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New Directions In Weight Management
by Stephen R. Van Schoyck, Ph.D.

Weight management is more complex and difficult than most people realize. Many believe that it is as easy as pushing yourself away from the table and exercising more. Some operate in two speeds: normal eating that causes weight gain, and a structured, restrictive diet. While this approach may work with the 5-10 pound problem, dieting this way for a person with a chronic problem and wider weight fluctuations can cause more harm than good. No matter what the size of the problem, when the weight is regained, a fact that occurs in the vast majority of cases, the dieter believes that the problem is a lifestyle problem and their fault. They blame themselves for eating too much or not exercising enough.

Unfortunately, as we now know, the problem is more complex than imagined. No two weight problems are the same. Many have a genetic component that determines the daily energy requirements and the drop in calories with weight loss. Some overweight people eat under stress, but so do many thin people. Many children who eat fast food on a regular basis become obese, but many who eat an equal amount remain thin, even if they do not exercise.

This complexity has given rise to some new directions and concepts in weight management. Listed below are some of the issues to consider when choosing the best treatment for a weight problem:

Research flaws: Studies that measure the success of one diet versus another based on rate of weight loss do not match subjects for differences in metabolic rate. Since this rate is the controlling factor in weight loss, differences among subjects can account for the results attributed to the composition of different diets.

Diagnose before you treat: Successful weight control is based on matching the person to the treatment. If the problem is lifestyle, education is needed. If stress eating occurs, the person needs stress management. Donít treat a lifestyle problem with a structured diet.

Psychology of weight control: Every intervention implies an explanation and carries the potential to do psychological harm. If the person is told to exercise more to lose weight, they can believe that the lack of exercise is the cause. More significantly, they can believe they have been too lazy to exercise, unfairly blame themselves, and undermine their self-esteem.

Fat is an endocrine gland: Newest research supports the fact that fat mass is not inactive, but secretes hormones that regulate appetite and energy requirements based on fat cell size. As a result, you need to know how your body will change as a result of weight loss.

Need for an Energy Study: To design a treatment plan, you need to know the energy requirements of your current weight and make a prediction how the energy needs will be reduced by the loss of body weight. Without this knowledge, weight control is based on guess work rather than science.

Not everyone is made to be thin: Health behaviors matter more than body size. If a personís genetically based energy requirements match a high body weight, and they eat a healthy diet and exercise reasonably, then that weight is their natural and ideal weight.

Body Mass Index (BMI) is incomplete: BMI, a height to weight ratio, has been adopted as the standard for ideal weight. A BMI < 25 is considered ideal, and a BMI> 30 the clinical indicator of obesity. However ,BMI does not account for differences in energy requirements and is a faulty measure for many people.

Exercise smarter, not harder: We now know that the ìno pain, no gainî approach to exercise is not true for calorie expenditure or endurance. Low level training including walking builds endurance and can be sustained better by the average person than jogging or intensive aerobic activity.

Gastric surgery: While gastric surgery is becoming more popular, it is often pursued pre-maturely before the nature of the problem is fully understood. Make sure that you have tried lifestyle changes following an Energy Study as an alternative before incurring the risks of surgery.

Recommendations for Healthy Weight Management

Health is the best reason to lose weight. Weight loss to make yourself feel better never works. As good as you feel on the way down is matched by how bad you will feel when you break the diet or regain some weight.

Lifestyle management is the key to long-term weight control. Weight control is based on the energy equation. Use portion reduction and increased exercise to reduce intake and increase output. Obtain a Resting Metabolic Rate test to know the exact level of your energy equation. It will take the guess work out of the process.

Start a low level walking program, with a low initial goal. Try to walk 3x per week and increase the time/distance each week to reach 10 miles/week.

The weight you achieve with improved health behaviors becomes your ideal weight. Donít set your weight by charts, scales, or body fat measures.

Donít choose a diet based on weight loss results. Weight loss with structured diets is highly popular and very ineffective. In fact, each diet you try will make you fatter.

Appetite suppressants may work temporarily, but watch what happens when you stop using them. Without knowing how to regulate your lifestyle, you are at high risk to regain any lost weight plus more.

If you want more specific information on healthy weight management, contact Dr. Van Schoyck.

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