"I Will work it off the next day"

Patients often tell me that they tell themselves if they eat lots of high caloric foods on night they will "work it off the next day". I tell them to be very careful because it is not an equal tradeoff. What do I mean by this? Well..here is an example....i run 5 miles in the morning and my treadmill tells me I have worked off 640 calories...yeas for the old guy Posner! BUT...the other day i was eating at the office some (please dont laugh) girlscout cookies and within 45 seconds ate 300 calories...almost half of what it took me 46 MINUTES to burn off earlier that day. Point being: you can consume lots of calories quickly but it takes long periods of time to burn off those calories.

Think in terms, before you eat a really high caloric food source about how many miles you need to run, treadmill, bicycle etc to burn off the calories that you are about ready to eat...perhaps you mmay think twice about that 800 calorie ice cream sundae and the 1 hour you will need to run to burn this off!

Rewards

Had a patient tell me yesterday that she has purchased a really elegant gown...something to be worn at a really upscale function...but here is the catch: she won't be able to fit into this gown until she loses another 30 pounds. The patient has the gown prominently placed in her closet so she can see it daily. This is a daily motivation for her to keep disciplined in her weight loss efforts.

I wish there was some way of bottling up the "good feel" that one experiences when you lose the weight you wanted to lose. What it feels like to have people tell you how great you look, how wonderful you feel about yourself, how those clothes look on you, the energy you feel...these are just some of the rewards you get by losing weight. Then if you could bottle these feeling, when tempted by a high-caloric food choice, you could take the bottle out, take a whiff of that wonderful smell, and this would allow you to make the choice of foregoing the food source.

Another note: HELP!!!!!! I am writing a book about weight loss and I have a really good idea about the chapters I want in the book. However, my patients are an INCREDIBLY smart and savvy group of people and I am asking your help for suggestions as to what types of chapters should be in the book. I am writing about stress eating, post menopausal weight gain, childhood obesity,the science behind the chemicals involved in eating behaviors, psychological aspects, recipes, our diet plans, and other stuff. Any suggestions to make this book a national best seller??? (or at least the best seller in Burke, Virginia???) Please e-mail me at: serotab@aol.com thanks!!!!

Weight Loss and Reunions

Over the years we have had many patients come to us for weight loss in anticipation of an upcoming event..a 25th year high school reunion, a wedding of a child and other very happy occasions. At these times, we all want to look our very best as many of our friends and relatives will be seeing us, lots of pictures will be taken and we feel that there is a certain spotlight on us.

This scenario provides and incredible motivation for people to "diet", and this implies a start date of the diet and certainly the "finish line" is the night of the special event. There is no question that the success rates of these patients are 100%...but watch out for the weeks after the special event. Such motivation gives us a clear cut "end" of our efforts and then we get to go back to the "fun" eating/drinking activities again. If I was making a bet in Vegas about the chances of the person keeping the weight off long term, I would demand huge odds against this permanent weight loss.

Special events can give us a tangible motivation, but the more nebulous "being healthier", "living longer", or "looking better" long term goals are often not as powerful to sustain long term weight control efforts. The point here is that you can use an upcoming event to provide an extra "kick-start" to your weight loss efforts, but if this is the sole reason for your weight loss, there will be little to non chance of keeping the weight off.

Another note: I was reading online about a camp in Laholla California that specializes in helping adolescents with obesity lost weight in a caring, nurturing environment. Apparently the people who work there essentially get paid about 41 cents an hour for their work. I do believe prisoners get paid more than that. I think it is great that caring individuals will basically donate their time to help a group of overweight people whose lives will change dramatically for the better by losing weight and keeping the weight off.

weight loss and reward systems

Had a patient tell me yesterday that she rewards herself at every 5 pound weight loss increment by buying herself an extra pearl that goes on a bracelet. I loved that concept...she is striving for a bracelet full of these pearls but will only allow herself one pearl at a time based on her weight loss success.

We, as humans, are driven by reward systems. Least you doubt that, look at how much more motivation we have to achieve benchmark results at work if a money bonus is based on reaching certain goals. Unfortunately, we have often used food as reward systems...have a hard day? grab a few drinks to relax. Difficult week? go out to a very large dinner. Think about how we reward our children..."if you are good, I will get you ice cream..."

Learning how to reward ourselves and others with non-caloric reward systems is an important step in gaining control of our individual and collective weight problems.

Another issue: article in the Washington Post today about childhood obesity perhaps turning the corner. Several professional opinions in the article about this not being the case, i.e. the problem seems to be getting worse.

Face the Music (or scale)

The Holiday weekend is over and back to work...perhaps there was a great barbeque yesterday...dogs, burgers, chips, beer, wine. Maybe in retrospect you think you may have eaten/drank too much and you are afraid to get on that scale.

Human nature is such that we don't like to confront bad news. Whether it be your stock market portfolio, reading about the prices of gas, etc., we often will avoid addressing the issue that may be unpalatable.

Losing weight is the same thing..when our weight goes up, we won't get on that scale for fear of the "bad news" that awaits us.

However, this is the exact time to get on that scale and see what happened, realizing that it is UNDERSTANDABLE that holidays/birthdays/vacations etc. will produce weeks in which weight gain may occur. The concept here is to see how much the weight may have gone up and then HAVE A GAMEPLAN as to what to do about it...perhaps a no carb/no fruit diet plan for several days...perhaps jack up the exercise. Have a plan as to what you will do to get back on track. Keep a clipboard next to your scale and log in your weight once a week.

When we do not monitor our weight or do not have a plan as to what to do about a weight gain, thats when we start the viscious cycle of spiraling weight gain.

Completely different topic: Memorial Day...just a word of thanks to everyone who has served our country...lots of sacrifice for the service members as well as the family. I was a Navy physician for 7 years and I was active duty at a time when there was no war. I was very lucky. I did treat many retirees from WW II, the Korean War, Vietnam. Now I have military families in my practice where the service member has been in the front lines. True heros...not getting paid millions of dollars to dunk a basketball or hit home runs...Real heros. Thanks!!!!!

Being sensitive to your guests

If you are inviting people over for some holiday fun, I would implore you to have some "weight-conscious" choices available to your guests. When someone is in a weight losing mode and he/she is invited to a friend or family member's house for a meal, it is sometimes awkward for that person to express their need for special menu items. If all that is available are high-caloric choices...burgers with bubs, chips, potatoe salad, chocolate desserts, etc, then the diet-conscious person has basically two choices: "insult" the host by not eating or taking part of the high-caloric foods and damaging the weight loss efforts. If, however, the host had set out other choices as well that were not of a high-caloric nature, then the overweight person would be able to follow a more prudent course of eating.

Be careful of the beer/wine. Alcohol really messes up your metabolism.

Tennis match for me this morning. I used to be pretty decent at this sport but this age thing is robbing me of some speed. That will be our next product: Serotonin-Age Control Formula. I will be the first user.

Distracted eating

I was at the movie theatre last night watching the new Indiana Jones picture. Sometimes I cannot help but observe people's behavioral patterns as that relates to eating at the movies. On all sides of me, there were people eating from these large containers of popcorn...non-stop! Hand to mouth...hand to mouth...almost like a ritualistic behavioral pattern.

Here is the issue: Distracted eating...when our attention is on something else, and in this case it is a thrilling movie, we are not paying attention to appetite signals or eating control modulators. To soothe our angst and heart-pounding thrills, we tend to reach repeatedly for small, repetitive food sources. By the time the movie is over, we see that the entire container of popcorn is gone.

Whether it be working at your desk, sitting at the movies or another scenario, do not put yourself in a distracted eating mode.

By the way, if my opinion counts (and there truly is no reason why it should because I am a doctor, not a movie reviewer) I give the movie only 2 stethoscopes up...Raiders was MUCH better.

exercise on the weekends

Saturday morning...kids soccer game? trip to Home Depot for gardening supplies?

Have you built time in your schedule for exercise?

Exercise is interesting in that we know that for long-term weight loss, a regular exercise program is essential, yet we find lots of reasons why not to do it. The bottom line is that exercise is not really fun when you are doing it...perhaps playing a tennis match, bicycling in the country, walking a golf course is fun. But, pounding on a treadmill or stairmaster is not exactly fun for most people...least you doubt that, look at people exercising in gyms..they are using IPODs, CD players, etc..doing everything possible to distract themselves from what they are doing.

Try to build in exercise time as part of your weekly schedule...almost like a business appointment. If you do not schedule this time in advance, but rather look at it as: "if i have time, i will exercise", it will never happen. Try to find activities that are not abhorrent to you..some people HATE running, but yet, swimming is fun. Obviously, pick activities that you may find relaxing. For instance, I have much more fun running outside at a park as opposed to a treadmill.

By the way, in the category of "embarrassing moments" for your Doctor, I was running at Burke Lake Park the other day, and heard a sound of something catching up to me from behind. Then , quickly passing me was a young mother jogging while pushing her baby in a carriage. I got dusted by someone pushing a baby! I feel old and slow!~

Memorial Day Weekend...watch those carbs!

Memorial Day holiday weekends usually mean barbeques, gatherings of friends and family members, and generaly fun times. Beer and wine is pletiful, burgers with the buns, chips and of course, desserts. Uh, oh...kiss goodbye your weight loss efforts. No!!!!!! You can still partake of all of the fun, make your food choices high protein, and really be judicious about the alcohol usage. The other thing to remember is this: during the entire year, there will be holiday weeks, your birthday week, vacations, etc., and there will be a good chance that you cannot lose weight that paritcular week. As a physician who treats people for weight issues, I do not expect my patients to give up all the food/beverage sources that accompany celebratory weeks. What I do recommend however is a vigilance as to what the "damages" were that week, i.e. get on that scale at the end of the weekend and see how much weight you may have gained. Then, have a gameplan as to what you are going to do to "undo" the damages of the preceeding week and get back on track. We get into trouble when we do not monitor our weight and human nature is such that when we know the scale will give us distressing news, we tend to avoid getting on it.

Have a great weekend and please log on daily as I will most definitely be posting stuff to try to help you navigate around the weight gain that often occurs on holiday weekends.

By the way, this has nothing to do with weight loss, but you baseball fans out there...can you believe how bad these overpaid Mets are playing? If all of us were less than mediocre at our jobs, we would have been fired by now...but yet these guys are getting paid millions and millions of dollars to play pathetic baseball. Sorry, just had to throw this rant in.

Infomerical Experts

I was running on the treadmill this morning and flipping channels and came across a very recognizable infomercial guy pitching his book about natural weight loss remedies. This guy has been a staple on these 30 minute tv commercials for years and has been on the Times best seller list with his previous books about health things "they" dont want you to know about.

Further investigation into this guy's history documents previous jail time for viloating FTC issues as this relates to making false product claims. This guy has made tens of millions of dollars hawking products on these infomercials...compelling stories about supplements that prevent cancer, cure diabetes, etc.

Point here is this: be very careful about so-called "experts" you see on these tv infomercials, especially the ones purporting to have special secrets about losing weight. There is no magic pill, supplement, book, etc. that provides some miraculous easy weight loss. Weight loss is work...no question about that. One needs to count portions, make wise choices, include some exercise, etc.

And, please think carefully before ever buying a supplement or book you see hawked on these infomercials. Lots of deception.

Alcohol and weight loss

One of the first questions I ask my patients who have a not-very-successful weight loss week is whether any alcohol was consummed. There seems to be a very deleterious effect of alcohol on weight loss efforts, even if a small amount is used. Many people have the habit of coming home at night and having a "cocktail" or open a bottle of wine with dinner. Reason? It tends to relax and have a calming effect after a long, stressful day ar work.

If you are trying to lose weight, I would strongly suggest that you keep alcohol completely off of your dietary intake, no matter how innocuous one glass of wine, one beer, etc. at night seems.

Another major saboteur? Small repetitive food sources..popcorn, nuts, chips, M&Ms, etc...because they are small, we get fooled by only ingesting a small amount at a time but when our guard is down, we will find ourselves repeatedly reaching into the bag for more.

Rainy days and weight gain

It is raining in the D.C. area today and this reminds me to bring up a seemingly common sense issue. When we are either snowed in, rained in or otherwise prevented from doing outdoor activities, we tend to sometimes reach for food sources in the house that somehow alleviate our boredom. These foods tend to be the chips, popcorn, homemade cookies and other high-caloric items that tend to thwart our mission to lose weight.

Solution: we cannot change the weather patterns (and if you can, please start working on gas prices) but we certainly can change the food sources that are available in our household.

This seems simplistic, but it sometimes escapes us: Do NOT have the food sources around the house that would tend to sabotage our weight loss efforts. If the chips, dips, popcorn, nuts, cookies, etc. are not around the house, you would have to get in the car and drive in the rain or snow to the local 7/11 to pick them up. Little chance of you doing that, right? However, if the food sources are in your kitchen cabinets, much easier to obtain that food source.

Another issue: great series of articles in the Washington Post this week about childhood obesity. I believe you can probably read this on their website: www.washingtonpost.com . This is a very big problem in America. I am devoted an entie chapter to this subject in my weight loss book that is coming out in January.

Non-caloric shows of affection and caring

I constantly ask my patients around holiday times or significant milestones such as birthdays what type of presents they get. Inevitably, the gifts usually involve some type of high caloric food sources...I have never heard of a birthday treadmill, birthday bicycle or birthday gym membership. However, birthday CAKE is assured.

Think of that concept...providing an obviously overweight person with high caloric food sources as a show of love, caring and affection. Would you give an obvious alcoholic a bottle of Jack Daniels as a show of love? Would you give a heroin fix and a needle to a drug addict as sign of how much you care? The answer to these questions is a resounding "NO!", so, let's get back to the overweight friend or family member. Why would you give them calories as a recognition? Especially if that overweight person has diabetes, hypertension or some other sequelae of his/her obesity...you are hastening their early death.

So the point here is that you can show someone you love that you care lots about them without giving them food sources. Be cognizant of the overweight person's need for not being tempted...and if you give that person a wonderfully smelling, beautiful birthday cake, there is little chance that person will not eat at least some of it.

Trying to lose weight at the buffet

The other morning I was at a breakfast buffet, and the first thing I noticed on the sign promoting this contained, very prominently, the words "ALL YOU CAN EAT". Hmmmm... that sounds like a challenge! Pay one price no matter whether you eat a small amount of food or stuff your belly so full that you have to unbutton your pants before you leave.

Well, true to form, I observed the eating behaviors of most people who were in the restaurant. Heaping plates of eggs, pancakes, bacon, french toast, toasted bagels, etc... (oh, yeah, I did overhear some of the people ordering a diet soda as their beverage.) It wasn't over at that point...another food station contained pastries, cakes and donuts, and wouldn't you know it, most people were attacking that table too!

My point here is this: If you are trying to lose weight, never put yourself in the position of testing the very foundations of human nature. "ALL YOU CAN EAT" is what our ancestors did when the kill occurred, because the primitives probably didn't know when the next "kill" would be. Observing people's behaviors on the buffet lines made me think that an "all you can eat" scenario will mentally push us to "eat all you can, even if you are not hungry anymore."

If you are in a weight losing mode, I suggest you stay away from buffet restaurants and instead, pay al a carte...you may find yourself eating less amounts of higher caliber foods.

Weight Loss and Prepackaged foods...Watch out for Kirstie, Dan and Tony

We constantly see new patients in our weight loss program that have previously used one of the prepackaged food weight loss plans. The marketing of these plans are usually incredibly effective. Usually, they pay some over the hill athlete or movie/TV star big bucks to lose substantial weight with their plan, and then run TV commercials and print ads. (Most recently I noticed the Tie a Yellow Ribbon guy on one of these and I wonder how many gigs at the Boyton Beach retirement home clubhouses did he have to cancel to film the commercial.)

They also usually show you foods such as lasagna, brownies and other staples of our American diet, and tell you how you can eat all of these foods and still lose weight.

Pardon my New York vernacular, but as I sneeze, you may hear an audible "Bull S---"

Please remember that for long term success in losing weight AND KEEPING THE WEIGHT OFF, prepackaged foods are not the way to go. You must learn how to eat "real" food differently in order to have a chance at keeping the weight off. "Artificial" plans that utilize a prepackaged caloriuc-controlled dietary plan will produce short term success but as soon as you go back to eating "real" food, if you haven't learned how to change your previous patterns of eating, the weight will come back on.

Weight Loss Jealous Sabotage?

We see patients frequently that tell us that their friends are trying to detract them from their weight loss efforts purposefully. That is when they go out with certain friends they are always trying to get them to eat foods or drink alcohol that would clearly hinder weight loss efforts. "Come on...a little piece of cake can't hurt you." "You are not fun anymore!"

Attempts on the part of someone trying to lose weight does often threaten others around them who also need to lose weight, but show little effort. I believe that subconsciously, the overweight person who is not showing control is made to feel even more of a "failure" by watching someone around them take a proactive stance. The efforts of his/her weight-losing friend are admired, yet somehow jealousy and a possible hidden hope of failure takes place. Hey, if everyone in the group is eating cheesecake for dessert, it must be okay, right? But, if one or several people in the group take a pass on dessert, those that are eating it do not have as much fun doing so.

I do not think that sabotage is truly intentional, but nevertheless, it certainly can make your weight loss efforts more difficult. Be firm with your friends who try to push things of high caloric content on you. Have a taste if you must but stop there. Tell them that you are trying to lose weight and you would love their help.

45% of Workers are Heavier than Last Year

A recent survey of 7,688 U.S. employees by Careerbuilder shows that 45% of workers have gained weight at their current jobs over the last year.

Other findings include:

• Twenty-six percent of employees report they have gained more than ten pounds and 12 percent say they gained more than 20 pounds while in their present positions.
  
  
• Women are more likely (50 percent) than men (42 percent) to say they have gained weight at their current jobs.
  
  
• Nearly two-in-five (38 percent) percent of employees surveyed eat out for lunch twice or more per week, making it difficult to control portions and calorie intake.
  
  
• Snacking can also be a slippery slope for those trying to cut back on calories, as two-thirds (66 percent) of employees surveyed snack at least once a day, while nearly 25 percent snack at least twice a day.

If these trends continue, workers will continue to gain weight year after year. It might be a good idea to learn more about what you can do now by clicking here to make sure that next year you are not part of the group of works that pack on more pounds.

Overweight in the Workplace

Overweight people are sometimes treated differently in the workforce. We have heard stories of people that don't recognized for their work because of being overweight/obese or are passed over for promotions, but as soon as they lose weight people suddenly start to notice them. They then get promoted and recognized. This can happen to anyone: CEOs, administrators, mail room clerks, janitors, etc. Unfortunately that is not fair but in reality, there often is a prejudice in the workplace against overweight people. They are often viewed as someone who cannot keep their own body "in order", and if that is the case, how could they possibly keep a company in order? This sometimes translates into pay inequalities. The good thing is excess weight is reversible. If you have put weight on, you can take it off. Of course it may take some time, but you can do it if you feel opportunities have passed you by.

People have many different motivations to lose weight and certainly career progression is one consideration. Of course, the public stance of anyone hiring/promoting people would be that weight plays no role in the decision making. There are many lawyers out there itching for cases of workplace discrimination of any kind. Usually we think in terms of racial, gender, age, etc. types of discrimination, but weight issues are certainly a factor that is not spoken about often.

Anyway, just wanted to bring this case up as "food for thought" (sorry..poor choice of words!) when you are thinking about applying for a new job, being asked to be considered for a promotion, etc...It is not fair to have the weight factor being part of the evaluation, but it is reality.

The "F" word and the "C" word

At our clinics, we don't allow the usage of two words...The "F" word and The "C" word. We strongly encourage people not to refer to themselves as FAT when they are overweight or that they CHEAT when they eat something not conducive with their desire to lose weight. I think this is important because when someone is overweight, that doesn't mean the person is stupid, slovenly, ugly or any other negative adjective you can come up with. That word "FAT" in fact, conjures up this image of a Jabba The Hutt, gross, amoeboid pathetic mass of protoplasm. Similarly, the word "CHEAT" makes us envision a CEO cashing out on stock knowing in advance that the company is tanking or a worker billing their employer for hours of work that never occurred. A crime is being committed

Being overweight is not akin to being an ugly person and eating something of high caloric content does not make for a criminal. This is important to differentiate because the self-esteem of a person trying to lose weight is often in the gutter and the last thing that person needs is to think of him/herself as a person who is a unattractive and a criminal. Feeling better about oneself, both physically and emotionally is a very important aspect to having happy, productive lives.

So, the bottom line is that if you are overweight, forget the "fat" thing and if you eat a chocolate bar, you are not a "cheater". Remember the major reasons as to why you want to lose weight and move forward in a confident, goal-driven manner.

Reaching the Diet Finish Line

People never want to start a weight loss effort on a Friday…always Monday. Why? Because as much as we don’t like to think about it in this manner, we equate “dieting” with sacrifice, deprivation and taking away our fun. For the long term strategy of losing weight and keeping that weight off we have to eliminate the concept of a “finish line”. Let me provide this analogy I give my patients: In a 100 yard race, when the sprinter crosses the finish line, he/she does not continue to run. The person drops to a knee, drinks fluids, towels off, rests and you can almost hear from the stands the happy exclamation: “Whew, glad that is over!!!” Similarly, when we embark on a weight loss goal, when we reach our perceived target weight, psychologically, we pass a “finish line” that allows us to go back to old behaviors. Unfortunately, the old behaviors result in the gaining back of the weight we worked so hard to lose.

Learning how to change our mindset when it comes to losing weight as a life-style change as opposed to a “diet” is difficult, yet necessary to achieve long term weight loss.