Weight loss should be taken seriously. It's a contract between you and your body. Guidance can come from many sources: your nutritionist, your doctor, or a recognized weight loss organization; but if you don't work at it, you'll be disappointed with your results.
Generally, you'll be given a diet and/or sensible eating guidelines. Our many years of experience have demonstrated beyond any doubt that "sticking to it" pays off handsomely in the end.
Your daily caloric consumption (your metabolic rate) can be estimated by measuring your REE (Resting Metabolic Expenditure), and adjusting this measurement for daily activity. The test is available at our facility.
If you decrease your calorie intake by 500 calories a day, you should lose approximately one pound a week. You'll lose more in the first week because of excess water loss.
If you increase your physical activity you'll lose more, depending on your type of activity. Walking a mile on flat ground burns 100 calories on average. Doing intense activity on a regular basis will also increase your metabolic rate, and further enhance the rate of your weight loss. Do not take on intense physical activity without consulting your physician.
Stick to your assigned daily caloric intake.
Weigh yourself frequently (daily is OK) on a reliable scale, same scale each time, preferably when you first wake up in the morning, before breakfast and before getting dressed. Record your weight on a single sheet (preferably on your computer, use Excel or a similar program if you have it), and bring it with you at your next visit with your health care provider.
Food calories
Fat: 1 gram has 9 calories
Protein: 1 gram has 4 calories
Carbohydrates: 1 gram has 4 calories
Alcohol: 1 gram of alcohol has approximately 7 calories
Fat is "calorie dense," it's packed with calories. Some fat is essential, and it helps keep appetite in check.
Most vegetables are "volume foods" with few calories and a lot of nutritional value; and they help fill your stomach.
Sugars of any kind (watch out for high fructose corn syrup, cane powder, "organic brown sugar" and others) are unhealthy carbohydrates. The same is true for white flour products and starch. Whole wheat products are a much better choice.
Take a close look at food labels, and make sure you look at the line that tells you how much sugar is in each portion; the less the better. There are acceptable sugar substitutes such as blue agave nectar (a liquid) and erythritol (sugar-like crystals).
Organic foods. Organic food is great. It's grown without chemical pesticides, hormones or antibiotics. But organic food may still contain unacceptable amounts of fat and sugar. So, again, don't forget to look at the food labels.
Snacks. It's OK to have snacks, but don't forget to take them into account when you calculate your calorie intake for the day.
Eating out. Eating out is not a sin. It's sometimes hard to keep a calorie count when you eat out. If you feel you over-ate, cut down the next day. Better yet, "bank" your calories by cutting down a little a day earlier.
Don't be embarrassed to ask the waiter to make sure that sauces are not too heavy, or to express other weight concerns you have. Don't rely on "iffy" answers: it's OK to ask to talk to the chef.
Use of special medications. Occasionally, medication may be prescribed to help you lose weight. These are usually meant to decrease you're appetite or the desire for food. Many of our patients have benefitted from the temporary use of appetite suppressants. But these medications are not meant to be a substitute for portion control, and their use has to be prescribed by a physician and monitored periodically.
Good luck in pursuing your weight loss goals.
Wednesday, November 17, 2010
Monday, November 1, 2010
A visit to Israel and a treatment for psoriasis and dermatitis
My wife and I returned today from a 12 day trip to Israel (which we have done many times before), and were back at work before noon.
This was a dual purpose trip: visit family, friends and new sites; and re-visit the developers of the new EdenSkin line of products designed to treat common skin conditions such as psoriasis, atopic dermatitis and seborrheic dermatitis.
Some of the exciting sites included the impressive IDF air force outdoor museum in the Negev; the Tel Aviv museum which exhibited the unusual and unique photos of David LaChapelle (born in Fairfield, CT); the Palmach museum in Tel Aviv commemorating the importance of this organization in the creation of the state of Israel, and the Druze village of Dalyiat el Carmel on the slopes of Mount Carmel overlooking the breathtaking Izrael Valley.
And on the medical front, we learned a lot more than what we already knew about the Israeli health delivery system, how effective it is, and how much simpler it is than what we have here. More about it in the future.
We also completed our review of the EdenSkin family of products, developed by a small company in Kfar Saba.
We have been watching the development of QoolSkin for several years. I've been using it successfully in the office for a while. It's herbal, and it contains no steroids, parabens, colors or fragrances. Most importantly, its side effect profile is extremely low, and it works where conventional therapy doesn't. We now keep the product at our office.
Other EdenSkin products include TopicSkin, also an herbal preparation, which I have used for the treatment of allergic dermatitis, and SeboSkin, which I intend to use for the treatment of seborrheic dermatitis.
Looking at the whole picture, this was a great trip, which also carries a potential benefit to our patients.
This was a dual purpose trip: visit family, friends and new sites; and re-visit the developers of the new EdenSkin line of products designed to treat common skin conditions such as psoriasis, atopic dermatitis and seborrheic dermatitis.
Some of the exciting sites included the impressive IDF air force outdoor museum in the Negev; the Tel Aviv museum which exhibited the unusual and unique photos of David LaChapelle (born in Fairfield, CT); the Palmach museum in Tel Aviv commemorating the importance of this organization in the creation of the state of Israel, and the Druze village of Dalyiat el Carmel on the slopes of Mount Carmel overlooking the breathtaking Izrael Valley.
And on the medical front, we learned a lot more than what we already knew about the Israeli health delivery system, how effective it is, and how much simpler it is than what we have here. More about it in the future.
We also completed our review of the EdenSkin family of products, developed by a small company in Kfar Saba.
We have been watching the development of QoolSkin for several years. I've been using it successfully in the office for a while. It's herbal, and it contains no steroids, parabens, colors or fragrances. Most importantly, its side effect profile is extremely low, and it works where conventional therapy doesn't. We now keep the product at our office.
Other EdenSkin products include TopicSkin, also an herbal preparation, which I have used for the treatment of allergic dermatitis, and SeboSkin, which I intend to use for the treatment of seborrheic dermatitis.
Looking at the whole picture, this was a great trip, which also carries a potential benefit to our patients.
Tuesday, October 5, 2010
Avoid those extra winter pounds
Winter is approaching, and the natural tendency for many of us was to stay indoors. For many of us, lack of activity and overeating follows, and the result is those frustrating extra winter pounds.
Weight gain is not only a medical issue. Sure, there is an increase chance of diabetes, high blood pressure, accelerated heart disease, joint pain, and many other medical conditions. But also important are the social, financial and psychological aspects of overweight. Thin and fit is still the general desire of most people. Some of us would become depressed over gaining weight and the inability to lose it, and others would feel that they lost a promotion opportunity because of it. Very few of us would enjoy buying a new, larger wardrobe, or the inability to fit into our summer vacation clothing.
So what are you going to do about it?
Losing weight is a full time job; you have to be aware of your goal at all times. Some of us can do it without much help. Decrease food portions, decrease fat intake, increase exercise --- the usual steps --- works. For others, professional help is a must.
Professional weight loss focuses on the entire person and his/her needs, and includes:
Establishing realistic goals. The ultimate goal of weight loss has to be a target weight that can be both achieved and maintained. This target weight may not be immediately identifiable, but becomes apparent as you work with your health care provider.
Portion control. Both the portion size and content of the food you consume need to be controlled and monitored. Accurate record keeping, while tedious, is extremely important. Your ability to keep records is a good indicator of how successful you'll be in controlling your weight.
Increase in exercise. Exercise helps burn excess calories, but don't count on exercise alone to reach your target weight. Cardiovascular exercise is best, but stretching and muscle strengthening are very important. Exercise at least four days a week, don't be a weekend hero. Special testing before taking on a rigorous exercise program is advisable, talk to your doctor.
Use of appetite suppressants when appropriate. The days of fen-phen long gone, but other medications are available. Stay away from over-the-counter preparations and "miracle drugs," they can be harmful, and, at best, you'll waste your money.
Use of meal replacement. Low calorie meal replacements have been available in super markets for several years. Others, of much higher quality, are available through some physician offices, including ours (e.g., HMR products). These products help in portion control and record keeping, and may keep you from binging.
Treatment of depression. Depression is frequently a cause of weight gain, and if it exists, it must be addressed.
What about weight loss spas? Many of them are very good, effective while you're there. But when you're back at home, you may still need to consult your health care professional.
When addressed correctly, overweight is manageable. And when you need professional assistance, go with those who will focus on your overall medical needs, not just weight loss. We're here to help!
Weight gain is not only a medical issue. Sure, there is an increase chance of diabetes, high blood pressure, accelerated heart disease, joint pain, and many other medical conditions. But also important are the social, financial and psychological aspects of overweight. Thin and fit is still the general desire of most people. Some of us would become depressed over gaining weight and the inability to lose it, and others would feel that they lost a promotion opportunity because of it. Very few of us would enjoy buying a new, larger wardrobe, or the inability to fit into our summer vacation clothing.
So what are you going to do about it?
Losing weight is a full time job; you have to be aware of your goal at all times. Some of us can do it without much help. Decrease food portions, decrease fat intake, increase exercise --- the usual steps --- works. For others, professional help is a must.
Professional weight loss focuses on the entire person and his/her needs, and includes:
Establishing realistic goals. The ultimate goal of weight loss has to be a target weight that can be both achieved and maintained. This target weight may not be immediately identifiable, but becomes apparent as you work with your health care provider.
Portion control. Both the portion size and content of the food you consume need to be controlled and monitored. Accurate record keeping, while tedious, is extremely important. Your ability to keep records is a good indicator of how successful you'll be in controlling your weight.
Increase in exercise. Exercise helps burn excess calories, but don't count on exercise alone to reach your target weight. Cardiovascular exercise is best, but stretching and muscle strengthening are very important. Exercise at least four days a week, don't be a weekend hero. Special testing before taking on a rigorous exercise program is advisable, talk to your doctor.
Use of appetite suppressants when appropriate. The days of fen-phen long gone, but other medications are available. Stay away from over-the-counter preparations and "miracle drugs," they can be harmful, and, at best, you'll waste your money.
Use of meal replacement. Low calorie meal replacements have been available in super markets for several years. Others, of much higher quality, are available through some physician offices, including ours (e.g., HMR products). These products help in portion control and record keeping, and may keep you from binging.
Treatment of depression. Depression is frequently a cause of weight gain, and if it exists, it must be addressed.
What about weight loss spas? Many of them are very good, effective while you're there. But when you're back at home, you may still need to consult your health care professional.
When addressed correctly, overweight is manageable. And when you need professional assistance, go with those who will focus on your overall medical needs, not just weight loss. We're here to help!
Saturday, September 18, 2010
Our Medically Supervised Weight Loss Program
The terms overweight and obese often trigger anxiety and frustration. Weight is a part of our personal self image, and an integral part of our well being. When weight is not under control, distress occurs, and poor health may soon follow. Americans have begun placing a great deal of importance on the "ideal weight" and many have gone to extremes to achieve it.
Our three decades of experience in weight management have shown that there is no single formula that fits everyone's needs. Weight loss programs have to be individualized; they must be designed to meet your individual needs. Genetics and personal habits must be taken into account in order to form a personal program that will help you achieve your desired goal.
We start our weight loss program with a thorough medical evaluation of your needs and your weight gain triggers. It includes a measurement of your daily caloric requirements and body fat analysis with the use of specialized equipment.
Weight control is achieved through several methods, sometimes alone and often in combination, depending on your needs. A suitable program may include:
- Ways to achieve portion control
- Meal replacement options
- Appetite suppression
- Exercise capacity measurement and exercise prescription
- Stress management
- Chinese and herbal medicine methods
Whether your reason is medical, cosmetic, or both, we can help you lose weight safely and maintain your weight loss over the long run!
To find your Body Mass Index (BMI), look at the BMI calculator on the left hand column.
Thursday, September 16, 2010
Your weight - setting realistic goals
Have you been repeatedly frustrated with your weight management efforts because you were not able to reach or maintain your goal weight? You may have been setting unrealistic goals for yourself, based on an “ideal of slimness” that comes from society.
Popular magazines and commercial diet programs still show you pages upon pages of beautiful, ultrathin models, many of which have been carefully touched up to make the models appear even thinner than real life. You may be comparing yourself not only to a model, but to an unreal model.
And then there is the Barbie doll. Barbie has the features of an anorexic person, but she still is a child’s role model. Her message is “if you get the body, you can get the guy.” Junior high and high school girls have described the ideal girl as 5’7”, 110 pounds, size 5, long blond hair and blue eyes. TV still shows the slim as the ones that are popular, successful and happy.
The ads keep you aware of how far from their ideal you are, and promote the feeling of failure. It is not surprising that we set goals that are not reachable or maintainable. Nor are they desirable.
The flip side of the drive to become slim is the continuing expansion of the fast food and the sweets industry. Advertising associated with this drive are directed at your emotions. They make it hard to resist unhealthy foods, and they confuse people. You feel guilty if you eat the advertised food, and deprived if you don't.
How can you develop realistic goals? Here are practical considerations:
• Slimness is not the only goal. Other health issues are just as important, including the maintenance of normal cholesterol, blood pressure and glucose levels, smoking cessation, stress management, and regular exercise.
• Your personal weight history and physical activity history should be taken into account. If you are a forty-year old woman who weighed 100 pounds when you were running track in high school, then 100 pounds might not be a realistic goal now.
• Metabolism slows with age. If you continue to consume the same amount of food as you become older, there will be a gradual weight gain throughout adult life. Frequently, you can compensate for this decrease in metabolism by increasing your physical activity.
• Metabolism slows with weight loss. When you are thinner, you require fewer calories to maintain your weight. Again, an increase in physical activity may help significantly.
• The ideal body weight, frequently determined from Life Insurance tables, is neither a good measure of your body fat, nor the best measure of the medical risk of obesity. Body mass index (calculable from your height and weight), the waist hip ratio, and body fat measurement by electrolipoanalysis, are much better ways by which to assess your appropriate weight.
When setting weight goals for yourself, remember this: don't compare yourself with someone else. You are an individual and your body likely behaves differently from someone else's body. When losing weight, make sure you exercise regularly. Feeling good and obtaining the benefits of healthy lifestyle changes is the real goal.
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