Making Changes That Last
What was your New Year’s resolution? If you’re like many of the people I know, it might have had something to do with either toning up or slimming down. And like many of the people I know, myself included, you’re lucky if you made it through February. It’s not that we weren’t sincere about our goals; most of us just don’t know how to go about it successfully. We had no long term plan.
In today’s world, there’s no shortage of celebrity diets and highly promoted fitness programs. So what’s the problem? Why aren’t we more successful at reaching our goals and improving our overall health? Well, besides the obvious fact that most fad diets don’t work at all and even fewer are sustainable for any significant amount of time, there is not enough emphasis on long-lasting lifestyle changes. There is not enough emphasis on obtaining optimal health and wellbeing despite your body shape.
Before we address the traditional “diet and exercise” element, I think it’s important to recognize that the way your physical appearance is perceived by others has no bearing on your value as an individual--and that includes the way you perceive yourself. There is nothing wrong with desiring to become more fit and healthy, losing a few pounds in the process, but I believe that self-worth is a very personal and individual issue. It's a genuine acceptance and approval of yourself that exists independent of physical appearance.
That being said, a quick word about diets: Avoid them like the plague! Generally speaking, if they’re not setting you up for long term failure, like losing muscle mass or eventually gaining back any weight lost and then some, your wallet is often the only thing that truly loses a few inches. The key to successes is to continue to live your life, while making some healthier choices along the way. So let’s get you started on the right track by explaining a few things about the way the body works.
At the risk of oversimplifying a complicated process, gaining or losing weight largely comes down to “calories in, calories out”. A hormone produced in the pancreas called insulin is critical and will be discussed later as will several other very important factors such as food timing, macronutrient ratios and the glycemic and thermic effect of food.
Your body needs a very specific amount of energy each day to survive, to keep your heart beating and your lungs working, etc. This is known as your Basal Metabolic Rate (BMR). A similar formula, the Resting Metabolic Rate (RMR) provides a more realistic and practical figure. Both are an estimation based on age, weight, height and gender. Additional formulas are used to estimate the calories you burn while going about your daily activities. I like to combine the two. Many online calculators are available, making use of several different equations. Try this site to get started. Note that this is an estimation and many calculators tend to overestimate.
Once you have a rough idea of what your body needs to survive, you’ll know how many calories you must consume to maintain your current weight. You lose weight by either eating less or burning more (But be warned, not all calories are created equal!). Either way, you're creating a caloric deficit. If you could manage to create a deficit of 500 calories per day or 3,500 calories per week, that would theoretically be enough to lose 1 lb of fat per week! Dropping even a measly 100 calories a day, the amount in a single glass of skim milk, would still allow you to lose over 10 lbs a year! If you're having trouble keeping your daily intake consistent, try looking at it on a weekly basis. A weekly deficit of 700-3500 calories is reasonable.
Therefore it becomes absolutely necessary that you track or count calories. Both your “ins” and your “outs”. You can do this by hand, making use of food labels, or do it online which is much easier! I recommend setting up a free account with MyFitnessPal or ChooseMyPlate among others. MyFitnessPal also has an excellent (and free) smartphone application. Keeping a "calorie journal" will help you make quantifiable and sustainable changes in your eating habits. And if you're holding out on account of the fact that you don't want to be counting calories for the rest of your life, rest assured that once your habits change and you develop a new way of eating, you might not need to keep a record any longer.
I’m a big proponent of eating whatever you want as long as you’re active (within reason). But I’m also a big proponent of portion control. In my opinion, there aren’t really any “bad” foods, just better ones. Yes, junk food is junk but it can play an important psychological role. On the other hand, we dramatically underestimate the power of the green stuff. Yes, vegetables. Not only are they packed with healthy vitamins, minerals and fiber but they are very light on calories. For example, you could eat 10 cups of spinach before you reached the same amount of calories in a single chocolate chip cookie! There is no reason to go hungry while eating healthy if you learn to like good vegetables! That being said, avoid unnecessary carbohydrates, especially highly refined ones--It's easy to overdo it and carbs have the greatest affect on your blood sugar which can tell your body to pack on the pounds.
On a side note, I am not a big believer in supplements. Dietary supplements are not approved nor regulated by the FDA which ultimately means that you have no idea and certainly no guarantee of what you’re actually taking into your body and whether or not it is safe. Not only is good, unbiased research and regulatory oversight lacking in the supplement market but eating a varied diet of real, fresh food can provide almost everything you need.
If you’re serious about weight loss then you must be certain that any weight you are losing is actually fat and not muscle. That’s why any legitimate weight loss plan will include measurement of body composition or the ratio of lean mass to fat. This can be done in a matter of seconds with a decent specialty scale or better yet with an inexpensive pair of skin fold calipers that can be purchased on Amazon for around $20. I like the Slim Guide brand. Another good way to track real progress is to measure your waist line. Who wouldn’t love to fit into those old college jeans again?
Some people love to go to the gym and spend hours working out. There’s nothing wrong with that if that’s what you love. If it isn’t, then find something that you do love. While your greatest power over calories is what you eat, physical activity cannot only improve your cardiorespiratory fitness but also expedite fat loss. Whether it’s hiking, gardening or playing basketball, it’s time to adopt a more active way of life. These are activities that you can log into your calorie counters and either accelerate fat loss or increase the amount of food you can eat—it’s a net decrease we’re after, remember.
But there are many more things that you could and should be doing to be more active on a daily basis. For example, when was the last time that you just parked in the back of the lot rather than driving around for 10 minutes looking for that spot closest to the door? Or took the stairs rather than the elevator? Find ways to get up on your feet and get outdoors. You wouldn't believe all of the benefits of exercise! If we could fit them all into a single pill, it would be the most prescribed medication in the world! For the best results, read up on High Intensity Interval Training or HIIT.
When people think about exercise, they think about treadmills and stationary bikes. I hope that we’ve already proved that that is not the only way to go! An often overlooked part of any valid exercise regime is resistance training. Building and maintain muscle will torch fat for men and women of any age. Remember that resting metabolic rate we talked about? Not only is it responsible for up to 75% of the calories you burn each day, but the only way to really increase your RMR or BMR and thereby burn more calories by simply existing, is to increase muscle mass! Muscles are more metabolically active than fat. But beware, muscle is also more dense than fat so a smaller amount of muscle weighs the same as a much larger amount of fat. This is another reason why tracking your progress by scale weight alone is a disaster waiting to happen!
Gaining muscle once again does not require you to buy a gym membership. Becoming more physically active will grace you with stronger, fat burning muscles all by itself but there is also an incredible amount of work than you can do from the comfort of your own home. A great tool that I recommend to all my patients is a resistance band. These are little lengths of rubber of varying strengths that can be bought for less than $20 online or at any local department store. Dozens of exercises using these bands can be found online. Not only are they cheap but they’re also ultraportable. How can you complain about a piece of gym equipment that fits in your pocket? I also use old fashioned body resistance workouts like pushups, sit-ups and squats. There is a great iPhone app called Gorilla Workout that will help you along that path without a single piece of equipment. While all of the above are things that you should be adopting as a daily part of your new life, most experts recommend exercising at least 30 minutes a day, 5 days a week and muscle-strengthening activities 2 days a week.
If you need help with the specifics, it would be worth meeting with a registered dietician or certified trainer to get you started. Your primary care provider, i.e. family doctor, is another great place to start. Not only can he or she help you stay safe and manage any complications that arise but they will also know where to refer you for more specialized help if needed.
I’ve tried to keep this as simple and succinct as possible. However, I realize that there are many details and some exceptions that I simply haven’t been able to mention. So now it’s up to you to go out and learn more! I recommend a great book by Warren Willey, an osteopathic physician and bodybuilder, called “Better than Steroids”. The target audience here is other potential bodybuilders but Dr. Willey does a great job breaking down the basics and even including some trade secrets for big gains (or losses!). His book is all about the the power of food. I’ve also been following the journey of Drew Manning, a fitness trainer from Utah who gained 70 lbs just to lose it again, in order to prove how effective, and destructive, certain lifestyles can be. He blogs about his entire journey here while detailing the steps he’s taken to get back in shape. I especially appreciate his focus on good food choices and sustainable changes.
In closing, let’s try and put these suggestions into a more manageable, step-wise approach:
1) Realize that your individual worth is not measured by the way you look.
2) Decide to improve your health through a series of enduring lifestyle changes. Set daily and monthly goals.
3) Use an online calculator to determine your BMR or RMR, taking into account your average level of activity.
4) Start recording all the calories that go in and all of the calories that go out.
5) Become more active! Get involved in something you love and start increasing muscle mass!
6) Avoid foods that are calorie-rich and nutrient poor. Eat more vegetables, lean protein, healthy fats and low glycemic carbs. Avoid making a habit out of highly processed and sugary foods.
7) Track your progress not only on the scale but also by measuring body composition and waist size.
8) Visit with your primary care provider for help and counsel.
9) Become accountable to friends and family. Get a workout buddy!
10) Be patient! No more than 1-2 lbs of fat loss a week is a good idea. If you’ve decided to take it slower, it could be 3-4 months before you notice a difference. And remember, time no longer matters because this is NOT a diet but a healthier way of living!
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