TGWWLC

There are two main reasons and often they both apply:
1. Eating too much food or the wrong food
2. Not being active enough
Metabolic, hormonal, or other medical problems are rarely relevant, although people vary somewhat in the amount of energy their body needs to keep running. Certain diseases such as hypothyroidism or Cushing’s syndrome are rarely the cause of obesity.
Weight problems tend to run in families. It also tends to run in minorities. But it crosses the borders of poverty as it’s prevalent in both extremes of society. Currently almost 2/3 of the country is overweight Weight problems can be due to the family environment or to genetic factors or both. Genes have a definite influence on body weight, so if you come from a family in which many people have significant weight problems, you are likely to be genetically vulnerable to similar difficulties.
Psychological factors lead some people to overeat. Some people overeat in response to stress or when they are unhappy or bored, whereas others find that their appetite is diminished. Extreme dieting can also encourage overeating. Some women tend to eat more around their monthly periods. Menopausal women have a tendency to gain weight.
Poor eating habits can are learned (at home, school, work or due to other circumstances). A particular problem in our society today is that most people eat too much high-fat food, largely because it is readily available and tastes good.
As a society we are also much less active than we used to be. We have jobs that involve little activity and people are also much less active at home. We use elevators and automatic garage doors. We fight over the closest parking spot to the nearest store. We drive our cars even to the shortest distances.

2. Why did I gain weight? (Top)

In order to have a healthy weight, your energy intake which is what you eat as food and drink must equal the energy you burn, i.e. the energy needed to keep your body going plus for physical activity.
Weight problems develop when your energy intake (calories) exceeds the energy you are burning up over a sustained period of time. Taking only 100 extra calories a day will translate to addition of a pound every 35 days. In one year it can add up to about 10 pounds. Every 3500 Kilocalories equals to one pound. This positive energy balance (excess energy) is stored in the body mainly as fat.
Excess weight (fat) is only lost when you create a negative energy balance so that your body draws on its energy stores. A sustained reduction in your energy intake (as food and drink) is needed to produce weight loss.
In principle your rate of weight loss could be accelerated by increasing the energy you burn up as a result of physical activity, but in practice the additional benefits are not great. On the other hand, regular physical activity does help weight maintenance. Studies have confirmed that exercise alone is an inadequate tool for weight loss.
Once you reach your target weight range, you will need to adjust your eating and activity level to stabilize your weight. This is an important skill that requires practice.

3. Didn’t I get fat because I have a slow metabolism? (Top)

It’s true that fat has a slow metabolism. Average pound of fat only requires 22 calories a day to run its metabolism. But the lean mass of an obese person and an average individual is very similar. Muscle has a higher metabolism so athletes burn more calories for the same amount of exertion. Considering the above the statement in the question is a myth. An average individual and an obese individual have similar muscle masses but an obese individual also has to feed his fat cells (although at a slower rate).Obese individuals tend to burn less calories due to obesity co morbidities and aches and pains associated with movements. So even if they eat the same they burn less and they remain obese.

4. What is a normal weight? (Top)

Average normal weight is calculated by Body Mass Index or BMI. BMI is weight in kilograms divided by height in meters squared (weight/height squared). Normal BMI is 20-24.9. BMI of 25 -29.9 is considered over weight and BMI of 30- 39.9 is obese. BMI of more than 40 is considered morbidly obese.
Although BMI is one of the best markers we have, it does not provide any information about the muscle mass. Muscular individuals burn more calories and are heavier than their lean counterparts. In order to accurately estimate athlete’s calorie intake, their muscle mass should be considered in the equation. Muscle mass can be measured by different instruments.

5. How many Calories do I burn in a day? (Top)

The energy needs of a person in energy balance can be estimated by using a formula for Resting Metabolic Rate (RMR) and multiplying the results by an “activity factor” based on the individual’s level of physical activity. A straight forward approach is calculated using the following formula:
Male: RMR = 900 + (10 X weight in kilogram)
Female: RMR= 700 + (7 X weight in kilogram)
Weight in kilogram = 0.45 X weight in pounds

Then multiply RMR by the “activity factor”:

Activity Factor is:

1.2 For a person with sedentary life style who does activities of daily living without walking extra or exercising.
1.5 For a moderately active person who is engaged in regular daily walks and exercises twice a week.
1.8 For a very active individual who exercises daily and burns 2500 kcals weekly by exercising.

6. What is Glycemic Index? (Top)

The glycemic index is a ranking of carbohydrates based on their immediate effect on blood sugar levels. Carbohydrates that break down quickly during digestion have the highest glycemic index which means the blood glucose response is fast and high. Carbohydrates that breakdown slowly release glucose gradually and have lower glycemic index. The glycemic index is about the quality of carbohydrate.
What the glycemic index doesn’t tell you is that how much of the food will turn to glucose. Some foods have different indices when cooked compared to raw.

7. What are different types of diets I may choose? (Top)

Besides commercial fad diets of which a new one pops up every summer, Weight loss diets are categorized to the following:
a. VLCD diets (Very Low Calorie Diets): Require physician supervision and are below 800 kcals a day
b. LCD diets (Low Calorie Diets): They are 800-1200 kcals a day and are recommended to be under physician supervision
c. BDD diets (Balanced Deficit Diets): They are above 1200 kcals but below patients daily requirements.

There are also high Carbohydrate, Low Carbohydrate, High Protein, Lowfat and Calorie Counting diet categories on the market.

8. What is a good meal replacement bar? (Top)

Meal replacement bars or protein bars are commercial products in the form of a bar that are used to substitute a meal. Examples include Zone bars and South Breach Meal Replacement bars. A good protein bar has the following three characteristics:
1. It has no less than 15 grams of protein
2. It has a protein to carbohydrate ratio of about 1/1
3. it’s less than 250 kcals.

9. What is the role of exercise in weight loss? (Top)

In general exercise does not lose weight but helps with weight maintenance. On the other hand no weight loss program will be successful without an implemented exercise plan because the individual will regain almost all the weight back in 2-5 years. There is a difference between cardiovascular exercise and weight loss exercise. For cardiovascular benefits exercise should be 3-4 days a week and is recommended to raise the heart rate 60-85% above the baseline and to maintain it for 25 out of 30 minutes of exercise. On the other hand weight loss exercise is recommended to be daily start slow and gradually increase. It can be divided to twice or three times daily. Heart rate is not a target at weight loss exercises. Resistance exercises and muscle building exercises are also recommended during the course of a weight loss program.

10. What should I do when I go to a party where everybody eats? (Top)

It may be helpful to think about ways of making celebrations enjoyable that do not involve eating (or at least eating large quantities of food) and trying these out. Try paying particular attention to the features of social occasions that make them enjoyable. This may lead you to conclude that eating moderate quantities of food would not spoil your enjoyment. Some people even discover that they enjoy occasions more when they eat and drink less.

11. What should I do when I am pressured to eat? (Top)

You may feel under pressure to eat more than you had planned. This can happen for many reasons: The sheer abundance of food may tempt you; you may feel people will be offended if you do not eat much; or you may feel that you will be ‘the odd one out’ if you do not join others in eating and drinking all that is offered. It is always easier to cope with such situations if you have made a plan in advance. Also it is helpful to practice refusing food politely but firmly. You do not have to eat to please others, and people rarely notice what you are eating and drinking.

12. What if I receive a gift of food? (Top)

On special occasions people may buy chocolate, sweets, cake, or other food for you. If this is likely, would it be worth asking them to buy something else instead? If you feel you could not make this request yourself, perhaps your partner or a relative or friend could discreetly advise others that you would prefer not to be given food. Also it would be helpful to consider how to cope if you receive such food unexpectedly. Could you give it to someone else?

13. What if I have a party and want to offer people snacks? (Top)

Sometimes on special occasions there is a wide variety of snacks on display. Having bowls of nuts, chocolates, and other high-calorie snacks is likely to be a temptation beyond most people’s endurance, so plan how best to cope with this situation. When such situations are under your control, you may decide to do things differently.
If you have to provide snacks:

•   Plan the shopping carefully and limit the amount of extra food bought.
•   Keep snacks in sealed containers, and only set out small quantities for specific occasions.
•   Have alternative, lower-calorie snacks such as raw vegetables with low-calorie dip, fruit, plain (unsweetened or unbuttered) popcorn~ and bread sticks.

14. I go to parties a lot, what should I do to avoid weight gain? (Top)

It is generally best to stick to your usual weekly calorie goal (as an average over the week). Be clear and realistic about how you will achieve this. Eating nothing all day in anticipation of a party is likely to lead to overeating later on. Instead, eating lightly the day before or after may be a better plan. Completely avoiding food that you like may also be a mistake. It is usually a good idea to plan to eat such food and incorporate it into your day’s eating plan. We recommend having a medium calorie, high protein snack before going to a party.

a. Planning - The single most important strategy for dealing with any special occasion is planning ahead. This is especially important if there will be extra food around over a period of several days, and if there will be more than one special meal or party. High-calorie foods and alcoholic drinks often seem to be an integral part of these events, so it is especially important that you make plans to deal with these challenges. It is generally helpful to make a plan for each day, and you may need to plan several days in advance when celebrations go on for several days.

b. Monitoring - It is very important to continue to monitor. This will keep you informed about how your strategies are working and help you to adjust your plans as necessary. It will also help you to keep focused on your goals.

c. Drinking - It is especially important to have a plan for dealing with alcohol; not only does it add calories, but it tends to weaken the resolve to eat moderately. Some alcoholic beverages are worse than others. In general: drink modestly. Avoid sweet drinks and mixed drinks, limit wine to one glass and drink your beverage slowly.

d. Focus on Other Pleasurable Aspects of Special Occasions -Although many social events may seem to center on high-calorie food and drinks, consider whether it is possible to celebrate without consuming these in large quantities. Substitute food for a nice conversation. Try low calorie drinks and avoid high carbohydrate finger food.

15. What should I do if I go to a restaurant? (Top)

Overall food in restaurants is greasier than home meals and comes in larger portions. Certain restaurants such as Applebee’s and Diners offer low calorie menus which is helpful. You may consider the following strategies to minimize weight gain:
a. First and foremost at least during the active phase of weight loss avoid going to restaurants as much as possible
b. Avoid restaurants that offer large quantities of food
c. Drop the appetizer especially if it includes bread or oil
d. If you anticipate a large meal ask for a To Go bag before you start eating
e. Share your food with others not on a diet.
f. Leave some food, even a little, on your plate.
g. In the middle of the meal get up and try the bathroom where you can clearly think without pressure. Decide if you are full enough not to continue eating.
h. Avoid heavy or creamy deserts. A bowl of fruit can make a nice desert. Be aware of heavy toppings some restaurants use.
i. Participate in the choice of restaurant if possible; look at the menu in advance, or possibly telephone the restaurant to ask about availability of low-fat or low-calorie dishes.
J. If possible, ask for food to be served without extra butter, and for dressings and sauces to be served separately so you can control the amount you have. Consider asking for a smaller portion of the main dish with extra vegetables or salad.
k. Be wary of set menus. They may include dishes that are not good choices for people who are trying to lose weight, but are also difficult to resist when you have already paid for them.

16. I travel a lot. What should I do to avoid weight gain? (Top)

Your Calorie intake and requirement are different during travel. After 2 hours of sitting in a car or on a plane your BMR (Basal Metabolic Rate) decreases by 5-10% which could translate into a lower calorie requirement. On the other hand travel seems to be a good time to eat as you have more time during the trip and more choices of fast food restaurants are available during the road trip. Cruise travels almost always end up causing weight gain of a few pounds and so do all inclusive travels.

Answer the following questions before the start of your trip.

•   How long will your journey take from door to door? What meals would you normally eat during this time? Will you be traveling overnight or on a long-haul flight? If so, how this might affect your eating pattern?
•   What food will be available? Is it worth taking your own to ensure you have control over what you eat? Are you likely to be tempted by the availability of snack foods in gas stations, airports, or trains? Will your food choice be determined by circumstances (e.g., food on an airplane)? If so, would it be worthwhile ordering a special meal?
•   What time will it be when you arrive at your destination (and at home on your return journey)? Can you arrange for suitable food to be available (e.g., by leaving a meal in the freezer at home)?
•     How can you make it easy to keep monitoring while you travel?
•     Will food be provided? Will you be eating out, preparing your own food, or a combination of these? How will you cope with the particular arrangements? Do you anticipate any difficulties? Planning ahead is likely to be helpful in these situations.
• How will your requirements fit in with the rest of the party?
•   What types of food will be available?
• Does your alcohol intake tend to increase when on vacation? How do you intend to manage this?

Many people find it is difficult to resume monitoring after a gap, so working out how to monitor through unusual situations is worthwhile. Making sure you have your monitoring sheets handy is important, and calculating in advance anything you take with you can make monitoring easier during the journey.

Here are some useful tips for frequent travelers:

Avoid overeating on route to destination. If you are truly hungry on the airplane or in the car try small portion of either a low calorie food such as a piece of fruit or if not available try a high protein , low sugar snack such as a protein bar. Count the calories on the meal to destination and try to avoid more than 250 kcal foods on route.
Try simple foods and the least processed foods if dining out
If you anticipate a large meal, try to use the gym at the residence and burn calories before hand, do not go to a restaurant hungry, avoid high carbohydrate appetizers, leave left over food on your plate, always pick a simple low fat meal and share the dessert with others and if not possible to share, avoid them. After the meal go for a walk if possible.
Substitute a meal for a protein bar or a protein shake.
Avoid situations that will force you to eat as much as possible
Use gym regularly
Drink water or diet drinks only

17. What if I am going on vacation? (Top)

Vacations can pose additional challenges when you are trying to control your calorie intake. You may be in unfamiliar surroundings where the food choice may be quite different from home, and you may have less control than usual over the preparation of food.
Planning ahead is important. In particular, it is helpful to ensure that you have thought about how to deal with both the practical issues related to eating, as well as how you might feel about keeping to a calorie limit. Most situations can be successfully tackled if you have a plan for dealing with them. On the other hand, if you are caught unawares you are at greater risk of encountering problems.
Vacations are a time to relax and enjoy yourself, and sometimes people see this as incompatible with restricting their consumption of food and drink. It is worth considering how you can make the most of your vacation without undoing all the hard work you have put into losing weight. The first step is to decide on your goal over the vacation. Do you want to continue losing weight or to maintain your current weight? If you intend to stick to your calorie goal with the aim of continuing to lose weight, be clear and realistic about how you will achieve this goal. If you think that it is not realistic to stick to your calorie goal, it may be best to work out a slightly higher calorie limit with your therapist for the vacation period, with the aim of maintaining your weight.
In making decisions about your goals, it may be helpful to consider what, besides being able to drink and eat freely, will be enjoyable about the time away. A vacation may provide an ideal opportunity to practice the new habits you have learned and experiment with the possibility that you can have an enjoyable time while still limiting your intake of food and alcohol.
Here are some specific practical issues to consider when planning ahead.

Monitor your Food and Weight on vacation.

• Monitor your food and weight while you are away.
• Weigh yourself daily
• Create a written diary of what you have eaten all day and try to stay below the maximum calories allowed.
• Try simple foods and the least processed foods if dining out
• If anticipating a large meal, try to use the gym at the residence and burn calories before hand, do not go to a restaurant hungry, avoid high carbohydrate appetizers, leave left over food on your plate, always pick a simple low fat meal and share the dessert with others, and if not possible to share, avoid them. After the meal, go for a stroll if possible.
• Substitute one meal a day for a protein bar or a protein shake.
• Avoid situations that will force you to eat as much as possible
• Use gym regularly
• Drink water or diet drinks only
• Limit alcoholic beverages.

18. I sometimes feel pressured to eat. What should I do? (Top)

If you tend to feel under pressure to eat more than you had planned, try to work out exactly what makes you feel this way. Are you concerned that people will be offended if you do not eat everything you are offered, or that you will draw attention to yourself if you do not eat as much as everyone else? If you can work out precisely what the problem is, it will be easier to think of ways to cope. For example, if you are concerned that your host will be offended if you do not eat much, you might decide it would be helpful to practice saying “No” politely but firmly. You could test out whether politely declining foods is likely to cause offence. You might do this by thinking about how you would feel if you were the host and someone declined food in this way; or by watching carefully to see if other people always eat large portions of everything available, and how others react if they do not. If you are concerned about drawing attention to yourself by not doing what everyone else is doing, you might observe the reactions of others to people who, for example, are not drinking alcohol, perhaps because they are driving, or perhaps simply because it is their preference not to do so. Ask yourself whether you think it would be reasonable to react negatively to such situations and whether you would do so.
Although planning ahead to make the most of your calories is helpful, it is not uncommon to feel that social events revolve entirely around high-calorie food and drink and to think that not being able to eat or drink everything that you would like will make these events less enjoyable. You could test this view to see whether you really enjoy occasions less if you limit your food and alcohol. Also, you could try focusing on all those nonfood aspects of social events that make them enjoyable (e.g., talking to friends, having time to relax, not having to wash the dishes) so that food and drink become less important aspects of social events.

19. What if there is an unexpected occasion? (Top)

Sometimes invitations to eat arrive unexpectedly—someone drops in and suggests having lunch together, or friends come around with take-out, or somebody suggests going for a meal after a movie. It is helpful to take a few minutes to think clearly about how to handle the situation. You may decide to join in with the meal, and cut down on calories later in the day or the next day. Alternatively, if you have already eaten or planned what you are going to eat, you may need to respond differently: perhaps by suggesting another time when you could have a meal together or explaining that you will just have a small amount as you have already eaten. You may wish to experiment with different possibilities and find out which one works best for you.

20. What if I am invited to a buffet? (Top)

• Look carefully at what is available before you actually put anything on your plate. Identify a few foods that you would really enjoy (rather than trying a bit of everything) and choose some low-calorie options such as salad or rice to fill you up.
• Try using a side plate rather than a full-size dinner plate.
•Treat it as you would a sit-down meal. Visit the buffet table only once, and then when you have eaten get rid of your plate as soon as possible.
• Alternatively, ask someone else to bring you some food, and tell them what you would like.

21. What if I am throwing a party? (Top)

Consider whether you are obliged to provide a high-fat, high-calorie meal. Many people are either watching their weight or being careful about their diet for health reasons. A lower-fat meal is just as likely to be welcomed by guests and certainly does not indicate poor hospitality.
a. Single-portion foods, such as individual chicken pieces, are often easier to manage and avoid the difficulty of having tempting leftovers.
b. If you do have food left over, either give it to guests to take with them or freeze it immediately.
c. If you tend to pick while preparing food, try immersing used dishes and utensils immediately in soapy water or chewing gum while you cook.

22. What if I am eating at someone else’s house? (Top)

If possible, try to find out in advance what will be served. If you know the host/hostess well, consider contacting them in advance to explain your situation and ask if it would be possible for him or her to help. You could perhaps find out what he or she is planning to serve so that you can decide in advance what you will eat, and plan your day accordingly.
It may be possible to offer to take a dish with you, so that you know there will be at least one low-calorie option.
Offer to help serve so that you can control your portion size, or ask for a small portion.
Fill your plate with salad or vegetables, and take only small amounts of high-calorie dishes. This helps to control the calories and avoids drawing attention to your weight control efforts.
Asking for recipes may be a good (and socially acceptable) way of finding out what went into a meal so as to calculate the calories you consumed

23. Why did I stop losing weight? (Top)

Ask yourself the following questions if you stop losing weight. Write them down and bring them to your next appointment with you

a. Are you keeping your food diary records?

b. Are your records accurate?

1. Is absolutely everything written down?
2. Do you accurately measure your portions?
3. Do you carefully calculate calories?

c. Weighing and weekly reviews:

1. Are you weighing yourself once a week?
2. Are you holding weekly review sessions?

d. What are your eating patterns?

1. Do your eating habits vary greatly from day today?
2. Do you eat regular meals and snacks through the day?
3. Do you skip any meals?
4. Do you go for long periods without eating?
5. Do you tend to nibble or pick at food? Are there particular times of day (or particular days) when you are liable to overeat?
6. Do you have “binges” (large or small)?

e. What are your portion sizes?

1. Are your portion sizes on the large side?
2. Do you take second helpings?
3. Do you always “clean your plate”?
4. Do you eat leftovers?

f. Your choice of foods and drink:

1. Are you prone to eat energy-rich (i.e., high-fat) foods?
2. Are you actively avoiding any foods?

g. Are you exercising daily?

1. Are you doing aerobic and non aerobic exercises?
2. How much time do you spend on exercise machines?
3. Do you prematurely stop to exercise?
4 How many days a week do you exercise?