OSR Weight Management

Don’t Overlook Smart Eating in December

Posted on December 16, 2015 by to press

The holidays are here! As an Obesity Medicine doctor I always hear the argument that this is a terrible time to go on a diet, stick to a diet, work on changing eating habits, etc because the holidays come only once a year, and you want to enjoy them! Sound familiar? But here are some…
The holidays are here! As an Obesity Medicine doctor I always hear the argument that this is a terrible time to go on a diet, stick to a diet, work on changing eating habits, etc because the holidays come only once a year, and you want to enjoy them! Sound familiar? But here are some fallacies in this argument. With the obesity epidemic only growing worse in the US and even in Hawaii (a traditionally ‘healthy’ state), we really can’t blame only the holidays. The risk of weight gain from unhealthy eating are actually a constant, year-long problem that is only worsened during holiday time. Speaking of holiday time – what we define as ‘holidays’ also contributes. A generation ago, holiday celebrations were generally limited to maybe one office Christmas party and dinner at grandma’s on the 25th. But now, the holiday celebration period tends to start for many quite early – sometimes even after Halloween – and includes a nearly endless string of social obligations, potlucks, and events, all involving unhealthy foods. So clearly the holidays’ effects on our waistlines are no longer limited to just one or two splurge meals. Not only do we tend to gain several extra pounds each during Thanksgiving and Christmas, but research shows that we also tend NOT to lose these pounds despite our best New Year’s resolutions. And even if you don’t think a couple extra holiday pounds matter, if you do that year after year, the pounds add up and they tip the scale, and your body composition, in the absolute wrong direction. Having said that, you don’t have to be a Grinch – you CAN stay healthy and still enjoy all the fun of the seasons. Some suggestions: -bring healthy snacks to share at potlucks – like a crudité platter -watch liquid calories like alcohol and eggnog -focus on activities and special events: walking through the Honolulu City Lights display with friends and family, or going to watch the     Nutcracker ballet, rather than just sitting and eating, to make the holiday memorable. -stick with like-minded, supportive friends as much as you can to reinforce and validate your commitment to the healthiest 2016 possible!

Shopping? Support the Obesity Treatment Foundation

Posted on December 9, 2015 by to press

As you are in the midst of all the hustle and bustle of holiday shopping, there’s a great way to use your retail dollars for good.  Via Amazon Smile, you can help support the efforts of the Obesity Treatment Foundation.   The Foundation is a non-profit organization with a critical mission.  First, the Foundation aims…

As you are in the midst of all the hustle and bustle of holiday shopping, there's a great way to use your retail dollars for good.  Via Amazon Smile, you can help support the efforts of the Obesity Treatment Foundation.

 

The Foundation is a non-profit organization with a critical mission.  First, the Foundation aims to help amplify the quality and quantity of clinical research.  Second (and near and dear to my own heart), the Foundation seeks to inform medical professionals that obesity is a chronic, complex disease warranting comprehensive medical management.

 

As doctors, we are currently under-treating our patients with overweight and obesity.  Often times, it is simply because we fail to start the conversation.   The Foundation along with it's parent organization, the Obesity Medicine Association, is working tirelessly to provide resources to clinicians regarding obesity care and treatment, as well as simple clinical tools to help break the ice, and engage and inform patients.  Support the great work they are doing by clicking the link below, while you buy gifts this holiday season!

 

http://smile.amazon.com/ch/90-0730509

 

Read more about the Obesity Treatment Foundation here:

http://obesitymedicine.org/obesity-treatment-foundation/about-the-obesity-treatment-foundation/

Could Bite-Counting Aid in Weight Loss?

Posted on December 9, 2015 by to press

Hate counting calories and/or carbs?  Have you tried counting your BITES of food?   This is only a small study of 61 individuals, but based on the results, bite-counting in the absence of any other effort to diet may result in modest weight loss at one month (3.5 pounds in the bite-counting group compared to the…

Hate counting calories and/or carbs?  Have you tried counting your BITES of food?

 

This is only a small study of 61 individuals, but based on the results, bite-counting in the absence of any other effort to diet may result in modest weight loss at one month (3.5 pounds in the bite-counting group compared to the non-bite counters).  

 

What's the mechanism of the weight loss here?  It was suggested that perhaps the bite-counters eat more slowly because they are counting, which we know increases satiety signals.  The bite-counters may even have gotten so sick of counting, that they stopped eating early.   These may be partially true - but what is intriguing about this study is that it may be a partial measure of the effects of mindful eating practices on our intake.  Counting bites could lead to increased mindfulness while eating, and possibly then weight loss.

 

Regardless of counting bites, WHAT you eat of course matters, which is why OSR Weight Management places such a big emphasis on Ideal Protein's high-quality meal replacement as well as the whole foods meals you cook at home.  After all, even if you are counting bites, it's doubtful that you can lose weight if every bite is fast food or sugary carbs. 

 

Read more here:

http://well.blogs.nytimes.com/2015/11/25/counting-your-bites-for-weight-loss/?_r=0

Obesity and Sudden Cardiac Death in Women

Posted on December 2, 2015 by to press

We’ve believed that the dangers of overweight and obesity were highest in midlife and beyond.  A new study of young adult women now suggests that early-adulthood obesity may increase the risk of sudden cardiac death.   A re-analysis of data from the well-known Nurse’s Health Study showed that women who were overweight or obese at the beginning…
We’ve believed that the dangers of overweight and obesity were highest in midlife and beyond.  A new study of young adult women now suggests that early-adulthood obesity may increase the risk of sudden cardiac death.   A re-analysis of data from the well-known Nurse’s Health Study showed that women who were overweight or obese at the beginning of the study showed an elevated risk of sudden cardiac death throughout the entire study period. Furthermore, researchers also found that weight gain in early-to-mid adulthood was associated with greater risk of sudden cardiac death regardless of BMI (body mass index) at age 18.  So even being slim in your younger adult years did not seem protective in this study.   The study began when the participants were age 18.  In following over 72,000 women, researchers documented 445 cases of sudden cardiac death, 1,286 cases of fatal coronary heart disease and 2,272 non-fatal heart attacks. Women with a higher BMI during adulthood showed a greater risk of sudden cardiac death – even among those who were not obese, but merely overweight.   The study certainly has limitations: because of the observational nature of the study, we can’t determine a definite cause/effect relationship between obesity and sudden cardiac death.  Also, most of the women studied were predominantly educated white women, so it is hard to know if the results are applicable to other socioeconomic and racial groups.  My take though is that educated white women often have better health due to better access to resources – so I suspect that the data may be even more worrisome in other ethnicities, such as our diverse population in Hawaii.   Bottom line though is we need to do everything we can to keep our weight under control throughout our entire adult life.  Being slim as teens does not seem to be protective, and clearly cardiac disease is not just a men’s issue.   Read more here: http://electrophysiology.onlinejacc.org/article.aspx?articleID=2473395

More Evidence that BMI Does Not Tell the Whole Story

Posted on November 16, 2015 by to press

The Annals of Internal Medicine’s latest edition calls attention to a high-risk segment of the population:  those individuals with a normal BMI but with a high body fat percentage. Normal BMI?  How could that be possible?  Most clinicians tell our patients that they are doing great with their normal BMIs.  But just how at risk are these patients, really?…

The Annals of Internal Medicine's latest edition calls attention to a high-risk segment of the population:  those individuals with a normal BMI but with a high body fat percentage.

Normal BMI?  How could that be possible?  Most clinicians tell our patients that they are doing great with their normal BMIs.  But just how at risk are these patients, really?

The Annals study authors found that people with normal BMIs and abnormal accumulation of abdominal fat had a significantly higher risk of death, than individuals with a BMI of 30 or greater.    

Doctors have noted this anecdotally in clinical practice:  take the huge preponderance of relatively thin males presenting to the ER with massive heart attacks.  Not what one might expect.  

This is another reminder that obesity cannot be defined by BMI alone.   Patting ourselves on the back for being 'skinny fat' is false reassurance.   And another reason why at OSR Weight Management in Kailua, our comprehensive assessment of metabolic risk for each and every patient goes way beyond BMI - that ubiquitous but severely misleading number that is likely leading us to undertreat adiposity.

 

Read more here:

http://conscienhealth.org/2015/11/how-obesity-matters-more-than-bmi/

Obesity Rates Still on the Rise

Posted on November 13, 2015 by to press

What plateau?  A preliminary peek at the latest data from the CDC:  in 2011-2012, the overall rate of obesity among US adults was 35%, a number that seemed to be holding steady from 2003-2004.  However, for 2013-2014, that overall obesity rate is now 38%. What are we doing wrong?  We’ve finally got obesity recognized as a treatable…

What plateau?  A preliminary peek at the latest data from the CDC:  in 2011-2012, the overall rate of obesity among US adults was 35%, a number that seemed to be holding steady from 2003-2004.  However, for 2013-2014, that overall obesity rate is now 38%.

What are we doing wrong?  We've finally got obesity recognized as a treatable disease by large powerful organizations including the AMA.  There's been a great effort among health professionals and advocacy groups to increase public awareness of 'healthy' eating.  By some measures, American were drinking less soda and eating less junk food.  Multiple new FDA-approved weight loss drugs have come onto the scene.  Even in Hawaii, a 'healthy' state compared to many others, I don't see us escaping the same fate as the rest of the nation.

We know obesity is complex.  So our best hope remains intensive behavioral efforts focused on dietary re-education, psychosocial support, and foods that support mobilization of fat stores.  Our efforts now are more critical than ever.

 

Read more at:

http://www.medpagetoday.com/Endocrinology/Obesity/54676

How Weight Affects Arthritis

Posted on November 12, 2015 by to press

How does your weight affect your osteoarthritis, degenerative joint disease of the spine, rheumatoid arthritis, fibromyalgia, lupus, or gout? Besides just sheer pressure (for every extra pound of weight we carry, our knees feel an extra 4 pounds of force), there’s another layer here. Why does excess weight worsen arthritis of the hand and wrist?  We…
How does your weight affect your osteoarthritis, degenerative joint disease of the spine, rheumatoid arthritis, fibromyalgia, lupus, or gout? Besides just sheer pressure (for every extra pound of weight we carry, our knees feel an extra 4 pounds of force), there's another layer here. Why does excess weight worsen arthritis of the hand and wrist?  We don't walk around on our hands all day, after all. We now understand that fat cells are very powerful endocrine organs in themselves.  Fat cells create and release inflammatory compounds which can cause and/or worsen all kinds of arthritis.  That's why people who are overweight or obese have a far greater risk of developing arthritis.  And once arthritis is established, the excess weight places that person at risk for long term joint damage - arthritis is far more than just a pain in the neck. Both obesity and chronic musculoskeletal pain each pose potential barriers to treating the other.  In order to improve each of these chronic diseases, we need to target both for treatment - which is exactly what we do at Oahu Spine and Rehab and OSR Weight Management, in Kailua! Read more here: http://www.arthritis.org/living-with-arthritis/comorbidities/obesity-arthritis/fat-and-arthritis.php

Holiday Eating Strategies

Posted on November 10, 2015 by to press

  Aloha to our Dieters and Maintenance-phase Graduates! Time to talk strategy for getting through the holidays!   There are a couple different approaches to holiday eating: THE IRON WILL APPROACH Some of you are recent grads and some are only weeks from graduating to maintenance. Some of you will choose the “Iron Will” approach,…
 

Aloha to our Dieters and Maintenance-phase Graduates!

Time to talk strategy for getting through the holidays!

  There are a couple different approaches to holiday eating:

THE IRON WILL APPROACH

Some of you are recent grads and some are only weeks from graduating to maintenance. Some of you will choose the “Iron Will” approach, eating nothing that would compromise your fat burning. Good candidates for this “Iron Will” approach would be individuals who are very new to the program and haven’t mastered a strong set of healthy eating habits yet. Also, those of you with only a few weeks left on the program, following the “Iron Will” approach will ensure you meet your goal when expected. Otherwise, you will extend your time on the program by 1-2 weeks by eating foods that would compromise your fat burning. So, keep that in mind. Plan to succeed or you’re planning to fail. So, if you’re traveling to someone else’s house, bring a large platter of veggies and some Walden Farms or bring a big mixed greens salad or some other creative side that’s safe on your program. If you plan to use the “Iron Will” approach, here are some key phrases you can use to excuse yourself politely from eating things you don’t choose to eat: The Crafty Dismissal: “Ooh, that looks delicious! I’m stuffed so I’ll just have to take it home for later.”  (Then store it in your freezer ‘til graduation, pitch it in the dumpster, give it to your dog…) The Firm Hand: “Thank you for respecting the fact that I have some personal goals I am working on and, while that looks delicious, it would compromise my goals so I’ll have to wait. Thanks!” The Medical Excuse: “My doctor recently told me I am pre-diabetic. I really have to watch out for foods that spike my insulin. I’ll have to pass.” Guess what?! If you’re overweight, you really are pre-diabetic. The Allergy Excuse: “I recently found out I am violently allergic to that! No thanks!” I have used this many times and it works!! The one question you might get is, “Wow, what happens when you eat it?” and your response can be as simple as this. “You don’t even wanna know!” That’ll stop the conversation right there.  

THE ‘ONE DAY PASS’ APPROACH

Thanksgiving comes once a year and there will be a number of dieters who feel they’ve earned a day off from Ideal Protein. If you choose this approach, here’s how we’d like to you to proceed if you choose to eat things that will compromise your fat burning.
  1. Moderation is KEY. Let’s not undo all the healthy habits we’ve built on this program. Practice regulating portion sizes- eat only 1-2 teaspoons of your favorite holiday foods and do not go back for seconds.  Skip the cookies and pies- they’re so full of fat and fast-acting sugar that it’s not worth it. Plus, if you don’t moderate, you may feel very sick the next day…ew.
  2. The “One Day Pass” is just that- ONE DAY ONLY. You are not authorized to spend the whole week of Thanksgiving eating this way. It’s not healthy and it’s destructive to all the new healthy habits you’ve worked so hard to build- don’t undo all your hard work!
  3. If you use the “One Day Pass” you must do the IP “Reboot” (see attached) the next 3 days following Thanksgiving. This means ultra low carb veggies and NO restricted food items (bars, puffs, ridges, etc.) Your pancreas needs to rest and recuperate from the abuse of the holiday foods, PLUS this will get you back into ketosis quicker.
 

THE ‘GOING HOG WILD’ APPROACH

This is not an acceptable approach if you are serious about changing your body, your health, and your life. We will question your motivation to lose weight if you use this approach. Here are some things to consider before “Going Hog Wild.”
  1. “If you always do what you’ve always done, you’ll always get what you always got.” Have you heard that before? Don’t expect to do something the same way you always have and expect different results. Binge-type eating and lack of portion control is part of what let many of you to the weight at which you started the Ideal Protein journey. It takes an average of 28 days to make a habit but only one minute to break it. Tread lightly.
  2. You are likely to feel very unwell that night, the next day, or even for several days after. You may feel hung-over, even if you didn’t drink but overdid it with sugars.
  3. You will start carrying excess water (bonded to the new carb molecules floating through your system), feel bloated, and probably guilty and have regret. Wow, it’s so not worth it!
  4. That’s expensive!! “Going Hog Wild” will cost you an extra $100-$200 because it will stop our fat loss, waste at least 5 days of progress, and ultimately extend your time on the program as well as compromise your overall results. Again, is it worth it?
In conclusion, you have a choice to make about how you will approach the holiday eating. Please know that you still should write everything you eat down in your food journal. Make choices you can feel good about.   We hope you enjoy Thanksgiving Day and we hope it’s amazing for each and every one of you! This Thanksgiving we are so grateful for all of you! You have been awesome to work with and we value the trust you place in us to help you meet your personal goals. Thank you for being so wonderful! You make our jobs joyful all year long!  

Kelli Wilson, Certified Health Coach

Linda Anegawa, MD

Ideal Protein Re-Boot

Posted on November 10, 2015 by to press

*for when you hit a plateau* *NO RESTRICTED ITEMS NO OCCASIONAL VEGGIES* Breakfast: packet, as usual Lunch: packet, veggies, and salad Dinner: 2 packets, veggies and salad No meat protein Snack: packet, as usual Stick to soups, “jello”, juices, and pudding packets You can make an omelet with 1 whole eff and 3 egg whites…

*for when you hit a plateau*

*NO RESTRICTED ITEMS NO OCCASIONAL VEGGIES*

Breakfast: packet, as usual

Lunch: packet, veggies, and salad

Dinner: 2 packets, veggies and salad No meat protein

Snack: packet, as usual

Stick to soups, “jello”, juices, and pudding packets

You can make an omelet with 1 whole eff and 3 egg whites and your veggies for supper in place of 1 of your evening packets. Again- you can add another packet if you want to double the protein.

This will put you at 4-5 packets for the day. Try this for 2-3 days. I often found that 2 days was enough to get the scale moving.

Do NOT exercise during these days.

Remember LOTS of water. Add some lemon juice to your water early in the day to flush out your system.

As much as we don’t want to hear it, sometimes restricted can slow the weight loss, so a few days without should shake things up!

FDA Recommends Cap on Americans’ Sugar Consumption

Posted on November 9, 2015 by to press

Finally. Obesity medicine experts and public advocacy groups, have been nudging the FDA for years to change their lifestyle and to help kick the sugar habits.  A high-sugar diet is likely to cause harmful metabolic effects separate from weight gain:  it likely promotes chronic inflammation, high blood pressure, and insulin resistance which can lead to outright diabetes…

Finally.

Obesity medicine experts and public advocacy groups, have been nudging the FDA for years to change their lifestyle and to help kick the sugar habits.  A high-sugar diet is likely to cause harmful metabolic effects separate from weight gain:  it likely promotes chronic inflammation, high blood pressure, and insulin resistance which can lead to outright diabetes and raise the risk of heart attack and stroke.  

 It seems the FDA  is finally starting to comply.  The new goals?  For Americans to limit their daily sugar intake to no more than 10% of their total daily calories.  For adults and children over the age of 3, that means no more than 12.5 teaspoons, or 50 grams daily - roughly equal to a can of Coke.

Giving up a can of coke though, is probably the easy part for most of us.  The much harder part is that sugars lurk nearly everywhere - in low fat yogurts, granolas and cereals, salad dressings, breads, processed foods, and of course in one of Hawaii's favorite marinades - teriyaki.  

 This means it's not enough to just quit soda.  Each and every one of us has to become expert label-readers.  We can't just rely on advertising that touts a product as healthy, without really knowing exactly what is IN the food we eat.

 Read more here:

http://well.blogs.nytimes.com/2015/11/09/placing-a-cap-on-americans-consumption-of-added-sugar/?ref=health&_r=2&utm_content=bufferf7408&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer