It seems like half of America is either on a diet or thinking about going on one. Every month a new exercise fad is promoted as the miracle solution to weight loss. Entire sections of grocery stores are devoted to fat-free foods and low-calorie snack items. Book shops feature the latest in celebrity exercise books and tapes. Yet, statistics tell us that Americans are still gaining weight.
Why You Can’t Lose
The chances of gaining weight increase two-fold between the ages of 20 and 60. In order to lose one pound you must cut back 3500 calories. This means the average person would have to eat around 1000 calories a day to lose one pound a week, and for many, a 1000 calorie diet is less than appetizing.
Another obstacle is the heavier and older a person is, the more difficult it is to lose weight. Instead of the 12 to 15 calories per pound a day that a younger active person might burn, an older overweight person may only need six calories per pound to maintain his or her weight. For a dieter who has followed their low calorie diet, but still hasn’t seen any results, great frustration can be caused when their doctor tells them that they must eat even less.
“Snacks are the biggest source of added calories for people trying to lose weight,” says Margaret Wilkman, RN, MPH, CDE.
Kris Berg, EdD, professor of physical education at the University of Nebraska, goes as far as to advise his patients to stay in the outside aisles of the grocery store where the fresh foods are kept, so that they will avoid the temptation of fattening snacks. This is sound advice considering that ten peanuts can be a hefty 200 calories and a regular potato chip might have as much as 25 calories in it. After a few high-calorie snacks a day, a person may find that they are gaining pounds instead of shedding them.
In addition, sometimes when a person feels hungry they might just be bored or thirsty. Instead of snacking, try drinking some water or going for a walk. Chances are you’ll forget about eating and save yourself from the unneeded calories.
Unfortunately, the new crop of fat-free foods don’t seem to be the answer for snackaholics either, since many dieters mistakenly think that fat-free is a license to overeat. “Fat-free foods are still filled with calories,” says Berg, “and they seldom fill you up.”
If you do feel the need to snack go for the crunch factor. Berg advises cutting up carrots, celery or other fresh vegetables and fruits and keeping them handy in the refrigerator.
A Success Story
Three years ago Evelyn Narad, age 76, weighed 226 pounds. Overweight since having her first child, Narad had been fighting the battle of the bulge for several years. One day she fell, breaking her left arm and hand. Confined to her house and feeling depressed about her weight, Narad decided then and there that she had to change her life. A friend lent her some tapes on a low carbohydrate diet formulated by a New York endocrinologist, Richard Bernstein, MD.
“My dietitian forbade me to go on the low carbohydrate diet. She said it would kill me,” says Narad. “I told her I was already dying from all the extra weight, so why not give it a shot.”
Narad followed Bernstein’s diet losing 100 pounds over a three year period. She now weighs a slim 125 pounds. Narad believes that the low carbohydrate diet was successful for her because it was a good match for her body type.
However, she credits her weight loss to a variety of changes not just the low carbohydrate diet.
She changed her eating habits one food at a time and committed herself to doing water aerobics five times a week at the YMCA.
Frustration Over Weight Loss
George David Taylor, age 65 and 280 pounds has been overweight since childhood. Diagnosed with type 2 three years ago, Taylor nearly lost a toe to gangrene last year and is now on insulin.
His doctor has told him if he loses weight he will lessen his chances of getting more diabetes complications and may be able to go off of the insulin. Still, Taylor feels overwhelmed by the thought of starting a diet and exercise plan.
“I have a whole shelf of diet books,” says a frustrated Taylor. “I read them and think I’ll start one tomorrow, but I never do.”
According to Jacqueline Pugh, MD, associate professor at the University of Texas, part of a patient’s frustration may have something to do with their doctor. “Often, a doctor will tell a patient to lose weight without giving them any counseling or advice on how to achieve this goal,” says Pugh.
In the future, Pugh would like to see a more hands on approach between health care professionals and patients when it comes to weight loss.
One way of doing this, Pugh suggests, is having diabetes educators or dietitians accompany their patients to the grocery store. There they can illustrate the proper healthy and low calorie food items for their patient’s diet plan. “More than just telling a patient they need to lose weight – we need to make sure that they understand how to do this,” says Pugh.
Pugh also points out that many health care professionals are not immune from society’s prejudices when it comes to the obese. “Many are judgmental and they view obese patients as being weak willed,” says Pugh. This can erode the patient/doctor relationship even further and increase a patient’s frustration over losing weight.
More Tips for Weight Loss
Steven Leichter, MD, FACP, FACE, co-director of the West Georgia Center for Metabolic Disorders in Columbus, Georgia, advises his patients who want to lose weight not to follow a detailed, printed diet. He believes that using these diets sets a person up for failure. “Nearly everyone abandons these diets as soon as they think they have lost some weight,” Leichter says, “and about 97 percent of these people gain the weight back. We try to reprogram eating for everyday life on a long term basis.”
Wilkman tells her patients not to deprive themselves entirely of the foods they love. “Just eat them in small portions and try to restrict them to weekends. If you’re forbidden certain foods it’s only going to make you go off of your diet because you’re going to feel deprived.”
Also, keeping a diet journal can help you not only keep track of the calories but also help you document the emotions and stress that may lead you to going off your diet. In order to change eating patterns, you first have to recognize why you eat.
Evelyn Narad credits her support group as being invaluable in helping her lose weight. “You need to have other people who know what it’s like giving up something they thought they couldn’t live without,” says Narad. “It’s good to be reminded that you are not a committee of one.”
How Fast Should I Be Losing Weight?
Leichter finds that many of his patients believe they should be losing weight much faster then they are. However, on the average one pound per week is a good rate of weight loss.
Evelyn Narad lost 100 pounds, but it took her three years to do it. “I took it slow and changed my exercise and eating patterns one at a time,” says Narad. “I got used to eating less and felt more satisfied with what I was eating, so I didn’t feel hungry all the time.”
Narad also suggests that diabetics be familiar with their medications’ effects. Since insulin and some type 2 medications can cause weight gain, this can be an added frustration for people with diabetes trying to lose weight.
Often people are more worried about how they look than if their body is healthy. “At my support group we have a scale and most are just interested in the numbers. I found I do much better when I think about how healthy I’m becoming,” says Narad.
Berg advises his patients not to weigh themselves for the first month. “It’s better to think of weight loss in terms of months and years rather then days or weeks.”
Is it in Your Genes?
Could your genes making your jeans too tight? In the last few years many studies have been conducted to determine whether obesity has a genetic factor. Their findings have changed the tide of opinion, now many health care professionals believe that obesity is partly hereditary.
Many individuals testify to this theory from personal experience. “I eat whatever looks good,” says Taylor. “Extra sausage and gravy with biscuits for breakfast. I like to eat late at night after everyone’s gone to sleep, then I go to bed with a full stomach.” Nearly everyone in Taylor’s family is overweight. His son weighs 500 pounds and his granddaughter weighs 250 pounds. “They want to eat everything in sight just like me,” says Taylor. His grandson is the only person that isn’t overweight. “He looks just like my grandfather who was real tall and thin. Thinness is in his genes I suppose.”
Pugh believes that both genes and environment play a major role in obesity. She cites the frequently studied Pima Indians as a prime example of this. The Pimas who live in Arizona eat a primarily high- fat diet and live a sedentary lifestyle. They have a high incident of obesity and type 2 diabetes. Whereas, Mexican Pimas’ live an agricultural lifestyle and eat unprocessed foods. They are slender and have virtually no cases of type 2 diabetes.
Pugh has many patients, primarily of Mexican and Indian descent who become frustrated when they see others around them eating twice as much but still not gaining weight. “A hundred years ago this fast weight gain would have saved their life in a period of starvation. Only now we live in a time of plenty, and their overweight, ” says Pugh. “Life’s not always fair.”
Exercise is No Sweat
Exercise not only increases the rate that calories burn, it also improves your emotional state and overall health. Take a walk during lunch or take the stairs instead of the elevator. Park far away rather than close to the mall. All of this will add up at the end of the day and contribute to your weight loss plan.
Berg emphasizes the importance of exercise in the fight against weight gain and diabetes. “Exercise fights insulin resistance by reducing fat. Most type 2s need to lose weight otherwise they’ll wind up having to increase their medication and may eventually have to take insulin,” Berg says. Berg recommends that those who haven’t exercised for some time start with walking. “Walk just ten minutes a day then increase it by five minutes when you feel ready. Don’t go so long that you feel sore from it,” he advises.
For those who are more active Berg recommends 30 minutes per day of aerobics and weight training 2 to 3 times a week to build muscle and improve blood sugars.
Pugh agrees that exercise is not only key in fighting weight gain, but also believes that it saves money. “Exercise lowers blood sugars as much as Metformin. Metformin costs about 50 dollars a month – so you’re not only saving your health by exercising but also your money,” adds Pugh.
Besides craving extra food, many type 2s are just plain tired, which makes starting an exercise regiment even more difficult. At first, Evelyn Narad could hardly get across the pool during her water aerobics class. “I was frustrated and ready to give up so many times,” says Narad. Still, she refused to throw in the towel. Instead, she kept going, adding a new set of exercises when she felt strong enough. Narad’s persistence paid off. “Now I attend water aerobics five times a week for 45 minutes and I’m not even tired,” she says. “I’m proud – you betcha! And I wear a size ten bathing suit.”
The Battle Continues
Technology has made our lives easier, but unfortunately it has also made our lives more sedentary.
The rate of obesity is increasing in epidemic proportions in the Western World. Berg agrees and believes that major lifestyle changes must be made in American society. “We sit all day at desk jobs, but we still eat large amounts of food. When you see pictures of people during World War II, everyone was leaner. Genetics haven’t changed – it’s our lack of exercise,” he says.
Just walking through a grocery store can illustrate how rich our society is. “In the grocery store there is row after row of just cereal,” says Berg. “Most people have 6-8 boxes of cereal at home. There are so many choices in the United States and food is so accessible.”
As our lives become more sedentary, Americans must become more ardent foot soldiers in the battle of the bulge. The benefits of losing weight are too numerous to ignore – especially for people with diabetes. A weight loss of as little as 10 pounds can reduce blood sugars significantly. And a person able to achieve normal body weight can have 25 percent less chance coronary heart disease, and 35 percent less chance of congestive heart failure and stroke and possibly increase their life expectancy by three years.
Weight loss has certainly changed Evelyn Narad’s life. She now has more energy, takes less medication and has a new outlook on life.
“I wish I’d lost the weight years ago,” says Narad. “My sons laughed when they saw me so skinny. They’d never known a thin mother. I’m proud of what I’ve done.”