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    Small Changes for Gradual Weight Loss and a Healthier Life

    Dr. Lori Sieboldt Bariatrician 01/18/2016

    Weight loss is a common topic this time of year, but the best-laid plans for New Year’s resolutions can go by the wayside if you try to take on too much at once!  There are several small changes to your nutrition and physical activity to implement over the coming days, weeks and even months to help you reach your weight loss goals


    “Dieting” Myths and Truths
    First, there are a couple of major myths out there that need to be addressed, as believing these things can totally derail any weight loss efforts.


    Myth 1: Skipping meals or cutting calories severely will cause weight loss.
    Truth:  If we cut back too far on calories, or go too long without eating, it will slow down our metabolism.  Our bodies will think there’s a true shortage of food and will begin to hang on to extra energy (in the form calories/fat). This will be harder to lose weight.


    Myth 2:   Elimination of all carbohydrates (or all fats) will help me lose weight.
    Truth:  Our bodies need food from all food groups.  Carbohydrates aren’t bad in and of themselves, but certain carbs—complex carbohydrates—are better.  Unprocessed/whole grain/complex carbohydrates should actually be about half of our daily caloric intake.  Fat is not all bad either.  You need some fat every day for health, but it should be high-quality fat.  Avoid “fat free” foods, because overall, what happens when a processed food is promoted as being low fat or fat free is that the fat has been replaced with sugar.  It’s better to focus on using healthier fats and watching your portions—3-4 servings per day are all that are needed.


    Healthier Daily Choices for a Healthier You
    Below are some tips that, if incorporated consistently, can help you make healthier choices, reduce calories in a meaningful way, and help you lose weight.

    • Start your meals with a side salad or broth-based soup. They take up room and are lower in calories.
    • Watch the overall bread/”white” carbs.
    • For pizza, it’s better to have thin crust pizza with lots of veggies.  Skip the pan pizza if you’re trying to lose weight!
    • Ordering a small hamburger, side salad (with low-fat dressing), apple slices and water is a great choice at a fast food restaurant.  Ordering a kids meal is a great portion control option—just skip the fries.
    • When eating out at a sit-down restaurant, either order a kids’ option or get a to-go box right away and put half your food in it to take home.  Another option is to share a meal/entrée with someone. Also, look online at restaurant menus for calorie counts to make healthier choices.
    • Instead of eggs, bacon and biscuits for your weekend breakfast, make eggs with just egg whites or Egg Beaters (egg substitute), turkey bacon instead of pork, and whole grain toast instead of biscuits or white bread.
    • Condiments can pack a lot of calories and fat.  Avoid full-fat mayonnaise and dressings.  Instead, try mustards or vinaigrettes.  Spice can add lots of flavor with little-to-no calories.  When using dressings, use half a package of instead of whole or dip your fork in your dressing and then stab a bite of salad.
    • While salads are often a great choice, you should still be mindful of the calories.  Add-ons such as breaded chicken, cheese, croutons, bacon bits, nuts, etc. pack a lot of calories and fats.
    • Avoid fried foods as a general rule.  They’re high in calories and usually contain bad fats.


    Making Fitness Part of Your Everyday Life
    The first step is to ask yourself a few important questions.

    • Are you currently almost completely sedentary?  (You have a desk job and the only walking you do is to/from your car.)
    • Do you have a job where you’re on your feet all day a few days a week?  (For example, many nurses here at Deaconess work 12 hour shifts 3 days per week.)
    • Are you somewhat active now?  (Maybe you go for a 20 minute walk after dinner.)

    Once you’ve been honest with yourself about what you are already doing, you can begin to identify improvements to make.


    Starting Your Journey
    We recommend that you start any fitness and exercise journey with knowing exactly where your starting point is.  It’s motivating to see progress and there are several ways to track your progress. 
    If you feel comfortable doing so, ask a family member or friend to take photos during your journey. Comparing photos every couple of months allows you to see the small changes you often don’t see daily.
    To track your daily activities, we recommend something that does this for you.  A simple pedometer that counts steps, such as a FitBit tracker or similar device; it could be an app on your phone that tracks your daily movements.  Any of them will work—you just need to choose what will work best for you. This can also be a great tool to help you set goals and improve your level of fitness.
    Remember that not all progress and improvements are numbers or graphs. Improvements in the way you feel both mental and physically are great indicators of a successful lifestyle change.


    Extra Steps Daily 
    There are tips we give patients that are not only great ways to start being more active, but really, they are things we should all do to make physical activity part of our day—all day, every day.  Once you’ve accomplished these daily improvements, make some additions.

    • Say goodbye to the elevator.  If you are going up or down three flights or less, don’t use an elevator.
    • Use the far-way parking lot (as weather/safety permits).
    • Visit a more distant restroom.
    • When you go to the store, take a lap around the store perimeter once prior to starting to shop.  It gets steps in and helps you organize your trip.


    Improving Your Activity Level
    For physical activity to truly benefit you and help you lose weight, it has to be of an intensity that is above what many people experience in their daily activity. We teach our patients about RPE – rate of perceived exertion. Basically, a rate of 1 is when you’re sitting on your couch watching TV—easy conversation, no effort involved.  A rate of 10 is full-out effort, with no conversation possible.
    We want people to work at a level of 6-8.  You should be breathing hard, but not completely breathless.  For example, if you’re on a fast walk or a run, you should be able to exchange a few words with someone, but not be in an ongoing conversation.
    Work your way up to this.  If you’re used to not doing anything, you may need to work on walking at a RPE of 3-5 before gradually moving up.  A good way to move up to more strenuous activity is to include short bursts of higher intensity movement.  This is often called interval training.
    HIIT is a High Intensity Interval Training program.  It’s a workout consisting of a period of high energy movement followed by a period of rest.  It helps burn fat while maintaining muscle.  Interval training is a top way to increase your fitness and burn fat and calories.
    Here are ideas from some of our most committed and successful patients:

    • Find a walking/fitness partner.  You need someone to keep you accountable.
    • Make your physical activity something you look forward to—whether it’s a special playlist of great music, or a podcast you download and listen to everyday.
    • Find something that’s fun to do.  Sign up for a dance class with your partner; join a Zumba class; try another fun group class.
    • Do exercise videos at home.  There are some great free options online (check that the source is credible); or if you subscribe to Netflix or Amazon Prime, look for videos included in your membership.
    • Set some sort of goal.  Start a “couch to 5K” plan and finally do some sort of race.  Build up to doing that “bucket list” item like completing a half marathon or more.


    Learn from “Losers”
    The National Weight Control Registry is a national registry that tracks people who have successfully lost weight and kept it off.  There’s a lot we can all learn from these people.  Here are some helpful statistics from these successful “losers.”

    • 94% increased their physical activity, with the most frequently reported form of activity being walking.
    • 62% watch less than 10 hours of TV per week.
    • 90% exercise, on average, about 1 hour per day.

    To lose weight, we know that people need to have moderately-intense physical activity for 400 minutes per week, which works out to almost 7 hours. This can be in smaller chunks of time that add up.  Weight loss maintenance requires at least 30 minutes per day, or about 3 hours of activity per week. Our big key is to find something to do that you can stick with.  Consistency is the most important thing.

    Deaconess Weight Loss Solutions offers several types of weight loss assistance.  Surgical weight loss, including gastric bypass and gastric sleeve, medical weight loss including Take Shape for Life, and medication management.  All of these include routine education, counseling, coaching and overall lifestyle management.
    To learn more about Deaconess Weight Loss Solutions, visit us online at www.deaconess.com/weightloss.

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