Category Archives: Weight Loss

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

Confusion about Muscle Confusion

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Muscle confusion is a big selling point in the fitness industry these days.   It is built on the fact that as the body “gets used to” an exercise, or builds muscle memory, it burns less calories.  The belief is you need to mix up your exercise to keep your body burning calories.

First, lets take a step back.  Why do you want to lose weight?  To make everyday life and the fun things easier? To be more comfortable in your body? To reduce pain?  To feel better? To improve health?

And, I am guessing you want those great benefits to last, right?

If that sounds like what you want, muscle memory is your friend!

For the things you need to do in daily life to be easier, it takes practice.   If you are always practicing something different, your body does not build muscle memory as well.   In everyday life we need stregnth for movements like bending down and getting back up, stepping up, lifting overhead, pushing, pulling, lifting and carrying objects.  Doing these movements on a regular basis, at a level that comfortably challenges them over and above the level of daily life, will make them easier.   This is why muscle memory is your friend.  Instead of playing the calorie burning game, you get what you truly want from weight loss.

Second,  your body is still burning calories!  The total decrease in calories burned is small.  Instead of playing that numbers game, put your energy into reducing the calories you take in from eating for reasons other than hunger.  These calories can add up much more!

The muscle confusion approach is taking one piece of science and applying it in a way that is very profitable for the fitness industry.   Yet, it leaves people who want fitness for improves health and function missing out on building muscle memory, doing sustainable exercise programs and feeling better now and in the future.

The bottom line: Life can be complicated and confusing enough! Your exercise time does not need to be.  Your body does adapt and yes, because it is smart, it will burn a few less calories for an activity when it builds muscle memory.  The calorie difference is not worth what you are missing out on by focusing on muscle confusion.   Focus on muscle memory and enjoy a body that makes it easier to enjoy your life!

Keep Moving, Be Well

Janet

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

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 | June 7, 2017 · 5:38 pm

Avoiding a Detour

I just finished the book Presence by Amy Cuddy. If you have not seen her TED talk, I highly recommend it.  Dr. Cuddy is a researcher who studies how our body language shapes our behavior. The  book is filled with amazing evidence from her research* and a whole slew of others, about how our body position changes how we think and behave.

detour-44160__480Sustainable weight loss is about keeping ourselves on course when detours pop up.    You come to the end of a VERY long day and you planned on walking, but it is cold and rainy and all you want to do is go home and veg out on the couch.  You are in the midst of a week of chaos in your life and you can’t even think of getting to the gym for  strength training. You get on the scale and feel completely defeated because, despite your best efforts, it is two pounds up!

What if we could get derailed less and back on track easier? What if it was something with research behind it that was simple, free, and completely accessible to you in any moment?  Would you try it?  Even if it seemed a bit strange and unlikely to make a difference?

It turns out that when our body is in a position with shoulders and back rounded we feel less confident.  We are less likely to make choices that are in line with what is most important to us.

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But, when we stand with shoulders and chest open, we are more confident, more likely to stick with what is most important to us.

high power pose

 

It is interesting that across many different cultures and situations, the most common expression of success is raising arms up in a “V”.   We now have some evidence this may work in reverse too!

athlete win 2

Give it a try!  Next time you step in the scale, put your hands on your hips and stand like your favorite superhero!  In the middle of a stressful day, stand or sit in alignment with your body strong.  When you are tempted to skip exercise, stand or sit with your arms up in a “victory” position for two minutes.

Post what happens in the comments section below!

Keep Moving, Be Well

Janet

*You may have heard some news flashes years ago debunking Dr. Cuddy’s research.  If you read her book, you will see that her study on power poses are just one in many showing there is something powerful in the way we hold our body.  Research is tricky business and one study does not prove anything.  Your best evidence is to try this for yourself and see how it works for you. 

 

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

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 | May 15, 2017 · 5:38 pm

The All-in-One Gauge

gasImagine if the gas gauge on a car measured everything – gas, oil, windshield wiper fluid, water?   Just one gauge for everything together.  How helpful would that gauge be for you?  How would you know what it needed when the gauge was on low?

The scale measures everything – fat, muscle, water, food, clothing – all together in one gauge.   Why then, do we put so much emotion into what it says?

Scale goes down – elation!  Scale goes up – frustration!

Even if it was up because you were on Prednisone that week, or your legs were swollen – that higher number can be so frustrating.  And if it goes down quickly – even if you know that 30% of what was lost was muscle because you were not doing strength training, elation still happens!

Yes, we weigh you here at the Weight Center and look for that number to go down. It is our best objective tool to know that what you are doing is helping.  But it is by no means a perfect tool.    It’s an “all in one” gauge!  That would not be helpful on your car, and it is certainly not helpful if that’s all we use to measure success with healthy lifestyle changes.

So we use other gauges.  How do you feel?  Do you have more energy?  How are you doing with emotional eating? Are you able to do more now than you could before?  Are your clothes fitting better?   Are you doing strength training?  These are the other measures we use as a guide because the scale is an “all in one” guage.

Next time you step on the scale, keep in mind it is an all-in-one measurement.  Use your other measures to really guide you with how your lifestyle changes are working.

Keep Moving, Be Well,

Janet

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

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 | April 26, 2017 · 6:56 pm

“All in!” Patient Perspective

jump-1209647__480Being “all in”  separates the goals we set because we “should…” from the goals we set because we “REALLY want…!”

Lets face it, trying to do something because we should is exhausting.  Working for something we REALLY want is energizing.  Below is one patients story of what happens when you go “all in”.  Although this is a patient who decided to have weight loss surgery, the approach can be applied to any goal set because we want to enjoy life to the fullest.

First, let me start by saying that when I went to the original orientation meeting for the Weight Center, I had absolutely no intention of having surgery. I was thinking that I could lose weight with behavior modification. Heck, I’d done it before. Of course, the weight always came back, usually those pounds brought a few friends with them. To consolidate this, I did have a sleeve mastectomy in 2014. At first, I reluctantly pursued an exercise regimen, because I was *told* that this was part of the program, not because I actually wanted to. My mindset at that time was simply this, I had gone through all the preparation and such to have the procedure done, I may as well do the work – this might be my last opportunity to be healthy (note, I did NOT say “skinny”).

I’m by no means saying that I’m perfect, or that anyone should see me as an example of what you *should* do. But I found, over time, that success becomes its best motivation. For every thing I suddenly realized I could do that I could never do before, I wanted to do more. Success is insidious and addictive. People who haven’t “been there” have no idea how empowering it can become to be able to MOVE, to do things that darn near felt like a near death experience before. Over the course of the last 2 1/2 years since my surgery, I’ve gone from being a card-carrying couch potato to working out nearly every day for an average of 45-60 minutes. I bought into the mindset that long term success requires total lifestyle change. It’s not a finite endeavor with some “end goal”, after which you can go back to your old habits. They’re what got you to the point of seeking surgery.

I’ve heard others say things like “I don’t want to deprive myself”, or “I don’t exercise, but I’m still losing weight”, and in inwardly cringe. These people just don’t seem to understand that bariatric surgery isn’t some magic pill that is going to fix what’s wrong…. it is merely a tool that can be used to aid in major changes in behavior. In order to be successful long term, you really DO have to go “all in” and exercise as well. No matter if your stomach is the size of a hard boiled egg or a Winnebago, exercise will *always* be a part of achieving a healthy body.

I went “all in”, and I still have work to do to reach my goal weight, but that is really secondary to what is truly important – being healthy. My advice, for what it’s worth is this: embrace the whole shebang, you might curse the process in the beginning, but when you see and feel your own success, you’ll be eternally grateful you did it.

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Keep Moving, Be Well, Be All In!

Janet

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

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 | April 10, 2017 · 3:18 pm

Myth #6: Myths of Strength Training

Weight loss can be up to 30% muscle loss!  Muscle makes up a big portion of our metabolism level so metabolism can take a big drop when we lose weight.    Strength training counteracts this metabolism lowering effect of weight loss.  However, there are several myths that get in the way of making strength training part of a weight loss plan.   Here are the reasons I hear most often:

I don’t need to do strength training, I get enough in everyday life:  Moving in daily life is thCAY06ENZimportant for health but is probably not enough to counteract the muscle loss with dieting.  Muscles are made up of many muscle fibers.  The muscle fibers we use, add to our metabolism. The ones we don’t use, go into a hibernation and don’t add much to metabolism.   Most daily movements don’t fatigue muscles fully, leaving some muscle fibers still “asleep”.  Strength training helps wake up muscle fibers and keeps them awake, burning more calories for the next 24-48 hours!

I don’t have time  for strength training:   Doing just one set of basic strength training exercises, working the muscles to fatigue, 2-3 times a week has been shown to be effective.  When you remove all the myth based exercises that just waste time, it really takes about 2-3 sessions a week of about 15-30 minutes.

dumbbell-940375__480I don’t have equipment/gym membership: Dumbbells are one of the best investments in fitness equipment.  They last a long time and they are all you need for a complete strength training program.   Check out yard sales and thrift shops for low cost options.  Want a free option? Soup cans or detergent bottles filled with water are great substitutes! 

I have back pain:    Strength training, done in a way that teaches the core muscles to protect the back during movements of daily life, can decrease back pain.  The key is starting light, listening to your body and paying close attention to using proper form before increasing the amount you are lifting.

I just want to work ____ part of my body:  When we work on “target areas” we are doing a program based on the myth of that we can burn more fat in certain areas of the body by exercising that part. (AKA “spot reducing).   Avoid wasting time on this myth based approach to exercise.  Instead focus on using all of your muscles so metabolism increases and helps your body burn fat all over.

I am concerned I will get hurt:  One surefire way to get injured with exercise is to do too much, too soon.  Listen to your body.  Be smart when adding a new exercise or increasing the resistance.  Exercise is very safe when we work with our body, rather than trying to push the limits to fast.

I want to lose weight first and then build muscle:  It is much easier to maintain muscle than regain it after it is lost.  Plus, losing muscle means lower metabolism putting weight loss success at risk.

I don’t want to bulk up: It is nearly impossible to build a lot of build muscle while losing weight.  It also takes more time and energy than most of us have to devote to exercise in order to “bulk up”.  If you have the genetics to tend to “bulk up” with strength training, keep the sets and repetitions moderate (1-2 sets of 8-12 repetitions) still working to muscle fatigue.

I don’t want to gain weight:  Muscle tissues is more dense than fat, so the myth that is scale-1987770__480weighs more has some truth.  BUT it burns more calories.   Studies show in a good quality three month strength training program participants gained only about three pounds of muscle, but that did not show up on the scale because they lost fat at the same time.

I don’t want to be in more pain:  It is a myth that muscle soreness is needed to build muscle strength. Strength training should not leave you in pain.   If you have arthritis pain, use a slow gradual progression but don’t avoid strength training.  It has been shown to reduce arthritis pain.

Keep Strength Training and Be Well,

Janet

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

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 | March 15, 2017 · 5:14 pm

Myth # 3: The Calorie Burning Game

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Have you been playing the calorie burning game?  Paying close attention to how many calories you burn during a work out or on your activity monitor? Letting those numbers tell you how much you can or can’t eat?  Relying on those numbers for your exercise motivation?  Getting frustrated when you don’t lose weight even though you have been burning a ton of calories?

If so, are you missing out?  The true benefit of exercise for weight loss is not the calorie burning!

The fact is that the amount of calories we burn during movement varies greatly.  It is relatively small compared to the amount we could consume in just a fraction of the time.  More importantly though, those number are a big distraction.  I often hear of patients suffering through exercise just to burn calories or so focused on burning calories without realizing how good exercise feels.

Stress is part of life!  There is no way around it. Whether it is a big stressful event or chronic long-lasting stress,  the response in our body is the same.  Stress prepares the body for movement.   When we don’t move in response to stress, it drains our energy, lowers our immune systems ability to keep us healthy, and adds unnecessary wear and tear on every system in the body!

comfort-foods-600x857When we are feeling down or tense from stress, we look for comfort. We naturally want to feel better.  Our brain learns pretty quickly that those easy to access foods with sugar and fat help the brain feel better.  Comfort foods increase brain chemicals that improve our mood, until… we realize we just blew our best intention to eat well.  Then feel crummy again, thus adding to the stress response.  It’s a vicious cycle isn’t it!

Enter the calorie burning game.  We might try to burn off those calories by fervently exercising.  Exercising to make up for a mistake keeps us in that vicious cycle.  We might be tempted to push too hard and feel more tired and sore after.  We are reminded how hard it is to burn off those extra calories and feel even worse.

Ready to end the game?

How do you know you are stressed? What does stress look and feel like in your life?  Tight jaw and stomach? Tension in your shoulders?  Trouble sleeping? Headache? Moody? Food cravings?  Great!  What? Yes, great!  These are your warning signals. It is your body telling you it is ready to move!   The fact is that exercise, even simply movement breaks, increases the same chemicals in our brain as comfort food, just in a natural way!  (minus the viscous cycle of extra calories and guilt).  Replacing eating in response to stress with movement gives the body what it really needs.  THAT is the real value of exercise for weight loss!

Keep Moving, Be Well,

Janet

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

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

Leave a comment

by | January 31, 2017 · 7:15 pm