Health Features

Weigh Your Options

Not many out there are totally content with their weight. Some are too thin (the lucky few), and the rest of us are battling those extra 5 to 10 pounds— at least. But rather than focusing on the same old, same old—diet and exercise—we thought we’d examine some less publicized aspects of weight gain and loss.

moral support

It’s great to have a friend along who will encourage you during a long journey. But it had better be a dedicated and trustworthy friend, especially for a lifelong travel through the land of diet, exercise and temptation.

stand by me
“It is very important to have an accountability partner who can help you stay motivated. You also need to have somebody to talk things through with you,” says Iris Salsman, a weight management mentor who operates Been There Done That StL.

Sometimes spouses and friends are not as supportive as you’d think, she cautions. “ When you are going out to lunch or dinner, people don’t always want to pick restaurants where you can have something healthy,” she says. “And they might insist that you share a dessert with them.”

In an ideal world, it is wonderful to have a support system, says Teresa Scott Syed of OneLife Weight Loss & Wellness Solutions in Creve Coeur. “But realistically, the only support system you can count on 100 percent is yourself.”

Syed advises clients to think of their fitness journey as a long hike. “Don’t take anybody along who is not going to help you get to the end of the line, anybody who is going to be a burden and pull you backwards,” she says. “If you don’t have anyone in your inner circle who can share your goals, become your own best friend.”

friends vs. frenemies
“Have a genuine conversation with your husband or wife about how important this is to you,” Syed says. “Acknowledge that maybe you haven’t been successful in the past but this time you want to reach the goal line. Express the difficulty you will be facing—ask them to be mindful that eating a bag of chips or a bowl of ice cream in front of you is going to make it harder.”

Syed also suggests launching your new lifestyle without a lot of fanfare. “ Surround yourself with people who are genuinely interested in your success, but remember that some people will be supportive only until you start becoming really successful,” she says. After that, competition could set in.

Fitness classes and other group activities can be a great source for new support systems of people who are traveling a parallel path. Salsman reminds that these resources are available at just about any price point, from group classes at the YMCA or JCC to sessions at private fitness clubs and with personal trainers. “Classes are great,” Salsman says. “There is something for everybody, and they can help you find a partner and accountability.

be prepared
Planning ahead for the temptations of dining out is absolutely necessary, Salsman notes. “I always tell my clients that nothing is as difficult as eating at someone else’s house,” she says. “If you’re eating at a restaurant, you can always find something on the menu. And at home, you can have your own shelf in the cabinet and refrigerator.”

Think of strategies for approaching a meal with friends, she says. “You don’t want to make people angry, but you want them to think of you as they would of someone who had a food allergy or another health problem.”

Syed has a pretty compelling way to get spouses onboard. “Men don’t understand how much harder it is for women to lose weight because of their metabolism,” she says. “Sell them on the idea that both of us will benefit: You will be happier and more fun to be around.

sugar
If the FDA joined the FBI in posting pictures on post office walls, Public Enemy No. 1 would be ‘Added Sugar.’ Oh, and its mug shot would be a can of soda.

the evil one
Added sugar is a leading cause of the obesity epidemic plaguing the United States. Obesity, in turn, commits additional crimes against us through diabetes and sleep apnea.

“Sugar has a whole lot to do with all this obesity,” says Kristy Robertson, clinical nutrition manager at SSM Health St. Mary’s Hospital. “Some people can drink 2,000 calories a day and not realize it.”

The American Heart Association recommends that women limit themselves to six teaspoons of added sugar a day, and men nine teaspoons, says Diane Friedman, a registered dietitian at Evolution Fitness. “One 12-ounce can of soda has nine teaspoons of sugar. That puts it in perspective.

good vs. bad sugar
“Good sugar comes in things like fruits, vegetables, milk and whole grains,” Robertson says. “These foods also have nutritional benefits—water, fiber, vitamins and minerals. But added sugars have no nutritional benefit.”

Much of the modern diet, however, consists of processed foods designed to taste as delicious and irresistible as possible. Food manufacturers largely achieve this degree of tastiness with added sugar.

“It is easy to consume too much sugar because people don’t realize they are getting it unless they look past the ingredient labels,” Friedman says. “You see it on food labels under many names: corn syrup, barley malt, dextrose. We call them empty calories because they don’t do much for us health-wise. They just provide calories and carbohydrates.”

Fruit juices are a surreptitious delivery system for added sugar, she says. “If you eat one apple, it takes you a while. It is somewhat filling and has fiber and a lot of nutrients. If you drink a cup of apple juice, that contains the sugar equivalent of three to six apples.” Even crackers, bread, salad dressing and ketchup can be dosed with added sugar, Friedman says.

the sugar scam
“Sugar has received more attention lately because large amounts are associated with inflammation in the body,” Friedman says. “That inflammation causes increased risk of heart disease, cancer, arthritis, hypertension and so on.”

Robertson explains that high-sugar diets also create conditions rife for disease. “Natural sugars come with other nutrients and fiber that slow the absorption of sugar,” she says. “If someone is inactive and has a lot of sugar in their diet, it’s converted to fat in the liver and is why we are seeing more of a condition called non-alcoholic fatty liver disease.”

Sugar also increases dopamine levels in the brain, Robertson says. “It gives you a sense of enhanced mood. There are some people who become addicted to sugar because of that. I encourage people who can’t stop once they start eating sweets to just not consume them. Don’t even bring them into the house.”

The obesity epidemic is most visible in the childhood and adolescent populations who have grown up with a juice box in one hand and a fast-food burger in the other. “If you are raised with a lot of sugary foods, you become used to that taste,” Robertson says. “Getting them to switch to healthy foods is very difficult.”

Moderation in sugar consumption will be aided by new food labeling requirements the U.S. Food and Drug Administration will enact in July 2018, Friedman says. “For the first time there will be a separate line for added sugar. Some manufacturers already are changing the sugar content of products because they don’t want the high amounts exposed.

metabolism
Some people eat rich meals followed by delicious desserts but never seem to gain an ounce. The rest of us get fat just driving past the frozen custard shop. Why, we plead? Why?

root causes
We carry genetic traits honed by distant ancestors— Grandpa and Grandma Caveman. In those days, survival favored those who packed on fat when they could, enabling them to survive tough times.

“Back in the 1960s, someone came up with the ‘thrifty gene’ hypothesis that says we perhaps have survival genes from ancestors who were fending off times of food scarcity,” explains Dr. Alexis McKee, a SLUCare endocrinologist. “We may still be carrying that with us.”

“There are huge differences among individuals in regards to how they handle energy,” says Dr. Christian Verry, family and sports medicine specialist at Mercy Clinic in Creve Coeur. “The excess allowed them to live through the starvation. But obese parents are more likely to have obese children, and that is passed down through their DNA.”

Human life has changed a lot since caveman days. Now we have the one-two punch of desk jobs and processed foods. “Food is everywhere and lots of times it is the wrong stuff,” McKee says. “We have become more sedentary so the amount of energy we expend is very low.”

beyond calories
“We are inherently designed to crave calories,” Verry adds. “We go for foods that carry more salt, sugar and fat and have high calorie counts. Those are going to be tastier to us.” And while there are no free rides, some people can eat a lot more than others before packing on the pounds. “A simple law of physics says that when the energy taken in exceeds the energy we expend, we should gain weight,” McKee says. “But that is too simplistic to describe the way our metabolism works. The brain regulates weight but gets a lot of inputs that have to do with genetics, behaviors and physiological factors. People have spent years, careers and lifetimes studying this, and we are still sorting it out.”

The quest to identify ‘obesity genes’ has not identified any, McKee says. “We have an idea that there is a complex appetite network in the brain. When we look at functional magnetic resonance imaging, patients who are obese over-respond to food cues. Ghrelin is a hormone made in the stomach that promotes ‘hedonic eating,’ or eating just for pleasure,” she adds. “That may be involved with obesity and stress eating.”

Unfortunately, the traits that encourage fat gain also discourage easy fat loss, Verry says. “Our bodies do their best to sabotage us because they want to keep that weight on.”

lucky vs. unlucky rates
Individuals vary greatly in resting metabolic rates, the pace at which the body consumes energy, Verry says. “People who have more lean muscle mass have a higher resting metabolic rate,” he notes. ‘Muscle is a living tissue that burns up a lot of energy to stay alive. People who have a lot of fat have a lower metabolic rate.”

But people can induce the laws of metabolism to boost their energy burn, he notes. “The most important thing you can do is modify your lifestyle with a diet that is based on vegetables and whole grains, with meat as the accent instead of the center of the plate. You should do regular physical activity, a minimum of 30 minutes of brisk activity a day for five days a week. That is for weight maintenance—double that for weight loss.”

McKee adds that muscle mass declines as we age if we don’t do resistance training. “It may be hard to get people to do weights, but it is so important,” she says. “We can’t change our genetics but we can work with them. It is a lifelong journey.”

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