Sunday, March 7, 2010

Archive of Meetings 5

I hand out articles, weekly, at my Thursday night PRAY IT OFF MEETINGS, that support my topic for that week. The group members, take their packets home, and read the articles before the next meeting.

EVERY SUNDAY, ON MY BLOG, I PLAN TO ARCHIVE MATERIALS FROM THE FIRST TWO YEARS OF THE PRAY IT OFF MEETINGS!


Hidden Reasons You Can't Lose Weight
From TodayShow.com

Every day I hear from people who try really hard, and just can't seem to lose weight. There are a number of "hidden" reasons this might be happening to you. That's the topic of my Today Show segment (check back later for the video).

I've found these can pop up in four different areas: your eating, your activity, your behavior, and your biology (body). Let me know if you agree - or have other hidden reasons you've discovered!

YOUR EATING

Confusing “heart-healthy fat” or “fat free” with low calorie. Switching to olive oil from butter is a heart healthy choice, but won't save you any calories. To lose weight, it's important to cut the amount (instead of a tablespoon at 120 calories, try a teaspoon at 40 calories, since it's so flavorful). Fiber rich, whole grains are a great choice, and fat-free, but the calories add up we don’t stop with ½ - 1 cup serving. The only solution to this is label reading for calories per serving; when you see that reduced-fat peanut butter has just about the same calories as regular peanut butter, you won't be fooled by clever ads.

Poor calorie “eyeballing” (studies show 50% too low). We all feel we’re good at estimating portion size, but the cues to do so set us up for failure. Studies show we are at least 50% too LOW in our estimates – even when professionals do it.

Skipping Meals. Too busy, or choosing to skip a meal to save calories? The problem with meal skipping is you get over-hungry for the next meal – “I didn’t realize I was so hungry”, once you start eating.


YOUR PHYSICAL ACTIVITY

Too much exercise is a biological stimulant for hunger. This is very common for dieters who only want to focus on exercise as a way to cut calories.. Rigorous exercise stimulates appetite to “refuel” for metabolic balance. I'm talking 2 hours of more intense activity. Plus, like the poor "eyeballing" of food, most of us aren't skilled at estimating how many calories are used for activity. Just remember it can take 5 minutes to eat a 500 calorie piece of pie, and nearly 2 hours to exercise it away!

On the other end of things, no exercise is a diet disaster. Whether it's lack of time, or lack of interest - only 100 cal a day – a 20 minute walk – helps you lose 10 pounds in a year! Even a small drop in physical activity (that people ignore) packs on the pounds. Here's an example I recently heard from a patient of mine: “I used to park blocks away in a cheaper parking lot. I got promoted, and get the corporate lot. I’ve gained 5 pounds in 3 months.”

YOUR BEHAVIOR

Lack of sleep is a huge problem – when we're tired, we eat for energy. When we're tired, we lose our focus, and discipline, and lose the mental control needed to stay on track. Between-meal snacks to “wake up” are the solution when a power nap would be better. Our body's have 24-hour rhythms in many hormones and pathways - like body temperature - that don’t “reset” and get out of balance with lack of sleep.

Poor stress management - a lof of mindless eating comes from the lack of focus due to mental stress. We often confuse business with poor stress management. "I feel overwhelmed" say many patients. We eat to soothe, to reward ourselves, and to indulge in extra calories. Food DOES make us feel better, but we have to learn to self-soothe in other, non-food ways as well.

Lack of consistency (5 days on, 2 days off). “I’m trying but lifestyle isn’t working”. Some general awareness every day is needed to avoid what I call “weight creep”. It takes only 100 calories extra a day to gain 10 pounds in a year. Most often, people “relax” their lifestyle on the weekend, and can easily pack on a couple of pounds a month – 7000 calories (that’s 2 pounds) – over 8 weekend days – only about 850 calories more a day.

YOUR BIOLOGY (BODY):

Medications can cause weight gain as a side effect, when they are started. Some stimulate appetite, and others slow your metabolism. A range of medications from antidepressants; antipsychotics some antihistamines, as well as insulin and blood sugar drugs, some blood pressure medicines, and anti-inflammatory drugs can pack on the pounds. Check with your doctor when starting a new medication, and always ask if weight gain is a reported side effect - there may be another medication you can take without this side effect. This happens only at the beginning of a new medicine. If you’re started a new medicine, and gained 4 pounds or more in a month, check with your doctor…..It’s NOT the cause if you’ve been taking a medicine, and then find suddenly you’re gaining weight, months after you’ve started.

Undiagnosed Mood Disorders. Undiagnosed depression or anxiety is both behavioral and biological. While many think depressive symptoms are only the “classics”: loss of appetite, insomnia, and weight loss, a large subgroup sleeps more and eats more. Oftentimes thyroid gland problems are linked to mood disorders (see below), and can result in weight gain.

Thyroid Function – The thyroid gland is your body’s “furnace” and sets the thermostat. This is regulated by a signal from the brain to release thyroid hormone into the system. Either resting or stimulated thyroid gland activity can be a problem, and result in slow, steady weight gain.

Elevated fasting insulin. This is known as "insulin resistance" or " metabolic syndrome" and often found in people with an "apple" shape (weight accumulates in the middle). It's invisible unless you get a blood test. Blood insulin levels can be high, with blood sugar levels being normal (everyone knows that number). It does not mean diabetes (where blood sugar is high), but is a sign of pre-diabetes. This can greatly sabotage a solid weight loss effort - and correcting the problem (with medication for starters) makes that weight loss effort easier. A further plus - more weight loss alone can help lower your fasting insulin - getting you off the medication to correct the original problem!


Emotional Eating, Part 1: What Is Emotional Eating?
By Kathleen Goodwin, RD

During a memorable Oprah episode featuring Bob Greene (Oprah’s personal trainer and weight loss guru), Oprah told the audience about how she met Bob in a spa in Telluride, Colorado, and hired him to be her health coach. At this point in her life her weight had reached an all-time high. She was exasperated about having lost and re-gained hundreds of pounds by trying every quick-fix diet of the moment. According to Oprah, ultimately it was Bob Greene’s words that turned her weight and her life around for good. You see, on the day they met Bob raised a crucial question: “When was the last time you were happy?” No one had ever asked Oprah about her emotional life, nor had they connected it to her weight issues. It was a new area for her explore. Many studies suggest 75% of overeating is the result of emotional eating. She was far from alone.
Defining "Emotional Eating"
In a nutshell, emotional eating is eating for another reason than because you’re hungry. If you overeat often, chances are that food has become your drug of choice, as well as your body’s programmed response to factors such as stress, loneliness, boredom, or sadness. Rather than dealing with a negative event or emotion in a solution-oriented manner, you may have learned to numb your problems with food. This can become such a habit that eating becomes an automatic response which we are barely aware of. Learning to eat mindfully is essential to changing this response. The good news is that a recent research study demonstrated that 85 percent of emotion-based eating was reduced in participants when they learned how to respond to negative emotions with a positive attitude and solutions. If they can do it, so can you!
What kind of eater are you?
The fast pace of today’s society has diminished the art and pleasure of mindful eating. Consider which of the following scenarios apply to you:
• Do you grab lunch from the drive through and eat in the car on the way to a business meeting?
-Or-
• Do you set aside 30 minutes for lunch, pack foods that are enjoyable and relatively healthy, turn off your cell phone, and find a place where you can enjoy the day as well as savor each bite while paying close attention to when your body feels satisfied?
If you chose scenario number two, you’re lucky—and quite the exception.
Overcoming bad emotional habits
Truly caring for ourselves tends to get put on the backburner for sources of immediate gratification like money, fame, possessions, or a double quarter pounder with cheese. The good news is that overcoming emotional eating is central to attaining better health, a normal weight, and improved energy. The bad news is that it takes some hard work—but the payoffs are huge.


Eating, Part 2: How To Identify Your Overeating Triggers
By Kathleen Goodwin, RD

Where do you get your information about how to lose weight? From books? From classes? From your friends? On the Internet? When you want to lose weight do you search for a menu plan or a list of foods to avoid? If so, you’re not really paying attention to the core behaviors that got you overweight in the first place. Those same behaviors are likely to rear their ugly heads again when you grow tired of following the latest diet fad. To successfully lose weight, you must get acquainted with you a whole lot better.
Lose weight permanently by changing your habits
A recent study by the National Institutes of Health determined that when people follow a diet plan as their only method of losing weight, two-thirds regained their weight within one year, and almost all regained their weight within five years. However, when exercise and behavioral changes were added to the mix, there was significant improvement in weight loss maintenance. Studies also show that long-term social support or accountability to a group or partner greatly increases the odds you’ll keep off the weight you’ve lost as well. Essentially, there’s no getting around it— keeping weight off is a lifelong endeavor; there’s no magic “secret” found in the diet book of the moment. The rewards you gain, however, by going slowly and changing habits from the inside-out are lasting, and will spill over and improve not just your weight but also many other areas of your life.
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Do you overeat for social reasons?
There are a number of things people respond to when they eat, the least of which is hunger. Many of these cues have been incorporated since childhood and are things that barely register to us at a conscious level anymore. For instance, was food used as a reward in your household? Are there memories of “if you clean your plate, you’ll get a dessert” or the ever popular, “if you’re a really good boy today, you’ll get a piece of candy”. Holiday and family gatherings are typified by spreads of food – a symbol of social cheer and bliss. Profuse cues are registered early on that food is a source of comfort and reward. Contact with others is rarely planned unless there is a meal involved. Social cues, then, are a huge part of why we overeat. When it comes to social cues, ask yourself:
• How often do I dine out socially or go to parties?
• Is it difficult for me to eat reasonable portions or healthy foods when I dine out?
• When I get together with others is food or drink always involved?
What are your situational cues?
Situational cues are also a big culprit when it comes to overeating. What kinds of situations do you encounter regularly that cause you to overeat? Some situational cues we have all been guilty of are: “It’s 12:00, time for lunch” or “It’s 6:00, time for dinner”. Situational cues also include the stimulation of our thoughts and senses as we pass Krispy Kreme or McDonalds. Thoughts, images, and smells trigger desires that are tough to pass up, especially when the tastiest of foods are so cheap and easily accessible. When thinking about situational cues, consider the following:
• Do I eat because it’s mealtime or because I’m hungry?
• Do I ignore my body when it’s really hungry because I’m too busy and then overeat later?
• Do I indulge in foods because they’re convenient, smell good, or taste good rather than first considering my hunger level or health?
Are there emotional reasons you overeat?
The emotional cues that cause us to overeat are probably the most difficult to identify and overcome. A big reason for this is that most of us are too busy to tune into how we feel and are often in a state of “numbness”. Most people say, “I don’t eat because I’m sad or lonely. I just eat because I like to eat”. If you have trouble identifying emotional cues (e.g. stress, boredom, sadness) that lead to overeating, you will need to learn to slow down long enough to get in touch with what’s in your head. Your feelings are in there somewhere, though they may have become cobweb-laden in the busy-ness of life. If you often find yourself wanting to eat more even after a big meal, you might consider journaling out whatever comes to your head instead. You may be surprised what surfaces over time. The mere act of identifying a food craving, and allowing it to pass without indulging, is a huge step forward. KEEPING A FOOD DIARY and finding passions are very effective methods for overcoming emotional overeating, and you’ll get the scoop on these later.

Emotional Eating, Part 3: Common Food Binging Cycles

By Kathleen Goodwin, RD
1. The “feel good” binge
Not only are we bombarded with social, environmental, and emotional cues to overeat, but our basic biology can work against us as well. Research has proven that certain foods produce “feel good” chemicals like serotonin and endorphins in our brains that can literally be addictive. High sugar and fat combinations (e.g. ice cream, chocolate, doughnuts, cakes, and pies) can boost endorphins in the brain. Endorphins are our body’s natural pain killers; they produce a feeling of relaxation and even euphoria. Foods high in refined carbohydrate (e.g. white breads, pastries, chips, sodas, and candy) cause an increase of serotonin production in the brain. Serotonin provides sedation and calmness. Unfortunately, these “quick fixes” are brief. And over time – just like in other addictions – we may require more and more of the “substance” (high sugar/fat foods) to produce the desired effect.
• Stressed → Eat high sugar/fat food → Endorphin/serotonin release → Feel relaxed, calm, better (temporarily) → Feeling less relaxed/more stressed again (actual stress is never dealt with effectively by eating) → Eat more to suppress negative feelings and stress.
2. The “sugar high” binge
Another cycle that wreaks havoc with our bodies is the cycle of sugar highs and lows. Binge eating on sugary foods causes a surge of glucose in the blood producing a sugar “high”, which is characterized by feelings of fullness, satisfaction, and calm. In response to a sugar binge, our pancreas produces more insulin, a hormone that rapidly takes up circulating blood glucose into our cells. This, in turn, produces a rebound “sugar low”, which can cause shakiness, lightheadedness, and an inability to concentrate. This process sends a false message to the brain that we need more food fast to perk up blood sugar levels. As a result, although we are not physically hungry, our cravings for sugary foods increase again. This leads to another binge, and another rehashing of this vicious cycle.
• Sugar binge → Feel “sugar high” → Insulin takes up blood glucose → Feel “sugar low” → Brain signaled to eat more (despite lack of hunger) → Sugar binge cycle starts again
3. The “forbidden food” binge
Psychologically-based, this cycle seems to be growing exponentially. It may explain why obesity rates are soaring. After an episode of binge eating, oftentimes the binger feels a loss of control, shame, and guilt. People feel pressure from society, the media, or family members to achieve bodily perfection. In their desperate quest to achieve an unattainable standard, they refrain from eating and deprive themselves often. Eventually, desires and cravings become too difficult to override, which usually leads to binges on unhealthy, fatty, sugary foods. The temporary aftereffect of this binge is a sense of relief; however, the subsequent feelings of shame and guilt lead to progressive drops in feelings of adequacy and self-esteem. There are many people who experience this cycle several times a week. Surprisingly, many of these people are perceived as very successful and attractive on the outside. However, internally they feel empty because restrained eating combined with binge eating has become their coping mechanism and obsession.
• Restrain from eating to achieve thinness, “bodily perfection” → Feel deprived → Binge on “forbidden” foods → Short term feeling of satisfaction → Long term feeling of shame and guilt and incremental decrease in self-esteem → No good coping mechanism to effectively deal with these feelings → Binge again to stuff away uncomfortable feelings of “failure”.

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