Tag 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

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

Myth #9: “It will be easier when…”

crocus-292306__480If you ever doubt humans are optimistic, talk to a New Englander in spring!   As the snow melts, so does the weight of winter on our motivation to move.  We feel the hope of longer days and walking outside without fear of slipping on ice.  Its wonderful!!!

Now, I don’t want to be a buzz kill.  I believe in optimism and do not want to squash any of it . However, I know from experience, a bit of realism this time of year can help us stay optimistic all year long.

OK… Brace your self – here comes the reality… Winter will return.  Breathe…. it will be OK!  Lets use this optimistic energy to ready ourselves now for next winter.  As they say “an ounce of prevention is worth a pound of cure!”

Chose your favorite way to take notes and  jot down your thoughts:

  • How does my body feels right now at the end of winter? 
  • How do I want it to feel?
  • What was my best experience with exercising during the winter months?
  • What did I learn from that experience I can use now?
  • What are the challenges to exercising in the winter?
  • What do I want to try next winter based upon what I know about my successes and challenges? 

Take your plan and put it where you will see it in October of this year.  Now you can rest easy knowing winter may be a bit easier with a plan in place.

Keep in mind, this optimism also shows up when we are setting out on a weight loss bicycle-788733__480plan.  The idea that “when I lose weight things will be easier”, can cause us to put off dealing with the true challenges to exercising regularly.  Take an honest look here as well.  What challenges will not go away not matter how much you weight?  What can you do to build your confidence in handling them now rather than hoping they will take care of themselves when you are at your goal weight.

Ok, enough realism! Lets get back to that Spring optimism!

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 4, 2017 · 4:08 pm

Myth #8: The Fitness “Expert”

Fitness expert

When you seek a professional to give you advice or provide a service, whether it is for electrical wiring in your home or getting a haircut, what do you look for? Of course you look to a source you can trust – a professional with the required certification, training, and experience.  It is important to know that the field of fitness has no requirements for professionals. Anyone can call themselves a fitness expert. Our source for advice about how to move and be well is sadly under-regulated and as a result, full of myths and mindsets that are not science-based. This means that right now, you, as a fitness consumer, need to stay educated or your exercise advice may lead you in the opposite direction of the motivation and fitness you are seeking.

Next time you listen to advice about exercise on TV or the internet, notice why they call themselves an “expert.”  Are they highlighting that they  a) have a personal success story,  b) were successful as an athlete, or c) trained someone famous? These are all red flags! Even if they are certified, know that there are no requirements for certification programs and no one is ensuring that person’s certification is up to date. Our professional organizations for degrees and certified exercise professionals are working on this, but it is a very slow process!

Currently, there are two sites that provide helpful information about fitness professionals for consumers. Use these sites to find a qualified professional who holds a certification that is accredited by the National Commission for Certifying Agencies (NCCA). This means the certification exam has met set standards for the exercise professional’s role as defined by the U.S. Department of Labor.

The United States Registry of Exercise Professionals maintains a list of professionals with any accredited certification. The American College of Sports Medicine (ACSM) is the “gold standard” for certifying exercise professionals. The ACSM continuously clarifies the various levels of training for exercise professionals,  defining their role and scope of practice clearly. This makes it easier to find a professional who has the right level of training for you, whether you are without health concerns and looking for a qualified personal trainer or have a health concern and need a clinical exercise professional to safely guide you with exercise. Check the ACSM ProFinder to find professionals with this level of certification and training in your area.

fitness-1730325__480

The myth here is that just because someone looks fit they know about how to help you get fit too.   Most important is to trust your instincts.   If the advice you are receiving is not leading to feeling better right away, keep searching for the right professional for you.  Remember, you don’t need to suffer now to feel good later. If exercise is causing increased pain, speak up.  If the professional you are working with tells you the pain is necessary to lose weight,  walk away from it and find a new approach.   My hope is that some day, this will be easier for you as a consumer. Until then, let’s not let the confusion get in the way of exercising consistently and enjoying movement.

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 | March 28, 2017 · 4:10 pm

Myth #5: Core Strength

crunchIf I had a dime for every crunch I did in my lifetime ,  I would have that dream home in the Caribbean by now!  Doing abdominal exercises in various forms, such as crunches, oblique crunches, sit ups, reverse crunches,  V-sits, and planks are a staple in most routines.  When I was teaching aerobics years ago, if I skipped the abs portion, I would have been run out of the gym by 30 people in leg warmers and “big hair” (OK, it was the 80’s!).  However, this is often still the case (minus the “big hair”).  It is time for this fitness myth to catch up with the science.

The trunk  contains some pretty important parts of the body –  the organs, spinal cord, spine, heart, lungs.  The purpose of the core muscle group is to stabilize and protect this area of the body during movements of daily life.

core-musclesWhen we are “working” the core, we often mean we want to reduce the size of the trunk area – AKA spot reduce fat in the abdomen.  Spot reducing is a myth (period).  Yet,  take a look most popular core programs and you will see the myth of spot reducing  alive and  well! (even if it is just implied).   We need to be very savvy fitness consumers to recognize myth based marketing when we see it.  The reality is “working” the core does not really “slim” the core!

What does it mean to strengthen the core?  We can plank longer, do more crunches or sit ups, lift more weight with our core muscles?  While this would be a measure of core strength, the real question is, does it lead to better function of the core in daily life?  Does a strong core mean these muscles can do their job to hold the spine in alignment and reduce daily wear and tear, minimize the risk of back pain, enable us to do daily tasks with ease?

coreRemember the principle of specificity of exercise?  If we want the core muscles to do their job, we need to learn to consciously activate these muscles with our brain during motions of daily life. Exercises done lying down do not mimic daily life and relies on gravity instead of conscious control from the brain to activate the core muscles.

What we want is core control.  This means you can consciously activate your  core muscles to hold your spine in alignment when lifting a heavy object, reaching overhead, twisting to reach an object, etc.  Here is how:

  • First, learn what alignment is for you.  When the spine is out of alignment, the core muscles are not “lined up” to work their best and this increases wear and tear on the back.
  • Notice when you are pulled out of alignment and practice using the brain to activate core muscles for that movement.
  • During ALL strength training exercises, incorporate core bracing with proper alignment, without holding your breath.
  • Practice turning off these muscles when you don’t need them. (ie: during cardio exercise).   Often we are taught to “hold in the core muscle” when we really do not need them.  Relax those core muscles in between activities so they can recharged for when you do need them

Admittedly, this will require a mindset shift away from the hope of spot reducing the abdomen and the idea that traditional core exercises will improve function in daily life.  The payoff is real “results” from an exercise plan based on the reality of movement science rather than long-standing fitness myths.

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 | February 13, 2017 · 3:57 pm

Myth # 3: The Calorie Burning Game

calories burned.jpg

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

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by | January 31, 2017 · 7:15 pm

Myth # 2: Scientific Discoveries

running“Scientists have discovered the best exercise to help people get healthy and lose weight”. As you can imagine, this article caught my eye this morning.  The myth that research can “discover the best” of anything, much less exercise,  keeps these headlines alive in the media.  Subliminally we can be bombarded with broad sweeping statements and recommendations about exercise for weight loss and health.  The simple act of skimming the news or social media can leave us more confused than motivated.

Because you are a savvy fitness consumer however, I know you read between the headlines.  This study is actually very interesting, but far from a discovery of the best exercise to lose weight and get healthy!

The study was published in the Journal Physiological Reports in December 2016. The actual title was:   The impact of exercise intensity on whole body and adipose tissue metabolism during energy restriction in sedentary overweight men and postmenopausal women.  Not quite as catchy, huh?!

Here is the info:

  •  The study involved 38 men and women, average age of 52 years old.  It is nice that it was not on college students and it was a mix of men and women.  Keep in mind, 38 people in one three-week study do not discover anything.  The data simply adds to our understanding.
  • Two groups, one exercised at 50% and one at 70% measured maximal exercise capacity.  Both groups exercised on a treadmill five times a week for three weeks, for the amount of time it took them to burn 400 calories at that exercise level (burning a total of 2000 extra calories a week).  Both groups reduced their calorie intake by 5000 calories a week.
  • Each group lost about the same amount of weight (no statistical difference).
  • The study actually looked at what happened in the fat cells of these participants. Both groups improved insulin sensitivity, lipid profiles, and markers of inflammation.

The take away here is that you have options.  You can do a high intensity shorter duration session or a lower intensity longer duration.  Both will add to weight loss and improve cell function.  (Despite the “fat burning” programs on most machines, lower duration is not better for weight /fat loss. This too is a myth.) They study did not mention the difference between the time the two groups had to exercise to burn those 400 calories.  My estimate it would be about 10-15 minutes extra.  Other studies have found that calorie burning can be broken up through the day, and actually may add to more health benefits.  So you might walk moderately for 30 minutes in the morning and then do another 15 min walk at lunchtime. The great news is that exercise does not need to be hard to get the benefits!!!  Something IS better than nothing!

This study just looked at cardiovascular exercise.  Remember, it is important to strive for a balance of time spent between strength training and cardiovascular exercise.  Each provide different benefits and cannot be combined very well.  If you are missing strength training in your exercise minutes, you are missing out.

Keep reading between the headlines and learning about what works best for you.  Although scientists did NOT discover the BEST exercise for weight loss and health, we do have more evidence to keep moving!

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 | January 18, 2017 · 4:05 pm