What’s it Gonna Take?
written by Melissa Stevens, MS, RD, LD,
Nutrition Program Coordinator, Preventive Cardiology and Rehabilitative Services
Being overweight is not what most of us aspire. Yet over 62% of Americans are either overweight or obese, and just like our waistlines this number keeps expanding. Unfortunately overweight and obesity is negatively viewed by our society more for aesthetic reasons (e.g. clothes are too tight, thighs too large) than for health-related reasons. The real reasons we should be concerned are more critical to our society, both economically and socially, as well as our own personal health.
Overweight and obese individuals are at greater risk of the following, to name a few:
- Coronary artery disease
- Some cancers
- High blood pressure
- Gallbladder disease
Not to mention that it just plain doesn’t feel very comfortable carrying an extra 10, 20 or more pounds around with you.
Who or what is at fault for the epidemic-like proportions of obese and overweight adults (and children) in our society? The answers are uncertain. Many believe it is the “super-size” generation that has evolved. Portions at restaurants, fast food chains, the candy isle, and even the produce section are two or more times the serving size they were a decade ago. This isn’t the only reason, however.
Our former Surgeon General believes lack of physical activity, community accesses to physical activity, and sedentary lifestyles should also be added to the equation. Top those with family, work, and social pressures and you’ve got a bag full of reasons Americans are becoming more and more overweight. But these reasons shouldn’t be excuses because you won’t be able to excuse your way out of coronary artery bypass surgery or diabetes.
So, what’s it gonna take? Read on to find ways you can start to take charge of your life and aim for a healthy weight.
Aim for a Healthy Weight – and for the Right Reasons
Just like you inventory your cupboards before heading out to the grocery store, you must first, above all things, do a personal inventory of yourself before trying to lose weight. Take 10 or more minutes to answer the following questions:
Why is it I want to lose weight?
Is it for health reasons, cosmetic reasons or both? The real reason you should want to lose weight is to reduce your risk for disease such as heart disease or diabetes. Feeling great should be next, for example, walking without pain or moving around more easily. Lastly, looking good is a good goal, but it shouldn’t be your only reason (think of it as a weight-loss perk).
What risk does my weight currently put me at?
Health professionals use the Body Mass Index (BMI) to determine your risk of being overweight through a calculation using your height and weight (for many athletes the BMI is overestimated due to extra lean body mass – see your healthcare provider for more information on an ideal weight). A BMI of 19 – 25 is considered healthy, 25 – 29.9 indicates overweight and greater than 30 obese. Determine your body mass index.
What is your goal weight (based on the BMI)?
Take into account that the safest weight loss (true fat loss) is achieved when 1 – 2 pounds of weight is lost per week. Aiming for your high school weight would be great, and is ideal for many of us. But with respect to being reasonable, consider your most comfortable, and healthy, adult weight. Was it easily maintained? How were you successful in maintaining that weight? Where did that weight fall on the BMI chart? Keep in mind that a modest 5 – 10% loss of body weight has shown considerable health benefits.
What obstacles keep me from losing weight?
Do your work, family, or social responsibilities inhibit you from losing weight? List the obstacles you feel prevent you from reaching your weight loss goals.
How will you overcome these obstacles?
Now that you have them listed, decide how you can change, minimize, alleviate, work around or avoid some of the obstacles in your life. Come on now, there’s got to be a way to work around some of these; remember there’s no more excuses. If you find overcoming these obstacles too difficult to do on your own, consider seeing a psychologist or therapist who can provide you with some effective strategies.
What are my short-term (one to two month) and long-term (six months to a year) goals?
Remember estimate no more than 2 pounds of weight loss per week. Do not set yourself up for failure. The weight didn’t come on overnight and it surely won’t go off overnight. Set reasonable short and long-term goals (even if it isn’t your end weight goal) and remember to REWARD yourself once you achieve the goal. Why not reward yourself, who else is going to do it for you? You do deserve it you know!
Make a list of what rewards you would like once you achieve each small goal.
Just like your weight goals, your rewards should be reasonable. Buy yourself a new outfit, those golf clubs or that purse you’ve had your eyes on. Or donate your now too large clothes to your favorite non-profit organization. Never make food a reward, it is counterproductive.Once you have these questions answered, move on to the diet and lifestyle inventory.
Diet Inventory – Be Honest with Yourself
Now it’s time to take a look at your dietary habits. For three consecutive days, take an inventory of what you eat, drink, chew, taste – you get the picture. Don’t miss one morsel or you’re not being honest with yourself. Once you’ve done this, look at the various times you eat each day and observe your portion sizes.
- Do you follow any specific schedule when you eat or do you grab food on the go?
- Do you eat because you’re hungry, bored, or for emotional reasons?
- Do you graze or snack at night?
- Do you drink excessive alcohol in the evenings?
- Do you read food labels to determine portion sizes or caloric content?
Once you take a look at three-days (or more) of eating determine some areas you can improve on. For example, if you grab a second helping at dinner each evening, portion yourself one serving and leave it at that; or enjoy a second helping of vegetables, skipping the extra potatoes and meat. Or if you always grab a super-sized meal deal at lunch, pack your lunch for one or more days instead. This strategy saves both time and money.
Here are a few key nutrition guidelines to follow when trying to lose weight:
- Always start your day off with breakfast. It gives your metabolism and brain a jump-start, fueling your body for the busy day ahead. Studies show those who eat breakfast are successful at losing weight and keeping it off.
- 2. Fuel your body the right way (and shed excess weight too) by eating four to six mini-meals each day. Four to six mini-meals is no license to eat whenever, whatever or how much you want – plan breakfast, lunch, snack(s) and dinner ahead and moderate your portions. Small, frequent meals and snacks keep your metabolism burning efficiently and prevents binge eating. Skipping meals, on the other hand, reduces your metabolism and increases your risk of eating excessively after a long fast.
- One of the most successful strategies to losing weight is to PLAN meals and snacks ahead of time. Regardless of your time commitments and constraints, if your goal is to lose weight and lose it the right way, MAKE the time. Nobody said this would be easy but like everything in life we need to work for it. Bring along fresh fruit, vegetables, nonfat yogurt or cottage cheese, low-fat granola bars or peanut butter on whole grain crackers for a mid-afternoon snack. Pack a fresh salad and top with raw nuts, tuna or a chicken breast or a sandwich with fresh veggies for a quick and healthy lunch. Set some time aside to prepare a menu of meals you’ll have for the week ahead. Prepare dinner ahead of time, defrost your meats in the refrigerator, or have all of your ingredients ready to go so you can quickly prepare and serve after a long day at work.
- Keep a food diary. Take a look at our food diary for an example. Studies show that people who keep a continuous food diary successfully lose weight and keep it off.
- Inventory your portion sizes. To effectively inventory your portion sizes, keep a food diary. That way you can see how your portion sizes have changed over time and how it corresponds with your weight loss over the long-term. Don’t know what a serving size is? Find some portion size examples. Too much of any food (be it fruit, vegetables or a brownie) will result in weight gain so keep an eye on your portions!
- 6. Choose highly nutritious, low-calorie foods to fuel your body for energy. Choose filling foods, rich in nutrients yet moderate in calories like fruit, vegetables or nonfat yogurt before reaching for chips, a cookie or candy bar. Take a look at our 200 calories or less snack list for some healthful ideas.
- Clear your cupboards of high calorie snacks like tortilla chips, cookies, frozen pizza rolls, cheese curls and the like. Keep your cupboard stacked instead with graham crackers, oat bran or whole wheat pretzels, low-fat breakfast or granola bars, fruit canned in it’s own juice, nonfat pudding packs or dried fruit and nut mixes.
- Avoid excessive calories from beverages. Some people drink over 500 calories a day from sugar-sweetened sodas, teas, juices or alcohol. Consuming an additional 500 calories each day is equivalent to a one-pound weekly weight gain! Avoid "liquid calorie" weight gain by eliminating these beverages. And don't forget to keep alcohol intake moderate (one drink a day for women, two drinks per day for men).
- 9. Drink lots of water! Aim for 8, 8-ounce glasses of water each day. It’s calorie and caffeine-free, versatile (e.g. add a lemon ring, orange zest or mint leaf for flavor), easy to carry and inexpensive. Plus it helps to keep you well hydrated. Did you know that we too often mistake dehydration for hunger? Keep that water handy!
- Eat until 80% full. This may seem tough at first but focus on being satisfied after a meal – not full. A little practice and you’ll be amazed at how much less food it’ll take to satisfy you.
- Avoid eating 2 – 3 hours before you go to bed. If you have diabetes you may need a nighttime snack, discuss this with your dietitian or physician. Eating before you go to bed is like putting gas in a parked car; if it’s not going to be used or “burned off” it’s going to sit in the “tank” and be stored (stored as fat in our case). Use it or you won’t lose it.
- Don’t overwhelm yourself. This is easy to do when trying to lose weight. Review your food diary and start making small changes like adding a vegetable to lunch, eating breakfast, cutting back on dinner portions, or increasing from two to three pieces of fruit each day. Accomplish your goal for a few weeks to a few months before moving onto the next one. Small changes over time will make a big difference – you can count on it.
Lifestyle Inventory – A Key Component to Weight Loss
All too often people who try to lose weight cut back on foods and don’t change anything else. This may be why so many people gain back their lost weight so quickly. The goal is not to starve yourself back to a svelte size 6 or 32-inch waist. This is a lifelong change, which includes behavior change, dietary change as well as lifestyle change. Getting adequate exercise is one lifestyle change that leads to successful weight loss.
To optimize your caloric expenditure, aim to exercise aerobically at a moderate intensity for 30 minutes or more on most, if not all days of the week. Find an activity that you like and you know you’ll stick with. Try some of these examples:
- Brisk walking
- Roller blading
- Stair climbing
- Elliptical training
- Cross country skiing
The list is endless.Many times people quit their usual routine when it gets cooler outside. Have a back-up plan in case this occurs. A gym membership, mall walking or aerobics class is a great alternative and can also give your workout a change of pace. In addition to aerobic exercises, consider adding some resistance training to your routine. It builds muscle mass, which helps you burn calories more efficiently at rest.
Consider having a personalized exercise prescription done to determine the best exercise and intensity for you. Ask your doctor or call Preventive Cardiology for more information at 216.444.9353.
Burn some extra calories each day by taking the stairs to your office, parking your car a little further away from your destination, taking a brisk walk at lunch, putting a little more oomph to your housecleaning or turning on the radio and just dance. Whatever you do, get off the couch and get moving!
All of the above material is a lot to take on when you are trying to make lifestyle changes to promote your overall health and lose weight. Take small steps day by day and realize that there will be pitfalls you didn’t anticipate, life changes that are uncontrollable and days you just plain don’t feel like eating that third serving of fruit. Just pick yourself up where you left off and never give up! These things take time and patience. Remember the first time you learned to ride a bike or drive a car – it didn’t happen overnight, nor will weight loss. But a little determination, positive thinking, planning, and practice can go a long way.
Make an appointment with a Preventive Cardiology registered dietitian to create a nutrition plan at 216.444.9353, or, toll-free 800.223.2273, ext. 49353. Individual counseling and group weight loss programs are available. For online assistance in creating a weight loss plan, check out our MyConsult Nutrition Counseling Service.
Whatever you do – good luck and don’t forget to reward yourself.
The best rewards: living healthier, happier and at lower risk of disease.
Melissa Stevens, MS, RD, LD is the Nutrition Program Coordinator for the Preventive Cardiology and Rehabilitation Program at the Miller Family Heart & Vascular Institute. For more information or to schedule an appointment, call 216.444.9353.
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