We all know that being overweight is probably not good for our health. It seems to make intuitive sense and there is ample scientific data that says losing weight is good for you in the long run. But there are many uncertainties. One of the unanswered questions is how best to measure body fat and how best to correlate being overweight with long-term disease.
This past week there was a big study published out of Europe that tried to address these issues. In this post I’m going to break it down for you and see if there is anything we can learn from this study. As always, it is important to note that this is just one observational study, which means that it simply looks at a large population of people and attempts to observe a specific medical outcome (in this case, heart disease) with a specific condition (in this case being overweight). It can’t prove cause and effect!
Consider this post a “mini-Medical School” in which I’ll walk you through a medical research study. It may get a bit nerdy. Here we go.
This post is about exercise and weight loss. Specifically: Is exercise an effective way to lose weight?
Hmmm . . . . donuts.
Anybody else have a somewhat idle piece of exercise equipment in your house? The picture at the top of this post is my actual basement treadmill. On the plus side, it is a terrific place to hang shirts while ironing. On the negative side, I’m delinquent in my ironing duties.
It is a pretty rare bird indeed who doesn’t sometimes want to lose some weight. I’m in this group. Although I’m a rather skinny, lanky guy – I do have that bit of a gut that hangs out more than I’d like. And I’m a runner, at least much of the time, so I’m thinking . . . WHAT GIVES? How can I exercise as much as I do and still have weight in places I don’t want it?
I have been told it is not a dearth of exercise that is leading to a big belly, but it is an abundance of donuts.
It is practically an expectation in health and wellness forums to talk about weight loss after the first of the year. New Year’s resolutions being all the rage in January. Perhaps you plan to lose a few pounds this year?
For me, it’s always around the middle where I put on a few pounds. You know, the little beer belly. The muffin top. The love handles. Begone, all of ye!
I was doing so well last fall, eating right, exercising more and so forth. Then winter in Minnesota hit. Now it gets dark at 4:30 in the afternoon. The perpetual ice slick on the sidewalks turn running or walking outside into a potentially bone-shattering experience. I mean, literally, bone-shattering as in broken hips and wrists. It has been so cold outside that your teeth hurt the minute you leave the house.
So I tend to hibernate a bit. Evenings on the couch reading next to a warm fire, although evoking images of Norman Rockwell, are not the way to shed pounds. Especially if I’m eating unhealthy foods all evening and maybe having a glass of wine with my chocolates. Wow that is starting to sound good: warm fire, wine chocolates, a good book . . . ah, but I digress. I’m supposed to be talking about diet and exercise here.
Reminds me of a post I did about the challenges of staying active in northern climates. Check it out here.
To show you the depth of my dedication to the cause of fitness, I included a recent photo of me above. Yup, that’s me all right.
Healthy life choices
So we talked weight loss and healthy livin’ on the show this week.
If you missed the show, you can to the podcast by clicking the “Play” arrow here:
Tips for losing weight and keeping it off
Natalie gave us some great tips from her work with patients trying to lose weight. I’ll review some of them here.
With her patients, Natalie meets monthly to set goals. The good news is that they don’t have to be huge undertakings. The goals can be small changes in your daily lifestyle which you continually adjust, a process which Natalie refers to as “turning up the dial” on your goals.
Just a few examples of achievable goals are:
Stress management tactics
Better food choices
Portion control when eating
Finding time for daily movement, like taking small walks on your lunch hour
Nothing big, nothing huge, just small changes to your daily routine.
People who are successful at weight loss have some common characteristics:
Natalie’s patients in the Great Slim Down have lost an average of about 16 pounds. That is not only impressive but it is a sustainable amount of loss. She points out a few characteristics of these patients:
They keep a daily record of their food intake. The simple act of recording what you eat – whether on paper or using one of the many apps for your mobile device – makes a person aware and less likely to fool themselves into thinking they are eating healthier than they really are. People usually eat more calories than they realize!
They are active often in their daily lives. They find a way to move throughout the day.
They are striving to meet their own goals, not goals set by someone else.
They hold themselves accountable by sticking with it.
Pop (soda for those of you not from Minnesota) is not a healthy choice.
After Natalie and I suggested that we ought to avoid so much sugary soft drinks, a few listeners asked if diet pop is healthier. In a word, no. Although diet soft drinks are probably better than sugary drinks, they also contain ingredients that lack much nutritional value. Maybe stick to water!
So how about water?
For years, decades really, people have been taught to drink more water. Most of us probably remember the “8 glasses a day” advice. That is, in fact, what I told patients for years. But the reality is that there is not a lot of scientific evidence that otherwise healthy people need to drink more water than they already do. In other words, if you are thirsty you get a drink and if you are not, you don’t.
So that’s it? Is that all there is to the water story – that it doesn’t matter?
I should caution that no single study can be used to definitely prove anything. Truth with a capital “T” is hard to come by in medical science! So whenever I refer you to studies like these, I do so to get you thinking about your own situation and not to imply that one study is proof of anything. Replication is the key in scientific studies (the findings of one study must be confirmed with separate studies).
But the water studies are at least thought-provoking. It makes sense to me that if you are focusing your liquid intake on water, you will be less likely to drink soft drinks and fruit juices that are loaded with calories and sugar. That has to be a good thing.
As Natalie said on the show, none of us should be “drinking our meals.” Amen to that.
One half of the healthy equation is Eat Less. The other half is Move More. But how? Most of us are not about to lace up our running shoes and hit the pavement for a long run. Most of us can’t get to the gym for a run on the treadmill or an exercise class. If you can do those things – great!
But lots of us have physical limitations that prevent vigorous work outs. And gym memberships ain’t cheap! So what can we do?
Let’s turn to Natalie again. As a companion to “The Great Slim Down” program, she has produced a series of short videos to give you ideas for exercise that may be right for you. Some are low intensity, others more vigorous. Some require standing and moving while others can be done by people from a seated position.
Here’s an example of one of Natalie’s videos:
To see the rest of them, go to the HCMC YouTube channel. If the link doesn’t work, simply search online for “HCMC YouTube channel” and click Playlists. You’ll find them there.
Housework is good for you
Listen to the show podcast (the player is above in this post). We talked about housework as a form of exercise. And you know what? It works. One listener to the show moved nearly 10,000 steps in one day simply doing housework. I complained that now I really have no excuse not to vacuum the house. Rats.
The Great Slim Down
I’ll close with one last word about the Great Slim Down. If you are in the Minneapolis area and struggling to lose some weight, maybe you should see Natalie. Simply call 612-873-6963 or check out the Golden Valley Clinic site here. No better time than now!
Thanks for reading. Hope you are all having a good day, a good week, a good winter where ever you are!
On a recent “Open Lines” radio broadcast (in which we have no topic and I simply answer the sundry questions from listeners) somebody asked about the health benefits of apple cider vinegar. Fair enough.
Well as a highly educated medical professional I am here to firmly and unequivocally state after my extensive exposure to the best in medical science that I know nothing about apple cider vinegar, whether it be the health benefits or culinary benefits or counter top cleaning benefits.
But happily, I’m not 100% ignorant about apple cider vinegar any longer. Just about 90% ignorant. That’s since my daughter introduced me to the stuff while I was visiting her far from home at college. Here’s how it all went down. I was having some queasiness in my belly or some such thing and she goes to the cupboard and pulls down a giant bottle of ACV (apple cider vinegar = ACV). Then she starts telling me all about how ACV improves everything from colds to upset tummy to sunburn and cancer and everything in between. But she does live in Los Angeles so I naturally wondered what the crazy Californians are teaching my level-headed Midwest-raised daughter.
But I was game to give it a try. So we poured some ACV into a glass of water, I held my nose, and drank it all down. It wasn’t too horrible to drink so that was a plus. And dang if my stomach queasiness didn’t get a little better!
So I chalk up my rapid improvement to one of two possibilities:
Placebo effect – I convinced myself that it helped because I wanted it to help.
Apple cider vinegar really does help upset tummies.
“Only 1-2% of people who could benefit from weight loss surgery are actually getting it done”
So says Dr. Gil Hartley, my radio guest this week on Healthy Matters. Dr. Hartley is an internal medicine physician, like me, who specializes in the care of people who are very overweight. We focused our conversation on bariatric surgery – which is the medical term for weight loss surgery.
The first step to knowing if weight loss surgery may be right for you is to calculate your own Body Mass Index, or BMI. You just have to know your height and weight, and it takes less than a minute to do. Find out your BMI by clicking the button —>
What does the BMI mean
Here are the categories of BMI:
<18.5 = Underweight
18.5 – 25 = Healthy weight
25 – 30 = Overweight
30 – 40 = Obese
>40 = Severely obese
It may be emotionally hard to find out which category you fall into – and you’d be right to note that it is just a number. But think of it as a starting place, and if your BMI is high, perhaps now is the time to take action. Especially if your BMI is greater than 40 in which case I really encourage you to see a weight loss surgery expert. For people with diabetes, the BMI at which to consider surgery drops to 35.
Is weight loss surgery right for me?
As Dr. Hartley mentioned, weight loss surgery is the best option for many people who are excessively overweight – the people who are at risk for complications due to their weight – diabetes being the most prominent example but also including high blood pressure and obstructive sleep apnea. I won’t get into all the details, as there are lots of good resources for people who are overweight or obese (for instance, check here for good info from the National Institutes of Health – a source you can trust). But what struck me about my conversation with Dr. Hartley was when he said the resistance of people to getting weight loss surgery is still a real problem. And he isn’t trying to peddle unnecessary surgeries on anyone. He simply knows firsthand that surgery is the best solution for many people.
And don’t be too hard on yourself. Being overweight is not a character flaw. For most people, it is also not just a problem with overeating (although that is the problem for some). Rather, obesity is a complex chronic condition with lots of causes and contributing factors.
I’ll close with a few more things I learned from Dr. Hartley today about weight loss surgery:
Weight loss surgery may be the most effective treatment for diabetic patients who are obese. Some patients actually leave the hospital after the surgery without needing their diabetes medications anymore!
We used to think it did not matter when you did your surgery. We told people to just think about it and do it whenever you are ready. Doctors are reconsidering this due to more recent evidence that suggests that getting it done earlier leads to better longer-term health in patients with diabetes. So waiting for years and years to do the surgery may not be the best idea after all.
The laparoscopic banding surgery, which showed great promise 10 years ago, is used much less today. The two more common surgeries are gastric bypass (Roux-en-Y), and vertical sleeve gastrectomy.
You can drink liquids without problem after weight loss surgery. One caller to the show was worried about being thirsty after surgery. Not to worry, you can still drink liquids normally as they just pass through your system just like they always did before surgery.
Loose skin can be a problem for some after weight loss surgery (to the degree that cosmetic surgery is considered), but for many people the skin does remodel back to a less bothersome condition over time.
If you are in Minnesota and want to take action on your weight . . . here is information on Dr. Hartley and his team at the Hennepin Bariatric Center.
Thanks for joining me on the air, streaming online, and on MyHealthyMatters.org!
Perhaps I don’t have to tell you that in the United States, the percentage of people who are considered overweight or obese continues to get larger with each year. I like to drive this point home when I am giving educational talks about health by showing a series of maps of the country from year to year, which clearly shows that this is becoming an epidemic.
Check out the percentage of obese people – those with BMI 30 or greater (Source: Behavorial Risk Factor Surveillance System, CDC).
You can get started bychecking your own Body Mass Index (BMI). It just takes a minute and knowing your BMI is the first step to take. Remember, >25 is considered overweight, and >30 is obese (or maybe a better term for all of this is “unhealthy weight”).
Wow. But it is more than a bunch of statistics. These are real people who are risk for diabetes, heart disease, sleep apnea, musculoskeletal problems, to name a few, not to mention the toll it can take on their sense of well-being, their relationships, their mood.
On today’s Healthy Matters (my weekly radio show), Natalie Ikeman, a certified Physician Assistant at HCMC’s Golden Valley Clinic, joined me in-studio to talk about strategies for losing weight, and specifically her new program, called The Great Slim Down.
Natalie grew up in Minnetonka, Minnesota, and attended the University of Minnesota for college and Augsburg College for her Master’s in Physician Assistant studies. She’s cool. She’s not judgmental. She’s smart. You’ll like her, trust me!