Introduction From Todd Raehtz

Weight is an important determinant of health and ultimately, one’s lifespan.  It can have an impact on self-confidence and many aspects of our personal outlook. Being underweight, or anything greater than mildly obese is associated with shorter lives. 1  Obesity, and its related illnesses, claim more than 100,000 lives per year. With a number as large as that, almost all of us need to either lose weight or be cautious not to gain anymore. This blog assumes that everyone understands that pursuing a healthy BMI (Body Mass Index) is good for our health. BMI is simply a way to use height and weight to calculate and classify weight. I was inspired to write this from my own journey, which is, admittedly, not over. Getting control over your weight is going to be laid out with simple, manageable steps that can be used for both short-term weight loss and ongoing weight management, using examples from my own journey.

There are hundreds of diets, programs, and coaches. What special advice is offered here? NONE.

There is nothing new here. There is no gimmick, no food to purchase, no coaches to pay. We did not conduct original research. Here you will find one overarching approach to managing your weight that is applicable to almost everyone. Intermingled, there are some practical tips so that you can comfortably succeed in managing your weight, which in turn helps you manage your health.

The Principle: If You Don’t Measure It, You Can’t Manage It!

“If you don’t measure it, you can’t manage it” is one of those sayings that is so logical, there’s really no reason to question it. And, most importantly, it applies to healthy weight management. There are two things that absolutely need to be measured to achieve better health:

Step 1: Measure Your Weight

Measure your weight to find out several things:  Is there a problem? How big is the problem? If I implement change, is the change process working?   Your weight drives your BMI. Your BMI is an important measurement parameter for health. My advice: Get a new scale that not only measures your weight, but also gives feedback about your body fat percentage, BMI, and other health benchmarks.  These new scales cost about $25 and they link to your smartphone using Bluetooth. They are fantastic and they give you a vast amount of information and feedback about how your journey is progressing. Are they perfect? They probably aren’t perfect, but that doesn’t make them a bad part of the system. Measure your weight every day at the same time.  Sure, your body weight will fluctuate, but we are looking for the trend and accomplishment of a weight goal.

Why should we measure our weight every day? The reason is that knowing the results is inspirational. Starting your day knowing the facts will inspire you to either try a little harder or celebrate your accomplishments. Further, the sooner you know if you slip off track, the easier it is to make an adjustment.

Step 1: Measure your Weight Every Day, Even if you Don’t like the Results

Step 2: Measure Your Calorie Intake

Your caloric intake is simply the number of calories (kcal) you eat in a day. Measuring your calories is so much easier today than it was 5 or 10 years ago. There are plenty of apps in the app store for your phone, or available from a search on your computer. And, almost every food has a package label. When I decided to lose my extra weight, I used the built-in calorie counter in my Fitbit app. With this app, I can simply scan the barcode of the product, enter the size of my meal, and it adds everything up for me, every day. The most eye-opening part of my journey was to see how many calories per day I was eating.  Even for my level of activity, I was clearly on a path of weight gain. This step is crucial in the journey. In the beginning, it is a little daunting and it takes time. If you want to achieve your goal, expect to make this commitment. 

There are many guides available to us for determining how many calories we should eat. The app that you use may help you set a target.  My normal caloric intake is probably about 1800 kcal per day. The recommendations vary based on your sex, age, weight, etc. Activity and exercise play a role here as well. There is a rule of thumb that in order to lose a pound, you will have to eat 3500 kcal less than you burn. Keep in mind, that rule works in reverse: 3500 calories more than you burn will lead to a pound of weight gain.

Step 2: Measure accurately the calories you eat daily (get an app)

Once you select an app, you may be pleasantly surprised about the other information you will access. My app provides information about macronutrients (Carbohydrates, Protein, and Fat). Once you know what your diet patterns are, you will be armed with the information you need to make a few changes and also improve your nutritional balance.

The benefit of using a wearable fitness tracker is that it can calculate (estimate) how many calories you burn. This article will not go through the math that determines calorie needs, but, our bodies need calories for normal operation (breathing, digesting, heartbeat, etc.)  and to fuel our physical activity. Each day we have variability in how many calories we need, because we have variability in our daily activities.

Similar to measuring your weight, recording your true consumption may provide the feedback you need to start making better choices. Personally, recording and knowing what I ate each day was an eye-opening experience. 

What To Do With The Recorded Weight & Daily Calorie Intake Information

While measuring daily caloric intake, it becomes obvious where the causes of weight gain (or non-loss) are. Armed with that information, your next job is to make choices to fix the problems. The recommendation we are making is not to skip meals, or otherwise fast. Instead, use the information at hand to manage your consumption through portion control or substitution.

Eat Smaller Portions at Frequent Intervals to Reduce Hunger

Through following the advice of diet experts, I found that eating small meals more frequently kept me comfortable (not hungry) throughout the day. This was done with small measured meals. Your body will tell you when you are hungry. For example, during one of my “normal” days I typically eat the following:

• 8:00 AM Small bowl of the lowest calorie cereal I could purchase with 45kcal/cup almond milk.

• 11:00 AM Large salad with low-fat dressing

• 1:00 PM Healthy Choice, or similar, microwaveable frozen meal

• 3:00 PM  Dill pickle spear

• 4:00 PM Snack size bag of microwave popcorn

• 7:00 PM Dinner with the family, while being mindful of the portions I consume

With this methodology, it’s NOT recommended that you deprive yourself of the things you love. Yet, if you are going to eat them, be honest with yourself about their impact, and make choices elsewhere to balance out an unhealthy treat.

Healthy Food Substitutes & Alternatives

Food substitution is a powerful strategy while on the journey to lose weight or simply eat healthier. While we enter our consumption data, look closely at the nutritional information on every package, and look at the portion size for those calories. It is natural to question if this food is right to eat. With experience, we gain insight into our habits and then have the opportunity to make changes if we find those habits to be problematic to our health.

Habit Changes Serve As The Engine To Reverse Someone From Long-Term Weight Gain to Long-Term Weight Loss & Management.

There can be food intake alternatives that are both big and small. Consider a 2,000 kcal diet, when 10% of that is eliminated a 200 kcal deficit remains. If someone continues to consume 1,800 kcals, instead of 2,000 kcals, they should experience the loss of 1 pound in just over 2 weeks. Deciding to subtract 200 kcals from your daily intake, 10% of a standard 2,000 kcal diet, can be easy once stock is taken of regular eating habits and where substitutions can be made.

If losing 1 pound during time spans of just over 2 weeks is too slow - know that is a personal choice. Also, remember, we did not get to our problem weight in the span of a month, why should we expect to fix it within a month? In fact, simply monitoring our intake is very likely to be the only intervention most people will need to turn their long-term weight gain into a long-term weight loss followed by long-term weight management.

As An Example of Saving Calories Through Food Substitutions, Here Are Adjustments I Made During Breakfast, Lunch, and With An Afternoon Snack

Measuring Food & Calorie Intake Will Make It Easy To Find Lower Calorie Substitutes

Using this methodology, it is pretty easy to see that perhaps changing one small dietary habit can tip your daily caloric excess into a small deficit leading to loss of weight, and inches.

Portion Control

Portion control is another effective component to this methodology. The calorie measurement technique relies upon having realistic measurements (or estimates in many cases). Going back to the concept of simply reducing 10% of your daily caloric intake, consider simply cutting back portions of everything by 10%.

Portion Control: Simply eating 10% less of everything can save you 200 kcal per day!

Critics may not feel it is practical or the best practice to toss 10% of your quarter pound hamburger with cheese into the garbage. While it is agreed that we should do everything practical to reduce our nation’s food waste problem, it is also true that once you buy that burger, it no longer matters if you eat it or throw it out...it’s too late to save any resource. And, of course, using our substitution method, perhaps you could order an ordinary cheeseburger instead of a double cheeseburger.

Cutting back by 10% is another method to enjoy everything one usually eats, and still reduce your caloric intake.  Further, combining this with substitution makes a powerful weight loss combination.

Supplements

When discussing this methodology with others, questions about these recommendations being “healthy” have come up. The response: “Is my current higher calorie diet healthy?” The answer, of course, was “I don’t know”. I know that I do not count my vitamin intake, and I don’t know anyone else that does either.

Supplementation of one’s diet is smart. This means it is smart to supplement if you are on a diet, or not on a diet.  Most people have no idea if they eat enough Vitamin C, or Folic Acid. But, we all know and agree that vitamins and minerals are important to our body’s functionality. And, while we know that experts suggest that if we eat a “well-balanced” diet, we probably do not need supplementation.  The problem? We really don’t know how much of any vitamin or other nutrient we get in our real diets every day, week, or month. So, instead of guessing, taking a simple high quality multiple vitamin is important.

Most of us do not eat a well balanced diet before or during a diet. Start to supplement daily to stay healthy with less food.

In addition, I recommend additional supplements such as Calcium with Vitamin D for most adults, especially women. Anyone with an expected dietary deficiency, or recommendation of a doctor, should be supplementing specifically chosen products. And, for people that do not have enough sunlight, a Vitamin D supplement daily is a good idea. Be careful here, keep it under 1000 IU per day unless you have been told differently by your doctor.

Supplementation of vitamins and minerals is generally safe and effective. And, our bodies are pretty smart at eliminating the additional intake. (After all, it would be a surprise to me to hear someone had a Vitamin C overdose from eating too many oranges). Despite this, supplement in moderation, following the guidelines on the package.

Exercise

As described earlier, weight gain is simply caused by consuming more calories than one burns. These additional nutrients end up in fat stores, and result in weight and circumference gain. It seems logical and scientifically proven that increasing activity through exercise is critical to the weight loss process. Agreed. However, my personal recommendation is to wait: add exercise later to your program. My concern about adding an exercise regimen to your new methodology stems from two principles:

1. We can only effectively integrate a certain amount of change in our lives at any given time.

2. We can accomplish so much with diet, that we can wait.

It’s easier to avoid a poor eating choice than it is to burn it off at the gym.

The statement about change management is self explanatory. Some people who need to reduce BMI might be ready to take on 2 major daily life changes at once. If that is you, and you have no health conditions that restrict you, feel free to pursue increasing exercise simultaneously. Many busy people may have more success with the dietary habit changes if they focus on those exclusively. However, after a couple of months of success, and new eating habits (and measurement habits), adding exercise is a great idea! Just remember to start slow, never do more than your doctor or your body tells you.

The other reason that I am not recommending starting with exercise is that it is often far more difficult to “burn off” your poor eating choices than to avoid the choice in the first place. For some of us, exercise increases hunger and we feel psychologically less affected by an after exercise snack.  Let’s look at the afternoon snack example from earlier to drive home the point:

If I snack on 1 Package Chocolate/Peanut Butter Wafer Bar (2 cookies per package): 320 kcal

Here are some exercises that burn off 320 kcal according to my Fit Bit app:

• 1 hour and 7 minutes of walking

• 32 minutes of running

• 7 mile, 30 minute bike ride

• 2 hours and 25 minutes of Pilates

• 1 hour and 54 minutes of Yoga

• 1 hour and 15 minutes of Aerobics

Because it takes so much additional exercise, our recommendation is to focus first on diet using the simple techniques above. Not eating the 320 kcal chocolate/peanut butter snack is not easy, but far more effective than eating it, then simply trying to  exercise it off.

Goals

Setting goals is usually important to success. After all, how do we know when our efforts have paid off without them?  Everyone would likely have a different goal and a different time frame to accomplish the goal. But, using the SMART approach, remember to make the goal Specific, Measureable, Achievable, Realistic, and Timebound.

Set Small Achievable Goals To Help You Make Steady Progress.

It may be valuable to set incremental goals within the overall goal. For example, if a healthy BMI is 50 pounds away, consider setting a goal of 5 pounds in 60 days. That would only require a reduction of about 291 kcal per day from target.

Commitment

Changing habits is very difficult. After all, if it was easy, this article would not exist, nor thousands like it or our national weight problem.

Consider a Few of These Tips to Help You Face The Challenges of Your Weight-Loss Journey & Stay Committed:

• Tell a few people closest to you that you are embarking on your weight loss journey. Simply announcing it is a powerful way to give yourself some additional strength. Sometimes, proving to others that you have the strength to do what you say is a great way to stay committed.

• Utilize a peer group:  having someone who is making a similar change is very helpful. Consider having a spouse, child, or friend make these changes with you. It gives you both an edge.

• Become part of a program. If Weight Watchers or a program that delivers healthy meals and shakes is what it takes for you to make changes, go for it. There are benefits to latching on to knowledge these organizations and groups have. However, if you use one of these programs, you should still practice the measurement methodology. It is the foundation of knowing where you are and setting a path to where you want to be.

• Get a dietary or health coach. If you are unable to find a coach, let us know. Grass Lake Community Pharmacy can offer recommendations for low-cost peer groups or individual coaching.

Short Term Weight Loss vs. Maintenance

Once you get to your weight goal, keep up the momentum. Remember, to stay at this weight, you need to keep your consumed calories equal to (or less than) your total calories burned. This is like getting a raise! It means that you now can consume more calories without the risk of weight gain.  However, like a raise, don’t overspend it. If you stop counting your intake or measuring your weight, you can easily return to an undesirable weight and resume bad habits. 

After getting all of your new habits in place, it can also be the time to start adding more exercise to your routine. Exercise can help with so much more than just feeling healthy. As noted above, exercise alone is not a free pass to poor eating, however, it certainly gives us more flexibility.

Let us know if you have any ideas about this content, or your own journey in the comments area below.

Good luck on your personal journey to a healthy BMI.

Author: Todd Raehtz, Rph. Grass Lake Community Pharmacy Owner & Pharmacist

Source:

• How Much Should We Weigh for a Long and Healthy Life Span?