weight loss and snow

We already discussed the need to NOT use the next 48 hours as an episode of The Cooking Channel, but this morning's entry will focus more on health considerations.

Every year, many people experience their heart attacks or even death while shoveling snow. The combination of undetected corornary artery disease, risk factors such as hypertension, diabetes and obesity (smoking, high cholesterol, age over 60, family history of heart disease and being a male are the other ris factors) and extreme exertion under inclement conditions can make the "perfect storm" so to speak for a massive myocardial infarction.

I implore everyone out there to warn anyone you know who fits the above description to NOT get out there to do lots of heavy snow removel. If you have the resources, hire the multitude of people ringing doorbells looking for this work....they need the money lots and lets you stay inside. No macho stuff...let others do it. If you have children, put them to work (unless they are young enough to be considered too young for this of course).

If you do go out and feel ANY shortness of breath, chest pressure, dizziness, IMMEDIATELY stop and go back into the warm house and if symptoms persist, do NOT attribute it to "gas"...call 911,

Use this time in the house to exercise, and read the 650 blog entire I have written. Nah, exercise, read the ones last week you missed, watch some movies and plan some fun meals that are creative yet low-caloric. And most of all be careful and do not put your hralth at risk .

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.

Dining Out-To Cheat or Not to Cheat?

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

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

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

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

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

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

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

How Much Exercise Do We Need?

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

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

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

Tips To Help You Stay in Control

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

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

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

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

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

Should I take a multivitamin?

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

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

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

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

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

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

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

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

Can insurance cover this program?

Did you know that two thirds of Americans are either overweight or obese? The cost of obesity and overweight in this country is staggering. NIH shows that annual costs were about 117 billion dollars a few years ago and are rapidly increasing. (http://win.niddk.nih.gov/statistics/index.htm#econ). It is reported that 92 billion was spent for medical care for health issues for the overweight and obese in 2002.

As you know, in our weight loss program, we do not accept insurance but if you have health insurance you should try to use it. I wish all insurance companies were more progressive but with persistence sometimes you can get reimbursement. We give you a medical superbill that you can take and submit to your insurance company. I code it according to your health history. Since you have paid us for your visit, you should have the reimbursement sent directly to you. If you receive a letter from the insurance company and it doesn’t have a check enclosed, bring it into me (Linda) and I can investigate to find out what they need. Sometimes they need further explanation, a certain code or a letter of medical necessity that I can provide. Then it is a matter of just sending in the forms again. It may appear to be a tedious process but we have patients that do get reimbursed. If you have a PPO, most will allow you to have an annual physical. Many times, if people have not had one when they come into our program, they can use our physical to be reimbursed. I also suggest to try to get the weekly visits covered. Many times people have coverage for nutritional counseling which is an integral part of this program and the bills are coded as such.

Similarly, if you have a flexible spending plan, this program will qualify for that as well. Sometimes your plan administrator will provide a form filled that we must fill out or I can write a letter of medical necessity for you.

Don't Let Anger Destroy Your Diet

Anger is a very strong emotion that causes stress to the body and to the mind. That stress also causes us to hold onto calories resulting in less weight loss if we are on a reduced calorie diet. Research shows that no matter how much you exercise or eat correctly, you are putting yourself at risk if you do not manage your anger. Anger causes a widespread negative effect on the body. Generally, if we react to this stress by eating, we have a double whammy, so to speak, causing poor nutrition and excess calories causing weight gain.

When we become angry, we may experience muscle tension, teeth clenching, higher blood pressure, chest pains, excessive sweating, chills, severe headaches or migraines. This is due to stress hormones being released. If people do experience chronic anger and it is not managed, more severe health issues may appear such as obesity, peptic ulcers, constipation, diarrhea, intestinal cramping, indigestion, heart attacks, strokes, kidney problems, and more frequent infections. Researchers have found the heart is affected by anger and can actually reduce the heart's ability to pump blood. Uncontrolled chronic anger can also have psychological effects resulting in depression and feelings of hopelessness, eating disorders, substance abuse and other self-destructive behaviors, and can cause significant changes in relating to other people.

When we eat in response to the stress of anger we are taking the anger out on ourselves and are actually punishing ourselves. We sometimes decide we don’t care about anything anymore, our weight or our health, etc. It is important to maintain nutrition when we become angry so we can manage our anger well. Always remember that with regard to eating we can limit our damage to ourselves. If we decide to give in to a high calorie snack, we can stop at one. But many times we say to ourselves, well I ruined it anyway so more chips or ice cream won’t matter. But it does. All of those calories add up and more weight is added to the scale. Just get right back on track with your diet, start to exercise to burn off those calories and forget about what you just ate.

Here is a listing of ways to begin managing your anger before it gets out of control.
• Exercise to release the anger- run or lift weights, punch a punching bag, do kickboxing
• Practice Deep Breathing – Begin with 2-3 minutes of deep breathing exercises
• Meditation -Relax and count to 30 blocking out everything that you see and hear.
• Call a friend to take your mind off your stress and to vent. If the friend is trusted ask for his/her opinion of the situation.
• Confront the one you are angry with and talk it out.
• Find something to smile about and laugh as laughter reduces stress hormone levels. Frequent belly laughter empties your lungs of more air than it takes in resulting in a cleansing effect - similar to deep breathing.

Weight Control on vacation

Good holiday morning! First, I want to thank Linda for posting some really good stuff on this blog while I was vacationing. Excellent insights!

Okay, some personal stuff about how I approach vacations as that relates to the scales. I went to a resort in Conneticut called Foxwoods. It is an Indian reservation and there is a new MGM Grand hotel that just opened several months ago. Wonderful new rooms..wonderful new spa and workout facility...wonderful new casino and WONDERFUL restaurants. One of the restaurants is a famous deli from Brooklyn, N.Y. called Juniors. They are especially known for their New York cheesecakes.

Okay: here was my approach: 1-every morning I went to the gym and ran treadmill, did some weights, pushups. 2-ate a pretty small breakfast of some type of protein 3-tried to walk lots during the day 3-lunch ...okay, was pretty negligent...corned beef sandwiches, potatoe pancakes, 4-dinner...no alcohol, lots of protein, some vegetables and carbs. allowed myself 2 pieces of cheesecake in 3 days.

Results: 1.5 pounds of weight gain in the three days.

Response: I will follow a modified Phase 1 dietary plan for this week and check the scale next Sunday.

This strategy works for me, meaning that on vacation, I will liberalize my food intake because to be honest, I understand completely that for almost everyone, part of the "fun" of the vacation are the foods associated with the place you go to,. To deny yourself everything will in fact take away from the global sense of fun you have. Pick and choose the things that you really want and perhaps eliminate some of the high=caloric sources that do not mean that much to you. Also, be sure to check that scale when you return and have some sort of forulated plan as to what you will do to bring the weight back down. We get into trouble if we do not check the weight or have no plan.

Have a great day!!!

Eating Fish Can Help With Weight Loss

The American Heart Association now recommends that everyone eat at least two servings of fish per week, and that heart patients consume at least 1 gram a day of the two most critical omega-3 fatty acids, known as EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). In addition, fish is high in protein and generally low in fat and calories. For best results in losing weight, it is a good idea to vary your proteins so that your body does not get used to the same food all the time and hit a plateau. There are varying amounts of fat in fish and it is a good idea to check the nutritional information before you consume.

Salmon is a great source of protein and can be found in a can, vacuum-packed pouch, or fresh. Look for the words, “wild Alaskan,” “pink,” or “sockeye.” The sodium content of canned or pouched salmon will be higher than fresh or frozen salmon. Salmon naturally contains more fat and cholesterol so it is best if eaten once per week or less if you have cholesterol issues. To reduce the amount of chemical toxins you consume, grill or broil salmon to allow the fat or other toxins to drain away, trim any visible fat from the cooked salmon, and remove the salmon skin after cooking because it does contain a lot of contaminants.

The level of toxins varies according to the pollution levels of the waters in which the fish swam. Atlantic wild salmon is safer than farm-raised. Chilean farmed salmon is another safe choice. Alaskan is considered safe and the Wild Pacific salmon from California or Washington should be eaten no more than once or twice a month. Seven ounces of salmon contains 355 calories, 20 g fat, and 40 g of protein.
Tuna is another great fish to eat as fillets, steaks or chunk. Fresh or frozen tuna steaks are lowest in sodium. Yellowfin tuna is generally lower in toxins. White or albacore may have more contaminants but can be eaten safely up to three times a month. If choosing fresh tuna, make sure it has an ocean smell. The flesh should be moist and have no brown spots. Canned or vacuum-packed tuna in a pouch should be a staple in your pantry. Any kind of light chunk tuna packed in water is the safest. Limit your intake of white or albacore tuna because of the high levels of mercury. When ordering sushi, Yellowfin and Bigeye tuna, aka, Ahi tuna, will always be lower in mercury. Avoid Bluefin tuna since it has high levels of mercury. Seven ounces of tuna contains 190 calories, 3 g fat and 42 g of protein.

In the United States, tilapia has shown the biggest gains in popularity among seafood, and this trend is expected to continue as consumption rises dramatically because of its moderate price. Although tilapia contains less Omega-3 fatty acids, it is still a great source of protein. Seven ounces of tilapia contains 170 calories, 3.4 g of fat and 40 g protein.

Fish is a great source of protein and is generally low calorie depending upon how it is prepared. Whether you eat fish or not, it is very important to vary your proteins throughout the week and not eat the same thing day after day. If you eat the same thing day in and day out your body will get used to it, get stuck in a rut and weight loss will be a slower process.

How can you lose weight in the fall when it is so busy?

September is a very busy time for all. School is back in session for students and teachers and youth sports programs will kick into high gear. Most of us have been stressed at this time of year trying to balance work, kids and after school and sports activities. After a full day of work, many patients are running their children around to music/dance lessons, sports practice or games in the evening along with monitoring homework progress. How can you eat well and still lose weight when you can’t eat dinner til 8:00 or 9:00 PM? The key is to be consistent with meals, snacks and water. Be prepared when you leave the house.

• Be sure you have some snacks with you whether it is a bag of carrots, celery, radishes or cucumbers or a yogurt, string cheese or cottage cheese.
• Bring a bottle of water so you remain hydrated.
• If you are waiting for your child to finish practice or a game, walk until they are finished. Walk up and down the street or walk around a field. Bring a light weight that you can lift as you walk. The goal is to burn calories. So if you find yourself waiting in the car, at least multitask and do something for yourself.
• If dinner is at 8:00 or 9:00 PM, do not eat a large meal. Make it more like a snack consisting of 3-4 oz. of protein, 1 ½ cups of vegetables and/or salad. Do not eat carbs that late unless you can do additional activity to work them off before you go to sleep. On the days that you know you will be eating late, have a larger lunch and make up the protein difference. That way you will more time to burn off those calories.

Just remember any activity you can do is better than nothing, even if it is only for 10 minutes at a time. You will be burning more calories and will lose more weight.

Benefits of a Low Carb Diet

In the Serotonin-Plus program we use a higher protein/low carb diet for the first few weeks. Many have asked, why do we do that? A low carb diet can help increase metabolism by forcing the body to temporarily use its fat stores for energy and can jumpstart the weight loss process. In our program, we generally see the most aggressive weight loss on phase 1. However, we give patients the choice of staying on phase 1 a little longer if they feel they want greater results quickly or moving to phase 2 which contains more carbs. More carbs will slow weight loss progress but the key is to burn off the carbs through activity and exercise.

A recent study done at the University of Aberdeen in Scotland, UK, showed that a diet low in carbs and higher in protein was more effective at weight loss than a balanced protein to carb ratio. In the study, healthy, obese men were given two different diets during their stay in the Rowett’s specialized Human Nutrition Unit. Both diets had a high protein content (30% of total energy value of the diet) but they differed in the amount of carbohydrate: One diet was low in carbohydrate (4%) and the other contained a moderate amount of carbohydrate (35% total energy value). Weight loss during the four week study periods was greater on the high-protein low-carbohydrate diet, averaging 13.9 pounds per person, compared with 9.4 pounds on the moderate carbohydrate diet. It is well-known that excess carbs in the body become deposited as fat and lower overall metabolism. It is possible that the additional carbs caused a slowdown in metabolism causing fewer calories burned resulting in less weight loss.

It was reported that the study participants felt less hungry on the high-protein low-carbohydrate diet compared with the diet which contained high-protein but moderate amounts of carbohydrate. It is known that when people eat low carbohydrate diets, within a relatively short time their body has to switch from using glucose as a fuel to using ketone bodies from the breakdown of the fat stores. Ketone bodies are appetite suppressing and appear to have an effect on the appetite centers in the brain. Also it is suggested that the additional carbs cause larger peaks and valleys in blood sugar levels causing more hunger.

When you are in our program, you have control over your progress. Your intake and activity will dictate your success. If you feel you want to have carbs, watch your portions and do what you can so you are buring off not just the calories but the carbs themselves, as well, so they don't become deposited as fat.

Neil Diamond and Weight Loss

Laughing....okay...got your attention with that title, huh? What does Neil Diamond have to do with topics about weight loss? I do remember a movie which contained a classic line: "There are two types of people in the world...those who like Neil Diamond and those who don't." Well, I happen to be one of the former. He was at the Verizon Center last night belting out all those tunes I remember first hearing when I was a teenager growing up in Queens...."Sweet Caroline, do, do do..." "Cracklin' Rosie get on board..." He had the place rocking (as much as you can get a group of aging boomers with arthritic knees, sore backs and enlarged prostates "rocking"). The guy must be late 60's and his voice was great...band was excellent and his songs sure did bring back lots of memories of growing up in the 60s and 70s.

Okay: what does this have to do with a blog about weight loss? No, Neil was in GREAT shape...appeared quite trim and fit and certainly did not appear overweight. Here goes: the food choices at the Verizon Center...HORRIBLE for those trying to lose weight. We saw (word of the day: Sweet Caroline) so many people eating cheese dripping nachos, fried chicken fingers, fries, popcorn, large pretzels, large cups of beer, etc. The concert started at 8PM leaving people plenty of time to do dinner before the performance either at home or a restaurant that offered a better selection of foods and drinks that are more compatible for a weight-conscious person. Planning your meals is a very important aspect of long term control of weight, and when you know you have an event at a place that will not offer you good choices, please plan your night out so as to avoid the necessity of eating at the stadium/arena.

And for those of you who are laughing at me for going to a Neil Diamond concert (such as my kids), next time you find yourself belting out at the National's game "Sweet Caroline", please think of your Brooklyn born, boomer doc!

Weight Loss and Energy

Good morning...When you ask most people why they want to lose weight, the "politically correct" answer is to improve their overall health. Obviously, wanting to look younger, enhance the aesthetic look, etc. is a major motivation as well.

The lack of feeling good energy levels is a very consistent symptom that our patients describe when they enter our program. There are probably multiple reasons for this, but certainly one of them involves having to move around many excessive pounds doing routine tasks such as climbing stairs, getting in and out of cars, walking around etc. I encourage my patients, after they have lost 30 or more pounds, to go to a Home Depot and pick up a 30 pound bag of mulch and try walking around the store for awhile carrying this bag around. Usually after a feww minutes, the person gets very fatigued and has to drop the bag. When that 30 or more pounds is on the person every second of every day, they cannot "drop the bag" and are forced to move this excessive weight around all the time. This can lead of course to chronic fatigue.

Sleep apnea caused by excessive soft tissue around the neck area (obstructive sleep apnea) is also a contributing part to the lack of global energy. When people lose weight, they often will sleep better causing a global increase in energy.

Please constantly assess your energy levels and if you feel that you do not have the "get up and go" continue to work diligently on your weight loss efforts and this will pay off for you with the energy increase you seek.

Regional rates of Obesity

This one is coming from the road...Your good Doctor is in Wilkes-Barre , PA enroute to the Catskill Mountains...business center at the Hilton Garden Inn.(the Ritz carlton in Wilkes Barre was booked for the night) ...no offense to anyone from Wilkes Barre who may be reading this but this sure doesn't seem to be a place where I see myself buying a second home ..

A study was released looking at the states in the US with the highest and lowest obesity rates...Highest??? Louisiana, Mississipi, Alabama, Tennessee Lowest??? Hawaii, Colorado, Conneticut, Massachusetts, Rhode Island... Healthiest and Best Doctor area? 9289 Old Keene Mill Road, Burke, VA. okay, last one was made up but the states listed for obesity rates were true...

Why do the southern states have a greater than 30% obesity rate and the lowest states boast aroud a 20% rate?

The answer seems to be the cultural and socioeconomic differences bewteen the areas. When we think Colorado, we conjure up a skier drinking vegetable juice and taking supplements everyday. Think Alabama and we think of a great rib place to eat at. This obviously is a stereotypic joke, but there is some truth to the issue that certain areas of the country emphasize certain food choices that would be more damaging to a maintaining a healthy weight. From a cultural standpoint, many people who have been raised on fried foods, lots of carbs, lots of fatty red meats will continue this pattern into adulthood. Conversely, if you were raised eating food sources more nutritious and "healthier" there would be a better chance of being at a more ideal weight as you get older.

From a socioeconomic standpoint, education and financial resources allow us to perhaps make wiser food choices and understand the ramifications on our health that obesity can cause. Of course, there are certainly MANY people with very high IQs and education who are obese, despite knowing full well the damage that may occur.

I guess the point of today's blog is to have all of us take a step back and see how much of our eating patterns are based on what we were raised with, and then see how we are feeding not only ourselves but our children. If we are repeating the same patterns that have occurred in our families based on our cultural/regional food "upbringing" and there are weight problems in our family or ourselves, we need to make some changes.

By the way, the numbers listed above are obesity..not just being overweight...the % of overweight Amercians is more than double the obesity rates.

Off to my run and then the travels continue...

weight loss and goodies

Good Morning...first, a couple of random things...I read an article in the Washington Post this morning about some coffee place which refused to serve a patron an iced latte expresso because of the concept of ruining the drink with ice. Apparently the customer became belligerent and demanded his drink, threw out some four letter words, and then proceeded to write on his blog (www.andiamnotlying.com) about this experience. The shop owner then wrote on his company website (www.murkycoffee.com) responding to this irate customer's rants. The article goes on to report that over 100,000 people visited the irate customer's site and over 15,000 visited the coffee website in one day.

Okay..so why the story and what does this have to do with weight loss? Answer: There are over 300 million people in America, 65% overweight which makes for about 200 million people who are overweight, subjecting themselves to early morbidity and mortality. Not that what is being written in this blog is anything that is earth shattering, but I am hoping that at the very least, my readers are helped to some extent by mentating through the issues that we discuss daily. Perhaps by thinking about issues daily, this will allow you to be more successful in your efforts to be healthier and therefore happier. So, for you 10 daily readers who visit my blog site, I want to thank you for taking the time to read the stuff I am writing daily, and for those 200 million americans (minus 10) who are overweight that would rather read about some loser with a blogsite ranting about coffee without ice, I invite you to spend your time a little bit more wisely on the internet. Laughing...okay, my rant is now over for the day..back to weight loss:

Yesterday a patient came into my clinic who gained a bit of weight and she proceeded to explain that she ws with her grandchildren and ate some of the "goodies" that she brought for her grandchildren. I want to propose that small, high caloric food sources that are repetitive (M&Ms, chocolate covered raisens, candies, etc) should not be thought of as "goodies " or "treats" but rather SABOTEURS. Those little evil things will thwart your weight loss efforts, lessening your chances of living longer to enjoy the grandchildren. What kind of "goodie" thing is this that will lessen our lifespan? Try as best as you can to redirect your mindset to look at wight gaining foods as not treats, but as things that hurt us.

Hey....thanks for the positive response to the concept of an organized walk/run in the summer. People are suggesting september instead of August. Please stay in touch with us for an exact date which will be forthcoming soon.

Setting Realistic Goals for Weight

We had two new patients enter our program yesterday who set their total weight loss goals at a very aggressive number. Both people mentioned that these were the weights they were in college, and they were hoping to get back down to those weights.

I think it is an important point to differentiate between what a person could realistically achieve as far as a total weight loss vs. what is sustainable. Clearly, if there was some reality tv show that would pay me a million bucks to get down to my college weight of 155, I have no doubt that I would be able to do that. However, to try to maintain that weight would be very difficult.

Similarly, we all must remember that our metabolisms change, our body habitus changes, and what we used to weigh in high school or college is not a weight that would either : 1-be a realistic goal to maintain and 2- aesthetically look good. If I came to work one day weighing what I did in college, all my patients would think I had a horrible medical disease.

In our clinics we always try to help people set realistic goals for their weight loss. This means trying to reach a healthier weight that would be reasoably sustainable. Once again, there is no "race" to lose weight or see this as some finish line meaning that when you reach that weight it is "over". Reaching your realistic weight loss goal is only the first initial step; maintaining that weight is our lifetime goal for better health and happiness.

Weekend...Watch those calories!

Friday....the end of the work week for most. Remember the commercial for Miller beer where the moto was "It's Miller Time"...and the commercial went on to show people at a happy hour downing the suds, eating foods and having a great time? In commercials and in real life, we always equate having fun with eating and drinking. Sweating on a treadmill is not usually construed as fun.

As the weekend is upon us, if you are in a mode to lose weight (and if you are reading this blog as opposed to some extreme right wing or extreme left wing political blogger ranting and raving about something my suspician is that you are in this weight loss mode), please keep an awareness of the following weekend saboteurs:

alcohol: this is perhaps the major saboteur that will knock you off your path to weight loss. Almost innocuous it seems to have a few glasses of wine or a few beers...but, there is something about alcohol that slows metabolism down and stalls our weight loss efforts

small, repetitive food sources: that movie theatre popcorn, the nuts we eat at home, grapes...all of these food sources lend themselves to eating more than we consciously think...when you are at the movies, watch people's behavior as that relates to eating the popcorn..hand to mouth, hand to mouth..almost subconsciously...distracted eating at its best as the person focuses on the thrilling moments of the movie they are watching and eating without even thinking about it. Make your plans to go to the movies AFTER dinner and do not pay that exorbitant fee for the popcorn or other snacks.

cookouts/parties: carbs and alcohol will be plentiful at these events...try to make your choices high protein and vegetables.

exercise: weekends are a GREAT time to carve out some exercise time...do something outside to enjoy the weather and burn off some calories. (And for my golfers out there, riding in a cart and drinking beer is NOT exercise!!!)

Okay, there you have it...make your time off not "Miller Time" but try to make it "Deer Park Time" and exercise....remember all those great reasons why you want to lose the weight and keep on the pathway to achieving your goals.

Weight Loss...Sometimes Help Is Needed

We entered a new patient into our Bethesda office yesterday and she said that she had been seeing our television commercials for months. The program seemed intriguing, but yet, she would not pick up the phone to call for an appointment because she felt "weak" admitting to herself that she cannot lose weight on her own. She had tried several commercial plans such as Nutrisystems, Jennie Craig etc, but results were limited. Her frustration was mostly based on the fact that "I know what to do" (i.e. eat less , cut back carbs, exercise more, etc.), but nor being able to follow through. She was embarrased to admit that she needed help.

With 65% of Americans being overwight, 35% obese, clearly most people who are overweight have difficulty achieving their weight loss goals on their own. This doesn't mean that everyone needs to enter a physician-monitored program , but if a person wants a "jump-start" to help get motivated and "into the zone" then reaching out for help is nothing to be embarrassed about. Whether it be a support group, Weight Watchers, or the very best medically supervised weight loss program in the world (sorry..had to get in the plug!), oftentimes it helps to have some type of accountability/support/jumpstart that will allow the person to see immediate success. It is so important to see results fairly quickly because this, in turn, motivates us to keep going.

It is "normal" to need some type of help when embarking on a weight loss mission, and we try very hard to have our patients understand that it is no sign of "weakness" or "character flaw" to have to reach out for help.

On a non-medical note: The Mets are now only 1.5 games out of first...could make for a fun summer pennant race!!!

"I Can't" vs. "I Won't" Eat That

Yesterday I had a patient who told me that a very important mental "shift" for her was the concept of not looking at losing weight as a series of "I cannot eat that" episodes. She went on to explain that when she is involved in social situations with other people, and a high-caloric food source would appear or an alcohol containing drink, she found herself constantly explaining to people that because of her desire to lose weight she would say and think "I cannot eat that". My patient then came to the realization that thinking in this way was making her weight loss efforts burdensome, because almost like a child being told by their parent to "not do that", her food choices seemed imposed by someone else. She then went through a mental exercise of changing this concept to "I Won't have this". What she means by this is that by changing her mindset to making food choices that she is controlling as opposed to some external mandated edicts, my patient is now able to feel better about being sround others during these social events. She is now able to feel better about telling the party host that she will take a pass on the marguerita not because she wants to but it is "forbidden", but rather it is her conscious choice to bypass this in order to achieve a happier and healthier weight.

It is very difficult to be around a social event and watch others eat and drink the food and alcohol sources that we know taste good. But often it is exactly these food sources that put us at a weight that is unhealthy and makes us ultimately very unhappy. Feeling in control of your food choices as opposed to feeling that there is an external parent-like monitor telling you "not to eat this, not to eat that" would be a more psychologically favorable mindset to help you lose weight and keep it off.