# Presentation: 209545

## Lose Weight To Control Blood Sugar 

- Techniques that work when diets don’t

## Why lose weight

- Glycemic control
- Decrease risk of heart disease
- Decrease development or symptoms of  osteoarthritis
- Normalize blood pressure
- Decrease risk of some cancers and other
-      disease (i.e. sleep apnea)

## Why diets don’t work

- No permanent change in food choice or amount resulting in regain
- Quantity control
- Energy In = Energy Out maintains weight
- Most people underestimate their food intake and overestimate their activity level
- Habits cause the same detrimental behaviors to keep repeating

**Notes:**
Diet is something you go on therefore you go off
Nothing is learned to use the foods you prefer so that when you stop dieting you return to the calorie intake that got you where you are in the first place

Many people make healthy choices but don’t consider how much they are eating, overeat on carrots or cookies and you are still going to store the extra calories

Univ of Ill study: moviegoers given a medium or large bucket of popcorn.Large ate 50% more.  Both groups estimated the same number of calories and ounces consumed
	Repeated with 14 day old popcorn, large bucket subjects ate 31% more and also estimated the same amt. consumed
Subjects given either 1⁄2, 1 or 2 pound bag of M&Ms and watched a video, 1⁄2 pound subjects ate 63, 1 pound ate 120, 2 pound ate even more
Secretaries were observed with a candy dish, clear opaque and covered, on the desk or six feet away, the cndy was counted evry night and refilled,If dish was clear they ate 9 pieces, opaque 6.5 pieces, 4 pieces if 6 feet away.  Same results when using carrots.  Take home message: being near food makes us eat
Larger packaging even from Costco makes us use more, about twice as much whether its MMs cereal dog food or non food items

## Battling Mother Nature

- Our bodies fight us to regain the lost weight
- Biological and physiological mechanisms defend your extra fat and try to return the body to the weight it was
- Research shows that people who have lost weight are hungrier and not just for any food
- Weight loss signals the brain that you are starving and will slow metabolism to conserve energy
- Keep in mind that metabolic rate is linked to the amount of lean and muscle tissue you have
- The only way to counter this is to exercise more

**Notes:**
Not a lack of willpower.  Our bodies are built to save us from famine.

The body will prefer high fat and high sugar foods after weight loss
Craving high calorie foods is the last thing you need at that point
National Weight Loss Registry members keep weight off by exerising

## More Bumps in the Road

- Lipoprotein lipase, an enzyme that promotes fat storage, goes up in fat tissue when you lose weight so you tend to store fat rather than burn it
- The good news is that you won’t gain weight unless you eat more

## Stick to the plan

- Research shows that whatever method you use, weight loss is almost identical.
- The difference comes from whether you are using a method you can stick with over time

**Notes:**
A study of Atkins, Onish, Weight Watchers and the Zone
By the end of one year, three out of four people slacked off or quit
Those on Atkins or Ornish were more likely to drop out, suggesting more moderate diets last longer

## The ABC’s of BehaviorAntecedentsBehaviorsConsequences

- Change your behaviors to change your habits

## Antecedents: the events, circumstances and emotions which occur prior to eatingBehaviors: the eating itself and the related events and feelings including speed of eating, rate of chewing, taste of food, what you are doing while you are eating Consequences: the events, feelings and attitudes that follow eating and can determine whether or not the eating will occur again

##  Average Joe

- Home on Sunday watching baseball game
- Went to the kitchen for his favorite snack, chips
- He sat down with the bag, watched the game and ate rapidly not tasting each one
- He ate until he was very full and then felt guilty about eating so much

**Notes:**
Antecedents-being home, watching the game, having the chips available
Behavior-eating rapidly until very full
Consequences-unpleasant full feeling, guilt about overeating
How does JOE reduce his chances of overeating?
Alterthe antecedents-do something other than watching the game, not keeping chips in the house
Change the behavior-eating slower, savoring every bite, not eating out of the bag
Change the consequences-different attitude that does not include guilt, self doubt that might stimulate more eating

## Many people have situations, times or activities that stimulate eating

- These events become paired with eating so that the event can make you feel hungry

## If you always eat with these activities, the activity can make you feel like eating, without actually feeling hungry

- Reading the paper while eating breakfast
- Watch television with a snack
- Movies in theaters with popcorn

## It is important to separate eating from other activities

- Eating should be the activity to maximize the experience from making healthy choices on quality and quantity to enjoying every bite

**Notes:**
The more awkward this seems to you the more you need it

- Besides stimulating eating, these other activities may:-give you all the calories with only part of the pleasure -distract you from responding to actual hunger and fullness

**Notes:**
Calories should be tasted not wasted

## Scheduling May Help

- Choose a meal and snack pattern that best accommodates when you are hungry
- Make it convenient, it doesn’t have to be conventional or by the clock
- Eliminates grazing or tempting snacks available around you
- Think more to eat less: if the snack is planned, it may help you put off the urge to eat

**Notes:**
Example:  Snack planned for 10:00AM, donuts by the coffee pot at 9AM.  May be able to resist the donuts knowing you have a snack of your choosing for 10 that may be lower in fat and carbs and will satisfy you intil lunch as you had planned.
When you feel like eating at other times than noted on your schedule, think carefully about whether you are hungry or just responding to outside influences

## A chain is only as strong as its weakest link

- Eating is a chain of events
- Once you analyze the links in your chain of events that sabotage your weight loss efforts, you can spot the link that will  break the chain
- If you can break the chain, you regain control

## Example of a Behavior Chain

- Buy cookies
- Leave cookies on the counter
- Home on a Saturday afternoon
- Tired and bored
- Urge to eat
- Go to kitchen
- Take cookies to den

- Eat cookies while watching television
- Eat till full
- Feel guilt and like weight loss is ruined
- More eating

**Notes:**
Where can she break the chain
Analyze your behaviors and identify the ways you can gain control of your weak moments
Remember you want to find the weakest link.  For many of us that is not bringing the food in as opposed to resisting the urge to eat it and relying on our resolve or willpower
Also you want to break the chain as early as possible, so not buying cookies in this example may be the most effective change in behavior

## Lapse and Relapse

- A lapse is a slight error or slip, a single event or time period like exceeding a calorie level or gaining weight
- A relapse occurs when several lapses occur one after another until the person has reverted to the former state
- A lapse is an isolated event and can be prevented from leading to relapse

**Notes:**
A person who thinks of a lapse as an unfortunate but temporary problem will respond positively and proactively to regain control.
Feelings of loss of control or the inevitable undoing instead of moving forward cause old behaviors to return
Keeping control may require looking at what placed you at risk and possibly learning from it to decide on a new behavior that will break the chain
Example:  You get home from a buffet where you overate, you feel like you blew your eating plan, say what the heck I blew it already and eat more, feel guilty the next day and continue to overeat for 5 days.  A more constructive manner would be acknowledge the increased calorie intake and increase walking by 15 minutes a day for next four days and cut calorie intake a few hundred calories a day for those days

## The SMART Approach

- The SMART method is a toolbox of lifestyle changes that do not include what is on your plate to encourage weight loss

**Notes:**
You can make decisions about what to eat to satisfy physical and emotional needs without impulse eating or overeating
Awareness of eating can help regulate food consumption

## SIZE

- How much are you eating and drinking?
- Often it is how much you eat not what you eat that makes a difference
- Our culture has supersized our portions
- Amount you put on your plate may be out of habit
- Leaving food on your plate may reduce calorie intake significantly
- Using a smaller plate may help

## Moderation

- Plan your meals and snacks
- Modify usual routine to allow for a larger lunch or a holiday dinner
- A few pounds are easier to lose than ten or fifteen, take notice of weight gain and take action when weight gain is within five pounds of usual body weight

## Activity

- As much as possible incorporate physical activity into your day
- Weight loss is greater and better maintained by burning calories
- An exercise program that challenges the body is beneficial for overall health but if unsuitable consider ADLs
- Many people are successful at increasing their activity level by wearing a pedometer with the goal of increasing the number of steps taken each day

**Notes:**
Walking to your errands
Using the stairs instead of the elevator
Walking the dog
gardening

## RATE

- It takes twenty minutes for the stomach to tell the brain it has had enough
- Eat fast and we are not able to determine when we are satisfied and continue to eat to until full
- Extra calories can be saved instead of stored by eating slowly or waiting for a second helping to see if we can do without

**Notes:**

Hunger/Fullness scale
When you get hungry again you can snack
Tools for slowing down:
Put fork down between bites
Chew thoroughly and swallow before taking the next bite
Sip water in between bites
If you need, set a timer for 20 minutes and do not refill your plate until it goes off and you have determined whether or not you need more food
Make eating the event

## TIMING

- Pay attention to hunger cues
- Feed your body when it is hungry
- Make time for breakfast
- If meals are farther than four hours apart, choose healthy snacks to decrease hunger which will lead to better portion control at meals and decrease binge eating behavior

**Notes:**
Skipping breakfast leads to overeating the rest of the day

## Guidelines to keep in mind

- Fat provides more calories than protein or carbs
- Too much of any nutrient is stored as fat
- Foods higher in water and/or fiber have fewer calories per bite and may satisfy your appetite in smaller quantities
- Substituting cheese, milk and meats for lower fat alternatives provides nutrients but saves on calories
- Low fat dressings, mayos and creamers save calories as well
- Compact foods like sugar, cookies dried fruits, nuts and granola are high in calories per bite

**Notes:**
Fruits, veg, and whole grains

## For successful long-term weight loss

- STICK WITH IT

## Nutrisense Inc.Amy Shapiro R.D., C.D.N.

- 373 Route 111
- Smithtown New York 11787
- (631) 979-6699