Thursday, March 19, 2020
It can feel impossible to drop a few pounds or 30. Not this time: These M.D.s help people lose weight for a living, and now they're giving you advice, copay-free.
1. HEALTHY FOODS CAN HAVE LOTS OF CALORIES
"I have a friend who suddenly, at 40 years old, put on 20 pounds. She was confused, and to be honest, I was too because I knew she ate healthfully. Turns out, she had started making granola at home. It was packed with various nuts — a smart, antioxidant-rich snack that can also be very caloric. Plus, she was incorporating more fruit into her diet, specifically bananas and grapes, which are high in sugar. I suggested that she swap the granola for almonds (they're lower in calories, as long as you limit yourself to about 10 per day) and the bananas and grapes for a handful of berries, which are much lower in sugar. Within three months, she had lost the 20 pounds she'd gained without making any other changes, and kept it off. Just remember: You can overdo it with even the healthiest foods, so choose wisely!" —Amy Rothberg, M.D., Ph.D., director of the Weight Management Clinic at the University of Michigan in Ann Arbor
2. YOUR JEANS KNOW MORE THAN THE SCALE
"A friend called me last winter, really frustrated. She had been working out every day for weeks and still hadn't lost any weight. 'How do your clothes fit around your waist?' I asked. Even if the number on the scale doesn't move, baggier shirts and loose-fitting jeans mean you've exercised enough to mobilize the fat that's been stored in your abdomen — and that's the first sign of success. In fact, even if you're dieting you may lose inches in your waist before dropping pounds, since you'll be putting on muscle and muscle weighs more than fat. Not that this is a bad thing: Muscle also helps you burn more fat eventually. I told my friend to focus on losing half a pound at a time. If you can work out five days a week, great, but if not, exercise as often as you can, and walk around for a few minutes after you eat anything. Pretty soon she was down inches and pounds." —Judith Korner, M.D., Ph.D., professor of medicine and director of the Weight Control Center at Columbia University Medical Center in New York City
3. SURGERY IS A SERIOUS STEP
"I know a cop here in Chicago who was put on desk duty after gaining roughly 100 pounds. Eating with her colleagues — most of whom were men with big appetites — simply caught up with her. After dieting and exercising without much success, we determined that bariatric surgery was the best option for her. Now, it's not for everyone; you have to try every other measure to lose weight before surgery. You also need a body mass index of at least 35 or 40 to be eligible, and usually have to be about 100 pounds overweight. Many surgical candidates are battling very high blood pressure or severe diabetes as well. If you meet those criteria, definitely talk with your doctor. Bariatric surgery can help you learn to eat healthier portions, and absolutely change your life. The police officer had her surgery, looks and feels terrific, and is back where she wants to be: on active duty, chasing down bad guys every day." —Mustafa Hussain, M.D., assistant professor of surgery at University of Chicago Medicine
4. STRESS EATING WILL GET YOU EVERY TIME
"I know a woman who gained weight from eating sweets whenever she was upset. It can happen to anyone: The stress hormone cortisol tells your body to make glucose, which is then stored away by another hormone, insulin, ultimately producing fat. Eating carbs floods your bloodstream with even more glucose and insulin, so I suggested a low-carb diet — instead of sweets, she could eat unlimited protein, like poultry, fish, and eggs, if she felt stressed and hungry, as well as non-starchy vegetables and other low-carb items like avocado and cheese, all of which can be very filling. I also advised her to write down several things she could do besides eating when stress builds up, hoping that a list would help divert her attention in that situation. She's been taking my advice, and I know it'll make a huge difference." —William Yancy, M.D., program director of the Duke University Diet and Fitness Center in Durham, NC
5. KNOW IF YOU ARE "SKINNY FAT"
"A lot of women have heard the term 'skinny fat,' but I don't think many really understand the risks. It's used to describe people whose weight is within a normal range but who carry extra fat around their belly and internal organs, which increases the risk of type 2 diabetes, heart disease, and kidney disease. For most women, this happens if your waist circumference is more than 35 inches. To measure yourself, place a tape measure around your middle, just above your hip bones, and breathe out. Worried by the number? The most effective way to lose belly fat is through diet and exercise. You want to cut back on sugary items like sodas, juices, and ketchup, instead loading up on non-starchy, colorful vegetables and fruits. Then do 20 minutes of high-intensity interval and strength training three days a week, in addition to your regular exercise." —Marijane Hynes, M.D., associate clinical professor of internal medicine and director of the Weight Management Program at George Washington University in Washington, D.C.
6. DON'T BUY A PILL OVER THE COUNTER
"My friends often ask if weight-loss pills really work. The short answer is yes: There are medications that have been approved by the FDA that can suppress your appetite or keep you feeling full, for example. And they'll help, as long as you're also sticking to a healthy diet and staying physically active. But you should never take anything unless it's prescribed and monitored by your doctor. Many of these medications can cause your heart rate or blood pressure to become elevated, so those need to be measured during regular follow-ups. And of course, only your doctor can know how a pill might worsen a medical condition you already have — so please, don't do this by yourself." —Amy Rothberg, M.D., Ph.D.
7. YOU CAN ALWAYS START AGAIN
"I have a patient who is an inspiration to everyone she knows. She's very successful professionally but has always secretly struggled with binge eating, to the point that she was about 70 pounds overweight. Although this caused her to feel depressed, and she had to restart her weight-loss efforts a number of times, her determination to never give up was and still is remarkable. I tell people who are struggling to stay motivated about how she learned to reshape her expectations and approach, and how she refused to dwell on mistakes. It paid off, and she has lost a great amount of weight. It goes to show that weight loss, like life, is a journey — you may get distracted along the way, and that's okay. Just re-focus, start over as many times as you need to, and really believe you're worth the effort. Because you are!" —Kelly Costello Allison, Ph.D., director of the Center for Weight and Eating Disorders at the University of Pennsylvania's Perelman School of Medicine in Philadelphia