Ask the MD: Healthy Weight Management

January 3, 2012
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We’ve gathered some common questions about weight management and posed them to the chair of our Integrative Health Advisory Board (IHAB), Dr. Brad Jacobs, MD. Here is his sage advice about maintaining a healthy weight.

What integrative therapies can I use to manage my weight?

First off, keep in mind that there are no quick fixes. But if you are willing to be persistent, then you can lose all the weight you desire. Exercise, diet, stress and sleep all play a critical role in weight management.

A good first step is to increase the amount of exercise you get. Modify your diet with smaller, more frequent meals, and make sure you’re managing your stress and mood. Stress can indirectly affect your weight, so try yoga, breathing practices, guided imagery, or supplements, if necessary, to manage stress. It’s also important to improve your sleep, so explore different natural therapies if necessary. As far as supplements go, I recommend people increase their fiber intake to increase feelings of fullness and improve digestion.

It is important for me to know my Body Mass Index (BMI) score?
BMI is a measure of body fat based on height and weight, so it’s a good thing to be aware of (you can find many BMI calculators online). Healthy people should achieve a BMI between 18.5-25, 25-30 is considered overweight and over 30 is obese. Note: People who are large boned or have significant muscle mass can have skewed BMI numbers. A doctor can help determine your BMI goal for your body type.

How should exercise figure into my weight management program?
People think of exercise as beneficial strictly because it burns calories. But that’s the least of its benefits. Exercise can help you lose weight in three ways: First, it increases your metabolic rate so that you burn calories more rapidly throughout the day (it’s like turning up the furnace in your house which in turn burns fuel more rapidly). Second, exercise can improve your mood and reduce stress, so it makes you less likely to crave foods for psychological reasons (one of the main reasons we overeat). It also helps you to sleep better, and lack of sleep is strongly associated with weight gain.

In terms of guidelines, shoot for exercise 5 days a week, 30 minutes a day. Keep in mind that even 15 minutes of exercise provides 65 percent of the benefit. By expanding your definiteion of exercise to include activities such as taking the stairs, walking during work meetings, walking to work, to name a few, you can easily exercise daily and it doesn’t have to take a lot of time out of your day. I recommend people get a pedometer and aim to walk 10,000 steps each day.

What dietary changes should I make?
The most important thing to consider is the quantity of food being eaten in terms of calories. You can track your intake online via WeightWatchers or SparkPeople.

Next, look at the types of food you’re eating. Try what I call “going brown,” or switching out refined carbs like white rice, bread and pasta for whole grain breads, brown rice, etc. These increase your fiber intake, which makes you feel fuller for longer and with fewer calories. In addition, increase your total vegetable intake, which increases the amount of phytonutrients you’re getting and improves the quality of food.

Try to eat frequent small meals. A good breakfast is important (including whole grains and a little protein), then mid-morning eat a good snack (protein mixed with a little fat and carbs, such as yogurt, a handful of nuts, or celery with peanut, almond or cashew butter). Have a light lunch (like a large salad), and a mid-afternoon snack before dinner. By eating multiple meals per day, you are less likely to crave sweets and salt and to eat large meals. You will also sustain your blood sugar levels instead of creating spikes and drops that can affect your mood and therefore your food choices.

Could my extra weight be caused by a medical condition or a prescription I’m taking?
You can gain extra weight if you are hypothyroid, so if you think this may be a contributing factor, get your thyroid levels checked by a doctor. Together you’ll be able to determine the best approach to regulating thyroid levels. Other conditions that can lead to weight gain are sleep depravity, depression and in rare cases, polycystic ovary syndrome.

As far as prescription medications go, the most prominent are insulin (for diabetics) and prednisone (a corticosteroid used for autoimmune conditions), which tends to make you crave food more and therefore can cause weight gain.

Each month we’ll be tackling a new topic and posing questions to members of our Integrative Health Advisory Board. Next month we’ll cover heart health, stay tuned!