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QUESTIONS AND ANSWERS

I've been told I have metabolic syndrome. What is this?
What is a Bariatric physician?
I've tried diet and exercise and still have problems with weight loss.
What is the best diet for me to go on to lose weight?
Is skipping breakfast a bad weight loss strategy?
Which is better for weight loss-dieting or exercise?
Every year I struggle with Halloween candy. Any advice?
Is it okay to combine my favorite parts of different popular diets?
Any tips for surviving all those holiday parties?
How do I know if I'm actually losing fat tissue when I weigh in?
How can I make my New Years resolutions stick this year?
How can I prevent Type II Diabetes?
Have portion sizes really changed?
What health problems are improved or prevented with weight loss?








I've been told I have metabolic syndrome. What is this?

To be diagnosed with metabolic syndrome you must meet 3 of the 5 following criteria: waist >35 inches (40 in men), triglycerides > 149, HDL cholesterol <50 (40 in men), blood pressure >130/85, and fasting glucose >109. Metabolic syndrome is the stage before diabetes, so take control of your lifestyle now and avoid this devastating health problem by increasing your physical activity and decreasing your carbohydrate intake!

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What is a Bariatric physician?

A Bariatric physician is an MD or DO who specializes in weight loss to help patients who are overweight or obese. Bariatricians have specialized training to help patients with any weight loss goal. The American Board of Bariatric Medicine even offers a three step board certification process. A qualified bariatrician has the expertise to design an individualized program geared toward each patient. Safe, effective and long-lasting weight loss is only a phone call away!

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What is the best diet for me to go on to lose weight?

The most effective way to lose weight is to lower your caloric intake. I would recommend watching both your fat and carbohydrate (sugar and starch) intake. If you cut 500 calories a day from your current diet, you should lose one pound a week. The best way to do this is to limit sweets, junk food snacks, and fast foods which all have more calories than we suspect. It is also important to think of your weight loss efforts as a lifestyle change and not a "diet" that you are either on or off. This is very important for long term success!

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I've heard that skipping breakfast is a bad weight loss strategy. Is this true?

While it is certainly tempting to lower your caloric intake for the day by skipping a meal that you don't have time for, it is definitely true that this will hamper your weight loss efforts. Our bodies were designed to store excess intake to get us through leaner times, so if we don't have regular caloric intake our metabolism slows hindering our weight loss efforts. We also will become hungrier and eat whatever is available later in the day. I recommend small, frequent meals, eating at least every 4 hours throughout the day.

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Which is better for weight loss-dieting or exercise?

My short answer to this question is that cutting calories is better for weight loss. Remember that it takes a deficit of 500 calories a day to lose one pound a week. Most of us do not have the time it takes to burn 500 calories each day. This is not to downplay the role of exercise though. Exercise will help keep us from losing muscle instead of fat (and the more muscle we have the higher our metabolism is) as well as improving our heart health.

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What should I do if I've tried both diet and exercise and still have problems with weight loss?

I would recommend re-evaluating both your daily caloric intake and your exercise regimen. Be sure that you are following a healthy, well-balanced program, not eating too much of any one thing but also that you are eating enough each day. Next look at your physical activity. It too should be varied as well as daily. If you continue to have poor results consult with a qualified bariatrician to evaluate you for medical problems associated with poor weight loss.

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Every year I struggle with Halloween candy. Any advice?

It certainly makes it difficult to stick to a healthy lifestyle with lots of candy around so here are a few ideas. Wait until Halloween arrives to purchase the candy so it's not sitting around tempting you. Don't purchase any of your favorites. Give out the rest of the candy to the group who comes last so you have no leftovers. Even consider having your kids go through their candy when they arrive home and handing out excess. Consider your children's candy as belonging to them and don't allow yourself to sneak any!

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Is it okay to combine my favorite parts of different popular diets?

Actually it may not only be unhealthy but may also be unsafe. Our bodies require many different vitamins, minerals, electrolytes, and nutrients to function properly. Assuming that the plans you are choosing from are both nutritionally sound, when you cut certain things out you may be left with a plan that will no longer provide you with your needs. It is best to seek out a well-balanced plan that suits you and your lifestyle.

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Thanksgiving is coming up. How can I avoid starting the holiday season with a weight gain?Any tips for surviving all those holiday parties?

Tips that have helped my patients the most include eating before going to the party so you don't arrive hungry, avoiding the area where the food is being served, avoiding or limiting alcohol as it will lower your food inhibitions, and giving yourself permission for a taste or small amount of whatever is tempting you most so you don't feel deprived. Pushy hosts can also be a problem, so be prepared with an answer you feel comfortable with (such as sweets have been causing your reflux to act up.)

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How do I know if I'm actually losing fat tissue when I weigh in?

Whenever you step on the scale and weigh less, the loss can be from a loss of water, muscle, fat, or a combination of these. Water is usually only lost at the beginning of a weight loss program so this can be ruled out after the first few weeks. Bariatricians utilize body fat analyzers (which measure the speed of a small electric current) to tell if someone is losing muscle instead of fat. A rough way to tell if your weight loss is fat versus muscle is to observe how tight-fitting clothes feel on you week after week. They will feel less tight as you lose fat because fat is less dense than muscle.

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How can I make my New Years resolutions stick this year?

First, I would recommend choosing just one resolution to focus on. Then, write it down and write out all of the reasons that you want to achieve this particular goal. Post different reasons around your home, car and workplace as visual reminders. Tell others your goal and seek out someone to be accountable to on a regular basis. Devise a strategy and monitor your progress towards the goal on a regular basis. Using these ideas will separate you from those who have forgotten their resolution by mid January!

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How can I prevent Type II Diabetes?

Type II Diabetes, traditionally a disease of later in life, has been striking younger and younger people, even children. Prevention is of course much better than treatment for this disease. Become physically active on a daily basis, maintain a BMI of less than 25, and limit your carbohydrate (sweets and starches) intake. One practical tip is to stop drinking fluids that have calories from sugars like sodas and juices. Also, remember it's never too late to take control of your lifestyle to manage even active diabetes!

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In general portion size doesn't seem that much bigger. Have portion sizes really changed?

Unfortunately, portion sizes for many items have dramatically changed in the past 20 years. An interesting web site which shows you these changes can be found here. This site gives the reader several examples of food items such as a bagel whose standard size 20 years ago was 220 calories and our bagel of today which measures in at 500 calories. This slow increase in size leads us to believe we are eating no differently, when in fact the difference is enormous. The site also gives you examples of how much physical activity you need to burn those excess calories!

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What health problems are improved or prevented with weight loss?

Surprisingly, many medical problems can be impacted with weight loss. It has recently been discovered that fat tissue does not simply store excess "energy." Fat tissue also produces inflammatory factors that wreak havoc on most, if not all, of our bodily systems. So besides the well known problems such as type 2 diabetes, sleep apnea, arthritis of weight bearing joints, and fatty liver, with weight loss we also lower risk for or improve Alzheimer's dementia, many cancers, arthritis of other joints, lung problems including asthma, infertility and stroke to name a few.

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