Head of medical weight loss program offers tips for keeping it off
Losing weight and saving money are the top New Year’s resolutions expected to challenge Americans this year, experts say.
“People need a motivation to lose weight and the new year is an opportunity to start fresh,” said Dr. Jessica Bartfield, internal medicine and medical weight-loss specialist at Gottlieb Memorial Hospital, part of the Loyola University Health System.
“Maybe it was the shock of seeing oneself in recent holiday photos, or not being able to fit into desired party attire that causes a vow to lose weight, and for many more it is a medical event such as a heart attack, the threat of diabetes or high blood pressure,” she said.
For Chicago-area newlywed Aaron Villarreal, it was seeing his wedding video.
"'Who’s that fat guy?’ I thought at first, and then was literally stunned and heartbroken when I realized it was me,” said the former high school football player. He joined the Gottlieb Medical Weight-Loss Program, a 12-week integrated regimen in which physicians, nutritionists, psychologists and exercise physiologists partner with participants who need to lose large amounts of weight.
“Behavior change is the cornerstone of healthy, successful weight loss and it takes about three months to establish a new behavior,” said Bartfield, a physician in the Gottlieb Medical Weight Loss Program. “At Gottlieb, a team of tried-and-true medical experts can teach you the skills you need to achieve and maintain behavior change.”
According to the Centers for Disease Control, two-thirds, or 66 percent, of American adults are overweight or obese. “We are a large nation,” Dr. Bartfield said. Despite a huge, billion-dollar weight-loss industry, it’s estimated only 20 percent of Americans who try to lose weight succeed in keeping it off after a year.
“Changing behavior is tough – it is actually a skill and needs to be approached that way,” Bartfield said. “When you learn to ride a bike, you expect that you will fall down a couple times and are prepared to try again and get back on; you need to have the same expectation with weight loss and to plan accordingly.”
The National Weight Control Registry (NWCR) consists of about 4,000 Americans who have each lost, on average, about 30 pounds and have maintained this loss for five years. “This registry provides a tremendous source of information about the behaviors associated with successful weight-loss maintenance. I often help my patients identify and incorporate these same behaviors into their own lives,” Bartfield said.
Top weight-loss behaviors from Dr. Bartfield and the NWCR:
• Eat breakfast – “Eating within one hour of awakening can boost your metabolism up to 20 percent for the rest of the day,” Bartfield said. Seventy-eight percent of NWCR members start the day off with breakfast. “Eating something is better than eating nothing, but ideally try to incorporate protein for longer-lasting fuel.” Villarreal, 33, used to routinely skip breakfast. “I thought I was being smart by creating extra room for the calorie overspill from my lunch and dinner,” he said. “Now I will eat protein bars, a slice of vegetarian pizza, almost anything to jump-start my heart and metabolism in the morning.”
• Weigh yourself once per week - “Monitoring your weight on a weekly basis provides a fairly accurate weight trend and, more importantly, an early detection of any weight regain, which allows you to adjust behaviors accordingly,” Bartfield said of the 75 percent of NWCR members who weigh in weekly.
• Get in one hour of moderate physical activity each day - “Snow shoveling, vacuuming, taking the stairs – you don’t have to run like a hamster on a wheel for 60 minutes. Take three, 20-minute brisk walks, or compile the one hour based on a series of activities,” Bartfield said. More than 90 percent of NWCR members engage in one hour of moderate exercise daily.
• Watch fewer than 10 hours of TV per week - “Many argue they don’t have time to exercise, but when I ask them to count the hours they spend watching TV or surfing the Net, they are able to find the time for activities where they are moving instead of sitting,” Bartfield said. Sixty-two percent of NWCR members watch fewer than 10 hours per week.
What not to do:
• Overestimate amount of physical activity - “Park your car farther away, take the stairs, manually change TV channels – these are all simple ways to get more physical activity and you need to write them down as they are performed to keep yourself honest,” Bartfield said. “Also, wearing a pedometer can help accurately document and track your progress.”
• Underestimate caloric intake - “I was ordering the No. 1 meal, not the 4,500-calorie meal, and so was everyone else in line at the fast-food restaurant,” Villarreal said. “When I began keeping a food journal, and documenting the calories, I was shocked to learn I was eating more than my daily requirement for calories in my lunch alone.”
• Set unrealistic goals - “Patients often set vague and outcome-related goals such as “weigh 150 pounds by summer” or “exercise more.” Goals need to be specific and attainable. Instead of trying to get to a certain weight, start by trying to lose 10 percent of your weight – that amount has been shown to have a statistically significant improvement in health and reduction in risk of obesity-related disease. “Success in meeting initial goals will foster additional weight-loss behavior,” Bartfield said. “I love cola and used to drink it all day; I substituted diet cola in my diet,” Villarreal said. “I was shocked to see that one simple change actually helped me to lose weight. That success motivated me to put forth more effort.”
• Lack of consistency - “Eat at regular intervals seven days per week,” she said. “Being ‘good’ on the weekdays and then splurging on the weekend creates a harmful cycle that discourages weight loss.”
• Failure to plan for setbacks - “When you learn to drive, or learn a sport or musical instrument, you make mistakes and you have an experienced instructor – maybe even several – to help correct the mistakes and prevent repeats. Enlist a trusted friend, or enroll in a program to learn and master the rules of weight loss,” Bartfield said.
And for teens who want to lose weight? “Treating child and adolescent obesity needs to be a family effort; families need to change behaviors,” Bartfield said. “Research shows that families – and even couples – who change behavior together are the most successful.”