The Results: The Weight Loss Battle

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The Results - The Weight Loss Battle
by Emily Pietro

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In our last issue, we continued to follow Susan on her weight loss journey with Physician’s Healthy Weight Center
(PHWC) and Dr. Warren. Since the last update, Susan has made it through the toughest time of year for anyone
trying to get or stay in shape – the holiday season. Even though she encountered some bumps along the way,
Susan was still able to stick to her goals and continue to lose weight.

“If you’re like me, whether you were on a diet before the holidays or not, you over indulged,” says Susan. “My
husband got a HUGE container full of Godiva and Ghirardelli chocolates, nuts, cookies, all kinds of temptations, so
obviously I dove into that a little. Christmas Eve came with all kinds of hors d’oeuvres, and of course we had a big
Christmas dinner, and then New Years rolled around. I told myself that was my last day of bad eating habits, so I
thought I might as well indulge, because if I didn’t, I knew I would feel deprived. My eating was offset by some
intense activity around my house. I completely redid my bedroom, and ripping up old carpet is hard work, about
three days worth. So even though I didn’t eat the way I should have, I got my daily activity in, and I was still able to
lose two pounds!”

When it came time to check in at PHWC, Susan reflected on her journey. “I am so grateful to be working with PHWC
again because their program is the only one that has ever consistently worked. There are so many positives here,
one of which being that I was able to get a prescription for Diethylproprion, which helps control my cravings. Dr.
Warren specializes in weight loss, so she knows what works and what is safe to take, medically speaking. I’ve
noticed on days when I’m off and basically stress free that if I don’t take my prescription, I have a low level of anxiety
and almost compulsion to grab a snack. When I take the Diethylproprion, the feeling is totally gone.”

“Another plus is speaking with Beth, their nutritionist, for meal and snack ideas,” Susan continues. “She takes the
time to find something that works for the long haul. I love going through her grocery bags of ideas. My recent
favorite is Lean Pockets. They taste great, are low in calories, and high in protein.”

Each appointment at PHWC begins with a questionnaire about recent problems, eating habits, or change in
medication, and this helps to address possible health concerns that could affect weight loss and to keep the patient
on track. Appointments also always include handouts with current information, a review of the last month’s progress,
and the weigh-in, BMI measurements, and the stethoscope.

“One thing I learned when I restarted at PHWC was that my Vitamin D count was exceedingly low: it was at 14
instead of what should be a minimum of 50. I would never even have had this checked if it wasn’t suggested to me
by Dr. Warren and her team,” Susan explains. “After being out of control for well over a year, I wondered, was the
weight really going to come off? Well, as you can see from the before and after photos, yes, it did.

ADD before and after data here (will email as soon as I have it)

My journey still has quite a ways to go, but I’m really excited to look and feel better and I’m already down a whole
pants size all thanks to hard work, commitment, and Physicians Healthy Weight Center.”

A common resolution for any new year is to lose weight. To help you achieve your goals, here are some helpful
hints for your weight loss journey from Dr. Jennifer Warren, co-founder and medical director of PHWC.

A new study in the New England Journal of Medicine confirms that calories are key to weight loss. "But I don't eat
many calories," you might think to yourself.

But calories are sneaky little devils. They can crop up in the most unexpected places. And trying to balance them
can be a bit confusing.

Here are a few common mistakes, and how you can avoid them:

1. "All natural, healthy food is low in calories." Don't make this mistake. As I mentioned in my last post, "healthy
foods" like granola and olive oil can be FULL of calories. It is easy to quickly consume large numbers of calories
unconsciously if you do not pay attention. Fat and processed carbohydrates may not immediately lead you to feel
full, and you may accidentally take in more calories than you need.

2. "If I eat sugar-free or low-fat foods, I don't need to count calories." Don't make this mistake either! Studies have
shown that people actually tend to OVEREAT these foods precisely BECAUSE they think they can get away with it.
They may actually eat MORE calories! Always check the calories in your portion size.

3. "If calories are the only thing that matters, I'll just starve myself all day to save up the calories for a really big
dinner." NO! Don't make this mistake. Studies have shown that starving yourself all day will INCREASE your hunger
hormones at night, leading to overeating. Furthermore, this practice may actually slow your metabolism during the
day.
One more problem with this approach – overeating a huge dinner at night can leave you too full to eat breakfast the
next morning, so you end up setting yourself up for the same vicious cycle. Start your morning off with a healthy
breakfast – you may have to force yourself at first, to break the cycle. Your body will thank you.

4. "I don't really eat that much – just a little grazing here and there. I don't know why I'm gaining weight." Studies
have shown that when people "graze", without any planning or formally keeping track of what they are eating, they
end up eating a LOT more calories than they realize. Other studies have suggested that people actually burn more
calories when they eat on a regular scheduled basis, rather than randomly snacking. The best way to avoid
"overgrazing" – plan ahead what you're going to eat for the day, then keep track of it in a journal.

5. "I want to lose weight quickly now by eating less than 800 calories per day, and then I can just maintain my weight
loss later by eating my usual calories." Um, can we say Oprah's 1980's diet? Starving your way to rapid weight loss
might sound great to some (not to me!), but this approach is FULL of PROBLEMS. For one thing, your body ends
up burning up its nice, lean muscle, not just fat, if you starve yourself. Secondly, starving yourself just plain doesn't
work very well for long term success. Cutting your calories to the "Very Low Calorie" level will slow your metabolism
down – so when you go back to a more normal calorie level, your weight will yo-yo through the roof! A much better,
kinder, and more successful approach is to find out your current daily calorie needs, and then cut calories and
increase exercise to end up with a "deficit" of about 500-1000 calories per day.

This will result in a one to two pound weight loss per week (you lose one pound of fat for every 3500 extra calories
burned – do the math. Cutting 500 calories per day, times 7 days, equals 3500 calories, or one pound lost.)

Doesn't sound like a fast enough weight loss? That adds up to between 50 and 100 pounds lost in a year. There,
that's a little better, isn't it?

If you really want to lose more than 1-2 pounds per week, it is possible, depending on your weight, health, and
medical factors, under the supervision of a physician and nutritionist.

6. "Once I reach my goal weight, I can go back to my old habits, and the weight will just magically stay off." Sounds
ridiculous when we say it that way, doesn't it? Yet so many people end up acting as if this was true!

The reality is that long term weight loss and maintenance requires some ongoing work. Simple as that. That said,
the reality ALSO is that it is actually EASIER TO MAINTAIN, THAN IT IS TO LOSE. That is good news, backed up by
long term studies of successful people. But it doesn't mean that you can become completely oblivious to calories,
and exercise. The reality is that you CAN eat more calories at maintenance, but you can't forget about calories
completely, or you risk excess "calorie creep." You also need to maintain regular exercise. Maintenance is an art
itself, but it is an art that you get better at, as you practice. Long term success is also tied to long term support, and
accountability.

The reality is that our society does not make it easy, or "automatic" to continue healthy habits. You'll need support
from somewhere, to "fight back" against all the unhealthy influences in our society. Most of our long term successful
patients check in periodically, just to keep themselves on track!

Jennifer Warren, M.D. co-founder and medical director of PHWC is a nationally recognized expert in medical weight
management and is the only physician in New Hampshire certified by the American Board of Bariatric Medicine.
Since founding Physicians Healthy Weight Center in 2004, she has helped her patients lose more than 40,000
pounds.
Physicians Healthy Weight Center has offices in N. Hampton (64 Lafayette Rd., Ste. 2), Dover (RW Bldg. 3 Webb Pl.
#4) and will soon be located in Salem, NH as well. Reach PHWC by phoning 603-379-6500 or visit their website at
ww.physicianshealthyweightcenter.com.