and Energy multivitamin. (This vitamin gives me the energy to write this blog at all crazy hours that you see posted)

Ready? (And NO use of the internet to help...you are on the honor system) Red meat was probably on the table at every dinner at the Cleaver family in the old show Leave it to Beaver. Name all of the actors (their real names): June, Ward, Beaver and Wally. Email to: Potomacinternalmedicine@starpower.net

Monday, March 23, 2009

weight loss and the Girl Scouts (Part 2)

Yesterday I wrote a bit about the temptation of passing those cute little gals selling those very tasty cookies and not feeling compelled/pbligated to buy a few boxes. The problem is that at least once a week you are exiting one of those stores and you either say "no" to a poor little girl bundled up in the cold or buy boxes of high-caloric cookies that will tempt you greatly sitting on top of your fridge. I suggested yesterday just making a donation or taking them up on their offer to send them to the troops.

The other angle here is that maybe as an organization, the Girl Scouts should come up with other items that can be bought by people who are trying to address their weight. Perhaps a really low caloric snack as opposed to those really high calorie cookies. Let's expand this concept to anyone or any organization trying to raise money by selling an item. With obesity being the nation's largest health concern, social responsibility would dictate that there should be choices other than high-caloric items. We should all feel a social responsiblility to helping, rather than sabotaging, the efforts of people who are trying to lose weight.

Sunday, March 22, 2009

Weight loss amd the Girl Scouts

Pretty much every time you walk into or out of a Giant, Shoppers Food or Safeway, there are some incredibly adorable girls selling Girl Scout cookies. Sometimes it is briskly cold outside, and these cute young ladies are trying to raise money for their organization. How can one possibly walk by these tables and not buy something from them??? The way they make change is waaay too cute with their mothers helping them add numbers and make the correct change.

Perhaps the next door neighbor has knocked on your door selling these cookies and unless you want to be labeled the neighborhood Scrooge, you of course buy a number of boxes.

Okay, I admit it...there are probably 20 boxes of Tag Alongs sitting on top of my fridge at home. I have brought others into my office and leave them in the kitchen. These cookies are NOT part of any phase of our Serotonin-Plus dietary plan in case you were wondering.

Most recently, several of the Girl Scout groups offer some type of donation where the cookies you buy are sent to the troops overseas. This is a GREAT idea...or...just donate some money to the girls. It is soooo tempting to make that donation and come away with a box of great tasting cookies...or even if your intent is to give those cookies to someone else, please consider not walking away with those cookies because temptation may be heightened. Make that donation...have them send those cookies to the Troops, but do not collect boxes of Tagalongs!!!

Saturday, March 21, 2009

weight and aesthetics

Today after office hours we are attending a launch event at Bella Cosmetic Center at the National Harbor. Dr. Michael Chiaromonte is an excellent plastic surgeon and we are opening a satellite office at his center in Maryland. Dr. C. is very much into "wellness" and at the same time he offers a number of procedures that truly make people look younger he is supportive of procedures that make the internal organs "younger". Weight loss is first and foremost the best "antiaging" procedure one can do for their internal organs. Clearly, weight loss makes us aesthetically look much younger as well. Dr. C. specializes in a number of procedures that can most certainly augment the process of looking younger. I have had a number of patients ask me my opinion as to whether procedures such as botox, breast augmentations, liposuction, etc. are a "good" thing to do. My answer is this: Everyone is entitled to live life as happy, healthy and with as much self-confidence as they desire. For some people, having procedures to aesthetically change their appearance makes them happier with a higher degree of self-confidence. There is absolutely nothing wrong with this in my opinion. Of course, it is important to choose a surgeon with great experience and expertise, who additionally sets realistic expectations of outcome. Dr. Chiaromonte is clearly a surgeon who possesses all of these traits and that is why we are very happy that Dr. C. is opening his facility to Serotonin-Plus to open our satellite office in that location.

New faces at our flagship office in Burke: Donna Eckenbode is a physician assistant who joined us several weeks ago after returning from maternity leave. Donna will be seeing Serotonin-Plus patients as well as medical patients. She has an incredibly positive-energy personality and her supportive approach and clinical expertise will be a great addition to our wonderful team. On the medical side, Donna connects great especially with females of all ages, and she will be introducing a more comprehensive female wellness program than we have had previously.

Robin Halland is here direct from Johns Hopkins University nutrition program and she will be providing care to our Serotonin-Plus patients as well as putting on seminars at times. She is the most highly trained nutritional specialist we have ever brought on board and we are excited to have her be a part of our Serotonin-Plus team.

Do not let their young appearance fool you! These ladies bring lots of knowledge, empathy and support to our program and you will be very happy when you meet them. Of course, Marcus Welby is still here (for any of you who understood that line, you are laughing and for those of you who do not, there was a TV show in the 60s called Marcus Welby, M.D., and it was about some really experienced gray haired doctor who was this really great family doc) so our team is bringing you decades of experience with a youthful exuberance and energy. I cannot tell you how excited I am about our team and I think you will be thrilled with your experience in our program. Have a great Saturday and watch those calories during the NCAA basketball games!!!

Friday, March 20, 2009

weight loss and early death

Yesterday one of my internal medicine patients came in for a physical and stress test and he was telling me that his business represents a Native American tribe in Maine. He informed me that obesity is rampant on the reservation and the average life span in the tribe is 57 years. I was stunned...57??? This is a life expectancy one would expect from the 1700's when plague and other infectious diseases had no cure. The reason? Clearly some genetic predisposition to diabetes and premature heart disease but most definitely the obesity contribution is a very large contributing cause. We discussed the possibility of bringing the Serotonin-Plus program into their health clinic and this would be incredibly challenging and fun to try to make a big difference there.

We most often think of our weight problems as being more of anesthetic issue, but hearing about a 57 year life expectancy for a group of people in the United States gives us pause to think about just how important weight impacts on our overall health and chances of living a long, healthy life.

Thursday, March 19, 2009

weight loss and credibility

When we ask patients "why do you want to lose weight?", we get usually four categories of reasons: 1-health 2-vanity 3-clothes 4-energy.

Yesterday I was discussing a fifth category with a patient: professional credibility

If I was running an auto repair service company, I am not quite certain my clients would care whether I was overweight or not. If I was a chef at a restaurant, similarly, I do not think my customers would think about it for one second if I was overweight.

I don't fix cars and I don't make souffle (did I spell that correctly?) but I do run a weight loss program and it would certainly raise some eyebrows if I was markedly overweight. Simlarly, othe rphysicians that treat patients for internal medicine issues such as diabetes, hypertension etc would have more credibility in recommending to their patients that they lose weight if the physician him or herself was at an appropriate weight.

In the healthcare field, it is important that we, as practitioners, try to set an example for our patients. When I did my internal medicine residency, 3 of the 4 oncologists at Portsmouth Naval Hospital smoked cigarettes. 4 of the 7 cardiologists smoked as well. How ludicrous was that?

No matter what your profession, credibility probably does enhance when we present ourselves in a "healthy" manner. Some professions are more sensitive to this than others.

Wednesday, March 18, 2009

"I like my,,,"

Last week I had a patient who had a difficult week and he professed that one of his roadblocks is : "I like my beer." I started thinking about the things that most people like and if you ask anyone that question.."What do you like?, you will get lots of common answers and lots of unique ones. On the food side, you are going to hear lots of high calorie "likes". On the activity side, you are going to hear lots of sedenary "likes" (such as "I like to watch football")

However, the answers that you will not hear much will be these "likes".."I like to live for a long time in a healthy state"...or ..."I like to feel proud of my appearance" or.."I like to feel high self-esteem". These are the type of "likes" that drive people to pick up the phone and call us for help in losing weight or motivate them to do something about their weight on their own.

One of the problems is that some of our "likes" conflict with others.....such as the beer and the desire to live healthy and play with your grandchildren. I guess the issue is that we truly cannot "have it all" and choices must be made. For the gentleman who "likes my beer", he cannot drink 2-3 every nite and expect to live a long healthy life with his obesity. He has to make a choice.

I suggest that you explore all of your own "likes", make a priority list, and decide which of your "likes" are most important to you. This will guide you on how aggressive you want to be about your weight issue.

Tuesday, March 17, 2009

Thinking about food...

I had a new patient start the program who brought up an interesting point. Often, it is an erroneous impression for those who do not have weight problems that the overweight person "obssesses" about food or thinks about food constantly. Contrarily, the patient said that her problem is that she does not think about food at all...does not plan meals..does not think about caloric content, etc.

I was thinking about our 8000-plus patient experience and I really do think that rare is the patient who obssesses about food. The overwhelming majority of our patients do, of course, describe epsodes of cravings, but not constantly thinking about food at all. The main problem for most is not "strategizing" their food intake...allowing themselves to be distracted by personal and professional issues, thereby not prioritizing their food selections. When this happens, inevitably we find ourselves reaching for the quick and easy choices.

Successful long-term weight loss most definitely involves "thinking about food", and then planning ahead for the obstacles that confront us..whether it be a vacation, business trip, stressful work week, etc.

Monday, March 16, 2009

weight loss and "dessert"

First off, I want to thank Sean M for his comment about the cost savings involved with weight loss efforts...on the immediate basis, buying less food down the "junkfood" aisles will save $$$, but of course, the long term has a higher cost savings impact..medications that can be stopped, less time missed at work etc.

Okay...today's issue: "Dessert"....whenever you go out to a restaurant, the wait staff will always ask: "Did you save room for dessert?" Often, they actually come with a tray displaying these tasty looking dishes....from the double chocolate cake to the apple pie with vanilla ice gream to the Cream Brulee....all of them look incredibly tasty.

But the question is: After a meal, does anyone actually feel hungry? Our eyes and brain tell us that these would taste great but in reality, we do not even remotely feel the sense of hunger. We will often "share" one dessert with our partner, but even then, do we still feel hungry for even 1/2 the high caloric dessert? The answer is of course "NO!" Ask yourself how much treadmill or spinning class time will be necessary to burn off that dessert. Is it really worth it to eat that item that you have no hunger for?

Try as best as possible to respond to hunger signals as opposed to learned behavior signals. If you do, you will most certainly say "no" to that dessert.

Saturday, March 14, 2009

"I Can't Afford it"

The recession is taking its toll on all of our retirement accounts and to a large extent our sense of security. Collectively, trillions of dollars have vanished and the stark reality is that we will all have to continue working for more years than we anticipated. Moreover, as the baby boomers remain in the workforce, this will create less jobs for their childrens' generation. A bleak picture, but reality. Probably all of us are evaluating where we spend our hard earned money and ensuring that we are putting this money to the best usage.

Yesterday I had a very nice woman, around 60 years old, who walked into the office requesting a consultation about the weight loss program. She had multiple medical problems, including a number of risk factors for heart disease. She seemed quite intrigued about the program, but when the subject of price came up, she very quickly determined that she could not afford the program. Of course, we respect everyone's financial situations and I gave her some resources that may help her even though she was not going to do our program.

I started thinking a bit about the relative worth of things. For instance, if you were home, and some one offered to sell you a glass of water for a dollar, you would think that is crazy. However, if you were marooned on a desert, about ready to die from dehydration, you would basically give all of your money for water that would save your life. If someone guaranteed that you would live healthier for 5-10 more years than what would be otherwise your natural course in life, what would you will be willing to pay for that? The answer, for most people, would be lots and lots of money.

I guess the above discussion gets back to the concept that when you make a decision to invest in your health...either for screening such as a physical, colonscopy, etc. or spend money on something like weight loss that is almost guaranteed to make you healthier (and happier), this is one of the best investments you can make. In the case of the cost of our 12-week program, if the woman had placed this on a credit card, it would cost her less than 50 dollars a month (if financed over 3 years) to lose over 40 pounds, and that weight loss would stand a great chance of allowing her to live 3 years or more longer in a better state of health.

Part of human nature is to look at things "short term". Looking at the big picture is sometimes difficult, but from a health standpoint, your focus on losing weight is truly one of the best investments you can make. You see what has happened to our money in the stock market and real estate. Whether it be a screening heart test, paying for a personal trainer, or coming to see us, there is no better investment now than investing in yourself.

Friday, March 13, 2009

weight loss and exercise

Each week will have a certain amount of caloric expenditure. If you have a very busy work week, are basically at your desk and have no time for exercise, you of course will burn off many less calories than if you had the time to hit the gym 4 times that week. If you do not adjust your caloric intake to offset this lack of burnoff, you will have difficulty losing weight, and may in fact, even gain weight that week.

Obviously, in a perfect world, you would have plenty of time to exercise, but things are never perfect so there will be challenging time constraint weeks. Please make sure that you lower your overall caloric intake those weeks and that will help you continue to lose weight despite the lack of exercise.

Certain people have orthopedic limitations that preclude aggressive exercise. I would strongly suggest that you hire for a personal trainer for a few sessions to help you learn how to maximize your caloric burnoff despite the orthpedic problems.

Have a great weekend!

Thursday, March 12, 2009

weight loss and physicians

Some things really do not change very much. During medical school and my internal medicine residency, we basically learned nothing about helping people to lose weight. We, of course, were taught about the causal relationship of weight problems to heart disease, diabetes, arthritis, hypertension, hypercholesterolemia, certain cancers, etc. We basically saw our mentors hand overweight patients diet plans or tell them to go to Weight Watchers, but little else was done to intervene. This was 1977-1984.

Fast forward to 2009. Posner has lots of gray hair, The Bee Gees are not on the radio every other song, and now the government is the major investor in car companies and banks. Lots of change. But, not in the physician's training/approach to weight loss. I was invited to give a Medical Grand Rounds talk to the Portsmouth Naval Hospital medical staff which is very exciting for me. I have not been back to the place I did my residency and they have built a new hospital since I left. Apparently, there is still virtually no "training" in helping people lose weight during the residencies.

Preventing major medical illnesses such as heart disease and diabetes is so much better than having to treat the sequelae of these life-altering diseases. If the epidemic of obesity can be reversed, millions of lives will be saved, quality of life would improve, and multiple billions of dollars could be saved. It starts in the school system teaching children about nutrition and the risks of being overweight, it continues at home where as parents, we should be more vigilant of our households' nutritional approach, and certainly in medical schools and residencies, young physicians should be given much more training in helping people lose weight. I appreciate very much the physicians in charge of the Grand Rounds at the Naval Hospital giving me the opportunity to educate some young physicians.

Wednesday, March 11, 2009

weight loss and failure

Just got back late night from our New Jersey grand opening launch event in Bergen County. It was very successful...lots of attendees and great interest. This morning I noticed a posting comment from a patient of Dr. Cho's who asked: "How do I handle it when all my co-workers are eating lots of stuff around me and what happens if I fail?"

Concerning the first issue, "control" is a very large part of any weight loss strategy. When we feel that we lose control, it is virtually impossible to follow the dietary intake necessary to lose weight. You can bring your meals/snacks to work or if there is a workplace eatery, pick the choices that are proteins and vegetables. On Sunday, write out your mealplan for the week and "script" this so you have a good gameplan. If others around you are choosing an unhealthy life-style and choose to remain overweight....feel tired, not feel happy with themselves, etc..why shoudl this affect you? YOU take control of your life and by doing this, you will he healthier and happier. Concerning "failure", that is NOT going to happen if you follow our transitional dietary plan. POSITIVE thinking is very important as well. You WILL lose weight and look younger, have higher self-esteem, look more youthful, be healthier, etc.

Monday, March 9, 2009

weight loss and restaurants

This weekend we went to dinner with some friends and one of the ladies is in a weight losing mode. The menu at the restaurant did not have a dish that she felt was compatible with her dietary plan, and she asked the waiter if the chef could prepare a special fish dish for her. GLADLY they said...and then went on to bring out a wonderful dish that was completely in synch with her needs. Point here: do not be afraid to ask for a specially prepared dish if the menu doesn't contain choices you are happy with. Most restaurants (especially in these difficult financial times) are happy to accomodate your needs.

On a separate note: I am in New Jersey attending a grand opening of a Serotonin-Plus Weight Loss Center that is opening in a Bergen County GYN doctor's office. Dr. Cho and her staff are very enthusiastic and they are going to help lots of people in this Northern N.J. area lose weight. Tomorrow nite they have a "Launch Party" and I have been asked to be there to discuss the program to a number of their prespective patients. We now have physicians in Massachusetts, Rhode Island, Southern Maryland and now New Jersey doing our program! It is really fun for me to see our program expand to help other people outside the D.C. area. The really cool thing ("cool"..what a term from the 70s) for me is that my personal participation with the national expansion is limited allowing me to be right where I want to be...in my Burke clinic taking care of my medicine patients and Serotonin-Plus patients. Be back tomorrow!

Sunday, March 8, 2009

weight loss and vacations

Many of us are planning our summer vacations and if you are in a weight losing mode (if you are not, why are you reading this blog???) then take a step back and think about the type of vacation that may be more conducive for your efforts. For instance , the "All Inclusive Resorts" encourage a drink-a-thon and eat-a-thon mentality....you are paying one price whether you abstain from alcohol or drink until you are dancing the conga line with people who would otherwise scare the daylights out of you. The buffet meals include a dessert bar....you paid for all of this and to not partake would be throwing your money away. Crusie ships are sort of the same concept.

A vacation at a nice resort that offers spa amenities, fine dining (paying ala carte ), swimming, etc may be a better choice. Or perhaps a "touring" vacation where you will need to walk lots to see the sights. Pick a destination or type of vacation that is not based around eating. And if you go to one of my favorite spots, Las Vegas, NO MIRAGE BUFFET!!!

Saturday, March 7, 2009

weight gain, embarrassment and accountability

Yesterday morning I had a cobversation with a patient who had a difficult week and she told me that she was very tempted to cancel her appointment but then decided to "face the music". Of course, she knows that we would not be "judgemental" or "admoish" her for a weight gain, but like so many others who gain weight during a week, there is an embarrassment factor that occurs.

Of all the times NOT to cancel an appointment is when you have had a challenging week. That is EXACTLY the time to come in to chat, reflect on the events that caused the difficultites sadhering to a sound dietary plan and moreover, what to do to prevent this from happening futuristically. We are here to HELP you through these challenging times and HELP you get back on course. Please do not feel that we are in any way "disappointed" in you.

Off to take Tsnner for a run in the dark!

Friday, March 6, 2009

Never too Old..Never Too Young

Every day I have the great fortune of seeing so many wonderful people and also having the opportunity to help them achieve their weight loss goals. Yesterday, I saw 2 patients who have achieved remarkable results, and their age difference spanned over 5 decades. One was a younge gentleman in high school who has lost over 100 pounds in our program. His entire demeanor has changed. When he first came to us, you could almost feel the depressive cloud above his head. Now, he exudes a positive attitude, an incredibly higher self-confidence and an overall energy that is now extremely high. The other patient I am referring to is in her mid 70s, and she has lost almost 50 pounds with us. What is remarkable is just how much better she is able to move around. Upon presentation, the arthritis issues and the weight basically made it almost impossible to get up on the exam table without help. Now, she very spryly hops onto the table. Similar to the young gentleman, her attitude is positive and her energy is upbeat.

I guess the point here is that it is never "too early" or "too late" to embark on weight loss efforts. From a health and emotional standpoint, dramatic improvements will accompany that weight loss no matter what the age!

Thursday, March 5, 2009

Weight Loss and Restaurant Choices

Last night we went to dinner at Friendlies Restaurant. The menu was full of really fun choices...waffle fries with cheese, "fronions" (a combination of fired onion rings and french fries) cheese sticks, very large cheeseburgers, and their special of the week: "ALL YOU CAN EAT" fried shrimp (with fries) and if you ordered that, you get a FREE ice cream sundae!

If you were in a mode to GAIN weight, this restaurant is a GREAT choice to help you achieve your goals. However, if you are trying to LOSE weight (and if you are reading this, then chances are pretty good that you are) then this is a very BAD restaurant choice.

In no way do I advise our patients to avoid eating out...we actually encourage it. When boredom sets in, the next step is usually a "give up" mentality. We want you to look forward to weekends when you can perhaps dine out, meet friends, break the routine, etc. The poiint here is to choose the right restaurant to allow you to enjoy yourself, yet not be faced with a menu full of choices that will hurt your efforts. Perhaps a steak/seafood place...have a really large steak or (not fried) shrimp dish...salad to start or seafood appetizer...side order of steamed vegetables..sorbet for dessert or some berries...this makes for a great meal and will not at all hurt your weight loss efforts.

When planning your meals out give good thought to the menu choices and remember..it would take you at least 1.5 hours of intensive exerice to burn off a Fribble (milkshake) that would take you 3 minutes to drink!

Wednesday, March 4, 2009

Take care of "YOU"

When you travel on the airlines and the flight attendant gives you the canned preflight instructions you are told that if cabin pressure drops and the oxygen masks come down, you should put the masks on yourself first, then help your children. The reason for this is that if you do not keep yourself awake and strong, you will not be in any position to help your children or anyone else around you that does need your help.

Okay, what does this have to do with weight loss??? The answer has nothing to do with not eating the bag of peanuts. The analogy here is this: If you have let your weight become problematic because you are too busy taking care of your family, taking care of issues at work, taking care of everyone else's issues, then you have put yourself in a precarious health situation. Not paying attention to yourself may result in an unhealthy situation which puts you at risk for a number of very dangerous medical problems. And if God forbid, one of those problems occurs, you will be in no position to help your children, elderly parents or anyne else that still depends on you. So, the message of the day: TAKE THE TIME TO TAKE CARE OF YOURSELF. This means thinking about your own dietary needs to lose the weight, making time to exercise, planning your meals etc. This is not being selfish...it is a necessary step to ensure that you will be there in the future.

Tuesday, March 3, 2009

weight loss...the small things....

Sometimes, effective weight loss efforts requires paying attention to even small things that may interfere with reaching your goals. Fruit juices, such as cranberry or orange juice seem innocuous...certainly it is not looked at as a candy bar. A handful of almonds is most definitely not an ice cream sandwich. A "protein bar" purchased from the local GNC is not a Three Muskateers bar.

However, all of these aforementioned items are caloric containing products that may slow down your weight loss efforts. The "obvious" sources...candy, cake, sodas, alcohol, etc. have red lights blinking behind them. However, a number of other "daily" foods and drinks can be damaging to our efforts.

Try to make it a habit to look at the nutritional information on any product you consume. If you see that a beverage contains over 50 calories in 12 ounces, consider not using it. If that protein bar has greater than 150 calories, find a different one.

Pay attention to the small details...this will be helpful in your overall efforts.

Welcome aboard to Donna Eckenrode, PAC. Donna is a physicians assistant joining our team. She is very excited by the weight loss program and is very anxious to meet our patients.

Monday, March 2, 2009

Snow and Weight

The snow is falling, school is cancelled so children are home and your work has a liberal leave policy in effect. Some people (teachers) LOVE the snow....others despise it. Whether you like it or not, you are home for the day. Computer time, check your e-mail, perhaps you have some business work to take care of, play with the dog, take a walk in the snow, but at some point you may have some cabin fever and feel boredom setting in. WATCH OUT!!! Snow days are notorious for producing what I call "Boredom eating'. Sometimes, we find ourselves wandering over to the fridge to check things out. Or, we want to become creative and make some fun dessert or dish to eat. Try very hard NOT to let the day become a high-caloric day. If you have some exercise equipment at home, make use of it! If you are going to exxperiment in the kitchen, think of novel and unique low-caloric foods you can prepare. Also, take the time to plan out your weeks snacks and meals. Try to not let the snow day hurt your weight loss efforts, but rather, try to make use of this day to make the effort more aggressive!