Happy Meals Over Big Macs...What a toddler can teach us about eating to achieve our weight loss goals

When you think about a toddler, what comes to mind? Boundless energy…fun-loving….and generally happy, except when they are mindlessly screaming because they wanted to shut the van door and you accidentally shut it yourself. Lack of emotional filters aside, we can really learn a lot about how to be healthy and lose weight from toddlers. 

1. Only eat the amount you need. Toddlers are great at this. To many parents’ dismay, children go through periods where one would think they are on a Lenten fast, and they won’t eat even their favorite foods. But toddlers will generally only eat the amount their body needs. In a survey by Appetite magazine, 85% of 142 families say they try to get their kids to eat to eat more at meal-time through persuasion. But the old adage that “a child will eat when he is hungry” is really true, and we should follow that rule as well.
2. Take your time when you eat. My son is the master at this…so much so that sometimes we have to set a kitchen timer just to get him to move it along when we are on a schedule. But Jake just really likes to talk at dinner….a lot! That translates into long meal times. It really is helpful to be social when you can with your meals. People that are too busy to sit down with their family to eat are often people who gain weight. Why? Because eating together, talking as you eat, and taking your time will help you feel full faster and eat fewer calories. But no, you don’t have to bring your favorite Thomas the Tank Engine or baby doll to distract you from your food.
3. Just keep moving! Now, your toddler probably does this before, during, and after dinner. I am not suggesting you move constantly during your meal, but I certainly think you could move before or after. Even if it is just to get on the floor with the kids and wrestle around with them after dinner, every bit of motion you can add to your day will help you in your overall weight-loss goals.
4. Happy Meals over Big Macs. When eating out, think about eating a “child’s” meal. A McDonald’s Happy Meal has anywhere from 450-650 calories. Since an adult meal should probably be around that amount based on a 1,500-2,000 calorie/day meal plan, adults should think about eating a child-size portion when eating out. No, you don’t have to eat a child’s hamburger and apple dippers, but you should rethink the size and quantity of your portions if you want to be successful in achieving your goals.

The Spiritual Warfare of Weight-Loss: A Christian Perspective

“The thief has come to steal, kill and destroy. But I have come that they might have life, and have it to the full.” (John 10:10)

Why is it so darn hard to lose weight? Once you lose it, why is it so hard to keep it off? While it is certainly true that many temporal factors such as self-control, chronic pain, medications, and genetics make weight-loss difficult, for those of us who are people of faith, we know that it can be a spiritual battle as well. Something we often forget is that we have an enemy. According to the Bible, this enemy seeks to “steal, kill and destroy.” If you think that the devil only seeks to utilize tools that are typically thought of to achieve his outcome, think again. He is going to attack wherever he thinks he can gain an advantage, as any impactful warrior would. With over 2/3 over-weight and 33% of American’s being obese, this has been a very effective weapon. (National Health and Nutrition Examination Survey, 2003)

What does obesity steal?

ENERGY: What more could we do to impact the world for good if we had some? How many times do you avoid opportunities to serve because you are too tired or just can’t physically do the task?

BEAUTY: The devil loves nothing more than to steal this from us since he used to be the most beautiful of all God’s creations until he fell, according to the book of Ezekiel. To see that God has granted a bit of his image to mankind that we can carry on this legacy must really spur him to steal this from us.

HOPE: If we have given up control over our own body, what else will we give up on?  Many feel that being healthy is a lost cause.

INDEPENDENCE: Too often, as a PT, I have seen the end stages of obesity. Some have lost so much independence they become completely confined to a specialized hospital bed. Of course this is the worst case scenario. However, do you avoid flying on an airplane because you have to pay for two seats? Do you have to sacrifice the memory of roller coaster rides with your kids because you can't fit in the car? Do you avoid taking vacations or even trips to the mall because you can't walk reasonable distances? If you can't do things you want and should be able to do, this is a victory for the Enemy.

What does obesity kill?

Obesity related disease is one of the most common causes of death in the United States. Annually, obesity causes 112,000 excess deaths due to cardiovascular disease, 15,000 excess deaths due to cancer, and over 35,000 excess deaths due to other obesity related diseases in just the U.S. alone. (1)

What does obesity destroy?

MARRIAGES: While a study in the Journal of Biosocial Sciences did not find a significant link between divorce and factors related to health (other than high risk behaviors such as smoking and drinking); anecdotally, surveys reveal loss of physical attraction as significant. Divorce expert Gary Blanchard lists this as the number 3 cause of divorce behind “abusive relationship” and “lack of communication.”

FAMILIES: Sadly, without energy, hope, and independence, many eventually “check out” of their significant relationships. Speaking from experience, as a dad who was 50 pounds over-weight, it was much easier to collapse in the easy chair and give into the “tube” than to physically engage with my kids. This was one of the issues that turned me around. I finally refused to be “that” dad and husband.

Farther down the line, since obesity causes needless early death, how many children are left fatherless or motherless because of this preventable disease?

However, the good news is the conclusion to the Bible verse: “but I (Jesus) have come that they might have life, and have it to the full.” James 4:7 says, “If we submit to Christ and “resist” the devil, he will flee from you.”

The key is, submit and resist are verbs and require action on our part. When we realize that we have an enemy that wishes to steal, kill and destroy us, we will realize what a fight we are up against. Take up your swords and put down your forks! This is a battle we must win!

1. Flegal KM, Graubard BI, Williamson DF, et al. Cause-Specific Excess Deaths Associated With Underweight, Overweight, and Obesity. Journal of the American Medical Association. 2007; 298(17):2028–2037.
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Redefining Normal

I read a great blog that fits in well with my philosophy of peeling away the layers of the fat onion by changing habits and redefining a new you.  Please check out Roger's great but short read on "Redefining Normal":

http://www.roglawfitness.com/redefining-normal/

Quick Post- Motion Doctor: Great Ipad App for Exercisers

Recently I came across a great application for those who are new to exercise who want to avoid improper movement patterns when exercise. It is called the Motion Doctor. This app will allow the user to click on an area of the body they wish to exercise, and then it will provide exercise recommendations and the proper way to perform them.

Soon after initiating an exercise program, many start complaining of nagging pain they makes them want to quit. The problem is not typically the exercise. It is the movement patterns utilized during the exercise often combined with too much resistance that are the cause of the problem.

For example, when I began yoga several months ago, I was having a lot of rear shoulder pain with the "warrior 2" move.where in a lunge position one arm is forward and the other straight back. I soon realized the shoulder pain was there because I was trying to strain my shoulder too much to get into the position to compensate for a restriction in trunk rotation. So, even though my shoulder hurt, it was my back that was the real problem! Of course as a PT, I am a bit more in tune with how my body should move than the average yoga student. So, I was able to make the adjustment and the pain resolved.

Motion Doctor is an app that was developed  by a PT to show you exactly how to perform each exercise...if you are lucky enough to have your own Ipad.  Please let me know if you have other great technological resources that will make weight loss easier and safer for the CT community.

You can read more about the Motion Doctor app at: http://www.motiondoctorapp.com/

BIG MOVES: A safe exercise routine for obese people who want to lose weight

Triathlons can be grueling events, even for the fittest of athletes. So, imagine everyone’s surprise at the 2006 Concreteman Triathlon in Springfield, MO when a man who was clearly on the plus side of 300 lbs showed up to compete. It wasn’t until after every other competitor had finished the 2-3 hour race that I noticed this man again. It was quite inspirational to see. As the rest of the competitors were driving away, and long after the awards for the top finishers were handed out, this man was laboring toward the finish line in 95 degree heat. Was he inspiring?…YES. Was he also a bit crazy? ABSOLUTELY. The chance for injury and perhaps much worse are pretty high in an individual competing in an endurance event in such condition. It is admirable to have such ambition. However, if you have the goal of competing in a triathlon, make that a long-term goal and take small steps each day toward it. This will increase the opportunity for a safe, enjoyable, life-long activity.

So where should you start? Increasing exercise activity is a crucial component for people who have weight to lose. According to the American College of Sports Medicine, it will take 45-90 minutes of exercise per day, 5 days per week to achieve weight loss. I know that seems daunting for those with a significant amount of weight to lose or with chronic orthopedic issues. However, it can be done…safely! Here is a proposed regimen that almost anyone can do:

Day 1: Start the week off with a brisk walk. If 45-60 minutes is too ambitious, go as far as you can go. For each subsequent walk, add 5 minutes until you achieve at least 60 minutes. This is not a quick-fix. The goal is to achieve long-term health and wellness. If you just can’t tolerate the idea of a 60 minute continuous brisk walk, break up the walk into three walks of 20 minutes each. The key word in this discussion is “brisk”. In order to achieve maximum benefit, the intensity needs to be relatively high. Although some use 60% of max heart rate as their target heart rate for fat burning, I would go for 80% to increase the number of calories burned per hour. To calculate your target heart rate, subtract your age from 220, and multiply that number x .80. I would recommend you purchase an inexpensive heart rate monitor to give you visual feedback on how you are maintaining your intensity during your activity. Polar makes an excellent heart rate monitor that provides everything you need. I have included the link here to the monitor on Amazon:

http://www.amazon.com/Polar-Heart-Rate-Monitor-LARGE/dp/B003SQS9Z6/ref=sr_1_7?ie=UTF8&qid=1310526915&sr=8-7

Day 2: Hit the pool! Water exercise is great for those with weight related orthopedic chronic pain issues. The main reasons are:

• The water decreases the effect of gravity and un-weights the joints. This allows for greater freedom of movement and longer activity duration.
• The water improves blood flow. The hydrostatic pressure is greater at deeper depths and decreases in more shallow water. So, if you are standing in the water, this aids in getting blood back to the heart.
• Water increases sensation all over the body. In general, this feels good, and provides feedback to the neurological system to help with balance and lessen pain.

There are many things you can do in the water, from low-impact water aerobic exercise and water walking, to higher intensity lap swimming and water polo. Whatever you decide, remember to wear your heart monitor. (The recommended on amazon.com is water resistant). You may notice it is a bit harder to hit your target heart rate doing water aerobics or walking. However, the nice thing about water is as you increase the speed of your activity, you will increase the resistance. The increase work will elevate your heart rate and help you achieve your target zone.

Day 3: By day 3, you will be ready for something different. A beginner yoga video or class would be a good choice. I know some people may be skeptical; I was as well. However, I have found that the improved mobility from the combined movement patterns, the mental discipline developed from pushing through the discomfort, the improved spinal alignment, and core strength gained from yoga has helped decrease pain and increase body awareness and fitness motivation.

There is a nice dvd specifically for obese patients who want to make yoga part of their fitness regimen. It is called Heavyweight Yoga. You can follow this link to get to the site: http://heartfeltyoga.com/shop.htm. In many communities, there are yoga studios with classes specifically designed for heavier individuals. So, don’t be afraid to give it a try. Yoga has become an important part of my fitness routine….but, I do take a pass on the “ohms”.

Day 4: Seated resistance exercises. Early in the weight loss program, it is important to focus on improving nutrition and aerobic types of exercise to maximize fat loss. However, incorporating some resistance exercise stimulates different muscle fibers, improves muscle tone, and facilitates increases in strength. For those who have a lot of weight to lose, many exercises can be done sitting down. In addition, you can do a whole body workout and still burn a lot of calories by doing an interval routine. That means you alternate between upper body and lower body exercises and perform the entire routine with just a couple brief rest breaks. Below is a link to a seated exercise routine that can be done at home:

http://exercise.about.com/cs/exerciseworkouts/l/blobeseexercise.htm

Day 5: Finish off the week strong with a nice, long bike ride. You could possibly make this workout fall on a Saturday so you can take a little more time and really enjoy a longer workout.  For most, this is a good alternative to running because you can increase heart rate without all the excessive weight bearing that places high loads on the back, hips, knees and feet. In addition, if you get outside you can enjoy the views, and a 2 hour bike ride can go by quickly. Of course, that is great for the spring and fall and most of the summer, but what about the winter? Joining a spin class at a gym can be a great social activity and help keep you motivated and elevate your intensity.

On the 6^th day, take a break! You deserve it. If you don’t feel like you can do this routine, do something.

The other day, my four-year-old son told his two-year-old sister that she could not have peanut butter because she was “electric” to it. I promise, you are not “electric” to exercise, even if you think you are going to have some sort of adverse reaction. Once you make it a part of your life, and start feeling changes in your well-being, you may even enjoy it!

The F A T Onion: peeling away the layers of bad habits that keep people from lasting weight control.

My favorite Facebook status update of all time was by a friend who said, “Mike is...still working on my before picture.” 

I remember laughing out loud when I read that. No, I am not saying my friend looks bad. I just mean it typically takes a great amount of time to become overweight, and it is going to take some time to reverse it. Jim Rohn, famous author and speaker, said, “Failure is not one cataclysmic event. You don’t fail overnight. Instead, failure is a few errors in judgement, repeated every day.”

So why do we so often feel like we need to drop the weight immediately by going on some drastic calorie restriction diet? The concept that needs to be grasped is that weight loss should be a decision to live life well, not just to look good as soon as possible. I often think of when we go on a diet to shed some quick weight. We lose 20 pounds in a couple months, and look great! But then, the diet ends, and we go back to the old way of eating. Within a year, we are back to our old weight. What did that diet actually do? According to obesity research, it actually makes us LESS successful at weight loss in the future!

With that said, I want to introduce to you my philosophy of gaining control of your health.  I call it the “Fat Onion”. The idea is simply that, just like peeling an onion layer by layer, you “peel away” the things that have contributed to the weight you are now....for good. Well, we at least want to eliminate them as constant, habitual acts.

Here is how to do it:

1. List every “vice” you have that contributed to your “before picture”. Each one will be represented by a layer of the onion. 
2. Try to prioritize the list from the thing that is easiest for you to let go of to the hardest. 
3. Start eliminating these habits (ie: peel the onion), with a new layer every thirty days. 
4. There are NO SUBSTITUTIONS. You can not replace the onion layer with a new contributing habit. For example, one admirable layer that people like to peel is soda. However, they then replace that layer of the onion with other sugary choices like lemonade or sweet tea. In all likelihood, they are just eliminating a bit of carbonation, but no calories. If you are eliminating soda, I would recommend drinking a lot more water and have a sporadic glass of unsweetened tea or Crystal Light. That way, you can actually see a bit of progress for all your suffering! :)

The idea is, we must make changes and eliminate (or drastically reduce) things that have gotten us to where we are now, and substitute new habits to replace them that will help you move in the direction of your “after” picture.

For example, my wife and I were talking today and she was a little dissatisfied with her amount of belly fat. She just is at a loss for what to do. I said, “well, let’s talk about what you do that contributes to the problem.” One of the first things we mentioned is the extra calories we both get in food preparation and nibbling off the kids’ plates. 

This can easily be an 300 extra calories per day. Since 3500 calories equal a pound, that is potentially an extra 31 pounds per year! So, we decided this was an unnecessary luxury and we are going to eliminate it from our “fat onions”.

At the end of the 30 days, we can evaluate. Are we happy with the choice we have made? Have we made progress? Have we made progress but reached another plateau? As long as you are happy with your continued progress, you can just continue on as you have. Congratulations! You have created a new habit. If you have reached a plateau.....you guessed it....pick another layer of the onion.

This may not be the fastest or most dramatic weight loss plan. However, it is effective. If you can keep these unnecessary evils out of your life, it will also be long lasting. 

Now, finally, Mike...and you...can start working on your AFTER picture!

To Be Skinny, Do Skinny People Stuff!

Confession: I am a huge Dave Ramsey nerd. He is a finance celebrity of sorts who encourages people to get out of debt. His wisdom and encouragement has helped millions of people pay off financial mistakes. One of his “pearls of wisdom” that has stuck with me is, "If you want to be poor, do poor people stuff. If you want to be wealthy, do rich people stuff.”

So, what does that have to do with a blog on weight loss? Recently, I received an email from a physical therapist colleague of mine. She is thin, even after having a couple of kids. However, she admits keeping weight off has been a struggle. Despite this challenge, she finds it upsetting when obese friends, patients, and co-workers make comments such as, "Oh, you wouldn’t know how tough it is…..you’re thin!” She feels the comments are not fair. “It doesn’t come easy," she says, "I choose to work out over lunch while others sit, and I go for jogs in the evening while others watch American Idol.”

As PTs, we are aware of obstacles patients face with limited ability to be active because of their medical conditions. However, she makes a very good point. Some have a protective mechanism built in that makes the assumption, if others have been successful it must have been easy. However, there is a very simple principle that will make your journey easier: To be skinny, skinny people do skinny people stuff.

So what is skinny people stuff

Skinny people move. When others choose to do sedentary activities like watch tv or sit and enjoy a prolonged lunch with friends, that is when my friend gets in some exercise. Most of my obese friends know they should exercise regularly, they just have a hard time finding time. However, increased physical activity has been correlated with lower BMI*. In younger subjects this was even more predictive than most food intake differences. 1 The decision needs to be made to find the time to be active. Start where you are at, and do what you can do. The goal is not to run a marathon today. The goal is to do a little bit more than yesterday. Here are some suggestions:
Wake up 30 minutes early. If you are worried about getting enough sleep, skip David Letterman.
Before eating lunch, take a brisk walk around your work place. It may cut into your eating time, but maybe that is a good thing.
If you must watch American Idol, develop a routine and get off the couch while you watch. Do some calisthenics and abdominal exercises while you watch the “boob tube”.
Start working out with your significant other or a friend. Interestingly, those who are thin do have a higher tendency to have an active spouse.4

Skinny people don’t diet. They don’t obsess about food the way obese people often do. According to a 2005 study published in Obesity Research, successful weight maintenance was associated with relatively fewer attempts at weight loss. 2 Think about your diet history. Are you guilty of doing the HCG diet to drop a few quick pounds before swim suit season, or a few weeks of the Atkins plan to fit in that wedding dress, or the office Biggest Loser contest to win a couple hundred bucks?
Skinny people love desserts, but they indulge in them occasionally. They usually do not clean their plates, and they often share a restaurant meal with their significant other. Skinny people may have a slice of pizza or two, but they don’t regularly go to Pizzarama’s all-you-can-eat buffet. The point is, people who are thin eat what their body needs for energy.2 As the cliché goes, they “eat to live, they don’t live to eat.”


Skinny people are ok with hunger. Doesn’t it feel like when you get a little bit of a stomach growl it feels like a 5-alarm emergency? But at worst, it is a distraction. The big secret is, a little tummy gurgling at 3:30 in the afternoon never resulted in death at 4:00. On the contrary, hunger pangs are often a sign of boredom or habit. I mentioned this in my last blog, but a signficant predictor of successful weight management is restraint. 2 I know it is frustrating when a thin friend at work says they are just going to have a bite of an indulgence, and then actually do it. But, if those who struggle with weight would start copying that behavior, they would likely start seeing the pounds come off. I am not saying to starve yourself and eat a 1000 calorie diet. I am talking about those daily indulgences that keep us from achieving our goals. Something I remind myself when faced with temptation is, "Nothing tastes as good as it feels to be in shape."

Skinny people are creatures of habit. In a 1999 nutritional study, it was shown that eating a high variety of entrees, carbs, condiments sweets and snacks coupled with a low variety of vegetables was associated with increased body fatness. However, less variety of the fatty foods while eating a large variety of veggies predicted the least amount of body fat. 3 So, ever notice that thinner people tend to have similar lunches day after day? I have. It may seem mundane but real change will come when you start treating food as fuel, not as your major source of fun.

This is by no means an exhaustive analysis. I am sure if you imagine Jeff Foxworthy in your head saying, “You might be a skinny person if you……(insert hilarious response here)” you’ll come up with all sorts of observations. In fact, that is how I want you to start thinking and then model those behaviors. It won’t be easy, and we are programmed from a very young age to follow the path of least resistance.

I was reminded of this the other day. My three-year-old's swim instructor called the house to inform us he was ready to move up to a more advanced class as the skills were now all too easy for him. We excitedly went to tell him the good news and were perplexed when he didn’t have as jovial a response as we anticipated. After he thought about it for a moment he replied….”but I like easy!”

I know. We all like easy. Making real lasting change is very, very hard. But it can be done! There will be costs involved. It will surely be slow and very frustrating. However, what seems impossible just takes a while.


Definitions:

BMI- body mass index. a ratio between rate and height that is a measure of obesity and an indicator of overall health. A BMI  greater than 25 is indicative of obesity. Those with a BMI of 22 are shown to have the low levels of illness. This scale is a good general tool for average individuals but is flawed when measuring those with high levels of muscularity. BMI is very easy to check. BMI calculators are readily available on the Internet by simply doing a search for BMI calculator.
References
1. Wendell, et al. Dietary intake and physical activity of normal and overweight 6 to 14 year old Swiss children. Swiss Medical Weekly. 2007 July 28. 137 (29-30): 424-30.
2. Vogels n, et al. Predictors of long term weight maintenance. Obesity Research. 2005 Dec; 13(12). 2162-8.
3. McCrory MA, et al. Dietary variety within food groups. Association with energy intake and body fatness in men and women. American Journal of Clinical Nutrition. 1999 March. 69(2). 440-7.
4. Davison KK, Burch LL. Lean and weight stable. Behavioral predictors and psychological correlates. Obesity Research. 2004 July. 12(7). 1085-93.