Lose Weight for Life - Week 7

Hi all!

As said, it may be our final week in Sooke, but it is only the beginning... Congratulations to everyone for your interest and participation (bracelets and keychains for everyone!).

I wanted to take this opportunity to thank Karen K and the IHN team (Lynn, Jo and Barb) for their support - we would not have been in Sooke if it was not for their hard work and dedication.

Today we did a power session - doing an overview of the many new tools and strategies you can use to become "fitter and healthier" for good!

Remembering the letters in CRAVED no more will help you go the distance.

When an unhealthy choice or behaviour is upon us - we can "kick it to the cortex" and make a better decision.

This is best explained in the 2009 Psychological Science study by Fujita and Hann called
"The Effect of Construal Levels on Evaluative Associations in Self-Control Conflicts."

From PsyBlog, http://www.spring.org.uk/

They used a simple test as a way of measuring people's unconscious thoughts about eating either an apple or a tempting candy bar.

Before taking the test people were put into either an abstract or concrete mode of thinking. Participants were split into two groups with each asked to think about maintaining good personal relationships, but in different ways. One group thought about why we need to maintain good relationships (abstract, high-level) while the other focused on how we maintain good relationships (concrete, low-level).

As you can see, for the purposes of this experiment, the reason participants were thinking abstractly didn't matter so much. That's because when we think abstractly about one thing, we tend to carry on thinking in an abstract mode about anything else that's put in front of us, including the choice between an apple and a candy bar.

Automatic, unconscious self-control

The results showed that, when participants were thinking concretely, they tended to unconsciously see candy bars in a positive light and apples in a negative light. But this was reversed when participants were thinking abstractly. Just as predicted, abstract thinking automatically made people unconsciously think of candy bars as the devil's own food.

To back this up they asked participants in the two conditions whether they would like an apple or a candy bar, right now. They found that when participants were thinking in a concrete low-level way, they chose the apple over the candy bar only 50% of the time. But when they were thinking abstractly this percentage shot up to 76%. Not bad for such a simple manipulation.

So it seems you can bolster resistance to temptation by thinking abstractly about the goal you want to obtain because it causes your mind to automatically associate temptations with negativity. Hey presto, more self-control and thank you unconscious mind.

To get abstract high-level think CRAVED no more!

You are doing it! SS had continued on her Committed Action of getting fitter and healthier by thinking past the Aero McFlurry... TV continues to do Activity/Exercise despite her pain (wtg!!)...JG is using the CRAVED concept for keeping on track...GC is using the "put 20% back rule" (go Environ -mental) to get slimmer... RB was using her Deep breathing and thinking that she is the only one Responsible and Accountable for her happiness and well being. WTG group!

Here is the list of "Short Snappers" to help get fitter and healthier:

• Remember 5-2-1-0: 5 fruits and vegetables a day, 2 hours of media a day, 1 hour of Exercise/Activity a day and 0 sugared drinks like pop or sports drinks a day (1 tsp in your tea or coffee is fine!)
• Drink healthy - water with a twist of lemon/lime or teas (white, chai) are great choices
• 2 to 3 bites of a dessert plus a hot beverage goes a long way to satisfy (it's all about portions!)
• if you are at a buffet, then only take 2 items at a time and go back for more
• never eat from the box or a bag - plate or bowl it out
• when at home - eat in the kitchen only (sitting down) - NOT in front of the computer or TV (go Environ-mental)
• if dining with others - pace yourself to the slowest eater at the table
• water, Deep breathe or grace before your meal (remember the 20 minute rule)
• use smaller plates, glasses and utensils (put them down between each bite)
• Remember the 1/2 plate rule: 1/2 vegetables and fruits, 1/2 starches and protein
• Nutrition Action is a great unbiased food resource: http://www.cspinet.org/nah/canada.htm
• when coming off track, use a SUCCESS Chart to get back on course
• lower calorie comfort foods like oatmeal, yogurt + frozen fruit, chicken soup, homemade mac & cheese and rice chips can go a long way
• eat breakfast (wtg LS!)
• using the phrase: "I'm not hungry, but I'm going to eat it anyway."
• use the "20% less rule" when plating out food (wtg GC!)
• Remember your 21 Days/Topics and CRAVED no more!
  

HOMEWORK includes:

1) continuing 20 minutes of Exercise/Activity a day (try and move up to 30 minutes everyday for full effect!). It doesn't matter if you are sitting for an upper body workout (the Sooke IHN team has a DVD which demonstrates this!).

2) keep the SUCCESS Charts going - remember a change of 100 calories a day translates into 10 lbs in a year! Slow and steady wins the race (Chunk it down!). Stay Commited to your Cause of becoming fitter and healthier for good! Remember your Attributes (your strengths) and Accomplishments! Appreciation and gratitude go a long way. Don't forget to Value your Values daily for success. Enjoy and savour each and every day of this journey. And don't forget to Deep breathe (4-6-7, fire breathing, box breathing or full breathing) for full effect!

3) check in with your family physician in the weeks ahead to have your blood pressure and other health parameters reviewed (especially if you had double digit scores on your PHQ-9 or GAD-7).

Remember we will be reconvening on Wednesday, June 30th at 10:30AM for Day 91 of the program. At that time, we will discuss the Rebel With A Cause in all of us and the IHN team will recheck your measurements to see if you are staying on track of becoming fitter and healthier (and any other 'er) for life!

Have a healthy month!

Dr.P

Lose Weight for Life - Week 6: Mmmmm marshmallows!

Hi ho everyone!

Another great day in Sooke! Nice walkin' group... TV you are definitely getting fitter and healthier!!

Today we reviewed our HOMEWORK from last week with continued behaviour change using our SUCCESS Charts (again if you have done at least 1, you will be Rewarded next week!).

We discussed Dr. Walter Mischel's marshmallow experiment which demonstrated that delayed gratification can go a long way when it comes to “success” in life.

Way back in the 1960′s, he took 4 year olds and gave them a choice of either eating one marshmallow right away or, if they were willing to wait while the researcher stepped out for a few minutes, then the child could have two marshmallows when they returned.

Mischel then went on to follow these children into their late teen years. He found that there was quite a difference in the “grabbers” versus the “delayers” in terms of life “success.” The “grabbers” had lower S.A.T. scores (210 points on average), they struggled in stressful situations, often had trouble paying attention, and also found it difficult to maintain friendships.

Mischel could predict life “success” at 4 years old… But the most promising thing that came out of these experiments is that one could teach the skill of delaying gratification. The “grabbers” could be taught the skills necessary to suppress the impulse to grab and eat the marshmallow right away.

This is exciting stuff! When it comes to addiction and other maladaptive behaviours, we can learn new skills and techniques to help our impulse control (i.e. CRAVED mnemonic).

We also learned about "an apple a day" may not keep the Doctor away. Merely adding 100 calories (an example would be a large medium apple) a day without changing activity and the types of foods eaten can result in about a 10 lb weight gain in a year (BTW I stretched the truth a bit with the apple analogy - the 100 calorie apple with it's fibre content is a much better choice than a `100 calorie cookie!). We also found out that it takes you brisk walking for about a mile (or 1.6 kilometres) to burn that many calories. So be mindful!

We also discussed that rest and sleep are important for healthy weight.

Topic 16: Sleep, Rest and Relaxation

The hormones leptin and ghrelin which are factors for satiety and hunger respectively become unbalanced with poor sleep. In class, we all did the Epworth Sleep Score and noted that if you scored 10 or more, been told you stop breathing while you sleep or snore loudly (ear plug anyone?) then you should follow up with your family physician. There are treatments available for these conditions!

We also added one last breathing technique to our breathing repertoire - full breathing (hands on stomach and chest - when inspiring, trying to push out the lower hand; the upper hand next and then the shoulders, then all 3 with 3 sets of breaths).

Lastly, keeping Accountability and Consequences at the forefront of our choices, remember that we make over 200 food decisions a day, we covered:

Topic 17: Creepy and Chilling Consequences

Topic 18: Choice, Responsibility , Accountability and NOT becoming a Victim

To ramp up Accountability, we will be having a Day 90 (since starting the program) class on Wednesday, June 30th at 10:30AM at the Sooke IHN office (I will be telelinking from Nanaimo!).

You can do this! It starts and ends with you and your Choices. Think CRAVED no more to help!!

HOMEWORK included:

1) 2 day Eating Log - if you find planning your eating for the day before then write out your Log in advance (Eat healthy!).

2) increase Activity or Exercise level to 15 minutes alternating with 20 minutes or 35 minutes every other day (remember not to skip more than 1 day to keep on track!).

3) add a set of 3 new behaviours to your SUCCESS chart - one new food choice (are you at 5 fruits or vegetables a day yet?), one Activity - see #2 above and one behaviour, i.e. Clean the Clutter in the kitchen, eat in the kitchen only, Appreciate 3 things/people in your day, Drink 1 more glass of water a day (you can add the limes we gave out to help with the water).

4) fill out the PHQ-9 and GAD-7 health questionnaires (which are useful to help monitor for depression and anxiety).

Have a healthy week!

Dr.P

P.S. For our final week in Sooke (and it's not the end! it's only the beginning!), we will be meeting at 10:15AM to walk our walk and then talk our talk!

Lose Weight for Life - Week 5

Greetings all!

Another great walk and day in Sooke!

We reviewed our HOMEWORK and Emotion Logs and how we felt during the week: it ranged from irritated/angry to happiness/enjoyment and savouring...

The first step in managing our emotions (as opposed to controlling them) is to be mindful and to Acknowledge and Accept them (even renaming can help, i.e. "miffed" vs angry). As said, our emotions can be much like the weather, we will get a whole range of meteorological conditions - it's in the how we respond which matters most. Again, Deep breathing can go a long way to help us Defuse or Distance from them. Got an umbrella?

We also reviewed the CRAVED no more mnemonic to help with higher (cortical) thinking. The munch monster at the midbrain level will get us doing behaviours which at times are less than healthful - so by thinking of "CRAVED" and the words and ways of thinking it represents can help us make better decisions (CRAVED words are now in bold).

Topic 13: CRAVED no more

For healthy living, "5-2-1-0" can help guide us. 5 fruits or vegetables a day, i.e. more vegetables vs fruits! 2 hours or less of media (which includes TV, computer, video games, etc.) a day. 1 hour of brisk Activity, i.e. walking counts (and yes, we are only at 15 minutes a day which is great!). 0 sugared soft drinks (including sports drinks) a day. All of these behaviours will keep the Doctor away for good!!

Lastly, we talked about the 20 minute rule - it takes that long for our satiety hormones to be released to let us know that we are getting full and satisfied. Remember from Dr. Wansink's experiments that we can eat less, but feel just as satisfied if we change our Environment and HOW we eat!

Topic 14: Ask - Questions are the Answer
Topic 15: Go Environ-mental

HOMEWORK for this week includes:

1) doing another SUCCESS Chart with 3 behaviours (food, activity and eating behaviour). Please hand in at least one so that you are eligible for a Lifestyle Intervention Clinic Reward.

2) increase your daily Activity to 15 minutes every day or 30 minutes every other day

3) adding or trying one new eating behaviour like eating in the kitchen only, putting all foods out of sight in the house except for a fruit bowl; using smaller glasses, plates and utensils; divide up large portions of food (like big box stuff) into smaller portions (to help curb the munch monster); saying grace or Deep breathing at the beginning of the meal or pacing how you eat to the slowest person at the table (it will be our secret!). Go Enviro-mental!!

Have a healthy week!

Dr.P

P.S. We will again be at the IHN at 10:15, so that we can do a walk before class! Rain or shine!

Lose Weight for Life - Week 4

Another sunny day in Sooke! Thanks for the walk plan Lynn! Kudos to everyone who came out and did the walk - TV you are inspiring!! You went above and beyond today!

We did the raisin meditation to realize that we can Enjoy and Savour anything and at any time... it all begins with being mindful.

We also began the discussion on the HOW of eating. As it turns out, as GC so aptly pointed out, it is our midbrains (aka the munch monster) that can hijack our eating and choose other unhealthy behaviours. We are up against thousands of years of evolution.

Dr. Brian Wansink's book, Mindless Eating, has numerous examples and methods to overcome our "midbrain moments," i.e. the plate size experiment.

We also reviewed some of the best strategies for healthy weight change and referred to the National Weight Loss Registry at:

http://www.nwcr.ws/

There is a cluster of healthy behaviours and attitudes which help like eating breakfast, choosing low fat foods, doing regular daily exercise, i.e. walking and limiting media - screen time (TV, Internet, video games). Can you say 5-2-1-0?!

Lastly, we discussed our feelings...

Topic 12: Feelings, Nothing More Than Feelings

which begins with being able to acknowledge what we are feeling - try and do the Emotion Log for the week ahead (at least twice a day).

HOMEWORK for this week includes:

1) doing another (or a first) SUCCESS Chart (thanks to JM for the blank charts!).
2) being more mindful of our emotions (2 or 3 times a day) and doing an Emotion Log from Topic 12: Feelings, Nothing More Than Feelings.
3) moving up to 15 minutes a day of Activity/Exercise alternating with 10 minutes or 25 minutes every other day.

Have a healthy week!

Dr.P

P.S. I have posted DW's great recipes in the comments!!

Lose Weight for Life - Week 3

Hi ho everyone!

I Appreciated being in Sooke today!!

Today we discussed WHAT to eat using the Canada Food Guide. We also noted that most of us VALUE food/eating, so again, the food choices we discuss (not diet), should be FUN. There are no exclusions here - only mindful eating!

Check out:

http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php

I also noted that I am a physician and not a dietitian and for more specific questions about food choices - the IHN dietitian or 811 (Dial a Dietitian) can be great resources!

http://www.healthlinkbc.ca/dietitian/

As said, fruits and vegetable as well as whole grains (rice, oatmeal, pasta, breads, even barley! - the browner, the better) rule!

It is important to note for the Milk and Alternatives - low fat choices are a good source of protein (more on this next week). Calcium carbonate 1000-1500 mg a day and vitamin D 800 IU are helpful.

The Meat and Alternatives are also important for protein with nuts (walnuts and almonds top the list of nuts) and legumes are good choices, but one must be mindful of nuts and the amount fat they contain (a handful is a better portion!)...

In the weeks ahead, we'll talk about how important portions are with regards to the HOW of eating.

Topic 9: Food for Thought
Topic 10: Appreciation and Gratitude
Topic 11: Enjoy and Savour the Moment

HOMEWORK for Week 3 included:

1) making a SUCCESS Chart for the next week - plotting 3 different behaviours: i) food choice (i.e. eat one more fruit/vegetable daily), ii) activity (i.e. 10 minutes of walking or any other activity - adding music and humming/singing can really help!) and iii) eating behaviour (i.e. drinking 1 glass of water (herbal tea, etc.) extra a day, eating breakfast, etc.).

2) plan your food choices for a day ahead - and see how close you can eat to your meal plan

3) the above Topics with their EXERCISES.

Next week, we'll begin our discussion around the HOW of eating.
Be sure to arrive at the IHN offices at 10:15 so that we can do a 10 minute walk before class (we'll be able to check it off our SUCCESS Charts!!).

Have a healthy week!

Dr.P

P.S. The fat and sugar that the delicious donut above represents is a reminder for me to tell you my donut story next week!

Lose Weight for Life - Week 2: Just add bacon!!

Hi all!

It was nice to see everyone again!

This week, we reviewed WHY we eat (see below). We also discussed how certain foods like sugar, salt and fat have a stronger impact on our midbrain in terms of why we crave and desire certain foods (like chocolate and bacon).

Homework for this week included doing the EXERCISE in the following:

Topic 6: Remember Your Accomplishments/Powerful Moments

Topic 7: Compelling Future – Hope

Toppic 8: Don't Hold Your Breath

For the week ahead, try and be mindful with Deep breathing.

Next week we will discuss WHAT to eat.

Have a healthy week!

Dr.P

Lose Weight for Life: The doctor is ill!

Hi all!

Can you say H1N2? It’s amusing to think that I went through the entire flu season this year without one bug (including H1N1) and then BOOM!

My apologies for not being in sunny Sooke this week…

Karen had a grand idea in that we would continue the momentum of the program and meet this week (kudos Karen!)…

We wanted to review your HOMEWORK and how you felt about it… please hand in your 2 day Eating Logs, how did it feel to leave food on your plate?...as well as we started some regular physical activity (5 minutes every day or 10 minutes every other day). We played badminton regularly this week and skied Mount Washington on Saturday!

We were to discuss WHY we eat (besides for nourishment), but some of the other reasons we munch (stress, social, boredom, low mood, etc.)... Next week we will learn about DOPAMINE, the little neurotransmitter which causes all sorts of "good" things...How it is involved with eating and procreating (the 2 F’s)...How it can be misused and overused in addictions.

We will also discuss that humans (like most animals) have the propensity to BINGE eat. Dr. Brian Wansink's book, Mindless Eating, demonstrates this concept very well...

We’ll talk more about this next week…

I have included some more TOPICS to help with mood and motivation:

Topic 3: Adding to Physical Activity and Exercise

Topic 4: The Value of Values

Topic 5: Rewards and Anticipated Events


HOMEWORK for this week includes:

1) try RATING (out of 10) before and after an ACTIVITY, i.e. walking or dancing – how you feel about it before then how you feel after.
2) find out what your VALUES are (pick your top 7 to 10, is EATING/FOOD valued?).
3) make sure you ACKNOWLEDGE that you are doing something very special for yourself and plan a REWARD or treat in the next week.
4) walking, dancing (singing, humming to music) or any other physical activity 10 minutes alternating with 5 minutes every other day or 15 minutes every other day. Don’t forget to use your new PEDOMETERS!

Have a healthy week.

I will be back!!

Take care,
Dr.P

Lose Weight for Life - Week 1

Greetings all!

It was nice meeting everyone today. I wanted to thank Karen and company for having us down to Sooke to teach this program!

As promised, we have this blog to help you with your journey of becoming "fitter, healthier and slimmer/thinner/curvier/ sexier/happier (you pick the ____'er)"...

Today we discussed how language can have a significant impact on behaviour change like weight loss through neurolingusitic programming (nlp). As said, the unconscious mind only processes positives, so we won't be "losing" weight in this program!

The program is FUN and not fear-based... Remember there is no failure here... SUCCESS is a continuum.

HOMEWORK for Week 1 is:

1) complete medical history form (including height, weight, waist circumference and BP).

2) 2 day Eating Log - write down everything you eat (time, what and how much, where, with whom and reason/feeling).

3) leave something on your plate/glass at least once a day this week.

4) walk or dance with music (hum or sing along) 5 minutes a day or 10 minutes every other day. Parking the car further from work or the mall can help. Put those FREE pedometers to good use!

5) think about your personal REASONS on why you are doing this program (specific health reasons, family or friends, financial, personal growth?).

If you have any other questions or concerns, please do not hesitate to post them on the blog or e-mail me at d.poteryko@gmail.com

Have a healthy week!

Dr.P

Lose Weight for Life - Sooke IHN

This will be a resource for those patients who are taking the "Lose Weight for Life" program at the IHN Sooke. Over the next 7 weeks, we will post a brief overview of the week's topics and the assigned homework.

The important note here is that you will only get as much out of this program as you put into it.

The address of this blog is: www.lifestyleinterventionclinic.blogspot.com

My e-mail is: d.poteryko@gmail.com

Looking forward to the weeks ahead!

Health and happiness!

Dr.P

Lunch Clubs for January and February 2010

Hi all!

This blog has moved, but I wanted to let everyone know that Lunch Club updates will be at the http://www.cisic.ca/ website...

For January and February, Lunch Club will be on Monday, January 11th at noon and Monday, February 15th at noon in room B224 at NRGH.

May you all have a happy and peaceful 2010!!

Dr.P