I know many of you are professionals in some area of health/nutrition and I was wondering what kind of things you recommend to clients/patients regarding weight loss?ab
"I know many of you are professionals in some area of health/nutrition and I was wondering what kind of things you recommend to clients/patients regarding weight loss?"1) Avoid fad diets.2) Avoid processed and refined foods3) Eat several small meals a day rather than a few large meals.4) Exercise5) Do not try to lose too much weight all at once. There is a theory that the body has a "set point" as far as weight goes. No matter what you do (eat a little, or eat alot) the body tries to maintain the same weight. If you go on a strict diet, your metabolism is going to change in order to maintain your current "set point." The only way to permanently lose (or gain) weight, is to change the "set point." This can only be done through gradual change. You should aim to lose mayne a half a pound a week, no more. When people try to lose too much at once they usually end up changing their "set point" - but not in a desirable way. If you shed too many pounds at once, your metalbolism slows down to compensate, then, if you start eating and gaining again, you end up gaining more than you lost...and also re-setting your "set point" to this new weight! So, bottom line...be patient! Eat natural whole foods, eat a little whenever you are hungry but not alot all at once and get some exercise. And do not deny yourself anything! If you are having a major craving - have a tiny bit of whatever it is you are craving. Do not deny the urge or you may set yourself up to binge!
Thanks catherine, I usually suggest all this too. I was really looking for a "magic bullet."Just kidding :)Thanks,ab
"Thanks catherine, I usually suggest all this too. I was really looking for a "magic bullet." What do you think about the "set point" theory? I actually came across that theory in chapter in a book on how to gain weight! The book explained that the best way to gain weight was by first losing weight!!! Then it explained the "set point" theory. This would explain why many people take weight off, only to eventually end up weighing more than they did when they started dieting :-)
It depends on where the person is starting, as many of us can improve. The diet has to fit with their lifestyle and budget. Some are doing better if they cut out the 2-liter bottle of Coke every day, and they can work on other things later. Others eat a traditional ethnic diet, and can lose weight if they eat no snacks, no seconds, only fruit for dessert unless it's a special occasion, and exercise more. In general, I recommend: exercise more, eat less, decrease fat, increase fruits and vegetables, decrease processed foods, and drink little to no alcohol. For some people, several small meals work better. For others, no snacks except fruit or vegetables, no seconds, and dessert only on special occasions (unless fruit) seems to work better. For those who eat where they work or eat out a lot, and clean their plate, I recommend balancing their diet over a day, so that if they eat a lot of meat and starch at one meal, they just eat salad and vegetables at the next meal. When people who eat a lot of fast or unhealthy food ask me for the name of a specific diet, I often say ADA diet (http://www.diabetes.org/nutrition/) partly because there is information readily available where I work. For many Americans, a diabetic diet is a healthy and realistic place to start. The ADA diet also makes people look at portion size. I refer people to a dietician. I try to get people to figure out what their "triggers" to eat are, and work on healthy alternatives. For those doing well with their diet, but wanting to do even better, I recommend more whole grains, more soy, more fruits and vegetables (especially cruciferous), etc. For those with family history of heart disease, I recommend Ornish diet (a variation of old Pritikin). This is a relatively healthy vegetarian diet the last time I looked at it. Often you have to figure out how to decrease calories without making people feel deprived. Some are helped if they can fill up with fruits and vegetables. Some do better if they can figure out what the smallest amount of their downfall is, and make a special exercise trip to go get it (ie 5 Hershey's kisses per day or whatever). Many people do better if they can keep sweets, chips and sodas out of the house, and have an alternative (fruit) when cravings start at work.I try to also give positive reinforcement and set realistic goals like one pound per month. Many of us would do well to lose 12 pounds a year. Usually people gain weight slowly, and it's actually healthiest to lose it slowly, too.
Highlandspring-That's about the most sensible approach to helping people work out an approach to losing weight that I've seen! And your regular inclusion of exercise, and eating less, are so important. There have been a spate of studies lately all documenting the importance of exercise as a component of losing weight and keeping it off. Too many people look only at their diet, not realizing that how we use our bodies is just as important as what we put into them. The simple act of reducing all portions (or not taking seconds)in a diet that's already reasonably healthy can have a significant impact over time without having to make major modifications or prepare different foods for different family members. Sheila
The set point theory is hard to prove, however, in practice, it does seem to work this way for many people. Overall I don't think it's as important as moving more and eating less, but it is interesting.ab
I often say ADA diet...I agree, the ADA diet is extremely well-designed and promotes weight loss.I recommend Ornish diet...I find Ornish to be much too strict for normal people to follow. The exceptionally motivated individual, however, can reverse arterial cholesterol plaques with this diet. The only diet I know of shown to be able to do this.ab
There have been a spate of studies lately all documenting the importance of exercise as a component of losing weight and keeping it off.There was a recent study that demonstrated that even obese people who engaged in moderate exercise such as walking 3X wk for 20 minutes reduced their all-cause mortality even if they didn't lose weight.ab
"The set point theory is hard to prove, however, in practice, it does seem to work this way for many people. Overall I don't think it's as important asmoving more and eating less, but it is interesting." I think its interesting too, but am not sure if its a sure thing or not. I have always had the opposite problem (a hard time gaining and maintaining weight)...and I can eat, believe me! I can even eat and drink weight gainer...so, I think the whole weight thing is really much more complex than we imagine.
"There was a recent study that demonstrated that even obese people who engaged in moderate exercise such as walking 3X wk for 20 minutes reduced their all-cause mortality even if they didn't lose weight." Yes, walking is probably one of the best things you can do for your body.
I think the whole weight thing is really much more complex than we imagine.As with many things, norms are defined by a range most people fall into. Most people can maintain their weight without even thinking about it by subconsciously adjusting their food intake and level of activity. You are at the far end of the standard deviation scale and the easy weight gainers/obese the other end. Metabolism varies widely and bodyweight/fat depends on external factors as well (or at least psychological).ab
ab1stock: ...norms are defined by a range most people fall into.This struck a chord with me since I was in to see my physician recently to review the results of my blood tests. Most were in the "normal" range, but a few were not (appears I should be eating more red meat). The abnormal were marked with an asterisk, that's how he could tell they were abnormal. I asked what constitutes normal and abnormal, and he couldn't say. What he did say was that it wasn't a bell curve argument. This in fact makes sense, because if you have a population which for some reason has 40% prime suspects for diabetes, it is no good to call 80%, or 95%, or whatever, normal by some marker if that is the value all those people come up with.Seems as though more attention is warranted.
<< I know many of you are professionals in some area of health/nutrition and I was wondering what kind of things you recommend to clients/patients regarding weight loss?>>The problem with addressing "weight loss" is that most folk don't have a clear idea of what it is they need to lose. They have an arbitrary ideal weight goal or clothes size in mind and the problem with trying to achieve it with dietary modification is that the weight that's lost is frquently a combination of fat and muscle loss.I seem to be surrounded these days by friends and aquaintances who are much fatter than they ought or want to be. Although they may eat a bit more than I do, they're not gannets by any means and are experts at losing weight (i.e. restricting calorie intake to make the needle on the scales move in the direction they want) Problem is, the diets have to be more and more restrictive as time goes by and the rebound in weight gain (plus the extra 5lbs)happens more quickly. I think this pattern is very representative.... especially of women "of a certain age"Fat loss and long term management for most people is best achieved by exercise (assuming no gross overeating is going on)..a combo of aerobic and weight/strength training being ideal. Building muscle that has either been lost as a function of aging or yo-yo dieting really does move stubborn "set-points" . Problem is, focussing on what the scales say tend to sabotage this type of programme since increase in muscle and subsequent loss of fat can often cause a gain in weight. My dietaholic office manager and I weigh about the same at the same height. She's a fairly blubbery size 10/12 at age 30, I'm a fairly muscular size 6 at age 48. The difference is I've never dieted but work out on almost a daily basis and she is always on a diet and is "waiting to get to her goal" before she starts exercising.
I asked what constitutes normal and abnormal, and he couldn't say. What he did say was that it wasn't a bell curve argument.Actually, it is a bell, or distribution curve that defines what is normal on your blood tests. The norms for these tests have been generated by the countless random samples taken, and the range of results, distributed according to age, where the majority fall between, is called normal.As for your argument regarding diabetes I'm not quite sure I follow it, but if the majority of people in the sample population are prone to get diabetes, then getting diabetes is "normal" for that sample. Somehow I don't think this is what you were getting at. I'd be glad to discuss it further if you care to elaborate.ab
Man, I knew I could generate some good stuff to talk about with the weight loss question. The board had been dead for a couple of days and now we have some good exchange. Cool.ab
"As for your argument regarding diabetes I'm not quite sure I follow it, but if the majority of people in the sample population are prone to get diabetes, then getting diabetes is "normal" for that sample. Somehow I don't think this is what you were getting at. I'd be glad to discuss it further if you care to elaborate." As a result of our modern "SAD" (Standard American Diet) diet, getting diabetes is probably starting to be "normal," if you just look at it from the presepective of samples and bell curves :-)
"Man, I knew I could generate some good stuff to talk about with the weight loss question. The board had been dead for a couple of days and now we have some good exchange. Cool." I don't know what anyone else's excuse is, but eating Thanksgiving dinner and having a few beers made me very lazy!!!! :-)
As a result of our modern "SAD" (Standard American Diet) diet, getting diabetes is probably starting to be "normal," if you just look at it from the presepective of samples and bell curves :-)Most, but not all, Type 2 diabetics are obese. it is part of a syndrome of insulin resistance and subsequent hyperinsulinemia. Bad stuff.ab
ab1stock, what I was trying to get at, and I think my doctor was too, is the notion that "normal", which we might equate on this board to "healthy", is not necessarily the same as being within a 2 sigma limit on a distribution of whatever.A competent doctor should know that a count of xxx of yyy represents trouble, and the fact that zz% of everybody has got that xxx, whether (100.0 - zz) is less or greater than 80% or 95%, shouldn't matter. If 60% of us are too fat and are possibly hurting ourselves (guilty), the asterisk should show up. But, maybe it doesn't on account of a decision by some computer programmer about reporting statistics. I simply don't know and the doctor didn't either.I feel I'm being somewhat incoherent here. I hope we can explore this some more to clarify the ideas and opinions.
ab1stock, what I was trying to get at, and I think my doctor was too, is the notion that "normal", which we might equate on this board to "healthy", is not necessarily the same as being within a 2 sigma limit on a distribution of whatever.Okay, I have no problem with that statement.A competent doctor should know that a count of xxx of yyy represents trouble, and the fact that zz% of everybody has got that xxx, whether (100.0 - zz) is less or greater than 80% or 95%, shouldn't matter. If 60% of us are too fat and are possibly hurting ourselves (guilty), the asterisk should show up. But, maybe it doesn't on account of a decision by some computer programmer about reporting statistics. I simply don't know and the doctor didn't either.Are you saying here that for a given result of a specific test that the doctor should be able to interpret it as +/- whether it falls within the curve or 1+ standard deviations beyond? If so, I agree, as all tests must be interpreted within the particular patient's gestalt. And if that result, possibly being indicative of harm or future harm, still results within the normal range due to a flaw in the sampling or population, but still must be interpreted and not looked over because it is normal, I agree.I hope I am being clear, though our language is a bit flowery. That's okay, but I will be signing off until morning. I'd like to resume the discussion. Until later.ab
"She's a fairly blubbery size 10/12 at age 30, I'm a fairly muscular size 6 at age 48. "*********************************************Fascinating... I was size 10/12 for years and was normal to slender if not outright thin.G.
"That's about the most sensible approach to helping people work out an approach to losing weight that I've seen!" Thanks, Sheila. This works, too. I think many people are looking for a quick fix instead of common sense. It's too bad someone doesn't promote a common sense diet instead of these fads. Look for the book: "The Common Sense Diet" ....just kidding ;-).
Man, I knew I could generate some good stuff to talk about with the weight loss question. The board had been dead for a couple of days and now we have some good exchange. Cool.<i/>ab1stock,How is your weight? Are you one of the person trying to loose weight?From my own experience:I am not overweight, but being in middle age, I notice my tummy is a bit rounder. In Japanese way of keeping helthy is not to over eat. If you eat to 8/10 full of your stomaach is considered to be an ideal situation. I have also started chew about 100 times for each mouthful. this is a logical follw through to eat less and do excercise. Besides this will be ahealthy and less work for your digestive system.For excercise, I do take a walk in the morning. Do some T'ai chi and Chi-gong. For me, what I feel important and essential is to do it regularly. I think we gain weight in log stretch of time, it is a gradual process. My holistic doctor says, in order to brake a habit you need to spend twice the amount to reverse the habit.My diet is consist of primarily vegetable, fruits and fish.Exception to people who has disorder in you system, I think chewing food thoroughtly will greatly help keeping weight in check.I have a client when he first came in, he looked like Alfred Hitchcock with bushy eyebrows. One time I noticed something different about him. So I said, " Hey! Elliot, Are you loosing weight?" He was so glad that I noticed. He has been loosing weight ever since. He is a succesful businessman, but I think he is very proud of personal accomplishment on loosing weight moree than anything else. His personality has changed as well. I might add he looks yonger and energetic. He does Lap swimming for excercise. His diet consist mainly Food intake in half. He told me the era he was growing up was during the Depression era. The family was always scrounging for food and eating became an obssesion. For people challenging to loose weight, in most cases, I feel you will accomplish your goal if you have a fierce determination and willling to take time, it is a reachable goal provided that you don't have any disorders.Good Luck to you,141421356
How is your weight? Are you one of the person trying to loose weight?No. :)ab
<<"She's a fairly blubbery size 10/12 at age 30, I'm a fairly muscular size 6 at age 48. " ********************************************* Fascinating... I was size 10/12 for years and was normal to slender if not outright thin.>>Then that would make you dramatically different in appearance from my office manager, wouldn't it??
<<Look for the book: "The Common Sense Diet" ....just kidding ;-).>>A neat little book that discusses why weight loss diets are doomed to failure is "Fit or Fat" by Covert Bailey. This is the guy who did the Healthrider infomercials a few years ago.The ability to store fat easily is a handy self preservation tool in times of famine. Considering that we're descended from stock that were the most efficient at storing fat and surviving lean periods, it makes sense that the body is programmed to make the most of whatever few calories are available. A reduced calorie diet or worse, meal skipping, is a sure fire way to make weight management a difficult task.I have quite a few overfat middle aged (but younger than I) patients who all wish they were in my sort of shape and want to know my secret. When I tell them, they come up with a range of reasons why it's not a course of action they'd be able to follow...lack of time etc. Interestingly, they identical excuses to the ones they use when I give them the "secrets" to good dental health.
"I find Ornish to be much too strict for normal people to follow. The exceptionally motivated individual, however, can reverse arterial cholesterol plaques with this diet. The only diet I know of shown to be able to do this."ab,You are correct. The people who are really motivated to follow the Ornish diet are those who have already had a heart attack. It is very low in fat, and also the only diet I know that has been shown to reverse heart disease. When people have a parent, sibling, or significant other with a heart attack, they will often at least incorporate parts of the diet. It gives them ideas about how to modify their diets. I make several of the recipes from the "Eat More, Weigh Less" and "Everyday Cooking..." books. The Ornish program also includes exercise and meditation/yoga/group support. I think his most recent book deals with the healing power of love, but I haven't read it. The meditation part isn't for everyone, but the diet and exercise advice works for motivated people with athersclerotic heart disease. Here is a link to one of his books:http://www.amazon.com/exec/obidos/tg/stores/detail/-/books/0804110387/reviews/ref=pm_dp_ln_b_6/107-8626867-0587709It looks like there will be a new edition in January 2001.
Serendipity.In my life I make room for it, it's a large part of my life. It's like sensing the flow of nature where you are being directed to a better road. Not necessarily an easier road, but one that enriches your life.Ab 1stock, when I read your first post yesterday it was easy to see it as a troll. As you've used the words Fad Diet in another post I simply did I normally do with such....ignore it.However, the drivel that followed was untenable. Even then, I refused to act. Last night I had a horrible time getting to sleep because of it, losing at least 3 hours. Even this morning, I wasn't going to get involved. Then serendipity interceded, as such, I acquiesced.Sometimes, you should be careful what you ask for Ab 1stock, you may get what you, need, instead.Mental Image:It's around 4 feet long. It's double barreled, doubled triggered. The stock is carved for excellent grip and holding properties. The barrel, blue steel, is engraved with phesents and bird dogs. It's illegal here in the US. It's an 8 gauge shotgun my uncle owned. Customs allowed him to bring it in thinking he couldn't get the shells. The shells are huge, they came over from England in champagne crates.I'm loading it.....Gee, exercise, eat less, less fat, eat right, exercise more, lose weight slowly, my....how....quaint. And so expected. Even PC.I think we all can do better than this. With todays lifestyles wouldn't you say something more is needed?You guys remind me of that Meridian commercial. You know, take this drug, eat sensibly, exercise (we won't go into side effects). Wow, what a concept. Change your lifestyle. Hey now??!!! If they eat sensibly and exercise, why in blue blazes do they need the drug? Seems strange to me.I think you're limiting your answers to people who are in a narrow catgory with the over-expectation of them changing their ways because it's the healthy thing to do. And showing off a wee bit about your lifestyles. You know, those that allow you to be below the norm in weight. Meaning you're most likely slightly above where you should be....perhaps....;-)Assuming that is, you know what your weight should be.Your Humble Servant,Gracefully Savage
The Yo Yo Diet Syndrome. Killing the metabolism slowly.First, lets talk about yoyo dieting and the dangers involved.Conditions:Lets ignore bulimia, lets talk about pure over dieting. Not getting into the dangers of different diets (yet). Just pure on off on off dieting.So whats happening? Lets use an example and figure it out as we go.A young woman weighs 120 lbs.She is 25 % fat. 120 * 25 % = ~31 lbs of fat.She diets, loses 20 lbs. Lets go with 50/50 Fat/Muscle loss.120 - 20 = 100 lbs.31 - 10 = 21 lbs of fat. Leaves 79 lbs of muscle.(100 / 21) * 100 = 21% fat.She gains twenty lbs. She does not exercise. But carrying around the added weight adds 5 pounds of muscle.So 21 + 15 = 36 lbs of fat.(36 / 120) * 100 = 30 % fat.Hummm, lets think about this a minute. She's at 120 again but is now carrying ~5 lbs of more fat. Think she might look different than the first time around?Loses 20 again. Same 50/50.36 -10 = 26 lbs of fat. 100 - 26 = 74 lbs of muscle.(26 / 74) * 100 = 35 % fat.Yikes! from 25 to 35 % fat in 3 diets! And that's not even taking it back to the 120, where she started!Can we see how her metabolism is now compromised. She needs to increase her muscle mass asap.Good Lord, if someone has been doing this for years! Yikes!GS
many people are looking for a quick fix instead of common sense. How very true. And part of that syndrome is that these individuals are convinced that what worked for someone else will obviously work wonders for them. And the diet industry caters to just that mentality. (Not just the diet industry!)Sheila
Eh?What's this? Come come, we have a job to do.Ok you professionals, fess up.Where's the Fat scale?You can't fool me, there's got to ba a scale of fatness somewhere. How can you treat a person when different shades of weight mean different treatments?Someone please post it.If I find out you Pro's have been treating people without a scale of, must have treatment, you're not gonna like what I say about ya.Let me tell you what I think. Anyone 40 lbs and over needs to take extreme measures asap.Where's that table?GS
many people are looking for a quick fix instead of common sense.How very true. And part of that syndrome is that these individuals are convinced that what worked for someone else will obviously work wonders for them. And the diet industry caters to just that mentality. (Not just the diet industry!) SheilaHummmm, Sheila, I agree with your part of that syndrome, people get such conflicting reports from the diet industry, the medical profession and other so called health professionals. How many Doctors tell the patient "Your high blood pressure is due to being overweight, lose it or die" "Your diabetes is due to your eating habits, change it or go blind or lose your legs...." Oh yes, they may tell them this, but way too late.Just give them stuff to continue with their present lifestyle.There was a pointer to the Diabetes Foundation. What a laugh, in their FAQ they say you may continue to eat sugar. Gee, really wouldn't want to offend someone by telling them "no you Dumb S__t, you're risking your life".But then, it's their life....so why don't they change? Is it a lack of understanding? Is it too much BS from diet companies? Does Doctor know best? Perhaps they just don't believe they can do it for themselves?A formulized list must be followed that covers all possibilities. Education would be key, but what we have had in place has failed.Wow, I feel a need for one of those diet shakes. You know, one high in carbohydrates. What BS!GS
Stupidity,Ignoring it plays a large part in my life. Such it is with Savagegrace's post of ignorance and revelations of self-doubt. The not-so-subtle allusion to suicide revealed your nature. Flowery worded jibes will not relieve your pain.ab
Wow,now isn't that typical. Unable to see the comparison of taking aim at a target and firing a few rounds at this MB.Self doubt? No, just aware how much time would be needed for this and not wanting to do it.Ignorance? Heck yes. Isn't that why we're here? There wouldn't be so many diet companies if a straight formula was known.But if all you're going to give people is the standard exercise more, eat less fat, what have you really accomplised?Unless a person can effect a lifestyle change, a diet (fad) can be a tool to prevent a number of weight related illnesses.A typical diet that most of you think is the best may be the worst thing for the person.I'm looking for something a bit more helpful to a greater number of people.But, do you prefer to be right, rather than use a tool or methodology that just might mean the difference to your patient's life?GS
Group, let's not get hyper. I have to admit, as must many doctors, that they could usually (not always, that is why we have doctors) be replaced by a robot that says "You're too fat, and lay off the salt."This may work -- I guess statistics show it does in general (the advice I mean). In my case, when I lost 25 pounds some years ago and went off salt entirely (like no Triscuits or Campbell's soup), the effect on my blood pressure was 0.00. So it's by no means universal.I suggest that in this day and age, the hostility that may develop between doctor and patient has to do with the limited time available for an office visit.
Salutations JABoa,This is the sort of information I was talking about.My wife lost 25 lbs and was able to go off Blood Pressure medicine.From this I would conclude that people have a set weight for nominal blood pressure. May I ask, could you lose another 5 to 20 lbs?Is it not possible that some may tolerate a higher weight without pressure increase, while others cannot.I would speculate further and say that people who weight train may reduce that pressure increase point.Assuming no genetic componet.It's these type of speculations that may give us a better view of how to handle problems or breakthroughs that benefit all.GS
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