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Weight loss and maintenance – lessons for all of us


We live in a society where being thin is the norm. Images of rail-thin supermodels and waifs like movie stars adorn every billboard and television screen. We idolize people who are the thinnest five to ten percent of our population. It’s ironic that we’re also a country with “super-sized” portions. The average portion size in American restaurants is more than 25% larger than our European counterparts.

Unfortunately, 64% of the American public is overweight and 33% of Americans are obese. Losing weight and maintaining it is the cornerstone of good health and a happy life. Obesity is linked to type 2 diabetes, heart disease, stroke, cancer, obstructive sleep apnea, depressed mood, and more. For most, weight loss and weight management should be a reality of life.


But for many people, the desire to lose weight or maintain weight loss does not necessarily determine success. Losing and maintaining weight is difficult work and successful strategies depend on how much weight a person needs to lose. Some people can be successful with diet and exercise alone, others require more invasive interventions such as surgery. And even for those lucky enough to realize their desired weight, maintenance, though more straight-forward, can be even more difficult than initial weight loss.

Losing Weight: Diet and Exercise


A person’s weight status is best determined by their body mass index (BMI). BMI is a calculation derived from dividing a person’s weight in kilograms by their height in meters squared. For the calculation-adverse, a BMI calculator is available at the National Institutes of Health website.

According to the Department of Health and Human Services, people with a BMI between 18.5 and 24.9 are considered normal weight. People with a BMI between 25 and 29.9 are considered overweight. Those whose BMI is between 30 and 39.9 are classified as obese. Finally, people with a BMI greater than 40 are classified as morbidly obese.

For Americans who are simply overweight, self-control measures are a good place to start. Medical intervention is best reserved for obese or overweight individuals who have medical problems or have failed self-managed diets on multiple occasions. Although exercise is important in any weight loss or weight maintenance regimen, research shows that diet is the most effective means of weight loss. A successful diet is a diet that is both balanced and calorie-restricted.

What does “calorie-restricted” mean? Everyone has a unique Basal Metabolic Rate (BMR). BMR is defined as the minimum number of calories required to maintain life activity at rest. It varies based on age, activity level, genetics, and gender (men tend to have a higher BMR than women). For example, the BMR of a Mr. Universe body builder may be several times higher than that of a bedridden senior citizen. To lose weight, a person must consume fewer calories than their BMR or maintain a diet equal to their minimum calorie requirements and burn enough calories exercising to lower their BMR.

According to the USDA, a balanced, calorically adequate diet that best approximates the BMR of an average American includes: 6–7 ounces of breads, cereals, rice, and cereals; 2 cups of fruit, 3 cups from the milk category, and about 6 ounces of meat, fish, nuts, poultry and beans. The USDA has developed resources to help people determine a diet that best approximates their own individual BMR based on their height and weight. These resources can be found at http://www.mypyramid.gov,

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All diets should be balanced because all types of food are not created equal, even if they contain the same number of calories. For example, a calorie-balanced diet high in trans-fats can harm the heart and facilitate the conversion of dietary fat to body fat. A balanced diet consists of a diet high in fiber (fresh fruits and veggies) and low in saturated or animal fat. Trans-fats often found in fast and junk food should be completely avoided.

So what about diets like Atkins or South Beach? Fad diets like Atkins or South Beach usually work as a quick-fix panacea. Very few if any dieters can maintain the weight lost from such a drastic dietary change. For many people, eating only meats and proteins can only go so long before it’s back to cookies and cake. Health researchers have found that people can only restrict their eating patterns for a short time before they crave the variety of a more balanced diet.

Exercise is also important for overweight people who intend to lose weight. Exercise is the “yin” to the “yang” of diet. Exercise increases a person’s BMR, maintains lean muscle mass, improves mood, burns calories, and prevents disease such as diabetes and high cholesterol. Any exercise program must take into account the health and physical conditions of the person planning to exercise. For most people, 150 to 200 minutes a week (30 minutes a day) of walking is a good place to start.

There is a certain psychology of weight loss. Our desire to lose weight can be facilitated by taking advantage of how we view our world. Health psychologists and weight loss experts have dedicated a lifetime to studying what works and what doesn’t. The following are just a few pointers from a long list of useful “mind tricks”:

* Log and contract: Everyone who intends to lose weight should keep a log of how much they eat and how much they exercise. Logs help keep everything in perspective and help dieters plan what to do. Diet and exercise regimens also help people lose weight. By writing a contract in concise and specific language, people create an obligation to themselves or others (another like-minded dieter, for example) to dedicate themselves to losing weight.

*Incentive control: Certain environments serve as cues or triggers for mindless eating. Good examples of mindless eating environments include sitting in front of the television watching “American Idol” or playing video games. Dieters should limit eating to one area of ​​the house, such as the kitchen or dining room.

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* Changing the way of eating: Most of the people eat very fast. By eating food quickly, people do not realize that their stomach is full. It is important for dieters to slow down and enjoy their meals.

* Social Support: No dieter is an island. It is best to take the help of friends and family while losing weight.

But inevitably most diets fail. People often underestimate their calorie intake and strive for unattainable weight loss goals. The worst part is that dieters often gain more weight than they lose. Many people develop an unhealthy history that includes failed diets and long-term weight loss and weight gain (“yo-yo dieting”). For some unsuccessful dieters, dieting and more intensive methods of weight loss are beneficial, such as Weight Watchers or medical supervision by a physician or health care professional. Others may need to have more aggressive interventions.

Losing Weight: Pills and “Going Under the Knife”

Many people are unable to achieve the desired health and cosmetic effects with diet and exercise alone. There are other options.

Some obese people with a BMI between 30 and 40 are eligible for drug (drug) therapy. “Pills” include antidepressants, stimulants and drugs such as orlistat that reduce the absorption of dietary fat. At best, the drug results in only a moderate weight loss of 10 to 15 percent once the patient stops taking the drug. Besides, all drugs have side effects and weight loss pills are no different. For example, because of their high addiction-potential, stimulants are only recommended for short-term use.

Bariatric surgery is the best option for people who are morbidly obese (BMI greater than 40) or people who are obese with a BMI greater than 35 and have medical problems such as diabetes, sleep apnea, or coronary artery disease. Are. Bariatric surgery has proven to curb medical conditions such as diabetes, heart disease, and sleep apnea, and significantly improve the quality of life. There are two types of bariatric surgery: restrictive and malabsorptive.

Restrictive bariatric surgical procedures such as gastric laparoscopic band (LAP-BAND) are becoming the most popular options for morbidly obese patients. Restrictive bariatric procedures reduce stomach volume and make people feel full faster. LAP-band surgery involves the placement of an adjustable band around the top of the abdomen by a highly qualified surgeon. Procedures such as the LAP-BAND have few medical consequences and less than one percent of all people who undergo such procedures die afterward. Qualifying for the LAP-BAND is not simple and varies by insurance carrier, but most insurance carriers require a history of failed attempts at diet and exercise and a battery of health visits with nutritionists, psychiatrists, and other health professionals. is required.

Beyond that, anyone interested in taking on the LAP-BAND must be prepared for a long commitment. The band must be maintained strictly after surgery. Nevertheless, the LAP-BAND is an excellent option for those interested in losing large amounts of weight gradually and maintaining this weight loss.

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Malabsorptive bariatric surgical procedures such as “Roux-en-Y” are more effective, resulting in greater weight loss, but are also more dangerous. Patients who receive this type of surgical intervention have a surgeon remove part of their intestine to interfere with the absorption of foods. After surgery, patients must be careful to eat certain types of foods and make proper nutritional choices. Furthermore, unlike LAP-BAND, malabsorptive bariatric procedures are irreversible and carry a high risk of medical problems resulting from nutrient deficiencies, small bowel obstruction, and infection.

Weight Maintenance: The Hardest Way

So you have lost weight or you are happy with your weight, now all you need to do is maintain. But weight maintenance is difficult in this land of abundance. Seemingly, candy bars abound in every major medium from convenience store counters and the McDonald’s line. Health-conscious John Q. What should the public do?

Now more than ever, maintaining a healthy balanced diet and exercise regimen is integral. Lifelong hard work is the key. Additionally, cosmetic medical procedures such as liposuction can help remove and contour subcutaneous fat.

As with weight loss, there is a psychology to weight maintenance:

* Visual Cues: Health researchers, notably Dr. Brian Wansink, author of “Mindless Eating: Why We Eat More Than We Think,” have found that people eat with their eyes, not their stomachs. For example, Dr. Wansink found that people presented with “bottomless” self-refilling bowls of soup consumed 73% more soup than they would have otherwise. Furthermore, they did not experience more satisfaction after doing so. People just keep eating without context like empty bowls. Anyone interested in maintaining their weight can take advantage of this simple psychology by buying smaller plates, smaller bowls, 100-calorie “snack” packs, and avoiding all-you-can-eat buffets altogether. Is.

* Taking a day off: Health researchers have also discovered that once physically fit people lose their abstinence, they are more likely to stick to their diet. In a bizarre experiment, researchers fed obese and physically healthy people a milkshake and then gave them as much ice cream as they wanted. Thin subjects, who are usually restrained in their eating patterns, exercised caution and ate more ice cream than their obese counterparts. This line of thinking influenced the common recommendation that everyone take one day a week off strict dietary maintenance. People looking to maintain their weight should have a bowl of ice cream and some cookies every Sunday night after “The Simpsons” instead of eating a candy bar every other day.

With regards to weight loss and maintenance, everyone controls their own destiny. It is important for all of us to understand that living a healthy life is within our control. Determination is the key to proper weight loss and maintenance. We all have our own keys to being slim and healthy.

Source by Dr. Amir Rassoli

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