March 28th, 2008 by Dr. Val Jones in True Stories
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I lived in Texas from 1990 to 1994. I haven’t spent much time there since, although I’ve had my eye on Houston’s unfortunate distinction as “America’s fattest city” for the majority of recent years (though Chicago won the honors in 2006 if I recall correctly). Armed with this knowledge, I arrived in Houston today hoping that I wouldn’t let down the members of my weight loss group as I entered the “lions den” of poor eating habits and sedentary lifestyles.
I had missed lunch, and opted for an early dinner at the hotel restaurant. The menu surprised me in two ways: first, it featured quail and wild boar (this particular hotel chain is not known for culinary artistry – let’s just say that their recent “upscale service campaign” involved an email to me the day prior to arrival, asking if I might like anything special in advance of my arrival – like a 6 pack of Budweiser waiting for me on ice. I kid you not.) Second, they had made an attempt to highlight “heart-healthy food choices” on the menu. One item was identified as heart-healthy. Only one.
So I resisted the urge to try the local southern fare (fried catfish and hush puppies) and decided on the heart-healthy option. Here’s how the conversation went:
Server: “Welcome to XXX. May I start you off with something to drink?”
Dr. Val: [Shivering and somewhat surprised that the AC would be on so high] Well, yes, I think I’ll have some hot tea. Do you have green tea? It’s quite cold in here, isn’t it?
Server: “It’s not cold. The lights above will warm you up real quick.”
Dr. Val: [Looking up towards the track lighting above me, wondering if they could function as a sort of heat lamp.] “Oh, ok.” [Server leaves to put a tea bag in a mug of hot water and returns with it on a napkin.]
Server: “Have you decided what you’d like to order?”
Dr. Val: “Well yes. I think I’ll have the heart-healthy fish, but I was wondering if I could have a side of greens with that?”
Server: “What kind of ‘greens?'”
Dr. Val: “Well, maybe a green salad or some broccoli?”
Server: “Did you see the salads on the menu?” [I can tell she thinks I’m one of those “high maintenance Yankee women” as her voice begins to tighten.] “We have spinach salad or perhaps a Caesar?”
Dr. Val: [Now fully aware that I’m being irritating but desperately wanting to make a healthy choice.] “Yes but those are entree-sized salads and they have bacon, egg, and cheese on them. Do you have something more plain? Or maybe some steamed vegetables…” [My anxiety grows as she stares blankly at me].
Server: “Well did you see the string beans side dish?”
Dr. Val: “Yes, but they’re wrapped in bacon, and [trying hard to help her to understand my quandary] I was hoping to order something healthy… you know what I mean?”
Server: Blank stare.
Dr. Val: Nervous stare.
Server: Sighing, “well I can ask the chef to make the beans without the bacon. Not sure if he can do it, though.”
Dr. Val: “Oh that would be great, thanks so much!”
Server: [Fake smile, whisks menu from my hand, waddles toward kitchen.] 10 minutes pass.
Runner: [Appearing with a huge plate on his shoulder] “Did you order the fish?” [Surprised that anyone ordered the heart-healthy dish].
Dr. Val: “Yes, I did.”
Runner: “Ok, here you go.” [Places gigantic plate in front of me with a separate bowl holding about a half gallon of stir-fried green beans in oil. The fish has cream sauce on top of it, about a quarter inch deep.]
Dr. Val: [Remembering the phrase “Texas-sized.” I scrape off cream sauce and cut green beans into bite sized portions. I think to myself: how can anyone eat out in this state and hope to maintain a reasonable weight? I promise myself to go to the hotel gym after my meal…]
Yes my friends, the next 9 days at this conference are going to be interesting. I’ll keep you updated as I rekindle my cultural connections to Texas. And I have the utmost sympathy for Americans who live in places where eating out regularly can be hazardous to your health. Losing weight can be a fight, every step of the way, can’t it?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 25th, 2008 by Dr. Val Jones in True Stories
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Just when you think you’ve seen it all… I read a charming discussion between two ladies in my online weight loss group. They were both understandably frustrated with the daily struggle to increase their activity levels, and were looking for some accountability and motivation. Apparently one has begun using a weighted exercise hoop for cardiovascular fitness, and offered to help the other to get back in the exercise groove.
That’s right, hula hoop your way to a thinner you! I’d never have guessed that I’d be saying this, but if the humble hula hoop is your exercise of choice, then by all means, use it to lose weight. I might just get one myself!
Anyone care to join us?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 25th, 2008 by Dr. Val Jones in Expert Interviews
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Women in their 40’s are at an advantage when it comes to weight control and fitness. How so? I asked three of my favorite medical experts to explain what it means to be fit and forty, and how you can get there.
Myth-busting With Dr. Dickerson
Dr. Val: I know that many women in their 40’s complain of having gained weight. What causes that weight gain? Is it inevitable?
Dr. Dickerson: Many women don’t gain weight in their 40’s so it’s certainly not inevitable. There are a few common misconceptions about weight gain and aging that I’d like to address.
First, hormone supplements don’t cause weight gain – menopause, in general, with or without hormones, is associated with about a 10 pound gain. This often starts in perimenopause so it could occur as early as the 40’s.
Second, lean muscle mass decreases slowly from mid-30’s probably until menopause when it decreases more steeply. So women in their 40’s don’t experience too large a change in their metabolism.
Third, the weight that women have in their 40’s is often about how many babies they have had. Data show us that women retain about 10 pounds per pregnancy. Weight begins to shift as the perimenopause era begins – more towards the abdomen and the hips and thighs.
And finally, weight gain is not due to hormonal or metabolic changes, but may be more about emotional eating. Women often experience the empty nest syndrome in their late 40’s and change their eating habits to constant “snacking” – they tend not to count these calories when adding things up
Dr. Vivian Dickerson, Past President of the American College of Obstetricians and Gynecologists, Medical Director, women’s health programs and care, Hoag Hospital, Newport Beach, CA.
Increasing physical activity is the key to success
Dr. Val: How can women in their 40’s counteract potential weight gain? What’s the most effective strategy to stay trim and fit?
Dr. Hall: While it is true that body remodeling and loss of muscle mass probably starts in the late 30’s it is almost completely a matter of now much physical activity is taking place. Much of the perceived change in body image, (gravity-dependent “sagging”) is also accentuated with decreased muscle tone in the sedentary woman. Weight gain, on the other hand is quite related to caloric intake. It is greatly modulated by the degree of physical activity as well.
My general feeling is that most diets do not work, and the older you are, the truer that is. After age 40 women cannot consistently lose weight and keep it off without a plan of regular physical activity (aerobic) plus some resistance work (weights, bands) to improve body tone.
Dr. Bill Hall, Past President of the American College of Physicians and Director of the Center for Healthy Aging, Rochester, NY.
The 40’s: no better time to get trim and fit
Dr. Val: Do women in their 40’s have an advantage in losing weight?
Dr. Dansinger: Your 40’s are a great time to take lifestyle changes to new heights. Whether for weight loss, or prevention of diabetes or other related medical problems, many women who struggled in their 20’s and 30’s finally find success in their 40’s. For many women at this age, previously insurmountable logistical barriers such as raising preschool age children, or inflexible work schedules, often improve somewhat. Such expertise in schedule-juggling, when combined with a renewed commitment toward preventing health problems, often gives such ambitious women the strength and experience to finally achieve consistency with an effective exercise and healthy eating routine that produces long-lasting results.
Although the metabolism slows gradually throughout adulthood, the effectiveness of lifestyle changes for health improvements remains strong throughout life, and may actually become most beneficial as we grow older. Gaining muscle and bone strength through weight-lifting type exercise may help a woman in her 40’s reduce the risk of muscle and bone loss that typically affected women of her mother’s generation.
Dr. Michael Dansinger, Lifestyle Medicine Physician/Researcher, Tufts Medical Center, Boston. Nutrition and fitness advisor to NBC’s Biggest Loser.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 11th, 2008 by Dr. Val Jones in Uncategorized
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As many of my faithful readers know, Dr. Val is a big fan of Web 2.0 principles (blogging, online communities, wikis, forums, chats, podcasts, etc.) I’m even leading a weight loss group online, and there are almost 1400 members already. Although I’ve been trying hard to lead by example, I’ve had occasional hiccups in my own weight loss due to the sweet lure of fine dining. Could YOU resist silky, black sesame panna cotta with butter crunch tuile and spicy cranberry compote? Well maybe you could. For me, resistance is futile.
But I digress.
What I really wanted to point out (before my thoughts were derailed by deliciousness), is that research is now confirming what many of us bloggers have known instinctively: social networking can improve the health care experience. In the Journal of the American College of Surgeons, post operative pain and length of stay were reduced for those who had more social support. This means that the more frequent and broad your social contacts, the less likely you are to be bothered by pain, and the more likely you are to get out of the hospital faster. Let’s hear it for using CarePages, FaceBook, and other online support groups while in the hospital, and perhaps as outpatients as well.
And if feeling supported isn’t enough to get you on the right track, more research in the Archives of Internal Medicine suggests that mail reminders can improve post-heart attack medication compliance. Perhaps email reminders would work just as well (and kill fewer trees?) One thing is for sure – Health 2.0 tools can make an impact on peoples lives and I’m excited to be a part of that.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 5th, 2008 by Dr. Val Jones in Health Tips, Opinion
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I’ve wrestled with this question for many years: “When is weight loss surgery an appropriate option?” I used to do weight loss research prior to working at Revolution Health. My studies focused on using “natural” methods to reverse type 2 diabetes – in other words, weight loss via diet and exercise. My study subjects were all obese, and most had struggled with weight for decades.
At some point during the trial, people would often ask: “Can’t I just have surgery for this and not have to struggle so much?” And I would gently remind them that surgery was no picnic, and to try diet and exercise first. “But it’s so hard!” they would say. I would acknowledge their difficulties and offer lots of empathy, and firmly encourage them to stick with their diet. In the end I found that only half of my study subjects could manage to stay on the diet for months at a time. So what should the other half do? Give up and let their diabetes ravage their bodies?
My friend and colleague Dr. Charlie Smith rightly points out that weight loss surgery can dramatically improve the health of people who have been unsuccessful at losing weight through diet and exercise. Heart disease, diabetes, and cancer rates were dramatically improved for morbidly obese people after weight loss surgery. So there is a clear benefit for some people to have the procedure.
However, the caveats should not be overlooked. First of all, weight loss surgery does not guarantee long term weight loss. It’s possible to gain back all the weight lost if eating behaviors are not changed. The human stomach is amazingly stretchy, and even if it’s surgically reduced in size, with repeated overeating it can eventually stretch to accommodate large meals again. Secondly, some types of weight loss surgery (like gastric bypass) can affect the body’s ability to absorb critical vitamins. Without enough of these nutrients, one can end up severely anemic, and osteoporotic just to name a few serious side-effects. And finally, the surgery itself is quite dangerous, carrying with it a potential risk of death as high as 1 in 200!
So weight loss surgery can be life-threatening, and is not a quick fix for a long term problem. However, morbid obesity itself is so dangerous (with the increased risk of heart disease, diabetes, and cancer) that it may require this extreme intervention to actually save lives. For people who have more than 100 pounds to lose, and have sincerely tried diet and exercise without success for a prolonged period, then weight loss surgery may be an appropriate option. For those whose lives are not at risk because of severe obesity, it doesn’t make sense to undergo such a risky procedure.
Are some people successful at losing a large amount of weight and keeping it off without surgery? Yes! The National Weight Control Registry keeps a list of thousands of Americans who have lost at least 30 pounds and kept them off for at least 6 years. What’s their secret? You guessed it – regular exercise and a calorie controlled diet. Some other things that these “successful losers” have in common: 1) they eat breakfast 2) they have a cardio machine at home 3) they weigh themselves regularly.
If you’d like to meet a group of people who are working towards long-term weight loss success, feel free to join my weight loss support group. We have weekly challenges, tools and trackers, a vibrant discussion group, and free medical insights to help you along your way. Weight loss is really hard to achieve by yourself. It takes encouragement, support, and a community of like-minded folks who are determined to make a difference. You can do it!… and I’d be honored to support you along the way.
P.S. There’s a special group forming at Revolution Health for folks who need to lose 100 or more pounds. It’s called “Overweight But Not Giving Up.” Check it out.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
