Obesity counseling should focus on neurobehavioral processes, not personal choice, researchers say

Obesity counseling should focus on neurobehavioral processes, not personal choice, researchers say

A few strategies recommended by the researchers include:

•In order to combat food reward, patients can remove high fat foods they crave from personal environments such as the home and workplace to prevent the activation of the reward circuitry.
•Limit the impact of reward on food choice by shopping with a grocery list or using online grocers.
•Practice stress management techniques since stress promotes overeating and obesity by enhancing food reward processing.
•Avoid situations such as buffets and restaurants that challenge inhibitory control.
•Focus on achieving short-term behavioral goals, such as cooking a healthy dinner on three nights of the week rather than focusing on long-term weight loss goals.

Click on the link above to review the entire article.

Success Story: An interview with S.T.

I had the pleasure of interviewing S.T. about her success after bariatric surgery. She had her surgery in September of 2009 and has lost 103 pounds. She continues to lose weight weekly. S.T. will be speaking at support group on 5/9/11 at 6 pm.

T: Why did you decide to have Lap Band surgery?
S: I had tried everything and I needed to do something that was well researched and had minimal invasiveness.

T: What were your goals and expectations before the procedure?
S: They were high, but the preoperative classes helped me understand that I had to work hard to do my part.

T: How has your life changed after bariatric surgery?
S: I have increased energy and decreased fatigue. I am not as irritable. My breathing has improved and I do not need my asthma medication as much. It was the best decision I have ever made and if I could do it all over again I would.

T: What are the keys to your success?
S: I follow the rules, but not eating and drinking at the same time has been most helpful. At first I lost only 30 pounds and the weight kept going up and down. I was losing it much slower than I wanted. Then I spoke with Dr. Shayani who suggested I drink before I eat (not when I eat) or when I was hungry. Six months ago I took his advice and my appetite when down and I started losing weight.

It was important for me to focus on only 10 pounds at a time instead of my overall goal. When I looked at the big picture and the amount of weight I had to lose I would get depressed. Breaking it into 10 pound increments helped me feel like I was doing something and I became more focused.

The other key that has been important for me was to start exercising. I work out at least three days a week at the gym or with a video. Total body exercises have helped me to tone. In the summer I walk 3.5 miles outside.

T: I know you are busy, how do you fit in your workouts?
S: I work forty hours a week so it was tough. I get up early at 4:30 am because I learned that if I wait until after work it would not get done. It started with motivation, and now that I can walk I want to keep it going. I consider exercise personal time to focus on myself. I enjoy listening to my music and it is nice not to think about kids, college or bills. It is great.

T: Do you have any advice for someone who is stuck or frustrated with their progress after surgery?
S: Yes. Go back to the beginning and look at everything we learned. This includes no eating and drinking at the same time and cutting out junk from your diet.

T: What are some of the changes that you have made to be successful?
S: I have two kids in college and a senior in high school who still lives at home. They are all athletic and have helped me to eat healthier. Kool Aide, sweets and junk food are no longer in our home. I save desserts for special occasions only. Every week I like to try at least one new recipe. My favorite thus far has been parmesan tilapia. I increased the amount of fish chicken and turkey that I make and no longer fry foods.

T: Do you eat out?
S: I used to eat out every day. Now we only eat out one time per week. Champs is my favorite place to go. I typically order s sample platter. It is not the healthiest food, but now I can treat myself because I worry less about weight gain. There is a lot less guilt now compared to when I dieted.

The Learning Curve of Cooking

It never ceases to amaze me when I hear “I don’t cook.” If one does not cook, then one must eat out or piece together a meal of highly processed items that are typically microwavable. As I have mentioned before, to move forward one must abandon old ways of thinking and behaving. One of the definitions of insanity is doing the same thing over and over expecting to get a different result. This same thought applies for weight loss and health. If one does not lose weight or become healthy by eating out every day before bariatric surgery, then one should not expect to lose or maintain a significant amount of weight after bariatric surgery.

I have to admit that I am no different than my clients. Cooking, preparing and planning are no easier for a dietitian than anybody else. It is falsely believed that a degree in dietetics absolves RDs from following the same guidelines. As many of you know, knowing does not imply doing. To do, one must take action by applying what is known.

After completing a masters degree, I had to recommit to eating out less by preparing healthy and delicious meals. Last Saturday afternoon, I dragged out a new cookbook, by a famous Food Network chef, and choose three new recipes to try. I assumed that the Food Network chef had fail-proof recipes, but I was wrong.

Anytime we try something new there is room for error, but we cannot let it drag us down. After spending money, time and effort on my new menu items, I was highly disappointed. Only 1 out of the 3 recipes I tried was actually good. The other two were HORRIBLE! I was disappointed, disheartened and upset. At least when you get food from your favorite restaurant you know it will taste good no matter how bad it is for you!

However, this cannot be an excuse to return to old habits. Even the best will fail. I am putting the cookbook back on half.com hoping to earn my money back to buy a new cookbook.

Cooking can be learned at any age. All you have to do is try. Over time it will get easier and tastier! Check the blog next Monday, 5/2, to learn tips on cooking, planning and grocery shopping.

The Trilogy: Skills, Motivation and a Paradigm Shift from "diet" to "lifestyle."

Weight loss is a journey. There will be ups, downs and plateau's. Last week during the "Chew and Chat" sessions I defined weight loss as "a set of skills that can be applied over and over again to become a new lifestyle." Although willpower, hope and motivation are important, they will carry you about two weeks. Consider adopting a weight loss philosophy that contains a trilogy: (1) skills, (2) motivation and (3) paradigm shift from "diet" to "lifestyle."

The trilogy is powerful for many reasons. It implies that you have control over your weight loss journey, overall health and room for moderation. A healthy lifestyle eliminates thoughts like good, bad, right, wrong, success or failure. In my opinion and experience, all or nothing thinking is a significant contributor to relapse or complete cessation of the program. It takes 3,500 calories to lose 1 pound. One high calorie meal, day or even weekend is not going to undo all of the hard work you have completed thus far. When you find yourself stuck in all or nothing thinking consider this: IF YOU LOST 10 POUNDS, YOU HAVE BURNED 3,500 CALORIES. YOU WOULD HAVE TO EAT 68.6 BIG MAC'S TO UNDO ALL OF THAT HARD WORK! When you stumble, stop the negative thoughts, put them in past and move forward.