Weight Management

Takeaways from Emory Bariatrics Live Chat, ‘New Year, New You: Successful & Lasting Weight Loss in 2016’

weightloss2016-cil638Thank you to everyone who joined us on Tuesday, January 19th, for our live online chat titled “New Year, New You: Successful & Lasting Weight Loss”, hosted by Emory Bariatrics registered dieticians, Victoria Delgado, RD, and Kasey LaPointe, RD.

During this live chat, Victoria and Kasey provided healthful living tips to lasting weight loss for those who have made weight loss a part of their New Year’s resolution. They also answered questions about surgical and non-surgical weight loss.

We were thrilled with the number of people who registered and were able to participate in the chat. The response was so great that we had a few questions we were not able to answer so we have answered them below for your reference.

Question: Does wrapping your body with Saran wrap while you work out help shed inches/pounds? If so, how does it work?
Answer: No, this is a myth. It may increase sweat which can result in water loss, but not fat loss. To lose inches and pounds, we must combine physical activity with a healthy eating plan.

Question: Am I too old to go on Optifast (a liquid meal replacement program) to reduce my weight?
Answer: Due to risk of losing muscle mass, we encourage our patient who are 70 year or older to follow a Partial Meal Replacement Meal Plan instead of the Full Meal Replacement Meal Plan. The partial plan includes using Optifast and whole foods, while the full plan consists of using only Optifast products for a short period of time. All patients are assessed individually by a physician prior to getting started.

Question: I am interested in learning more about the lap band surgery to help with weight loss.
Answer: I recommend clicking on this link to learn about lap band surgery. Once you decide which Emory location is more convenient to you, you will find details about each of the surgical weight loss options we offer. You may also register for a seminar. Our video seminars define the three procedures we perform: the band, sleeve and bypass. There is also contact information and other resources at these sites.

Question: Can I go from the lap band to the gastric sleeve?
Answer: Absolutely. The surgeon can remove the band and convert to the sleeve all during the same procedure. You may click on the following link to choose a location and get started: http://www.emoryhealthcare.org/emorybariatrics/index-nav.html.

If you missed out on this live chat, be sure to check out the full list of questions and answers on the chat transcript. You can also visit emoryhealthcare.org/emorybariatrics for more information.

Also, if you have additional questions for our registered dieticians, Victoria Delgado, RD, and Kasey LaPointe, RD, please feel free to leave a comment in our comments area below.

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New Year, New You: Successful & Lasting Weight Loss in 2016 Live Chat- January 19th

weightloss2016-cil638Is weight loss part of your New Year’s resolution? Let Emory Bariatrics help you make 2016 the year you commit to getting healthy through weight loss.

Please join us for a live chat on Tuesday, January 19, 2016 at 12:00 p.m. EST with Emory Healthcare registered dietitians, Victoria Delgado, RD, and Kasey LaPointe, RD. They will discuss healthful living tips to get you on the path to lasting weight loss and answer your questions about surgical and non-surgical weight loss. Weight loss can be a big challenge, both physically and mentally, but with hard work, a strong support system and a positive outlook, you can achieve better health in 2016. Register here for this chat!

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Understanding Some Basics of Mindful Eating

mindful-eatingEating mindfully is not something we learn as a child. As a matter of fact, we are often taught the exact opposite. As children, how many of you were told by your parents “Clean your plate!”? This idea can actually lead to a lifetime of overeating, as many of us feel guilty leaving food on our plate, especially when there are “starving children” in the world. But the concept of mindful eating can lead to healthy habits and lead to less waste.

So what is mindful eating? Simply put, it is eating with awareness. Your focus is on your food, your body, and your body’s response to the food you eat. We put forth time and effort when we review bills and bank statements or when we plan a meeting, but when it comes to eating, we do so absent-mindedly. Even when we are in the act of eating, our minds drift or we are in the midst of conversations with others, that we don’t focus on how much food we put in our mouth, the texture of the food or the taste.

So how can mindful eating help with weight loss? Many of us struggle with food. We react mindlessly to it. We eat when we are not hungry. We continue to eat even though we have eaten enough already. And often, we do not use food for its intended purpose – to nourish our bodies. With that being said, if we started asking ourselves, “Is this food I am about to eat nourishing to my body?” our response to food would likely be much different. If you answer truthfully, you may find yourself choosing a healthier option altogether.

Another great question to ask yourself before eating is, “Am I hungry?” We find ourselves eating whenever it is convenient or whenever food is present, regardless of whether we are hungry. And when you ask yourself that question, you open the door to other mindful questions which, when answered truthfully, can impact your eating habits and food choices tremendously.

The great thing about mindful eating is it is a way of life – a lifestyle. It is not a diet. It is just you treating your body, and the food you allow to enter your body, with respect. It increases your awareness and attitude toward food without judgement. It allows you to think, and not react, to food.

Moving forward, consider the following choices in planning your meal: the type of food you eat or drink; where you eat; when you eat; how often you eat; the amount of food you eat; the size of the bite you chew; how fast or slowly you chew; how thoroughly you chew; when you swallow; how much time you take between bites; and when you stop eating . The list can go on and on – go ahead and add some of your own thoughts or questions. And let’s begin the practice of mindful eating today.

For more information or questions about weight loss services offered at Emory Healthcare, call 404-778-7777 or visit http://www.emoryhealthcare.org/emorybariatrics/.

Reference:
Fletcher, Megrette, MEd, RD, CDE; Frederick Burggraf, MEd; Discover Mindful Eating, 2010
http://amihungry.com/what-is-mindful-eating/

Power Up with Breakfast

oatmeal-breakfastYes, the old adage is true…breakfast really is the most important meal of the day. Why is that? Research has shown breakfast eaters are more alert during the day, perform better at work and school, and are more likely to exercise. Eating breakfast can also help trim your waistline. When we eat breakfast, our metabolism is given a boost that last throughout the day. Eating in the morning also helps us to not overeat at lunch and dinner. Some people even feel less hungry at night when they eat breakfast compared to when they don’t.

The two most common reasons people don’t eat breakfast is: 1.) “I don’t have time.” and 2.) “I’m not hungry in the morning.” The answer to prevent number 1 is to plan ahead. Have “grab and go” foods in the house as you run out the door. Do any prepping or cooking the night before so you don’t have to in the morning. Try cooking a large batch of steel cut oatmeal on Sunday night and keep it in the fridge. Scoop out a serving each morning during the week, and then heat and eat.

Addressing number 2 is a little trickier. The reason most people are not hungry in the morning is that they have trained their bodies to not expect food (or they may have eaten too much the night before). Our bodies are meant to have food in the morning; therefore, it is up to us to train our bodies back. Try eating something light like low-sugar yogurt or a homemade fruit smoothie until your body gets used to eating in the morning again.

Here are some quick and easy breakfast ideas:

  • Oatmeal with dried fruit and nuts
  • Low-fat yogurt with granola
  • Whole-wheat pita with hard boiled egg and spinach
  • Whole-wheat tortilla, peanut butter and banana wrap
  • Leftovers from last night’s dinner

Below is a recipe to one of my favorite “grab and go” breakfast items. It is full of protein and will give you plenty of energy to get you through the morning:
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Overnight Peanut Butter, Banana and Honey Oats

Ingredients:
– ¼ cup steel cut oats
– 1 cup light vanilla soy milk
– 2 tbsp natural peanut butter
– ½ tbsp honey
– Dash of cinnamon
– ½ banana, sliced

Directions:
Mix together all ingredients and place in an air-tight container in the refrigerator. Let sit overnight and enjoy in the morning. You can heat it in the microwave or eat it cold.
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Reference:
Lombardo M, Bellia A, Padua E, et al. Morning meal more efficient for fat loss in a 3-month lifestyle intervention. J Am Coll Nutr. 2014;33(3):198-20

Takeaways from Emory Bariatrics’ Successful & Lasting Weight Loss Live Chat

successful-weight-loss-cilThank you to everyone who joined us on Tuesday, August 11th, for our live online chat on “Successful & Lasting Weight Loss: Strategies for Reaching Your Goals”, hosted by Emory Bariatrics registered dieticians, Megan Moyer, RD, and Kasey LaPointe, RD.

For the millions of Americans who diet, stop dieting and then promise to diet again, the constant struggle to lose weight and keep it off can be exhausting, not to mention discouraging. During this live chat, Megan and Kasey discussed strategies for long term weight loss success. They offered healthful living tips to get you on the path to lasting weight loss and provided successful strategies to help make this time the one that leads to a healthier, happier lifestyle. Here are just a few highlights from the chat:

Question: What’s the best way to keep on track: daily weigh-ins? listening to tapes?

Meagan Moyer, RD: The best way to stay on track really depends on the person. Some people choose to weigh themselves everyday, but that can take a mental toll if they beat themselves up every time they step on the scale. That’s why I recommend not weighing yourself more than once a week. It’s also helpful to have a person you can call when you need support and in moments of “weakness.” Some people also choose to track what they eat using a website or app.

Question: Does eating before bedtime make you gain weight? What time should I stop?

Meagan Moyer, RD and Kasey LaPointe, RD: It’s a misconception that the metabolism stops at a certain time during the night. Usually the problem lies more with eating later in the night after your calories have been consumed for the day. Late night eating can be out of boredom or habit. One thing I suggest is asking yourself the reason you are eating, whether it’s out of boredom or actual hunger. Try to occupy your time with something else to keep you from snacking late at night. I keep a crossword puzzle next to my bed if I feel my mind wandering towards hunger.

Question: After months of steady weight loss, I feel like I might be at a plateau. My weight loss has been incredibly slow for the past few months. Any suggestions on how to adjust my diet to see better results?

Meagan Moyer, RD and Kasey LaPointe, RD: Reaching a plateau is completely normal when it comes to weight loss. The body gets used to your behaviors and habits, so it’s good to adjust your routine and diet. Try incorporating new activities into your work outs in order to continue to see results.

Also, while you may reach a plateau when it comes to the scale, the body often continues to change in other ways. Try to focus on other non-scale victories to measure your weight loss success. You can focus on how your clothes fit, seeing a decrease in inches using a tape measure, having more energy, sleeping better and other noticeable changes is a good way to measure your success.

Question: How do I know if I’m a candidate for Bariatric surgery?

Kasey LaPointe, RD: If your body mass index is greater than 40 or if your body mass index is greater than 35 and you have weight related health issues, you are a candidate for bariatric surgery. You also have to be ready to commit to a lifelong healthy lifestyle and be mentally prepared for these changes.

If you missed out on this live chat, be sure to check out the full list of questions and answers on the chat transcript. You can also visit emoryhealthcare.org/emorybariatrics for more information.

Also, if you have additional questions for our registered dieticians, Megan Moyer, RD, and Kasey LaPointe, RD, please feel free to leave a comment in our comments area below.

Bariatric Surgery: What are the Differences in Surgical Options?

bariatric-appleLosing weight with diet and exercise can work for many individuals. However, for some, diet and exercise may not be enough causing individuals to be at high risk for disease-related complications due to obesity. In these cases, weight loss surgery may be an option.

The decision to have weight loss surgery should never be taken lightly. Contrary to popular belief, it is not “the easy way out” and won’t instantly cure the emotional and physical issues which lead one down the path to obesity.

Emory Bariatrics performs three types of weight loss surgery. Below is a brief description of each type offered.

  •  Roux-en-Y, also know as “gastric bypass”, is a combination procedure. It is a restrictive procedure and a malabsorptive procedure. The surgery reduces the size of your stomach, therefore limiting the amount of food you can eat at one time. A malabsorptive procedure means your intestines are rerouted so that your body does not absorb as much nutrients from food. Lifelong vitamin and mineral supplements must be taken to avoid deficiencies.
  • Sleeve gastrectomy, also known as “sleeve”, is a restrictive procedure. About 80% of your stomach is removed, leaving a tube-like pouch that resembles a banana. The stomach and intestines are not rearranged, but since you are eating less, there may be vitamin & mineral deficiencies if the recommended supplements are not taken throughout life.
  • Adjustable gastric banding or “band” is a restrictive procedure. An inflatable band is placed around the upper portion of the stomach, therefore making you feel full on less food. Tubing connects the band to a port under the skin, and the band is inflated or deflated using a needle, as needed. You may have to visit your physician’s office several times for as long as you have the band. Vitamins & minerals must also be taken when you have the band to prevent malabsorptive issues.

All three procedures have pros and cons. Your doctor will recommend a procedure based on many things such as your medical history, your weight, and past surgeries. The most important thing to remember is that weight loss surgery will help you lose weight, but maintaining this loss for years to come is up to you. Weight loss surgery is a tool. Making healthy food choices and exercising regularly are essential to maintaining weight loss. If behavior changes are not embraced, weight loss is not guaranteed. Attending support groups and seeing a psychologist or mental health counselor will help you with these behavioral changes. Remember, it is a “journey”, not a sprint.

For more information about bariatric surgery options offered at Emory Bariatrics, call 404-778-7777 or visit emoryhealthcare.org/emorybariatrics.

Recommended readings:

  • “Weight Loss Surgery for Dummies” by Mariana S. Kurian, Barbara Thompson and Brian K. Davidson
  • “The Emotional First Aid Kit – A Practical Guide to Life After Bariatric Surgery” by Cynthia L. Alexander, PsyD
  • “Eat It Up! by Connie Stapleton
  • “Emotional Eating Toolbox” by Melissa McCreery, Ph.D
  • “Dying to Change” by Katie Jay
  • “Eating Well After Weight Loss Surgery Cookbook” by Patt Levine, Michele Bontmpo-Saray, William B. Inabnet and Meredith Urban-Skuros

Understanding Nutrition Facts Labels

Nutrition LabelCalories? Fat? Sodium? Carbohydrates? What do you look for on a nutrition facts label? Food labels tell you a lot about what’s in the foods you choose to eat. But they can be hard to decipher. Follow these simple steps to help you make the best food choices for what your body needs.

Step 1: What’s the serving size?
One of the most important pieces of information is also the most ignored! How many times have you eaten an entire package, thinking it’s one serving, just to turn it around and see that it’s actually two servings! That means you have to double all the numbers on the label. Instead of 150 calories, you ate 300. Instead of 7 grams of fat, you ate 14, and so on. Always check the serving size before portioning out your food.

Step 2: How many calories?
This section is helpful to look at if you are working on losing, gaining or maintaining weight. “Calories” listed on the left side are the number of calories for one serving. “Calories from Fat” tell you how many calories come from the fat in the food for one serving. Balance how many calories you eat with how many calories your body uses to maintain weight. Eat more calories than you burn to gain and less calories than you burn to lose.

Step 3: Nutrients to Limit
Choose foods with lower numbers of the following nutrients: Total Fat, Saturated Fat, Trans Fat, Cholesterol, and Sodium. Eating too much of these nutrients may increase your risk for heart disease, some cancers, or high blood pressure.

Step 4: Get More of these Nutrients
Most Americans don’t get enough fiber, vitamin A, vitamin C, calcium, and iron from the foods they eat. Eating more of these nutrients may improve your health and help reduce the risk for some diseases and health conditions.

Step 5: What are Percent (%) Daily Values?
The percentages listed on the right side of the label tell you whether the food gives you a lot or a little of that nutrient. Five percent (5%) or less gives you a “low” amount of that nutrient. Twenty percent (20%) or more gives you a “high” amount of those nutrients.

The Gluten Free Diet: Is It for Me?

Gluten FreeThere has been a lot of hype around “gluten-free” diets in recent years. While thousands tout the benefits of going gluten-free, many people aren’t exactly sure what it is or if it’s the right diet for them. If you’re unsure of what “gluten-free” really means or if you should give it a try, here’s a quick and dirty rundown of things you should know:

  • The first thing you should know is that a gluten-free diet is used to treat celiac disease.
  • So what is celiac disease? Celiac disease is an autoimmune disorder in which the small intestine is sensitive to the protein gluten, often found in wheat, rye and barley.
  • What are the symptoms of celiac disease? It’s a digestive disease, and symptoms include abdominal bloating and pain, chronic diarrhea, constipation, fatigue, iron-deficiency anemia, osteoporosis, missed menstrual periods and numbness in the hands and feet.1
  • How does an allergy cause such a wide array of symptoms? The effect of celiac disease is twofold. First, when gluten is ingested by a person with celiac disease, it can damage the lining of the small intestine, causing uncomfortable digestive symptoms. Secondly, due to the damage of the small intestines, crucial vitamins and minerals don’t get absorbed properly, leading to malnutrition and long-term negative health effects.
  • How do I know if I have it? Celiac disease is genetic, so if anyone in your family has tested positive, it’s probably a good idea for you to get checked, too. The disease can occur at any age, and affects people in all parts o f the world. You can get tested for celiac disease with a simple blood test. People with the disease will probably have higher levels of certain autoantibodies that your doctor will be able to identify.
  • What if I don’t have celiac disease? Can I still do a gluten free diet? Gluten free diets are only necessary for individuals with celiac disease or a wheat allergy. Before going gluten free, take a closer look at your diet- Is your diet balanced? Are you eating a variety of fruits, vegetables, legumes/beans, nuts/seeds, whole grains, and lean meat/low fat dairy? Often, when someone goes from a diet high in processed foods to “gluten free” they end up increasing other foods groups. This increase in fruits, vegetables, legumes/beans, nuts/seeds which may actually be reliving the symptoms, not the avoidance of gluten. If you’re not convinced, make any appointment with your gastroenterologist and discuss how to determine food allergies or sensitivities.
  • Will eating gluten-free help me lose weight? Not necessarily. Don’t fall prey to the idea that “gluten-free” equals “healthy” or “low-fat.” Some processed gluten-free foods are low in fiber so you won’t stay full as long, and they’re often stripped of important nutritional elements. In one case study, the vast majority of participants that adhered to a gluten-free diet gained significant weight.3 And since gluten-free foods often carry a heftier price-tag, you might want to think twice about going free just for weight-loss’ sake.

Takeaways: The gluten-free diet is really only necessary for people who have celiac disease or gluten sensitivity. Don’t get sucked in to the mindset that gluten-free equals a healthier diet. If you want to improve your health choose a variety of fruits, vegetables, beans/legumes, nuts/seeds, lean meats, low fat dairy, and whole grains.

Related sources:

References:

1. National Digestive Diseases Information Clearinghouse, a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institutes of Health (NIH) . http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/#1
2. Antonio Di Sabatino, Gino Roberto Corazza. “Nonceliac Gluten Sensitivity: Sense or Sensibility? Annals of Internal Medicine. 2012 Feb;156(4):309-311.
3. T. A. Kabbani, A. Goldberg, C. P. Kelly, K. Pallav, S. Tariq, A. Peer, J. Hansen, M. Dennis andD. A. Leffler. “Body mass index and the risk of obesity in coeliac disease treated with the gluten-free diet.” Alimentary Pharmacology & Therapeutics. 35:.6; 625-744, March 2012.
4. Biesiekierski JR, Muir JG, Gibson PR. “Is gluten a cause of gastrointestinal symptoms in people without celiac disease?” Curr Allergy Asthma Rep. 2013 Dec;13(6):631-8.

Four “Healthy” Foods That Sabotage Weight Loss

Multigrain BreadIf you’re trying to lose weight, it’s easy to fall into the trap of all of the “healthy” products food companies are pushing these days. Extra calories can be cleverly hidden in these products, sabotaging even the most well-intentioned consumer. The best way to manage or lose weight healthily is to control portion sizes and to eat a balanced diet consisting of lots of fresh or frozen fruits and veggies, lean proteins like chicken, fish, and beans, and low fat dairy. Do your best to avoid these sneaky “health” foods at your grocery store.

Fruited or flavored yogurt
The benefits of yogurt are plenty. It’s a good source of calcium, the live active cultures in yogurt help promote a healthy and happy digestive tract and it packs a protein punch (especially Greek yogurt). But this health food angel can often be a devil in disguise. Fruited or flavored yogurts are usually low fat or fat free, but can have as much as 31 grams of sugar in one six-ounce container! That’s almost eight teaspoons of sugar in your so-called “healthy” snack. Get all the benefits of yogurt without the extra sugar by buying plain, nonfat yogurt (Greek or regular) and adding your own fresh or frozen fruit.

Enhanced waters
Staying hydrated is important to maintaining a healthy weight, but getting the recommended eight glasses a day is difficult for some. Many people fight plain-water boredom by drinking enhanced waters like Vitaminwater. These are basically sugar water and a vitamin pill. If you eat a well-balanced diet filled with fruits, veggies, whole grains, and low fat dairy, you may be getting enough nutrients from food. Do your waistline a favor and drink plain , calorie-free tap, purified, or bottled water. Check out this previous blog post for ideas on making regular water taste delicious without the extra calories.

Fast food salads
Fast food chains want you to believe you really can eat healthy at their restaurants. Many have extensive salad offerings to reel in weight conscious consumers. But beware: the dressings, toppings, and add-ons for these salads can add as much as 500 extra calories to your healthy bowl of fresh veggies. What’s more, the nutritious parts of a salad, like tomatoes and cucumbers, are often used sparingly. If you find yourself with no other choice besides fast food, your best bet is a grilled chicken sandwich — hold the mayo — paired with a side salad. Don’t forget to use the dressing sparingly!

‘Multi-grain’ products
Whole grains are an important part of a balanced diet, giving us carbohydrates for energy and several key nutrients. But don’t confuse ‘multi-grain’ with whole grain. A whole grain product will contain all parts of the grain: the germ, the bran and the endosperm. Whole grains provide essential fatty acids, fiber,and B vitamins. Unfortunately, a lot of the grains in our food supply are refined. A refined grain has the germ and the bran removed, leaving the endosperm, which is mostly nutrient-poor starch. Refined grain flour is easy to work with in cookies, cakes, and breads, which makes it a cheap and versatile ingredient for food manufactures. A food company can claim their product is ‘multi-grain’ even if all of its grains are refined. The term implies nothing about the product’s nutritional value, and it could still have the same amount of calories and fat as any other cookie, cake or cracker out there. To make the right choice, look at the ingredients list on the package label. Look for the word “whole” before the grain listed, and make sure it’s one of the first two ingredients. Better yet, avoid packaged or processed foods and choose whole grains you can see: oats, brown rice, bulgur or quinoa.

Author: Courtney Plush, MS, Emory Healthcare Dietetic Intern

As it Turns Out, Apples May Keep More Than Just the Doctor Away

Apple a Day Keeps the Pounds AwayAmericans have a nasty habit of depriving ourselves when we want to drop pounds. We often believe that cutting calories is the secret to success, but we wind up just feeling hungry all the time. It may surprise you that one healthy alternative to the hopeless feeling of hunger is to actually add food to your diet. Evidence suggests that adding nutrient-dense, fiber-rich foods to your diet can actually help reduce your cravings. The secret? Fiber slows down the digestion of food, so you get a slow and steady source of glucose rather than ups and down in blood sugar levels.

Most Americans don’t get enough fiber. On average, we take in 15 grams a day of the 25 to 38 grams that are recommended, depending on your gender 1. So where do apples fit into all this? One apple with the skin on contains roughly 4.4 grams of fiber, about one fifth of your daily intake. Also, apples are rich in a very powerful kind of fiber called pectin, which is typically used as a gelling agent and stabilizer in food. It’s that stuff that they make jams and jellies out of. Pectin also is effective in delaying the emptying of the stomach by slowing the movement of food from your stomach into your small intestine, which works to discourage overeating and help you sustain that full feeling for a greater extent of time.

Still have your doubts? One study showed that substituting pectin for regular fiber doubled the time it took subjects’ stomachs to empty, keeping them full that much longer 2. In another study, scientists found that when participants ate an apple or a pear before meals they experienced weight loss 3. So, while it might seem counterintuitive, adding in those extra calories before meals can actually help you stay full for longer so that you resist those dangerous junk foods between meals!

But that’s not all. There is more to apples than just their awesome ability to keep us feeling full for longer. Apples provide many positive health benefits, specifically anti-cancer benefits. One report published in 2008 claimed that apple extracts and components have been shown to influence multiple mechanisms relevant for cancer prevention in in vitro studies. They also went on to say that epidemiological observations indicate that regular consumption of one or more apples a day may reduce the risk for lung and colon cancer 4.

Next time you’re looking around for something to eat, try grabbing an apple. By you’ve taken that last bite, you probably won’t be hungry anymore. You may just find that over time it helps you to become a slimmer, healthier you!

 Related Resources: