| Diets are no joke to the author of this article...she has tried them
all. While she has not yet made the commitment to try again, talking
with Dr. Birken has at least shed some light on the subject.
What follows is the perspective of a hard core dieter...
It's that time of year again; the holidays are just around the corner
and each morning your bathroom scales uncompromisingly prove you are getting
no closer to your ideal weight. Popping another corn chip into your
mouth, you wonder why the pounds just won't come off.
You have gained and lost the same 50 pounds at least five times in your
adult life. You’re a shoo-in to be the poster child for the "Yo Yo
Syndrome." You have truly come to hate the word "diet" and, after  searching
for the most acceptable euphemism, believe you can live with "weight management"
because it implies that you have some control.
The first step to "weight management" is to try to find someone
else to blame. Here are some examples you may have overlooked: the
clothing manufacturers are skimping on fabric this year; the dry cleaner
made everything in your closet shrink a size or two; it must be heredity
because everyone in your family -- on both sides -- is overweight; you
had to gain weight for a part in a movie; your job keeps you tied to your
desk and makes exercise impossible; or, how about your boss forces you
to take clients to lunch at restaurants that only serve rich, fattening
food?
Step two is to deny you have a problem at all. This is
not so easy when “step one” destroyed all your your credibility.
You can pretend that you like to be overweight. Fat people are always
jolly, right? Sign up to be the life of the party. Just consider
the benefits...you can stay close to the buffet table so you don't miss
any of the goodies.
Step three. Well, OK, maybe you do need to shed a few pounds.
When they called you the Pillsbury Doughboy at the class reunion, it really
got to you, didn't it? Putting your favorite outfit at the back of
the closet because it no longer fit was really depressing. And listing
"couch potato" as your hobby on a job application was a bit over the top.
Face it, you can choose to do something about your weight or just go
on adding a pound here and a pound there. At that rate, in twenty
years you could be another twenty pounds heavier. On the other hand,
maybe it is time to get help; professional, medical help.
MAKING THE DECISION
Deciding to get "weight management" help is really up to you.
If step four is taken for you it won't work; it has to be your decision.
You can kid yourself one more time that the two-day, all ice cream and
mangoes diet will make you thin again, or you can really take control of
your weight problem and investigate ways to do it right...once and for
all.
The odds are particularly discouraging, but don't let them defeat you.
Just so you’ll know, research indicates that the probability of an obese
person (medically speaking, one who is more than 20 percent over their
ideal weight) losing 40 pounds or more on a conventional diet, and then
actually keeping it off for any period of time, is less than five percent.
So, once you have made up your mind, you’ll just have to work harder to
stick to it.
According to Randy A. Birken, M.D., "We need to change our mindset about
obesity. Think of obesity as a chronic condition which may be controlled,
but rarely ever cured. That doesn't mean you can't take the extra
weight off and keep it off, it just means you have to be resigned that
the problem will always be with you and will be something you'll have to
work on the rest of your life."
WHY ARE PEOPLE GETTING FATTER?
Let's face it; major changes have happened in the American lifestyle
which have resulted in a basic reduction in physical activity for most
of us. In the early 1900's, for example, an average 125 pound woman
required about 2200 calories a day to maintain the same weight. She
was much more physically active and she had less fat in her diet.
Just think about how much "energy" it must have taken to do laundry
by hand, to do housework without all the time-saving appliances, and to
get everywhere she needed to go on foot. If she worked outside the
home, she probably had to climb at least one flight of stairs to get there.
Today, her granddaughter needs only about 1400 calories a day because
she doesn't burn as many. She has a sedentary job, she uses elevators,
she drives instead of walks, and you can bet she uses all the labor-saving
devices she can.
What we eat has changed considerably, too. America's "fat tooth,"
it seems, is one of the major culprits. We consume about 30 to 35 percent
more fats in prepared foods, junk foods, and more fatty meats. What
we appear to crave is convenience. We don't want to buy food anymore;
we want to buy meals. Almost every home is equipped with a microwave
and some folks eat out as many as three times a week.
All calories aren't created equal, so it is not surprising that all
this fat intake -- at 9 calories per gram instead of the 4 calories per
gram in carbohydrates and protein -- is heading straight for America's
collective fat cells. It doesn't take a rocket scientist to realize
that it isn't just calories that make you fat; fat makes you fat.
While far too many of us continue to be nutritionally illiterate, we
must be making some headway as evidenced by the fact that the annual sales
of low calorie foods is approaching $10 billion. We may be dodging
the "headline" foods, but we are still getting our "fat fix" in other ways:
our consumption of ice cream, cheese and cooking oil, for example,
continues to increase, but we are not eating any more fruits and veggies
than we did 50 years ago.
Consider for a moment that, in an average American household, the refrigerator
door is opened 20 to 25 times each day. Although we may know what
good eating habits are, food scientists suggest that we are nibbling and
snacking like a society of rats. Just look around you: more than
half the adults in this country are overweight. We not only spend
billions and billions of dollars every year on obesity and other related
medical problems, but we also part with billions on weight loss products
and services.
HOW DID I GAIN SO MUCH WEIGHT?
There are at least three factors that contribute to a person becoming
overweight:
-
you eat more food than your body can use;
-
you get too little exercise; and,
-
you have developed habits or lifestyles that interfere with healthy eating
and activity.
Today, physicians who treat overweight patients have come to the conclusion
that people who understand why they gain weight are more successful in
taking it off. We know that an inherited tendency toward low fat
burning can make fighting those extra pounds a battle of a lifetime.
If you seriously want to lose weight, you have to learn to control your
calorie intake; to identify and reduce your intake of foods high in fats,
sugar, cholesterol and salt; increase your intake of high fiber foods;
and try to find some joy or amusement in exercise. Set some reasonable
goals and follow good nutritional guidelines. If you don't know what
these are, or what a calorie is, maybe an expert can help you.
WHY DIETS DON'T WORK...
On any given day, there are millions of people who are actively engaged
in the Battle of the Bulge. Approximately one-third of all adults
in this country are above their ideal body weight. In fact, at any
given time, about 50 million Americans are on some kind of weight loss
program.
Why don't diets work? Why do so many people
fall victim to promises
of quick weight loss only to find themselves on a physical and emotional
roller-coaster, losing and regaining the same 20 pounds over and over again?
One reason is that they focus on looking good as their primary reason for
shedding unwanted pounds instead of getting -- and staying -- healthy.
There are loads of "diet derailers" that can sabotage even the most
carefully thought-out plan, and unrealistic expectations heads the list.
If you're going on a diet to become "model thin" because that is the only
way you'll ever find the man of your dreams, you have set yourself up for
a devastating defeat.
If your diet limits food selections, and calls for large quantities
of just a few foods, you are likely to become bored with the program and
could even end up with nutritional deficiencies.
Some diets call for such elaborate food preparation that you soon run
out of time or money -- or both -- and you simply decide to give
up. On the other hand, diets that don't include at least some of
your favorite foods may also destined for failure.
If the weight loss is not quick enough, some people get impatient and
move on to another method without allowing an adequate trial.
DOCTORS TO THE RESCUE
Statistics show that the demand for "commercial" weight loss programs
is down 30 to 40 percent. That is not because people don't have weight
to lose, but because of unrealistic expectations fueled by clever TV commercials
full of stars selling success stories.
More and more people are turning to their doctors for help in losing
the extra pounds, and are now relying on medically supervised, individually
tailored programs that address the myths and realities of weight management
in a realistic, supportive way.
"It is not surprising, really," Dr. Birken explained. "Once a
woman has a good relationship with her physician, it is quite natural to
rely on him or her to provide the support and assistance necessary for
losing weight, as well. In fact, a physician who is familiar with
the woman's medical history is ideally suited to assist in developing a
weight management program that allows her to set realistic goals...and
to reach them."
"After so many of my patients began asking for my help in losing weight,
I attended some special medical conferences and continuing education programs
in weight management. In addition, my undergraduate and postgraduate
interest in Psychology and Psychiatry has been very useful in helping people
learn to cope with obesity as a chronic problem," he continued. "With
all these factors in place, it seemed appropriate to start a weight
management program for patients already in our practice who must constantly
battle those extra pounds. It's a tough problem, but it can be overcome
with sound medical supervision, encouragement and good support." |
