The Label vs. The Packaging: Weight Loss & Understanding the Difference

As a former teacher, one of the sayings I love is “when all else fails, read the directions!” It was true for most students and it is true for most of us still today: we don’t read instructions, nor do we read food labels either. The government is trying to keep us informed by insisting those nutrition labels are there, and it even mandates what the manufacturer can put on that nutrition facts label, but the labels don’t do any good if we don’t read them. When you ask most people, they don’t read the labels for a variety of reasons: 1) ‘I already know what it says’; 2) ‘It’s all lies anyway’; and 3) ‘I can’t make sense of all that gibberish!’

Ideally, I should say I am a dedicated reader of labels, but most of the time, unless it’s something new, I don’t really check the labels either. (My bad!) Even then, most of the time, I do what I am sure most of us do: I check the calorie count! I will also check the protein, fat and carbs, but I’m normally checking for calories and serving size.

There is a very real and important difference between packaging and the nutritional facts label on a product.  When it comes to packaging, the government is much more lax than when it comes to the nutritional facts.  For example, a lot of consumers will purchase a loaf of bread that has the words “all natural” on the packaging, but there is no legal definition of “natural.” The cellulose mixed with shredded cheese to keep it from clumping up comes from wood pulp (as in trees!) and it can be labeled as “all natural.” However if your avocado has a sticker on that says “Certified Organic,” that means it has to have been grown according to certain requirements.  Manufacturers know that when it comes to packaging, it’s what more of us pay attention to and read over that little box of information on the back.  So they put a lot of their own attention into putting the right words and phrases on the front of the package!

One of my friends gave me a good example of packaging vs. the label a few weeks ago.  She was at Trader Joe’s and saw of bag of black licorice with the words “Gluten Free!” on the front.  The Gluten Free hype is one of her ‘hot buttons,’ so when she scoffed “licorice has always been gluten free,”  she was surprised when I told her that licorice is made with wheat flour. I’ve read the nutritional label on licorice for the ingredients, among other things, so licorice hasn’t always been gluten free. While I am sure she perused the label for the calories and probably even the serving size, unless you read the ingredients, you don’t know what is in it. This is why so many people stop at those first two items; the ingredients list is a whole new headache!

Those first two items (the serving size and the calorie count) are enough of a headache! How many of us have bought a candy bar, checked the calories “eh, 220 is okay,” eaten the whole thing, only to realize that the manufacturer counted that entire candy bar as two servings? I found out that way about my favorite Pay Day bars. Yikes! It’s on that nutritional facts label, so no one can say the manufacturer didn’t warn me. It’s my fault for not reading that label! This is why there was such a strong movement to put the entire calorie count on the front of the package: most of us aren’t going to drink half a 12 oz. can of soda or bottle of lemonade, so by putting the whole amount of calories on the front of the bottle or can, we knew right from the start how many calories we’d be getting!

There is no denying that calories count (it says so on the front of vending machines now) but there is a lot more information in those little labels than just servings and calories.  The ingredient list is also a little important and the manufacturers like to play fast and loose with that too! One of the commercials I’ve been seeing lately is for Kind bars.  In the commercial, they compare a Kind bar made with almonds to a Clif bar made with brown rice syrup. [Kind vs Clif] As the commercial points out, brown rice syrup is another name for sugar. There is a reason labels manufacturers use ingredients such as brown rice syrup, agave syrup, maltose, dextrose, sucrose, or even just plain honey: either they sound really “natural” or “healthy” or we don’t know what they are.  They are all forms of sugar. (Hint: pretty much anything ending in -ose on a label is a sugar.) The manufacturers of foods like Clif bars and Kind bars know that many of their consumers are looking for something healthy or all natural, which is why choosing a product that doesn’t say “sugar” is more attractive. Or perhaps more deceptive.  If you want to cut back on your sugar intake, you may not realize that the agave syrup, molasses, cane syrup or honey are all metabolized the same as table sugar (sucrose).

Of course, no one is going to quiz you on the ingredients in your kombucha, BBQ sauce or pancake mix. What you choose to eat is all up to you, but if you are trying to lose weight or just eat healthier, it’s worth it to spend a little time looking at those food labels.  A big way to cut down on your label-reading is to make it simple: buying mostly whole foods makes it pretty simple! When I buy a bag of broccoli, the ingredients list simply says: “Broccoli.” Buying bagged salad is similar: “Green cabbage, carrots, butter lettuce, baby spinach.” Even if you get a salad kit, you can choose to use or not use the croutons or salad dressing included.  Half the time, I use my own salad dressing.

This is one of the places where I do read the ingredients, serving size and calories! I am trying to avoid “crop oils.” These are things like canola oil, safflower oil or other vegetable oils other than olive or avocado. Those oils tend to be higher in Omega-6 fatty acids which are pro-inflammatory.  Since arthritis (an inflammatory disease) is one of my issues, I try to get more Omega-3 fatty acids in my diet, such as fish, olives and avocados.  By sticking with mostly whole foods, I avoid a lot of them, but if I am buying something new, I read the label for those crop oils.

If you are one of those people who is sensitive to gluten, lactose or anything else, reading the ingredients list should be part of your regular practice. I am not sensitive to gluten, but I was surprised to find that one of my favorite foods (surimi aka ‘fake crab’) isn’t gluten free because a lot of it is made of fish paste (usually pollock) and wheat starch as a binder.  That was a big shock to me, since I also try to avoid starch.  Here’s one place where I should have been reading the labels!

You don’t need to examine every ingredient on the label, nor do you have to memorize how many calories per serving or how many servings per package, but taking a little time to review what you are eating isn’t a bad thing.  It can also help you make better food choices, especially if you are trying to lower your blood glucose, sodium intake or watch those calories. I think it is also important to remember that just because a product says “all natural” or “natural flavors” does not mean it is organic, pesticide or herbicide free or isn’t genetically modified.  If these are the kinds of things that matter to you, then spend a few moments to look at the label.  You might be surprised to find how much you don’t know about your favorite candy bar!

 

 

Little Things, Big Things: Weight Loss & What Matters

We’ve all said it: “this one little thing won’t matter!” In most cases, you are right: that extra bite of the bagel isn’t going to send your diet careening off the cliff, but how many of those “little things” do we eat during the day, or the week?

To put it in perspective, remember the last time you broke a twenty dollar bill to buy something that was only a couple dollars? That left you with $18 in your pocket, probably in ones, a five and a ten.  Later that week, you opened up your wallet to pay for your coffee and discovered there were only three dollars in there: what happened to the rest of my money? It all went to “little things!”  This is why most of hate breaking a large bill: it’s too easy to spend the small change without thinking about it!

We do this with time also: it’s not that we spend hours and hours on Facebook or Instagram or Twitter, but we spend 15 minutes here; 20 minutes there and then a few more minutes at lunch and then while we are at the gym or waiting in line for coffee, and by the end of the week, your phone tells you that you spent 12 hours online that week– and that is just your phone! How much time are you spending on the tablet or the laptop?

It never feels like we spend 12 hours a week online or that we spend $50 on coffee a week, but when we look at the actual numbers, that’s what it comes out to.  My phone adds up how much time I spend online, my bank statement shows me how much I spent on coffee but each time, it feels like “these few minutes won’t matter” and “it’s just one grande latte– it won’t matter!”

Yes, they DO matter! Our time gets wasted in minutes; our money gets wasted dollar by dollar and our weight loss gets eroded bite by seemingly inconsequential bite! That’s the bad news; the good news isn’t that we have to turn into Diet Nazis and never eat anything that isn’t 100% in line with our weight loss goals. We just need to make sure our habit isn’t telling ourselves “this one thing won’t matter!”

It sounds simple but it’s that mindset that lures us into the “Doesn’t Matter” habit.  We try hard not to be that Diet Nazi but then we lean too far the other way.  It’s that same pattern that leads us to spending all our loose change and all those extra minutes online. We need to keep our focus: what are we spending our money on? where are we spending our time? what are we eating and drinking?

One simple way to keep track is to whip out that phone and take a picture. We do it for Instagram or Facebook so why not do it for ourselves? We don’t have to keep them forever, but at the end of the day, it’s a pretty good reminder of how many of those ‘little things’ we actually ate. It can be surprising! There was one woman who started putting all those ‘little things’ she would normally eat at work into a gallon sized ziplock bag and at the end of the day, the bag was nearly full! She hadn’t eaten an entire cake or box of cookies: the just the calorie equivalent in little bites!

Instead of telling ourselves that “one little thing doesn’t matter,” we need to start asking ourselves “what else have I had today?” Even better, we can just tell ourselves “not today.” We don’t need to track everything we eat and drink, although that’s not a bad idea, but getting into the habit of pausing before we give ourselves permission is a great way to start! It works with money and time too! Instead of just reaching into your pocket or clicking on the app, pause for a moment. Take a look at the money in your wallet or put your phone in a drawer: it’s amazing how much money, time and calories you can save when we take stock. Besides, when you finally sit down to enjoy that online time, shopping or special treat, you can focus on how much you really enjoy it!

 

The Insidious Snack: Weight Loss, What You Eat & WHEN You Eat

In his book The Obesity Code, Dr. Jason Fung refers to “the insidious snack” in chapter 11.  As a nephrologist (kidney doctor), most of Dr. Fung’s patients are diabetics and usually obese, which sparked his research and subsequent books on the subjects of obesity and diabetes.  After indepth research and years of treating his patients, Dr. Fung has come to a few conclusions: the major cause of obesity, diabetes and weight gain is insulin resistance and the two driving forces behind insulin resistance are diet and meal timing.

Insulin resistance is what happens when we always have insulin (a storage hormone) in our blood stream. We eat something; our digestive tract turns the food into glucose, amino acids and fatty acids which flood our blood stream and our body releases insulin to put the glucose into storage as fat.  When we are insulin resistant, our cells are resistant to letting in the insulin with its attached glucose for storage, so our body has to release more insulin to do the same job as before. The more insulin we have in our blood stream, the more we need to release to keep doing the same job and the longer it takes to clear the glucose and insulin from our blood. Say you are sweeping up a handful of sand from the floor.  If your broom has tight bristles, it only takes a few sweeps to get up the sand, but if your broom has gaps in the bristles or they are frayed and loose, it will take twice as many sweeps to get up that same handful of sand.  It takes longer and isn’t as effective, so you keep sweeping up what was missed.  This is what happens with glucose and insulin when we are insulin resistant.

Insulin resistance happens over time and it isn’t something that ‘happens’ to us like an illness or an accident: we make ourselves insulin resistant through our food choices and eating habits. In the last fifty-plus years, we’ve been encouraged to eat more ‘healthy whole grains’ and processed foods and we’ve been encouraged to eat more often.  These are the two chief causes of insulin resistance and its metabolic companions, obesity and diabetes. Refined carbohydrates such as bread, pasta, cereals and other grains, along with sugar, are the major offenders when it comes to blood sugar and insulin.  Eating a bagel for breakfast will cause a bigger spike in our blood glucose which means more insulin is released into our blood stream than if we had eaten scrambled eggs instead. That means it takes longer to clear the glucose and insulin and return to fasting (non-eating) levels.

Refined carbohydrates aren’t a new invention but snack foods are. In the past, snacking between meals was discouraged and there certainly wasn’t a class of food made just for snacking! In the late 1970’s, food companies started encouraging people (and kids especially) to eat between meals.  Snack cakes, snack crackers, snack packs of pudding and other snack foods fill up grocery store aisles and most gas station mini-marts are dedicated almost entirely to these snack items. Most of these foods are sugar-rich or made up of refined carbohydrates but what’s worse is that we are encouraged to eat them at any time of day!

Some health care professionals promote eating every two to three hours to “boost our metabolism.” In short, eating more often supposedly ‘revs up’ our metabolism so we lose more weight. So, ‘Eat More, Lose Weight’? Not likely! While eating briefly speeds up our metabolism to digest the food we ate, the increase is negligible compared to the extra calories and the insulin resistance which results from the continued snacking! All those times we told ourselves that this one little snack won’t hurt us? Wrong!

Remember when I said insulin is a storage hormone? That means you can’t burn fat (lose weight) while insulin is in the blood and every time we eat, we release insulin so the insulin never has a chance to clear because we are always eating! When we are insulin resistant, it takes even longer to clear, so if we eat every two to three hours, when are we able to burn fat? That would be never! So we keep on gaining weight and becoming more and more insulin resistant until we become diabetic and our metabolic problems continue to multiply.

Before the obesity epidemic arose in the early 1980’s, people ate refined carbs and cereals but other than lower sugar consumption, this idea of snacking is the biggest change in eating habits. People ate breakfast, lunch and dinner and nothing in between.  That meant that for several hours in between meals and during the night, insulin wasn’t circulating in their blood stream.  They ate meals, including refined carbs, and then they stopped eating for hours until the next meal.  That meant insulin was released, cleared the glucose and went away until the next meal. They didn’t become insulin resistant because they weren’t constantly exposed to insulin even when they did eat sugar or refined carbs.

In several of his books, including The Obesity Code and The Diabetes Code, Dr. Fung recommends fasting to counteract insulin resistance.  He also deals with some of the misconceptions that come with the idea of going without food for a prolonged period of time in his book The Complete Guide to Fasting. This doesn’t mean that you have to starve yourself for days or weeks to lose weight. It does mean that we should stop eating between meals and if you aren’t hungry at breakfast or lunchtime, then don’t eat. Skipping a few meals if we aren’t hungry or are too busy to eat isn’t going to hurt us and will improve our insulin resistance and for goodness’ sake, put down that insidious snack!

What’s In YOUR Yogurt?: Weight Loss & Probiotics

A few days ago I was having lunch with a friend of mine and I had brought a bottle of kombucha.  As she looked at the bottle, she commented that “everything has probiotics now!”  It’s true: there are a variety of foods you can get that have the words “live probiotics!” enthusiastically plastered all over the labels.  Pharmacies and health foods have entire aisles devoted to probiotics, prebiotics and combos of both. Obviously there is a huge market for these now, but in reality, probiotic foods have been around for centuries.

Pretty much everyone now knows that yogurt’s live bacterial cultures are actually probiotics.  That’s one of the reasons yogurt is good for you, aside from the calcium and protein in it.  Looking back at some of my most favorite foods, there are a lot of them that are probiotic: yogurt, kefir, sauerkraut, pickles, kimchi, etc.  Essentially, these are foods which have been fermented in order to make them.  We add some bacteria to milk and let it sit in the right conditions: voila! yogurt or kefir! We do the same thing to cabbage and we end up with either sauerkraut or kimchi, and when we do it to cucumbers, we end up with pickles! Even if we don’t add the bacteria, by leaving it where bacteria can get in, we still end up with the same result.

I am sure there are some of you are thinking “Ewwwww!! Spoiled food!” The truth is that by fermenting the foods, we are preserving them. While the food will eventually spoil, the fermentation not only adds a little shelf life, but it provides some necessary and healthy bacteria.

But in today’s antibacterial world, the idea of bacteria can seem unhygienic.  On the surface it appears ironic: everything is antibacterial but everyone is taking probiotics! Unfortunately, there is more than a little correlation. But first: why is bacteria important to our health instead of bad for it?

The new buzzword for “healthy bacteria” is microbiome.  Our intestines and pretty much the rest of our bodies are covered with bacteria. (There is even a body wash being marketed as ‘good for your skin’s microbiome!’)  However, it’s the bacteria in our intestines which are necessary for our survival.  No exaggeration here: these bacteria break down the food we eat so our intestines can absorb it.  No bacteria= no breakdown= no absorption= no you. It’s that simple! They also protect us from some of the toxins we ingest as well. If our gut bacteria aren’t healthy, we aren’t healthy.  This is why the stores and internet are full of probiotics (healthy bacteria) and prebiotics (food for that healthy bacteria).  Everyone is very concerned with keeping our gut bacteria healthy because unfortunately, so many of us have problems with our gut bacteria aka digestive issues.

Remember: everything is antibacterial these days! Those antibacterial soaps, hand sanitizers and antibiotics do not discriminate against “good bacteria” and “bad bacteria.”  If you take something for an ear infection, you are killing not only the bacteria causing your infection, you are killing your gut bacteria too! We don’t seem to realize that when we are ‘waging war’ on bacteria, our healthy bacteria end up being collateral damage, but until we start having issues with our health, we don’t realize that we are also part of that collateral damage!

Some of you may know that many years ago, my sister worked at the law firm where I am now a legal assistant and while my sister was here, one of the assistants had to retire due to inflammatory bowel disease. When I came to work at the same firm years later, I was shocked to see giant bottles of hand sanitizer on practically every flat surface! Each desk, filing cabinet, table, counter and work space had an industrial sized bottle of the stuff. Even the table in our lobby had the giant version and the one pervasive scent in the building was ‘hand sanitizer.’ Once I saw everyone using hand sanitizer almost daily, it made me wonder if that assistant’s IBD had been triggered or aggravated by the constant use of antibacterial hand sanitizer.

I am not against antibiotics or antibacterials.  I have my own small bottle in my purse. I keep it for those situations where something I touched was gross and soap and water weren’t readily available but it still takes me forever to go through it. In fact, I usually lose it or it dries out before I finish off a bottle because I’d rather just wash my hands.  It’s not that I’m a slob or unhygienic but there is an advantage to being exposed to different bacteria.

While I didn’t exactly grow up on a farm (like my dad), I did live in the country for several years in addition to visiting my grandparents on their ranch.  The barn and orchards were my playgrounds most of the time and I think that was good for me.  Dr. Josh Axe in his book Eat Dirt [Eat Dirt book ] referenced a study involving Amish children and their non-Amish peers. The Amish children growing up in a mostly rural environment are exposed to all kinds of dirt, manure, plant pollen and animals.  As we all know, the country can be kinda dirty! The Amish children also ate far less processed foods than their non-Amish peers. What many researchers found surprising is that the Amish children had much lower rates of asthma, illness, infection and other diseases compared to their non-Amish peers living in an ‘hygienic’ urban environment and eating a modern diet. The researchers theorized that exposure to a variety of bacteria kept their immune systems healthier than those children whose immune systems have less  exposure and therefore less resistance.

Many ‘gut specialists’ note that bacterial diversity is important when it comes to the bugs in our guts.  The more good bacteria we have, the better! They give more digestive advantage and protective advantage, but because our environment has changed so much, we no longer have the wide diversity that older generations had.  Why? Antibiotics, antibacterials, environment and the change in diet have all taken their toll on our healthy gut bugs!  Foods like artificial sweeteners, pesticides in our foods (hello, Round Up!) and other modern chemicals can be toxic to our healthy gut bacteria.

There are some weight loss programs now touting probiotics as a new tool to help weight loss, but I believe the real weight loss advantage comes not from downing probiotic pills and supplements but in maintaining the health of your microbiome.  This means simple things like eating more fiber which feeds your healthy bacteria, eating more whole foods than the processed foods which can contain chemicals toxic to your bacteria and eating the healthy fermented foods you enjoy, such as yogurt, kombucha and kimchi.  By keeping a healthy microbiome which allows you to get all the vitamins and nutrients from the healthy whole foods you are eating, not only are you healthier overall, you will likely lose more weight! It’s a simple recipe: fewer processed foods, more fiber, less hand sanitizer and a little more exercise outdoors are not only good for your outsides, they’re good for your insides too!

 

Cheap Eats?: Weight Loss & The Real Meaning of Cheap

Sometimes when I’m in the mood, I will watch cooking shows on PBS, usually Martha Stewart Cooking Class or America’s Test Kitchen. The idea that I would attempt to make anything they demonstrate is absolutely laughable, partly because it’s usually far too complex for me but also because some of Martha’s ingredients are more than a little pricey! Also, where the heck am I supposed to find candied lemon rind in my podunk town?

While America’s Test Kitchen’s recipes are still too involved for me, they will let us know where we can skip a step or what we can use in place of a more pricey or hard to find ingredient without seriously bungling the recipe. When you go through all the steps to put together some of these recipes, the last thing you want to do is waste all that time and money!

Time and money are usually the biggest excuses when it comes to eating healthy. We have this idea that making healthy food is complicated and expensive, but in reality, it’s like anything else: we can make it as hard or as simple as we want it to be.

Example: my dad and I both love home-made enchiladas but making them the way my grandmother made them was an all-day job, so I figured out a quicker way to do without too much difference.  Granted, they weren’t quite as delicious as my grandmother’s, but they only took about an hour or so to do and it was good enough for us two!

I know from experience that we can google healthy whole food recipes that will take all day and require a long list of ingredients, some of them more than you want to spend on a weeknight dinner. Whether you are looking at dinner for one or two or even a family of four or more, a cart full of healthy whole food groceries starts looking more like a major investment!

I’ve seen the “it costs too much” excuse used a lot on My 600 lb Life.  Rather than buy whole food groceries, they run through the drive-thru. Listening to what they order, the cost of that fast food meal can run from $10 to $30 (for two). That’s not particularly cheap either! My groceries routinely include a $5 box of salad greens, bottle of salad dressing ($4) and package of meat which usually runs around $6.  The box of salad will last me at least five meals; the salad dressing about 10 meals and the meat at least two.  That means if I increase the meat for another three servings, I’ve got dinner for about five days which would run me about $24. That’s less than five dollars a meal! Yikes! That’s expensive–NOT!

What’s the real difference here? I had to make the dinner myself. That means I took out the skillet, put the meat on to cook, cooked it for about twenty minutes or so and then I dumped out the salad greens into a bowl and poured on some dressing.  Dinner usually takes me 30 minutes or less to make at home.  Granted, I eat pretty simply.  If I added some other veggies to my salad, it would obviously cost more, but even adding a few tomatoes, radishes, mushrooms or cucumbers, the cost per meal might go up as high as $7 dollars a meal! (Seriously, how many cucumbers do you put on a single salad?)

I eat pretty cheaply mainly because I like simple food (see that Martha Stewart remark above!) I get the box of salad greens because it’s cheap and it’ll last me until Friday.  I buy my meat in the Manager’s Special section of the meat department.  This is the meat that has a “best by” date in the coming week, so it’s been discounted by 30-50%. Since I either eat it or freeze it by the date, it’s no problem for me! Sometimes, I do spring for the tomatoes, mushrooms or avocados on my salad, or I opt for Brussels sprouts instead but the cost still isn’t exorbitant. Even if the meat isn’t ‘grass fed’ or ‘organic’ it is still fresh and even organic grass fed meat isn’t much more expensive than the ‘regular’ stuff if you know where to shop. (I like Trader Joe’s and Sprouts for good bargains on those!)

There is also something else that usually gets missed in comparing cheap eats and whole foods. How much of them do you eat in one sitting? One of the more interesting details about human anatomy is our satiety signals in our digestive tract. These are the hormones our bodies release to let us know that we have eaten enough. We have signals for protein, fat and fiber but none for carbohydrates.  That’s why I can eat half a bag of Brussels sprouts and feel like I can’t choke down another bite but could easily eat the family sized bag of Ruffles potato chips without even slowing down. Unfortunately, the only “sensor” we have that we’ve eaten too much ice cream, chips, crackers or cupcakes is the actual discomfort that comes from an overstuffed stomach! I am way too familiar with that one!

The Cheezits, chips, bread and rolls might seem cheaper but we don’t stop to think that we finish them off way more quickly than we do the whole foods. That box of salad greens isn’t any bigger ounce-wise than that family size bag of chips I used to polish off in one or two sittings, but there’s no way I can eat the whole box of spinach and butter lettuce at one go without throwing up! That’s because those whole foods aren’t just more ‘nutrient dense’– they are just plain dense! Let’s compare that bag of Brussels sprouts to that bag of Ruffles potato chips: The sprouts are 10.8 oz (Birdseye Steamfresh) and the chips are 9.5 (Ruffles Family Size).  There’s four 3/4 cup servings in the sprouts and ten in the bag of chips ( ~1 oz) but seriously do we only eat one ounce of chips at a time? Although they are about the same size, after eating about a cup and a half of sprouts, you would be getting the “stop eating” signal because your nutrition needs would be met. How long before your brain would tell you to stop eating the chips? Odds are, you’d be probably three fourths of the way through the bag before your stomach would be feeling full, and if you are me, you’d be polishing off the bag!

Honestly though, there are things that are missing from the sprouts: like preservatives, sodium and extra carbs, plus the vegetable oils that are fast coming under scrutiny. On the other hand, they do have lots more vitamins and fiber (that’s the stuff that makes you feel full!) I know for a lot of people, foods like sprouts, salad greens and other whole foods can taste pretty blah without all kinds of sauces to ‘dress them up.’ That’s because we have gotten so used to eating those additives and flavor enhancers in processed foods.  Those are the additives that don’t actually have to be made from food to be called “all natural.” Most pre-shredded cheeses have cellulose added to them to keep the cheese from sticking together.  Cellulose comes from wood pulp but because it comes from trees, they can call it “all natural.” Yummy!

It’s all a matter of taste and budget: you don’t have to eat as simply as I do, but think about what you are really buying. What is really in that burger and fries you ordered? It might be fast and it might be convenient, but what is the real price we pay for cheap eats?

 

 

Speed Up Your Health By Slowing Down: Weight Loss & Slow Food

Some of you might have heard about the “Slow Food Movement” in the restaurant industry (Slow Food).  Essentially, it’s about creating healthy nutritious food in a green sustainable community, which isn’t a bad idea.  There are a lot of reasons why slow food isn’t just good for the environment and local community but also good for you.

At the risk of sounding like your grandma, I am old enough to remember (barely!) when fast food was still something of a novelty. When I was a kid, the main street in my hometown had more drug stores, gift stores or Five-and Dimes than it did fast food chains and the fast food places it did have were local independents.  When the first McDonald’s opened in our town, it was kind of a big deal. Because fast food was still new, it wasn’t something we had every day or even on a regular basis.  Food made at home, from scratch, was more the norm.

It’s not just restaurants that have ‘fast food’ either. Processed foods were also something new back then and most of us thought of it as something good. We can make mashed potatoes in ten minutes instead of an hour. Macaroni and cheese takes fifteen minutes instead of all day.  Oatmeal and rice take no time at all now that we have microwaves! So now that fast food and processed food have been around ‘forever,’ how are those working out for us?  Ummmmmm…. let’s think about that!

For most of us, the best thing about processed food is that it saves us time. Growing up, I spent a lot of time in the kitchen. For holidays and family gatherings, I would spend most of the day in the kitchen with my grandma and my aunts.  That is where I learned to make all kinds of foods that I could probably get at a restaurant or in a grocery store now, but none of it would taste like what I made in that kitchen with my family. Not everything that came out of my grandma’s kitchen was completely homemade, but most of it started as a whole food.  Grandpa’s chile started with fresh jalapenos he cut up, garlic he peeled and mashed and pork steak he cut up himself.  The only can he opened was the tomato sauce.  All of those ingredients were sauteed and simmered for a couple of hours or so.  My grandma’s adobo recipe began with pork steak and chicken cut and boiled in vinegar and water with her blend of spices added.  After a couple of hours or so, it was served over rice that had been steaming on the stove next to it!

As a kid, most of the food we ate started out as whole potatoes, whole dried beans, whole chickens from the butcher and rice from bins at the grocery store.  Our salads were lettuce, radishes, tomatoes, carrots and cucumbers that we washed and sliced or shredded ourselves. Making dinner wasn’t ten or fifteen minutes of opening a plastic bag while something heats up in the microwave.  Preparing food took longer because it started out as close to whole as possible!

A few years ago I was watching one of those chef competition shows with Gordon Ramsay, something I normally don’t watch, but I was glad I saw this episode. There were about five or so contestants who all touted their cooking skills as ‘chef quality’ and this show was to weed out the pretenders. The first chore? Take this whole chicken and cut it into eight equal pieces.  I was unimpressed with the task until most of these wannabe chefs looked at the chicken and their eyes glazed over: they had no idea what to do! REALLY?!?!  I’ve been cutting my own chickens since I was about twelve and I am certainly no chef! Even at twelve, I could have done a better job than some of them did.

Another incident I recall had to do with potato salad.  At a luncheon, I was talking to the woman next to me about potato salad (it came out of a box!) and I mentioned that when I made it, I sometimes added tuna to make it more of a main dish. When she asked me about making it, she commented “isn’t it hard to take the skin off all those little pieces of potato?” I waited to see if she was joking (she wasn’t) so I told her gently “You peel the potatoes before you cut them up and boil them.”

As I mentioned above, I am definitely not a chef and until incidents like those above, I never really considered how far away we have grown from whole natural unprocessed foods. Yes, they can take longer to prepare but they also have more nutrition and less chemical additives and stabilizers. Most of us know this but what we might not realize is that processed foods are quicker because they are in a lot of ways “pre-cooked” and “pre-digested.” That box of potato flakes are potatoes which have been so highly processed they have virtually no fiber or vitamins or minerals. They have virtually no protein and no fiber, although they do have a little potassium (150 mg) and iron and even less vitamin C.  What else is in those ‘potato flakes?’ Sometimes it’s stuff we can’t pronounce, let alone spell! (Ingredients in Instant Potatoes)  I am sure that comes as no surprise to a lot of us: there are chemicals in our processed foods! Yes, let’s all roll our eyes at that one!

Think about it for a minute: we are eating food with less nutrition but with more chemicals. How much of what we are eating is actually food? And what do those chemicals do to our bodies? While listening to a couple of my favorite books for the second time (The Obesity Code by Dr. Jason Fung and Brainmaker by Dr. David Perlmutter), I was reminded of a few things. Margarine is only one molecule away from becoming plastic; transfats cannot be expelled from our bodies, and artificial sweeteners not only raise our insulin levels, they kill our gut bacteria. Humans invented most of these chemicals in the last century so they are absolutely foreign to our bodies. Our bodies have no idea how to process them or expel them, so some of them end up in our liver or fat permanently because these compounds are recognized as “food” (because they aren’t). There are a lot of chemicals in processed foods that were never intended to be “food,” such as the sawdust in your processed grated cheese.  The manufacturers put it in there to keep the cheese from clumping together but our digestive bacteria and our intestines don’t know what to do with it, so…. what happens to it? (Woody Cheese?)  FYI: it’s not just in Parmesan, either!

It’s not just about nutrition: processed food can get in the way of your weight loss. Remember I called it “pre-digested”? That’s because the manufacturers have already begun the digestion for you! That is why it takes less time to cook! Consider those mashed potatoes: when they are made from potato flakes, the potatoes have been cooked, dried out and then processed with chemicals so they won’t spoil on the shelves.  When you eat them, it takes no time at all to digest them because 90% of what your body would do to them has already been done to them! Mashed potatoes from whole potatoes have more vitamins and fiber because those parts haven’t been removed or broken down yet. A simpler example is broccoli: raw broccoli is a whole lot crunchier because the fiber isn’t broken down by the cooking process. It’s the same reason canned green beans are mushier than fresh or even thawed frozen green beans. The canning process requires cooking while freezing doesn’t.  This is why your nutritionist will tell you if you can’t get fresh fruits and vegetables, frozen is the next best thing.  On the can, the label usually reads “green beans, water, salt” while your bag of frozen beans reads “green beans.” The biggest difference is the fiber and nutrition which aren’t lost in the cooking.

Faster processed food means it’s digested faster, hits our blood stream faster and so we get hungry again faster.  Add to that there is less nutrition in what we are eating but more stuff that is making us fatter, such as the carbs, transfats and sugars. As someone who eats a Paleo diet, rice is one of those things I like to stay away from, but it’s not the natural rice that makes people fat.  Many cultures using rice as a traditional staple in their diets weren’t obese until their diet became more Westernized.  It’s not the steamed rice that makes them fat: it’s the processed Western diet that did that! Real whole food takes longer to prepare, has more nutrition and is something your body knows how to digest. It also takes longer to be absorbed so we tend to stay full longer. It just makes more sense! One of my friends jokingly calls the processed cheese food she buys “plastic cheese” because of the individual plastic wrapper on each slice. She doesn’t know how right she is!

 

 

 

 

 

Breaking the Code: Weight Loss & The Secret Formula

On the surface, this looks like another No Brainer: how do you lose weight? Eat less, move more! Duhhhh….. except anyone who’s tried that knows it doesn’t work for long. Besides not working, it’s hard and it’s miserable!

If you were to ask ten random people of random weight on the street “why do people gain weight?”, you would likely get a variety of answers such as eating too much, eating too much sugar, eating too much junk food, eating too much fat, eating too many carbs,  not enough cardio, not enough weight lifting, not enough vegetables, etc.  There are as many answers as there are people on the street to ask! Are all of them wrong? Some of them have to be right, …right?

Well, yes and no.  I’m not being a smart-ass here. Because there isn’t just one reason we gain weight! Think back to some of the excuses we’ve given about why we’ve put on “a few extra pounds,” such as too many Girl Scout cookies; it was the holidays; missed a few workouts; been out more with friends than normal; a lot of stress; bad sleeping/ late nights, etc.  While most of us know they are excuses, we usually feel there’s a germ of truth to them and we are right: those are all possible reasons why we’ve gained a few pounds, but they are all just as likely not to be the sole reason we’ve gained weight!

In reality, it tends to be a formula: we mix a few sleepless nights, with some extra work related stress, throw in some missed workouts, a few (boxes of) Girl Scout cookies and other sugary carbs and then mix in some extra snacks and ta-daa! We’ve gained some weight! Congratulations on winning the Chubby Award! Now: how do we get rid of it?

We get rid of it pretty much the same way we got it: we have to undo that formula! The problem is that we didn’t take notes when we were gaining weight because we weren’t really paying attention. (If we’d been paying more attention, we probably wouldn’t have gained the weight we did!) Essentially, we need to follow a basic formula for weight loss and tweak it to fit our individual metabolism, and that formula is most definitely NOT “Eat Less, Move More!”

Remember those excuses listed above: cookies, holidays, stress, sleepless nights, snacking? Those are all part of the reason we gained weight. We all know that sugar and refined carbs such as bread, pasta and cereals are all broken down into sugar by our digestive tract. As quick carbs, they boost our blood sugar and insulin and then they get stored as fat in the body.  We also know that stress boosts our cortisol levels which means there is more glucose in our blood stream and glucose means insulin again, so again being chronically stressed translates to “stored as fat” by our bodies. The busy holidays and sleepless or late nights translate to “stress” so again: “stored as fat!” Constant snacking? “Stored as fat!” In order to convince our bodies that it is okay to burn fat and lose weight, we need to do a few things consistently! 

The simple formula to lose weight? 1) Reduce stress; 2) Avoid processed foods; 3) Stop snacking; 4) Fast more often.  A couple bonus tips: 1) Add a little vinegar to your diet; and 2) Add more fiber. Before you start rolling your eyes about fasting, this is not my weight loss formula. This is from The Obesity Code by Dr. Jason Fung. Dr. Fung makes a few simple suggestions such as adding in more natural fats, more fiber, moderate protein consumption, managing stress and above all, avoid processed foods and constant snacking.

Geez, that almost sounds too simplistic! And a little nutty too! But before you cross off Dr. Fung as another kooky diet doctor, he’s arrived at this simple formula after years of working with diabetes patients.  Dr. Fung is a nephrologist, which means he’s a kidney doctor, and as anyone with diabetes can tell you, one of the biggest problems diabetics have is kidney failure. What’s the best way to stop kidney damage? Don’t get diabetes! What’s one way of not getting diabetes? Don’t get obese! After treating thousands of obese diabetics, he’s learned a few things about what makes people fat. His simple answer is insulin resistance (insulinemia). In short, chronically high insulin leads to insulin resistance which leads to weight gain. If you want to lose weight, you need to reduce your insulin resistance. Most of us jump right to cutting out refined carbs and sugars (which is a great idea) but we usually don’t think of the other two major culprits with insulin. It’s not just about keeping your blood sugar low: it’s about keeping your insulin levels low too.  We mistakenly believe that if our blood sugar is low, our insulin is too, and it’s not the case.

We all know the three macronutrients: carbohydrates, protein and fat.  Most of us have been taught to avoid fat at all costs, and many of us also avoid carbs too, so that means we go whole hog on the protein! What we don’t realize is that too much protein gets converted to glucose. Our bodies can store fat and carbs but they can’t store protein, so it gets converted to glucose and then it’s converted to fat! (Yes! That healthy protein ends up on our butt!) Protein also raises our insulin levels, though not as much as carbs, and fat has nearly no effect on our insulin at all.

Most of us also know that whole food carbs such as fruit and veggies have less of blood sugar spike than processed carbs like bread and sugar. Whole foods have a lot of fiber so they are absorbed more slowly and there is less of a spike. Also, all that fiber makes us full faster and we stay full longer. Ever know anyone to eat a whole pound of Brussels sprouts at one meal? Compare that with someone eating a whole box of cookies or an entire pint of ice cream. Fiber = full!

So we moderate the protein, cut back on the processed foods, add in some healthy fats (avocados have healthy fat plus plenty of fiber too!), manage our stress and we still don’t lose weight? That’s because most of us are still doing the number one behaviors that keeps our insulin levels high: we snack. How many of us have been told that ‘constant grazing’ will keep us thin? As Dr. Fung states, “if we were meant to graze, we’d be cows!” To be blunt: any food raises our insulin, and when we keep snacking all day long, our insulin never gets the chance to drop! Because it never goes down, our bodies become resistant to it, and the vicious cycle continues.

Here’s a simple example of what happens with insulin resistance. I live between two churches which both have schools, behind a hospital with a helipad and within two blocks of a fire station.  When I am home, I hear school bells, church bells, helicopters and sirens all day long. I have heard them so often that I don’t pay attention to them anymore. In fact, a few years ago, I took a trip with some friends and our motel room was literally across the street from a fire station (we could see it from the room’s door).  The morning after our first night, everyone was complaining about the constant sirens during the night- except me! Because I heard them all the time, my brain stopped noticing them! When our insulin is high all the time, it becomes the sirens which we eventually stop hearing, so we have to make them louder to get noticed. That means we secrete more and more insulin to be effective. The only way to get insulin low and keep it there (so we notice it) is to stop eating! It means no snacking! It also means skipping a few meals now and then.

It doesn’t mean we have to starve ourselves in order to lose weight, but it does mean we need to be sensible about how often we eat. Most of us have been told that we need to eat three meals and three snacks during the day. In fact, my favorite food journal comes with Breakfast, Lunch, and Dinner headings, along with Mid-Morning Snack, Mid-Day Snack and Evening Snack! Even if they are ‘healthy whole foods,’ I am sure Dr. Fung would agree with Dr. Nowzaradan’s emphatic proclamation “there is no such thing as a healthy snack!” (My 600 lb Life, TLC) Even a healthy snack keeps our insulin levels elevated, and the only way to lose weight is to lower our insulin and keep it low! Three meals a day are more than enough. It also won’t kill us to skip a meal or two, especially if we aren’t hungry! Dr. Fung makes a clear distinction between ‘starving’ our bodies with chronically reduced calorie intake vs. intermittent fasting, which is periods of low to no calories in-between periods of regular calorie intake.

This idea of not eating every two hours or so might seem kind of weird since a lot of us grew up being constantly fed. Skipping a couple meals or more probably seems crazier, but the simple truth is the more often we eat, the bigger we get. To drop those “few extra pounds,” we have to drop our insulin levels, and that means making some changes to what and when we eat. In his book, Dr. Fung offers some level-headed advice: “Listen to your grandma! ‘No snacking!'”

For a quick summary of Dr. Fung’s book, see Fast Life Hacks: The Obesity Code

 

 

 

 

Gaming the System? Weight Loss & Eating Like an Adult

When most people think of “gaming the system,” weight loss and dieting are usually not the first things that spring to mind– unless of course you are one of those ‘perennial dieters.’  Unfortunately, most of us (me included!) fall into this category: we are always trying to lose weight! And since we are always in a hurry to lose as much weight as we can as fast as possible, we’ve gotten pretty good at “gaming the weight loss system.”

Gaming the system means that we jump at the quick fix option instead of trying to make lasting changes.  Obviously we tend to see quick results with the quick fix, but we forget that ‘quick’ usually isn’t lasting, and let’s face it, while we want quick, lasting is what we are really after! No one likes losing those stubborn twenty pounds only to gain it back (and usually a couple more) and have to lose it all over again.

The problem is that ‘lasting’ takes too long and we get tired of waiting and frankly, tired of doing the work without seeing real results.  It doesn’t make us irresponsible or lazy or mean that we have no will power– it simply means that we’re human. Enter the quick fix with those quick results! But those quick fixes are usually something more drastic than the lasting change option, which is why we see those results so fast.

One of my mom’s famous quick fixes was meal replacement bars and shakes.  Instead of having breakfast and lunch, you have the shake/ bar and then a ‘healthy dinner.’  (Sound familiar, anyone?) We end up cutting out a lot of calories, so we lose weight fast, which makes us really happy for a while. Have you ever lasted on that program for more than a few weeks? I know I can barely manage one week because the shakes and bars taste so awful to me! We all know what happens as soon as you stop with the bars and shakes: Hello, weight gain!

The same thing happens with ‘diet food’ programs: once we stop eating the packaged low-cal meals, we begin to gain back whatever we lost while eating them. If all you want is to lose a few pounds so you look fabulous at the wedding or special event, that’s fine.  There’s an end date to the quick fix and if you gain it back, you are okay with that.  Seriously, though, there aren’t very many of us who are eating the bars, shakes and diet food just because we want a temporary weight loss! We’d rather lose weight permanently so we can look and feel great all the time.

When we opt for the long term lasting change method, the weight comes off slowly and steadily because we are learning as we go. We learn what healthy foods we enjoy and help us lose weight.  We learn how to eat when we’re hungry and how to stop when we’re no longer hungry. That may sound pretty simplistic, but think about it: ‘feeling full’ is not the same as ‘not being hungry!’ Most of us eat until we feel full, which usually means we’ve over-eaten, and many of us also sit down to eat without asking ourselves “am I even hungry?”

Making lasting changes means a lot of us have to change how we think about food and hunger, and that can feel pretty embarrassing to some of us.  Do we really need to learn how to monitor our hunger?  Do we really need to be told to stop eating when we’re not hungry anymore? For a lot of people, yes! Growing up, many of us were made to eat whatever our parents served us and if we didn’t eat “enough,” we were punished for it! I saw plenty of my cousins who had to force down food they didn’t want, either because they didn’t like it or weren’t hungry, just to make their parents happy.  This is what many of us were taught to do as children and many of us (like my cousins’ parents) grew up to force our own children to eat as well.  It was “meal time,” so we “have to eat!” The whole idea of not being hungry isn’t part of that equation, so is it any surprise that many of us sit down to eat at the appointed times and that we eat all or most of what is served to us?  This is what we were taught to do!

For me, this is a big part of what makes those quick fix meal and/ or meal replacement programs such a quagmire: we aren’t learning how to change our thinking about food, meals or hunger.  We are simply substituting one prescribed ‘meal’ for another! Instead of having a real food breakfast, we’re having a shake.  Instead of eating a real food lunch, we’re eating a bar.  Instead of eating a real food dinner, we’re microwaving a packaged meal.  No wonder many of us do so well on the meal replacement systems only to stumble when we try eating real food again: instead of learning what’s good for us and how much of it satisfies our hunger, we are eating what someone else decided was good for us, just like we did when we were kids! When we start eating real food again, we really are like little kids not knowing what to eat or how much of it. As parents, we know we don’t let the kids choose they want to eat all the time because we know it’ll be something like cereal three times a day or fast food for dinner each night.  We accept that children don’t know how to eat well-balanced meals but how many of those ‘kid meals’ sound like something we eat on a semi-regular basis? How many of us come home from work and rather than fix something nutritious, we settle for cereal eaten at the kitchen sink? Or we hit the drive thru for the third time because we’re late getting home again?

We know it’s not healthy for us and we tell ourselves that it’s not our “normal” way of eating, but at the same time, it’s our fall-back meal.  No time to heat something up? Cereal time! Or toaster pastries or granola bars etc.  The same thing happens when we come home late, or are too tired to cook or just don’t want what we’ve got at home: we get drive thru or take out or microwave a packaged meal. Is it any wonder that we have problems with our weight and our health when we eat like kids?

Changing how we think about eating isn’t fast and it takes a fair bit of practice but when we stop opting for the quick fix we end up making some real lasting progress with out health and our weight loss.  We only really win the game when we stop playing with our food!

Taking a Short Cut?: Weight Loss & Real Food

Weight loss is a very lucrative industry, especially in America.  As we become less and less mobile and food continues to be more and more easily obtainable, we keep getting more and more obese.  You would think food would become healthier, and in some cases, it has, but overall, the more food is processed, the more nutrition is lost.

In most cases, manufacturers enrich their finished products with vitamins, minerals and other essentials to make them healthier.  In some cases, it’s the result of a government campaign, as in breads, cereals and milk, which are routinely fortified. While these fortified products are better than the unfortified version, there are still questions about how healthy highly processed foods are for us.  Yes, they may have “all the required vitamins” to satisfy the recommended daily allowances, but what else is in there?

One of the commercials I’ve been seeing a lot is for a vegetable juice drink which compares itself to a banana.  The commercial asserts that the little can of juice drink has as much potassium as the banana, claiming “it’s a post work out snack you don’t have to peel.”  This statement makes me roll my eyes every time I hear it.  I am not claiming the commercial is lying about the potassium levels, but we’re comparing juice to a whole food. Something which is as highly processed as juice is likely not as nutrient dense as a whole food, especially when it comes to fiber.

It’s bad enough that nutrition and fiber are taken out of foods in processing: other things are added in to make them more shelf-stable, to preserve “freshness” and taste and to make them look prettier. That can of vegetable juice has less fiber, likely less nutrition from the vegetables themselves and way more sodium than the vegetables it was made from, since the vitamin C and betacarotene are added. However, it is much easier to carry around a little can of veggie juice than the actual vegetables!

That is the primary reason people choose processed foods over whole natural foods: convenience!  How many times have we bought fresh fruits and veggies only to have them spoil in our fridge? (Raising my hand here!) It happens more than I like with spinach, lettuce and cabbage.  It happens to me most often with milk, and in fact, it happened–again!-– last weekend! I love coffee but I only drink it with cream.  I also only drink coffee at home on the weekend (since that’s when I spend the most time there), so I went about making coffee only to realize right before I turned on the machine that the cream in the fridge had spoiled. No cream, no coffee! As I added it to the grocery list, I considered buying something shelf-stable that wouldn’t spoil for weeks so this wouldn’t keep happening to me.

How much easier it would be for me to have powdered cream sitting in my cupboard for me to use whenever I needed it!  I wouldn’t have to worry about spoilage and I could have coffee without first checking to make sure I have cream.  Wow, wouldn’t that be great! Except the list of ingredients on the powdered creamer reads like a chemistry experiment because it really is more chemicals than actual food! Does it taste good? Most definitely! I admit it: I love the stuff and used it for years for mainly because it’s convenient and good tasting.

Unfortunately, in addition to being shelf-stable and delicious, it also has so many things that I don’t like, such as preservatives, corn syrup solids and trans fat.  Yes, if you look on the labels of many of these, they say they are “free of trans fats.”  They are allowed to say that if the serving size is very small. Even though you are getting only a small amount of trans fats with each serving, let’s consider how much of that stuff you, or rather I, consume! I don’t put in one or two tablespoons (1 serving) mainly because I drink great big mugs of coffee and usually more than one daily.  So over the course of a weekend, I’m going to have probably six or eight tablespoons each day.  That’s a lot of “little amounts” which build up into a real number! (Seriously, I think all the trans fats & saccharin I’ve eaten over the years have become part of my DNA–ugh!)

Then there are all the extra calories that come with that shelf-stable powdered creamer! Once I reminded myself of why I stopped using that stuff, I ended up putting a small carton of half and half in my shopping cart.  I know what’s in that and most importantly, my body knows what’s in it too! This is the problem with chemical preservatives and additives: some of these things were invented in the last century and our organs don’t know what to do with these things, especially trans fats! As a result, these unstable compounds just get stored in our bodies. Some chemical compounds can really disrupt your gut bacteria, resulting in poor nutrient absorption or even a more serious disorder such Small Intestine Bacterial Overgrowth (SIBO).  Anyone who has had any kind of digestive disorder knows what kind of havoc they can wreak not only on your health but on your daily life. The last time I had a stomach bug was bad enough for me!

Not all processed foods are unhealthy but they should not be the majority of your meals. The best way to minimize your intake of trans fats, preservatives or other unhealthy chemicals is to eat as few processed foods as possible. I occasionally buy refrigerated or frozen foods out of the sheer convenience.  They are mostly fruit or vegetables and they tend to be minimally processed. Usually they are raw frozen foods and the ingredient labels read” sweet potatoes” or “green cabbage,” but I do buy the occasional frozen entree or other processed bagged item. However, these items are “occasional.”  The majority of what I eat doesn’t come in a bag or a can: it comes in butcher paper from the meat counter or in its own natural (and sometimes edible) wrapper.  There’s something to be said for the vitamins and nutrition in those natural vegetable wrappers: I can guarantee you they taste better than that juice can!

 

 

 

“E” is for Effort (& Excellence): Weight Loss & Missed Opportunities

Last night I got an unusual text from my sister.  She was watching the same rerun of My 600 lb Life that I was, although it was new to her.  I’ve mentioned before that I watch the show, reruns and all, because they are my version of a 12 Step meeting.  They remind me of some of my old bad habits (ugh! so reminded last weekend!) and overall they keep me motivated.  This particular episode was James K.’s story.  In so many ways, James is both motivating and incredibly frustrating.

We’ve all heard the expression that ‘water sinks to its lowest level’ and the same is true of our efforts.  If we don’t put forth any effort, we shouldn’t be surprised when we get no return, but usually we are shocked when we don’t get amazing results.  We’ve somehow gotten it into our heads that we can phone in the effort and get what we want without a lot of work. James puts forth nearly no effort at all but expects to get awesome results and is repeatedly disappointed when he fails to make any progress at all.

To recap, James is approximately mid-forties, weighs about 800 lbs and has been bedbound for nearly three years when we meet him. He lives with his girlfriend Lisa and their teenage daughter Bayley, who are his caretakers.  Both Lisa and Bayley are afraid that his eating will kill him because he gains about 30-40 lbs every year, and James himself is afraid that he’s going to die in his bed soon. Besides his super morbid obesity, James also has severe cellulitis infections in his legs, but he still wishes that his days “would start with food and end with food.”  He admits that if he doesn’t get what he wants to eat as soon as he demands it, he gets angry. Giving him something healthy only starts a fight.

James sets up a phone consultation with Dr. Nowzaradan, who advises him how dangerous it is to be super morbidly obese and immobile (bedbound).  He sends him a 1200 calorie diet, tells him to begin losing weight now and come to Houston.  If he is under 600 lbs when he arrives and there are no major health issues, he will schedule him for bariatric surgery as soon as he can.

My issue with James isn’t that he’s gained about 800 lbs: my issue is that he does as little as possible to help himself or improve his situation. He was well over 500 lbs when he fell and injured his ankle, landing him in the bed three years ago.  Since then, he’s continued to gain weight and it isn’t hard to see why.  When you aren’t being active and continue to eat as much as you did before, it’s an obvious result.  However, James has made no effort to change his eating habits, nor has he made any effort to get out to the bed.  He tells everyone he wants out of that bed and he’s ready to get back to his old life, but to make change, you need to put out some effort!

He and Lisa had initially planned to load him in the back of her van and drive to Houston but because of his weight and longtime immobility, both Dr. Nowzaradan and the EMTs they later call advise against it.  The EMTs also tell him he is wider than the van is so driving that far would be extremely painful (why ultimately James vetoes the idea.) James tries to get a bariatric ambulance to transport him from Kentucky to Texas but when the plans fall through and his fund-raising efforts (an online campaign) also fail to generate enough money, he uses this to justify his continued calorie consumption. Basically, it’s a depressing situation and the insurance company has given him a ‘death sentence,’ and the only thing that brings him any happiness is eating everything he wants to eat, so that’s what he’s going to do!

In this case, James is not even putting forth minimal effort: Lisa and his daughter set up the online campaign and Dr. Nowzaradan is fighting with the insurance company over the ambulance.  The least James can do is work his hardest on losing weight.  This is what the doctor had instructed him to do and frankly, it’s the best thing he can do for himself, but he doesn’t do it. He makes no effort to help himself.

Later, when he finally arrives in Houston, he weighs in at 791 lbs and continues to gain weight, ultimately reaching 843 lbs.  At the end of the year, James has gained back any weight lost while hospitalized on a controlled diet and has been told that he has congestive heart failure and his body is barely functioning.  Throughout that year, he blames circumstance for his lack of progress and ultimately accuses Dr. Nowzaradan of not helping him.  The simple truth is that he refuses to make any effort to help himself.  This dismal lack of effort is what makes James so frustrating but also so motivating.  His story is full of missed opportunities to help himself: he announces again and again how he’s ‘fired up’ to lose weight, but when his daughter offers to bring him his dumb bells, he waves her off.  When Lisa protests that the Chinese rice he wants isn’t on his diet, he has a tantrum, demanding it anyway. “I’m tired of fish and chicken!”

Anyone who has changed their eating habits can commiserate with this tantrum.  My dad actually jokes that I’ve eaten so much chicken, he expects me to sprout feathers any day now! There’s been more than a few days that the thought of eating more salad, veggies, chicken or anything else healthy makes me want to gag. There’s also been many days I’ve wanted to blow off my exercise classes because I’m tired, I don’t feel like it or I just want to do something else! We have all been there! But watching James give in over to his whims is also what makes his case so motivating.

We all have opportunities to improve our health and weight loss.  None of it comes easily to any of us. Change and progress require effort and if we want to make the most of our opportunities, then we have to put forth our maximum effort! Blowing off the opportunities is always easier but then we have to live the results of our lack of effort.  We can choose to blame circumstance and everyone around us for our lack of progress, but ultimately the choice to work as hard as we can is our own.  We can do what we want, like James, or we can do what’s best for us as hard or as uncomfortable as it may be.  In the end, giving in to our whims and blowing off efforts to help ourselves only seems easier.  Living with the extra weight is not only hard on our self-esteem: it’s hard on our health. For some of us, it means we have to go back to our “fat pants” or loosen the belt another notch instead of tightening it up.  In James’ case, his lack of effort landed him in the ICU with sepsis, fatty liver disease and kidney failure.  [At last report, he recovered enough to be discharged.]

We all have been disappointed with our results at times.  It’d be nice if they were always amazing and fabulous.  The least we can do is make the best of the opportunities provided to us by giving it our best effort.  When we don’t even do the least that we can do, we have no one to blame but ourselves for our failures. Watching James throw away opportunity after opportunity reminds me not to do the same.  It is a sad and scary lesson that James presents to us and hopefully we’ve all learned from it.