Wednesday, June 27, 2007

Some interesting thoughts on weight loss

Those of you who have been reading my blog know that John Robison has motivated me to put fingers to keyboard. Heck, if he can write a book...anyone can! Just kidding John. ;-)

Well one theme that we try to get across to patients and clients alike when it comes to weight loss is how the brain is involved. There are a myriad number of hormones involved in your brain for appetite control and emotional states. What we see though is that when it comes to behavior, these hormones are a factor, but not the end all be all to what the outcome is in our relationship with food.

One of the Dr's and my central themes is the acronym H.A.L.T. What this stands for is Hungry, Angry, Lonely, and Tired. These are the primary emotional states for why people eat. Let's break them down.

Hungry is the only reason you should eat. I recognize that people may have mechanisms that do not enable to tell if they are hungry. Or, worse yet, they are hungry all the time. In the clinical environment we discuss with the patient what is actually going on in their life and in the 'moment' to discern if they really are 'hungry all the time'. Invariably, they are not. It just seems to be this way because they never tied the behavior/action of eating to the overall emotional state or the momentary stresses in their life. Hunger is one of the most governable issues with food. Simply put...Plan for success NOT for failure, yet this is exactly the opposite of what most people in our society do when it comes to food. Picture this:

1)Get up late for work.

2)Race out the door and maybe get a coffee sipped down and a Bagel? Donut? Nothing?

3)No Snack

4)Lunch time, since you were late you didn't BRING anything so now you are at the mercy of your stomach and where the other co-workers may order out from. You eat too much.

5)No after lunch mid-afternoon snack. If you ate light at lunch you are already hungry. If you ate heavy you get sleepy and fatigued from too many calories and poor food choices and won't eat until later in the evening.

6) Dinner at 6-7 PM or 8-9 PM. Very hungry because lunch was at Noon. Eat a standard 'too big' dinner. Sleep horribly due to food sitting in gut. Despite what the literature says, the majority of calories, many of them coming from refined carbohydrates are stored for future use since there is no stimulus to utilize them in the evening. Wake up unrested and somewhat late.

7) Repeat cycle!

THIS is a plan for failure.

Anger represents a group of emotions. Frustration, Irritability, Fear and Anger can all be grouped together. In response to emotions that usually well-up from perceived situations of helplessness it is common as humans that we look to things that help us 'feel' better. Food can stimulate hormones that do, in the short term, make us feel better. Anyone that has been incredibly stressed out and then had a nice rich sampling of chocolate truffles or Lindt chocolate understands what I'm talking about.

Lonely is another term that does not just represent the physical proximity of someone. I explain it to patients and clients that "Lonely" can also be rephrased as disconnected, bored, or under-stimulated. To most it would not be hard to understand that the our relationships can add a significant amount of value to our lives. From them we can feel connected to something bigger then just ourselves. For whatever number of reasons I have seen in both my clients and patients a large number of people that are very dissatisfied with their primary relationships, if they even have one. I am tickling a Pandora's box here as I have also come to the conclusion that the most significant relationship that these people have trouble with is the one with themselves. We don't have enough to go into this particular aspect, for sure. Suffice to say without being good with yourself any other relationship is a distraction from that fact. Those that eat from 'loneliness' often have issues with being alone, and finding things to engage in that bring their mind to a place where food is not central. Even work functions as a distractor or connection point that can alter a persons desire to eat. I do not want everyone to be a workaholic to not eat, but the facts still remain that many can make it through most of their day not fixated on food. The people that I have worked with that eat from 'loneliness' as a general trend do not become involved in extra-curricular activities, watch a lot of television, read a little if at all, and have no social group to belong to. Any of the above would, at the least, distract from he 'food/ soothe' mechanism and at best potentially 'solve' the concept of loneliness for them.

Tired as an eating stimulus is understandable. If you are very tired it IS a fact that we, as adults, do not sleep while we are chewing. Even babies and small children actually stop chewing mid bite when they fall truly asleep. We have all seen the baby in our family fall asleep during dinner in the high chair. Guarantee that when their head is down they are not still chewing. So it is with adults, except we actually allow food in our mouth and the action of chewing to keep our minds somewhat alert. Clients and patients with sleep apnea use this 'skill' to cope with their problematic issues keeping their eyes open. Couple this with a lowered waking metabolism from the sleep apnea itself and you have a recipe that aids in weight gain.

So what should we do?

The bullet answers. You may not like them, but I will use another quote we use in the Dr's office all the time. "Continuing to do what you do everyday and expecting something different to occur is a form of insanity." Basically, open up to just the ideas that I will give and think of how your life could be different and enhanced by changing. We can all come up with reasons why we CAN NOT change because of our circumstances but often this doesn't help us get to our goals.

Hunger: Plan in advance and don your bullet proof vest. Instead of jetting out the door without food and starting the cycle all over again. Change it!

The night before pack in a cooler your great lunch and a few snacks. Now you are not at the mercy of co-workers and raging hunger while at work. Get up a few minutes earlier and make a healthy satisfying breakfast that will hold you over. Many are not hungry in the morning but on review we find it is because of the big dinner still digesting from the night before. Eating a good breakfast is the first step in changing the cycle.

Eat a dinner that is on par with what you plan to do for the rest of the night. If you are going to watch TV and chill then eat lite. I often recommend no or very low carbs in the evening for patients that cannot get out and do something. Ideally we would do the Buddhist skill of 'walking a thousand steps before we retire.' Remember though, the lighter you get the less time it will remain in your belly and satisfy you. Shut the tv off earlier and get to bed!

Angry is an emotion not a REAL reason to eat. Connecting your emotional state to why you eat is key. If you are going to eat think for 5 minutes about WHY. Sometimes you may eat that something anyway but others you may just 'let it go' and find something else to get you through. Having good food available like we mentioned above helps greatly in the process.

Lonely is not something we can usually fix immediately but it helps to practice skills that eventually may help to get you less 'lonely'. Get involved with people and groups. Sports groups or recreations that involve your body and other people are great for distractions AND get you out there. TV has been studied to make kids forage for food. Why would we think we, as adults, would be different? Books on the other hand make our brains work differently and even though we are on the coach or in bed we are not eating. Sounds like a better distraction to me. If our relationships that we do have are not fulfilling then that brings up other issues. Many people get involved with the wrong people for the wrong reasons. This would be defined as a decision with life altering potential. Never easy but often necessary for any type of true future happiness. In the meantime, recognize how this relationship is making you sabotage your physical health and adopt a new 'skill' to avoid the soothing mechanism you have learned and used up until now.

Tired is the easiest fix. Simply, get a good amount and quality of rest/sleep. Sleep needs to be done to get all the hormones and metabolic benefits. We repair and clear our minds when we sleep. Get your sleep! As we get older our bodies sleep hormones start to decline. It is a fallacy that we 'need' less sleep as we get older. We only have less hormonal stimulation that allows us to get it. Sometimes poor sleep is self imposed. many people want more and more 'things.' That's fine, but if it is making you work 2 jobs and only get 3-4 hours of sleep a night, YOU, your decisions and wants are causing your own pain and weight gain. At the very least, contributing to it. Re-evaluate and get your rest. In the end you maybe happier about it. Target goal. 7-9 hours nightly. If you were able to get the occasional nap in on the weekends your body would only thank you.

In the end, HALT no more and you will have worked around many of the weight issues surrounding the modern age. Remember, it is relatively easy to change the human is very difficult to change the human mind. These ideas may offend or seem impossible to implement because of your life but doing what you are doing now will only get more of the same. Change something.


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