Monday, June 27, 2016

New Ways of Thinking - 7. Physical Activity


The Medically Supervised Weight Loss Program through KATC Bariatric program does not require physical activity – in other words, you can participate and not exercise, but they do teach the benefits of regular exercise.  My observation was that those who exercised the most also lost the most weight.

Studies show that people who lose weight by dieting alone gain most of the weight back after less than a year, however people who increase their physical activity in addition to cutting calories are more likely to maintain their weight loss long-term.  This finding is especially true for people who have lost very large amounts of weight through medically monitored weight loss programs.

Health Benefits:

  • Decrease appetites – vigorous activity causes the brain to release a natural appetite suppressant
  • Increases resting metabolic rate – muscle mass burns calories, so your body burns more calories all day long
  • Improves oxygen uptake –
  • Reduces blood pressure – thereby reducing the risk of disease like heart attack, stroke, alzheimers, etc
  • Reduces blood sugar/ Reduces Triglycerides/ Reduces LDL/ Increases HDL – reduces risk of diabetes
  • Slows bone loss – helps to prevent osteoporosis
  • Reduces stress & Improves mood – exercise releases endorphins which help alleviate anxiety and depression
  • Improves sleep
  • Improves self-esteem and overall satisfaction with life in general

 

Exercise Planning: F.I.T.T.

It is essential to have a plan for both exercise and activity.  Our bodies like to do what’s easiest, so if we don’t plan carefully, we end up not going to the gym and sitting on the sofa instead of walking.

Use the F.I.T. tool to plan and monitor your exercise:

F – Frequency. 
How often – the Public Health Canada guideline recommends 150 minutes per week of moderate-to-vigorous aerobic physical exercise per week, in bouts of 10 minutes or more.  The more active you are, the greater the health benefits.
 
I – Intensity. 
The level of exertion is important.  In order to have the maximum health benefit, the activity must be aerobic.  You get the best weight loss benefit from ‘brisk’ to  exercise.  Try the Talk Test.  You should be able to breathe comfortably, deeply, and rhythmically at all times during the activity.  You should be able to carry on a conversation.  If you’re breathing so hard that you can’t easily talk, your activity is too intense.  On the other hand, if you can comfortably sing, you should be working a little harder.
 
T – Time. 
How long is the active session?  To get an aerobic benefit, the session must be at least 10 minutes.
 
T – Type
The type of exercise is important.  Our smart bodies adapt fairly quickly to new demands, so changing up the exercise type ensures that new muscles are constantly being developed and worked out.
 

The most effective exercise is weight-bearing and uses our biggest muscles, our legs.  It’s best to select low-impact exercise like walking, cycling – especially to start out.    Aerobic activity uses mostly fats and carbohydrates for energy sources, so it does burn calories.  It also can prevent the loss of lean muscle mass, which can result from dieting.  Most importantly, aerobic exercise can boost your metabolism for hours or even days after each session.

 

Since nearly the beginning of the medically supervised weight loss program, I have completed 30 minutes of moderate-to-brisk aerobic exercise 6 days out of every week.  Mostly, it’s been walking or biking, but sometimes active yard work like lawn mowing, stump pulling, or moving wheelbarrow loads of mulch.  I really didn’t like exercise at the very beginning because it was hard and didn’t feel very nice.  My body adapted quickly and the breathing and movement became easier.  Now that it has become routine, I still have to plan it, but it is definitely less of a burden.

My personal advice – make like the Nike commercial and ‘Just Do It’.

Friday, June 17, 2016

I’ve been thinking a lot about “What was it like a year ago today?”  In some ways it seems like a whole lifetime ago, and a strange and different world, far far away.  In other ways, it seems like it was just yesterday, and life hasn’t changed a whole lot.

A year ago, I had been eating nothing but Optifast shakes for five weeks.  I had lost 23.5 pounds, I had started exercising daily, and I was beginning to feel renewed from the inside out.  I had pretty much run out of 'skinny clothes' and was doing a lot of shopping visits to Value Village and Phase2 stores.
The renewal part is big.  I have developed healthy habits around eating and exercise, but it goes a lot deeper than that - I have developed a new way about thinking about eating and exercise, and about who I am in general.
I have had a few days when I have made bad choices, and it's amazing how quickly the negative self-talk can start back up again.  A couple of times, my weight has been up a little bit or I've felt bloated, and its amazing how I feel like a fat person again and start getting down on myself.  The difference now is that I have learned some tools and I have been able to find a path that allows me to forgive myself for bad choices here and there, and empowers me to problem-solve and come up with strategies and solutions to take corrective action.
Having worked through these struggles has given me a degree of confidence - I'm still nervous about my weight and possible re-gain, but I'm feeling a little less terrified.

Monday, June 6, 2016

New Ways of Thinking - 6. Managing Conditioned Eating

How do we manage this ‘Wanting’ to eat?

There can be every day events that make it difficult to manage your eating, like a particular time of day or event, like watching TV.  Some events happen less often, like eating at a restaurant or going to a social event.  Identifying trouble spots can help us recognize where we need to concentrate our efforts.  Once you identify the high danger times, you can me more aware.
For me, my ‘danger’ times are munching after work and late evening.  My danger situations are parties and pot luck events.
There are some tools that can help us manage conditioned eating:
1.  S.T.O.P.P
See the choice point.  Recognize there is a choice to be made instead of going to the default behavior.
Take a breath.  Counting to 5 can help you settle into this point in time.
Observe your experience.  What emotions/ feelings/ triggers are you feeling?
Play the film to the end.  Try taking a look at how ‘giving in’ will impact you afterwards.  If you indulge now will you feel uncomfortably full, have trouble sleeping, or feel bad about yourself later?
Plan an alternative.  Take a moment to plan out at least 1 alternate behavior.  Maybe just sitting with the ‘wanting’ for 20 minutes, or maybe going for a walk or a bath.
2. Try a Competing Behavior.
Find some activities that you enjoy.  Plan to switch out the conditioned eating with one of these enjoyable activities when you feel like you ‘want’ to eat.  A few of my activities: play guitar, work in workshop, write in journal.
3.  Acceptance.  Distraction or ‘fighting’ a craving can make the craving more intense.  Acceptance is the willingness to experience the wanting to eat without acting on it.  A craving increases in intensity rapidly for about 5 minutes, then levels off.  At about 8 minutes, the intensity starts to decrease and at about 15 minutes the craving will be gone.  Plan to accept the ‘wanting’ for a little longer – about 20 minutes – and the craving will be gone.
It often works best to combine #3 and #4 for best results.  Remind yourself that the new activity is more in line with your values.
4.  Smart Plan.  Make a plan for changing a pattern of behavior.  Picturing yourself doing it beforehand can help you avoid falling back into old habits during a Choice Point.
Example:
What I want to do: stop snacking in the evening while watching TV
Why it’s important: I want to be a role model for my grandchildren
My plan: “I will go for a 15 minute walk when I start to feel a craving every day this week.” (remember SMART – specific, measurable, action, realistic, time-based)
My back-up plan: “I will play the film to the end when a craving hits and remind myself of my ‘why’”
Think of 1 possible barrier that could hold you back from your goal and at least 1 solution to the barrier.
Remember that a ‘slip’ is a first attempt in learning, not a failure.  Slips are an important part of the learning process.

 

Wednesday, May 4, 2016

Happy Anniversary - Year 1


Yesterday (May 3, 2016) was my 1 year follow-up appointment with the Bariatric program.  May 7 of last year was my start of the medically supervised weight loss program.  The appointment itself was kind of a letdown.  It was really for their benefit – record weight, height, and waist measurements, discuss blood work, complete a medical survey, say ‘good job’ and wave bye-bye.  There was no benefit to me, but if it helps them justify the program and keep it supported with ministry dollars then I guess it’s the least I can do.
It was good for me to go from a motivational perspective.  I remembered how difficult it was for me to take the stairs that first week.  I remembered the effort and sacrifice that I put into this journey.  I remembered the ‘before’ pictures and how ‘crappy’ I felt about myself.  It was good to have this little walk down memory lane.  What do we say at Remembrance Day?  “Lest we forget”.
I’ve been able to keep off all the weight that I lost.  All the medical studies that I’ve read report that this is nearly impossible, in other words, gaining back some of the weight lost is nearly the norm.  To make it worse, those that gained back weight – even as little as 5 pounds – typically never lose that weight again.  So I’ve been very careful – weighing nearly every day and recording calories and exercise.  If my weekly average weight is up 2 pounds over my baseline, I start reducing my eating or increasing my exercise, or both.  So far in the 6 months since I ‘graduated’, I have not ‘up’ more than 3 pounds or more than 2 weeks.  Hopefully, the diligence will pay off with successful long-term weight maintenance.
I’m thrilled that I was able to participate in this program.  Would I do it again?  In a heartbeat.  My only regret is that I didn’t do it years earlier.  I feel 30 years younger and I have a new lease on life.

Monday, April 11, 2016

New Ways of Thinking - 5. Building Support

The classroom content for week 6 was 'Building Support' (week 5 was one-on-one sessions with the dietitian.  This is foundational content in that if you are not proactive in developing support relationships and if you are not assertive in stating what you need to support healthy habits, you will not have good success.

Looking back over the past year, I've very grateful for a loving and amazingly supportive wife, supportive family, and an amazing group of friends that have offered amazing support and encouragement.  These amazing people made building support relative easy for me, but others in my cohort were not so lucky and you could tell because they struggled.

Building Support









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Sunday, March 13, 2016

Almost a Graduate!

I've been finding it a little more difficult to post every week.  There doesn't seem to be as much stuff that's new and exciting.  I've been going to a monthly group classroom session.  It has been disappointing.  There really hasn't been new material, and I haven't got a lot of benefit from it.  Apparently, others must feel the same - attendance has trickled down to only a few people.

I was just reading through some of my posts and it's hard to believe that only a year ago I was itching to get started with this program.  Now, I'm ready to celebrate my 1 year anniversary of starting.  It's also kind of weird figuring out what should I celebrate - when I asked for a referral to the program, December 2013?  My first group session, May 7, 2015?  My last weekly session, August 28, 2015?  Well, for now, it's very close to May 7th and I feel like celebrating.  Probably I'll celebrate again in August.

I've generally grown to be pretty comfortable in my new 'skin', but it's not 100% locked in yet.  A couple of weeks ago we were at the YMCA and I was doing some weight lifting and I happened to see this 'skinny' guy in the floor-to-ceiling mirrors - then I realized it was ME!

I'm looking forward to the warmer weather, so we can do a wider range of physical activity.  I've been very faithful with the daily 30 minute aerobic exercise, but many a time it felt more like a chore than something fun.  I've continued to be sensitive to the cold around the house and office, but I've been pleased that when I dress warmly I've been able to enjoy cold weather activity - you know, the whole two times we've had enough snow to snowshoe this Winter :-)

Still drinking 2.0 to 2.6 L of water every day.  Some days it's hard to manage, but it seems pretty normal now.  I think it's because of the high intake of water that my flabby skin is tightening up.  I still have some loose skin, but it's improved by at least 50%.  Yaaayyy.

I've been monitoring my weight and daily food intake very closely.  Still weighing and measuring most of the time.  I've gone several periods where my weight has been up 2 or 3 pounds for several weeks, and each time I've been able to catch it and gain better control - and the weight has come back down again.  It's still alarming, but not so bone chilling scary as the first time.

I've got a few goals.  I'm still working on reviewing my classroom notes, so stay tuned - I'll get them posted here eventually, I promise.  I hope to get in 4 of the 46 high peaks this Summer, and I'd like to get out kayaking at least a couple of times this Summer.  Another goal is to join the National Weight Control Registry.  It is a controlled study involving people who have lost at least 30 pounds and kept it off for at least 1 year.  I'll be able to join in a few month's time.  It will be nice to give back, and it will be a little added accountability.

So I found out this week at group that we don't actually graduate from the program until May 2017, but April 15th is my last group session and May 5th I go in for my final weigh-in, interview, and blood work - so I guess I FEEL like a graduate!

Tuesday, January 26, 2016

New Ways of Thinking - 4. Conditioned Eating

Our class discussion for week 4 was about automatic eating behaviors, or conditioned eating.  The session was about learning to identify your personal eating habits that are based on environmental or time-related cues rather than on physical hunger.  The concept is that if you can identify habit-based eating, then you can develop a plan to eliminate or reduce the counterproductive eating behavior.  More on that next time.

Identifying Conditioned Eating (or 'Needing' vs 'Wanting')






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Tuesday, January 12, 2016

New Ways of Thinking - 3. Motivation

So back to the classroom materials.  I've been taking my time to summarize and organize the classroom materials and the Optifast binder.  It's taking quite a bit of time to work my way through all the pages.

The third classroom session was called 'Values and Goal Setting'.  It was really about making sure that our specific fitness goals are aligned with more global values.  This makes sure that we will have better motivation in working towards the specific goals.  Because the theme was 'motivation', I've included some of the relevant sections from the Optifast binder and a quote from a great book that I was reading at the time.

Motivation



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Saturday, January 2, 2016

Christmas Holidays # 1 Under My Belt !

Boy, Christmas holidays are a really big challenge to healthy habits ! 

Looking back at the holidays, I did Ok - I didn't gain any weight.  I make specific plans on how to deal with the high risk eating times; some worked, some not so well.  I've got some ideas on how to make the next holidays a little more health friendly, so I'm practicing the 'forgive and move on' part.

Lessons learned:
  1. High risk meals need a WRITTEN plan.  One of our family traditions is to have a buffet of festive finger foods on Christmas Eve after our Christmas Church service.  Everything was healthy - nothing fried, not lots of sweets, meatballs with lean turkey, some veggie options.  I had planned to limit myself to a small plate with no refills, and have a balanced snack beforehand to reduce physical hunger.  Good.  Well when the time came, there was so large a variety of fun foods that it wouldn't fit on just one plate.  Since I had helped select the menu, I really wanted to have some of everything, so I though 'Ok, so it's Christmas, two small plates won't hurt (permission thinking), just no refills'.  The plan was also not specific enough - I had not thought through the composition of the plate.  I ended up having way too much volume of high-density stuff like meat balls, cheese balls, crackers, etc.  Another thing I hadn't planned for was the high-calorie beverage, hot spiced apple cider, yum.  I ended up having several mugs, when I should have probably had one followed by a switch to water or tea.
  2. Weight loss has not 'fixed' my migraines.  I had thought that my weight loss had taken migraines out of my life - nope!  I spent the next three days suffering from a migraine episode - mostly abdominal migraine, but not fun.  It seems to have been triggered by the high volume (relatively) of high density food.  Certainly gives me some motivation to not repeat the heavy eating episode any time soon.
  3. Dealing with nuts and candy dishes is hard.  Sue talked with me about the candy and nut bowls ahead of time.  We decided that we would limit these bowls to Christmas Eve/ Day and the times we actually had guests.  This worked reasonably well.  Next time, I should have a better plan on how to include these as 'treat events', in terms of how many/ how often, etc.
  4. I CAN avoid Frozen cookies.  Cookies are hard for me - because I eat them so rarely, they are a highly prized treat, and of course, inherently addictive.  We were able to limit the period of time the cookies were on display, and I did plan on incorporating 2 - 3 into my 'treat events'.  All good.  Several weeks after New Year's day I happened to open the downstairs freezer.  I discovered that there were two containers of Christmas cookies.  Oh my - that was a tough evening.  I managed to stay away - but I ended up having a near binge of healthy fruit in my efforts to steer clear.  A couple of days later I mentioned to Sue that I'd have to bury these containers under other stuff in the freezer, and Sue mercifully got rid of it all.  So yes, I can avoid frozen cookies, but it's better to have an avoidance plan, like bury them or seal the containers, or something.  Better off to keep them out of the house.

So starting of 2016 with flying colors - here we come.....