As a primary care physician, I have watched with interest the debate about healthcare reform. At the heart of the matter, however, is the fact that taking care of a predominantly overweight population is expensive. It is estimated that obesity costs our health care system $147 billion annually. Excess weight puts us at an increased risk of heart disease, stroke, diabetes, certain cancers, chronic pain, and depression.
The problem has multiple contributors. Processed foods have become the cheapest and most convenient foods to eat. Vending machines, snack bars, and fast food chains have become increasingly prevalent (I do remember McDonald’s coming to Brigham City). Portion sizes have grown while jobs have become increasingly sedentary. All of this contributes to our current epidemic.
Is there hope? Unfortunately the statistics are grim. Studies show dieters maintain only 6-8 pounds of weight loss at 4 years. But the statistics shouldn’t discourage us. Instead we need to realize that losing weight is not easy and there is no quick fix. We also need to think in terms of months and years, rather than days and weeks. A general rule of thumb is 1-2 pounds of weight loss per week. Even a loss of 10 pounds can improve blood pressure and lower blood sugar.
For most people weight loss is simply an equation. Calories eaten – calories burned = weight gain or loss. There are some proven strategies to help. The most important is to watch the calories eaten. The damage that can be done in 20 minutes of eating can take hours and even days of exercise to undo. According to research, people who succeed at weight management keep track of the food they eat. Usually 3-4 days of keeping track of everything that goes in your mouth is enough to help you realize where or when your breakdowns are occurring. You can then plan ahead to avoid or make better choices during these situations. A website I frequently recommend is www.livestrong.com. Sign up for a free profile and then spend a little time learning how to calculate portion sizes. After that it is just a matter of recording everything you eat and the website will calculate calories, along with keeping track of your recommended calories for the day. The problem I find most commonly is drinking calories in juice or soda. Research also shows that diet soda stimulates appetite and leads to increased intake.
Another frequent question is “what is the best diet? Atkins, HCG, or another miracle diet?” There is a lot of debate, which usually means there is no clear-cut answer. The principles we learned as children still hold true, whether we learned it from a grandmother, a pyramid, or a plate. Fruits, vegetables, and whole grains should be the staple of our diets. Choosing low fat options when available (I apologize to my dairy farmer ancestors!), and sweets should be treats, not regular parts of every meal. Most dietary changes are simply breaking bad habits built over a lifetime. It takes awhile for a bowl of pineapple to be as fulfilling of a way to end a meal as a bowl of ice cream.
Now, the other side of the equation: calories burned. (I guess it is the same side so I hope Mr. Yeager is not reading) If you have been inactive a long time, expect to feel worse for a little while. It is important to start gradually. Next, break it up. A 20 minute walk before work, a 10 minute walk at lunch, and 30 minutes walking after work burns the same amount of calories as an hour before work. Look for ways to incorporate activity during the day, shun elevators, walk while talking on the phone, ditch your remote control. If you have bad joints, getting into a pool and swimming or walking is a great way to burn calories while lessening the impact. And last but not least, schedule something every day. Make your 20-minute walk a priority and plan it into your day.
We would all love to lose weight quickly, but unfortunately this kind of weight loss is temporary. Physiologic barriers to weight loss are relatively rare, but if you are having a hard time losing weight despite burning more than you take in, a visit to your doctor may be worthwhile. Permanent weight loss is all about changing habits and lifestyle. Remember you didn’t gain it all in a month and losing it in a month is unrealistic and often unhealthy.