SUSTAINABLE WEIGHT LOSS

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Summer 2000

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Health Consequences of Obesity

• Coronary heart disease, stroke, and high blood pressure.
• Type 2 diabetes.
• Cancers, such as endometrial, breast, and colon cancer.
• High total cholesterol or high levels of triglycerides.
• Liver and gallbladder disease.

Health Consequences of Obesity (cont.)

• Sleep apnea and respiratory problems.
• Degeneration of cartilage and underlying bone within a joint (osteoarthritis).
• Reproductive health complications such as infertility.
• Mental health conditions.
• Autoimmune illness has also been implicated.

NWCR and other available data

National Weight Control Registry.

Characteristics of Successful "Losers"

• Incorporate activity into their lifestyle
• Have regular meals
• Learn to plan ahead
• Develop problem-solving skills
• Make Small Changes

NWCR Findings

• 45% of registry participants lost the weight on their own. The other 55% lost weight with the help of some type of program
• 98% of registry participants report that they have modified their food intake in some way to lose weight.
• 94% increased their physical activity, with the most frequently reported form of activity being walking

NWCR members report maintaining a lower intake and increased activity

• 78% eat breakfast every day
• 75% weight themselves regularly to monitor
• 62% watch less than 10 hours of television per week
• 90% participate in activity for an average of about one hour per day

Important        interventions for us

• Self-monitoring (find your own style)
• Cooking and eating for satiety
• Regular adjusted exercise
• Trial and error with diet and exercise
• Responding quickly to results of what we're doing lately

Self Monitoring

• Weighing
• Food Diaries
• Exercise Logging
• Many free Smartphone apps now available

Digital Tools

• Food/Exercise/Weight/Biometric logging
• MyFitnessPal
• Cron-o-meter
• Map My Fitness
• External Accelerometers like Fitbit

Cooking and Eating for Satiety

• Properties of food
• Glycemic/insulinemic index and Glycemic load
• Caloric density
• Choosing food for high fiber both soluble/insoluble

Glycemic Index:

indicates how rapidly a carbohydrate is digested and released as glucose (sugar) into the blood stream.

Caloric Density:

Choosing foods that are less calorie dense — meaning you get a larger portion size with a fewer number of calories — can help you lose weight and control your hunger.

What do we eat?

• A minimally processed, lower glycemic diet
• Lots of vegetables, some legumes, some animal protein
• Some fermented dairy and soy.  
• Enough nuts, seeds, oils to meet our requirements for fatty acids.
• Occasional whole grains such as oat groats, quinoa or wild rice.

Meals in Support of a Minimally Processed Diet

• Salads, Soups, Stir Frys, Stews, Curries, Omelettes, Grain Porridges
• Lend themselves to leftovers for following days
• Tools: Pressure Cooker, Slow Cooker, Thermal Cooker, Wok, 
• Good cutting board/knives, Good storage containers for leftovers

Exercise

• We find it best to look at it as an adjunct to weightloss.maintenance
• There is really no way to exercise one's way out of a bad diet (I tried!)
• Find something that you will consistently do and mix things up.
• Great for building/maintaining muscle mass.  
• We like hiking.

Hiking

• Provides a bit of resistance in addition to cardio on steeper grades
• Mostly free!
• Great places close at hand
• Dogs love it.  Also good social activity
• Mental health benefits from spending time in outdoors.

Planning Ahead

• Going to have poor access to decent food?
• Pack a cooler with meals for times you will be away.
• Thermoses are also great for soups/stews and beverages
• You can even cook in a wide-mouth thermos.
• Very effective for cooking grains for breakfast, or soups.

A Plan for Dining Out

• There will always be times you have to find something at a restaurant.
• There are sensible choices to be had.
• Places like Subway/Chipolte where you can stipulate what goes in your salad
• Chinese restaurants will often prepare just steamed meat and veggies.  
• What about "Cheat Meals/Days"?

Cheat Meals/Days

• We believe they are a generally poor idea.
• We don't know anyone who has maintained a big loss for long that uses them.
• We found it best to blacklist lots of "old favorites".  
• They just set off cascades of overeating.
• It was in our interest to create new versions of old favorites.

Setbacks

• Every longterm maintainer I know has had setbacks.
• Life happens.  Illness.  Trauma.  Upheaval.
• The key is to quickly recognize that you've crossed a threshold and correct
• Quickly respond to changes and make reasonable corrections.
• Understand that there will be setbacks.  Plan for them.