Monday, March 2, 2009

"Why Can't I Lose Weight?"

"Doc, how could I have GAINED 5 pounds this month? I've been LOSING so well for months!" This was the mournful lament of a forty-something year old woman patient, who had lost over sixty pounds with our program, generally losing 5-10 pounds per month. A quick review of her diet over the previous month revealed the small change that lead to her gain...(more on this in a minute.)

And then there was the fifty-something gentleman with a similar story; after a successful fifty pound loss, he "mysteriously" gained 7 pounds in one month...

What did these two patients have in common, that threw off their weight loss success? Answer: they added some "healthy" food to their diets.

Yes, you read that correctly. "Healthy food" lead our two patients to gain weight.

Our successful lady had gone to the "health food store", and picked up some "natural granola". She had no idea how many calories, how much carbohydrate, how much fat, and how little protein were in the granola...but she was adding it to her yogurt, her cereal, and munching on it for snacks. Our nutritionist Beth did her best to guestimate the extra calories...and it was clearly the one change that had thrown our successful patient off track. No problem...with a few tricks and healthy substitutions (we switched our patient to a tsp of slivered almonds and a tsp of Nature's Path Granola to top off her yogurt), and in one month our patient had LOST all the weight she gained, plus extra.

Our successful gentleman had read that olive oil was healthy. He proceeded to pour olive oil over his salads, and into many of his lunches and dinners. He had no idea that ONE TABLESPOON of OLIVE OIL had about 120 calories. He was eating about TEN to TWELVE TABLESPOONS per day! Do the math - that is 1200 to 1440 EXTRA calories per day! Yikes - it is amazing he only gained 7 pounds!

Too much of any food - even healthy food - can lead to weight gain. This highlights the need to be aware of calories.

A recent study in the New England Journal of Medicine comes to the conclusion that CALORIES are critical to weight loss: http://content.nejm.org/cgi/content/full/360/9/859 It is an interesting study which varied the amounts of protein, carbohydrates, and fats, in different test groups. In the end, the most important factors for successful weight loss were CALORIES, and ongoing support. All groups, regardless of percentages of protein, carbs, and fats, followed "heart healthy" guidelines in terms of healthy fats, and high-fiber whole fruits, veggies, and grains.

What does this mean for you? It means that while HEALTHY FOOD is important to your overall well-being, you also need to become aware of the calories in your food in order to achieve substantial weight loss. It also means that there is no one, magic "formula" for all people, such as "high carb, low fat", or "high fat, low carb".

To be healthy, and successfully lose weight and keep it off long term, your diet will have to be individualized to your needs. For example, some people absolutely NEED to have a fair amount of healthy fat in their breakfast, in order to feel full. Others need very little fat in order to feel full. Research is just beginning to identify the genetics associated with this need - but don't waste your money on the phony tests you see advertised - real tests are not yet available to the public. With a little journaling and experimenting with different ratios of protein/fat/fiber, it is easy to figure out what you need, no blood tests needed!

Other people need much less fat in the morning, but more carbohydrate (this is often true for people who perform intense cardiovascular excercise in the morning.) But even these people generally need to have adequate amounts of protein, to balance the carbohydrates (and allow their muscles to rebuild), in order to keep full and feel satisfied!

Sound complicated? Don't worry! Its not as bad as you think. The bottom line is that calories are key to weight loss, and the balance and quality of your food are key to health and satisfaction. Once you find your "success formula", don't be afraid to stick to it! This is what we help people find, every day.

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