Weight Loss- "Honey Do You Think I'm Fat?"

Recently I've had a revelation.

Successful weight loss has nothing to do with knowing how to lose weight.

Bear with me.

Lets take the example of smoking cessation which I think shares many parallels with our topic here. Everybody knows how to stop smoking. You cease to place lit cigarettes between your lips and take a drag. Simple.

How about weight loss? A little more complicated but not by much. Most researchers agree that calorie restriction is the most reliable method to drop the pounds and regular physical activity for maintenance of the loss. Again, simple.

Is there a reason to quit smoking or to lose weight?

No sane individual these days can doubt the harmful effects of cigarettes. This gives us a reason to quit and as we saw before there is a way to do it. Yet many including some with undoubted intelligence and character find it hard to kick the habit.
Take me for example. I stopped smoking in 1997 after many previous failed attempts and despite full knowledge of it's harm. Well meaning people would tell me "you should know better" or "so and so just decided to stop one day and never looked back". Great! Whoop-de-doo for so and so and yes I certainly knew better.

There was more help, guidance and research available if you were hooked on hard drugs than if you were addicted to cigarettes. It wasn't until some people figured out how to make money with patches, gums and pills that more research became available. And they made some of their money from me trying all these products three or four times before I managed to stop. The act of ceasing to smoke was simple but it required a change in behaviour which was the hard part.

What are the harmful effects of being overweight?

There is increased risk of diabetes, high blood pressure, heart disease, hormonal imbalances and emotional and psychological disturbances. There is also an obvious decrease in life expectancy because of these risk factors. Just like with smoking, most of you have heard these a thousand times before.

So there you have it. The reason to lose weight and how to achieve it. But what about the change in behavior?

It's a cliche and also a well understood concept among psychologists that the first step is to admit that there is a problem.

It's easy with smoking. Nobody asks their spouse; "Honey do you think I'm a smoker?" One either is or isn't and no one is likely to spend the night on the couch by providing the wrong answer.

Confronted by a similar question about weight however may present some difficulties. One untested approach may be to be factual and say; "Well sweatheart according to your BMI, fat is not the correct terminology. Overweight? Yes."

Let's stop being ashamed of being overweight. It is not about having a weak will power. Don't wallow in self pity or envy those that can apparently eat like a horse and not gain an ounce.

Don't tell yourself; "I've brought this onto myself and I just need to get myself out of it" or "I know what to do. I just need to do it". Don't feel silly for having weight loss as an issue. Nobody will care as much as you should.

Demand help! Demand from your physician and find one that can give you practical help on how to change your behaviour. Demand better food at work. Demand better food at schools for your children. Treat it as you would if you found your 6 year old with a cigarette in her mouth.

Successful weight loss has nothing to do with knowing how to lose weight.

Calorie restriction and exercise WILL result in long term weight loss. Not juices or shakes or magazines promising results with just five minutes a day of exercise. Relearning of behavior is what is necessary to incorporate these in your life.

Step one: Acknowledge the problem.


For weight loss affirmations go to meisalus.com

Weight Loss- Channel Beowulf

My son's class has been learning about myths and legends and so our homework has been following a similar theme. Yes! OUR homework. I've always been an enthusiastic proponent of parental participation in children's education but this appears to require committment in par with at least a part-time position. By the time I have researched the subject on Wikipedia so as not to appear foolish and redirected his attention from a Nintendo created product we are both exhausted and ready for bed.

Recently however, thanks to our homework I learned about Beowulf. An important work of poetic literature written in 700AD. It depicts the life and battles of the heroic Beowulf against various monsters and demons. This is a quote from this poem:

"O flower of warriors, beware of that trap.


Choose, dear Beowulf, the better part, eternal rewards. Do not give way to pride.

For a brief while your strength is in bloom but it fades quickly; and soon there will follow

illness or the sword to lay you low, or a sudden fire or surge of water

or jabbing blade or javelin from the air or repellent age.

Your piercing eye will dim and darken; and death will arrive, dear warrior, to sweep you away."


Uplifting it may not be but wonderful advice none the less in any battle involving us and our demons. As you become more self assured and start to lose some weight, you must remain vigilant. There are many forces out there and deep within you ready to pull you down. "O flower of warriors, beware of that trap."



Over the past three posts we’ve tried to look deeper at what makes us not achieve and maintain our goal in weight loss. I hope that some of the examples that I wrote about hit home and gave you some insight into what might derail your efforts. Now knowing what they are, feel prepared and we can start.


Let’s set a realistic goal first. If you’re BMI is between 25-30, our aim would be to lose about a 1lb per week. If the BMI is higher, about 2lbs per week. Your first target date should not be more than 5 weeks away. So you’re looking at 5-10lbs in the next 5 weeks.

1) Dietary intervention: You are going to log in dailyburn.com or a similar site everything you eat and you will enter your daily weight, daily.

It is important for you to get in a habit of doing this everyday. If you have eaten too many calories for a day or two, it is not the end of the world or this program. You need to talk to your family, friends or other support group. They will make sure that you stay strong.

2) Physical exercise: Exercise alone is not a good method for weight loss but studies have shown that it is extremely effective in long-term weight management and improved health. Remember, you have looked within yourself and you know why you want to lose weight and what your specific barriers are. Exercise puts a different face to this challenge. You need to practice affirmations that will make it a positive experience. Your mantra should be to say over and over to yourself. "I enjoy exercise" "Exercise makes me feel alive", "I feel better, I breathe better, I look better after I exercise".You can see more on meisalus.com. I am not gonna bore you with what you should not say to yourself because I am sure that you are very familiar with those!

3) Behavior modification: What this is based on is that being overweight is the result of having learned incorrect eating and exercise patterns and the good news is that these can be re-learned and modified. The first part involves self monitoring (keeping food diaries and activity records) which you will be doing on dailyburn.com

The second part is stimulus control. Some eat to comfort themselves. Is that the case? We need to find what specific things trigger that feeling and find different comforting measures. Do you eat more or lose self control after you drink too much alcohol? Don't worry I'm not gonna suggest you stop drinking altogether but for this to work you have to know how it affects your resolve and eating habits.
100% honesty. That's our contract. Maybe you don't even know everything that is going to try and trip you up. We need to be vigilant.

Finally lets get back to the beginning. Before starting this challenge go to your health care provider and first get a medical clearance. Second, make a demand for help losing weight. Your family, friends and your healthcare provider are the cornerstone of the support you will need.

Let me leave you with another quote and feel free to use it as your war cry;

"I am Ripper... Tearer... Slasher... Gouger. I am the Teeth in the Darkness, the Talons in the Night. Mine is Strength... and Lust... and Power! I AM BEOWULF!"

"Lose Weight The Easy Way" and next week "Get Rich Quick, Doing Nothing"

The hunger center in my brain wasn’t very active when I was a child. It didn’t need to be. I gave it everything it wanted and more. Way more. It would only be time to leave the dinner table when the stomach pain overtook the desire to consume more food.
This along with an innate dislike of too much physical activity led me down an inevitable path which was to be known as the chubby one throughout my childhood. I know, the story is sad and you are probably trying to hold back tears but let them flow because there is more. Even now as I am in my early forties, kind relatives remind me at every opportunity of my childhood fondness for all things edible.

Any lesser man would have been left with a life long sensitivity towards his weight. But not me. No sir.

I have however, purely for professional growth had the opportunity to study and observe various weight loss measures. I have seen some amazing success stories that have proven the most reasonable approach to be the right one.

This approach is based on consuming fewer calories than you expend which is an elaborate way of saying eating less than you burn off. This is GUARANTEED! to cause weight loss. I wish that what I just said was as profound as I tried to make it sound. The importance of my statement is not that it offers a new way to lose weight but its promise to be an equal opportunity method. No matter who you are if you consume less than you expend, you must and will lose weight.

Our task for today is to find out as much about ourselves as possible;

First lets see who is at risk for complications of being overweight and obesity and needs to consider weight loss. Go to BMI Calculator and by inputing your height and weight calculate your Body Mass Index (BMI). A BMI of 18.5-24.9 is considered normal. If your BMI is less than 18.5 you are considered underweight. The following are the various stages of being overweight and and their corresponding BMIs and risks of medical complications such as type2 diabetes, high blood pressure and heart disease;

Overweight: BMI 25.0-29.9, Increased Risk

Obesity(Class I): BMI 30.0-34.9, High Risk

Moderate Obesity(Class II): 35.0-39.9, Very High Risk

Extreme Obesity(Class III): >40.0, Extremely High Risk

Realizing that you are overweight or obese is not going to be the best news that you've had today but burying your head in the sand is not the solution either. Recognizing the task at hand is the first step towards resolving it.

Second, are you ready to get started today?

Are you ready to tackle this issue once and for all? Why do you want to lose weight? What are the things that make it hard for you to start? Can you commit to 15-30 min a day to this process?

Third, we need a very clear idea of what we are eating before we can think about modifying it. There are online calorie counting sites available with smartphone applications. The one that I like is dailyburn.com.
Sometimes just realizing how many calories you are ingesting is enough to start the process of modification. Before we talk again you must become religious about tracking how many calories you are eating. The site has thousands of food item entries including ones from restaurants. You must be careful as we tend to underestimate our portion sizes. This time, stay true to this endeavor and you may be surprised at the results.


We will base our approach on the American Gastroenterological Association Medical Position on Obesity. You will need a medical evaluation before we can proceed from this point. This may include history taking, physical examination and possible lab tests which may elicit obesity related health risks. You must notify your medical provider of your intention to embark on a dieting regimen involving calorie restriction and increased physical activity.

I saw an ad for a smoking cessation aid that said "never quit quitting" and something similar needs to be our moto. Despite the title of this post, this journey will be hard and at times you will falter. It doesn't mean that your body is immune to this way of life. It means that we regroup and start again. Not in six months, or next new year's day but tomorrow or in a week.

Over the next couple posts I will try to go in a little more detail about the different aspects of this approach. Feel free to comment and even help us come up with a slogan or a name.

Weight loss after childbirth

We were two weeks away from her due date when my patient asked me how soon after the delivery she could start exercising again. It came as a bit of a surprise since up until that point my efforts to encourage physical activity had for the most part been ignored. She was concerned about losing her pregnancy weight.
We discussed that exercise after childbirth is safe and is important. The timing to some extent depends on the mode of delivery. That means whether the delivery was vaginal or through a cesarean section. Most physicians recommend six to eight weeks of recovery time after a cesarean section. After a vaginal delivery the timing depends on how the mother feels but probably two to four weeks after delivery would be reasonable. If the delivery happened to be complicated by tears or episiotomies then a discussion with the physician or the midwife is warranted.
Many women enjoy and relish the transformation that their bodies go through during pregnancy. Most of them however cannot wait to get back to their pre-pregnancy or even lower weight. That’s why I am asked a similar question quite a lot.
According to the Cochrane library review of the literature, weight retention after pregnancy can contribute to obesity. It is suggested that women who return to their pre-pregnancy weight by about six months have a lower risk of being overweight ten years later.
This review also indicates that probably a sensible approach would be to achieve this weight loss through a combination of diet and exercise.
Diet in this case does not mean severe calorie restriction. In order to see a sensible approach go to http://womenshealth.about.com/cs/breastfeeding/a/nursingdiet.htm .
Since my children were born I have tried to do something that doesn’t always come naturally. I have tried to exercise regularly and with a smile on my face! This is for the hope that they will see this as a normal part of daily living and not a torture to be endured either for health or weight loss.
I am a firm believer that starting your exercise routine in the postpartum period will help you reach your pre-pregnancy weight as well as act as a life lesson for your newborn.