Sunday, April 12, 2009

3 Predictors of Successful Weight Loss

The largest published study to date, not surprisingly, showed that the 3 main predictors of success were:

  1. The amount of self-reported weekly exercise (minutes per week)
  2. The compliance with educational session attendance (just over 30 sessions/year)
  3. The number of meal replacement consumed. Weight loss was greater with greater number of servings consumed.
The study, published in Obesity (2009) 17 4, 713–722, assigned over 2500 people into 2 groups. One received an intensive lifestyle interventions (ILI) with educational sessions and meal replacement and the other a currently used diabetic self-education curriculum. The ILI group lost significantly more weight, with improvements in all the markers of weight related problems, such as blood pressure, cholesterol and blood sugar.

This, once again, underscores the importance of having a system in place that will keep You motivated and compliant with Your nutrition and exercise plan.

Friday, April 10, 2009

How Outside World Makes Us Overeat

I am very concerned that the most important point in the discussion of obesity causes and weight control strategies is getting lost- the abuse of our brain reward systems by external marketing forces.

Specifically, research shows that environmental factors cause us to overeat, oftentimes without even realizing it.

A recent article in Diabetes Journal cites several human characteristics that can be exploited to cause you to overeat:

1. Food and images of food cause automatic secretion of chemicals in our brains creating desire to eat. We are surrounded by abundance of food images in our daily lives via billboards, store shelves and other marketing venues.

2. Inborn preferences for sugar and fat cause people to reach for foods that provide immediate calories during stressful times, especially given the easy access and availability of high-sugar/high-fat foods and snacks. These high impulse items are typically placed at the end of aisles and inside check-out centers, responding to the human trait of being unable to resist innately desirable foods for extended periods of exposure (e.g. waiting in line).

3. Built-in survival mechanisms automatically respond to food abundance and variety by greater consumption. The increasingly greater variety of food on store shelves and restaurant menus, without regard to their calorie or nutritional value, results in calorie over-consumption without nutritional benefits.

4. What's in YOUR dinner?
Sorry to tell you, but biologically speaking, none of us have the capacity to detect with precision the calorie load we are consuming during our meals. Our satiety mechanisms are not very exact and usually turn on much slower than the time it takes us to gobble up a good chunk of calories. Plus, thanks to the marvels of modern food science, quite petite portions of many marketed items contain a pretty good density of calories (usually in the form of fat and carbohydrates). They look very small (and so appetizing and cute), yet pack quite a punch (to the visceral gut). So, next time you are taking a trip to your local grocery store, check out the calories/serving of most foods in the middle section. More importantly, ask yourself - would consuming 1 serving of this product satisfy my hunger? If the answer is no - perhaps, avoiding that isle next time would be an easier way to get out of the store unharmed.

5. Laziness (energy preservation) is in our genes!
In the nature's game of survival, a species' success depends on its ability to preserve energy for absolute essentials. We were bred for millions of years to make the best use of the available energy sources. Everything was going according to plan, until...we developed a refrigerator. That singular invention has essentially turned the entire "survival of the fittest" concept on its head. We now have the unlimited access to food, any time - day or night, winter or summer, and so on. The only problem is that we unfortunately, did not leave our biology behind and have continued to try to minimize our energy expenditures in anything we do. So, why schlep all the way to the farmers market and buy fresh vegetables (which then need to be washed, chopped, mixed with olive oil, etc) when i can just swing buy my corner convenience store and pick up my favorite snack and enjoy the afternoon?!

Out of curiosity, when was the last time You saw a an advertisement for fresh veggies on TV? ...and for potato chips?

6. It's OK 'cause they are all doing it too!
Weight gain is a team sport. Recent medical study showed that the person's weight was highly correlated with the weight of his social network. We tend to imitate behaviors of others around us. So if something is OK to do at your friends' house, why should You deprive yourself? I am not saying you should get new friends or be less accepting of them, I just want you to be able to decide for yourself which behaviors are truly your own and which are just imitations. So, the next time they are having their cheesecakes, maybe you could enjoy that fruit salad?

Thursday, April 9, 2009

Weight Maintenance... Exposed!

"How do I maintain my weight loss once I go off your program?" That is THE question we get asked every day in our clinic, by all our clients. Let me use my favorite format of top 3 things to remember:

1. Know thy metabolism - all theoretical things aside, you need to know what your average resting metabolic rate is (RMR) - i.e. how many calories your body burns on a daily basis at rest - to know where your target calorie intake should be. Knowing this number alleviates any sense of ambiguity and anxiety over the insidious and uncontrollable nature of gradual weight regain. To get an idea of this value go to and plug in your height, weight and sex. By adding the amount of calories burned via physical activity to the RMR, you can easily decide how many calories you can safely consume daily without gaining weight.

2. Know thy cues - it is important to recognize all possible internal and external cues stimulating eating behavior. You need to know which ones are particularly troublesome for you, because that's where your locus of control will reside!

For example, one of the instances where i start seeking food is boredom. Whenever I have down time, my hand unconsciously reaches for that bag of popcorn or a cereal box. Am I hungry? You know the answer (1 hour after lunch!). Knowing this has taught me to keep more fresh fruits and veggies around and less of the stuff i can't resist; to arrange my leisure time to be spent in settings without easy access to food, such as libraries, parks and gyms.

3. Know thy muscle - Yes, get to know, love and "grow" your skeletal muscles. Consistent moderate resistance training will result in increased lean muscle mass, which burns more energy per unit time. In such a way, you essentially, increase the amount of calories burned per day even while at rest. This does not require a very strenuous work out routine putting your joints at rest - these simple exercises will do: push-ups while standing on your knees, gentle squatting (even without any weight), walking up hill for 15-30 min. Do 3-5 sets of 12-18 repetitions for each exercise 3-4 times per week. Engage in aerobic activity for 15-30 min/day 5-6 times a week. Be honest with yourself - if this activity is not "scheduled" or otherwise not incorporated into your daily routine, it is not going to happen! After a few weeks, you will be glad you did this and will not want to miss a session as it will make you feel more energetic, happier and relaxed.