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Sunday, July 3rd, 2011

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Five Tips To Lose Weight ……That Are Not True!Myth #1: A Calorie is a Calorie is a Calorie….Is it true?

It is not unusual for people battling weight gain to hear from a dietitian or a physician “a calorie is a calorie is calorie.” This old saying implies that to lose weight it doesn’t matter what we eat as long as we cut back on the total calories consumed. The less the total calories taken in, the more the weight loss…. But is it true?

Indeed, outside of our bodies a calorie from orange juice is the same as a calorie from chicken or chocolate. But inside our bodies that old dogma doesn’t hold up because foods are not just consumed, they have to be digested as well. The process of digestion or integration of nutrients into the body is not equally efficient for different food types. For example, fat is 95% efficient. Meaning of 100 calories of fat consumed, 95 calories are stored in the body (mostly in fat cells.)

Carbohydrates are about 85% efficient meaning 15% of calories are lost during digestion. Finally, protein is only 70% efficient. Our body cannot store fish, beef or chicken protein. It has to break down all amino acids (the building blocks of proteins) and re-assemble them into human proteins. This process wastes about 30% of the calories consumed from protein. That is one reason that all calories are not the same.

Another reason all calories are not the same has to do with our metabolism – how our bodies decide to process food at any given time. For example, studies have showed that eating the same amount of calories (in a study of college students it was 2000 calories) in one meal in the morning versus in the evening have different effects on body weight. Eating more at night causes more weight gain.

Myth # 2: Shut your mouth and you will lose weight!

How many times have you heard overweight people say but “I do not eat much at all?” How many times have you noticed that your overweight friends or relatives eat very little at the dinner table? People who skip meals or even starve themselves are under the impression that the only way they will lose weight is to drastically cut their caloric intake. Indeed, even doctors tell their patients “shut your mouth and you will lose weight…” We now know that this “myth” is not true.

The discovery of a gut-brain axis regulating appetite and satiety has shed a new and fascinating light on the physiology of cravings, feeding, as well as energy storage. Signals released from our stomach such as the hormone ghrelin, or leptin which is released from fat cells, among others, all “talk” to neurons in our brain.

Ghrelin levels rise when we fast, peak immediately before meals, and are typically higher during weight loss and in anorexia – as if the stomach is telling the brain to eat more. Before a meal, blood ghrelin levels can double depending on the timing and amount of calories eaten at the previous meal. Skipping lunch would therefore trigger more appetite for a bigger dinner. In addition to controlling appetite, ghrelin also shifts the body’s metabolism to an energy-sparing mode by slowing fat breakdown and by lowering body temperature.

So, people who starve themselves should know that by doing that, they are shutting down their metabolism and increasing their appetite. When they finally eat, whatever the portion size, the food “sticks to them” that is it goes directly to fat cells for storage.  By eating the right food choices, it is possible to lose weight while eating more. Raising your metabolism is similar to feeding a furnace high-octane logs around the clock. It burns faster and hotter!

Myth # 3: Tell me your secret.

There is a diet out there called the “Da Vinci Code diet.” When people ask me what it is, I tell them I do not know because it is a secret! At any given time, roughly half of all American women are dieting – often in secrecy. None of us like to admit that we are unhappy with our weight and are trying to lose weight with the latest diet. The latest diet because the previous ones are no longer trendy or failed to work. Even when people succeed, they do not want to tell friends, family members and co-workers that they had to diet to lose weight.

The truth is that there is no secret diet or weight loss solution out there. Even if there were secret solutions, they would not apply to everyone. Your secret diet, supplement, surgery, medication, or exercise routine may not work for your friends even if you divulge it to them. It is not about a secret formula or a secret diet. When people ask “oh, what is your secret” they are really saying “ congratulations!”

Here is how I see it: As you lose weight the healthy way, people acknowledge your success and are appreciative of your newly regained sense of control. There is indeed a lot of pleasure in weight loss. The waistline is shrinking, the cheekbones are once again prominent, and energy and libido are back up to where they were decades ago. People are noticing, sometimes they even try to ask you out. Others come to you and quietly ask you how you did it, where did you go, what are your secrets, etc. You are glowing in success. You have truly achieved something that millions of people want but are unable to get. You have lost fat, gained strength in body and in your spirit and look fantastic. If your life and body transformation do not bring you the sweetest pleasures there is something wrong! You are delighted that your efforts have paid off. You are body proud and you know it: that is your secret!

Myth # 4: Doc just tell me what me what to do.

Unfortunately, I hear this from my patients more often than I would like to. “Doc jest tell me what to do” translates as “Doc spare me the details of the process just give me a diet…” The problem is without grasping the knots and bolts of the process of change, all diets (or any lifestyle change) are bound to fail. Dietary and exercise guidelines are important. But cognitive skills such as time management, setting priorities and boundaries, organizational and stress reduction techniques are more important. Further, these skills have to be customized and personalized. For example, for people who travel a lot, lifestyle change tools have to take into account and adjust to time spent in airports, meals at restaurants or the road, nights spent in hotels and sometimes lack of access to healthy food choices or exercise equipment.

The flip side of this myth is in the fact that doctors cannot tell people what to do when it comes to lifestyle change. Docs do not learn much nutrition, even less about exercise in their medical training and have even less understanding of weight gain or loss! Finally, they do not have time to interview their patient in debt to give them personalized and relevant lifestyle change advice.

So what are you supposed to do? First, understand that there is no quick fix even it is recommended by your doctor. Second, understand that the “money” so to speak is in the coaching process. Third, understand that there are many ways to lose weight – some are more successful or easier than other – and that there is one approach out there that will work for you. Finally, understand that for lifestyle change to take roots, it has to be constantly re-evaluated and changed. The exercise you begin with will have to be modified for you to reach your goals. The food choices and the portion sizes have to be re-examined as well. So, “doc just tell me what to do” should be replaced “doc I need a health coach, can you help me?”

Myth #5: No Pain No Gain. Exercise to get bigger?

I often hear: “Doc I exercise everyday and I am getting bigger.” Or, “I had to fire my trainer because he would kill me but I was getting bigger and bigger.” Is it possible that exercise would cause more weight gain? Absolutely, most exercise regimens are anabolic meaning they help you get bigger and stronger. Sometimes, it is important to gain muscle to lose fat. But usually, people who are overweight or obese have plenty of muscle. Therefore, they just have to use them to burn calories. Sub-maximal and frequent fat-burning exercise such as a brisk walk or low-impact aerobics, and whole body callisthenic workouts is the way to go. Here are other reasons why some people don’t lose weight with just exercise:

Exercising, dieting and still gaining weight?

Which group do you belong to?

-Hefty Athletes (crew, football and hockey players in particular) who eat everything in site after a long aerobic training session.

-College Partiers who exercise hard for three straight days but party and hang out starting Thursday nights till Sunday (pizza, pasta, beer, cake…)

-Good Wives who watch what they eat all day and even exercise an hour a day but overeat to keep company of their husbands at nights or weekends – husbands usually choosing the menu!

-Weekend Bingers. They work hard all week, exercise regularly and then drop the ball completely on the weekends. A weekend getaway: extra bonus!

-Socialites. Try to be committed to weight loss, fundraisers and board meetings all at once! The “society calories” win over the private sweat and chagrin.

-Boat People. Once off shore, the rules of thermodynamics no longer apply. Calories do not count when consumed on the boat!

-Serious Bingers, Night Eaters and Closet Eaters: Calories do not lie no matter how much you exercise.

Why am I writing a blog?

Have you ever felt like sharing personal experiences with others because those experiences are so unique? Not sharing special moments means they fail to be captured and they’ll just fade away in time — so, the purpose of my blog is to share my experiences.

As a physician, I am privileged to learn from my patients (who will be referred to as “members” since they are not always sick.) Like traditional family recipes that you want to remember forever, I feel like the lessons I learn from members of my practice are so rich that they should be saved and shared with others.

An important note: in all my blogs, the identity and confidentiality of all members will be respected as an absolute rule. I will change the context, the nature and details of my exchanges so no one feels that their private relationship with me or my practice are compromised.

And second, a disclaimer: my blogs and all the exchanges I’ll be sharing are for educational purposes and because they’re interesting. Do not expect medical advice or even health coaching here – that’s not what I am doing, nor is it possible. So please think of my blog and any exchanges we have as writings that will enrich our lives and enjoy them as trusting and supportive material limited to the following topics (click on categories on the right to see each blog thread):

East River Fall Reflections

Stress and Stressors:

Learn how people feel stress, identify stressors and handle them.

Lifestyle Management:

The process of change for a healthy and enhanced lifestyle.

Meditation Moments:

Simple observations, thoughts, reflections and random accidents that make us pause for a moment and then move on enriched by the experience.

Goal Setting:

We live in a world defined by goals. Well okay, some do not set goals – it is a turn-off for them. But those people end up as drifters, they go with the flow and often that leads to the dead waters. In this track, I will write about goals … setting targets and committing to the process … reaching them … and then setting new ones. As part of this track, I will share with my teachings about various subjects such as reward systems, organizational skills and time management among others.

Exercise:

Always a big topic. I will write and share personal, member experiences and their results; latest trends and other matters related to and aimed at designing an exercise regimen.
Nutrition: Another big topic. There is so much mis-information out there about diets, foods, cooking, supplements, etc., that I believe this track will be a big player on this blog. Every now and then I will include a recipe…

Life Cards:

This is one of my favorites …often, life hands us cards, good or bad that we have to know how to play. However, one lifetime is not enough to experience and learn from all the possible twists and turns of our lives. My goal here is to share these experiences and their results with fellow readers so that we are all well-equipped to deal with the next life-changing event. Learn to make “lemonade out of lemons.”

Healthy Fun and Play:

There is no point in setting goals and reaching them, only to be disappointed that in other layers of life, we are miserable and unhappy. Being mindful of the need for fun and play in life is critical to achieving long-lasting happiness. Topics like parties, games, pet stories, surprising stories fit here.

News:

I feel like I cannot keep up with health-related, medical and scientific news that I am interested in. One day a medication or a supplement is a “must,” then another day it is harmful to your health. One day, a medical breakthrough is celebrated, another day it is refuted. We need someone to navigate us thru all this enormous amount of information. I hope my blog can help separate noise from news.

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Dr. Reza Yavari M.D. is a Board Certified Endocrinologist and founder of Beyond Care®, a leading preventive care and obesity center located in Guilford, CT. Learn More

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