Weight Loss - Dallas/Ft. Worth, TX

Weight Loss - Dallas/Ft. Worth

HOW FAT IS TOO FAT

The word is getting out that most Americans are overweight, but a lot of people are still not aware that includes them .

We're not just talking about not looking good in a bathing suit. Even someone who is just "a little round," or "pleasantly plump" is already at higher risk for significant health problems that are costing Americans $130 billion a year. Fully two out of three Americans are overweight today.

So just how fat is too fat? The euphemisms we use nowadays to refer to body weight mostly imply that it's a matter of image or appearance, distracting from the real issue-excess weight is hurting our health. So how do you know when to be concerned? When has body weight gone from a cosmetic issue to one of well-being?

The standard tool for measuring that is the Body Mass Index (BMI). The BMI calculates height and weight to come up with a score that is indicative of a class of health risk. A score of 18.5 to 25 is typically considered a healthy BMI. Above 25, the level of body fat begins to constitute a health risk, because the excess contributes to problems like elevated blood pressure, elevated blood sugars and high cholesterol, which all lead to serious ailments.

A woman who is 5-foot-4 and 155 pounds has a BMI of 27. That's overweight, and she's already at higher risk for various health problems. But if she also has one or more other risk factors-doctors call them "co-morbidities"-such as hypertension or a family history of diabetes, her physician should strongly recommend that she bring her weight down and be vigilant about keeping it stable at a healthy level.

But that same woman just 15 pounds heavier is clinically obese, and at great risk for a host of major medical problems including heart disease and even cancer. Her risk of ultimately dying from those problems simply skyrockets once she reaches that 30 BMI mark.

Along with BMI, doctors also use the measurement of waist circumference. A waist circumference of more than 35 inches for women or more than 40 inches for men is considered bad news. That's because where our weight is distributed can be as critical as how much we're toting around. Weight deposited abdominally-sometimes referred to as the "apple" body type-has a much greater impact on internal organs and the way our bodies function, so it's much more dangerous than weight carried mainly on the hips and thighs, as with the "pear" body type.

How our weight is distributed is largely a result of our genetics and we don't get a vote in it. But if we end up with a body that carries weight in the torso, we get stuck with fat that is far more likely to cause elevated blood sugars and high cholesterol, that is more likely to impair kidney function, more likely to interfere with our cardiovascular health. So someone with a BMI of only 25 or 26, but with a bigger waist circumference, may be advised to lose some weight anyway, just to help avoid some of those serious health concerns.

And what of those folks who have been overweight for a long time, who are comfortable with their bodies, and so far haven't noticed any ill effects of their excess weight?

It is possible to be fit and fat, and a few people are, but it's very few. Health risks do increase with age, and you may not notice initial signs of trouble developing. But you don't have to wonder. You can find out if you're having any negative health effects because of your weight with a few simple tests conducted by your doctor to tell you if your blood sugars, cholesterol, or insulin levels are outside the healthy range.

And if they are, you know it's time to make some changes for the better, before your body takes a turn for the worse.

DINING OUT WEIGHING IN, RESTAURANT MEALS ARE HIGHER IN CALORIES

With two out of three Americans overweight today, it’s getting harder to believe that all this extra fat is a simple problem of self-indulgence or poor personal discipline.

In fact, researchers and clinicians from various sciences say unequivocally that it’s not. Certainly adults are responsible for what they put in their mouths. But when so many are affected, from all across the American demographic, we have to also look what’s going on in our culture at large.

And one thing that’s going on is that there’s a lot more going out. In 1978, just 18 percent of the calories Americans consumed were eaten away from home. But by 2003, that was up to half.

Why should that even matter? A calorie is a calorie is a calorie, right?

At the bottom line, yes. The trouble is that when we eat out, we simply have much less control over what ends up on our plates, and from there, on our bottom line. That shows up in a variety of ways.

Nutritional research indicates that for almost any given dish that you might choose to prepare at home, when it’s compared to a restaurant dish of the same name, it’s often not the same thing at all. So even trying to consciously select what looks like the healthiest choice on the menu might not do you much good.

Restaurants tend to use more oils and fats, more sugar, and more salt in their food preparations. The reason is simple: if the food is yummy, you’ll come back! But that tends to add up to a lot of extra calories you weren’t counting on.

And speaking of extras, how about all those extra nibbles: the plates of appetizers, the baskets of warm bread with pots of cool butter, the bonus beverage specials? Most families simply don’t have all those edible accoutrements with regular home meals.

But at a restaurant, your drinks are brought before you even order. You often get bread or rolls to eat during your wait, and appetizers and desserts are helpfully suggested by your server.

Yet those extras can have even more calories than your meals! An order of buffalo wings with blue cheese dressing? That’s a tidy 1,010 calories before dinner. For a fried onion blossom with dip, figure around 2,000. Even a basket of garlic bread is about 800 calories. How many people are sharing those calories at your table?

Then you get to the main attraction, and the major problem with dining out—portion size! Restaurant meals are often three to four times larger than a normal serving size.

Even plates, glassware and utensils have grown. Very often, the dinner plate you get in a restaurant would qualify as a platter in any home kitchen, but then, they have to be bigger to accommodate those super servings!

It wouldn’t be such an issue if we were better at walking away. An old adage about fitness says that the most important exercise to do is “push back,” as in, when you’ve had enough, push back and get up from the table.

But research shows that Americans in general tend to be “completers,” and many of us were raised to feel a sense of guilt if we left food on our plates. Add that programming to a giant dish of pasta, and suddenly, you’re stuffed!

The truth is, no matter how we're raised, or whether we're slim or fat, if more is put in front of us we'll eat more, period. And usually, we're not even particularly aware of it. This has been proven out by study after study, in both the United States and abroad.

And that's not all. The research also shows that as we become accustomed to those mega-sized meals we’re presented in restaurants, we tend to prepare bigger portions at home, as well. We may not use all the extra oil, salt and sugar that restaurants do, but we’re certainly having more of our main ingredients, and we’re eating big and hearty.

The other thing that restaurants have over the home meal is variety. Even the most accommodating home cook typically won’t make a different special meal for each member of the family. Again, the nutritional research shows that the more different things you can have, the more you’ll eat overall.

United States Department of Agriculture studies showed that when offered three varieties of a given food item—say, sandwiches or cookies—people would eat more than if they were offered three items of the same variety. That’s part of why those all-you-can-eat buffets are such a caloric catastrophe. Who ever has just a little?

Given the demands of today’s busy lifestyles, dining out nowadays is not only a pleasure, but a time-saving survival tool. Restaurants may eventually be required to provide nutritional facts for their meals, but even without hard numbers, awareness of the pitfalls can go a long way toward helping us control those calorie counts.

We just need to think about what we’re up against when someone else is serving, so that when we’re eating out, we’re not taking so much in.

Make Yourself at Home!

If you eat out frequently, think about adjusting your restaurant eating habits to conform more to those you might practice at home. No one’s feelings will be hurt if you don’t order an appetizer or if you say no to the extra beverage refill. And remember to do those “push-backs!”



LIQUID CALORIES COUNT EVEN THOUGH THEY DON'T REGISTER

When researchers go looking for trends that might explain the nation’s obesity epidemic, most agree on at least one thing: Americans have a drinking problem.

It’s not only alcohol. It’s everything—sodas, sport drinks, specialty coffees and teas, fruit beverages of every ilk. Except for milk, Americans’ per capita consumption of virtually all beverages has steadily increased over the last couple decades … right along with our average weight.

Does that mean all the extra guzzling is to blame? Nutritional researchers think it’s definitely part of the problem, for several well-documented reasons.

To begin with, in spite of advertising promises of “satisfying refreshment,” the science shows that when we drink our calories, we actually don’t feel satisfied, literally. With the notable exception of milk, fluid intake typically isn’t sufficient to trigger production of the hormones that alert the brain that the stomach has been fed. That’s the sensation doctors call “satiety;” most people call it “being full,” and recognize it as the cue to stop eating.

This is particularly so if you’re slowly sipping, but research shows that it holds true even if you slam a tall, cold one, and in Southwest Florida, who hasn’t done that? But that sudden temporary bloat you’ll feel is no substitute for satiety.

Now consider that point together with another key part of the problem: portion sizes for food servings are ballooning out of control, and drinks are the worst of it.

Pick any given bottled beverage, one of those fancy coffees or teas, a fruit drink, soda or sport cooler. Then check the nutritional label, first for calories and then for number of servings. Most contain two or more servings, but how many of us are really sharing that Snapple with a buddy?

And dietary research at Penn State showed that even among consumers who did check nutritional labels for calories, they just didn’t take the extra step and multiply for the extra servings, to get an accurate total calorie count.

Fountain drinks are even more troublesome than bottled beverages. Ounce for ounce, those big fountain drinks are a better deal, so we’re buying more and drinking more! A 32 ounce, convenience-store fountain beverage costs, on average, about 69 cents. It sounds like a real deal, but keep in mind that a typical adult should consume from 2,000 to 2,500 calories a day. If you put regular sweetened soda in that vat, you’ll add about 300 calories to your daily intake, get no nutritional benefit whatsoever, and not even alleviate your hunger! That’s no bargain, no matter how big the gulp.

Maybe you’re one of those sippers or gulpers who’ve made the switch to a “healthier” fruit drink or sport beverage. Don’t assume you’re coming out much ahead of those who are sucking up the soda pop. A lot of commercially produced fruit juice drinks don't actually contain much juice. They're mostly high fructose corn syrup, water and fruit flavorings. The nutrients, if any, have usually been added after the fact to make the product more appealing to those consumers who do investigate the nutritional data.

Take Hi-C, that perennial kid favorite. It’s “fortified” with extra vitamin C, but it contains only 10 percent fruit juice, a fact that is emblazoned proudly across the label. Sunny Delight would have us believe that "citrus beverage" is a healthy drink choice, and it’s heavily marketed as a smart alternative to soda. Don’t believe the hype. Sunny D is mainly corn sweeteners, water and fruit flavorings, and it’s a poor source of nutrients relative to caloric content.

Researchers also find that when we drink our calories, as opposed to consuming them in food, we just fail to recognize that we’re taking in calories at all! When we load on extra calories by having a treat or eating too much at a meal, most of us will compensate by cutting back on something else, so as to try to consume roughly the same amount of calories overall.

Not so with drinks. Study after study shows that it’s as if people think calories don’t count if they come in a fluid form. People often sip drinks all throughout the day, but seldom displace any food intake to allow for it. The 300 calories in that large cola just get added on to the bottom line. The same goes for alcohol. People tend not to think about the calories in alcoholic beverages, and after the first couple drinks, they tend not to care about them, either.

The good news is that as unwanted calories go, it’s pretty easy to shave beverage calories back off the bottom line. While dieters often have trouble reducing their food calories, research shows that cutting back on drink calories is, well, a lot easier to swallow.

Quick liquid calorie cutbacks

Simply switch to low- and non-caloric beverages like diet soda, regular coffee and tea, or good old water. It may take you a few drinks to adjust to your new flavor choice, but it’ll be a lot easier than adjusting to a new, bigger pant size.

PORTION DISTORTION, WHY BIGGER ISN'T BETTER

Ah, the good life. Dining out, shopping for clothes, dining out, shopping for clothes, dining out, shop… wait a minute. Is there a pattern here?

Americans are eating out more and more, and leading researchers say that’s a big part of why so many of us are overweight. The biggest part of that big part? Big portions!

When we eat out, we are usually getting a portion of food that is double, or even three or four times the size of what is considered a normal serving.

Many restaurant meals are upwards of 1,000 calories for a single meal! Remember what a big deal the Quarter Pounder was when it was introduced in the 1970s? Nowadays, it’s not surprising to see one-third and one-half pound burgers on a menu.

And it’s not just at restaurants. Grocery stores, bakeries, delis, everywhere, the portions are simply ballooning. Remember when a muffin was roughly the size of a cupcake? Not any more!

Yet researchers find, we’re still eating the whole thing, whatever the thing, without comprehending the alarming increase in our daily caloric intake.

It’s not that restaurants and food producers are deliberately trying to make us fat. They’re just trying to protect their market share of your food dollars, and to do that, they look for ways to improve value and appeal for their consumers.

Actual food ingredients are relatively cheap, compared to packaging, labor, rent, research, marketing, lobbying, advertising, and all the other expenses of bringing you that meal or snack. So from their end, it’s just good business to give you more and make you feel like you’re getting a deal. Everyone loves a bargain, and good value keeps us coming back.

The regular old 7-11 soda grew into a Gulp, and then a Big Gulp and then a Super Gulp. The basic American hamburger and fries meal got supersized, then double-sized.

But no matter how big they get, we keep eating whatever is served. With that much more food passing as a single meal, they might as well call it trouble-sized!

Many of us were raised hearing the admonition to “clean that plate,” and we feel obligated to finish whatever is served, whether or not Mom is still watching.

So take a plate full of way more food than we need, together with the training to eat more than we might even want, and you have a pretty reliable recipe for over-eating, and hence, weight gain.

But perhaps the most important consequence of all the commercial supersizing is what it’s done to our perception of appropriate portions.

As we get used to seeing those big portions when we eat out, we tend to recreate them in our home kitchens, so that even when we do our own cooking, we again serve ourselves more than we need, or even should have.

Researchers found that of all the places where we’re getting bigger portions, fast food servings have grown the most, followed by those we dish up at home. Our sense of appropriate servings has simply been distorted.

So what to do? When you’re at home, fill the plates from the stove and bring them to the table. Repeated studies have shown that if the food is within arm’s reach, we’ll eat it. But if we’ve got to go and get it, we are less likely to have more.

And before you do go for seconds, just sit a few moments and let your body catch up. It takes about 30 minutes for the hormones that signal satiety to get the message from the stomach to the brain.

When eating out, just imagine that every meal you order has a notation in the menu that says “serves two.” Decide how much you want to eat at the beginning of the meal, and before you even start, put the rest in that take-home container.

And when you’ve had enough, stop. Being satisfied doesn’t mean feeling stuffed, and enjoying a good meal shouldn’t leave you uncomfortable afterwards. That mountain of mashed potatoes isn’t Mr. Everest, and you don’t have to eat it just “because it’s there.”

And finally, whether you’re driving through, or sitting inside, or even ordering delivery, always resist the temptation to supersize.

It may seem like a great bargain at the moment, but in the long run, you end up paying for the extra calories, not with those extra few cents, but with your health.

THROUGH THICK & THIN

Remind yourself that you don’t have to eat everything you’re served, even if your mother is with you. After being trained all our lives to “clean that plate,” this can be a tough one. But go ahead and ask for that doggie bag, or give yourself permission to just leave some of your dinner on the plate.

GLYCEMIC INDEX, GOOD CARB, BAD CARB

If you’re one of those people who can’t stand all the counting and tracking and adding and charting that some diets require, you could find a refuge in one simple numerical scale: the glycemic index. On the other hand, you might find it another maddening way to complicate the simple act of eating.

The glycemic index is a measure of the quality of carbohydrate foods. It’s kind of a good carbs/bad carbs thing, based on how they affect your blood sugar. Though it’s not new, it did start getting a lot of press when the anti-carb movement took hold.

It works like this: in the glycemic index, pure glucose is arbitrarily assigned the score of 100; it doesn’t mean anything in particular; it’s just a set reference point for how it has affected the blood sugar by about two hours after eating. Then all other foods in the index are given a number relative to glucose and its affect on the blood sugar.

Foods with a low glycemic index typically break down slowly and don’t cause drastic fluctuations in blood sugar. Foods with a high index typically do. For instance, green peas have an index of 39, while corn flakes have an index of 92.

Originally developed to help folks—particularly diabetics—control their blood sugar, the glycemic index includes mainly carbohydrate foods, because protein and fat don’t have much immediate effect on blood sugar.

But assigning numbers to different foods based on their glycemic effect just happens to create a scaled list of foods that ends up being a very useful tool for people dealing with obesity and other health issues, as well. That’s because simply maintaining a low-glycemic index diet tends to guide people toward healthier eating and weight loss, even when that is not their specific goal.

Consider: Type II diabetes, as well as various cancers and cardiovascular disease, are all highly correlated with high glycemic index diets. There’s abundant research that shows that reducing the overall glycemic index also reduces the risks of those problems.

That’s because almost by default, a low-index diet will include more fresh fruits and vegetables, more fiber, more dairy, all foods that offer essential nutrients, that are more likely to be lower in calories and which tend to keep the body sated longer, holding off the next hunger spell. All that usually adds up to weight loss, no matter what the program.

Proponents of the glycemic index say it’s more helpful than counting calories or grams of fats or carbs, and actually offers a simplified approach to learning to eat better, but some experts caution that people shouldn’t get too wrapped up in worrying about the precise numbers. Instead, they urge that people pay attention to whether the foods they’re eating have a low, medium or high index.

That’s because, as with any rule, there are exceptions to the fairly consistent physiological rules that underlie the glycemic index. For instance, watermelon has a pretty high glycemic index, about 75, which is even higher than table sugar. Does that make it bad for you? No. Because in spite of its high index, watermelon actually has a pretty low glycemic load. That’s a measure based on the amount of food you’d actually consume, not just an arbitrary quantity used in testing, as with the index.

The glycemic load of a food can be determined using the glycemic index number for a food, divided by 100 and multiplied times the available carbohydrate you’d eat. With most foods, low index is consistent with low load, but there are the quirky exceptions. Of course, to find them, you’d be back to doing a bunch of math again, and that’s just not the way people normally eat.

That’s why doctors and nutritional experts encourage people who are trying to develop a healthy diet to avoid getting caught up in the numbers game and look more generally at the foods in the index, leaning toward those at the low end. Anything over 70 is considered high index, 55 through 69 is medium and below 55 are foods with a low glycemic index.

And look what’s in those groups: high index foods include most breakfast cereals, white breads and other processed baked goods, most potatoes, ice cream, candies and table sugar, your veritable Atkins nightmare.

Lower index foods include cherries, grapefruit, broccoli, legumes like lentils and beans, most whole grain baked goods and most dairy foods. So even without counting calories or keeping track of specific index numbers, you can see that steering your diet toward the low end of the index is bound to do you good.

We like to encourage patients to think of glycemic index and glycemic load as just two more tools that can be helpful in developing healthier thinking and planning about dietary habits.

A final thing to remember: there’s not one standardized glycemic index list and most indexes include brand-name items that people buy on a typical shopping trip, as well as the more generic items like vegetables and fruits. This is one of the more helpful aspects of the lists, but only if you get one that relates to where you live.

If your average Southwest Florida resident looked at an index created in Australia, it wouldn’t be much help, because really, when’s the last time you had a couple Golden Pikelets with a nice glass of Milo?

THROUGH THICK & THIN

Fruits tend to have a high glycemic index, so I recommend that people take their fruits with a meal, or with some protein like cottage cheese or regular cheese. These protein sources help mitigate the fruits glycemic effect. Don’t let a high index number keep you away from your apple a day.

UNDERSTANDING YOUR SETPOINT, LEARNING TO STOP

The human body is a wonderful, complicated machine.

Your digestive system, your brain and your fat stores all work together through a highly complex biochemical interaction to help you maintain a stable weight. These different parts of your body communicate with one another through various feedback mechanisms in an effort to coordinate the various activities that maintain your weight at a specific level. That level is known as the setpoint.

Think of your setpoint as a thermostat. In your home, you set your thermostat at the temperature you most enjoy and expect your heating or air conditioning system to respond to outside conditions and maintain your home at that temperature. By the same token, your setpoint raises or lowers your appetite and metabolism-the rate at which your body burns calories-in response to how much you eat.

You may now ask the obvious question: "If my body is designed to maintain a stable weight, then why did I gain weight and why is it so darn hard to lose it?

Back to our thermostat analogy. Let's say that the outside temperature is 85 degrees and you want your home's cooling system to maintain an indoor temperature of 72 degrees. No problem. Your air conditioner won't have to work too hard to cool the outside air by only 13 degrees.

But let's throw in a heat wave when the outside temperature climbs to a sweltering 110. No matter how hard your ASC struggles, it won't be able to maintain that desired 72 degree temperature. The gap is just too big. So what does it do? It maintains the lowest temperature it can-but it will still be higher than 72 degrees!

That's what happens with your setpoint. If, over a long period of time, you develop a greater gap between the calories you eat and those you use up in exercise, your body's weight regulation system will adjust your setpoint upward. Your body then settles in to maintain that higher weight.

That answers the first part of your question, but what about why it's so hard to the weight back off?

When you start to lose weight, your body's metabolic alarm goes off. It alerts your body-which strives for equilibrium or that stable status quo-that you are not eating as much as usual. In turn, your body demands more food. It's a survival mechanism, built in eons ago, and not easily reprogrammed.

For years, I have reassured my patients that dieters don't fail for lack of willpower but because of cravings! As long as your setpoint remains elevated, you will be assaulted by those blasted cravings every time your body senses that you are not eating enough to maintain your present weight.

Those physiological hunger alarms thus make it extremely hard for overweight people to lose weight, and even harder for them to keep it off. Your body is fighting to hold on to whatever excess fat it has become accustomed to, and it does its best to replace any weight you lose.

Last week, I offered a number of strategies for dealing with cravings, but here's a little framework for bringing them into play.

People who know the phrase "lead us not into temptation" grow up thinking of temptation as the first step down a slippery slope into some kind of disaster, and it often is, if you yield to it.

But you can also think of temptation as an early warning system. Sure, there are times when it just doesn't bother you to be around a lovely plate of brownies, or French fries, or some other treat that's just not on your dietary program. But sometimes you are tempted. But instead of regarding that craving as the first step toward actually eating the off-limits treats, regard it as the signal to pull in reinforcements, just in case. Even before you start to feel really compelled to go for the goodies.

If you feel tempted, STOP!

STOP is an acronym for a four-step process that you can use to good benefit.

S-Stop! Visualize a stop sign and hear the word "stop." Immediately stop whatever it is you're doing.

T-Take a deep, cleansing breath. This creates a window of opportunity during which you can recognize and assess the temptation you're faced with, and take appropriate action.

O-Observe your situation, yourself, and and your options. Analyze what's going on. How are you feeling? What do you want? What do you need? In your observation, use the HALT analysis. Am I Hungry, Angry, Lonely or Tired? That's because we often react automatically, sometimes inappropriately to these stimuli. Of these, only true hunger is a good reason to eat. If there's something else playing into your temptation, then eating is not the correct response, plain and simple.

P-Plan your correct action. You've got choices, so what are they? What's really important to you? What actions will help you move toward what matters, toward an appropriate response, and away from the temptation and reactionary eating.

Go ahead and let yourself hear whatever voices inside you are suggesting that you abandon or sabotage your healthy intentions, and pause long enough to acknowledge and respond to those voices. A good response might be, "Thanks for sharing, now move along."

Then shift the focus away from food by doing something else: sit quietly for five minutes and let your attention rest on your breathing; phone a friend; review a list of your motivations for getting healthy (you have made that list by now, haven't you?) or take a walk.

And encourage yourself as you would a friend or loved one. We're often too willing to let ourselves fail without offering the support we would give to even a casual pal. Remember that sometimes, if you're not hearing what you need to hear, it might be because you're not saying it yourself.

The more often you use the STOP method to manage cravings, the more easily and effectively you'll be able to resist temptations and overcome your body's natural tendency to push you back to your setpoint.

But the more frequently you do it successfully, the easier it becomes, just as with anything else that takes practice. After a while you get good at it, and it just becomes a habit. A good habit.

This educational content is for educational purposes only and does not constitute legal, financial, home improvement or health advice. Content on this page is provided by Ask The Experts and not the featured advertiser.

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