Monday, July 20, 2009

My top 3 "hidden" causes of weight

Over the years I've seen literally thousands of patients. While certainly many come to my office with a clear understanding of where their weight's come from, a significant percentage come in and truly can't understand why they're having difficulty losing weight or why they gained weight in the first place.

Indeed there are a myriad of sources of struggle, but here are my top 3 (in order):

1. Meal skipping

These folks often come in and tell me they barely eat. Looking at their weight and lifestyle inventory (WALI) these are the folks that skip breakfast, generally avoid daytime snacks, have soups or salads for lunch and then eat a large dinner and often struggle with cravings and impulse control in the evening. I can understand why they feel they barely eat as the vast majority of the day, they're not eating at all. Of course by the time they do eat, they're hungry. And of course when we're hungry our bodies crave calories. So what happens? While it's true they might only eating one substantial meal per day, during that one meal, due to the influence of hunger, they're eating more calories than their bodies burn the whole day and hence, gaining - not losing.

Simple try at home solution: To lose weight you can't be hungry. Eat every 2-3 hours and include protein with all meals and snacks.

2. Eating out

These folks often come in and tell me they only eat healthy. Looking at their WALI you'll see them eating out anywhere from 4-10 times per week. When I point out their frequent meals out these folks will often tell me that they're great at choosing healthy options at restaurants. Unfortunately for them, even healthy options at restaurants can contain ridiculous numbers of calories.

Simple try at home solution: Here's an easy way to think about meals out. Assume that every meal out you eat will result in a day you don't lose. If you eat out 4-5x per week and then add in a few days of normal life stress struggle you might well not lose a pound. Eat out more than that and you're likely to gain. It's important to point out that while I think zero is certainly too few meals out in the context of a realistic and enjoyable lifestyle, to lose weight you'll have to lose the convenience meals out and keep only the truly celebratory ones and occasional social ones.

3. Liquid calories

These folks are often the most confused by their weight. They may be eating regular meals and snacks, eating in and watching their portions. Looking at their WALI you might see them having 2 glasses of milk, one glass of juice and one glass of wine a day. Put together that's roughly 40lbs of liquid, non-filling calories per year.

Simple try at home solution: Don't drink your calories. If you're drinking any beverage for health reasons (milk for calcium, juice for vitamins, wine for heart health, V8 for vegetables, etc.), stop. If you're looking for calcium - take supplements. If you're looking for vitamins - take a multi. If you're looking for heart health - take a 10 minute walk a day and if you're looking for vegetables - eat them. At roughly 10lbs per glass per beverage/day per year none of these so called health benefits are worth their weight.