1. Never Arrive Hungry for a Party
Holiday treats will seem even more tempting if you show up hungry to a party.  Plan ahead and have a sensible snack or a small meal before leaving for holiday events.  You will be less likely to sample the cheese dip or the cookie tray if your hunger is already at bay. 

2. Limit Alcohol Consumption
Alcohol is a quick way to pack extra calories into your day.  The average alcoholic drink contains 150-200 calories per glass and seasonal drinks, such as eggnog, can have up to 450 calories per drink.  That’s more than 25 percent of what the average woman should have in an entire day!  Alcohol also lowers your inhibition, which makes it harder to resist those high calorie appetizers on the buffet table.   Allow yourself one drink and then switch to seltzer water or diet soda for the remainder of the party.

3. Avoid Indulging in Seasonal Coffee Drinks
A Peppermint Mocha might sound like a festive way to warm up a cold winter day but this Starbucks favorite is loaded with calories.  A 16-ounce Peppermint Mocha with whipped cream packs in 470 calories, the Pumpkin Spice Latte a close second with 410 calories, and the Gingersnap Latte closes in with 370 calories.  If you feel the need to treat yourself, order your drink with nonfat milk and no whipped cream to save around 200 calories per drink.  Or go to the website of your favorite coffee store to see how your holiday drink stacks up.  

4. Don’t Rush the Meal
It takes about 20 minutes for the stomach to signal the brain that you’re full, so make sure to extend all of your meals for at least that long.  Take your time, eat slowly, really taste your food, and enjoy the company of your family and friends. 

5. Fall Back on that Food Journal
A food journal is a dieter’s best friend…any time of year.  Writing down what you eat helps you to recognize those extra treats (and extra calories) that sneak into the day.  In fact, research shows that people who keep a food diary consume 15% less food than those who don’t. You’ll be less tempted to have one more handful of caramel popcorn if you know you have to account for it later.  If you don’t have a pen and paper handy, do a mental rundown of your food and beverages for the day to keep the mindless eating in check.    

6. Don’t Starve Yourself Before Thanksgiving Dinner
We’ve all been tempted to skip breakfast and lunch on Thanksgiving Day in hopes of balancing out the calories from the feast ahead.  Unfortunately, this approach only sets you up to binge when dinner finally arrives.  Eating every few hours will keep your metabolism burning all day.  Skipping meals momentarily slows down your metabolism and can leave you feeling ravenous, which makes choosing healthy food and monitoring portions a difficult task.   Eat small, high protein meals or snacks (such as string cheese with an apple or nonfat yogurt with berries) every three to four hours before the big dinner and you will be more likely to pass on that second serving of mashed potatoes.

7. Treat Yourself…To Something Other Than Food
The stress of the holiday months can be exhausting and overwhelming.  Instead of rewarding yourself with eggnog and Christmas fudge, resist the temptation to turn to comfort food.  Try rewarding your hard work with something non-food related that really makes you happy.  Go out to coffee with a friend, schedule a massage or buy a new book.  Relaxing without the use of food or alcohol will help you to feel better while keeping your waistline in check.

8. Make Time for Exercise
Sometimes, life seems far too hectic to exercise.  During the busy holiday months, however, it’s important to make time in your schedule for physical activity.  Exercise will help to burn some of the extra calories from holiday treats with the added bonus of decreasing your stress level.  Your best bet is to stick to your regular exercise schedule but if you find yourself tight on time, aim for short bouts of exercise throughout the day. 

9. Have one Tasty Indulgence
Don’t attempt to deprive yourself of your absolute favorite food.  Deprivation can set you up for a disappointing binge.  Instead, allow yourself one small serving of your favorite treat to really savor.  Then switch to low calorie, healthful options such as veggie slices, shrimp cocktail and turkey breast without the gravy.

10. Don’t Lick the Spoon
Many would argue the best part of baking is “testing” the batter, but those sample bites can really add up.  Just a few spoonfuls of cookie dough may cost you a few hundred calories.  Try chewing gum while you bake so that you can’t easily sneak in a quick taste.  If you are still tempted, ask yourself if a taste is worth the calories.  After all, for 300 calories you can eat a whole slice of pumpkin pie (hold the whipped cream) or 3 ounces skinless turkey breast with 2 tablespoons of gravy and ½ cup of stuffing.  Which would you prefer?

11. Be Kind to Yourself if you Overindulge
The holidays are filled with temptations beginning with Thanksgiving Dinner and lasting through New Year’s Day, but don’t beat yourself up if you overdo it at a meal.  It takes an extra 3,500 calories per week to gain one pound.  Overeating once or twice probably won‘t lead to weight gain if you don’t use it as an excuse to continue indulging.  When you eat more than you were intending, pick yourself up and get back on track.  It’s never too late to start making smart choices. 

12. Follow the ‘Dessert Split’ Plan
Go ahead and take something from the dessert table but split it with a friend.  If you must taste two desserts, split them with two friends. If you feel the need to sample three desserts, split them with three friends.  You get the idea.  That way you’ll get to taste your favorite holiday treats and your friend’s newest recipes without completely breaking your calorie budget. 

Keep in mind that the amount of calories you burn doing any activity changes with your weight. A 150-pound person walking an average of 3.5 miles per hour burns about 130 calories an hour. When you weighed more, you burned more calories with the same workout.

If you don’t lose weight when walking anymore, mix it up. You may be experiencing a plateau because your body has become accustomed to what you’ve been doing — that means you’re burning fewer calories. Remember the FITT principle? It stands for frequency, intensity, time and type of exercise.

You may have to adjust all four of these factors to start peeling pounds again. If you can’t alter all aspects at once, tackle one a week (Walk more often this week; walk faster the next week, etc.). If you find you can’t consistently make workout changes, you may need to adjust your food and beverage caloric intake to be lower. The lower your weight, the fewer calories you need.

Consider alternating your regular walk with another type of exercise such as a kickboxing class or starting Pilates. This will give your weight-loss efforts a boost and will introduce you to a new activity that you just might find more enjoyable than that same old, same old walk!

Since 1985 obesity has been recognized as a chronic medical condition caused by a complex set of inter-relating factors. Among those involved in the interplay include contributions from genetic, biological, psychological, social, cultural, and economic factors. Importantly, obesity is also now recognized in association with a multitude of serious health risks including type 2 diabetes, high cholesterol, high blood pressure, cardiovascular diseases, metabolic syndrome, sleep apnea, knee osteoarthritis, and more.

The good news is two-fold. First, under our guidance at Jumpstart, patients safely and comfortably achieve remarkable weight loss results they never thought previously possible. Second, many of the health risks associated with obesity are reversible or markedly improved by sustained significant weight loss. We can help.

Being overweight or obese puts you at serious risk for developing many obesity related diseases. That’s the bad news. The good news is that reducing your weight dramatically reduces these same risks. For those patients who suffer from these conditions, weight loss can significantly improve or completely correct these conditions.

Insulin Resistance and Diabetes Mellitus

Obesity leads to insulin resistance, a diminished biological response to the hormone insulin. This resistance is characterized by an elevation of circulating insulin, a diminished ability to store glucose, and a propensity to store fat.

In patients with non-insulin-dependent diabetes mellitus, serum glucose levels improve within days after starting a weight loss program. One study showed that the average fasting blood glucose levels in persons with type 2 diabetes decreased from 290 mg/dL to 110 mg/dL in 3 days in response to a very low calorie diet (1). Medication (oral agents or insulin) can be greatly reduced or eliminated in such cases (2). Another study reported that, after a 23-kg weight loss (22% of initial body weight), all patients taking oral agents and 82% of patients taking insulin were able to discontinue medication (3). Similar results were reported with weight losses of 9.3 kg (4). In general, patients with a 15% reduction in total body weight may consider stopping oral agents. (5). Smaller decreases in total body weight may even cure “pre-diabetes”, a significant cardiovascular risk.

Hypertension

Hypertension improves with weight loss in overweight persons. In patients following Very Low Calorie Diets (VLCD’s), one study reported a significant decrease in systolic blood pressure in 81% of patients and in diastolic pressure in 62% of patients (6). Patients receiving a diet of 800 to 1200 kcal (typical for Jumpstart patients) who averaged a weight loss of 10.5 kg showed decreases in both systolic and diastolic pressures of about 20 mm Hg. In about three quarters of these patients, blood pressure returned to normal. (7) Adding an exercise regimen to weight loss lead to even greater improvements in blood pressure.

Dyslipidemia

Obesity is often associated with an elevation of serum triglycerides and total cholesterol. The ratio of LDL to HDL cholesterol is usually elevated, resulting in an even greater risk of heart attacks and strokes. All of these values generally improve with weight loss. Often, fasting triglyceride levels that may be as high as 1000 to 1500 mg/dL will return to normal levels (<250 mg/dL) with dietary treatment alone. Weight loss has been repeatedly reported to increase HDL (“good”) cholesterol levels. Even rather small weight losses of 5% to 10% of initial weight will have this result. (8)

Sleep Apnea

Obesity can be associated with mild to severe respiratory functional impairment. Increasing obesity is associated with decreasing oxygen saturation. Two primary disorders ensue: obesity-hyperventilation syndrome and sleep apnea.

Patients with hypoxemia (low blood oxygen levels) and sleep apnea improve quickly with weight reduction. For every 1 percent decrease in weight, sleep apnea patients decrease their apnea-hypopnea indices (the amount they stop breathing at night) by 3 percent (9). In fact, many sleep apnea patients who sleep with CPAP machines are able to stop using their breathing machines at night after weight loss.

A disturbance of ventilation-perfusion (a mismatch in breathing vs. circulation) is common in obese persons. This disturbance can result in heart failure. These conditions also improve with weight loss. With significant weight loss, essentially normal pulmonary function can be achieved and cardiac function can be normalized.

Metabolic Syndrome

Intra-abdominal fat is metabolically active and associated with serious health risk. Metabolic Syndrome describes a cluster of cardiovascular risk factors which combine to produce a pro-inflammatory and pro-thrombotic (hypercoagulable) state. This condition leads to vascular diseases that result in heart attacks and strokes and a pro-inflammatory state associated with an increased incidence of a number of cancers. It is estimated that over 50 million Americans are currently at risk, but that less than 5% are diagnosed. (10).

To qualify for Metabolic Syndrome, one needs 3 out of 5 of the following components: 1. increased intra-abdominal fat defined by a waist circumference greater than 40 inches in men and 35 inches in women 2. high blood pressure 3. elevated triglycerides 4. low HDL cholesterol 5. diabetes or pre-diabetes. Abdominal obesity is present in 84% of patients with Metabolic Syndrome.

In summary, fat location matters. Intra-abdominal fat is metabolically active and dangerous and can lead to heart attacks, strokes, cancers, and more. Fortunately, 1st-line treatment for Metabolic Syndrome is weight reduction and increased physical activity. (11). Waist circumference and intra-abdominal fat decrease markedly with the type of weight loss typically experienced by patients at Jumpstart Medicine.

Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) affects 5 – 10% of reproductive age women. It occurs in association with obesity, type 2 diabetes, and anovulatory infertility. As noted above, weight loss improves diabetes. Weight loss in PCOS patients can also significantly improve their reproductive potential (fertility).

Degenerative Joint Disease

Low back pain and osteoarthritis of the knee are both more common in obese persons. Obese women are 4 times more likely and obese men 5 times more likely to develop osteoarthritis of the knees (NHANES I). Fortunately, the associated knee pain and disability improve or resolve with weight loss. According to the Framingham Study, an 11 pound weight loss in women decreased their risk for knee osteoarthritis by 50%. The degree of improvement varies with the amount of structural damage but relief can oftentimes be complete with moderate weight loss.

Social Stigmatization and Prejudice

In addition to suffering from health risks, obese individuals also suffer discrimination and decreased competitiveness in our society. Compared to a normal weight counterpart with otherwise equal credentials, an obese person is less likely to be hired for a job and more likely to be paid less if he or she receives the job. Obese individuals are less likely to be admitted to competitive colleges than their otherwise equal normal weight candidates.

Other Benefits

Because the risks attending general surgical procedures are greater in obese patients, it is often beneficial to reduce a patient’s weight before attempting a major elective procedure such as an orthopedic operation, cholecystectomy, or gastric bypass. A 5% to 10% reduction in body weight or a 5-unit change in body mass index (BMI) can reduce the duration of hospitalization and the incidence of postoperative complications (12).

1. Henry RR, Wiest-Kent TA, Scheaffer L, Kolterman OG, Olefsky JM. Metabolic consequences of very-low-calorie diet therapy in obese non-insulin-dependent diabetic and nondiabetic subjects. Diabetes. 1986; 35:155-64
2. Anderson JW, Hamilton CC, Brinkman-Kaplan V. Benefits and risks of an intensive very-low-calorie diet program for severe obesity. Am J Gastroenterol. 1992; 87:6-15.
3. Kirschner MA, Schneider G, Ertel NH, Gorman J. An eight-year experience with a very-low-calorie formula diet for control of major obesity. Int J Obes. 1988; 12:69-80.
4. Fitz JD, Sperling EM, Fein HG. A hypocaloric high-protein diet as primary therapy for adults with obesity-related diabetes: effective long-term use in a community hospital. Diabetes Care. 1983; 6:328-33.
5. Wing et al., Arch Int Med 1987; 147:1749.
6. MacMahon S, Cutler J, Brittain E, Higgins M. Obesity and hypertension: epidemiological and clinical issues. Eur Heart J. 1987; 8(Suppl B):57-70.
7. Reisin E, Abel R, Modan M, Silverberg DS, Eliahou HE, Modan B. Effect of weight loss without salt restriction on the reduction of blood pressure in overweight hypertensive patients. N Engl J Med. 1978; 298:1-6.
8. Wolf RN, Grundy SM. Influence of weight reduction on plasma lipoproteins in obese patients. Arteriosclerosis. 1983; 3:160-9.
9. Peppard et al. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 2000;284(23)3015-3021.
10. Ford ES et al. Prevalence of the Metabolic Syndrome Among U.S. Adults. JAMA 2002; 287: 356-59.
11. Expert Panel on Detection, Evaluation, and Treatment of High Cholesterol in Adults, JAMA 2001; 285: 2486-2497.
12. Pasulka PS, Bistrian BR, Benotti PN, Blackburn GL. The risks of surgery in obese patients. Ann Intern Med. 1986; 104:540-6.

For a complex variety of reasons, obesity in America has rapidly risen in the past 30 years. Today, obesity affects over 58 million Americans or one out of three members of society. This upward trend has serious implications on our collective health and contributes greatly to healthcare expenses namely because obesity is linked to over 100 diseases (American Society of Bariatric Physicians Website www.asbp.org), many of them quite serious. In fact, obesity is now America’s second leading cause of preventable death (JAMA, 1996; 276:1907-1915), trailing only smoking and rapidly catching up as the incidence of obesity rises and the rate of smoking declines.

Why is the rise in the incidence of obesity associated with a rise in disease and an increase in mortality in our country? Because obesity is a major risk factor for hypertension, type II diabetes mellitus, high cholesterol, metabolic syndrome, cardiovascular diseases, sleep apnea, multiple cancers, and more. Obesity further parallels the rising rate of knee replacements in America as obesity is strongly associated with knee osteoarthritis.

Obesity has a more subtle impact as well. Obesity is associated with depression, low self-esteem, job discrimination, infertility, low back pain and many more diseases and conditions that diminish a person’s quality of life.

In short, the epidemic of obesity has serious consequences for individual patients and our country. At Jumpstart, we believe that little justification exists for treating diseases associated with obesity but not obesity itself. In our practice, we combine a high quality of service with a weight loss regimen that is supported by scientific evidence, safe and effective long-term.