1. Slice chicken breasts into thin pieces and place in bowl. Sprinkle seasoning mix over pieces and toss to coat.
2. Spread chicken over foil-lined baking pan. Top with peppers and onions and drizzle with olive oil. (Add red pepper flakes for extra heat if desired).
3. Bake at 400 degrees for 25-30 minutes or until browned and chicken is cooked through. Serve with low carb tortillas, salsa, cheese & sour cream.
The goal is to identify essential weight loss principles that you can use starting today for both medical and surgical patients. I’ll throw in a few “random thoughts” by Dr. Clark telling you my though process. One of my favorite quotes and favorite people, Albert Einstein, said “If you can’t explain it simply, then you don’t understand it well enough.” So, hopefully I can explain it simply.
It often seems like weight loss concepts and principles are significantly different between medical patients and surgical patients. Nothing could be further from the truth. The principles and concepts are exactly the same thing. The weight loss principles for a patient will be the same post weight loss surgery. They just have a slightly different anatomy. The essence of any weight loss plan will always be behavior modification. Change what you do, whether it’s nutritional or activity level. Change (weight loss) will not occur unless you change your behavior. Sometimes we’re waiting for the life around us to change or people around us the change. The reality is that’s never going to happen. If you don’t change, change will never occur. Don’t wait for someone else to change for you.
Energy storage is extremely important for survival. If we couldn’t store energy, we would have to eat continuously. We can store energy in 2 ways. We can store it as fat or we can store it as glycogen. Storing energy as fat is unlimited. We can store hundreds of pounds of fat. Even a thin persona has a lot of fat storage. Even a 200 pound male with 10% body fat has 70,000 available calories. That’s a lot of stored calories! We can’t store very much glycogen (sugar). We can only store about 2000 calories. Most of the glycogen is in the muscle. The muscle doesn’t like to give up any of this energy (it’s kinda selfish). The liver is unselfish. It will share sugar. What’s the problem with this? The problem is just because you may have a tremendous amount of stored energy as fat does not mean that you have unrestricted access to it. Unfortunately it’s not very accessible.
What do we do here at The Center for Weight Loss Success? We have 2 comprehensive programs. We also have a full fitness center, nutritional store, clinical area, educational classroom, behavior modification classes, weekly live webinars, weight loss meds, Hormone Replacement Therapy, and more. We have a 6 month medical program referred to as “Weight Management University™.” We have a 12 month post-surgical program called, “Weight Management for Weight Loss Surgery™.” Both of these programs are very similar. A lot of the topics in the programs are interchangeable. The medical program has 14 different topics. The surgical program has 12 topics. The difference is how we present them. We put them in different order because they become pertinent at different times depending if you’ve had surgery or not.
The real question is: how do you do it?? The dietary plan, activity plan, and behavior modification changes don’t take place immediately just because someone has undergone weight loss surgery. There should not be a “cloud of mystique” that surrounds someone who has had weight loss surgery. We didn’t change things by operating on you.
My job is to figure out why someone is overweight. Then, I have to figure out what are the right “things” to do for that individual. Finally, (the hard part), is how that individual implements those things and make them a lifestyle. Part of that is being willing and able to do those things in order to lose the weight. That’s a very important concept and mindset for anyone, especially with weight loss. Some people are just natural athletes. They may have never picked up a golf club. But when they do, they’re able to play pretty darn well. Other people might have to practice really hard but are mediocre at the sport. Is there a difference? Maybe some of us will never be pro golfers. But if we practice and work at it we will get better. All weight loss surgery does is just exaggerate the “normal” weight loss curve. The normal weight loss curve is this: you go on a specific diet and lose weight. Then you’re weight is going to stabilize. You might regain a little bit. With weight loss surgery you lose weight much quicker, greater weight loss, and it lasts longer. Long term it’s still doing all the same things. One of the “downfalls” of WLS is….it works! Because WLS works so well, people often think they’re doing the right things. You’re going to lose weight the first few months no matter what you do, but if you don’t do all the right things long term you will find that you’re going to start struggling. You need to do all the right things. Weight loss is something we work on forever. It’s a process. You’ve got to do the right things. Are you willing and able to do the right things?
I’ll sometimes see people back in the office several years after having WLS. They’ve gained weight. Or, I see people who were successful in the Medical program but they return because they’ve gained weight back. No one gains weight due to a deficiency of surgery. Some people say they need surgery because they’re gaining weight. Likewise, no one gains weight due to a deficiency of phentermine or any other weight loss medication. They gain weight because they are eating and/or doing the wrong things. As physicians sometimes we contribute to that. There are certain medications that physicians prescribe that cause weight gain.
The concept of eating is, “How little can I eat and be satisfied.” It’s not, “How much can I cram in there.” The difference between those two thought processes is about 20-25%. It’s often the difference between losing weight and keeping it off, and gaining weight. Long-term the pattern of eating needs to be 3 meals a day +/- a planned snack. No one has ever starved in 3 hours. If your mind is telling you it’s time to eat something, but it’s not time to eat, drink some water or do something else. Meals should be small plate size. The best food has absolutely no labels. It’s eating green and clean.
The “Basics” of the eating plan are calories, protein, and carbohydrates. Everyone has a calorie “ceiling.” If you go above it, you gain weight. It does not mean that if you stay below the calorie ceiling you will lose weight. You can’t survive without protein. Preserving lean body mass is key. We talk about this all the time. The best protein source is from food. Everyone has a carbohydrate “tipping point.” A certain level of carb intake makes insulin levels rise. Insulin turns on fat storage. Some people have a very high tipping point. They can eat just about whatever they want to and never gain a pound. They don’t have a better physiology. They have a more efficient physiology. If what you eat increases your insulin levels. It turns on fat storage. If you eat a mountain of lettuce and it makes your blood sugar go up, it will also make your insulin level go up. One thing you can do is get a blood sugar monitor and check your blood sugar after you eat.
I have a few things for you to “chew” on. “Kinda” working on weight loss will never help. You can’t, for example, do a good job during the week and then go crazy on the weekends. If you’re only going to do one thing, count your carbohydrate intake. Carbohydrate is not an essential nutrient and there is no such thing as carbohydrate deficiency. Carbohydrate influences insulin which is the “fat storage” hormone. If you don’t make insulin, you cannot store fat. One of the first symptoms of a Type I diabetic who does not make insulin is that they are losing weight like crazy. They can’t store fat. Two thirds of the population is “carb sensitive.” If they eat carbs they get large blood sugar swings. Large blood sugar swings cause 2 major problems: symptoms (headaches, irritability, shaky, not thinking clearly) and weight gain.
What do blood sugar swings actually mean?
If your blood sugar level is 100, what does that actually mean? That’s at the higher end actually. We would rather that it be 80. Each of us has about 5 liters of blood in our body. When we say that your blood sugar is 100 mg/dl, that means there is 5 grams of sugar in your entire blood volume. There’s 1 gram in each of those liters. How much sugar is 1 gram? If you have just 5 grams of carbohydrate, in theory you will double your blood sugar. If it was 100, it will jump to 200 after eating 5 grams of carbohydrate. Examples of 5 grams of sugar (1 tsp): ½ Oreo, 1 triscuit, 1/5 banana, ¼ apple, ¼ slice of bread. I often have patients come into the office and say, “Well I only had…” It only takes a little bit and you’ve doubled your blood sugar. The point of all this is that it doesn’t take much carbohydrate to give you tremendous blood sugar swings.
In review, the Basics of the eating plan include: a calorie ceiling, sufficient protein, and a carbohydrate tipping point. The trick is to figure out the numbers. If you’re a woman who’s had WLS, if you get about 1200 calories you’ll struggle. If you’re a man and get about 1500-1600 calories you’ll probably struggle. Protein is based on lean body mass. It almost always comes around 90-100grams/day. It depends on how big you are. A male with a much bigger frame is going to need more protein. We typically say less than 50 grams a day. Some patients are so sensitive they need to be in the 20-30 gram range to really see good weight loss. What about fat? I’m not concerned too much unless it drives your calories too high. You want to try and stick to the monounsaturated fats. There are good and bad fats. They do tend to influence calories. Fat does not affect the hormones the affect weight. Carbohydrate and protein do affect hormones that affect weight.
The best foods have no labels
The best foods have no labels. Eat just 3 things. We would die without water. Water is the best thing to drink. Get rid of everything else. Good protein sources are meat, seafood, cheese and eggs. They have basically no carbohydrates. Eat colorful vegetables/salad stuff which is typically low calorie, nutrient dense, and fairly low carbohydrate. If it falls outside the “core,” then don’t eat it!
Dr. Clark’s low carb diet simplified (LCDS) is avoiding these three things: starches, “crumbly” carbs, and watching the fruit. Fruit can be the downfall of any weight loss plan. I’ve heard so many people say they eat healthy (including a lot of fruit). Fruit is healthy. There’s no doubt about that. However, it won’t help you lose weight. Healthy and losing weight are two different things. The main starches to avoid are potato, rice, pasta and bread. The “crumbly” carbs (6 “C”s) are chips, cookies, cereal, cake and candy. That includes hot cereal too. It’s simple to understand but NOT easy to do! Simple does not equate with easy.
A good weight loss plan includes a good diet/nutrition plan, activity/exercise plan, and behavior modification. There is no difference between surgical and medical weight loss patients trying to lose weight. The hard part is behavior modification.
We can help you get started! Call us at 757-873-1880 to schedule a free consultation if you are interested in a non-surgical program or watch our free weight loss surgery webinar.
We all make mistakes, especially when we’re trying new things like weight loss. With weight loss people have typically tried many things. These are going to be some of the more common mistakes. You need to see it as an opportunity to change, and hopefully for the better.
Mistake #1 is “kinda” working on weight loss. Kinda working on weight loss does not work! We often want that quick fix. We have to learn the skills over a period of time. If you’re just going to “kinda” work on it, it isn’t going to work. Skills have to be learned. Then, they have to be ingrained and become habit. They have to be practiced over and over and over again so they can become lifelong habits. Think about a serious athlete trying to make the Olympics. They can’t just “kinda” work on it. Commitment is absolutely essential. You can’t expect perfection. We’re going to make mistakes.
Mistake #2 is making weight loss too complicated. Yes, weight loss is hard, but you really need to stick to the basics. The basics are: dietary changes, behavior/habit modification, and increased activity and fitness. Those are the basic concepts. It sounds easy, but obviously it’s not so easy. I put together a webinar about a month ago that went over some really important concepts about controlling weight. It really boiled down to controlling insulin levels. It was about all the things you need to do to control insulin levels. Diet has to be the cornerstone of all that. Slowly work on all the basics and you will continue to make progress. With any type of change you need to ask yourself two questions: Can I do it? Is it worth it? If you can’t answer yes to those two questions you’re going to struggle and not make that long term change.
Mistake #3 is not exercising! Exercise does not make you lose weight faster. So many people come in and say they’d be losing weight faster if they were exercising. It’s probably not true, but it’s still very important. It’s absolutely essential to preserve lean body mass. The natural part of aging is losing lean body mass at a rate of 1% a year. LBM is what drives your overall metabolism. Simplistically speaking, a pound of muscle burns a lot more calories than a pound of fat. It’s actually a pound of well-trained muscle (think of the Olympic athlete) burns calories like crazy versus a pound of fat. You want to have a fuel-burning machine. Muscle does that. Our overall metabolism is dependent on how much lean body mass we have. The better trained the lean body mass, the higher the metabolism will be. You can increase your metabolism with better trained muscle. It burns a lot more calories than untrained muscle. So exercise is extremely important. It doesn’t make you lose weight faster. It makes you lose weight longer and makes it so much easier to keep that weight off.
Mistake #4 is avoiding the scale. I’ve said many times that the scale is the best monitor we have. Patients often say they don’t weight themselves routinely. They only weigh when they come into the office. Why would you think that’s a good idea??! I’ve said many times that you need to stand on the scale every day. The best time to weigh yourself is early in the morning. It’s the most accurate. If you forget to weigh yourself in the morning, just wait until the next day. Your weight will go up during the day. Make that part of your morning routine. The reason is to reflect on the previous 24 hours. What was different about that previous 24 hours? You’ll figure out the little things that matter. It may be as simple as you had to much salt or you didn’t have a bowel movement. Those little things that we typically eat really matter and will show up on the scale. Once a week doesn’t work. How many of us can look back on a week and figure out what we did differently during that week versus the previous week? Literally two days I can’t remember what I did differently. Looking back on 24 hours is relatively simple. What worked? What didn’t work? You’ll figure those little things out that affect day to day weight.
Mistake #5 is believing that genetics is responsible for your weight. Genetics does influence our weight. But if we are using genetics as a reason for our weight that’s just an excuse. When you really look closely at that thought process, weight is more likely contagious than it is inherited. We tend to do the things we surround ourselves with. If everyone in your family is overweight it is slightly genetics but it’s very likely what they’re eating and doing. It tends to be contagious. We do the things that the people we hang around do. That’s true in our family and social life. It’s going to be a very rare situation where genetics is truly the reason. Weight is more likely contagious rather than inherited.
Mistake #6 is giving in to saboteurs. Friends, family, and acquaintances will all try and sabotage you. They will say the following: “You deserve this.” “A little won’t hurt.” “It’s the holidays!” There will be saboteurs. Be prepared to say, “No thank you” in multiple different ways. Deflect the comments by changing the subject. Explain to them the importance of this and that you want to recruit them to help. Tell them you value their support. You want them to help you rather than hinder you. Sometimes they don’t realize they’re sabotaging your progress.
Mistake #7 is being inconsistent. It’s that mentality of, “I’ve been good all week. I’m going to take the weekend off.” “I deserve this vacation because I’ve been so good.” Consistency goes along with commitment. Ask yourself those questions: “Can I do it?” “Is it worth it?” A bad weekend can undo 2 weeks of hard work. You tell yourself that you can slide just a little bit. You’ll find that you’ll slide a lot. It’s really easy to gain weight. It’s incredibly easy to gain weight. Write down your motivations for weight loss and review them often. “Why am I doing this?” “Where do I want to go with this?” Hopefully you’ll realize being consistent is worth it.
Mistake #8 is not eating enough. The common thinking is less is better. The reality is starvation has never been a good weight loss plan. Starvation is cutting way back but history has shown that it isn’t successful for weight loss. Fifty to sixty years ago some semi-starvation experiments were done. Around WW II there were contentious objectors. These people refused to join the military so they were asked to help by being put on semi-starvation diets. They found that if you cut those calories in half of what someone normally would be eating, people didn’t actually lose weight. They lost weight for a while but their metabolism slowed way down to make up for the calorie deficit. Part of the problem with just decreasing calories, and to continue to decrease calories, is that it only tends to work for a short period of time. Your body adjusts fairly quickly and it will slow your metabolism way down. It can slow it down to almost 50%. That is your body’s survival mechanism which is good if there truly is a famine. However, most of us aren’t living in a famine. Part of the issue with the semi-starvation diets is they cut their protein way back. If you’re getting sufficient protein, typically your calories will be decent. Weight loss will become more difficult. It will also become really easy to regain weight.
I had written that mistake #9 was skipping meals. It’s actually not such a bad thing because intermittent fasting works really well. Intermittent fasting is just skipping meals. I do encourage people to eat breakfast for a couple of reasons. There are also reasons to skip breakfast. There isn’t a right and a wrong here. I’ve become convinced about that. Some of it depends on what you’re eating for breakfast. If you tend to eat a high carbohydrate breakfast, studies show you’re going to be eating 300-400 calories a day extra because you tend to be hungrier. If you’re going to eat a high protein breakfast you tend to stay full longer and you eat about 200 calories less a day. Most people don’t wake up starving. For certain individuals, skipping meals can actually work nicely. Skipping meals can actually be a good thing.
The NEW Mistake #9 is thinking that meal “timing” doesn’t matter. It DOES matter. The same meal late in the evening has a greater insulin response. If you eat that meal earlier it will have a different insulin response. This goes along with skipping meals. Some people do much better with eating 2 meals a day. We already talked about intermittent fasting. It works. There’s no doubt about it. Insulin is key to weight control. The longer time you can spend with lower insulin levels, the easier it is to lose weight. The concept of eating multiple small times throughout the day will never work well. If you’re sensitive to carbohydrates or somewhat insulin resistant, the small meals throughout the day will never work for you. The reason is that, no matter what, whatever we eat will raise insulin levels. Carbohydrate just does it the most. You want to spend as much time as possible with low insulin levels. Skipping meals will give you more time with lower insulin levels. Eating the same amount of calories but spreading it out throughout the day is asking your body to stimulate insulin levels multiple times throughout the day. That concept doesn’t have a whole lot to do with how many calories you’re eating. It’s just a pattern of eating. Timing matters. It’s a really rare person that controls their weight well by eating a little bit multiple times throughout the day. That’s just not my patient population. That’s not who I see. There are some individuals who aren’t that sensitive to carbohydrates. Those people will be fine eating small meals throughout the day.
Mistake #10 is having that “All or None” mentality. It’s feeling that you’re either doing everything great, but if you make a mistake you’re all done and throwing in the towel. This is a learning process. We’re human and we won’t be perfect every day. Accept the mistakes and move on. You didn’t gain the weight overnight. It didn’t happen with just one meal or one bad day. When you have that bad day, chalk it up to a learning experience. Figure out what you’re going to do differently when you’re in that same situation next time. Figure out those tools you can utilize to prevent you from falling off the deep end and get back on track for the next meal. Don’t beat yourself up.
In summary, to err is human but it does not define your destiny. Don’t let mistakes derail your weight loss plan. Dust yourself off and keep going. At CFWLS this is what we do. We’re here to help you. If you need some help just give us a yell. If you have any questions give us a yell here at CFWLS. Call, send an email, or walk in the door. You should be checking your body comp. Make sure you’re losing fat not lean body mass.
If you would like weekly weight loss tips and recipes and a chance to ask me questions, subscribe to Losing Weight USA! Remember it’s your life! Make it a healthy one! Have a good evening everyone. Take care!
Fat blockers are out there. You’ll see them on the internet. You can buy them over-the-counter. Do they work? Can they be helpful a weight loss plan? The short answer is potentially they really can be helpful.
What are fat blockers? There are two different fat blockers out there. They’re the same generic medication called orlistat. Orlistat can be found over-the-counter as Alli. It also can be sold in prescription strength as Xenical. They’re the same thing. But what they can do is block 25%- 1/3 of the fat that you eat. By doing that, it can decrease the amount of calories that are absorbed. You have to be very careful because if you’re not absorbing that fat, it’s going to run through you.
Potentially, fat blockers can cause significant gastrointestinal problems. You might get bloated or have cramping. Eventually, it’s coming out the other end. If you eat too much fat it might be coming out the other end sooner than you thought. So, you’ve got to be careful. But it can be helpful. If you’re doing the right things like a good diet and exercise, cutting back on fat can decrease some of the calories you’re eating.
Today I’m going to give you a talk about some of my thoughts about weight loss and also some of my thoughts optimizing health in the long term. My concept of this has evolved over a number of years. This discussion is pertinent for anybody looking to improve their health or looking to lose weight (whether or not you’ve had weight loss surgery). This is not just about losing weight. This can pertain to anybody. Hopefully this discussion will help many people.
We’re talking about optimizing health and optimizing weight loss. It’s a new year, so all of us have that somewhere in out “to do” list somewhere. The essence of any weight loss plan (of health plan) will always be behavior modification. If we don’t change our behavior then literally nothing will change in our life. We have to do the changing. It can’t be that we’re waiting for everybody else to change for us and that will change our life. That just doesn’t work very well. We have to change behavior. Change is not going to occur unless you change your behavior! It really is up to you. No matter how you look at it, it’s still a personal responsibility. That’s true for me. It’s true for everyone.
This is an overview. I also call it an Over Simplification. Controlling weight and health, I’ve become convinced, is controlling insulin levels. If we control insulin levels, we control weight and health. Insulin is a hormone. Its main function is to control blood sugars. When blood sugar goes up, insulin goes up to help keep our blood sugars controlled. Insulin causes a lot of other potential problems. It causes the following: water retention, increases B/P, increases chol/TG’s, increases inflammation, increases heart risk, and turns on fat storage (weight gain). If we can control insulin weight and we can control health. The real question is how do we control insulin??? It’s a hormone you can’t live without. I’m digressing a bit. But if you look back 100 years ago before insulin was available as a medication Type I diabetics (they make no insulin) were pretty much given a death sentence because it was a slowly wasting disease. We want the insulin numbers as low as possible because it worsens so many other health problems. We can control blood sugar somewhat by getting rid of anything that raises blood sugar; keeping calories low, keeping carbohydrates really low and a modest amount of protein. Subsequently we can control the blood sugars ok without any insulin. Without insulin, you can’t store fat. So, 100 years ago, people with Type I diabetes would just keep losing weight. Zero insulin is a bad number.
Controlling weight and health is controlling insulin levels. How do you control insulin? There are 4 ways. There are actually two more that I’m not going to get into too much. We need to control stress and get quality sleep. When we are highly stressed and suffer from poor sleep, cortisol levels go up which results in higher insulin levels. Control stress through deep breathing, exercising, warm bath, or whatever. But there are four main ways of controlling insulin. Number one is low calories. Insulin levels will come down if you lower your calories. The issue is, if we take calories too low, over time your metabolism will slow down significantly. Cutting calories way back long term isn’t necessarily a doable thing and might not lead to as much weight loss as we would like because of slowing of metabolism. Exercise can be very helpful. The more intense the exercise, the better it works. That’s where high intensity interval training and the weight training comes in. The more active you are, the more controlled your insulin will be. Anyone that has Type II Diabetes should absolutely be exercising. Low carb has got to be the cornerstone of an eating plan to control insulin levels. It’s carbs that influence insulin the most. If you ignore eating low carb, it’s going to be next to impossible to control insulin levels. How low is low? I’ll get into that later. But it is somewhat based on the individual. The fourth way to control insulin levels is intermittent fasting. It works the very best to control insulin levels. Intermittent fasting means not eating. Two of the reasons it works is because it’s both low calorie and low carbohydrate. There are lots of other reasons it works too.
How do you actually implement these ways to control insulin levels? Three out of the four have to do with eating. You can say that diet trumps everything else. We still have to really work on our diet. Words to live by: eat a small amount of good food slowly. Make that your mantra! If you do that you’ll typically be eating healthy. When I say “good” it doesn’t necessarily mean it tastes good like a candy bar. By good, I’m talking about quality food. Tape it to your refrigerator door or make it your screen saver.
Let’s talk about the “concept” of eating. This is your overall thought process of eating. “How little can I eat and be satisfied”, NOT “How much can I cram in there…” The difference between those two statements is generally a good 20-25%. That’s the mindset. Then we need to look at the “pattern” of eating. The pattern of eating is the simplest thing to change. When we’re eating has nothing to do with what we’re eating. I like for people to have a good pattern of eating. That doesn’t necessarily mean it’s a regular pattern. It can actually be an irregular pattern. If you think about it, throughout history it typically has been an irregular pattern. For some individuals, it works really well eating every few hours. I assure you that’s not my patient population. Forty to fifty years ago that was the norm. The pattern of eating was typically 3 meals a day. That was it. There weren’t a whole lot of snacks because you didn’t want to “ruin your appetite.” Obesity and these health issues weren’t nearly as prevalent. That also meant there were 12 hours after that 6:00 supper. Fasting was typically part of a normal eating pattern 50 years ago. Thousands of years ago fasting was a huge part of it because food wasn’t available. You were lucky if you got one or two meals a day! It’s figuring out a pattern that’s good for you. Again, it doesn’t necessarily have to be a regular pattern. It might work well for you, but other people not so much. For the surgical patients we often tell them they should eat breakfast each day. There is some rationale to that. But for long term most people get beyond the surgery and feel good and it’s not necessary. But you need to get your protein and hydration in. It’s really hard to do right after surgery. It’s not hard to do long term. Eating when you’re not hungry is probably not such a great idea. Skipping meals is ok unless you just had surgery. Some people need a snack. Others don’t need a snack.
Remember that what we’re trying to do is control insulin levels. It doesn’t matter what you eat. Anything you eat will make insulin levels go up. You need to have time for insulin levels to go back down. If you’re eating every couple of hours, insulin levels never go back down. There is good evidence that the same size meal taken late in the evening versus earlier in the day will stimulate a much more dramatic insulin response. A much more dramatic insulin response is going to turn on fat storage that much more. Literally the same calories eaten at a different time can affect us significantly. With the Mediterranean diet they have the big meal mid-day and typically light eating in the evening. In the US we have that backwards typically. We’re often having our latest meal later into the evening. If it’s really getting later into the evening you’re getting a much bigger insulin response which turns on fat storage and turns on all the other problems. The pattern of eating is something we have to figure out. It’s simple to change. You’re either eating or you’re not eating. When you make the decision to eat, there are so many other decisions that have to be made; what are you going to eat? How much? What’s the makeup of all this stuff? The pattern of eating is the simplest to change. But simple doesn’t mean easy.
What should a meal be? A meal size should be a small plate size. It’s true whether you’ve had surgery or not. A small amount of good food slowly. The best food has no labels (non-processed food). That means we prepared it ourselves. It’s the processing that causes a lot of these problems. Try to avoid processed foods. Purchase it yourself. Prepare it yourself. Get it from the edges of the supermarket.
So what am I going to eat? This is where we have lots of decision making and lots of shades of grey. The basics of any eating plan is looking at three things: how many calories, how much protein, and how much carbohydrate you’ll be sensitive to. I didn’t say a whole lot about fat. Fat will influence your calories. Fat also has minimal influence on insulin. I don’t recommend “high protein” diet. High protein actually stimulates insulin levels significantly. The trick is figuring out the numbers. There’s always a calorie ceiling. If we go above a certain number of calories (for every person it’s different-no matter what you’re eating) you’re not going to lose weight. There’s always a calorie ceiling. No matter what we eat it will influence insulin levels. But carbohydrate raises it the most. Just because you stay below that calorie ceiling doesn’t mean you’ll lose weight. It just means you’re not gaining weight. That’s all.
We can’t survive without protein. Your body is utilizing it second to second, day to day for everything that’s happening. It’s used for heart beating, digestion, breathing, growing hair, etc.… If we don’t take in enough protein each day, your body is going to steal what it needs from your lean body mass. If you’re breaking down lean body mass, you’re slowing your metabolism down. Lean body mass is what drives our overall metabolism. The more lean body mass you have, the higher your metabolism. How many calories does a pound of muscle burn? It depends on how well trained it is. In an elite athlete, a pound of muscle is burning calories like crazy. World class athletes can eat 7-8000 calories a day. Couch potato muscle doesn’t burn much! Muscle burns more calories than fat. The better trained the muscle mass, the higher your metabolism.
Everyone has a carbohydrate “tipping point.” That means that at a certain level of carbohydrates your insulin levels will jump up. When insulin levels go up, you retain water and store fat like crazy. It turns on fat storage. When you turn on fat storage you’re not going to lose weight. You can figure out what your tipping point is, but it’s not easy to do. The healthier the carbohydrate and less processed, your tipping point will be higher. If you’re exercising your tipping point will be higher. If you’re not very carbohydrate sensitive you’re tipping point will be higher. There are people who aren’t carb sensitive who eat a lot of carbs and don’t gain weight. They just have a more efficient physiology. If it only takes a tiny amount of insulin to make your blood sugar decent then you’re not going to turn on fat storage.
Here are some things to “chew” on. “Kinda” working on weight loss does not work. You need to be all in. If you’re only going to do one thing—count your carbohydrate intake. It gives you the most bang for your buck. There’s no such thing as carbohydrate deficiency. Since carbohydrate is not an essential nutrient and they do significantly influence insulin, try to get the carbs as low as possible. 2/3 of the population is carb sensitive. Close to 95% of my patient population is carb sensitive. Many of those people are also insulin resistant. It’s like a stepping stone; Carbohydrate sensitivity to insulin resistance, to diabetes type II. This means when you eat just a little bit of carbohydrate you tend to get very large blood sugar swings. What should happen is the blood sugar goes up a little bit after eating carbs. The insulin levels only go up a little bit. If your carbohydrate sensitive, what tends to happen is a delay with the insulin.
It’s supposed to kick in but it doesn’t. Subsequently, you get a huge blood sugar swing. Then the blood sugar plummets. The insulin is chasing the blood sugar around all day. The blood sugar swings tend to cause symptoms: headaches, irritability, not thinking clearly, and weight gain. Weight gain comes from the blood sugar swing up which causes a big release of insulin. Insulin turns on the fat storage. The treatment is to not get the upswing. If you don’t get the rise up, you don’t get the fall. People who are fasting keep their blood sugars rock even. It’s only when you start eating that things get out of whack.
Many doctors, clinicians, and dieticians don’t understand this probably because they haven’t thought about it. The concept is very straight forward. A blood glucose of 100 is the highest end of normal. Ideal range is 65-85. If your blood sugar is 100, what does that actually mean as far as how much sugar is in your blood? It’s only a tiny amount. We each have about 5 liters of blood in us. So if we say your blood sugar is 100, how much sugar is in your entire blood stream? The answer is 5 grams. That’s a miniscule amount. It’s the amount in a sugar cube. If you’re sensitive to carbohydrate, it only takes a tiny amount to get a blood sugar swing. 5 grams is ½ an Oreo, 1 Triscuit, 1/5 of a banana, ¼ apple, or ¼ slice of bread. If you have just one of those food items, you’re potentially doubling your blood sugar. A tiny thing can have major implications with your health. If your blood sugar is 80, that’s only 4 grams. If you eat ½ an Oreo, you’ve more than doubled your blood sugar. If you’re sensitive to carbohydrates (2/3 of the population is), it only takes tiny amounts to throw this out of whack. This turns on all those health problems.
The “core” of the eating plan is what you need to concentrate on. The best food has not labels. We fix it ourselves. We get it from the perimeter of the grocery store. Eat just 3 things. Number 1 is hydration. Water is the best thing to drink. Get rid of almost everything else. Number 2 is good protein sources. We would die without protein. The best sources are meat, seafood, cheese, and eggs. They are protein with no carbohydrates. This is considered adequate, not high protein. High protein will make insulin levels go up high. The whole concept is preserving lean body mass that keeps your metabolism decent. Number 3 is the vegetable/ salad stuff. It’s unprocessed food. No one ever gained 100 pounds eating too much broccoli. They’re low calorie, nutrient dense, and fairly low in carbohydrate. If it falls outside the “core”, don’t eat it! Easier said than done. The concept is simple but not easy to do.
The other end of the spectrum is the processed carbohydrates. This is the low carb diet simplified (LCDS). There are 3 things: the starches, the crumbly carbs and fruit. Fruit can be the downfall of many weight loss plans. It’s not because it’s not healthy, but it has a lot of sugar. It can turn off weight loss because it can affect insulin. Remember that eating healthy doesn’t correlate with weight loss. They’re two different things. The starches are potato, rice, pasta, bread, and corn. You really want to avoid the processed foods. The crumbly carbs (what I call the 6 “C”s). They are chips, cookies, crackers, cereal, cake, and candy. Get rid of them. Simple to understand, but not easy to do.
I’m going to give you the Basic Health Strategies that I encourage everybody to do. I try to do these things myself but I’m not perfect at it. I’m not willing to tell you to do something that I’m not willing to do. The first is monitoring. The scale is the best monitor we have. Weight yourself routinely. I encourage people to weigh themselves daily. I know everyone else out there from your dietician to your other physicians say not to weigh yourself every day because weight fluctuates up and down and you don’t want to be disappointed. The best time to weigh yourself is early in the morning. Get in the routine of weighing yourself every day. The reason is not to just look at the number, but you need to reflect on the past 24 hours. What happened or what did you do differently the past 24 hours that affected your weight? It’s relatively easy to look back on 24 hours. It might be as simple as you ate more salt the day before or you didn’t have a bowl movement. Very likely it could be too many carbohydrates which caused too much of an insulin response. The insulin caused you to retain water. It’s more difficult to reflect on a week or two.
The second basic health strategy is eating. Think “how little can I eat to stay satisfied”, not how much can I cram in there! Everyone has a carbohydrate tipping point where they struggle. The core of your eating plan is hydration (water or something that’s natural with no artificial sweeteners or flavors), protein, and veggies. Significant evidence has shown that diet sodas (even without carbs) will make you gain weight because there’s a significant insulin response. It’s not that it affects your calories or blood sugar necessarily, but what does it do to insulin? The insulin effect is the key.
Exercise absolutely helps with controlling insulin levels. The more intense, the better off you are. The biggest misconception is thinking that you need to exercise longer. But you need to increase intensity, not duration. You can get a tremendous workout in 20 minutes. There are a lot of examples out there. Nobody has to go to the fitness center for 1 ½ hours. This can be done at home in your own time.
Sleep is important because of cortisol levels. If you have poor quality of sleep, you’re typically going to struggle. Control stress. When it is out of control we struggle with our weight and health.
Intermittent fasting (IF) can be a tremendous addition to any health plan. Fasting is not starvation. They’re two different things. Starvation is something forced on us that we don’t choose to do and we don’t know where our next meal is coming from. Fasting is something we choose to do. We know when our next meal is coming, we just choose not to have it. Your body’s response is completely different. The hormonal changes that happen with IF actually work to improve health and decrease weight. Growth hormone goes up. The reality is we all fast when we go to sleep at night for about 8-10 hours. The world record for fasting is 382 days. The point is that it can be done safely and for an extended period of time. The question for each individual is how long to do it and how often. I can help you figure that out.
The final health strategy is personal responsibility. No one can do it for you. You have to decide you’re going to do this and then actually do it. It’s nice to talk about it and have support but you have to do it.
A few resources before I wind this down. The Art and Science of Low Carbohydrate Living is a good book about how carbohydrate works. It’s written by Stephen Phinney and Jeff Volek. Stephen is a physician and PhD. Jeff is a researcher and he’s at the University of Ohio. They’re very smart guys who live this stuff. Dr. Phinney has studied this for 30 or 40 years now! They have a second book called The Art and Science of Low Carbohydrate Performance. This book looks at how you can actually improve athletic performance with low carb. 15 years ago we talked about carb loading. But you don’t need to. You can improve athletic performance with low carbs. A very good book by Dr. Jason Fung is The Complete Guide to Fasting. You can get them on Amazon.
If you think of questions, just pick up the phone and call the office (757-873-1880). Don’t hesitate to send us an e-mail. Our address is: www.cfwls.com If you’re contemplating surgery know that more occurs than just having a smaller stomach. There are hormonal changes. The ghrelin levels go down which helps with controlling insulin levels.
Our nutrition store is open to the public. Come by and see us. Thank you for listening. Hopefully this was helpful. I apologize for dragging on a lot longer than I thought I would. This is important stuff. This is an overview of weight and health. Controlling weight and health long-term is controlling insulin levels. Thanks for listening. I’d love to hear from you. Take care. Have a good day.