Posts Tagged ‘Losing weight’

Diet advice for 2012 – from Cleveland Clinic

January 5, 2012

It’s  a new year and I resolve to write more blog posts this year than last. So, I’ll start with what is on many people’s minds now: which diet should I choose? Here is the latest from a respected source – Cleveland Clinic.

This New Year’s, losing weight will undoubtedly top many Americans’ list of resolutions – and it’s an important one. One reason? Heart disease is the main health threat caused by obesity. Make your efforts to slim down more successful this year by becoming wise to the “secret of calories!”  …

Just follow these 5 rules:

1. Understand the basic principal of dieting for weight loss. With all of the opposing diet plans forbidding carbohydrates or preaching against fat, it’s easy to see why confusion prevails. But, Cleveland Clinic experts say, recent studies comparing these different diets have found that the proportion of carbohydrates, proteins and fats in your diet do not influence weight loss. 

This means, in a nutshell, you can lose weight with any diet as long as you burn more calories than you take in. That’s the secret.

2. Know how many calories you need. Would you believe that of the half of Americans who are dieting at any given time, only 12 percent know how many calories they should consume daily? This number, which for adults ranges from 1,600 to 3,000 a day, depends on your age, gender and activity level. [Here is a useful daily calorie calculator]

3. Change your calorie intake to lose weight. If you want to lose weight, eat fewer calories than you burn. Eat 500 to 1,000 fewer calories per day and you will lose weight, often one to two pounds per week. But don’t be discouraged when weight loss begins to slow after a few weeks of dieting – this is a normal event as your body adjusts to your new diet. Keep watching calories and exercising and you will keep heading toward your weight loss goal!

4. Don’t be fooled by fad diets. More isn’t always better. In fact, it can be harmful. Any loss of more than two pounds a week is usually just water weight. Studies also show that the faster weight comes off, the quicker it is regained. Stick to a diet that has a goal of only one to two pounds weight loss a week [even better, in the long run, would be one pound per month].

5. Choose a diet you can live with. For your weight loss and weight maintenance efforts to succeed, you must continually manage your calories. No one diet is better than another. Studies show dieters tend to lose five to 10 pounds over the course of a year, regardless which diet they pick. What’s important is to pick a diet that works for you and that you can stick with. And if you’re not successful, pick a different diet next time.

Overeating leads to — more overeating

January 17, 2009

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Several lines of research describe mechanisms in our bodies that cause a vicious cycle, so that when we overeat we are much more likely to continue to overeat. These mechanisms involve our biological clock, insulin metabolism, and nerve endings in the stomach.  Even drinking too much water with a meal (especially ice water) can  accelerate the problem.  For more details, see this NPR story.

If you want to do only one thing to counteract your tendency to overeat, simply keep a journal and write down everything you put in your mouth.   Food diaries or journals have been shown again and again to be effective tools in weight management.  See these sites for more on food diaries (here and here).

For more information on avoiding overeating, see here.

Looking your best in 2009

January 1, 2009

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For my first post in 2009, I am passing along to you a sure-fire 9-step program to help you lose weight and/or accept yourself. It is straight from the January 5 issue of The New Yorker (by Amy Ozols):

People say that obesity is an epidemic in America, but I’m determined not to become part of the problem. That’s why I’ve spent years perfecting the secret to a trim and attractive physique. My foolproof system involves just nine easy steps.

Step 1: Avoid what psychologists refer to as “emotional eating.” This is hard, because many people have a tendency to experience emotions. To solve this problem, consume increasing dosages of psychotropic medications until you cease to feel emotions of any kind.

Step 2: Visualize yourself as a thin person. This is very important, because the body often takes its signals from the brain. Each time you take a bite of food, imagine that you are a thin person taking a bite of food, chewing the food, then spitting the food into a napkin, then tucking the napkin into your backpack or purse. After you’re done visualizing these things, start doing them.

Step 3: Get rid of your “fat clothes.” Keeping your closet stocked with unflattering garments will only distract you from your quest for a slender body. To complete this step, shred or burn everything in your closet, including any hangers or shelving that a fat person may have touched. Refrain from donating anything to charity, as this could cause underprivileged people to become obese, which would be unsavory and possibly even illegal.

Step 4: Refrain from consuming food.

Step 5: Surround yourself with thin people. This will naturally encourage you to emulate their healthy habits. Weigh your friends on a regular basis, then weigh yourself. Do you have a friend who weighs less than you? If so, consider gastric bypass surgery.

Step 6: Drink plenty of water. As you’ve probably heard, water functions as a natural lubricant in the body, flushing toxins and fat cells from the digestive tract. Water is also a delicious replacement for higher-fat liquids, such as milk. Try pouring water on your cereal or in your coffee. If you’re a baby, try pouring water into your mother’s breasts.

Step 7: Buy a pet. Having a pet will force you to take walks, which are a form of exercise. This is true unless you make the mistake that I made, which was buying an iguana. Iguanas walk very slowly and smell strongly of turds. I really cannot dissuade you strongly enough from buying an iguana.

Step 8: Vigorous sexual intercourse burns up to two hundred calories per hour. Therefore, if you are not currently promiscuous, it is essential that you begin “boning” immediately. Start by having sex with every person you know. Then have sex with numerous people you have never met. Continue doing this until you are thin.

Step 9: Self-confidence is the most attractive trait a person can have. For this reason, strive to love yourself and accept yourself exactly as you are. This will be difficult if you are overweight, on account of your loathsome physical appearance and compromised value system, but do your best. And, if the going gets tough, remind yourself: every person is beautiful on the inside, provided that they are also extremely attractive on the outside.

Portion Distortion

June 20, 2008

Joe Average has lost over 50 pounds in the past four months, and one of the main ways he did it was to cut portion size. It is amazing how we all distort (underestimate) the amount of food we eat in a “serving.”  To really get a feel (with good visuals) of your own tendency to do this, check out the Portion Distortion site right now! Here is a bit more about portion size in an excerpt from Weight Management for Your Life:

Much research supports the fact that portion size is a major determinant of how much we eat. For example, Brian Wansink, Professor of Marketing and of Applied Economics at Cornell University, conducted several studies which showed that:

• Moviegoers ate 45% more popcorn when served in a large tub compared to a medium sized container.

• People watching a movie ate twice as much M&Ms from a large bag compared to a small bag.

• In neither of the above studies were the research subjects able to guess the number of calories they had consumed; people consistently underestimate the amount they eat.

• While people tend to acknowledge that portion size and container size may influence other people, they often wrongly believe they themselves are unaffected.

We all suffer from “portion distortion” when we estimate the amount of food we consume, not only at mealtime, but when we snack and eat without being mindful (automatic eating). To see whether you have this problem, check out the Portion Distortion Quiz on the Internet (http://hp2010.nhlbihin.net/ portion/).

Rethinking Thin

June 12, 2008

Gina Kolata, author of the book Rethinking Thin, has a point of view: it is almost impossible to lose significant amounts of weight and keep it off. I respect her work, but take issue with her pessimistic tone. Here is a review of her book I placed on Amazon.com:

Most books on diet and weight control, and there are hundreds, fall into one of two categories: research-based but narrowly focused and selective in order to promote a specific point of view; or completely opinion-based and hyping some fad or promoting a product (which may be the book itself). Rethinking Thin falls into the first category.

Author Gina Kolata, a New York Times science reporter, contends that being “overweight” has been oversold as a health problem. She correctly criticizes the hugely profitable “diet industry” for capitalizing on people’s belief that they can and should try to change what they weigh. Her major argument is that people have little control over their weight and that, like height, it is mostly biologically determined through a poorly understood interaction of heredity and environment.

I agree with Kolata that being overweight is not necessarily a medical problem and also agree with her criticism of dieting, but I disagree with her emphasis on how little effect our behavioral choices have on the outcome. For example, she writes, “It must be that free will, when it comes to eating, is an illusion.” She throws out the baby “willpower” with the bathwater of self-blame and shame. The problem, as I see it, is not with willpower but with the misuse of it in trying to comply with worthless diet plans and attempting to achieve unrealistic goals.

For some people there is a major genetic and/or biochemical component to their difficulty in maintaining the weight they desire. Ongoing research concerning the roles of leptin, ghrelin, insulin, and many other hormones in regulating body weight and hunger demonstrates that some obese individuals (perhaps as many as 5% or more) may have genetic mutations affecting their ability to control their appetite. Related lines of research indicate there are biological forces that make it difficult for most people to lose weight once it has been gained. Such evidence suggests that once fat tissue accumulates, a system of overlapping neurological and hormonal mechanisms works to prevent it from diminishing. Even so, most of us do have a significant degree of control over our eating and activity level, and this means we have some control over what we weigh.

Here are some relevant lines of research that Kolata essentially ignores:

  • The important role of “non-exercise activity thermogenesis” (NEAT) in determining what we weigh;
  • The thousands of success stories of people who have lost significant weight (and kept it off) through conscious control of eating and activity (this may be a small percentage of the overweight population, but a significant group);
  • The proven role of social networks and support systems in affecting our weight and lifestyle choices;
  • Exciting research (using sophisticated neuro-imaging) which shows how and where the “conscious” brain exerts influence on our eating and impulse control (including the role of “won’t power”);
  • Extensive research on consumer behavior when it comes to food choice, portion control, and automatic or impulsive eating behavior;
  • Research on stages of self-change and willpower fatigue (and ways to increase self-control and overcome learned helplessness).

Kolata concludes her book with this statement, which is a bit pessimistic in tone, but also offers realistic hope for people who are interested in taking action toward improving their health: “The lesson is, once again, that no matter what the diet and no matter how hard they try, most people will not be able to lose a lot of weight and keep it off. They can lose a lot of weight and keep it off briefly, they can lose some weight and keep it off for a longer time, they can learn to control their eating, and they can learn the joy of regular exercise. Those who do best tend to be those who learn to gauge portions and calories and to keep their houses as free as possible of food they cannot resist. The effort, the lifelong effort, can be rewarding – people say they feel much better for it. But true thinness is likely to elude them.”

Please let me know what you think; are you an optimist or pessimist where weight management is concerned?

Exercise — who needs it?

June 6, 2008

There has been a lot of controversy about the role of exercise in weight management. The old conventional wisdom has been that, to maintain weight, one needs to balance calories in with calories out, and that exercise is the way to boost the “out” side of the equation. That is still basically true, except we now know that it takes a lot of exercise to counterbalance a large intake of calories, and our bodies are real good at seeing that we eat more to fuel the extra exercise. Most research shows that the amount of exercise that improves our general physical and mental health (like 2 hours of moderate-intensity walking per week) is simply not sufficient to affect weight very much.

The fact that exercise had been oversold as a weight-loss aid has led to some very cynical articles claiming that exercise is practically useless for weight management (such as this and this). But these articles overlook two important facts:

1.) Thousands of reports of people who have lost significant amounts of weight and kept it off reveal that exercise is a key reason for their success. Many of these reports are featured on the National Weight Control Registry website (nwcr.ws), which tracks people who have been successful in losing weight and keeping it off. Here is how the co-author of the website summarizes the role of exercise:

The key [according to James Hill] is exercise. ‘Activity becomes the driver; food restriction doesn’t do it. The idea that for the rest of your life you’re going to be hungry all the time – that’s just silly.’ People in the registry get an average of an hour of physical activity every day, with some exercising for as much as 90 minutes a day. They also keep the fat in their diet relatively low, at about 25 percent of their calorie intake. Nearly all of them eat breakfast every day, and they weigh themselves regularly. ‘They tell us two things,’ Hill says. ‘The quality of life is higher – life is better than it was before.’ And ‘they get to the point with physical activity where they don’t say they love it, but they say “It’s part of my life.” … I think you pay the price for having been obese and you have to do a lot of activity to make up for that.’

2.) There is a very important form of activity that is technically not exercise, but is crucial in determining our ability to lose or maintain weight. It is “non-exercise activity thermogenesis” or NEAT, and it accounts for a very significant proportion of our energy output. An excerpt from Weight Management for Your Life summarizes this research:

Research at the Mayo Clinic by James Levine, MD, has clearly shown that the more we move throughout the day, the more weight we lose (or don’t gain). He calls this kind of movement NEAT, which stands for Non-Exercise Activity Thermogenesis. For most of us, NEAT accounts for far more of our daily calorie expenditure than formal exercise does (even fidgeting uses calories!). Levine found that thin people are on their feet an average of 2.5 more hours a day than their overweight counterparts. NEAT is responsible for between 20 percent (in very sedentary “couch potatoes”) and 50 percent of our total daily energy expenditure. Most of the rest of our energy expenditure is due to “basal metabolism” (calories used when we are at complete rest) which accounts for up to 60 percent; and “thermic effect of food” (digestion, absorption, storage) which accounts for 10 to 15 percent. Levine discovered that our individual NEAT level is largely biologically determined (possibly genetically) and that people with a naturally low level can be taught to increase their “non-exercise activity.” He recommends that we aim for 40 percent NEAT by changing the way we work, such as standing while working and walking around during meetings and while on the phone. He uses a treadmill going very slowly (1 mph) throughout the day (a “walking workstation”); this kind of easy activity doubles our metabolic rate and uses an extra 100 calories per hour (compared to sitting). This would be a great way to watch TV!

What is the take-home message from all this?

First, be wary of articles, even from prestigious sources, that take an extreme view. Life is never so simple, and weight management is especially complicated and multi-faceted.

Second, how active we are (whether through formal exercise or NEAT) has a major effect on our health and our weight: the less sedentary the better.

Finally, what and how much we eat is just as important as exercise and activity.

Please let me know what your experience with exercise and non-exercise activity has been.

Mindful eating vs. mindless munching

May 28, 2008

A recent article in The Wall Street Journal (May 13, 2008) provides an excellent overview of the growing body of information about “mindful eating.” Two quotes from the article will give you an idea of what all the excitement is about:

Chronic dieters in particular have trouble recognizing their internal cues, says Jean Kristeller, a psychologist at Indiana State, who pioneered mindful eating in the 1990s. “Diets set up rules around food and disconnect people even further from their own experiences of hunger and satiety and fullness,” she says.

“Try to eat one meal or one snack mindfully every day,” advises Jeffrey Greeson, a psychologist with the Duke program. “Even eating just the first few bites mindfully can help break the cycle of wolfing it down without paying any attention.”

The article highlights research which demonstrates that mindful eating can reduce binge eating. Research to test whether mindful eating can be taught in a way to help people lose weight or maintain a desired weight is underway.

Here are some more links to sites and books that discuss mindful eating and mindless munching:

Emindful

The Center for Mindful Eating

The Mindless Method program (Dr. Wansink)

the CAMP System (Control, Attitudes, Mindful eating, Portions)

book: Mindless Eating: Why We Eat More Than We Think (by Brian Wansink)

helpful blog post on Emotional Eating and Mindful Eating

blog: Eat, Drink, and Be Mindful

book (by me): Weight Management for Your Life

There are many other resources and books about mindful eating, but these should get you started (I don’t have any direct experience with the programs listed above, but they look interesting; I do know Brian Wansink is an expert in the field of eating behavior).

I agree that mindful eating can be a powerful tool and one of several ways we can take more control over our lives and the decisions we make.

Please write a comment about your experience with mindful (or mindless) eating.

What is the role of willpower in losing weight?

May 23, 2008

Perhaps no single issue in the ongoing debate about how best to maintain a desired weight, and generally live a healthy life, is more controversial than the role of willpower. Many “experts” avoid the term altogether, and assure their readers and potential customers that willpower is an evil concept which blames the victim of unhealthy habits. I was very surprised, therefore, when I saw this article on willpower in the New York Times (“Tighten Your Belt, Strengthen Your Mind” April 2, 2008). Could it be there is something positive to say about the concept?

Here is an excerpt from Weight Managemet for Your Life regarding the role of willpower in weight management (pp. 26-27):

While it is beyond the scope of this book to discuss the many meanings over time of the terms “free will” and “intentionality,” and whether human beings actually possess any, I believe we are able to exercise freedom of choice and, in varying degrees, make unique decisions and valid commitments. Neuroimaging studies (“functional MRIs” which show brain activity as we perform tasks) demonstrate that conscious decision-making accounts for from twenty to fifty percent of brain activity, depending on the novelty and complexity of the task. Many of our everyday decisions are made in the pre-conscious mind – outside our immediate awareness, but readily brought into awareness. Thus, our willpower (also referred to as conscious volition, intentionality, or self-control) is a force we can call upon when necessary, and with some degree of freedom.

When people hear the term “willpower,” many envision Sisyphus, from Greek mythology, who was condemned to repeat forever the same meaningless task of pushing a rock up a mountain, only to see it roll down again. That is because we usually only pay attention to our own willpower when we are having problems applying it to a difficult task. The majority of the time we use it without even being aware of it, such as when we decide to watch TV instead of reading, or vice versa. In the following sections, I will suggest ways to make willpower more accessible in order to increase your effectiveness in getting what you really want out of life.

The power of social networks to improve health

May 22, 2008

Quitting smoking and losing weight (if you are overweight) are perhaps the two most important behavior changes you can make to improve your health. A new article in today’s New England Journal of Medicine confirms what a previous article has shown: people we interact with in our social network (friends, spouse, co-workers, etc.) strongly affect our behavior when it comes to smoking and weight gain or loss. We also affect the other people in our network. Today’s article is titled “The Collective Dynamics of Smoking in a Large Social Network” by Christakis NA, Fowler JH (NEJM, Volume 358:2249-2258). The earlier article, and similar research, is described in Weight Management for Your Life (p. 79):

In 2007, an article appeared in the New England Journal of Medicine with the title “The Spread of Obesity in a Large Social Network over 32 Years” [N Engl J Med. 2007 Jul 26;357(4):370-9] The same day the article was published it made front page news. No previous research had focused so intensively on “the obesity epidemic” as a social network phenomenon. The main finding of this elaborate study was that friends have a highly significant influence on our weight, specifically whether we become obese. The effect of friendship was surprisingly large and exceeded the influence of siblings and spouse (whose influence was also significant). … The editorial in the NEJM accompanying the article put it this way: “As the article by Christakis and Fowler [the researchers] shows, … networks, in this case those that pertain to social influence, may have just as strong an impact on the development of obesity as the otherwise strong genetic effects.”

These studies provide exciting and compelling evidence in favor of the bio-psycho-social model for disease and wellness, meaning that biological (e.g., genetic), psychological (e.g., coping) and social (e.g., interpersonal and cultural) factors interact to produce health problems and all must be addressed in reversing or treating these problems.