At the beginning of every year, primary-care physicians such as myself are flooded with patients getting that first-of-the-year physical. We anticipate a large workload; we add night hours to accommodate the increased number of physicals needed. From the past 10 years in primary care, I am prepared to address patients' requests for guidance on how to lose weight.
The information I give to all the patients is a strategy I started 10 years ago. I studied the commercial diets, including Jenny Craig, Weight Watchers, the Slim Fast diet and many others. One common denominator was the fact that these diets advised eating multiple small meals throughout the day, as opposed to one or two large meals, which is the case for most. To illustrate this concept, imagine two scenarios.
In the first scenario, a person has 1,500 calories divided equally between two meals. This person would consume 750 calories for lunch and 750 calories for dinner with no breakfast or snacks. The second person has five small meals of 300 calories each, spaced out among three-hour intervals, divided throughout the day.
Imagine the first person listed with two meals has dinner at 7 p.m. and doesn't eat again until noon the following day. This person went 17 hours without eating, getting no nutrition during that time period. Over time, three physiological changes will occur: His natural metabolic rate will slow down; his body will increase its storage of fat to include a higher amount of abdominal fat, which contributes to diabetes, hypertension and heart disease; and the person will have increased hunger before lunch and dinner.
Then, imagine going to a fast-food restaurant to make a food selection. Even though most of these restaurants have healthy selections, it is almost impossible to choose the healthier selection if you have not eaten for 17 hours.
When you allow yourself to go that long, you make decisions based on hunger.
To give further instructions to my patients on how this program works, I use my own schedule as an example. Making decisions on what to eat includes asking yourself a simple question with every food selection: Is it healthy? Most patients agree that they easily recognize unhealthy options.
The rule I give to my patients is to realize that giving up taste when making food selections will help with weight-loss success. Most foods low in calories don't taste good to many, but the reward is an improvement in health. Exercise is important, too, and I advise starting out slow with walking and increasing intensity as you become more able to exercise.
My personal schedule includes the following routine daily meals:
- I eat breakfast around 7:30 a.m. It includes two boiled eggs, a packet of instant grits or oatmeal, and a piece of veggie sausage.
- My first snack, at around 11 a.m., includes a protein shake or half a sandwich prepared the night before.
- When I eat lunch, around 2 p.m., I eat the other half of the sandwich and a piece of fruit such as an apple, an orange or a low-calorie, sometimes pre-made or frozen meal.
- My second snack, around 5 p.m., includes a selection similar to the earlier snack.
- Around 7:30 p.m., I eat a dinner that consists of a similar selection to lunch, or a small portion of a white meat with vegetables or a salad with a small amount of low-calorie dressing on the side.
Here are some other ways to make your 2015 healthy resolution last.
Exercise more. Many believe the misconception that you have to run a 26-mile marathon to get an effective workout. My grandmother would frequently say that something is better than nothing at all.
Many people feel hopeless when it comes to activity or exercise. They feel that there is no purpose, because they are not in "shape." But know that people who are not in the best physical shape lose weight at a much quicker rate with the start of exercise than people who are in the best shape. I suggest first consulting with your medical provider for safety, and if he or she gives you the green light, start a reasonable program. If you're able, walking is an excellent and safe exercise for beginners. Start with a moderate pace and increase the intensity at your own rate. Listen to your body and don't ignore pain or discomfort. If you are unable to walk due to joint issues, consider water aerobics. Just remember that every journey begins with one step.
Set a goal of achieving better health, not looking better. Many patients tell me that their motivation behind weight loss is to be more attractive. As a physician, I encourage anyone to start activity and improve diet with the goal of better health, and not just looking better. Diabetes, hypertension and many other chronic medical conditions are positively impacted by moderate activity with weight loss.
For example, I had a patient who weighed 350 pounds and took many medications and insulin for her worsening diabetes. After incorporating exercise with diet and losing 50 pounds, she was able to control her diabetes with only pills. In a follow-up visit, she said that she was unhappy with her overweight appearance but did not feel discouraged because her motivation had changed. During her last visit, she smiled and said that she was so happy to have her diabetes controlled without insulin that she was going to continue her improved lifestyle changes to include a better diet and increased activity despite the fact that she was still unable to confidently wear that two-piece bathing suit.
Get the recommended screenings by your medical provider. While in a grocery store a few weeks ago, a lady I did not recognize hugged me without warning. She told me that she saw me do a lecture in her church about the importance of obtaining a mammogram. She followed up with her physician and got one. The results revealed a microscopic calcification. Doctors removed it with an ultrasound-guided biopsy.
The lady later told me that the pathological report revealed cancer-free cells in the margins and no lymph-node involvement. The lady, in tears at this point of her report to me, said that doctors told her that they diagnosed her cancer and removed before it had the opportunity to metastasize or spread. Go get your screenings, because it can save your life.
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