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August 2014

My Summer Soap Box
Obesity and Weight Loss Equation, Part II

Dr. Stephanie Coulter

I’ve gotten on my Summer Soap box and written a three-part series on weight loss, obesity and healthy lifestyle modification strategies. These are big, important topics, so here are some further words on them:
  • Body Mass Index (BMI)
    Measuring BMI is the first step. BMI, a measure of body fat based on height and weight, is easy and fast to calculate using our online calculator. In addition, it can identify adults at increased risk for morbidity and mortality due to obesity. BMI can also be used to guide recommendations for weight management.
     
  • Weight-loss medications: Who should take them?
    There is no silver bullet. Drug therapy, along with diet and exercise, may be helpful for some people. However, among those with cardiovascular disease, certain drugs may be contraindicated. The role of drug therapy has been questioned because of concerns about efficacy, the potential for abuse, and side effects. In short, seek and follow your doctor’s advice.
     
  • Weight loss surgery
    This strategy helps people with extreme obesity who cannot lose weight through diet and exercise, or who have serious health problems caused by obesity. There are different types of weight loss surgery (bypasses, bands, and sleeves) and all have risks and complications, such as infections, hernias, and blood clots. Many people who have the surgery lose weight quickly, but regain some weight later on. If you follow diet and exercise recommendations, you can keep most of the weight off. You will also need medical follow-up for the rest of your life. This is a specialized surgery and we will not cover it here, however, the National Institutes of Health put out a 94-page guide if you are interested in reading more.
     
  • Regaining weight
    If losing weight wasn’t difficult enough, regaining lost weight is a common problem in any treatment program. It is extremely important for people with known cardiovascular disease or cardiovascular risk factors, such as high blood pressure or high cholesterol to maintain a healthy weight. Consult your doctor for help.
Habits to Help You Lose Weight

To lose and maintain a healthy weight you must transform your eating, exercise and daily habits, like how much time you spend sleeping, watching TV, surfing the Internet, etc. Healthier habits will make a difference, but don't expect to do it all at once. Choose a goal suitable for you and stick with it for a week. Once you’re able to keep consistency, add another one. Over time, you will have incorporated many of these habits into your routine. Beyond this, consider these steps:
  1. Find a support system
    To help you get and stay motivated, find at least one weight-loss buddy (a friend, spouse, relative, or colleague). Weight Watchers and many other online programs are great for this.
     
  2. Set small, specific, and realistic goals
    Setting a goal to be the same size you were in your teens or when you got married may not be realistic, at least not in the short term. Set a more realistic goal, say losing 5% to 10% of your weight, and you'll have a better chance of success and becoming inspired to continue your progress. Prepare healthy meals, ban unhealthy foods, and exercise with friends.
     
  3. Start self-monitoring
    Writing down what you eat and how much you exercise can help you gain awareness of your behaviors and track your changes. To keep tabs on your eating and exercise, you can go low-tech (a pocket-size notebook with a pen) or high-tech (a smartphone app). The idea is to pinpoint areas you need to improve.
     
  4. Eat breakfast every morning
    If you are always in a hurry, try waking up 15 minutes earlier to accommodate time for breakfast. Select whole grain foods low in sugar with at least 6 grams of fiber per serving. Including strawberries, bananas, berries or apples plus nonfat dairy products will make meals tasty and healthy.
     
  5. Eat more slowly and savor your food
    The ideal time to spend eating a meal is 20 minutes. Practice eating slowly by putting down your utensils and sipping water, coffee, or light beverages between bites. Set a timer to check yourself.
     
  6. Energize your exercise
    Try new exercises and find one that you really enjoy. This will make it easier to stick to an exercise routine and is a great way to keep you challenged.
     
  7. Make sure you’re getting enough sleep
    Inadequate sleep can lead to weight gain. In general, people need about eight hours of sleep a night, though this could vary. You can tell you slept the right amount if you wake up feeling refreshed and ready to start the day.
     
  8. Monitor and modify your sitting time
    In order to have time to exercise and prepare healthy meals, you will need to watch the hours you spend using your computer for fun or sitting in front of the TV. Keep track of your sitting time for a week, then try to decrease the number of hours, and dedicate that time to weight-loss activities.

Texas Heart Institute exercise infographic

I am inspired by what singing star Jennifer Hudson wrote about her public struggle with weight: “Permanent weight loss doesn’t come with an on and off switch.” And neither does cardiovascular disease.

Remember, it’s for your health!

(Print the graphic above as a motivational poster and hang on your fridge.)
 
Until next time! 

Dr. Stephanie signature
Stephanie Coulter, MD

Top exercise questions for Ask a Texas Heart Institute Doctor.

Learn more about exercise.

Read past issues of Straight Talk.


Do you have a topic that you would like to learn more about from Dr. Stephanie? Send us an email at women@texasheart.org and your question may be the next Straight Talk topic!

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Visit the Center for Women's Heart & Vascular Health at www.texasheart.org/women.

 
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