Hi, I’m Deacon Shoenberger, a licensed clinical psychologist. If you read last month’s newsletter you started paying attention to your regular routine and you’ve been to the doctor, cut down the booze, are well-rested, moderately exercised and ready to go…. So what’s next? Get after the diet you say?
Well, let’s take a look at the research on dieting. The New England Journal of Medicine, one of the most respected publications in medical research, tells us that 92% of diets fail after 2 years and 95% fail after 5 years. This does not bode well for diets. (But any of us who have been on a diet know that one). How many times have you lost 30 pounds only to gain back 40?
There are a number of reasons for this failure rate, but the one we will take a look at today is called deprivation. There are two types of deprivation associated with eating, biological and psychological. Biological deprivation is the process inside your body that is associated with your innate drive to eat. This process kicks off pretty quickly after you start restricting yourself from food, or dieting. Within as little as three hours, your physiology changes and your blood sugar levels (glucose and glycogen) start shifting to a “pre-starvation” mode. Cortisol (the stress hormone) starts releasing, and your body starts to move into a protective mode. And over time, chronic dieting has been shown to teach the body to retain more fat when you start eating again, slow the rate of weight loss with each successive attempt to diet, slow down your metabolism, wipe out the satiety (fullness) cues, and increase binges and cravings. Not good…
Psychological side effects of chronic dieting include increased stress, anxiety, depression and lowered self-esteem, reduced trust in others and yourself, and a belief by some obese individuals that there is something fundamentally wrong with their character. Speaking of having been there, anyone who has a loved one who has been on a diet can speak to how crabby, irritable, and anxious they get the longer they are deprived of food. And not just over time – it happens so immediately my wife can speak to how crabby I get if I get busy during the day and don’t eat my usual meals….
Since deprivation is not the answer, what do we do? One critical deviation from traditional dieting that takes place here is that the doctors and coaches at iMetabolic aren’t looking to restrict calories, but instead are looking to restore healthy, regular eating and lifestyle routines. By providing healthy meal replacements, regular eating routines, education about food choices and eating pattern we are not looking to restrict food, but are seeking to allow your body and mind to heal the damage that has been done through years and years of restrictive dieting. This will allow you to stabilize physically and emotionally and put you on the path to long-term health. And if you happen to lose weight along the way (which we know you will) even better.

Walking can cut obesity gene effect in half

The millions of people whose genes make them prone to obesity aren’t at the mercy of nature. How they choose to spend their free time can make a big difference in their waistline, according to new research presented at an American Heart Association (AHA) meeting in San Diego.
Watching TV for two hours each day increases the effect of certain obesity-related genes by as much as 25%, the researchers estimate.
If, on the other hand, people with a strong genetic predisposition to obesity spend one hour each day walking briskly or engaging in comparable exercise, they can halve the genes’ effect.
“In terms of evolution, this makes sense,” says Dr. Roxanne Sukol, a preventive medicine specialist at the Cleveland Clinic, who was not involved in the study. “We didn’t evolve to sit still for hours a day.”
To explore the interaction between behavior and genes, Harvard researchers analyzed data on more than 12,000 men and women participating in two large studies of health professionals.
The researchers measured the participants’ genetic risk by identifying how many of the 32 known variants of the so-called obesity gene each person had. (The gene is officially known as the fat mass and obesity associated, or FTO, gene.)
Roughly half of the general population has some genetic risk for obesity, says lead author Qibin Qi, Ph.D., a research fellow in nutrition at the Harvard School of Public Health, in Boston.
At the same time, Qi and his colleagues looked at how many hours per week each of the participants spent in front of the TV, as well as how much time they devoted to physical activity. Two years into the study, the researchers also recorded the participants’ body mass index (BMI), a ratio of height to weight used to measure body fat.
Each additional obesity-related gene variant was associated with a 0.13-unit increase in BMI, the researchers found. To put it another way, the average person with 7 to 8 variants can expect to have a BMI roughly one unit higher than it would be without the variants. (One BMI unit is equivalent to about six pounds on a 5-foot, 6-inch woman.)
The influence of the gene variants, however, appeared to be strongest in people who watched the most TV. The variants’ effect on BMI was about four times greater in people who spent 40 hours or more per week in front of the TV than it was in those who watched an hour per week or less.
“Prolonged TV watching exacerbates the effect of the gene,” Qi says.
By the same token, weakening the genes’ effect was as simple as switching off the television and going for a brisk walk. The average difference in BMI between a person with the highest genetic obesity risk and a person of identical height with the lowest risk would be cut in half if the high-risk person were to walk for an hour each day, Qi and his colleagues estimate.
The main problem with TV watching is that it tends to involve so much sitting, Qi says. As long as they keep moving while they watch, people don’t necessarily need to miss their favorite shows.
“Rather than just sitting there, I have a better idea: When they watch, they should exercise,” he says. “There’s nothing wrong with TV per se, but TV watching may be indicative of a sedentary lifestyle.”
Sukol often recommends pedometers to patients who are trying to be more active. The devices enable patients to track their progress by measuring the number of steps they take each day, and they also motivate people to keep walking.
“Human beings are designed to move,” Sukol says. “If we’re not moving, we put ourselves at risk.”
Qi and his colleagues presented their findings today at the AHA’s annual meeting on nutrition, physical activity, and metabolism. Unlike the research published in medical journals, the study has not been thoroughly reviewed by other experts in the field.
-Heart.org

Hi, I am Deacon Shoenberger, a licensed clinical psychologist. I’ll be writing some brief articles over the next several months about topics that may be of interest to those of you currently pursuing or thinking about engaging in medically supervised weight loss. As many of you know, making significant changes in your own personal behavior is very difficult to do, especially when considering a shift that involves as many factors as losing weight.
Increasing attention to what, when, and how much you eat, exercising more, becoming more aware of your emotional responses, maintaining motivation, dealing with cravings – these are all aspects of the weight loss challenge that can sometimes feel overwhelming when you begin reading or talking about weight loss, or even when you enter a weight loss program. And further, the factors that drive the decision to make the change can sometimes be considered a crisis. “My wife is going to leave me,” “the doctor says I’m going to die,” “I just found out I have a marker for diabetes” – these are some of the reasons people give for wanting to improve their health. As a result, sometimes the basics can get lost in the shuffle, which is unfortunate because the basics are often the most necessary aspects of successful behavior change.
Returning to the basics has been presented in many different ways and has always been expressed as a critical step to be taken prior to attempting to address more complicated problems. Maslow in his hierarch of needs identified physiological needs (food, water, sex, sleep, etc) as the base layer of needs to be met for human emotional health. Without attention to the basics, there is no way to pay attention to anything else. Or, as an emergency room assessment specialist once told me, “how am I really going to know if someone is homicidal if they are hungry, thirsty, cold, in pain, or tired?”
Self-help groups and addictions treatment programs in the 90’s espoused the acronym HALT – Hungry, Angry, Lonely, Tired – as a way to quickly assess your readiness to make effective decisions and to highlight the importance of taking care of your basic needs before making complicated or important decisions. “If you are hungry, angry, lonely, or tired it’s probably not the best time to think about leaving your husband.”
Current behavior therapies have combined the acronym and hierarchy of needs ideas as skills for reducing emotional vulnerabilities and increasing your ability to regulate your emotions and make better decisions. Treating physical illness, eating regularly, avoiding altering drugs, balancing your sleep, and exercise make up the skills practiced in this type of therapy. Again, the fundamental idea is that the foundation for effectively making a lifestyle change is to make sure the basics are covered first.
In sum, trying to effectively lose weight is tough and will involve much more than just eating less and exercising more. And with all of the anticipation about what you will learn and how it will turn out and what everyone will think, sometimes it may feel like a roller coaster. At these times, not only is it useful to remember the basics, it can be critical. So if you are getting ready to engage in this process or even if you are already on the road, get good at the basics – sleep enough, eat enough, exercise, kiss your wife, cut down the booze, and get to the doctor if you are sick. None of us do these as well as we ideally could, but the better you get at them, the higher your likelihood of success at changing any behavior.
Good luck until next time when we’ll talk about the different aspects of behavior change and some of the problem with traditional dieting.

Your heart has a big job to do — and a healthy heart plays a huge role in your overall health. The heart pumps blood through your vessels to all your vital organs, including your brain, so chronic heart or blood vessel disease can lead to not only stroke and heart attack, but depression and decreased brain function. There are several habits that everyone should follow for better heart health, and one of the most important is a diet for a healthy heart. A heart-healthy diet means sticking to foods low in unhealthy fats, specifically saturated and trans fats. Just as important, it also means eating plenty of fruits and vegetables, whole grains, and healthy fats such as fatty fish, nuts, and avocados, which can help promote weight management and prevent heart disease

If you want a healthy heart, you have to work at keeping fit — unfortunately most of us don’t. A study conducted by the CDC found that more than 68 percent of adults are overweight, while another 35 percent are obese. Weight management is one of the major keys to help prevent heart disease. You can watch your weight by eating a healthy diet in addition to getting plenty of exercise. Exercise is one of the best ways to build a strong heart and promote weight management. Aerobic exercise, which gets your heart rate up, is best, but strength training can help your heart, too. The more exercise you get, the better, but even just an hour of exercise per week can help prevent heart disease. If you really want heart-health benefits, a brisk, 30 minute walk most days of the week is excellent exercise.

A number of health problems are linked to heart disease and can stand in the way of a healthy heart. Diabetes management is vital for heart health, more patients with diabetes die from heart disease rather than the diabetes itself. Other conditions that threaten heart health are high blood pressure and high cholesterol — you’ll need to work closely with your doctor to prevent heart disease by bringing these conditions under control through diet, exercise, weight management, and medications, if necessary. You’ll feel better and improve your heart health to boot.

Smoking causes health threats that go beyond serious damage to your lungs. It can also damage your arteries and threaten your heart. One study found that even in young people, smoking was associated with significant heart problems. If you smoke but want to commit to having a healthy heart, recognize that you may need help beating your addiction. To take charge of your heart health and overall health, explain to your doctor that you want to quit and ask for recommendations on smoking cessation programs. Worried about weight management? Add exercise to your post-smoker lifestyle to stay busy and fit.

When your stress levels go up, so does your risk of heart disease. For a strong heart, find effective and healthy ways to alleviate stress. Regular exercise is a great way to reduce stress. Learning relaxation techniques, a good laugh, and venting can all help relieve stress and promote a healthy heart.

Wow, along the lines of better late than never, the USDA just issued some new school lunch nutrition standards. It’s only been 15 years since the last standards were established. In that period of time, the obesity epidemic has sky-rocketed. As a whole these new standards seem basically sound. We are hearing about more fruits and vegetables everyday along with smaller portions. Only low-fat and skim milk will be offered as well as a lot more whole grain. Additionally schools will reportedly get more money per meal to make all of this a reality.

However, there are still some disturbing players out there that are helping shape policy. For example, Congress voted 2011 to disallow the USDA from limiting the serving size of potatoes in school lunches. There are also laws out there allowing schools to count tomato paste on pizza as a vegetable. However, the USDA seems steadfast in their efforts to make sure that beneficial changes occur. We’ll see… Here are a few details that seem promising: Calorie restriction depending upon the grade being served. The ranges go from 550 on the younger scale to 850 max for the oldest kids. Of the three ranges, each has a cap that permits no more than a 100 calorie swing. I.E. 550 to 650 for grades K-5. Additionally, not more than 10% of total calories can come from saturated fats and all meals must have zero trans fats. It would be nice to see some “rules” on protein. All in all, some decent steps are taking place. Will this be a total game changer? Only time will tell, but it’s nice to see that we are at least trying to make some positive changes.

Attached is a link to the full press release: http://www.usda.gov/wps/portal/usda/usdahome?contentid=2012/01/0023.xml