Protect Your Heart by Losing Weight

Saturday, December 5, 2009

Losing weight lowers your risk of heart disease and stroke because it helps you control blood glucose (sugar), blood pressure, and cholesterol
levels. You don’t have to lose a lot of weight to see the benefits— even a loss of 10 to 15 pounds can help a lot.

Weight loss can be a struggle because it means making changes in the
way you eat and in your level of physical activity. The older we get, the harder it is for us to lose weight because we burn fewer calories. We also tend to be less active. Losing weight takes time— and that can be frustrating. The good news is that you can lose weight and keep it off, even if you’ve never done it before.

What strategies can help me lose weight?

Here’s what works for people who have lost weight and kept it off:

• They cut back on calories and fat.

• They’re physically active most days of the week.
  

• They eat breakfast every day.

• They keep a record of their weight, what they eat and drink, and what they do for physical activity.
  

Some people attend weight-loss programs; others use these strategies on their own. Think about which approach will work best for you. Just remember that studies show it’s much easier to lose weight when you use a combination of meal planning and physical activity.

What’s the secret to changing habits?

Understanding the process for changing habits can make it easier for you to change the way you eat and increase your activity. Every change involves several stages, and each stage is important. Here’s an example. Sue used to have ice cream almost every night for her snack. But she wanted to lose weight.

• At first, she wasn’t interested in making a change. She wasn’t ready to give up her ice cream. She thought it would be too hard to do.

• Then she thought about ways she could cut calories to lose weight. She decided that one way might be to eat something instead of ice cream. She wasn’t ready to try it but thought she might be ready in the future.

• After a while, she decided that soon she’d be ready to make a change in her snack, even within the month. She made a realistic plan— she’d have fruit instead of ice cream several times a week.
  

• Then she took action. She bought her favorite fruit and started eating it four times a week instead of ice cream.
  

• Now, after more than 6 months of her new habit, it’s part of her routine.

Think about what stage you’re in for changes you’d like to make. Are you in the early stages— not ready for a change yet? Or maybe you’re interested in losing weight but you haven’t taken action. The next step is to decide what you’re willing and able to do. Then plan exactly how and when you’ll do it.

Strategies for Losing Weight
Choose things to do that will help you lose weight. Put a check mark next to the things you’re willing and able to do. Or write down your own ideas. Remember that every step you take helps move you toward your goal.

How to cut back on calories and fat

• Eat smaller servings of high-calorie favorites.

• When you eat out, split a main dish with a friend or family member. Or take some home for tomorrow.
  

• Ask for salad dressings and sauces “on the side” and then use as little as possible.
  

• Include a fruit or a vegetable with every meal or snack.
  

• Cook in low-fat ways: roast, broil, grill, microwave, steam, or bake. Use nonstick pans or cooking sprays.
  

• Substitute low-fat ingredients in your favorite recipes. For example, try low-fat cheese instead of the regular kind.
  

• Cut back on high-fat toppings, such as butter, margarine, sour cream, regular salad dressing, mayonnaise, or gravy. Instead, season your food with herbs, spices, salsa, lemon juice, or other low-fat choices.
  

• Check food labels. Choose the products with fewer calories and less fat.
  

• Stock your kitchen with low-calorie, low-fat snacks, such as air-popped popcorn, pretzels, and fruit. Keep serving sizes small.
  

• Other things I can do: _____________________ _________________________________________

How to be more physically active

• Take a 30-minute walk every day. Or split up your daily activity—try a 10-minute walk after each meal. If you haven’t been very active recently, check with your health care team first. Start off with a 10- to 15-minute walk every other day, then little by little walk farther and walk more often.
  

• Find a physical activity you enjoy, like swimming, dancing, bicycling, or doing the exercises on TV programs.
  

• Be active around the house: work in the yard, play with the kids, get up to change the TV channel, and walk around while you talk on the phone.
  

• Take the stairs instead of the elevator.

• Take the dog for regular walks.

• Walk instead of drive whenever you can.

• Park at the far end of the shopping center lot and walk to the store.
  

• Other things I can do: _____________________ _________________________________________

How to keep a record of your progress
Keep track of your weight loss efforts. Many people find that writing everything down helps keep them on target. Use a small notebook and keep it with you all day.

• Write down everything you eat and drink. Include the serving size. Some people set target levels of calories or grams of fat and keep track of their daily totals.

• Make a note of what kind of physical activity you’ve done and for how long.
  

• You may want to check your weight once a week and write it down or use your clothes as a measure of weight loss. Are your pants a bit loose around the waist? Can you fit into the blouse you haven’t worn for years?

How a support system can help
Many people find it motivating to meet on a regular basis with people who are also trying to lose weight. You may want to consider joining a group for weight loss, exercise, or general support. Or create your own support system by talking with friends and family about your successes and your struggles. Find a walking buddy or friends who also want to improve their health and work together to set goals for success.

Lose 40 pounds in 4 weeks: Regulating commercial weight-loss programs

Friday, December 4, 2009

The $50 billion North American weight-loss industry comprises a morass of fantastical claims of products and programs promising quick, easy, long-lasting results. Given this wealth of magical weight-loss aids, why is obesity still a problem? Perhaps because magic exists solely within consumers’ hopes and dreams, which many commercial weight-loss providers happily exploit.

Although experts agree that obesity management requires long-term behavioural, medical or surgical intervention, the majority of commercial
weight-loss providers manipulate vulnerable consumers with impunity, cultivating unrealistic expectations and false beliefs. Consequently, we regularly see preposterous claims, such as claims that subcutaneous B vitamin injections aid in weight loss by accelerating lipolysis (a claim lacking published medical evidence) and claims of “magical” herbal supplements that curb appetite, accelerate metabolism and reduce cravings (claims deemed “not convincing” in a 2004 meta-analysis of dietary supplements and weight loss).

Recognizing the substantial morbidity and mortality associated with obesity, physicians, public health campaigns and nongovernmental organizations fuel the fire of the public’s weight-loss desires by promoting awareness of obesity’s risks. However, by not explicitly recommending evidencebased treatments, these well-intentioned
messages drive consumers to blindly navigate in an unregulated weight-loss wilderness. This has, at times, had fatal consequences, as with the administration of ephedra and with medically unsupervised very-low-calorie diets.

Failure to impose and enforce penalties for false or misleading weight-loss claims results in a major public health hazard. Not only are patients being swindled, but it is also reasonable to assume that those who have had multiple failed attempts at fraudulent programs are less likely to engage in evidence-based approaches. This increases the risk that these individuals will suffer or succumb to the myriad health consequences of excess weight and, in so doing, increase society’s burden of illness and global health care expenditures.

Physicians, governments and public health departments all share medical and moral obligations to protect consumers from shady weight-loss practices. Since weight loss addresses a medical concern for which treatment guidelines exist, weight-loss products and services must be regulated to protect consumer health. Precedents from other areas of health care suggest that the weight-loss industry can indeed be regulated and consumer protection enforced. Currently, hospitals and other health care facilities, both public and private, are subject to mandatory accreditation. Also, professional associations can be given authority to oversee and set standards for health care practices that provide specialized services, as has occurred recently in Ontario with private cosmetic surgery facilities.

Before we can truly address the devastating obesity epidemic, we must first stem the centuries-old flow of snake oil. We call on governments to
require formal accreditation of weight-loss providers to ensure quality and to provide consumers with an easily recognizable means of identifying evidence-based services. Simultaneously, governments must pass legislation to subject weight-loss products to regulatory approval before they can be marketed, as has recently been proposed for other therapeutic products not presently covered by current drug-approval regulations. This would give health and drug directorates the power to require manufacturers of weight-loss supplements to substantiate their claims scientifically and eliminate the lure of “weight-loss in a bottle” scams.

Finally, health professionals must be taught evidence-based principles of obesity management to ensure they can understand, provide and support healthy weight-loss efforts. Neither public health agencies nor the medical community are doing enough to solve the problem of obesity. Those suffering with obesity are often desperate for solutions and hence prone to exploitation. It’s time we put an end to this nonsense.