weight loss and challenging yourself

First, to my well-wishers thank you very very much for the very kind comments...especially Heather...a very wonderful thing for me to start the morning was reading your comment.

Challenging yourself...this is something that makes us attain better things in our lives...from challenging yourself to perform better in school to challenging yourself to read more to challenging yourself to work harder than others...all of these make us more fulfilled and probably more admirted both self and others...

Challenge yourself to become healthier....it is no challenge to succumb to eating high caloric food sources when others are as well...it is no challenge to drink cocktails when everyone around is imbibing...it is no challenge to remain in bed rather than getting up to exercise....

Challenge yourself to reach your weight loss goals to become happier and healthier

weight loss and age

Okay...kind of a sensitive issue for me as I turned a year older yesterday, but a few words about the "aging process" as this relates to weight control.

Entering college at 17, i was 155 pounds and ate easily about three times the amount of calories I do now. I did not exercise everyday back then and now, age 54, I exercise daily, eat much less calories and weight 20 pounds more than I did in college.

As we get older we all notice that metabolism slowdown and in order to maintain weight control, we must adjust our eating to account for this. Women get especially hit with this issue, as their metabolism slowdown, in most cases, is much more pronounced then men.

Sometimes we have new patients who come in that state they want to get back to their college weight. This is not a realistic goal in most cases because of the aforementioned metabolism changes.

As time moves forward, to maintain weight control we actually need to be slightly more aggressive each year on our portion control to account for these metabolism issues.

And for those of you wondering, 54 is the new 53...

weight loss and ability to exercise

First, thanks MM for the very nice note and the inspirational thought to everyone that one of the great by-products of weight loss is being able to move around better...from being able to get in and out of a sitting position, to fitting into an airline seat to manipulating thru a busy convention floor to being able to run 5K, 10K or even marathons: weight loss is incredibly effective in achieving these...

Being able to exercise more/longer further contributes to the positive cycle as being able to do more allows fofr more caloric burnoff which in turn causes more weight loss. Quite frankly, at a high weight, the thought of exercise is abhorrent in many cases because it is very difficult...but weight loss causes the exercise to become easier.

Schedule that exercise time...3-4 times a week...the more you do, the more weight loss you achieve and the happier and healthier you will become!

weight loss and aesthetics

First a funny side note....yesterday i had horrible laryngitis...couldnt speak..had to whisper to everyone....the funny part is that people would whisper back at me....So yesterday I provided the sequel to Redford's Horse Whisperer..I was the Patient Whisperer....

We had a booth at an aesthetic convention here at the Gaylord hotel over the past several days. The conference was for plastic surgeons and other aesthetic physicians whose practices are focused on making people look younger, healthier and more appealing.

We were the only weight loss opportunity on the show floor....there were more liposuction machines, vaginoplasty tools, laser machines than you can count. Of all the things that make people look younger and healthier weight loss is A-Number 1, yet, Serotonin-Plus USA was the only company imploring physicians around the country to focus on helping patients lose weight.

Sucking out fat and lasering hair off does not make a patient lessen their risk of weight related co-morbidities such as diabetes, heart disease, pancreatic, breast , and colon cancer etc. Yes,, these procedures can make a person look better physically but does nothing for the internal organs.

Anyway, just an observation...the medical profession does need to get involved more with helping Americans lose weight and I am proud that Serotonin-Plus USA is getting the message out there.

weight loss and routines

Many people are very routinized in their daily activities....awake the same time, eat a certain type of breakfast, put on the same news show, drive the saame route, answer e-mails the same time, etc...The entire day is almost scripted out the same way to a large extent. Changing this routine is difficult from a practical standpoint, as there are only so many hours in the day and if things are added on, then time needs to be subtracted from other routinized activities.

Okay..you know where I am going with this: Exercise...if your routine does not include daily or every other day exercise, it is very difficult to incorporate this. Now, if you knew you could get a free massage 4 times a week for an hour, chances would be pretty good that you would figure out a way to alter your routine to allow for the one hour 4 times a week. Exercise? we will often find lots of reasons (well, more like excuses) as to why you cannot break the current routine to find the time for exercise.

Whether it be a routine of excluding exercise or a routine of snacking on some high-caloric food at nite, examine your routinized behaviors and see what you can do to change things up to allow for your pursuit and reach of your weight loss goals.

weight loss and confidence

Over the past several months I have had several new patients enter the program and their major motivation was the fact that they were trying to get back into the workforce after having been previously laid off and they felt they would be seen more favorably at a healthier weight.

When we look our best, we all tend to have a heightened confidence level that translates into carrying ourselves more confidently. Whether it be interviewing for a job, trying to get a promotion at work or even on the personal front of seeking a relationship, when we are able to reach and maintain a healthy/confident weight, many apsects of our lives will improve.

weight loss and clothes

Certainly one of the fun byproducts of your weight loss is being able to go into that closet and start wearing outfits again that did not fit previously. When I query patients as to why weight loss is important to hem, aside from the health benefits and reduction of comorbidities, women more frequently than mn will identify clothes concerns as a major reason.

Confidence and self esteem rise as we lose weight, and this transforms into the ability to wear clothes that "show us off" as opposed to clothes that "hide". We all have favorite clothing items that just look better when we are able to wear them at a healthier weight.

Looking younger and being able to wear the more fashionable form fitting clothes is another positive byproduct of your weight loss efforts.

And....do not forget...JUNE 19, SATURDAY 3PM is our Serotonin-Plus Fashion Show..brng those clothes that do not fit you anymore because of that great weight lossand donate them to a great cause.

weight loss and decisions

We make many decisions daily..from the clothes we will wear to the rote we will take to our destination....we make many many decisions everyday....some of those decisions will impact our health and we tend to usually make decisions that will not place us in harm's way....for instance, we would not stand too close to the edge of a cliff....we would not put ourselves in front of ongoing traffic.....then why do we make decisions that put us in harms way as this relates to eating decisions? The answer can be found I believe in the instinctual nature of humans...we are geared to eat high calories and to not do so requires the intellectual part of our brain to rise above the instinctual part.....

Take a step back and try to allow your decision making as this relates to food intake be in lign with all of your other decisions you make to keep you healthier.

weight loss and the medical profession

Okay, today I need to vent a bit about a subject that really annoys me sometimes...and that is the approach that some of my collegaues have to helping their patients lose weight. Yesterday I saw in followup a patient who entered our program last week and she had an abnormal EKG. I did not prescribe phentermine, recommended that she have further cardiac workup but I did start the serotonin and Phase 1 of our dietary plan, neither of which would adversely affect any potential heart issue.

The patient went to her primary care physician to initiate the work up and right off the bat, the guy tells her the serotonin is not safe and she should stop the program entirely. The patient of course was perplexed and confused because she has one physician (me) telling her its okay to sytart the supplement and Phase 1 and her own doctor tells her it is dangerous.

This is not an isolated case....all along the way over these past 8 years, when I do a consultation about our program and the patient tells me that he/she needs to go back to their own doctor to get their opinion, I laugh to myself because I know there is no way that patient ever comes back. Why? Because upon hearing about the elements of our program, most (not all, as we do ahve a number of referring doctors who "get it") doctors will tell their patients 'Phentermine is not safe and neither is that serotonin". These same physicians do NOTHING to help their own patients lose weight, and if they did, then we wouldnt have their patients coming through our doors to either sytart our program or find out more about it. A doctor handing out a 1200 calories diet sheet and telling their patients to "eat less and exercise more" is not obviously a time-tested effective measure.

I guess like any other profession, physicians will be "territorial" about their patients and not want them going to any other doctor for "help" unless they do the referring themselves. I guess it is a bit of a slap in the face when a patient has to look elsewhere for help that could be provided by their own physician. The same physicians who are prescribing boat loads of blood pressure, cholesterol, diabetic pills etc. to their overweight patients are fearful about a supervised weight loss program where patients are being monitored weekly? Give me a break.

I strongly believe that we, as physicians, need to play a more active role in weight loss efforts for our patients rather than nay-saying others efforts.

weight loss and fod availability

I know we have covered this topic before but yesterday I saw several patients who voiced similar complaints and I felt this was worthy of discussion again: The concept of having food sources around the house that would be tempting and would most certainly derail weight loss efforts. The patients themselves were not purchasing and placing these challenging items in the house...rather, the spouses were doing this.

I recommend that when you are in a weight loss mode, talk to everyone around the household and ask for their support. Part of this support is NOT having challenging food/snack items out in the usual, open places. You are not asking them to not partake of these food sources themsselves, but rather that they not be in eye's view for you. When it comes to freezer items such as ice cream it is difficult to not have this visible. However, if it is the case that other members of the household have weight control issues, it is not unreasonable to just keep those food sources out of the house completely.

Working with the entire family unit and asking for their support to allow you to become healthier and happier can be very helpful with achieving these long term goals.

weight loss and old behaviors

I had a medical patient come in last night who was "fired" by his endocrinologist because the doctor was really upset at the patient for not doing self-home glucose monitoring. The patient has pretty poorly controlled diabetes mellitus and is morbidly obese. Previous attempts at weight loss, including our program, failed to achieve significant weight loss for him.

I had not seen him in awhile, as his diabetic care was being taken care of by the endocrinologist. We started discussing some of the issues involved with his poor compliance with self monitoring and it became apparent that he has a pattern of behaviors that are "routine"...skipping of breakfast..snacking on carbs...not focusing on a high proterin high vegetable/low carb low fruit intake...no exercise etc. Clearly the behavior patterns are fixed and unwavering. Obviously I tried to convince him that this behavior pattern, as comfortable as this is for him, will most certainly either prematurely kill or maim him.

If you are in a weight losing mode, I would ask you to examine your own "routine behavior" patterns and take a step back and explore which of these behaviors may hurt you, and then make a conscience effort to change that behavior permanently. This is not an easy task, but a neccesary one to become happier and healthier.

weight loss and resolve

When it comes down to it, being able to lose weight and maintain that weight loss requires lots of resolve on your part. The path between your current weight and the weight that would make you the most healthy and happy is a treacherous path. The example I give is like walking a tightrope on your journey. At almost every step of the way, there will be external forces and internal forces trying to knock you off the tightrope. Externally: well-intentioned friends or family members who implore you to eat food sources that will derail your efforts .."Oh come on, you look great,....you are getting too skinny....a little bit cant hurt you..." Internally: old instinctual and learned behavior patterns that make us want to reward ourselves with food sources.

You must have the resolve to "stay the course" and keep walking along that tightrope..do not allow the external and internal forces to sabotage your efforts. The pot at the end of that rainbow is a great one...being healthier, looking younger, having more energy, wearing those clothes you want to wear etc.

weight loss...men vs. women

We often have husband/wife teams come into our program at the same time and there is often much frustration on the woman's part as to how fast the man loses weight compared to the female. Clearly there is a marked metabolism difference (in most cases) in men vs women in that the male seems to be able to consume many more calories and still exhibit heightened weight loss.

Men have more muscle mass and as muscle burns more calories than fat, this plays a large role in the differences noted. The androgen vs estrogen difference also results in a different metabolic rate, with androgens (testosterone) producing a heightened muscle development and inherent metabolism difference.

I try hard to alleviate the frustration (sometimes it is downright anger!) by explaining these differences to the couple and reassuring the female partner that weight loss is not a "race'....we all will lose weight at different rates, even eating the same exact amount of calories/portions. Adhering to a high protein/high vegetable-low carb/low fat strategy will allow the weight to come off briskly even for females. No competition!

weight loss and ease of movement.

From the bending down to put on shoes and socks to the movement onto a exam table to walking down an airplane aisle, moving is most definitiely impacted by the weight status. I have many patients tell me that when subtsnatial weight loss occurs, one of the better by-products of this weight loss has been their ability to move around much more easily and gracefully.

When the weight loss occurs in our program, we notice the weight coming off all areas, including the hips,butt and legas which make it easier to ambulate and to deftly move through tighter areas.

Yet another wonderful aspect of weight loss!

weight loss and soft drinks

Yesterday I saw a fullpage ad in the Washington Post showing the major soft drink companies moving sugar-free drinks into the schools replacing the current selection of sugar-containing beverages. This was a joint ad by the Coca-Cola, Pepsi and Dr Pepper companies. They were showing their responsibility as this relates to making decisions for school age people as opposed to allowing them the choice of the sugar-filled drinks.

As parents or spouses, sonsider the same repsonsibility: If you are doing the shopping for the household, do not allow those sugar filled drinks into your residence if you have any people with weight control issues living with you. Childhood obesity and adult obesity are the two most major health concerns in this country. Eliminating sugar containing drinks is a relatively easy way of ridding pounds without much effort. Personally, I lost 19 pounds 17 years ago by just getting rid of those cokes.

At the store, make your selections for your family healthy and responsible ones.

weight loss and happiness

First: to the issue of white wine and cooking.....once a week does not sound like a derailing event...sipping out of the glass nightly will!

Okay...to the subject this morning...does your weight loss bring a heightened level of happiness?

I suppose I do not see the entire cross section of overweight Amerifcans because by definition, people coming to our clinic are not happy with their weight and that is why they are taking time, effort and spending $$$ to have us help them in their quest. One great outcome of watching people lose weight over a three month period is observing just how much energy and happiness they exude over the course of the program.

For many, being overweight carries along with it medical co-morbiditiess requiring meds and doctor visits, unhappiness with the appearance, lower energy levels, low self-esteem and confidence etc. As the weight comes down, all of these issues improve and all told, the general level of "happiness" improves greatly.

So I do suppose for many weight loss increases levels of happiness. Short term a high-caloric food source may bring a brief moment of elation, but for the long term, weight loss kicks ass on a piece of chocolate!

weight loss and alcohol

Previous entries here have raied against the use of alcohol as this lingestible liquid really derails weight loss efforts. There is something more damaging than the calories contained...there is something about alcohol that skows down metabolism,

Social functions nand vacations ntend to be the most harardous environments for the use of an excessic=ve amoiunt of alcohol.

Certainly a light wine will do much less damage than a Pina Colada. Downing a 6 pack of beer damges more than 2.

Try to NOT build your vacations around alcohol (such a s touring wib=ne country vacationa) andmost certainly do not put yourselves in all incluive reorts where you maty drink as much alcohol and eart as much food as you want.

Keeping alocohol to a bare minimum will help your quest to be healthier happier, younger and better about yourself

weight loss and routines

We, as human beings, tend to be quite "routinized" in our behavior patterns. Remember in college in the lecture hall? Did you always seek the same seat? Which sock do you put on first in the morning? Do you have coffee always before work? Do you watch the same shows weekly?

Many of us (certainly me included) are very routinized in our ways and this translates as well to our eating and exercising behaviors. Some people routinely have to snack before bedtime...some people routinely arise every morning and work out. Some routinized behaviors are derailing to weight loss efforts and others are much more conducive.

Examine your "routinized" behaviors as those relate to your food ingestion and exercise behavior patterns. Try to change those routinized behaviors that thwart your weight loss efforts and try to build on those behaviors that support your quest to become happier and healthier.

Changing routinized behaviors is difficult, yet for long-term weight loss it is necessary to achieve your goals.

Weight Loss Book

The Serotonin-Plus Clinical Staff is coming out with a book about weight management. Donna Eckenrode, PAC has written a number of chapters and in charge of working with the editor, designer and printer to have it ready by the end of May. Julia, our expert RD and I have also written chapters. Our new Medical Director of the national expansion, Laura Balda, M.D. wrote the chapter on childhood obesity and the L. Araba Sam, M.D., who is our partner in our Ft Lauderdale practice wrote the chapter on African Americans and weight control issues.

This book will be a reality book about weight management. So many books about weight loss are marketing-hype books professing to have some easy, no-work required approach to losing weight. The title usually includes the word "DIET" at the end, and as all of you know, Posner always tells people that the "D" word is not allowed....a "Diet" implies a start date and an end date....to lose weight and keep it off requires a life-style change, NOT a diet.

Please circle the following dates: Friday June 18 and Saturday June 19. We will be having book signings with all the authors and contributors those days...Friday late afternoon at our office and Saturday June 19 at our Fashion Show for charity at the National Harbor. Please come out to both events!

weight loss and corporate responsibility

Yesterday there was a comment to my blog about salads describing the chain Panera now listing calorie contents of foods and offering up a number of lower caloric choices. EXCELLENT! This is showing a responsibility to society as opposed to just making it all about the $$$.

Soft drink companies removing soda machines from schools: GOOD

Fast food companies offering toys/childrens movie paraphrenalia with the purchase of the "value childrens meals" : BAD

Bistro restaurants offering "free dessert" with the purchase of certain meals: BAD

I believe with enough ingenious thoughts from their MBAs and marketing people on staff, most huge companies offering food services to America can find the right way of making $$$ and yet not killing Americans...

It is kind of sad to say, but there is a truth here: We do need to be protected against our own destructive behaviors at times, and aside from personal responsibility to make the "right" food choices, we cannot be incentivized to make the wrong ones.

weight loss and salads

The concept of a "salad" usually involves a bowl with various vegetables, some dressing and perhaps a piece of protein.

When the salad contains numerous croutons, a high fat cheese, a high fat bacon , avocodo, and a thick creamy dressing, all of a sudden this "salad" has turned into a high-caloric derailing meal.

Fast food restaurants offer in many cases a very high calorie salad but you are made to believe you are making a healthy choice. Do NOT be fooled...stay away from fast food restaurants and their salads.

High grade vegetables, chicken/tuna/salmon, a lite dressing...this is a healthy choice.

weight loss and investment

We all spend money on "necessary" things...house payment, food, clothes, children's schooling needs etc. We also spend "discretionary" monies on recreational things, such as eating out, hobbies such as golf, vacations etc. We make decisions all the time as to where to direct our hard=earned money.

What is it worth if you could "buy" living for more years free of disease processes such as heart disease or diabetes? What would it be worth to you to look and feel 10 years younger? What price would you pay to be able to wear those clothes in the closet that no longer fit?

The answer for most people: Those above mentioned things are worth LOTS.

Whether it be investing in a piece of gym equipment for your home, hiring a personal trainer, or even entering a weight loss program such as ours, your investment into your own health and happiness is the very best investment you can make.

weight loss and Cultures

I am down in Southern Florida today for the launch event of our Ft Lauderdale Serotonin-Plus Weight Loss Center. This will be in the offices of Dr. L. Araba Sam, a prominent GYN physician in the area. Dr. Sam is Head of Robotic GYN surgery at a local hospital and mentors other physicians on this procedure. She is a well-known physician who is co-authoring the chapter in our soon-to-be-released weight loss book about African Americans and weight control.

I grew up in a Jewish-culture household where you were made to feel guilty if you didn't eat all of the food placed in front of you by your little Jewish grandmother. At gatherings, bountiful amounts of high-caloric foods were present and EVERYONE ate much more than their hunger levels. From matzoh balls to potato knishes to seven layer cakes, thousands of calories were consummed.

Eating lots of food however is not limited to Jewish families. My Italian patients and friends tell me that a large part of the culture is based around family gatherings where tremendous amounts of foods were cooked and eaten.

But I believe that EVERY heritage and culture shows LOVE and NURTURING to the people of that culture through the use of food. It is almost instinctual to "care" for family via feeding them.

Particularly in the African American community, weight issues are producing a grave prognostic medical situation. With 86% of the female African American community overweight and 68% obese, the ramifications medically for severe co-morbidity development is ominous. The rate of heart disease, diabetes mellitus, breast cancer and other life-threatening medical conditions asociated with being overweight will rise exponentially.

I would ask everyone, regardless of culture, religion, or race to reinvent your family gatherings to include many more healthy choices and try to separate the love you have for your family from thje need to feed into weight problems. When you take a step back and think about it, if you are encouraging high-caloric foods to your overweight relatives, you are actually hurting them, not showing them love.

weight loss and support

Last night I attended the group meeting that occurred in our office Tuesday evenings. Kymberly Posner was the group leader and over the past number of months a small group gathered at the office to discuss issues that may be supprt/help for members of the group to share.

Along your pathway of weight loss, finding a person/people who are similarly sharing this mission can be very helpful. Support both logistically (exercising together) and psychologically are both vital elements that can enhance a person's weight loss efforts. When we feel "alone" in our efforts, the journey is often more difficult.

Seek out others who you know are in a weight losing mode and offer supprt systems...occasional meetings, forming an exercise group, sharing recipes, etc. Having support will make your weight loss efforts easier and more successful

weight loss and snoring

It seems that this pertains more to men than women, but it is clearly the observation of most that when weight loss occurs, the quality of sleep improves. One of the symptoms that markedly improves is snoring.

Obstructive sleep apnea is secondary to excessive soft tissue (fat) in the neck area and this can obstruct the breathing mechanics. This leads to episodes during the night when a person cuts off their breathing, leading to the deep breathing and snoring that start occurring. Often, the affected person is unaware of this process, but most certainly the person's bed partner does.

Because the quality of sleep is being disrupted, the affected person may exhibit chronic fatigue and daytime somulence.

Losing weight improves the mechanics of the breathing process, improve the quality of sleep which leads to heightened energy. Yet another great reason to stay focused on your weight loss efforts!

weight loss and counting portions

Losing weight requires "work"..gainign weight requires no work at all. When I say "work" I mean that to lose weight, one has to consciously count portions, avoid certain food and beverage sources, not skip meals, get much protein in, exercise etc. One has to plan their meals, mentate how to handle business trips, meals in airports, etc.

Sometimes when I provide a consultation about our program, the listener will bristle when i say that our food intake is a "counting portion" program. I sometimes will hear "that is too much work".

Sorry, but the reality of losing weight is that IT IS WORK. There are no "easy" ways around this...not a magic pill, not a miracle supplement, not a wonder book with a cartoon and funny title to read...

But the "work" is soooo worthwhile....feeling more energy, looking yopunger, ridding yourself of certain medications for co-morbidities, finding your self esteem return....all of these are well worth the work required to achieve these.

weight and Easter

A very Happy Easter holiday to everyone. A great day to be around family and celebrate the holiday.

Traditionally, there will be many food sources appearing that will not be helpful to your weight loss efforts. If you are preparing the feast, please keep a sensitivity that many around the table may be in a weight control mode so please provide alternatives that will not derail their efforts. HIgh protein choices and vegetables are conducive to the mission to lose weight.

If you are attending someone else's feast, make the smart choices. Remember at all times that you have placed a priority on being healthier, looking younger, having higher self-esteem etc., but to get there you need to NOT give in to food sources that will derail your efforts.

Being around the people you love is what the holiday is truly about. The high-caloric food sources that are available have no love for you and you can easily say "no" to them.

weight loss and self-confidence

One of the great by-products of achieving significant weight loss are the higher self-confidence and self-esteem that accompanies this body change. Globally, we feel better about ourselves, as we look healthier, younger, better in our clothes etc. We exude a more positive aura that others can detect.

I want to take this opportunity to promote our Fashion Show for June 19, 2010 3PM at Bobby McKeys piano bar at the National Harbor. The purpose of this event is twofold: Our "models" are not professional models...they will be our patients (hopefully YOU) who have lost a significant amount of weight....not necessarily their entire goal, but yet enough weight that they can now feel comfortable and confident wearing something in front of other people that they never would have done before. This is the motivationa;/inspirational part. The charity part is that we asking people to donate their clothes that do not fit them anymore to a charity that collects clothes for people who are trying to get back into the workforce who cannot afford them.

At the event, we will also be doing a book signing for our new weight loss book being released in May, 2010. We will have a professional makeup artist applying makeup to our "models". This will be a really fun event and I hope that you will consider being one of our models! Aside from providing motivation and inspiration for others, you will also get a free signed book! Give us a call at: 703-866-4144 and ask for Jennifer Johns. Please attend as a participant but if that is just too uncomfortable for you, then please attend the event and bring those clothes!

weight loss and protein

We have found that for effective weight loss to occur, one must optimize protein and vegetable intake and minimize fruits and carbs. However the source of protein does make a difference...

We have noticed ingestion of protein sources such as chicken, turkey, fish, seafood, lean red meat is a better mechanism for weight loss than other protein sources such a beans and cheese. The lower the fat content of the protein source, the more aggressive will be your weight loss.

Try to keep your protein ingestion high but at the same time remember that the more you can stick to the above mentioned protein sources, the more aggressive will be your weight loss..

weight loss and the herd mentality

In social settings, it is very difficult to be around a bunch of people eating high-caloric food sources and drinking alcohol without feeling compelled to join in the "fun". Think of a dinner out with a group of friends when the waiter comes over with the dessert tray. Everone starts talking about what looks great, how people can share the several items that will be ordered etc. Or, how about after the first round of alcohol drinks when the waiter comes over and asks if everyone wants a refill? The "herd" mentality usually takes over in these situations and we find ourselves compelled to follow the pack.

Try not to fall into the "herd" mentality and do not feel that you must join everyone else in the eating and drinking behaviors that will make you less healthy and less happy. Be a role model for others, as I am going to bet that in anyone's circle of friends, there will be a number of overweight people. Become the "herd leader" and lead by example.