Examining a Family’s Coping System Can Help Weight Loss

When we decide to lose weight, we don’t have to look far for reliable information about diet and exercise. Finding and maintaining the emotional will to change lifetime habits is a more difficult, but critical, requirement for success.

According to Kathy Sheffield, a therapist and registered dietician, individuals may be in a better position to live without overeating when they understand how overeating functions in their lives. She asserts that the answer can be found by examining a family’s emotional coping system. For example, when family members relate to each other in a dysfunctional manner, they may unwittingly adapt to the difficult situation at the cost of their own well-being. The resulting conflict and inner tension is managed through food.

One interesting study observed that weight loss occurred at least temporarily when the family system changed. Without exception, the desire to lose weight appeared when a shift in a relationship changed the emotional climate for the dieter.

In one case, a husband's became more emotionally available when his job changed. In another, a difficult relationship with a mother-in-law became manageable after the family moved. Once the emotional climate improved, the dieter was able to make changes. If the climate shifted back, weight was regained.

According to Sheffield, therapy can help individuals discover the link between relationships and eating disorders and offers new possibilities in weight-loss success.

"To err is dysfunctional, to forgive codependent" Berton Averre

Would You Walk a Mile for a Doctor?

If you’re a patient of Dr. David Sabgir’s, you might find yourself doing just that. Every Saturday at 8:30 a.m., rain or shine, Dr. Sabgir heads out on a walk at Highbanks Metropolitan Park in Lewis Center, Ohio, with 175 to 200 patients, neighbors, friends and family members.

Three years ago, after unsuccessfully admonishing his patients to lose weight, Dr. Sabgir had a flash of insight. Why not walk with his patients every Saturday morning? During the walk, patients, along with their family and friends, would have the opportunity to talk with medical professionals to learn how to take care of their health. By becoming more active, patients could alter the course of anticipated heart disease and improve the quality of their lives.

The project quickly became a family affair. Dr. Sabgir’s wife, Kristin, began bringing lower-calorie fare to the walks to demonstrate healthy snacks. Alexandria (age 9) and Charlie (age 7) joined the walks. Dr. Sabgir’s father telephones weekly reminders to participants without access to e-mail. Other volunteers who joined the effort include nurses who provide free blood-pressure checks, an exercise physiologist who leads and closes the program with appropriate stretches and sponsors who provide free pedometers. Healthy recipes, samples of the recipes and nutritional weight-loss tips are provided each week. Participants can also receive a free one-hour counseling session with a registered dietician.

Dr. Sabgir, a board-certified cardiologist, practices with clinical cardiology specialists at McConnell Heart Hospital and Grady Memorial Hospital. Through these organized weekly walks, Dr. Sabgir has found a way to encourage healthy physical activity in people of all ages, sizes, shapes, physical conditions, ethnicities and socioeconomic backgrounds.

Dr. Sabgir considers the diversity of the walking group to be its strength. He says, “The diversity of the group is most apparent when you see a young mother pushing her newborn in a stroller alongside a couple in their 90s. Both obese walkers and endurance athletes share in the benefit of education and exercise.”

With Ohio’s obesity rate approaching 27 percent, Dr. Sabgir has a big job. His state ranks 17th among the 50 states. Moreover, the numbers on the scales of Ohio citizens—and of the rest of the nation—are heading up. Even more worrisome is the fact that interventions—whether undertaken by medical personnel, private companies or government entities—have yet to reverse the trend. Dr. Sabgir’s has designed his volunteer efforts to do just that by creating a greater awareness and commitment to health among residents in his community.

Besides making new friends and having fun, patients learn the medical benefits of walking. Exercise helps patients feel less tired, decreases stress, aids in weight loss and weight control, lowers blood pressure and cholesterol levels and improves circulation.

If you’d like to learn more about the Walk with a Doc program, you can sign up for Dr. David Sabgir’s newsletter, e-mail Dr. Sabgir at contact@walkwithadoc.org or call 614.273.8030.

"I have two doctors, my left leg and my right."

G. M. Trevelyan

Mirror, Mirror on the Wall: Will You Help Me Become Friends with My Body?

This letter came to me from a reader. I wanted to share it because many of you will be able to relate to what she says.

Dear Carole:

About 10 years ago, The Body Shop ran a campaign that showed a plus-size Barbie on a sofa and the words, "There are 3 billion women who don't look like supermodels and 8 who do. Learn to love your body." That was a huge statement. I bought up the magnets and gave them to every woman I cared about.

I turned a corner when I became conscious of the critic in my head that said I couldn't be acceptable unless I looked a certain way. I think women in particular are raised to nurture that critic. We're taught to listen to it. For as long as I can remember, I’ve looked in mirrors and dissected the things that are wrong with me. The nose. The hair. The legs.

Lately though, I've started to appreciate that this body is what I'm going to live in for the rest of my life, and I might as well make friends with it. It takes me where I want to go and is the source of my physical and emotional responses to the world.

Today, I don't want to get fit to become more acceptable or meet some outside ideal. I just want to be healthy and active as long as I'm in this body.

On some level, I think I owe my body an apology. I'm sorry for starving you; overfeeding you; purging you; and manically exercising you, then completely neglecting you. I'm okay with the waxing and dyeing—you'll just have to deal with that. But seriously, want to go for a walk and catch up on how things really are? I think I'm ready to be friends. J.E., Walnut Creek, CA

Isn’t this a wonderful conclusion to her letter? Becoming friends with our bodies is a powerful idea whose time has come.

"Getting my lifelong weight struggle under control has come from a process of treating myself as well as I treat others in every way."

Oprah Winfrey

Healthy Aging—for Kids?

One potato, two potato, three potato, four.

Kids won’t live as long as their parents did before.

This lighthearted chant conveys a serious message: today’s children may be the first generation to suffer more health problems and live shorter lives than their parents will.

September is national Healthy Aging Month, and the traditional focus of this health promotion has been on adults 50 years or older. But in light of the downward trend in longevity, the concept of healthy aging needs to be applied to everyone—even children.

I wrote about this issue in an article titled “Healthy Aging—for Kids?” that appeared on Gabby Reece’s Web site

on August 24, 2008. Go here for the full article.

Whether we’re teachers, friends, parents or relatives, we can help children get FIT and preserve their option to age healthfully. Here are three FIT tips:

F: Feed your children home-cooked meals that include vegetables and fruit. Fix family favorites but reduce calories—for example, replace oil or butter in baked goods with applesauce. Fill your cupboard and refrigerator with healthy “fast foods” (for example, bananas, apples, hard-boiled eggs, whole-wheat bread, raisins and carrots) that kids can grab and eat on the run. Find games to play either indoors (Wii Fit or another exergame) or outdoors that will get your family moving.

I: Inquire about the calories and content of restaurant and processed foods and check specifically for fat, trans fat and sodium. Involve yourself in parents’ groups promoting healthy school lunch programs. Initiate family rituals that include a nightly family dinner. Introduce concepts about portion size and caloric content. Invite your children to help you cook.

T: Teach children about nutrition. For example, discuss the importance of drinking milk to build strong bones and eating fresh fruits and vegetables to provide needed vitamins, fiber and nutrients. Track your family’s screen time (video, television and computer) and set a limit on use. Take time to participate in fun physical activities with your kids and show them by example that exercise is important.

Raising children is a daunting yet fun-filled challenge. Whether we’re a parent, relative, teacher or physician, we have one goal: to develop children into fit, productive adults. To assure this happy outcome, all of us must adopt a healthy lifestyle. We’re never too old—or too young—to focus on fitness.

Five potato, six potato, seven potato, eight.

We need to help kids change before it is too late.

What’s Triggering Body Inflation?

The price of food throughout the world has risen at an unprecedented rate, according to a warning issued by United Nations. In 2007, the global food price index rose over 40 percent compared to 9 percent in 2006. Agency officials cite global warming, changes in farming practices, natural disasters, war and rising demand for food and fuel from growing populations as key factors.

In the United States, the price of fresh fruits and vegetables rose 74% between 1989 and 2005, and we can expect the cost to continue to rise given the damage to crops from flooding in the Midwest and a drought on the west coast. In terms of the dollar’s purchasing power, it takes $125 to buy the same goods today that $100 bought in 2000.

Given the rising cost of food, why are Americans—along with citizens of other countries—ballooning? Obesity is even becoming a problem in some parts of Africa as the pendulum for many now swings from under-nutrition to obesity without bothering to stop at normal weight. Is inflation contagious? Is it triggering inflation in body weight as well?

In an effort to address this question, a special health issue of Time magazine focused on supersized kids. The expanding problem (excuse the pun) of childhood obsesity is a concern for many but especially parents, grandparents, teachers and medical professionals.

Time’s eight lengthy, well-researched articles cover topics ranging from the economics of obesity (how limited access to fresh fruits and vegetables in inner cities and certain rural areas, referred to as food deserts, encourages calorie-laden diets) to genetic causes of obesity and medical solutins. Practical tips to help parents trim their oversized kids by helping them become more active is also included.

But is the problem of body inflation this complex? And is the solution more exercise?

Not according to biologist John Speakman at the University of Aberdeen in the U.K. He narrows it down to one simple cause: we eat too much. In a study reported in the June 4, 2008, issue of Science Now titled “The Couch Isn’t Making You Fat,” Dr. Speakman asserts that overeating rather than under-exercising is the root cause of obesity.

Dr. Speakman and a fellow biologist, Klaas Westerterp of Maastricht University in the Netherlands, studied data that measured the daily energy expenditure stretching over a twenty year period. Then they compared the data from the long term studies with results they obtained measuring the current energy expenditure of 366 individuals. Rather than rely on subjective reporting, the researchers measured the ratio of hydrogen and oxygen in the urine of subjects, a ratio that provides information on the rate of metabolism.

Their conclusion was both startling and controversial. The researchers found that the daily expenditure of energy for their subjects was about the same as it was for people measured twenty years ago. True, watching television has replaced listening to the radio, and surfing the Internet or playing video games has replaced reading books. But the effect of these changes does not significantly alter energy expenditure.

Even more impressive was their conclusion that the expenditure of energy was consistent over the entire twenty year period. Surprisingly, geography had little impact. That is, the expenditure of energy remained constant whether the data came from studies in developing or westernized countries.

His study confirms my own experience in losing over sixty pounds. How did I acquire the surplus pounds? I ate too much.

Here’s a typical day of eating before I lost weight.

Breakfast

1 fried egg 100

2 slices of bacon 80

2 slices whole wheat bread 200

2 cups of coffee with cream 90

1 8-ounce glass of orange juice 130

Total 600

Lunch

1 double cheeseburger 440

1 large order French fries 500

1 packet catsup 15

1 12-ounce McFlurry with M&Ms 620

Total 1,570

Snack

2 chocolate chip cookies 200

Dinner

2 slices cheddar cheese 210

4 whole wheat crackers 100

1 baked potato 90

2 heaping tablespoons sour cream 120

1 heaping tablespoon butter 100

1 breast of chicken 200

1 cup green salad 180

3 tablespoons salad dressing 100

1 cup green beans with butter 100

Total 1,200

Total for the day 3,570

Given my height of 5-feet 2-inches, even with an hour of exercise, my body burns around 1,500 calories a day. So what happened to the 2,080 surplus calories on my typical eating day? My body stored fat around my middle, hips and thighs.

Had I tried to burn the extra calories through exercise, I would have needed to walk 10 hours. As you can see, there weren’t enough hours in the day to burn off the surplus calories.

Although I’m not a math major, I figured out that except for the ultra-athlete engaged in intense, continuous training or the competitors on The Biggest Loser, exercise by itself would not be sufficient to lose weight. Consequently, my approach to losing weight involved eating less (reducing portion sizes) and eat differently (substituting lower-calorie foods for richer ones.

Don’t get me wrong. Exercise shapes and tones my body, lowers my blood pressure, improves my balance, sharpens my mind, strengthens my muscles and bones, reduces the risk of certain chronic diseases and lifts my spirit. Exercise also helps me sleep better, boosts my energy and burns a few incidental calories. Because exercise has these enormous benefits, I’m committed to daily exercise. At the same time, I’m realistic about the ongoing need to monitor the amount of calories I consume if I want to keep from packing on pounds.

What triggers body inflation? Genetics? Too much screen time? Or do we eat too much? Is it simply consumption inflation? If it is, can we accept such a straightforward answer? Or will we seek an answer that does not require us to alter our current way of life. And eating.

Like Brutus, will we continue to look for answers—not in ourselves—but in the stars?

"The fault, dear Brutus, lies not in our stars but in ourselves..."                            Shakespeare

Local fitness guru goes global on AARP Web site | TheUnion.com

http://www.theunion.com/article/20090616/NEWS/906169998/1053/NONE&parentprofile=1053

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To Size Down, Wise Up—on Serving Sizes

Are you the kind of person who calculates each serving you eat? Do you weigh each ounce of nourishment on a food scale? Most of us aren’t that precise about our eating habits, and perhaps it is just as well. Food is meant not only to nourish our bodies but to be enjoyed.

Still, to manage your weight, you need to have an accurate idea of what constitutes a serving. If you don’t pay attention to the amount of food you eat, you can easily consume 20 to 30 percent more calories each day than you realize. One study, reported in the Annals of Internal Medicine, found that the larger the meal, the greater the underestimation of the total calories consumed—sometimes by as much as 38 percent. Another study estimates 40 percent. These researchers found that the more people eat, the more they underestimate their caloric consumption.

Labeling of food products is helpful, but the federal government requires that the caloric content be within only 20 percent of the actual content. And although New York City’s Board of Health recently introduced regulations requiring restaurants to post the caloric content of the food served, it did not mandate any standards for accuracy. The restaurants are on the honor system.

Making it harder for us to judge serving sizes is the supersizing of portions over the past 20 years. Here are a few dramatic comparisons in calories resulting from the supersizing of portions:

1988 2008 Difference

Cheeseburger 330 590 260

Bagel 140 350 210

Turkey sandwich 320 820 500

French fries 210 610 400

Soft drink 85 250 165

In general, today’s food portions contain over three times as many calories as the portions served 20 ago. We’ve become so accustomed to oversized, calorie-packed versions of our favorite foods that ordinary-sized servings seem woefully skimpy and certainly no match for our appetites. Who, for example, eats the standard serving size— 1/2 cup or 1 scoop—of ice cream? Aren’t we more likely to have 2 or 3 scoops?

Distinguishing between a portion, the amount of food served, and a serving, the measure of caloric and nutritional content, is essential for weight management. If you are not mindful of this distinction, you will underestimate the total calories consumed even though you are diligent in keeping a food journal.

The following list of common foods, along with a few tips, will help you gain perspective on what constitutes one serving:

1 slice bread

1/2 cup cooked grain, such as rice, oatmeal or pasta (about the size of a cupcake wrapper)

3/4 cup cereal

1 medium potato

1/2 cup cooked vegetables (about the size of one tennis ball)

1 cup raw leafy vegetable, such as lettuce

1/2 banana

1 cup melon or fresh berries

3/4 cup fruit juice

1/4 cup dried fruit

1 ounce meat, poultry or fish (3 ounces equals a deck of cards)

1 ounce cheese (equals about 4 dice)

1 egg

1/2 cup beans or tofu

1/3 cup nuts

2 tablespoons nut butter, such as peanut butter

1 cup milk

1/2 cup cottage cheese

2 teaspoons oil, butter, margarine or mayonnaise

2 tablespoons regular salad dressing

4 tablespoons reduced-fat dressing

Until you are familiar with serving sizes of various foods, it’s helpful to use a measuring cup, tablespoon or teaspoon to measure food. This exercise will help you gauge a normal serving size until the serving size looks familiar to you.

Knowing how many calories your body requires and keeping track of your food intake are good foundations for weight management. Accuracy in gauging serving sizes, however, is just as critical. If the numbers on the scale aren’t moving in the right direction, keep this handy guide in your kitchen so that you can quickly identify your serving sizes and make corrections.

"The greatest gift that you can give yourself is a little bit of your own attention."                         Anthony J. D'Angelo

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