Herbal Health
Herbal Remedies Blog
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FAD DIETS: IMPLICATIONS
Weight loss diets abound, all with the promise of eagerly sought results. If any formularised eating plan is to be used, those working in fat loss need to:
1. Look to scientific research for the basis of claims, and ensure the eating plan is not actually a danger to health.
2. Sort through the claims and promises for the actual strategies required.
3. Assess if it requires anything special to make it work, including pills, potions or machdnes.
4. Assess its consistency with recommended food selection guides and the use of locally available foods.
5. Assess the promised rate of weight loss.
6. Assess the energy level and macronutrient composition and compare this with national recommendations.
7. Ensure that it is nutritionally adequate in micronutrients, and not reliant on supplements.
8. Assess the cost of the plan, particularly for long-term implementation.
9. Ensure that it is sustainable, incorporating commonsense food selection and regular, appropriately chosen physical activity.
10. Refer to an appropriately qualified health professional if unsure.
11. Reject any diet promoting a specific food or drink as a fat ‘burner’.
12. Consider only those eating plans which are likely to be adhered to for extended periods without alterations to physical nutrient profiles.
13. Be aware that liquid meal replacement diets without an accompanying activity program should only ever be used for the very obese and with appropriate professional supervision.
14. Discourage dieting in favour of healthy eating plans.
15. Keep in mind that diets of less than 1200kcals per day should not be used except under strict professional supervision and only in cases of extreme and life-threatening obesity.
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Weight Loss
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ANOREXIA NERVOSA: BEHAVIORAL TREATMENT
Having a contract reduces the “arbitrariness” of treatment and makes it easier to accept. The rules are codified, written down, and stored away someplace-somewhat like the Constitution. The patient might argue about how to interpret those rules, or how they should be enforced, but she can’t dispute that they exist.
Of course, it’s important to work with patients to help them overcome their fears and anxieties. I tell them, “Look, I know this whole situation is pretty scary. But we want to help you. Of course we want you to gain weight, but that’s really your responsibility. We’re not going to be spies and monitor every mouthful you eat. But if you find you’re having trouble, we’ll have someone sit with you and help you get through the fear. Yes, we need to give you enough calories so that you begin to gain weight, but we don’t want to go too fast. We’re not here to just fatten you up and send you on your way. We want to help you gain weight in a healthy and calm manner, so that we can begin to find out what’s really troubling you deep down inside.”
The food journal provides clues about strategies that might work. Anorexics might not be ready to fill out such sheets, especially at first. They dwell on food constantly anyway; writing it all down might just make them more anxious (that can be true for bulimics, too). If they feel that way, I don’t push it. Sometimes keeping a journal focusing just on feelings and events (not food) can be useful.
A journal can provide a vivid record of the patient’s thoughts and feelings about her situation. By examining these thoughts, we can often reveal distortions in the way the patient perceives and interprets events in her life. Cognitive therapy, which I will discuss in just a moment, is a good method for correcting such distortions.
In the final phase, we concentrate on helping the patient maintain her weight within the target range. We reinforce normal eating habits and look ahead to her continued recovery as an outpatient.
Before sending her home, we work out a plan to monitor her weight. We agree on who should do the weighing-a doctor, a nurse, her parents. She understands that if her weight drops below a certain limit, she will have to come back to the hospital.
A word about outpatients: It is possible to set up a contract with anorexics treated outside the hospital, even though they are not being monitored twenty-four hours a day. Usually such contracts set lower goals for weight gain-say, between one and two pounds a week. In family therapy sessions we work out the system of rewards and penalties. The parents may agree, for example, that if the patient fails to meet her target, they will suspend her allowance or ground her.
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Weight Loss -
STIMULATE YOUR DETERMINATION: SHE PUT FITNESS FIRST AND LOST 155 POUNDS
With a family, a home, and a part-time job, Sandie Howe doesn’t have a lot of free time. But no matter how busy she is, the 34-year-old Stockton, Missouri, resident sets aside 30 minutes a day, just for herself, to exercise. Her no-excuses attitude toward fitness helped her lose 155 pounds and 10 dress sizes.
Sandie never had a weight problem when she was younger. But once she and her husband decided to start a family, she gained between 35 and 40 pounds with each of her four babies. By age 32, she weighed 300 pounds.
“My mom took a photo of me that Christmas, in 1997,” Sandie recalls. “When I saw it, I was so ashamed that I wanted to cry. I made up my mind right then and there to lose weight.”
The trouble was that she didn’t even know where to start. “In the past, I had made some half-hearted attempts to lose weight, but without much success,” she says. “I really didn’t know what to do.”
She knew from experience that dieting didn’t work. So this time, she decided to combine a sensible eating plan with regular exercise. She began by counting calories and grams of fat and exercising for 30 minutes at least three times a week. “I really struggled through my workouts at first,” she recalls. “Whether I was walking outside or doing aerobics to a Pdchard Simmons video, I was pretty winded by the time I was done.”
As the pounds came off, though, she felt stronger and better. She noticed that her feet and knees, which had bothered her when she was at her heaviest, no longer hurt.
Over time, Sandie expanded her exercise program so that she was working out for at least 30 minutes every day. She continued to monitor her calorie and fat intake, too. Within 2 years, she lost 155 pounds. She’s now a fit and trim 145 pounds.
“When it comes to exercising, the biggest excuse is not having time. I know—I used to tell myself that, too,” Sandie says. “I learned ST that I can make time, if I really want to. Some days, I get up a half hour early so I can squeeze in my workout before things get hectic. j §
Other days, I exercise while my children are napping or playing at friends’ homes. If all else fails, my husband is great about watching j the kids so I can go walking for 30 minutes. I |
“Somehow I always find the time I need,” Sandie adds. “You can, too.”
WINNING ACTION
Make yourself a top priority. No matter how busy a family life you have, follow Sandie’s example and demand a half-hour a day for yourself. If your family objects, explain to them how important it is to you and that they’ll benefit, too—by having a happier, healthier wife and mom. Out of 24 hours in a day, you deserve 30 minutes!
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Weight Loss