So You Say You Want To Lose Weight...

2011-04-26T20:17:00.002-04:00

This past Sunday was Easter. I had a great day with the family. No more Easter egg hunts for the kids (okay, so they're 25 and 19). As a matter of fact, I didn't buy any Easter candy this year. NO peeps, marshmallow eggs, or all those other things I buy for others because I am selfless like that. I then tend to 'help' them consume these treats because I am nothing if not helpful.

Instead this year, I made a small, simple dinner. I did make everyone's favorite dessert but just a single batch which worked out to one serving per person.

I then took the frozen cookie dough that I had purchased from a school fund raiser (which has been sitting in my freezer taunting me) and baked all the cookies and gave them away.

So it's a new week and I'm left with no leftovers and no temptations.

Life is good.....

Priorities

2011-04-13T22:03:00.001-04:00

I haven’t written in a long time and my weight is up since last fall.

What do I attribute this to: winter blues, family crisis, working overtime….
I would love to stick a label on it and place blame. But it was me.

It was poor planning on my part, not setting my priorities, and having big, catered pity parties for one. Not the best plan.

Gandhi said it best: Action expresses priorities.

Problems vs. Decisions

2010-09-04T20:34:00.001-04:00

You don’t have a problem; you have decisions to make.

Well, that’s an interesting statement and a fun parlor game when you’re playing with someone else’s life. When you start applying it to your own life—it’s not quite so fun as it’s often difficult to discern a real problem from something that you’ve just accepted as such.

A problem locks you in and drains you. But when you have a decision to make, there is a sense of energy that comes into play as you analyze the situation and begin to turn it over and look at it from different angles instead of just accepting the view from a self imposed pity party. Even the process of making a difficult decision can give you a sense of empowerment as you come to realize that you own the decision and the consequence. They don’t own you and for some reason that is freeing.

We spend our energies on people and things that are out of our control and overlook the things that we can control. When we come to accept this, we will begin to see that we have far fewer problems than we think we do and many more decisions to make. The more decisions we make, the fewer problems we will have.

Mind Over Matter

2010-08-27T13:16:00.001-04:00

I did it! I sat with my angst yesterday and didn't budge....I flinched and it wasn't easy but I stayed. It's not that I expect it to be easy but.........

But what?
I know that the longer I stay and do the things I need to be healthy~~emotionally, spiritually, physically~~the easier it is to stay and do the things I need to be healthy. It's when I step away for a time that it's hard to come back.

Then there's the matter of support: when I'm doing the right things, I show up and I share and these things only strengthen my staying power. The opposite occurs when I'm choosing unhealthy living. I stay away from the people and places who support me in healthy ways. This staying away only encourages and allows for prolonged periods of poor behavior and makes it harder to come back and face myself and others. And now it's not an outside voice telling me when I'm on a destructive path because my body informs me as my joints get more painful from the extra pounds and inactivity during my down times.

I know that the body is an amazing machine that responds to even small changes by sending out neurotransmitters that enhance the mind and block pain in the body. I know that the mind is an amazing mechanism and the real catalyst for change. Yesterday I changed my mind and the rest of me hobbled along after it.

Middle Ground

2010-08-21T09:37:00.001-04:00

There is no peak to the mountain you are climbing, just rest stops along the way.

So there you have it:
I have been at a ‘rest stop along the way’ but now it’s time to get moving again. I had my knee surgery two weeks ago and I am sick of hanging around. To be honest, even the two weeks prior to my surgery were spent waiting around for my surgery date. These pity parties are getting old and my excuses sounding lame even to me.

I’m off to the gym now to ride the stationary bike. I will take it slow and that is where I find it most difficult as I’m usually at ‘full speed ahead’ or a ‘dead stop’. It’s the middle ground I find difficult to maintain.

But difficult doesn’t mean impossible…….

Good Morning

2010-06-19T10:07:00.003-04:00

It feels good to feel good. I woke up early this morning and realized/remembered how much I love the Matrix Food Plan. I get the satisfaction of eating all the foods I love all day. And then, by stopping my carb intake by late afternoon, I get a great nights sleep and wake up feeling energized.

Wow! Who knew?

Yeah, I know, Dr. K. and Matt knew it all along. I just sometimes need reminding.

Sisyphus:

2010-06-11T22:18:00.001-04:00

Sisyphus not to be confused with syphilis....

In Greek mythology, Sisyphus was a king who was punished by the gods. His punishment: he was condemned to roll a boulder up a hill only to have it roll back down again before he reached the top. And this he was to repeat for all eternity.

Some days I feel a bit like Sisyphus with exception that I can’t blame the gods for my predicament, it’s all me. I stop my own success; I stall my own forward motion and I can’t seem to get out of my own way long enough to hit a goal these days.

Okay, so I’m feeling a bit dramatic this evening. I’m just back from vacation, feeling not so ready to rejoin the world, and hating that I injured myself and am unable to work out right now.

And here’s the thing: I usually get my way. If I see something I want, I am pretty good about making it happen. So why hasn’t this (hitting my goal) happened for me yet? Do I really want it as badly as I want to want it?

The Most Debilitating Condition

2010-05-08T21:42:00.003-04:00

I think the most debilitating condition we can have is the one we speak over ourselves when we make excuses, say we can’t do something, and then turn that illusion into our reality

As I stated previously, I blamed my eating and my weight on my past and then the situations and people currently around me. And let’s not forget about my thyroid, it is underactive you know. But while my thyroid was definitely underactive, my imagination was not. I could conjure up all sorts of illusions and excuses for myself.

And I love how I just wrote that in past tense as though I’m reformed.

Let’s face it: we all have these grand schemes and illusions that we’ve created in our heads that help us explain away the reasons we are the way we are and do the things we do. They seemingly protect us until someone or something comes along and shatters our illusions by introducing reality in the form of a test result or, in my case, my circle getting smaller and smaller and me still having the same problems.

But the good news is this: since we’ve created this place in our heads to begin with, it is within our power to create a new and better place if we so choose.

I'm not gloating or anything but.....

2010-04-06T09:23:00.002-04:00

http://www.eurekalert.org/pub_releases/2010-04/epr-eef040210.php

It's a tough job being right but SOMEONE has to do it. Lol

Exactly what we have been telling patients for years. Realize it actually doesn't HAVE to be eggs but any protein rich food that alters gastric emptying enough and controls blood sugar. Have left-over pork loin in the morning if you want, or left-over baked fish. Just GET the high quality proteins in.

I'm sorry....but is it me???

2010-03-15T19:07:00.002-04:00

A few weeks ago I had a ‘not so great’ week with food. When asked why I hadn’t done well, I had many reasons….most of them started with someone else’s name as though my actions are controlled by someone other than me.

BUT

I can’t keep making excuses and blaming other people; I need to take responsibility for my own actions. I can’t keep saying, oh it’s because I was going out, it’s because I’m feeling smothered , I’m feeling bothered by this, I’m feeling stressed about that……it’s not about those things; it’s about me….it’s about the way I handle things and process my world.

I feel like I started with this large circle—okay, it’s my past….the trauma from my childhood is my problem. And so I work on resolving those issues as best I can. They’re never completely gone, they’re always droning on in the background as new things come to light but it seems as though I’m getting a better understanding of it.

And so I go……, wow, glad that’s done!
But then……Why do I still feel and behave this way?
OH, it must be my...."fill in the blank".

So I work on that and shrink down that circle.

But the feelings still stay.

And then the circle gets smaller and smaller until it’s my household. Yes! It’s definitely the person I live with…… he’s my problem.

This continues until it’s only me standing there alone in the spotlight with the same problems and un-coping behaviors. Do the math; I am the common denominator here. My thinking and my behaviors are causing my problems.

So if it’s not other people I need to change, what does that mean?
Oh, this can’t be good……….
There is only one person I can change—wanna guess who that is.

Obstacle Mentality

2010-03-05T14:49:00.001-05:00

“Past behavior is the most reliable predictor of future behavior.”
Too Soon Old, Too Late Smart by Gordon Livingston, MD

That quote scared the heebie-jeebies out of me because, though I can usually lose weight, I have a much more difficult time sustaining the weight loss. Before working with Dr. K and Matt, I had never lost weight and kept it off for any length of time. And truth be told, in the past year I have regained some of my weight. After reading that quote, I thought I was doomed to failure and a continuing roller coaster ride. It seemed to both explain and excuse my behavior.

That was my obstacle mentality speaking: you know that part of me that looks for obstacles and excuses.

Then I was reminded of all challenges met and victories won in these past three years. No, I have not done this perfectly but I have learned to put down my pride (which weighs a lot) and ask for help and I have learned to interact more honestly.

So I’ve decided that if past behavior is the most reliable predictor of future behavior: I’m going to face and conquer obstacles. I’m going to charge ahead, fall down, get back up, act courageously, whine like a baby, stop worrying, freak out, worry about the fact that I’m not worrying, learn, and grow.

Exercise vs. Lifestyle Changes

2010-02-10T07:34:00.003-05:00

You know all those things our parents told us that we may not have listened to in our youth but then all of a sudden you have an eureka moment and think: oh, now I get it! and maybe my parents weren’t so lame and ‘out of it’ as I had always assumed they were.

Well, I’ve had a moment or two of this lately, not with regards to my parents but to some wisdom and insights shared with me by Dr. K. and Matt. Not that I have ever considered them lame or ‘out of it’ but I do feel as though I have been in a bit of a prolonged adolescent phase as of late.

Quite a while back, Dr. K. and Matt had suggested that I incorporate more activity into my lifestyle. I didn’t understand what this meant because I love going to the gym. I like going early in the morning and then going about my day. So really what is the big deal about doing it my way?!

Now I get it. It’s easy to stop exercising when you get discouraged but it’s much harder to stop living and doing the things that have now become part of your life….for me that is yoga and hiking. And now doing the things I love has become more difficult.

Hauling my extra weight up Mt. Toby is not fun. And I love Toby. When I was at my lowest weight I would carry my daypack with food, water, books, and my journal and spend the whole day exploring her trails. Now I find myself packing lighter because I’m already carrying a bit extra on my hips and thighs. In Yoga—trying to hoist my backside up into a bridge pose and hold for 5 breaths feels like I’m actually trying to hoist and hold a bridge. This may sound amusing but certainly doesn’t feel that way.

Dr. K and Matt were right. It’s easy to avoid the gym and even the scale but giving up the things in my life that bring me peace and happiness is a whole different matter. So again I stand in awe and repentance—awe at their expertise and caring attitudes about all aspects of my life and repentance for not heeding their warnings sooner.

Motion vs. Progress

2010-02-03T21:29:00.002-05:00

“Never confuse motion with progress.”

I read this quote the other day and thought, damn!, so when was the last time I actually had some measurable progress here. And right there I understood the difference. Motion alone can keep you turning in circles, no closer to your goals. Progress is measurable by some standard.

We get busy, run here and there. Sometimes for me the motion/busyness is only in my head as my mind races. But moving one pile from here to there without getting more organized or any actual work done is not progress. Gaining and losing the same 10+ lbs. is not progress. As well, moving my behaviors from one bad ‘habit’ or ‘coping’ mechanism to another is not progress.

Progress is measurable by some standard.
Yes, I know I just repeated that line but I’m trying to burn it to memory.

Old Habits

2010-01-18T21:54:00.004-05:00

The old adage—“old habits die hard”—is an understatement. I’m not sure they ever die; I think they just take up residence in other areas of our lives or lay dormant but always ready to be reborn at a moments notice.

Old habits are, afterall, born out of necessity of the moment and bring with them some type of comfort, or at least distraction from the problem at hand. Without some sort of benefit, they wouldn’t have become habitual; they would have been laughed off the table at first glance. But instead the distraction and momentary comfort they bring help lessen whatever it is that is presenting itself at the moment.

The underlying factors that made me what to run and hide to begin with are no longer present but the behaviors that I once used in stressful situations are so ingrained that I still find myself turning to them without thinking. At one time, I would gain back all of my weight before I even had a cognitive moment. By then, the retracing of the lines back to where my undoing began would seem unattainable and so why try. It didn’t really matter anyway….or so I’d tell myself.

I still have trouble recognizing these behaviors until a consequence hits and then I will begin to realize that I have fallen into old habits of 'coping'. This is discouraging but even in this I can see growth because the old behaviors no longer bring any type of lasting comfort; the consequences of poor choices now more quickly outweigh any short-lived benefit. But still, in all honestly, I find myself taking the detour more days than I’d like to admit to.

Learning to say no....

2009-12-09T11:28:00.005-05:00

During this crazy time of year, the whole world seems to go manic. It's rush, rush, rush with no time to stop, plan, and make the decisions that will ultimately keep me on the right path. I don't want to wake up on December 26th in further debt and unable to fit into the clothes in my closet. So I am learning to say no: NO to gift exchanges with co-workers and acquaintances. NO to holiday parties. NO to overspending and overextending myself.

Well, it's December 9th and so far I've been invited to three Christmas parties and 2 Holiday Gatherings. I'm not sure what the difference between the two is but I can tell you, definitively, what the similarities will be: parties that start in the evening and often go on 'til the wee hours of the morning with food and drink in abundance. As the gatherings will start late in the day, temptations will be harder to fight off and getting up the next day at a reasonable hour will be difficult. Saying no can be incredibly difficult but I've had to really give thought to what is important to me personally and to my family and then decide which gatherings are necessary , which people I can postpone getting together with until after the holiday rush, and what I can let go of altogether.

So it's been awhile

2009-12-01T14:19:00.003-05:00

Think I may have almost forgotten my password to log in....But Beth was and is doing such an insightful job of helping us with this Blog......I though better to leave well enough alone.

I just had my 25th High school reunion. I was expecting a typical breakdown of present weight and fitness levels across the board. I was pleasantly amazed by what I found and it started me thinking. The Wilbraham class of 1984 was remarkably fit in comparison to the overall general populations. A few disclaimers are in order: 1) Of those that showed up. People that feel good about themselves generally are more apt to put themselves in new and uncomfortable situations. 2) Demographically.....Wilbrham and Hampden Ma are the example of middle class suburban life.

Still, even with these two disclaimers, why is it that this class/group of people are generally more fit then a societal cross section?

I haven't given it much thought other then to question it. But I WILL review what we know factors into obesity. Maybe, if I link this blog to my face book, I will be able to get some classmates to respond and see how they fair against these factors.

Demographics: As we said above.....it plays a factor. If a budget is middle class or higher, typically better food choices are made at the grocery store. Meals typically are well rounded as well...Protein, Carb and a vegetable or two. Many other factors keep referring back to this one.

Family Time: One of the biggest factors to ameliorate childhood obesity is to sit and eat dinner as a family. Also family's that stay active TOGETHER rely on food less for comfort.

Sleep: Studies show that sleep helps with overall health, reducing inflammation and optimal weight.

Stress: Reduced stress, or if not reduced, a coping mechanism that allows for a more balanced stress levels has been shown to reduce stress hormones and markers as well as maintain optimum weight.

Family status: 2 Parent households. Interestingly we find that more of our patient population comes from a single parent family or divorced family. Relationship?

Attitude: Call it what you will: Spiritual, attitude, self worth....how someone thinks about themselves changes how even the SAME variables affect 2 different people.

These are just a sample of what we see in the practice on a daily basis related to factors of obesity. Maybe we can get some comments as to how many are or are not factors for this class of '84.

Finding Balance

2009-08-22T11:58:00.002-04:00

Maybe it’s a personality flaw, maybe it’s a discipline issue….but it’s definitely something I need to address and work on. I tend to become ‘slightly’ obsessed with a new course of action, a new hobby, or a new routine and then go into overkill. If it’s a new hobby, I’ll try to acquire the latest gizmos and gadgets that go along with it. If it’s a new exercise routine, I tend to want to incorporate it into what I already do and then do it as much as physically possible, most of time to the detriment of other things. Now there are just so many hours in each day and so many days in each week. And I have a family and friends that need me too. And let’s not forget the job that I must go to in order to be able to do any of these other things. So how do I find a way to balance all of this?

If you were looking for another paragraph on how to accomplish this, I’m sorry to disappoint. The bad news is that I don’t have it all figured out. The good news is that I’m willing to learn and grow and that I’m not giving up. Any suggestions?

Confusion in Aisle Three

2009-08-20T17:27:00.002-04:00

Some time ago my husband was reading an article where a school system was considering stopping the use of ‘F’ as a grade for failure because they didn’t want to hurt the students’ self-esteem. They had decided that using the letter ‘E’ for deferred success would be less harmful to the ego. At the time I thought, where will all this nonsense end? This week I realized that there is not an end in sight.

I have always hated clothes shopping. For many years, I would head to the plus size store and then to the biggest size available and hold my breath and hoped something would fit. Color and style didn’t matter much; it just had to cover where it was meant to cover.

The other day I went clothes shopping and the fog of confusion rolled in. No longer were jeans marked in sizes 14, 16, 18, 20, etc. Now they were marked with sizes 1-8. I have to admit that I hated, in the past, when I had to buy size 28 but asking for a size 1 or 2 seems ridiculous. Where is the truth in labeling!

So what this means: one of my good friends who wears a size 13 is now officially (according to the tags in our jeans) a much larger size than I am because I am now a size 1 (or 2 on a fat day). I found humor in this fact. Her? Not so much. Now if only they would resize woman’s shoes. I hate wearing a size 11.

QED- the 80/20 rule revisited and proved again.....

2009-08-02T12:54:00.002-04:00

Back in February I wrote about the 80/20 rule, reminding myself that successful weight loss depends 80% on the food I eat and only 20% on exercise. This simple math problem points out that inactivity (though not a wise choice) is no excuse for weight gain and more importantly, that preplanning my meals (and then sticking to my plan) is crucial to achieve success on this journey.

But of course, as usual, I test and retest every theory that comes my way….even the ones I believe wholeheartedly in because I have witnessed firsthand their results.

I have not been inactive these past few months by anyone’s standards. As a matter of fact, I have incorporated even more variety into my exercise routine but yet I have watched the numbers on the scale either stand still or climb at a slow, steady pace because I had stopped doing the simple little things that I know work such as counting calories and refraining from eating at night.

I wish the 80/20 rule was the other way around because, quite frankly, I enjoy exercising and its effects on my brain and body. Life would be so much simpler for me if exercise counted for the 80% of my success but that is the wishy, whiny side of my emotions speaking—you know that side that has trouble accepting the truth even when it has been proven out many times before. The math problem is simple. The equation is accurate. The acceptance and application on a consistent basis seems to be the most difficult part—but difficult doesn’t mean impossible, does it?

My Dis-Ease

2009-07-08T22:32:00.004-04:00

Cyclical living:

I stopped drinking over 20 years ago thinking that maybe I had a problem with alcohol. I didn’t drink often but when I drank it was often to excess. So I labeled it an addiction and put it to bed. Problems solved or so I thought even as my eating and weight went out of control.

Years later, I decided to abstain from eating sugar and carbs thinking that maybe that was my problem. For a time, I was even an unofficial member of a group that met weekly, had a VERY specific food plan, and a sponsor you had to report to. I dropped 50 lbs. and thought—yes, I’ve done it—figured out my problem—addiction to sugar. And for ten months it worked and I was able to be ‘good’ with regards to my eating but went nuts with shopping and spending. Eventually I started eating sugar again and then spiraled downward and gained all my weight back. So there I sat, bigger than ever and now in more debt. I felt like a failure all around.

I couldn’t understand why I couldn’t pull all the areas of my life together at the same time. Each time I tried something new, I had a period of great success followed by a time of even greater failure. And each failure left me worse off with regards to my weight, debt, and self esteem. There was never a time of rest or peace or contentment even during the times of short-lived success with each attempt. There seemed to always be the pull and drag of something I couldn’t quite see or understand.

Treating the Symptoms:
So what was my problem back then?

I believe it was a misdiagnosis as I was only treating the symptom thinking that it was the disease. I realize now that there was no disease just a dis-ease caused by my inability to cope with things in my past. Some of these were big issues which rightfully twisted my sense of self esteem (my self worth, trust in self and others, and personality) and produced thought processes and coping mechanisms which then made their way to behaviors which created symptoms and a pattern of cyclical living.

Here’s what it looked like—the initial incident—how I processed it—questioning and doubting self—initial onset of new coping mechanisms to protect against future incidents (dull out, hide out, eventually using food and my ever growing body to cover my feelings and protect myself) knowing that I could never truly trust anyone to take care of me so I took care of myself all the while looking selfless to the outside world because all of my eating and spending was done in private. These behaviors created symptoms, the most obvious being—obesity. Now that seems odd—obesity as a symptom and not the diagnosis; but that is exactly what it is. I did not get to this size or this state of being because of a great love affair with food; it was other issues that brought me here.

Once I realized and accepted that my weight was just an outward manifestation of an inward problem, the real work could begin. And trust me…..this is real work.

Melting an iceberg with a blow dryer:

A while back, I tried to explain this all to a friend this way:
In order to understand how I got here, I had to backtrack and learn and understand some initial things about myself. I explained that my weight is not my real problem. It is just a symptom of a bigger issue that lies under the surface unseen… much like an iceberg. Very little of the iceberg is visible above the surface of the water even though to look at it, you would assume that this massive mountain of ice must be the monster in need of conquering. But when you dive in and start to examine what it is you are looking at, you discover another massive mountain of ice, attached, inverted, and unseen with a depth, width, and height that make the visible mountain of ice seem minuscule. When I came to recognize and accept that my weight was not my real issue, it came as a relief because this explained it all….all those years of struggling privately, not understanding why I felt the way I did…..weighted, pulled down one moment and buoyant the next. Now it was becoming clear to me and the work could begin.

In the past, I would only attack the surface problem but now as I am working on the weight I am also working just as diligently on the underlying problem that made me want to run and hide behind the weight to begin with. I feel that by working this problem from both ends it is definitely more productive and that it has and will continue to produce life changing results.

Then and Now:

And is it really any different now? Yes and no.
Yeah, I know…big help but don’t give up.

The beginning of healing came when it was pointed out to me that I was not okay and that I might, in fact, need outside help. Isn’t it funny that I needed an outside source to pointedly tell me something that should have been obvious. I had an understanding of what and where things had gone wrong in my thinking but had never cognitively done the work to recognize and remove the ‘hook’ that the original trauma had in my mind.

I had feared that the original pain was too great to withstand so I continued to avoid it even when the consequence of avoidance was greater than the original pain I was trying to avoid. I read a great line in a book: Healing hurts. But hurting heals. And the healing process does hurt but, in the long run, it’s less painful than running repeatedly into the same wall. I understand now why I created the original thought processes and coping mechanisms but I also understand that they are no longer needed and that I can and will get through whatever presents itself. And all of this does get less difficult with time.

Once I began to examine where things went off track and came to recognize and understand how my mind works, I began to appreciate and even enjoy how it is my thoughts come about. And instead of letting them ‘hook’ me and take me for a ride into coping mechanisms and behaviors, I learned that I can let these same thoughts just float by like a cloud without attaching myself to them—they’re just thoughts and the choice to make them into a behavior is mine. I love this quote from Victor Frankl:

“Between stimulus and response, there is a space.
In that space is our power to choose our response.
In our response lie our growth and our freedom."

Sometimes I remember what I just wrote and even laugh out loud as my ‘old’ thought patterns try to steer me to the rut I once walked in daily. Other times I follow along like a well-trained puppy until an old symptom reappears and I start to feel lousy and recognize that I have again fallen into a pattern of cyclical behavior. But the good news is that I so enjoy ‘good’ living now that the old patterns that once brought me comfort now bring me to discomfort very quickly.

Pro-Action vs. Re-Action

2009-05-19T18:44:00.002-04:00

I am learning to recognize some of my triggers--you know those people or situations or even verbage that set me off and cause me to lose my focus. The list is long so I won't bore you with all the details but suffice to say that I now recognize that I allow some people and/or situations to cause me to either shut down, dig my heals in, or completely rebel. These reactions are usually silent and the wounds self inflicted as I don't generally react outwardly towards other people. Instead I shut down and try to 'numb' out with food when strong emotions present themselves, especially anger.

(Now I will stop here and claim full responsibility for my own actions and reactions in all situations. I understand that no one can cause me to behave a certain way.)

But by learning to recognize some of these triggers, I have been able to plan in advance for success. At times it’s as easy as preplanning my menu and having a game plan before I go somewhere that has been a problem in the past. Having a meal plan and set times I eat throughout the day at work is one of the things that has helped me stave off eating during times of boredom or stress during the workday. The fact that we no longer have TV in our home has helped me not to zone out and eat mindlessly at night. Letting someone, be it a friend or coworker, know when I am having an off day and getting some emotional support has helped lately as well.

Life isn't always organized and doesn't always give warning signs but understanding what it is that pushes my buttons and recognizing the warning signs and triggers before I react can sometimes slow down or even stop the behavior I am trying to unlearn. I know that I will never manage this or any part of my life to perfection so remembering to cut myself some slack when I slip up is as important as trying to learn new ways to interact with my feelings....sometimes I need to remember to be just as kind and gentle with myself as I would be with someone else who is struggling.

Inertia

2009-05-03T08:10:00.002-04:00

The Principle of Inertia: (when applied to physics)
the tendency of a body to resist acceleration; the tendency of a body to continue moving in a straight line at its current speed and in its current direction unless acted on by an outside force

The outside force that started my journey two years ago was—desperation, discomfort, and fear as my weight went out of control and hit an all-time high. Once I began the process of change and started applying all I was learning from Dr. K and Matt, the momentum really took on a life of its own. This is not to say it was easy but it definitely seemed more doable. The greater the momentum, the easier it was to stay in that straight line.

Now that I have wavered a bit, it seems much more difficult to restart the process. You would think that it would be easier but that is not the case. Logic would tell you that it should be easier because I already know how to count calories, exercise, and interact more honestly with other people and my own emotions. Logic would tell you…..’Just do what you did and you will get the same result that you got.’ But here’s the thing: I had made a decision to stop forward motion and live status quo for a time. It may not have been an outward decision but honestly I got comfortable and started to REALLY enjoy life ‘knowing’ that I could pick up where I left off and get going again ‘tomorrow’. However once I stopped the forward motion by accepting complacency, I lost momentum and the struggle to regain it seems harder than the original struggle to attain it. Why?......
because the desperation that ignited the process to begin with has been replaced by a comfort level that was brought on by the changes in the way I look and feel.

Does this mean that I have to get to a point of despair in order to jump start this process all over again? Well, no, but then what outside force will help me restart before I reach that place again? These were my questions to Matt and this was his reply:

In the past, you had no idea of what you could accomplish but now you are aware of the possibilities. Why not take that knowledge and, instead of waiting to run from something negative, prepare to move towards something positive. Make a plan, set a date and a goal, move, prepare and pack for that new adventure—keeping your eye on the prize instead of focusing on the past.

Words are Powerful

2009-04-25T15:38:00.003-04:00

Our words contain the power to build or to destroy. If you're a parent, you have seen what words and even tone can do to your child. But what about the words we speak to ourselves. We sometimes speak to ourselves in harsh tones and accusations that we would never speak out loud to another human being. And once spoken or even thought a plan of action is put into place as our bodies follow the pathway of our minds.

When my kids were younger, I would play these songs for them about taking care of their bodies and their minds. One of the songs was titled GIGO which is a computer term that stands for "Garbage In, Garbage Out." It means that if invalid or corrupted data is entered into a program, the resulting output will also be invalid and corrupted. And this is much the same way our brains work.

A while back during a time of struggling, I would get on the scale and the numbers were going up from the week to week. I was so disappointed and angry with myself that I thought....“Just great! How much longer are you going to continue on this way? Exactly how much weight are you planning on gaining?” And then, I actually sarcastically answered myself naming a number that I was sure to reach if I kept up my current behavior. Most of the time, I wouldn't admit to such crazy behavior as talking to myself but I know I'm not alone here. And wouldn't you know it; my body followed my mind and reached the weight gain 'goal' I had spoken. I shouldn't have been surprised. Now I am playing a different 'name game' with myself and naming what successes I plan on reaching each week.

We don’t have to travel alone….

2009-04-19T18:25:00.002-04:00

Just when I 'feel' like throwing in the towel once again, I ran into someone else who was struggling on their journey. And I recognized it immediately......her mannerisms mirroring my own as we politely asked each other how we are doing; but then can’t quite meet each other's eyes as we answer with the usual, polite lie...I'm doing okay, and you? When we took a moment to really connect and we were both honest, we admitted that neither of us is doing so well, but of course, we 'feel' embarrassed and alone in our rut.

The truth is that each of us will have hills and valleys on this journey. Without one, would we recognize or appreciate the other. And no matter which place we're standing in today, we are not alone unless we make the choice to be and even then we're not truly alone just blind to the fact that others are struggling right beside us. It was helpful to recognize that someone else feels the same as I do and it somehow seemed to lighten my own load for a moment as I came alongside to help and encourage another on her journey.

After talking with her, I remembered a quote by Mark Twain, “to get the full value of joy, you must have somebody to divide it with”. Maybe, in reverse, this principle applies to sorrow and struggling as well. When you share your burden and help someone else carry theirs, yours will somehow seem to lighten in the process.

Victim vs. Victorious Living

2009-04-09T21:00:00.002-04:00

I believe that we all have things we have to deal with—childhood trauma, our own shortcomings, or perhaps a diagnosis of some sort. Some have more problems than others, some real and some imagined, but it is how we choose to deal or not deal with those shortcomings that determines our quality of life, and to some extent, the quality of life of those around us. I say ‘to some extent’ because we all have a choice as to how we will react to others and how much we will let their lives affect our own.

There are some who will try to educate others regarding their diagnosis, their weaknesses, their childhood, or their problems and expect the world to bend and form to them and their needs. And then there are others who will educate themselves and then quietly find, examine, and then grow their strengths.

This, I believe, is the difference between victim living and victorious living. Am I going to empower my weaknesses or my strengths? I will always possess attributes in both camps but the camp that I spend more time in will be the one that grows and matures. You cannot be both a victim and victorious. You have to make a choice and then move towards that goal. This is not to minimize anyone’s pain and this doesn’t mean that you won’t have bad days when you feel like curling up in a ball in the corner. This doesn’t make it an easy task but it is a necessary task if you want to move out from your own center and gain victory on whatever it is that has a hold on you.

Sometimes we have been in the role of victim so long that it seems that we no longer have the self confidence needed to reach the finish line. But you don’t need the self confidence or the perseverance to reach the finish line today….you only need the desire and courage to get out of bed and take one small step….and then another.

Andrew Ryan (BioShock) reminds us that……
We all make our own choices, but in the end our choices make us.

Finding the Way Back Again...

2009-02-28T20:06:00.003-05:00

As I was hiking this morning it dawned on me how quickly and easily I tend to lose my way. I love going off on ‘rabbit trails’ and exploring but I always mark my path so that I will recognize it when I come back through. These markings are the breadcrumb trail I leave so I can find my way back.

I tend to get turned around pretty easily on this other journey I am on as well. I hate to call it a weight loss journey because it is about so much more than my weight given that I believe that everything about me is intertwined and connected and I cannot distinguish where one ends and another begins. I have left a breadcrumb trail here as well through my journal writings. At times this can help me to reconnect with the things that were working for me before I wandered off course. Truthfully, the only way I can get out what is bothering me is to write.

Though I am normally a private person, sometimes the only way I’m able to share what is troubling me is to write it out and give it to someone I trust. And trust doesn’t come easily. The writing and examining can be difficult but the trusting and sharing are actually painful…..painful but necessary at times.

This past week as I was struggling, I handed a note to a friend. His reply back to me was only a few lines but contained a powerful truth that I had forgotten. He reminded me that nothing has changed and that I have the ability to succeed. Just that word….ability….helped to remind me of something I had forgotten—I do have the ability to stay the course. He also reminded me that reaching out and asking for help is not a sign of weakness but of strength and wisdom….reminding me once again that I don’t have to do this alone.

Here I go again...

2009-02-21T21:41:00.005-05:00

February has not been a banner month for me. I know that most people start out the 'New Year' all gung-ho with their resolutions but I’m not sure that I have actually shown up yet this year. I am enjoying playing in the snow and winter hiking but I really haven’t come back into full swing with consistently counting my calories and pre-journaling my food plan. This inconsistency is hindering my weight loss and wreaking havoc on my emotions.

I know the 80/20 rule but, unless I apply it on a consistent basis, knowing it won’t change a thing. So here I go again.

80/20 Rule

2009-02-01T23:24:00.003-05:00

I tend to have an all or nothing mentality. Last Friday I had a small procedure done and was told that I had to refrain from all exercise for two weeks. TWO WEEKS! Now two years ago that would not have been a problem but now I not only enjoy working out, I tend to use it as a stress release. I even went down the list with doctor to discern exactly what she considered exercise to see if there was some loophole to her instructions. There were none.

It doesn’t really take much for me to allow even a small diversion to sidetrack me. But I really don’t want to keep traveling down the same road every time life gets a little bumpy.

So I reminded myself that this is no excuse for me to gain weight. Inactivity should not make me gain weight because the 80/20 rule applies here. My success depends 80% on the food I eat and only 20% on exercise. This simple math problem reminded me that it is not all or nothing unless I make it so. The choice is mine.

An old lesson relearned

2009-01-24T14:07:00.003-05:00

This morning I was taking inventory of how I have been doing as of late and I realized what my problem is. I started out confused by the fact that I haven’t lost all my holiday weight. So I decided to really stop and think about what I could possibly be doing wrong.

Emotionally: I think I am doing well in this area. For the most part, the old messages that used to play in my head have been replaced with a more constructive dialogue. And I have made and am continuing to make strides in my interpersonal interactions. I am still on a bit of a learning curve some days but, in general, things have been moving along in these areas.

Spiritually: I am a work in progress but I am always in communication and learning and growing and wrestling (Jacob has nothing on me except that he was a quicker study than I am).

Physically: I am having a blast playing in the snow on the weekends so I am getting my fresh air, sunshine, and outside activity which is something I always lacked in the past. This has been helpful at keeping the winter blues at bay which is great. I am still going to the gym regularly, but truth be told, my workouts have gotten somewhat sluggish and boring….so an adjustment is needed there.

Then the last thing I got to thinking about this morning was…..then what the heck am I doing wrong. What am I missing that I had been doing previously? Oh, now I remember….food. When I first began and up until last July, I was diligently preplanning my menu and counting my calories. How could I have forgotten such a basic component of the equation? It amazes me how fast and furious some things leak out of my brain if not put into regular practice.

Solution: I pulled out my old food journal and preplanned my day. This made me realize how many extra calories I was consuming without thinking as I go about my day. I haven’t been binging or eating huge meals but just picking a little here and there but that was really adding up.

I refuse to beat myself up over this because I see it as progress that I was able to stop and reevaluate where I am at and then make the adjustment to move forward.

Need vs. Want

2009-01-04T21:42:00.004-05:00

So I am on the road again, this time staying at the house of my son’s future in-laws in Georgia. It’s all true…the things we hear about Southern hospitality…. great family, great culture down here in the South…the people are friendly and inviting, the pace is calm and relaxing, and the food is home-cooked, delicious, and plentiful. There is not a want or need that is not met when you are visiting in the South.

Last night I wanted a piece of red velvet cake…I didn’t need it but I wanted it.
This morning I needed to jog. My body craved movement and the outdoors. My mind needed quiet and solitude and to watch the sky change colors as the sun came across the horizon. This was more than just a physical need, it was spiritual as well.

I wanted to give in to all the excuses that my mind was providing as a way out of doing what I truly needed. ‘You don’t know your way around this town. What about dogs…I hate running into strange dogs when I’m out jogging. And then there always is the fear of stranger danger’. What if…that is the mantra that plays in my mind when my wants and needs collide.

I used to think that my needs and my wants would eventually align perfectly and then all would be right with my world. I would become that person that I so admire…courageous and free. But I don’t think that’s how it works. There are moments and even days that the voice of my want speaks loudly and with such a sense of urgency that it feels that the only way to quiet it is to let it have its way. But then I will have a morning like today when I listen and do what is truly needed, not giving into my wants or fears and I realize that I do possess the ability to make good choices regardless of my situation.

Now I understand that this does not mean that I have it all together because even as I sit here and type this—the voice of want is reminding me that there is another piece of that cake and it is calling my name as the voice of my need is quietly reminding me that my food plan has Greek yogurt on it this morning not red velvet cake.

Quality of Life

2008-12-17T21:33:00.007-05:00

I have a seventeen year old who is generally a great student. This year he fell a little behind in his schoolwork and it prompted me to remind him who is ultimately in control of the quality of his life….to a certain extent, he is. I told him that the choices he makes now will determine, at least in part, his future—what college he will attend and how much money he will get in scholarships. I told him that I want him to enjoy life now and to succeed in the future but the choice is his. I can provide the atmosphere, supplies, and guidance he needs but the work has to be done by him.

I also have a 94 year old grandmother, who as of late, has been choosing to have others push her in a wheelchair instead of walking. I will say that she does get tired out easily but her legs are perfectly capable of carrying her to and from the places she needs to go. I took her aside the other day and gave her ‘the talk’…..reminding her that even at 94 years old the quality of her life would be determined by the choices she makes. If she chooses not to walk and loses more muscle tone eventually she may be unable to walk altogether.

So as I am talking about all this the other day, I realized that maybe I needed the same talk because the quality of my life is determined by my choices. I can whine about my crazy over-extended schedule, menopause, past abuse, and my metabolism but ultimately I am the one in charge now. These things may be part of the equation but they are not the deciding factors of whether I succeed or fail.

It was interesting and enlightening to stop and listen and realize that what I was saying to someone else applies to my own life and will continue to apply at whatever age or juncture I find myself.

I know that when I am looking for an excuse…anything will suffice but when I am looking for victory—nothing will stand in my way. Last year when I sprained my rotator cuff and was having a pity party, Matt kindly reminded me that there was nothing wrong with my legs and that I needed to stop whining and get moving. And just this week Dr. K. asked me how I was doing with my toe which has recently been diagnosed with arthritis. I told him, it is what it is but I will not let it stop me from becoming what I want to be.

On the road again.....

2008-12-07T20:58:00.003-05:00

This summer and fall I have traveled a lot more than usual. First I went camping for two weeks and even though I jogged, chopped wood, and hiked I still managed to gain about 12 lbs during my vacation. But I came home and went back to work and took it off within two weeks.

Then came the big vacation….our cruise to celebrate our 25^th anniversary. The instructions from Dr. K and Matt were simple. Have fun. Jog at least three times during the week. And buy an outfit two sizes too small while in Bermuda and that will be your winter goal. We set sail on Sunday and by Thursday when we went shopping on the island, all the clothes we had come onboard with were two sizes too small so I certainly did not feel like clothes shopping. This is not particularly funny but true. But again I came home and got back to work and took off the weight I had gained.

By the time I had regrouped and was back to my pre-cruise weight, my son sent me to Georgia to meet his new future in-laws and I again repeated this same travel pattern….weight gain and then back to work and losing it.

And then last week we drove to Kentucky to welcome our son home from Iraq and to spend Thanksgiving with him and his fiancée. . Yippee! It was awesome and oh so good to see him back in the USA.

But, I again gained the same 12 or so lbs. Now don’t get me wrong I am not whining here. But I did mention to Matt the other day that I have not done so well on my eating and exercising while traveling thus far. His response to me was, ‘You have not chosen to do well while traveling.....’ And he’s right. I know that I will take the weight off but then……

My son is getting married on New Year’s Eve in Georgia….another yippee! I am very excited for him and my new daughter-in-law. But frankly I am getting sick of gaining and losing the same 12-15 lbs. By this time, if you add up all the times I have lost these pounds, I could have been at my goal weight. I don’t plan on stressing about this but I do plan on ‘choosing to do well’ during the next leg of my journey.

I’ll keep you posted.

Acceptance: A hard pill to swallow

2008-11-23T12:51:00.009-05:00

Many years ago I lost a significant amount of weight and actually got down to about 208lbs. but I couldn’t enjoy it. I kept thinking…I need to lose 50 more lbs. and then I will start making plans and enjoying life……

I never did lose those 50 lbs. I gained back everything I had lost and then some before I could even enjoy one drop of happiness. It would be 13 more years before I would even try again. I could never fully understand why I couldn’t enjoy the success I was having and why it all went away so quickly. But now I think I am beginning to get it.

Acceptance:

Not once during that time did I accept that this was more than just a weight issue and so I just tried to eat right and exercise. While these things are essential they are not the whole equation. There were feelings that were emerging as my body was changing but I never accepted and dealt with them.

And equally important, not once during that time did I pick my head up, look around, and accept and enjoy where I was on the journey. I just kept thinking that things would feel better for me once I reached goal. I have let so many years pass me by while I was waiting to reach some number on the scale because I didn’t know how to accept where I was on a daily basis.

It’s a balancing act….to love, accept, and enjoy where I am today while still striving towards the goal of tomorrow all the while learning from my past without letting it swallow my future. It’s a lot to take in but still so much less work than running and hiding and striving.

And here’s another thing I’ve learned about acceptance: Learning to accept where I am is also helping me to have more compassion and acceptance about the journey others are on.

Reality vs. how I 'feel'

2008-11-14T14:40:00.005-05:00

I just came in from the gym and I was thinking about my workouts and how my body is changing. I’ve worked hard for this. The fruits of my labor may never truly be seen because I have such a large amount of loose skin that covers the muscle tone underneath. But that doesn’t change the fact that there is muscle tone and definition there and the flab doesn’t diminish the fact that I have been and still am working hard on this stuff.

This got me thinking about my ‘feelings’ and how having a bad day emotionally doesn’t lessen the amount of progress that I have made in that area of my life as well. I tend to have an all or nothing mentality and think that I am back to square one after a few days of darkness but that is not reality. It is just a shadow dancing on the wall.

This is hard work. I can accept help and guidance. I can seek support. I can surround myself with friends and family that will encourage, motivate, and counsel me but ultimately I am the one who has to work it…….at the gym, on the food front, and from the emotional, historical, and spiritual standpoint. I sometimes wish there was an alternative but, at the end of the day, if it had come to me any other way it would have been overwhelming. Just as it took years of applying layer upon layer to physically and emotionally cover my wounds, the uncovering, discovering, and healing needed to be a process as well.

I once joined this exercise place that had these tables that moved your body for you….okay don’t laugh, but basically I have tried it all. Being passive, standing by, waiting for someone else to direct, motivate, and move me may work for a time but real change requires real courage and real movement (and I’m not talking about the gym here)……movement in the direction of wellness and wholeness. I don’t necessarily think that will look the same for everyone. We all have our own stories to tell as to how we got to the place in which we currently reside and we all have to find the path that will lead us back out. Some of those paths will definitely intersect as there are basic principles for healthy living but just as the details of our stories differ so will the details of our journeys.

Putting together the puzzle:

2008-11-04T07:54:00.004-05:00

This is incredibly hard work. It is so worth the effort but I can’t minimize the amount of effort that it takes to put it all together. I have been at this for over 18 months now and have had my ups and downs. I feel physically and emotionally better than I have ever felt in my life but I know there is still a lot of work to be done in both of these areas.

Sometimes even the successes don’t bring about the victory dance that you would expect as my mind races to keep up with the physical changes. Trying to put this all together…the emotional, physical, historical, and spiritual is much like constructing a puzzle and I have never been a fan of puzzles.

The food plan, the calorie counting, the exercise….all of these behavioral changes are challenging but not nearly as challenging, at this point, as putting the finishing pieces together. This process is like building a puzzle and those ‘outward’ things are the border pieces which if unattached to the rest of the puzzle can break apart easily. The rest of the puzzle….the emotional, the historical, and the spiritual challenges are the center pieces that add the depth, color, and stability to the picture.

For me that is the truly daunting but necessary work that will bring it all together. There are days when it seems like this puzzle is coming together and a clearer picture is emerging. I need to be honest here and say that they are also days when I wonder if all the pieces will ever be found and exactly how and when that will happen and what it will look and feel like. That brings up a whole other lesson that I am being taught through this process…..learning to stay in the moment. But we’ll talk about that another day.

B.

Setting boundaries and resetting friendships.

2008-10-16T21:40:00.004-04:00

When I began this journey, I was met with some resistance from some close friends and prominent people in my life. Some missed the sarcastic ways which I had adopted and used through the years as a defensive tool. Others had a hard time with the lifestyle changes. I heard comments such as, ‘I like my fat friends fat.’, and ‘I feel like the best part of you is gone.’ At the time I couldn’t appreciate the difficulty they were experiencing in letting go of some of the things that had help to bond us together. I now understand the insecurity they must have felt as I let go of these things and was grasping onto a new way of living and looking at life.

This was a quiet, personal journey for me and as I let go of unhealthy thoughts and behaviors, I realized more and more that I needed to set healthy boundaries for myself in all areas including my relationships in order to continue to move forward. In some cases, I had to distance myself from people and situations that were constantly having negative affects on me. I have made an effort to make sure that the people who were/are my support were people who would encourage, challenge, and love me unconditionally as they helped keep me accountable. This is a hard road to climb and going it alone or with people fighting against you makes it all the more difficult.

As I have stated before, this is a journey with no destination in sight. But as I have become more confident and able to understand and express my own needs, I have slowly moved back some of the boundaries that I had needed in the beginning. I have to be honest here and say that not all of the relationships have survived the journey. But the ones that did have grown deeper as we’ve come to love, accept, and appreciate one another on a whole new level.

B.

Take your oxygen first.....a lesson learned.

2008-09-26T00:09:00.006-04:00

It sounds so selfish….take your oxygen first. Prioritize yourself. Look out for number one. But the instruction is very clear—when on an airplane you are instructed in the case of a crash—pull the oxygen mask down and take your oxygen first before attempting to help anyone else. Why? Because if you are gasping for breath, you will be of no help to anyone else.

Let’s face it…life sometimes feels like a plane crash. And that’s how I was feeling a short time ago when life gave me the opportunity to relearn the importance of taking my oxygen first…that is, placing my physical and emotional needs as a priority in my own life in order to be able to continue to help others.

When my 94 year old grandmother broke her hip and needed surgery, I stayed at the hospital to make sure she received the level of care she required. I was eating on the run while making sure her nutritional needs were met. I was making sure her body was being moved so she wouldn’t get bed sores while mine sat in a chair by her side. I made sure she was seen by her doctors while I canceled my own doctor’s appointments. I did all this while trying to be there for my husband and sons and working a full-time job. Until….. I woke up at 4am with muscle spasms in my neck and shoulder and was forced to re-evaluate the situation—my grandmother will be fine. She’s a tough old bird and I can be there for her and still be there for myself as well. I can love, nurture and support my family but not to the exclusion of my own needs.

I kept thinking…I will get back on track with my healthy eating, gym schedule, and taking care of myself as soon as she is…….able to eat on her own,…more mobile, ….settled in at rehab,…..etc. As she met those goals, I was still unable to let go. There will always be a reason, real or imagined, to put yourself on hold but the reasons to prioritize yourself and your needs far outweigh all the other distractions we allow in. Taking care of ourselves physically, emotionally, and spiritually on a daily basis make us available physically and emotionally to take care of our loved ones on a daily basis. That should be reason enough for us to take our oxygen first.

Changing Your Mind

2008-09-19T07:28:00.007-04:00

I was once told by a wise teacher that if you change your mind your body will follow. At the time I thought…’great bumper sticker’ and then dismissed it. Ah, but now I appreciate the wisdom of that philosophy but I also understand that it doesn’t stop there.

Although creating a new mind set is the first step to real change, it needs to be followed closely with discipline and consistency. Just as it took time to develop those things that you are trying to unlearn; it will take time to set into a pattern the new behaviors you are trying to incorporate into your life. Discipline and consistency will encourage you along the way with the periods of success that you will need to recall during times of set backs…which happen to all of us….be it getting back on track after a vacation or those times when life just has its way with you.

Old behaviors have a habit of resurfacing as you find yourself in new situations where you haven’t yet had the opportunity to try out your new coping techniques. It’s a tender thing the way we are drawn to the old responses that never worked well in the past but yet we automatically try to remold and reapply this same cast again and again in seemingly new situations hoping for a different result. As the periods of success become longer through consistently applying discipline, the times of reverting back to old behaviors will shorten because you will recognize that the old ways of coping no longer bring about the desired effect they once had in light of your newfound awareness.

Of one thing you can be sure. The one goal you will not arrive at, no matter how diligent the effort, is perfection. This is and will always remain a journey. Trust me on this! I sometimes make the mistake of thinking I have arrived only to find out I am standing at yet another departure gate.

AND TO ADD TO THAT THOUGHT...

One of the things I see in the clinic, and in my own life, is that changing the body is EASY compared to changing the mind. Unfortunately, we are the sum total of all events leading up to now... we take with us all our pre-conceived notions and baggage into every new situation. Often we hope that our experience will help us...but if the experience is a NEW experience, it is not likely to happen that way. Worse yet, if our knowledge is jaded, out-dated, or downright incorrect, then we will battle with what we know, what we feel and what we believe. Ultimately, facts rise to the top and feelings may not always follow...which creates conflict. In the end we have to have the FAITH in our FACTS so that our FEELINGS will follow...
And if God cares so wonderfully for flowers that are here today and gone tomorrow, won't he more surely care for you? You (and I) have so little faith!

Dr K.

Expectations and Reality

2008-09-18T09:39:00.008-04:00

I was excited to hear that Beth was going to start assisting with our blog. Just to let all of you know, Beth has been inspirational to us at the practice as well.

She has taught us that there are expectation and there is reality in everything. Often in our lives these two powerful entities do not line up. And when they do not line up we have days filled with frustration and dark nights of the soul. It has been said that all frustration is birthed out of unmet expectations...and I can agree with that whole-heartedly.

Beth, among other patients, have shown us that there is a great deal of emotional and spiritual work that needs to be done internally before results can occur externally. I look forward to hearing more insight from Beth as we go forward. I personally know the intense and powerful journey that she has made internally...and it has had marvelous internal (and external) results.

I would like to suggest that this balance of internal and external is difficult to achieve and does require discipline, especially at the start. I am reminded of a scene in Batman Begins (it was on TV recently) where Kate Holmes said something to Christian Bale. Bale, as Bruce Wayne, is explaining to Holmes, his girlfriend, that there is more to him than meets the eye...that he is not the rich playboy that everyone sees. Her response is something that we all must adopt in our lives. She looks at Bruce Wayne as he leave a party and says,

"It’s not who you are underneath, but what you do that defines you”

Let us all DO the things that define us so that who we are underneath can truly come out and be seen.

Thanks for the intro, Matt.

2008-09-14T21:52:00.009-04:00

My name is Beth and I have been on a journey of self discovery and healthy living for about 18 months now. When I set out, it was with the intention of losing weight and that has and will continue to happen, but the self discovery aspect of this adventure was a bit unexpected for me as I didn’t realize that there was this other ‘self’ hiding beneath the layers waiting to be set free.

I had been a patient of Dr. K’s back in 2005 and had done quite well. But when my older son was deployed to Iraq I repacked my emotional baggage and went into hiding. In February of 2007, at my highest weight ever, 302.8 lbs, I finally came out of my funk and went back to see Dr. K and Matt. I was so embarrassed and felt like I had failed not only myself but everyone who had tried so diligently to help me. Instead of the reprimand I felt I deserved, I was met with understanding, encouragement, and acceptance.

I have lost over 100lbs. since beginning this leg of my journey in Feb. 2007. I am very fortunate to be surrounded by a great support team. Dr. K. and Matt have taught me the caloric value of food, the importance of exercise, and have encouraged and kicked my butt along the way….whichever was needed at the given moment. My husband and my son are there for me on a daily basis helping, encouraging, shopping, and reminding me that I am worth the effort.

So please check back often and let me know your thoughts, struggles, and triumphs as we continue on this journey together.

New Moderator

2008-09-11T07:49:00.003-04:00

Many of you have noticed that Dr. Keroack and I have not been posting at the frequency we once were. Life is busy and we are immersed in patients and helping people learn a new way of life. With that in mind, I would like to introduce Beth J. Beth has been on a tremendously inspiring journey of weight loss and self dicovery and will post her thoughts and insights from the journey that never ends.

Don't worry, Dr. Kerack and I will still be here looking in and helping with answering questions or even posting our own comments and insights.

From here I will leave Beth to do any more introductions of herself and hope you continue to read, learn, and make your journey and amazing one.

Why do I want carbs at night?

2008-07-02T09:26:00.002-04:00

One of the things that we see frequently in our patients (and in ourselves) is the desire for Carbohydrates. This desire is especially powerful in the later parts of the day. It seems that when we wind down and begin the relaxation part of our evening, we are drawn to relaxation foods, like carbohydrates (and sometimes fats and alcohol).

Why does this happen? (and more importantly, why does it matter… and even more importantly how can we stop it?)

To understand this phenomenon, we first have to take a look at the psychology of the typical American day. We, as Americans, can claim to be the hardest working culture on the planet. You can debate whether this is something to be proud of or not, but we start our days running…running to get to work, getting the kids ready, completing all our errands, and attempting to fit it all in… Sadly, in the midst of all this, we waste a lot of time…time waiting in line, waiting for meetings, watching TV, surfing the internet, writing and reading blogs, etc.

As a result, we do not make time for healthy methods of eating, activity, and relaxation during THIS time of the day. Then, as the day progresses into night, we are exhausted. Still we believe that we have earned some real rest and relaxation from our hard day of busy scheduling combined with the frustration of time wasted. So we “derserve a break today”…we should “have it our way” (any of this sound familiar?).

When evening occurs we want some time to ourselves…and we will stay up late to get it! Then the whole scenario starts all over again.

Now let’s combine this with the physiology of Carbohydrates. Taking in carbohydrates leads to an increase in the plasma ratio of tryptophan and other large amino acids. This change in tryptophan has been shown (at least in animal models) to raise the serotonin levels of the body and ultimately the brain.

Now, serotonin is a chemical that is linked to mood. As a result there are many benefits to raising the serotonin levels in the brain in order to improve mood.

Unfortunately there is more to the story than just raising serotonin levels. Carbohydrates also raise insulin levels. This powerful hormone is a anabolic, or building, hormone. Although insulin does play a role in the building of muscle, it is more likely that insulin will play a larger role in building fat. So the ingestion of carbohydrates in the night time in order to boost our mood through serotonin will also boost our insulin levels prior to bedtime. This hormone with then assist in the building of fat. Not only will the insulin do that, but the insulin secretion at night time will actually “protect” our current fat from being accessed or metabolized.

As if that were not bad enough, the powerful energy component from the ingested carbohydrates will likely keep us up when we really should be getting to bed.

So in the end…as with many short term satisfaction behaviors, what we thought would benefit us actually winds up sabotaging our efforts.

Know this, hopefully we will stop and think of the long term consequences of our actions in the night time.

I think it is reasonable to have enjoyment after a long day of work. By all means, raise your serotonin levels… but do it by going for a walk, or reading, or connecting with your friends or your spouse.

If all else fails, choose protein and non-starchy vegetables during the later part of the day so as to better control your insulin and the consequences of your insulin.

More importantly, do everything you can to protect yourself from serotonin deficiency. This can be done by taking in carbohydrates and real food during the day. Make time for breakfast and snacks so that when you are depleted by your busy schedule, you will be less vulnerable to poor choices in the later parts of the day.

And by all means GO TO BED (see Matt’s entry on sleep). This is an amazingly powerful part of recovery and, in the end, weight loss.

So, drop your carbs at night…and make this transition easier on yourself by making time to eat during the day.

The culture is changing. What a difference a few years makes

2008-06-23T14:33:00.003-04:00

Dr. Keroack, the new practice Physician's Assistant Karl Haywood, and I just got back from a 3 day medical conference in Boston on the 'Practical Treatements of Obesity'. This was the 22nd Annual conference meeting and it was run by some of the 'father's' of bariatric medicine. Lecturers from all over the world came in to give great talks on many aspects of obesity science and therapies that have shown promise.

I have to admit to being very pleasantly surprised at the tone and curricum of the conferance. When I had attended a similar conferences a few years ago it was very much hyping the aspects of surgery for the treatment of obesity. And why shouldn't they have? Immense changes in diabetic medicine needs, decrease in HbA1C ( a marker for how well sugar is being regulated), almost immediate return to optimume of blood sugar measurements, weight loss, the list goes on. With powerful results like these post-operatively it is understandable that something so difficult to manage like obesity and diabetes, would gain a new first line treatment in the form of surgery. What hadn't been reviewed long term were the results for weight loss. These very same physicians are now recognizing that surgery, in and of itself, is, and only should be, presented as an adjunct to other lifestyle changes. As Dr. Keroack referenced last post. Surgery is NOT a brain transplant.

As the data rolls in from the VERY FEW patients that actually continue to submit data greater then a year post op, we find that weight regain is almost assured to some extent. Even more frightening, we see a marked increase in depression of post operative patients. Hmmm, this sounds reasonable too, to us. Let's looks at it from the patient's point of view. After years of dieting with little long term results (reasons for which we won't go over here and now, suffice to say they missed an important piece of the puzzle) a patient gets excited that 'the solution' is in the surgery. As posted by Dr. Keroack before, this would classify as an improperly prepared patient in our eyes.

Upon the surgery, if they are one of the lucky ones, they will lose a large amount of weight without complications. But even these people will fall back on old compensation and soothing mechanisms if life throws them a curve ball. They may have to modify HOW they compensate, which is even more scary, but they will find a way. Couple this with the bodies ability to neutralize the rapid weight loss with other metabolic mechanisms and data shows weight loss slows to a stop in the 16 month post operatively, in even the best patient. Eventually weight starts to come on. Imagine the feelings of a post surgical patient who realizes that sugery was not the 'solution' to their problems. That life's curve balls could still get them eating that comfort food, that their emotional state is actually tied less to their body image then they had at one time thought, that the things that they wanted to 'get better', their relationships, feelings of self worth, and maybe how friends treat them, didn't really improve all that much. I would be depressed as well.

This conference spent a large amount of it's time resource on the lifestyle and holistic approaches to weight loss. Whole breakout sessions spent on daily activity increase with either exercise or life based movement. Stress and emotional aspects of mental health were looked at. How obese patients coud benefit from restructuring their thoughts and world views to better cope with change or trauma was touched upon in almost all lectures.

I hate to say it, but it kind of felt like we were watching these people (conference attendees over the past years) climb up a steep mountain only to find us sitting their asking what took them so long. We may not do research, but we sure do observe what we see in our own practice populations. Dr. Keroack and I knew that depending on a surgery to do what should and could be done by themslves through education and cognitive restructuring is not great plan. Surgery is an adjunct to these front line therapies when a patient is not able to implement change without a safety mechanism. These patients should consistently see a baratrics physician and comprehensive program, post surgery, to keep from depending on the surgical negative reinforcers too much.

Is Surgery a Short-cut?

2008-06-17T20:44:00.001-04:00

We have spent a majority of our career helping others lose weight. Many of our patients lose their weight through nutrition counseling, exercise prescription, and occasionally the addition or pharmacotherapy. In more extreme cases, in the process of losing weight, some of our patients will opt for surgical intervention. Surgical intervention usually consists of gastric bypass surgery or adjustable gastric banding. There are other methods, but currently, these are the two most popular methods in the United States.

In the process of our patients choosing surgery I am struck by two common, but diametrically opposed, opinions that patients have about surgical intervention.

In one instance, surgery is seen as a foolproof method to end the battle of weight gain forever. Surgery is seen as the proverbial answer to all their prayers…no more planning, no more dieting, no more struggle…only a smooth and steady path toward success.

In another instance, surgery is seen as a method of cheating the system and ultimately should be chosen only when utter failure is reached. Surgery is seen as a scarlet letter marking the collapse of effort and lack of discipline needed to succeed in the realm of medically managed weight loss.

Both are distinctly different opinions and both are dramatically flawed in their viewpoints.

Surgery is not foolproof… surgery is not cheating… surgery is not a short cut.

When patients do opt for surgical intervention for weight loss, we teach them that surgery is a valuable tool to help them have an advantage in the behaviors needed for successful weight loss. Surgery incorporates both positive and negative reinforcement factors that assist patients in achieving their goals, but, pardon the expression, surgery is no cake walk.

Surgery needs to be seen as an intervention that creates and anatomical alteration in order to solve a behavioral problem. The stomach is altered and often restricted in the process of surgery. This is done in the hopes that the rearrangement will reinforce the ideas of small and frequent meals which are some of the cornerstones to successful weight loss.

This surgery, however, is not a brain transplant.

It is true that some surgeries alter hormonal and chemical feedback systems in order to assist with hunger and satiety. It is also true that many metabolic disorders are often altered and improved by some surgeries. These and other factors play a powerful influence in the success rate of weight loss related to surgery.

However, many experts in the field of bariatrics will agree that without the long term behavioral changes necessary for long term weight loss, long term success will not be achieved.

In the end, behavioral and life style changes are still the end result. Ultimately then, we strive to inform patients opting for surgery that the surgery is not the end, but rather the beginning to the life long changes necessary for long term success. Patients will often get a golden window of great benefit from choosing the surgery. However, if behavioral modifications and lifestyle changes are not place…if there is not a focus on optimal nutrition and physical training… if you think that surgery is a short-cut … then you will be disappointed.

Surgery is a powerful tool that will assist greatly in the goal of weight loss. However, surgery is not a substitute for the necessary behavioral changes needed to succeed in long term weight loss.

Surgery will not end the stress at work, the frustration in your relationships, or the insecurities you have about your self-image. As much as we want to believe it, intuitively we know that manipulating the physical does not necessarily alter the emotional, spiritual and psychological factors of our life. These areas, the areas of ESP, also need attention so that long term change can occur.

In the end, where there are no behavioral or lifestyle modifications, surgery becomes a temporary fix to a life long problem.

Ask us (or some of our post-operative patients) how we know…

Sleep: The important, and often 'missing', link

2008-06-09T12:57:00.004-04:00

Sleep is often one of those many things in our busy lives we put to the back burner. We have little sayings like, "I'll sleep when I'm dead!" on bumper stickers and T-shirts that jokingly poke fun at sleeping and resting. The interesting thing is that by NOT sleeping enough, or well enough when you do, you just may be helping yourself to be dead, sooner.

This article was just posted on Yahoo! earlier today concerning the detriments of not enough sleep. This whole post is long, but well worth it.

Sleep: A Necessity, Not a Luxury By Dennis Thompson, HealthDay Reporter - Sun Jun 8, 8:49 PM PDT

SUNDAY, June 8 (HealthDay News) -- The pace of life gets faster and faster, and people try to cram more and more into every minute of the day.
As things get more hectic, sleep tends to get short shrift. It's seen as wasted time, lost forever.
"For healthy people, there's a big temptation to voluntarily restrict sleep, to stay up an hour or two or get up an hour or two earlier," said Dr. Greg Belenky, director of the Sleep and Performance Research Center at Washington State University Spokane.
"But you're really reducing your productivity and exposing yourself to risk," Belenky added.
That's a message doctors are trying to spread to Americans, including the estimated 40 million people who struggle with some type of sleep disorder each year.
Before Thomas Edison invented the light bulb in 1880, people slept an average of 10 hours a night. These days, Americans average 6.9 hours of sleep on weeknights and 7.5 hours a night on weekends, according to the National Sleep Foundation.
"The group of people getting optimal sleep is getting smaller and smaller," said Dr. Chris Drake, senior scientist at the Henry Ford Hospital Sleep Disorders and Research Center in Detroit. "When a person's sleep drops to six hours or less, that's when a lot of things become very problematic."
While experts recommend seven to eight hours of sleep each night, the amount needed for an individual can vary.
But lack of sleep affects a person in one of two ways, Belenky said. First, sleeplessness influences the day-to-day performance of tasks.
"The performance effects are seen immediately," he said. "You short-change yourself of sleep, and you see the effects immediately. You can make a bad decision. You can miss something. Have a moment's inattention, and you're off the road."
The longer-term effects of sleep deprivation involve a person's health. Doctors have linked lack of sleep to weight gain, diabetes, high blood pressure, heart problems, depression and substance abuse.
"Hormones that process appetite begin to get disorganized," said Drake, who's also an assistant professor of psychiatry and behavioral neuroscience at the Wayne State University School of Medicine. There's a decrease in the amount of leptin, an appetite-suppressing hormone, when a person gets too little sleep. At the same time, ghrelin -- a hormone that stimulates appetite -- increases with a lack of sleep.
Too little sleep also interferes with the body's ability to regulate glucose and can cause inflammation leading to heart problems and a rise in blood pressure. "There's a stress response to being in a sleep loss," Belenky said.
The types of people not getting enough sleep also break down into two groups. First, there are those who make the conscious choice to go without enough sleep.
"It's sort of part of the culture," Belenky said. "People pride themselves on getting little sleep. You'll hear people bragging, 'I only need six hours a night.' So there's a macho element here."
On the other hand, there are people who are suffering from sleep disorders. These disorders include:
Insomnia, an inability to go to sleep or stay asleep.
Sleep apnea, or breathing interruptions during sleep that cause people to wake up repeatedly.
Restless legs syndrome, a tingling or prickly sensation in the legs that causes a person to need to move them, interrupting sleep.
Someone suffering from any of these problems should visit their doctor or see a sleep specialist, Belenky said.
Sleep apnea, the most prevalent sleep disorder, can have particularly serious long-term effects if left untreated. "You're waking up out of sleep to breathe. You can't sleep and breathe at the same time," Drake said. "It's a risk factor for developing major cardiovascular health effects."
Some people who have trouble sleeping will resort to mild sedatives like Ambien and Lunesta.
The U.S. Food and Drug Administration recently asked the makers of these sedative-hypnotic drugs to strengthen their warning labels. This action followed reports of dangerous allergic reactions, as well as a host of bizarre behavioral side effects that include sleep-driving, making phone calls, and preparing and eating food or having sex while asleep.
Drake and Belenky both consider sleeping pills to be fine for the short term if taken properly.
"Sleeping pills are a temporary solution," Belenky said. "If you're upset about something or have situational insomnia, or you're trying to sleep at the wrong time of day because you've traveled across time zones, they are effective."
But, both doctors noted the pills will do nothing to help a chronic sleep problem. "They don't address the pathology of their sleeplessness," Drake said.
The U.S. National Institutes of Health offers these tips for getting a good night's sleep:
Stick to a regular sleep schedule.
Avoid exercising closer than five or six hours before bedtime.
Avoid caffeine, nicotine and alcohol before bed.
Avoid large meals and beverages late at night.
Don't take naps after 3 p.m.
Relax before bed, taking time to unwind with a hot bath, a good book or soothing music.
If you're still awake after more than 20 minutes in bed, get up and do something relaxing until you feel sleepy. Anxiety over not being able to sleep can make it harder to fall asleep

Now let's look at a newly released study invovling getting more then the recommended 8 hours. Imagine if we could feel like setting personal best records every time we got up in the morning!

Ongoing Study Continues to Show that Extra Sleep Improves Athletic PerformanceAmerican Academy of Sleep Medicine06/04/2008

EMBARGOED FOR RELEASE
June 9, 2008, at 12:01 a.m.

Contact: Kathleen McCann
American Academy of Sleep Medicine

WESTCHESTER, Ill. – Getting extra sleep over an extended period of time improves athletic performance, mood and alertness, according to a research abstract that will be presented on Monday at the SLEEP 2008 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS) in Baltimore, Md.

Participants in this ongoing study were five healthy students on the Stanford University men’s and women’s swimming teams. For the first two weeks of the study, the students maintained their usual sleep-wake pattern. The athletes then extended their sleep to 10 hours per day for six to seven weeks.

Athletic performance was assessed after each regularly scheduled swim practice. After obtaining extra sleep, athletes swam a 15-meter meter sprint 0.51 seconds faster, reacted 0.15 seconds quicker off the blocks, improved turn time by 0.10 seconds and increased kick strokes by 5.0 kicks.

“These results begin to elucidate the importance of sleep on athletic performance and, more specifically, how sleep is a significant factor in achieving peak athletic performance,” said lead author Cheri Mah of the Stanford Sleep Disorders Clinic and Research Laboratory. “While this study focuses specifically on collegiate swimmers, it agrees with data from my other studies of different sports and suggests that athletes across all sports can greatly benefit from extra sleep and gain the additional competitive edge to perform at their highest level.”

The study also monitored daytime sleepiness and weekly changes in mood. Daytime sleepiness decreased significantly with extra sleep, while mood improvements related to getting extra sleep included higher ratings of vigor and lower ratings of fatigue.

“Typically, many athletes accumulate a large sleep debt by not obtaining their individual sleep requirement each night, which can have detrimental effects on cognitive function, mood, and reaction time,” said Mah. “These negative effects can be minimized or eliminated by prioritizing sleep in general and, more specifically, obtaining extra sleep to reduce one’s sleep debt.”

Mah and colleagues reported similar results in a previous study of six players on the Stanford men’s basketball team. Performance measures such as sprint times and free-throw shooting improved after extra sleep, as did ratings of mood and alertness. The research abstract was presented at SLEEP 2007 in Minneapolis, Minn.

Over the years Mah also has worked with the football, tennis, golf, cross country, and track and field teams at Stanford. Now she hopes to expand the project to work with athletes at other colleges, as well as professional athletes who are seeking a unique competitive advantage.

“It is interesting to note that many of the athletes in the various sports I have worked with, including the swimmers in this study, have set multiple new personal records and season best times, as well as broken long-standing Stanford and American records while participating in this study,” she said.

According to Mah, coaches at Stanford have been paying close attention to their athletes’ involvement in the ongoing study.

“Many of the Stanford coaches are definitely more aware of the importance of sleep,” she said. “Coaches have even started to make changes to their practice and traveling schedules to allow for proper sleep habits. For many athletes and coaches, this study was the first time they truly understood how large of an impact sleep can have on their performance and results.”

Mah offers these tips to help athletes improve their performance by maximizing their sleep:
Make sleep a part of your regular training regimen.
Extend nightly sleep for several weeks to reduce your sleep debt before competition.
Maintain a low sleep debt by obtaining a sufficient amount of nightly sleep (seven to eight hours for adults, nine or more hours for teens and young adults).
Keep a regular sleep-wake schedule, going to bed and waking up at the same times every day.
Take brief naps to obtain additional sleep during the day, especially if drowsy.
The SLEEP annual meeting brings together an international body of 5,000 leading researchers and clinicians in the field of sleep medicine to present new findings and discuss clinical developments related to sleep and sleep disorders.

More than 1,150 research abstracts will be presented at SLEEP 2008, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The three-and-a-half-day scientific meeting will bring to light new findings that enhance the understanding of the processes of sleep and aid the diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.

Abstract Title: Extended Sleep and the Effects on Mood and Athletic Performance in Collegiate Swimmers
Presentation Date: Monday, June 9
Category: Sleep Deprivation
Abstract ID: 0384
Lead Author: Cheri Mah

Now go get some sleep!

Math Vs. Metabolism: stuff we have observed in patients

2008-06-02T10:28:00.004-04:00

We often get patients that have reached a certain BMI of around 35 that comment on the difficulty to move their weight down more. To put it into perspective, a BMI of 25 is considered to be the high of ideal for any person. The BMI scale itself is a tool that has compared hundreds of thousands of individuals and created a relationship for health surveying purposes between a person's height and weight.

Some patients have begun their journey at a BMI of 45 or higher. For a 5'4" woman this would put their weight at around 254. The BMI of 25 would have them nearer to 140 lbs. These facts set the framework to what I will discuss. If the patient above practices good meal portion control and reduces the overall amount of calories they take in they will lose weight. This isn't a 'sometimes' or 'most of the time', but every time. Remember back to one of the initial posts, less energy in and more energy out and the result is weight loss. If I ate a dozen donuts for breakfast usually and I cut back to only six, then I would be cutting my calories in half.

The interesting thing though is when patients reach the area of BMI 35-30. Things get tricky. All we can do is report the anecdotal observations and theorize, but when the research finally comes in I think you will be able to say you read it here first. We observe that just cutting back on the energy becomes not enough. Energy comes from calories that we consume, but these same calories also are part of the nutrition that our bodies need on a daily basis. Cutting back too much on calories leads to poor energy, hunger cravings and loss of lean tissue/muscle. Similar to exercise, what was once enough to lose weight now becomes not enough, but instead of cutting more, the trick is to actually eat better.

This is no small idea. It IS easier to just cut back. If it would work that I could continually lose weight by just cutting it would certainly make it easier mentally in terms of figuring it out. Unfortunately, that's not the way it works because we eventually run up against hunger, nutrition loss, lean tissue wasting, and starvation responses. None of these are good for a weight loss goal.

We find that renewed weight loss can be initiated with patients at the same calorie intake level if they take on the job of understanding food types and choices. By combining foods that require more 'work' by the body to digest, or just move through as in the case of some fibers, we stimulate the metabolism without the problems from above. We help patients by explaining the Glycemic Index and how to utilize it to their best benefit. We also go over meal timing and fiber intake with fresh fruit and veggies. Protein also plays a key role in making the body work through digestion. The recipe for each of us is somewhat different so I hold off on giving an exact idea of what we do. I don't want even one person getting the wrong idea from a post. Come in and see us for your food overhaul.

Bottom line is that weight loss IS achievable with portion control and 'cutting back', but getting to the goal of near 25 BMI will require that little extra in regards to stimulating metabolism from understanding food and their combinations.

Self Image: Is who you see in the mirror who you want to be?

2008-05-29T10:44:00.006-04:00

Self Image, and by extension self worth, is one of the key areas we work with patients on at Pioneer Valley Weight Loss. Medicine, AKA healing, isn't all just pills, potions and procedures as you may have been led to believe in our 'sick care system'. It also includes helping people change some of the ground floor belief systems they carry around about themselves.

Recently I saw a patient that self admitted to not 'following any program'. As would be expected she continued to gain weight and was about 10 lbs heavier then her visit with me 3 months earlier. We began the appointment with me reiterating that all of us in the practice are HERE TO HELP HER and to never feel like she is disappointing US. Coming in and asking for help is a big step for people. Failing and then coming in and asking for more help is often times a deal breaker. I always encourage and reiterate to patients that I work for them and am like a library, sometimes a smart-mouth one, but here for them none the less.

The next step was to open up the box of 'breaks' that may be inhibiting her from doing the plan that leads to a healthier lifestyle and weight loss. Works full time, school part time, kids at home, wife, the list goes on in how she prioritizes things in life before herself. Then, she began with "I have always been overweight all my life so.." It's at this point that I quickly interjected and asked her to 'Stop' her description for a moment. It is a very, very important distinction to understand that if a patient views themselves as "always" being over weight that that in NO WAY means that they MUST be overweight forever. To those of us that may be lucky enough to not have a weight problem, this is simple. For those that have, as my patient, always been overweight, it can very well be like wrestling with The Serpent itself...everyday, hour, and minute of their lives.

Let's make something perfectly clear here, and I would ask Dr. Keroack to chime in if he desires. In 20 years of being in the health industry and now in the clinical environment for a few years, with thousands of patients seen, I have NEVER seen an intractably obese person. I have seen patients and people that have learned poor food habits from their family's, carried them forward into adulthood and gained weight. I have seen people with diseases that are related to their previous weight gain and thus makes it easier for them to gain weight rather then lose it. I have seen people that prioritize everything else first and catastrophize their lives which helps in weight gain. But I have yet to meet a single human body that is intractably obese. Even the 1000 lbs patients seen on The Learning Channel programs are not intractable. They are enabled and broken, as we all are in some way, but they can lose weight.

It is a very large part of my job as the lifestyle, exercise and nutritional consultant to get people to understand that the image of themselves that they keep most often in their minds eye will be exactly the image they continue to get. We learn self-image from the cradle and it is reinforced through family, friends and society, all of our lives, until the grave. What's most important to understand is that the self image we have of OURSELVES is really the only one that matters. It is this inward view, that we can't help but express outward to the world, that predisposes every relational transaction, every social setting, and every thing we do to a self actualizing bias.

I'll leave you with a quote that resonates on this theme,

Mind is the Master power that moulds and makes,
And Man is Mind, and evermore he takes
The tool of Thought, and, shaping what he wills,
Brings forth a thousand joys, a thousand ills:—
He thinks in secret, and it comes to pass:
Environment is but his looking-glass.

Author:
James Allen 1902

So what self image reflects in your metaphorical mirror? How does having this reflection help your self worth? You are in charge of how you think and feel about yourself. (It is important to know that it must be in this order. You only feel about yourself in such a way as to reflects the thoughts you have of yourself.) When you begin to change your self image you begin the journey of changing what we reflect back to the world, both in who you are and in your appearance.

It's a jungle out there!

2008-05-26T15:07:00.003-04:00

So the family and I are just back from a week in Disney. Great time but intersting observations. The main one is that it is VERY difficult to go to a resort like Disney and eat in a fashion that will help a person's weight or even to maintain their weight.

I'm a fitness coach and involved with a very healthy lifestyle and I gained 10 lbs over the week! Yikes! Imagine if I didn't run 3 times, swim a few laps and walk all over the Disney each day. Crazy.

What makes it so hard is the prepackaged and prepared foods at every corner. Truth be told, it is sadly easier to eat this way then healthier. Part of the food/dining plan, if you choose to get one, is based on quick foods. You guessed it, chicken fingers and french fries. By the end of the trip even our kids had had enough and were begging for healthy foods and veggies.

You can make better choices but it requires discipline and thought. Just like it does when you are home. I really think we held our weight down more then most by making choices based in protein and salads when ever they were available. Trust me, we splurged and made some fun (read: Less then optimum!) choices in food and drink, but we usuaully got back on track for a few meals the next day.

Vacations are for fun. Both in activities and dining, but limits should be set. I hit mine with 10 lbs as I know by the end of this week I will have it back off. (most of it being water and bloat, it should come off faster then if it were actually fat) A few good choices during the morning and evening and some special choices for fun can be added in along the way.

Disney was grand and the kids and Andrea and I had a great time but it's nice to get back to real life and real food!

Concepts about Activity and Exercise

2008-05-15T08:53:00.006-04:00

Activity, or for those that are a bit more fit, exercise is one of those topics that is understood as one of those 'must do' aspects of losing body weight and getting into better condition. For the majority of the patients that come through Pioneer Valley Weight Loss, activity and/or exercise is usually one of three things: Something they never did growing up so they have no idea about even basic concepts, something that was far enough back in their life that they really have forgotten about how to re-engage with it, or, they feel so poorly about themselves and view activity/exercise as so daunting, that even the thought of becoming more active makes them feel even worse and less motivated. In any of these scenarios the 'must do' aspect of turning the ship of their body weight and condition around, is not happening. Let's help with that.

First: What is exercise? Exercise is any ACTIVITY that engages the body to movement and creates a beneficial response in any aspect of the physiological systems. Simply, if you move and make muscles adapt and get stronger from this movement, or walk and get your heart and lungs some benefit then you are doing activity/exercise. ANYTHING can become or viewed as exercise. Some patients are just told to get up out of a chair repeatedly or moving soup cans in a certain way. For them, this is exercise.

We often hear confusion about the types of exercise from our patients and clients. Let's clarify this in simple terms. Strength or resistance training, as it is often called, is the type of exercise that stresses bones and muscles so that they adapt, get stronger, and more productive in daily or exercise activity. Cardio or aerobic exercise is that type of exercise that stresses the heart and pulmonary (lung) systems so that they supply the muscles and body with oxygen and energy more efficiently. Walking even a few steps around the interior of a house every hour can be viewed as exercise for some patients.

A program that starts a person off at an 'appropriate' level for each of these kinds of exercise, is best. What's appropriate? An exercise or activity level that is doable, stresses the body 'just enough' and does not create undo soreness post exercise. Consistency with this type of program will generate results of better conditioning and weight loss if a reasonable food and calorie program is followed.

"But I saw results at first and then it stopped! Maybe exercise doesn't work for me."

This is one our favorite statements from patients in the practice. It proves two ideas quickly. 1) It shows that this person HAS the ability to lose weight. 2) It also shows that this person does not truly understand the ideas concerning exercise, weight loss, and progressive intensity. The analogy we will use is a car. This car is going up hill and it's a BIG car loaded down with luggage and people. To keep this car going uphill at an speed of 50 MPH we would need a BIG V8 engine and 4 gallons of gas. Why? Because you need a lot of power and energy to get that car up the hill. But let's say you are in a tiny little compact, no luggage and only you in it. You can go up the same hill at the same speed (50 MPH) with only a 4 cylinder engine and 1 gallon of gas. Why? It weighs less and needs less energy and power. Our bodies are EXACTLY the same. When a person loses 10-20 lbs that actually makes the 'resistance' less in almost every aspect of their daily life, including activity/exercise. Want to test that theory? Load up a small suitcase with weight until it weighs on a scale about 25lbs. Carry it around for 10-20 minutes through ALL of your daily activity. (If you can) I think you will notice a difference when you drop the 'weight'. Here's the bottom line: If the same exact 'output' of activity is done then no further results will be seen with respect to weight loss and conditioning, unless, some other variable is adjusted, like food, to make the body want to lose weight. Unfortunately, if a person continues to restrict calories and continues to lower their food intake they will eventually take in too little nutrition to keep optimum health and energy levels. This is a post for another day, but suffice to say, no good will come of it. The proper response is to slowly increase both the quantity and intensity of exercise/activity so that the body never senses the weight loss. In this way, continued results are possible. No worries, you don't have to run marathons to get the ideal body. But you may have to change it up enough, that from the start of your journey to weight loss, your activity level looks nothing like it once did. Remember, 'Progressive Exercise and Activity done Consistently' (PEAC) helps lead to peak fitness and and ideal body weights.

Mission Statement

2008-05-11T20:05:00.003-04:00

Just to give you an idea of the kind of weight loss centers we run...

Our Mission

At Pioneer Valley Weight Loss Centers, we commit ourselves to the care of people with weight problems and assist in achieving their weight loss goals. We consist of a team of health care professionals who specialize in weight loss and weight management. Our commitment to excellence assures that the well-being of each individual is addressed though the provision of exceptional medical care.

Ultimately, we believe that there is an optimal weight for every human being. We also believe this optimal weight assists individuals in reaching their full potential in order to live a healthy and fulfilled life. In order to accomplish this, we are committed to making the needs of our patients our highest priority.

Lastly, we recognize that there are three major components that influence weight loss: Physical, Mental, and Spiritual. We incorporate all of these components in the care of our patients and strive to educate patient in the Truth about weight loss, lifestyle modifications, and behavioral change.

ESP

2008-05-11T20:02:00.005-04:00

As Matt has already told you, we have been working together for several years and recently we have combined our efforts in a professional manner in order to help people lose weight, optimize their health, and become energized while doing so. As you can imagine, we truly love our jobs because we are in the business of helping people change and as a result, rediscover themselves by accomplishing their goals.

Often we are asked “What is “The Secret?” These kinds of questions remind me of a best seller that currently claims to reveal the most powerful law in the universe. As one would expect, the most powerful law in the universe is all around us…and it is no secret. We use basic ideas and principles to explain what really works in terms of weight loss and health.

Our most basic concepts relate to the energy balance theory. Loosely expressed: ENERGY IN - ENERGY OUT = BALANCE. In terms of physical weight loss, we use this equation to focus on the MATHEMATIC and METABOLIC principles of weight loss. From a mathematical perspective, this of course involves calories. But, as many of you have experienced, calories alone can only take you so far. Too many calories can lead to weight gain, but too few calories can lead to metabolic shock and shut down…or worse yet, over-eating as compensation to starving. Metabolic principles are not so subtle, in that what and when we eat can influence our weight loss and energy. In brief, there are correct times to eat certain foods and there are incorrect times to eat certain foods… and if you rely only on math, you will soon be disappointed with your attempted weight loss. Not surprisingly, as you lose weight and get leaner, your metabolic pathways play a larger role than your mathematic pathways…but this is what we do every day of our lives in the office. And, more importantly, this is not what I want to write about here.

Alas, the physical side of the energy balance theory only plays a part in optimal health. There are many other factors that also influence balance. These factors we have termed ESP (Emotional, Spiritual, and Psychological). As one would expect, these factors play a much larger role in optimal health. I might go so far as to say that Physical health is only a reflection of what is going on with Emotional, Spiritual, and Psychological health.

The principles of energy balance still apply. The types of energy are the factors that change. In other words:

EMOTIONAL ENERGY IN – EMOTIONAL ENERGY OUT = BALANCE

SPRITUAL ENERGY IN – SPIRITUAL ENERGY OUT = BALANCE

PSYCHOLOGICAL ENERGY IN – PSYCHOLOGICAL ENERGY OUT = BALANCE

We look forward to exploring these much larger factors with you in days to come. In addition we look forward to assisting you in ALL the aspects of balance in your life.

A word about the book list

2008-05-10T20:55:00.004-04:00

We often see patients and clients that are looking for the next 'quick fix' to their seemingly never ending weight problem. The truth of the matter is that their is no quick fix...but their is a fix. Dr. Keroack and I often use the analogy of 'The Stuck Brake' which we have borrowed, with all honors and accolades due him, from Brian Tracey. 'The Stuck Brake' analogy is basically the idea that all people have 1 thing that is very difficult to give up that is their 'stuck brake'. It could be an idea you have about yourself, another person, how you choose to perceive reality, or any number of other things that represent your 'brake'. But if your beautiful 500 series Mercedes has a front brake caliper fused shut...you WILL go around in circles. Forward progress because of that brake will be nothing.

The brakes that we often see that inhibit people from making forward progress to lasting wellness are deep and complex. Relationships and the emotions surrounding them are one example. Spiritual grounding, or lack there of, is often another. The psychology of how a person learned to think about themselves or reality is also a common issue or brake. We call these three factors the E.S.P. of weight loss and health. These books and their ideas are listed to help people have a new way of dealing with and creating their emotions. After all, emotions aren't reality...they are response manifestations of how we are viewing reality. Spirituality doesn't have to mean a direct relationship with God, although for many it does. What it does mean is a connection or grounding force to something greater then themselves. What this could be may be different for every one, but what we do see is that the more limited and self involved a person's connections are, the more blind spots and limited the potential for change they seem to have. Many of these books have given new meaning to our patients and clients lives, a connection to something greater then their problems. Maybe it's coincidence, but they seem to make better progress toward their goals with these insights. Psychology is often thought of as how we think but it is actually much more. It's how we learned and continue to learn, it's how we develop relationships, how we communicate with one another, it's how we think of ourselves and the process of how we learned even this. Psychology is complex to say the least. Again, some of these books help to give direction and, for some, new tools to use in their quest for weight loss and health. To sum it up; Spiritual Grounding gives us the strength, courage and purpose to make the journey to our goals, where ever that journey may lead. Emotions give us the direction and stimulus to know when we are going in the right direction, sometimes painfully and other times joyfully. Psychology gives us the tools and the ability to learn a new way of life for ourselves. It is our hope that these books and those that we will add to the list, will offer help along the way.

Welcome and hope you enjoy the ride...

2008-05-10T17:58:00.011-04:00

The inspiration for this blog came from many patient and client hours spent helping and counseling others in the pursuit of their fitness, health and weight goals. Not everyone has the same goal as far as their physical wellness. Some way want to just weigh less, others aspire to achieve a certain accomplishment and still others may want to get off medicines and become more healthy. Whatever the goal, Dr. Keroack and myself have usually heard of the goal and either helped someone to achieve it got them started down the path toward realizing it.

We have quite a set of knowledge and experience bases between us.

Dr. Keroack is a Graduate of Amherst College, Springfield College and Tufts University School of Medicine. He is board certified in both Internal Medicine and Bariatrics (Obesity and Weight Management Medicine). Dr. Keroack started weight management program as two of the leading hospitals in Springfield. Currently he is in private practice at the Pioneer Valley Weight Loss Centers in order to independently service all local physicians and hospitals.

Most of Dr Keroack's patients come to Pioneer Valley Weight Loss Centers to work medically and holistically with Dr. Keroack toward their weight loss goals. And equal amount of patients see Dr. Keroack in preparation for surgical intervention for weight loss. Although Dr. Keroack is not a surgeon, he works with local surgeons to help prepare patients in the pre-operative period of surgical weight loss. He also assists in both the short and long term care post-operatively in order to maximize health, nutrition and weight loss in the patient undergoing weight loss surgery.

Lastly, rounding out the concept of balance in all aspect of his practice, Dr. Keroack is also certified in Age Management Medicine. This emerging field is designed to help patients age with as much vitality and resistance to disease as is medically possible. Patients in this aspect of the practice get exclusive and comprehensive evaluations that are aimed at optimizing nutrition energy, and athleticism. This is done via an appropriately targeted nutrition and supplementation program in conjunction with an appropriately designed progressive exercise program. If needed, the program will also include appropriately treating hormonal deficiencies in order to optimize hormone levels so that they are more in line with a healthy vigorous system with improved vitality.

As for me, I have been involved with wellness and fitness on many levels for the last 30 years. In the past I have been a competitive bodybuilder and competed at the international levels. After ending the competitive aspect of my bodybuilding career it transformed into an ownership position at the Springfield Massachusetts Gold's Gym. At this stage of my life I spent years and countless hours training both staff and members in methods to achieve optimal wellness. It was at this time that Dr. Keroack and I met and became friends. Certified as a Nutrition Specialist via Apex Nutrition and Exercise Systems, National Academy of Sports Medicine Fitness Professional certified, I used my education and personal experience to help people from all walks of life achieve their health goals. Selling the gym I migrated into a private fitness consulting practice. It was in this aspect of my career that Dr. Keroack and I began our affiliation. Presently I work with Dr. Keroack at Pioneer Valley Weight Loss Centers in Springfield Massachusetts as the fitness and exercise specialist.

We welcome visitors and their questions concerning weight loss. We will deliver information that we have seen be helpful to patients and clients on their journey toward a more optimal health.
Along the way you will get excerpts and insights into our book on weight loss. Interestingly enough, the ideas and methods we use may not be at all what you think.