Food Cures (4 page)

FINAL WORDS OF ADVICE

No one expects you to be perfect. We’re all human, even nutritionists. We, too, have days when we indulge our food lusts—remind me to tell you about my personal love affair with frozen peanut M&Ms. But I make healthy foods my
habit
, and frozen candy an occasional treat. If you really want to think like a nutritionist, start by becoming mindful of your eating habits. The good ones are your keys for overall health, weight management, and quality of life. Think of the indulgences as just that—a luxury you can only occasionally afford.

I know you can do it. Remember, we’re in this together. Are you ready? Go ahead, find your starting chapter, and dive in!

I
f you are reading this chapter, then you’ve decided you want to lose weight. Good for you! I’m going to help you do it.

Unwanted pounds are the number one reason people come to see me. Some of my clients are hundreds of pounds overweight, others have been trying for years to drop just 10 pounds. Some people are referred by doctors because their weight puts them at high risk for certain disorders, while others want to fit into a wedding dress, or to return to their wedding weight in time for an anniversary or a big birthday. I advise actors and actresses who need to look a particular way for a role, athletes who need to boost their strength and energy, and fashion models who need to be thin but not emaciated. No matter what your personal reasons or motivations, I’m thrilled that you have made the commitment to a healthier, slimmer you. Whatever brought you here, welcome to the party!

Yes, you read that correctly…this is a party, not a dreary march down a dark and fruitless dieting path. A plan that has enjoyed as much success as this one is a cause for celebration. Just think: If you had made this commitment a year ago, you would already be 12 to 50 pounds lighter, a few sizes smaller, and feeling happier and healthier than ever. By this time next year, you could be that person. Better still, you’ll feel great doing it. Yes, I know that weight loss is your overall goal, but the process of getting there is empowering. After just one week following my 4-Step Program for Weight Loss, most people feel more confident and in control. They sleep better and feel more alert during the day. And, yes, their clothes are more comfortable, even a little looser. After a month, my clients can’t imagine going back to their old ways. After three months, friends start asking
them
for their weight loss secrets. Your commitment is the first essential step in this process and visible results aren’t far behind.

WEIGHT-LOSS BASICS

Most of my clients know everything there is to know about the mechanics of weight loss. Chances are you do, too, so I’m not going to go into exhaustive detail—I’ll just review enough of the basics so that you understand the reasons behind some of my recommendations. I also include client stories (all names have been changed!) and weight-loss lessons to help you avoid some potential traps.

HOW MUCH SHOULD YOU WEIGH?

Are you overweight?

The answer is not as straightforward as you might think. Sure, there are scales and charts and different scientific methods for calculating “fatness,” but determining whether a particular person is overweight isn’t as easy as saying whether a light is on or off. It’s more like trying to judge whether a particular light is “bright.” Sometimes there will be a general consensus that a particular light is, indeed, bright—most people agree halogen floodlights are bright. But there are times when reasonable people could disagree. A 60-watt bulb might look dim at noon, but at midnight—when it is the only source of light—the same bulb might appear bright. Contextual factors play a role in judging whether someone is carrying extra pounds too—ballerinas and sumo wrestlers, for instance, have very different definitions of overweight. Physicians and their patients may have different definitions, too. Like judging artwork or the taste of a meal, there is an aspect of weight that is less scientific and more subjective.

HEIGHT AND WEIGHT

Ever hear someone say, “I’m not fat…I’m just short for my weight”? That really is one way to look at it—when doctors decide who is or is not overweight, they rely on charts that provide a range of healthy weights based on height. It’s important for them (and you!) to know if you are overweight because hundreds of scientific studies confirm that those extra pounds increase the risk of many types of diseases…and losing weight can reduce those risks. The first height-weight charts were constructed in the 1940s by a life insurance company as a shorthand way to determine which applicants would be most costly to insure; the greater the risk of an early death, the more likely the company would be to lose money on that particular policy. The company collected years of mortality statistics and created tables of “desirable” weights by height, which were used, in part, to educate the public about the health risks of weights that fell outside the desirable range. The charts have been revised and refined since then, but the concept is the same.

Source: Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2000
.

According to height-weight charts, people are considered overweight if they carry more weight than what is usually expected for someone their height. For example, a woman of 5′8&8243; who weighs 155 pounds is at a healthy weight. However, 155 pounds puts a woman of 5′4&8243; in the category of moderately overweight, and a woman of 5′0&8243; in the category of severely overweight. Height and weight charts are a valid, if imperfect, way of defining overweight. Obviously some of your weight is muscle, bone, and other tissues that are essential to your physical functioning, and every inch of height adds healthy pounds to your total weight. Excess body fat, on the other hand, adds unhealthy pounds.

BODY MASS INDEX

In order to standardize the height-weight relationship to a simple numerical scale, scientists created the body mass index (BMI).

By using this chart instead of the height-weight chart, doctors use one number to determine whether you fall into a healthy weight range. There are five BMI categories:

• Underweight: BMI under 18.5
  
• Normal weight: BMI 18.5 to 24.9
  
• Overweight: BMI 25 to 29.9
  
• Obese: BMI 30 to 39.9
  
• Extreme obesity: BMI over 40
  

As with the height-weight measure, BMI is not perfect, but it’s pretty darn good. It is a quick, inexpensive indicator that can be easily calculated during any physical examination. If you haven’t already checked out where you fall on these charts, check now. Do the charts say you are overweight? If so, and you’re not overly muscular (i.e., a body builder), chances are the charts are right.

Source: Adapted from
Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report
.

WAIST/HIP RATIO

While young people with a high BMI are at an increased risk of disease and death, the relationship for older folks is less clear. As we age, our body composition changes and the predictive power of the BMI and height-weight charts weakens. Unhealthy pounds still matter, but BMI is not always an accurate measure of fatness among older people, especially those over age 75. Fortunately, the waist/hip ratio (WHR) succeeds where the BMI fails.

To calculate your WHR, measure your waist circumference with a flexible tape measure. (If you have a visible waist, measure around the narrowest part of your abdomen. Otherwise, take the measure at the level of your navel.) Record that number as your waist measurement. Then, measure around your hips—the widest part of your lower body, at or below the level of your pelvis. Record that number as your hip measurement. Now, take your waist measurement and divide by your hip measurement. That is your WHR. (For example, if your waist circumference is 30′, and your hip measurement is 38′: 30
38 = 0.79.) Higher WHRs indicate a greater proportion of weight carried as abdominal fat. In 2006, British researchers discovered that, for people older than 75, the greatest health risks are for men with a WHR greater than 0.99, and for women with a WHR greater than 0.90. For people younger than age 75, WHR also provides a measure of fatness that is related to an increased risk of cardiovascular disease, diabetes, and other disorders. For this younger group, the increased disease risk has a lower cut-off point: a WHR of 0.95 or greater for men, or 0.80 or greater for women.

PERSONAL EVALUATION

In addition to these mathematical formulations and charts, there is another expert you need to consult on the question of fatness—your own gut (pun intended). Do
you
think you are overweight?

Losing weight shouldn’t be about pleasing other people or meeting some arbitrary social standard. Losing weight is about feeling great, both physically and emotionally. You know your body better than everyone else—your energy level, how well you’re sleeping, whether your appetite is under control, and how your waist size has changed in the past year or two (or ten). You know whether you’ve been dragging or energetic and fit. And you know whether you are happy with the way you look and feel. That counts for a lot.

Weight loss requires hard work, faith in yourself, and a dream for your future. If it comes down to a battle between numbers on a BMI chart and emotions, emotions win every time. Your doctor can advise you, but he or she can’t give you incentive. That part is all you. That’s why I always encourage my clients to get in touch with their true motivations for wanting to lose weight, some personal reason, something to keep them going that has nothing to do with the numbers.

Take a moment now and think about your reasons for wanting to lose weight. You might be motivated by an milestone event you hope to enjoy with your family—like seeing your child graduate from college. It can be mundane, such as wanting to fit into a particular designer outfit. It can even be pure frustration with a weight issue that has stuck with you since childhood. Whatever your reasons, embrace them. They will carry you forward to success.

CALORIES COUNT

Calories are a measure of how much energy food provides. We need calories to do chores, run after the kids, make it through a full day of work, or go out with friends. All body processes use energy, too, including breathing, digesting, growing hair and fingernails, making hormones and enzymes…everything. Even the most inactive sofa sloth needs a certain number of calories to get through the day; active people need quite a bit more.

Here is the weight-loss formula:
If you take in more energy (from food calories) than you use, the excess gets stored as body fat—most noticeably around your waist, hips, or thighs. If you use more energy than you take in, then your body gets the energy it needs by breaking down the stored fat, and you lose weight. That’s it. That’s what it takes to lose weight—use up more calories than you eat. Of course, you and I and everyone on the planet knows that it is
way more difficult
to do than it is to explain.

CALORIE CALCULATIONS

If your goal is to burn more calories than you take in, you need to know how many calories your body needs on an average day. There’s a mathematical formula I use to make this estimate. And although this calculation can be incredibly helpful, it doesn’t take into account genetics, your age, and muscular makeup—all of which play an important role in the amount of calories you burn each day. As we go along, I’ll run through the numbers with our hypothetical 155-pound woman (height doesn’t matter here).