Reached June Goal Today!

So I hopped on the scale this morning and was rewarded with a happy number, my June 1st weight goal.

I have simply been eating small amounts frequently (every 3 hrs or so), tracking calories thru the DailyPlate.com, and increasing exercise.

I feel great and it has not been hard at all, just required a bit of persistence. My trainer Jasmine at the High Point Regional Fitness Center has been super, motivating me to stay on track, without making me feel so sore I couldn't function.

So now I have to plan a new goal. Will aim for an additional 20 lbs by June 1, which will be hard, but at least I have some momentum going.

Wish me luck.

Down 17 pounds!

I am 3 pounds off my June goal, and very excited about the progress.

Eating frequently, never missing meals, not saying no to occasional junk food (tacos and birthday cake over the weekend) and feeling great.

Exercise is getting easier, etc, etc.

Simply tracking with the DailyPlate.com and following Intuitive Eating - total cost $10 for the book.

Feeling better - Priceless

Diet soda = poor appetite control

I used to be a diet soda junkie, esp in Med School and Residency, but have virtually stopped drinking them after reading many reports on how they seem to increase weight gain.

However, over the weekend, I picked up a big bottle of diet cola with a couple videos on a whim. What I noticed was that I have crazy cravings for comfort food and ended up finishing the leftovers from dinner, which were not exactly health food.

I have not had these kind of feelings in months and it was striking to me. The only real variable was the diet cola. Definitely plan to avoid this in the future, especially in the evenings when eating in front of the telly is a risk.

Just an anecdote, but definitely fits with the research.

Down 15 pounds!

I continue to use TheDailyPlate.com for calorie tracking and the suggestions of Intuitive Eating, along with a small amount of exercise when I have time and have consistently dropped 2lbs/week, while not feeling like I am dieting.

Amazing.

Intuitive Eating + DailyPlate.com

I wanted to say again how impressed I am by this combo of teaching and tracking for weight loss.

I have been doing this now for approx 6 wks and have lost 13 lbs, but most impressively I have not felt like I was dieting, and have not been hungry most of the time.

One of the tenets of Intuitive Eating is to "honor your hunger" and listen to what your body is telling you. When I have practice this, I have been consistently suprpised to find my caloric intake to be within my goals and this is evidenced by the consistent weight loss.

I have also stocked up on Power Bars, which are 240 cal each, and have a good carb/protein/fiber balance, in order to have a relatively healthy snack available at all times, and find myself eating 1-2 a day when I get hungry. Easy to eat and track.

Down 13 pounds since Jan 1!

See link for book on Amazon:

http://www.amazon.com/gp/product/0312321236/ref=pd_lpo_k2_dp_sr_1?pf_rd_p=1278548962&pf_rd_s=lpo-top-stripe-1&pf_rd_t=201&pf_rd_i=1591796822&pf_rd_m=ATVPDKIKX0DER&pf_rd_r=0TXPM1J42PWZXVM6ACGZ

Intuitive Eating

On the recommendation of Angel Schroeder, I have been reading Intuitive Eating, and making a point to eat when I am genuinely hungry.

Have not finished the book but so far it seems to be in line with what I know about nutrition, metabolism and weight gain/loss.

Today I ate when I felt I needed it, which seemed like I snacked too much, however when I tallied my calories at the end of the day was still within my target.

The Bet

I have been toying with the idea of a motivational bet, to keep me on track, since just knowing I need to lose weight and get fit has done dinkus for me over the past 10 years.

On my FB page I suggested donating money to a charity, but as that's a win/win, I'm not sure its the best idea, and we already do that anyway.

A psychologist friend suggested writing a check to an organization I hate and having someone mail it if I fail, but I am torn about that idea as well.

So I have decided that since I hate being out in a swimsuit in public at my current weight, that I will post a full body shot of myself on my public FB page if my goal of 1 lb/week is not met by June 1, which would be a goal weight of just under 230.

If I meet that, I will renew the bet for the next quarter or so.

Since neither I nor my viewers want that to happen, I think I will get the encouragement I need!

What do you think?

Exercise & appetite

Recent studies have shown that very vigorous exercise may actually interfere with weight loss due to disinhibiting hunger control, i.e., when you work out hard and burn off stored sugar from the liver, your resulting hunger may cause you to consume more calories than burned. Net effect - no weight loss, and even minor weight gain.

I have heard this complaint over and over again from patients who have joined a gym, and have not lost the weight they hoped.

I am therefore trying to keep my workouts light for starters, with heart rates maxing in the low 140s, which my trainer apparently agrees with. Right now its 3 times a week at the gym, but plan on 5-6 when the initial soreness improves.

Yesterday was a good meal day with calories not exceeding my goal, though it took some discipline between 8 and midnight, my danger zone.

Getting back on the wagon

So work and life have gotten in the way of my own health in the past year, which is the same story I have heard from hundreds of patients.

My goal however is to join my family which have all taken up speed skating, a sport which I once enjoyed but now find painful due to my weight and lack of fitness.

To kick things off, I have enlisted a trainer at our hospital fitness center, with 2 meetings a week to make sure that I show up. We are starting slowly to avoid injury, but it feels great to be in a gym again.

Secondly, I am trying to get group support from my Facebook friends on my Henry Dorn MD page, which like Weight Watchers seems to be an effective way of staying on track.

I am also considering a wager too in order to keep me focused. Amber Kelly, a great local counsellor & friend, suggested that I write a check to an organization which I dislike, which will be cashed if I fail to meet my goal. Like McDonalds.

Anyway, I need to watch the calories and bump up the fitness.

At least being on the skates makes me PAINFULLY aware of where I am and where I need to be.

Goal is one pound per week until July 1 for starters. Wish me luck!

After dinner struggles

I am sure I am not alone in my struggle to control my appetite after dinner. The kids need to eat early (about 2 hours sooner that I would eating on my own), and by 10-11PM I am starving again.

Especially if I am watching TV or something passive.

Now the obvious solution is quit watching TV, but hey, a man needs his guilty pleasures, right?

Last night I did pretty well with a huge salad, but had to add an extra breadstick to cure the munchies.

This will be my biggest long term hurdle, and something I need a long term plan I can stick with.

I'm back!

I have dropped the ball on the blog and the diet and paid the price!

10lbs have snuck back on me and I know what I need to do.

So, I am making a new commitment to follow my own advice, and get back on the program.

So far today, I had a so-so breakfast of 1 cheesebread stick with coffee, but a good healthy frozen dinner for lunch, at under 300 calories.

Stocking up on easy to prepare veggies.

Plan to knock these pounds off before the spring!

Bad boy.

I have been negligent about blogging and diet and it shows. I gained back about 5 pounds.

Need to get back in the groove.

Had my sites on 200 by New Years. Will settle for sub 215.

Perspective on universal healthcare - please read

This is not related to my other blog posts but I wanted to pass along a letter I read from a Brit which may be enlightening to those in the US who have been biased against universal healthcare.

My husband, an English teacher, also wanted to get the facts from someone who has experience with national health care. He asked a former student (who is now working as a MD in England) what he thinks of this whole conundrum and whether an 85 year old person can have a necessary operation under the UK health system. The reply was very interesting, and is reproduced below.  

 

"As usual the debate on healthcare 
reform is being reduced ad absurdum. There is not rule that says an 85 year 
old person cannot have an operation. It all depends on the medical status of 
the person and the benefit that the operation will have to a patient.

Medical care in the UK is given free at the point of delivery based on 
medical need, not the ability to pay. If an 85 year old person has a need it 
needs to be balanced with the risk of the operation to the individual and 
the needs of others for the same intensive care bed after the operation. If 
the 85 year old person does not need an intensive care bed they are likely 
to get their operation, even if they do they are likely to get their 
operation but it may be delayed if a 25 year old person has a car accident 
and jumps the que (line) into the ICU bed.

The point that the scare mongering congressman made is that all 85 year old 
patients in the UK have the right to be considered for an operation and they 
have had that right all their life where as the 85 year old patient in the 
USA will have to deal with co-pays and deductibles and bureaucracy and bills 
and may not feel empowered to even attend the doctor because until they were 
65 years old they did not have medical care at all.

When you come to see a doctor here in the UK you don't pay, you don't sign 
anything no one is counting how often you came or looking at what conditions 
you have -- you simply get the care you need -- that may be different from 
the care that you want. Much of the care for people who have insurance in 
the states is care that scientifically they don't need or is of marginal 
benefit.

The best example is the yearly pap smear. Medically a low risk patient probably needs 
one every 5 years. The pick up rate for a screen every 5 years is 87% when 
you increase the frequency to every 3 years it jumps to 96%. The increase 
to every year jumps to 97%. In the USA women are told to go every year. The 
false positive rate is about 20% Therefore, 20% of the women who are being 
screened are being told they may have cancer when they really don't -- this 
leads to a lot more tests and a lot more potential harm in the USA because 
you are screening 3 times as often with only a very marginal benefit. And 
who makes all the money from that -- doctors who should know better. It will 
and does lead to women having unnecessary surgery and even death from 
complications. The major point is though that all Women in the UK get their 
pap smears because it is free where many American women wont because it is 
not.

There is truth in that we do not spend as much on the elderly but that is 
more a national attitude than a government policy. Here there is a more 
straightforward expectation that you have to die of something sometime and 
when people of an elderly disposition get their fatal illness -- which 
necessity dictates they must get, the British are more reserved and resigned 
to the fact that they will die someday. There is none of this heroic 
fighting against the odds that goes on in the USA. That is not to say we 
don't try to do the best for people but at the same time they aren't 
throwing good money after bad trying to save the life that just can't be 
saved. We also care better for people. We have a hospice network and our 
terminally ill mostly die at home with a nurse and sometimes me by their 
side, not in a hospital hooked up to machines which is what happens in the 
USA.

The NHS has its problems and is wasteful but its waste provides a peace of 
mind that no American will ever imagine. It is coupled with a Welfare State 
that ensures you will not starve. Everyone has a right to be housed and 
everyone has a right to subsistence. It isn't great for some but it allows 
most to feel that they are not alone in the world.

The longer I live over here the less I am proud of the USA. My cousin in 
Ohio is currently being treated for Leukemia. She waited 30 days of feeling 
deathly ill because she had to wait for her workplace based insurance to 
start before she would go to the doctor. Then she missed too much work and 
she lost her job, Ohio Medicaid picked up the tab but now she has no money 
and she had to be unemployed for 60 days before she can claim disability. 
That is not a moral society and the richest country in the world should know 
how to deliver health care and basic welfare to its poorest without making 
them into criminals. My cousin is a nurse and she has been treated badly by 
the system. It would have never happened here.

Basically, the example that the congressman brought up would never happen 
because we would never have gotten to the point that an 85 year old woman 
would need an operation. We would have taken care of the problem years 
before because that woman would have had health care - free healthcare --  
her entire life!

The UK wants the NHS to be better but it would never and will never trade 
its system for something like the US or even Germany. The NHS and the BBC 
are 2 institutions of which the British Public are incredibly proud and they 
have given the BBC to the world. We are going to keep the NHS for ourselves."

The Perils of Going Home & Getting Serious Again

It seems that I need a strategy to deal with travel, vacation and family visits, as far as my diet goes, since I have had set backs every time I have gotten out of my new routine. This has happened despite packing healthy snacks, and planning meals. It seems the triggers to eat badly still have quite the hold on me, and I need extra vigilance. Any suggestions?

So having bounce back a couple pounds during my time away, I am getting back on track.

Today I resisted a lovely looking cheddar scone for breakfast and instead had 2 bananas and a slice of walnut bread from Grateful Bread, and of course a cup of coffee, with skim milk.

Lunch I unintentionally missed due to a hectic schedule but breakfast carried me over.

For dinner for the family, I made a large green salad, with parmesan & lightly dressed, followed by a makeshift  Pasta  alla Bolognese, made with ground turkey (which was in the freezer).

In the interest of time, I partially browned the turkey but placing the frozen meat in a hot pot with few tbs olive oil, and scraped off the browned meat as it cooked and thawed. Midway thru I added a large chopped onion and 1 shredded carrot, & towards the end a couple cloves of diced garlic cloves. I added 1 cup milk (skim as thats what I had), and reduced it over med high heat.

The meat had a chunky texture which is not what Bolognese calls for, so before the liquid was reduced I used an immersion blender (the kind on a stick) and ground the meat finely in the pot which gave just the right texture.

I then added 1 can diced tomatoes, salt, 1 bay leaf and a bit of marjoram, a milder cousin of oregano. Because the kids were starving, I cooked this quicker than usual of med heat and stirred frequently for 10 minutes. Finally I added 90% cooked pasta to the pot with a ladle full of the pasta water and simmered it until the pasta soaked up the excess liquid.

Pretty damn good for mock Italian, fake beef, wham bam Pasta alla Bolognese, lower in fat than usual (no butter, whole milk or beef fat) and on the table from frozen in 30 minutes. 

And I didn't over eat! No more weight gain!

Julie & Julia + Awesome Chinese in High Point!

So tonite, my wife and I decided to go out for an impromptu date. We have both been looking forward to seeing the new movie Julie & Julia, based on the book which was based on the blog that inspired this blog. Very, very enjoyable, especially Meryl Streep's portrayal of Julia Child, one of my heroes.

Before that though, we went to a new Chinese restaurant in High Point, which was recommended to me by one of my Asian patients as being the only authentic one in the area. This was Full Kee Restaurant off Eastchester, near Wendover. Absolutely perfect. I have eaten truly good, authentic Chinese food only a few times, and then in large northeast cities. This was equal to any of them.

We asked the owner George Yu to cook whatever he like for us, and he promised to please. We started out with Szechuan Eggplant, which was garlicky and rich, yet delicate and not at all spicy for my wife, who has a more delicate tongue than I do. Amazing.

This was followed by Ful Kee Shrimp, which was shrimp prepared 2 ways, in both a cream and sweet & sour sauce with brocolli. The cream shrimp were slightly crispy, but not battered, and lightly sauced and were as good as any shrimp I have EVER eaten., and I have had some shrimp!

Finally we were served Steamed Sea Bass, which was served with scallions and ginger, and was perfectly prepared. Could not have been better in my opinion.

All the dishes were light, and bore absolutely no resemblance to what has become the standard chinese fare in the US. No heavy, sweet generic brown sauce with limp veggies and a dollop of MSG. This is the real deal, according to those who know better than I, and we will certainly be back very soon. Mind you, this fine dining comes at a slight premium, but the service and atmosphere was spot on, and we felt it was a relative bargain.

One  aspect of the meal that was notable in terms of my diet, was the portion size. We shared 3 dishes and which was just the right amount of food for a special meal. Definitely not the typical huge platters of marginal quality stuff that we usually find at American Chinese restaurants. @ dishes shared would have been enough for a fairly low-cal dinner, but we were splurging. If we all ate out like this, portion-wise, obesity would be far less of a problem, I feel.

As for the rest my day, the morning grub consisted of a light breakfast (fruit/coffee) and lunch (350cal frozen dinner) , so overall a great food day.

Diet Drinks = Diet Killer

I used to be a diet cola junkie. This started in high school, and by the time I was in medical school I could easily drink a couple 2 liters a day while studying.

I have cut down a lot lately, mostly because it was affecting my sleep. Over this past weekend though, I noticed a phenomena which hadn't been obvious to me earlier.

My biggest hurdle with my diet has been cutting down on snacks after dinner. I had gotten into a good pattern, allowing myself veggies and fruit after dinner if still hungry, but no high calorie snacks.

My family visited my parents over the weekend, and my mother, being the good Southern host that she is, always keeps the fridge and pantry stocked. There was a bottle of Diet Coke which I helped myself to, encouraged by the summer heat. That evening after what should have been a satisfying dinner, I remained ravenously hungry and really blew my diet on chips, chocolate, cheese (the 3 Ch's!).  I simply could not get rid of the gnawing feeling of hunger.

The only thing I could attribute it to was the diet cola. The next day, I refrained from the cola but did have several cups of unsweetened coffee, and felt fine after dinner. So the caffeine was not to blame.

This fits with a recent Swedish study which showed that diet soda drinkers gained as much weight as reg soda drinkers, with a hypothesis that perhaps the sweetness without the calories caused the body  to crave more calories afterwards, as if it is "getting even" after being tricked.

All I know is the diet soda seems to be a diet killer for me and will be avoided in the future.

Now I don't mean to imply by my title that diet drinks can kill you, so all you Coke & Pepsi lawyers can back off. 

Breakfast - Coffee, banana

Lunch - Thai vegetable soup, 1 cup white rice

Dinner  - 1 slice pizza, huge green salad.

222lbs (-18) , BP 124/75, P64 - thats all

Very happy about results today

Day 35 - Slacker (blogwise) - Down 14 pounds though!

First off, a big thanks to those who have posted comments. It really motivates me knowing someone is actually paying attention, if only passingly!

So I haven't been posting regularly his week, but have been staying on a good diet.

I believe I have had something for breakfast every day, which is unusual for me, unless it had been a muffin or danish at the doctor's lounge. Now it is a BIG handful of nuts if I am rushed, 1-2 pieces of fresh fruit (usually bananas), maybe a cup of yogurt,  and coffee with lots of skim milk. I have had leftover pizza (1 slice), a cheese sandwich, big bowls of granola as well, which all start the day off better than sugar.

Lunches have been almost exclusively frozen dinners at work, which are usually 3-400 cal, with veggies and other good stuff. I have been getting the posher, organic ones on sale which I like to think are a bit healthier. Then again, just about anything is better than the burger and fries that had been my mainstay.

If I happen to be over at the hospital, I get a big veggie plate from the cafeteria, usually 4-5 servings, which is VERY filling and low cal.

Dinners have been smaller servings of the same stuff I have always eaten, which could be almost anything, since I love to cook. I basically fill my plate once, and only allow myself veggies if I want seconds.

One big thing I have found is that TV is a trigger to snack. 100% of the time, I feel the urge within minutes of turning on the tube. If I am busy doing other stuff, even killing time on the web, I rarely get the munchies. I am not planning to give up my shows, but I know now I need to be on guard when I plop my less & less fat butt down on the recliner.

I have even started using some 20lb dumbells for a little upper body workout when watching TV, to make it a good thing.

Today at the office I weighed 226 (!), which represents about 12-14 pounds of real weight loss. Now this I know is more than I recommend to my patients, but I was really pigging out there before, and it takes a pile of calories to maintain that sort of weight. I calculate that at my ideal body weight of 160-180, I should be consuming about 1900-2000 cal/day, so that is my target amount to eat, ballpark.  My goal is to teach myself what a normal amount of calories is for my height and frame, and get used to eating that, rather than do the crash diet thing, and eat an amount that is not sustainable.

I am paying attention to the amount of calories only as a teaching exercise for myself,  but have zero plans to keep tabs on it down the road, once good habits become ingrained.

Honestly, I did not think I could do it due to truly meager willpower when it comes to food, and often joked that the only way I was getting back in my old clothes was going to be a good case of cholera or similar wasting illness. Thankfully that does not seem to be the case. 

My size 40 pants were getting snug a month ago, and now I can button up some old 38's without holding my breath. Down to 1 chin again, which I seem to remember is the normal number!

Day 30 - A New Week

For the weekend, I visited my family, and like many others, find that going home often involves reverting to old habits. The house was stocked with chips and other temptations of old and I allowed myself to indulge, but not the the same degree as before. When I weighed in, I found I may have added back a pound, but that's hardly a major setback. 

And so, with a new week ahead, a new commitment to a healthy diet.

Breakfast - Fruit, coffee, milk

Lunch  - 350 cal frozen dinner

Dinner - 1 can Progresso soup, large salad, 2 handfuls plain almonds.

Not hungry after dinner :-)

Day 26 - Getting blogged down

So despite my lack of posting this week, I have still managed to stay very mindful of what I put in my mouth, and continue to lose weight, a total of 12 pounds so far. The biggest differences are portion size and choice of snacks. I have avoided seconds of entrees at dinner, but have allowed myself additional portions of veg if unsatisfied. These have been mostly steamed, so very low cal, and I do love 'em. Snacks have been mostly unsalted nuts (the salt encourages overeating I have found), fresh fruit, salads, etc, instead of cookies, dinner leftovers, chips, etc. From my weight loss I must be consuming at least 1500 cal a day less than before, which says more about what I was eating then, than how much I am eating now. 

I truly did not believe I was capable of this kind of discipline about my diet, as I have been using food as a comforter, especially when my schedule has not allowed other recreation.  So the blog has helped my awareness greatly, and I need to keep it up, for the sake of maintaining the new changes.

Hopefully I will eventually get some comments on the blog, if only to let me know someone else is reading, to keep me on track. That sounds like begging I know, but it does feel a bit like sending messages in a bottle! 

Will be going out of town and off line for the weekend, so thats my excuse for the next few days, but will put up a decent post on Sunday.