Category Archives: Nutrition

Can the pressure to lose weight keep you from losing it?

Enjoy this guest post by one of our amazing clinical dietitians Narmin Virani, RD, LDN

Today, I want to tell you a story.  I have had some very interesting conversations with a few post-op patients that I simply had to share.  I met 3-4 post-op patients over the last 2 months or so, all of whom were about 6-24 months post bariatric surgery, starting to regain some weight, struggling with getting back on track.  Very similar situations.  These were all bright and sensible women, who had each encountered some stress in their lives.  One had to pick up extra hours at work due to a coworker of hers getting fired, one had some medical issues that had got worse, one was caring for an elderly parent, while one had had an accident that caused her to take leave from work.  Due to these additional demands on their time and energy, or due to not being physically able, all had got off track with exercise.  This led to some weight regain for all of them.  This weight regain led to feeling depressed and discouraged, which led to low motivation with planning and preparing meals.  This led to eating out, not caring about meal planning, which led to guilt.  This guilt made the feelings of depression/discouragement worse, which led to “comfort eating”, which caused some more weight gain.

What struck me about each of these women was that they all were feeling terrible about their weight gain, said they almost didn’t attend their follow-ups because of that, were beating up on themselves for having got off track, and were wondering if they could go on a crash diet to lose the weight they had gained.  These women had all encountered some very real stressors that life can sometimes throw at us.  But instead of being kind and compassionate to themselves during these difficult times, they beat up on themselves for gaining weight, which ironically discouraged them further.  It made me realize: the pressure to lose weight can keep you from losing weight!  How ironical!

Now, as someone who has been doing weight-loss counseling for 15 years, and as someone who had my share of weight cycling/crash dieting as a teenager/young adult, here are my 2 cents of wisdom I’ve gleaned over the years:

  1. The scale can be a double-edged sword.  Yes, having a weight goal can sometimes be motivating, but at other times can lead to discouragement and feelings of failure.
  2. There will come times in your lives, when you will have to put weight loss on hold.  Times when you are overwhelmed with extra demands on your time and energy or times when you are sick.  At such times, chasing weight loss will only add to your stress, and stress can deplete your motivation.
  3. At such times, focusing on self-care – eating foods that nourish and satisfy you, moving in ways that de-stress and energize you – will actually motivate you and help you lose weight. Thinking that losing the weight you have regained first will motivate you to plan meals and move more is actually a “backwards” way of going about it.
  4. At such times, accepting and respecting your body can lead to nourishing and caring for it, while being critical can lead to body-punishing exercise/diets that are hard to sustain.
  5. At such times, going on a crash diet might leave you hungry, tired, deprived, and miserable for a few weeks, and make you lose a lot of water weight, which would come back on as soon as you added regular foods back in.  And you may already know this, but dieting leads to deprivation, deprivation leads to cravings, cravings lead to out-of-control eating.
  6. Satisfaction and Convenience are 2 key ingredients for long term success.  You could be on the world’s healthiest diet, but if you are not satisfied, you could end up thinking about and looking for food all the time, because you’re missing something.  Similarly, if it takes a lot of time and effort to put together meals daily, it will be hard to keep up during busy periods in your life.
  7. Satisfaction means eating foods that are not only filling, but that also leave you feeling energized, and that please your palate.  It’s striking a balance between taste and health, allowing yourself regular indulgences without guilt.  Convenience means keeping frozen meals on hand as back-up for busy days, and knowing that it’s perfectly okay to get take-out meals at times, which may include some healthy choices and some not-so-healthy ones that you are craving, without guilt
  8. These times in your lives are BUMPS IN THE ROAD, NOT THE END OF THE ROAD.  And the more you focus on self-care vs. weight at these times, the sooner you will lose the weight you have gained.  And it’s okay to tell well-meaning family members who instill the fear of relapse in you, that they are not helping.
  9. Maybe you won’t lose 80-100 lbs, but say 30-50 lbs.  But what’s the point of losing 80-100 lbs if you’re unsatisfied all the time?  Isn’t it better to lose a little and keep it off, than to lose a lot and gain it back? And aren’t health and quality of life more important than weight?
  10. As far as comfort-eating goes – for a person for whom food is the only way they have learnt to soothe their soul, turning to food at stressful times is actually a very smart survival mechanism – without it, they may either jump off a bridge or take to other, more dangerous ways of self-numbing.  The problem is not turning to food for comfort – everyone does it at times – the problem is when food is the only source of comfort.  The solution?  Cultivating other ways to cope and soothe – from building strong support systems, to making time for rest and recreation without guilt, to putting your needs above those of others.

Of course, all this is easier said than done, when you have spent half your life dieting, chasing weight goals, beating up on yourself for your weight, eating by numbers – calories/carbs/etc, and forgotten what true hunger/fullness/satisfaction feel like.  It’s natural to keep reverting back to what’s familiar and comfortable, even though we know it doesn’t always serve us.  It’s easier to be critical rather than accepting of our bodies in a thinness-obsessed society.  It’s harder to give yourself credit for the weight you have lost and kept off, and easier to beat up on yourself for the weight you’ve gained.  This is why support groups are helpful.  For sharing your struggles, which might not be yours alone.  For coming up with ideas for coping with stress.  For coming up with ways to practice self-kindness and compassion.  For cheering others on who may be struggling.  For sharing your stories of what helped you get through the tough times in your life.

Don’t ever give up!  Take each day at a time!  Eat in ways that satisfy you!  Move in ways that give you more energy, help you sleep better, reduce stress/anxiety!  Come to your follow-up appointments, we are here to help, not judge you! And oh, take that number on the scale with a grain of salt!

“For both excessive and insufficient exercise destroy one’s strength, and both eating too much or too little destroy health, whereas the right quantity produces, increases and preserves it” – Aristotle

Narmin Virani, RD, LDN

Clinical Dieititan, Weight Center
UMass Memorial Medical Center



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by | June 13, 2017 · 8:15 pm

10 Tips for Treating Yourself Without Overindulging

This is a guest blog by one of our amazing dietitians Narmin Virani.  Enjoy her “just in time” tips this week:

With the holiday season upon us, being around sweets and treats is inevitable.  Don’t let this stress you out though.  Anxiety and fear around food and eating only keep you from relaxing and eating mindfully.  And when you’re not eating mindfully, you don’t enjoy the food, and don’t feel satisfied, which ironically makes you want more.  Relax!!  And try these simple tips for indulging without over-indulging.  Oh, and don’t take my word!  Try out these tips curiously, as an experiment, rather than “dietitian’s orders”, and see for yourself if they work, to reduce cravings and increase satisfaction!


  • Treat yourself on an empty stomach. Intense hunger = eating fast and eating too much.  Save a treat for the end of a meal when you’re comfortably full
  • Skip meals or snacks. Skipped meal = low blood glucose levels.  Guess what our brain asks us to eat when our blood sugar level is low, to keep us from fainting….? Have a shake if not hungry or too busy.
  • Save your treats for the end of the day. Fatigue is a trigger for overeating, as the part of the brain responsible for impulse-control starts fading toward the end of the day, and the auto-pilot part of the brain takes over
  • Deprive yourself of your favorite treats for days or weeks. When does a food become a “trigger food” or cause you to eat too much? When you haven’t had it for days, and know you won’t be having it for days.
  • Categorize foods as “good foods” and “bad/forbidden foods”. When you define success as “not eating X/Y/Z food”, then eating even a little of these foods makes you feel like you failed, leading to an unhealthy relationship with that food.


  • Eat small, frequent meals, every 3-4 hours, and don’t eat in between. This keeps blood glucose levels from crashing, which reduces cravings.  Have a shake if not hungry, or out and about.
  • Include some protein at every meal and snack – this also prevents blood glucose levels from spiking and crashing, by slowing down the absorption of carbohydrates, which reduces cravings. Remember the 3 craving busters – protein, fiber, and small amounts of fat at every meal and snack.
  • Include treats on a regular basis. If you give yourself a small amount of your favorite treats on a regular basis, its easier to tell yourself when you’re craving a second helping, “I can have some tomorrow, and the day after.”
  • Include your favorite treats in small amounts on a regular basis, along with some protein to keep the carbohydrates from causing cravings later in the day. For example – a 100 calorie bag of chips or cookies or pre-portioned ice-cream sandwich or bread, along with a piece of cheese, or some yogurt, or ¼ cup nuts.  You can have this sort of “balanced snack” everyday if you wish, as part of your 5 small meals a day.
  • Eat slowly and mindfully when treating yourself, and generally. Engaging all 5 senses helps you maximize satisfaction from every single bite.  Try to avoid multitasking when eating.
  • Stay hydrated. Thirst can get mistaken for hunger or cravings.  Especially make sure you’ve had a glass of water before you treat yourself
  • Engage in activities that you enjoy on a regular basis: Sweets and treats give us a dopamine rush and hence feel rewarding, but so do hobbies, socializing, exercise that you enjoy, meditation, and making a difference to others. The more circulating dopamine you have in your system, the less pleasurable food will feel.
  • Know the calories in your favorite treats. That way you can indulge in just the right amount, as often as you want, without any guilt.  And when you eat mindfully, just a few bites might be enough.

-Narmin Virani, RD, LDN

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by | November 21, 2016 · 8:02 pm

“Carbs” Clarfied by our own Anna Polucha, RD

Confused about carbs?

Check out this video by our own Anna Polucha, RD on carbohydrates.

If you still have questions, submit it in the comments section.

Keep Moving, Be Well,



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by | April 21, 2016 · 6:18 pm

Boost Weight Loss Success

weightWhat does the number on the scale represent?

Everything that makes up body weight- fat, water, lean tissue(muscle) bone, etc.

Here is an important fact about weight loss (on the scale) to know.

About 30% of weight loss is muscle when a person does not do strength training!

So losing 100lbs on the scale could be the loss of 30 lbs of muscle!

The scale only shows that the goal weight was achieved, not what was lost.

Is this successful weight loss?
If the scale is your only goal then yes.
But your goal, I am guessing, goes beyond the scale.

Being able to do more. Being able to keep the weight of long term. Those are important goals I hear all the time.

The muscle loss means:

  • a lower metabolism
  • easier weight re-gain
  • lower strength
  • reduced balance
  • lower bone strength

It would be easy to attribute these changes to just getting older or genetics.  Reality is, when muscle is lost, the body changes. You could say it ages faster.

stMuscle loss is invisible, but not inevitable.

The good news is that the equipment the body needs to regain strength, metabolism bone and balance is still there. The muscle fibers are still there, they just need to be re-activated.

Cardio exercise such as walking, running, elliptical, swimming etc. do not re-activate the muscle fibers anywhere near as well as strength training.
Give yourself the best chance for success with weight loss with these three “not-so-time consuming” steps:

  1. Adopt a strength training routine with
    1. 2-3 non-consecutive days a week (ie: every other day)
    2. 1-3 sets of a group of exercises that challenges all the major muscle groups
    3. 8-12 repetitions to fatigue. The fatigue part is important. If you can do more than 15 repetitions it is time to up the weights.
  2. Time a snack with protein right before or right after your strength session. Studies show this will improve fat loss and muscle gain. The details of how much protein used in the studies are a bit complicated for this article. Generally adding 10-20 grams of protein beforemilk or after strength training seem to make the difference. One study found simple glass of milk was effective (8 grams of protein).
  3. Stick with strength training for life! Because we tend to lose muscle with aging, even after you reach your goal weight, strength training can insure your strength, metabolism, bone density and balance stay strong.

Keep in mind one set of strength training exercises to fatigue two days a week will do it – it is about quality not quantity. So if time is a barrier, a little investment in time can go a long way.

I cannot stress this enough.

These are three easy steps to boost your weight loss success in as little as one hour a week!

And please, please do not let the myth of muscle gain get in the way. It takes a lot of work to gain muscle that will show up on the scale. A lot of time that most of us do not have. With all that is working against muscle (weight loss, aging,  menopause, etc) too much muscle is not a worry for most of us. If you do feel you have too much muscle, cut back to the minimum level of 1-2 sets two days a week to fatigue. But don’t give up all together on this metabolism saving exercise.

If you are a Weight Center patient and are not following these three steps, email me for more information on how to get on a program.

Keep Moving, Be Well,


These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.


by | November 12, 2015 · 6:42 pm

Mindful Eating Summit + Another reason to do strength training

Here is another great free online resource coming up.  The Mindful Eating Summit is a five-day, 20 speaker online event.  It looks like a great way to learn about how habits and emotions affect the way we eat and tools for eating healthy.

And here is a nice article about research on strength training and  brain health!  I have one caution – please do not do the exercise like they are showing in the picture – elbows above the shoulder increases the risk of shoulder injury. Only raise the elbows to just below shoulder height.  Otherwise enjoy the article.

Keep Moving, Be Well,


These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.


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by | October 22, 2015 · 8:13 pm

New Series for Patients After Weight Loss Surgery

Please join us for our new series starting November 5th 2015:
“Fresh Meal Ideas To Help You Stay On Track”
• Food tasting sessions
• Quick, healthy recipes and snack ideas
• Smart shopping tips
• Tips for eating out
• Cooking demos
• Easy calorie-counting
• Healthy potlucks

*Reminder: this is for patients who have already had weight loss surgery.

1ST Thursday of every month, 4-5 pm
At the Lazare / Hiatt Auditorium (or other location on University Campus)
(Please call, or stop by the Weight Center to confirm: 774-443-3886)
• November 5 2015
• December 3 2015
• January 7 2016
• February 4 2016
• March 5 2016
• April 7 2016
• May 5 2016
• June 2 2016
• July 7 2016

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by | September 17, 2015 · 6:03 pm

Enjoying Exercise and Better Food Choices

enjoy exercie 2As a part two from last weeks blog about enjoying exercise, here is an article on research finding the enjoyment of exercise can lead to less emotional eating.

This is just one of many articles that highlight the great side effects of exercise.  Enjoying exercise creates a surge in ‘feel good’ brain chemicals.  These are many of the same brain chemicals that surge when we eat foods high in simple carbohydrates and fats. With a healthy dose of these chemicals helping us feel good after exercise, we are not as likely to search for comfort foods.

We can get so focused on the amount of calories we burn during a workout, forgetting the huge value of enjoyment for gaining this lasting effect.  Doing a high calorie burning workout that you don’t enjoy may not have as many benefits in the end for weight loss as doing a more enjoyable, yet lower calorie burning session.

The goal is to burn only as many calories as you can ENJOY burning!

As highlighted in the last blog, the reasons we don’t enjoy exercise are often created by a wide variety of challenges.   We might think these factors don’t matter, or that there is no good solution.  Since they keep us from enjoying exercise, this article reminds us that finding solutions and enjoy moving again is a key to success.

So, on this beautiful week of end of summer weather, choose an activity you enjoy or find a way to make what you can do more enjoyable.

It sounds like a win-win.  We get to enjoy some time moving AND enjoy feelinenjoy exerciseg good about our food choices too.

Keep Moving, Be Well,


These weekly emails are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

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by | September 17, 2015 · 5:28 pm