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Key to fighting obesity is in small changes, not quick fix

As the first month of the year comes to an end, so do most people's new year resolutions, many of which are weight-loss related.

January magazines flaunt covers promising to help readers lose weight and reach their resolution goal with diets and exercises. Television shows such as "The Biggest Loser" reward contestants with money for slimming down. Even Gov. Sam Brownback is encouraging Kansans to lose weight by participating in the Governor's Weight Loss Challenge, which started Jan. 15.

Despite these resolutions, diet plans and weight loss challenges, more than two-thirds of adults in the United States are overweight or obese.

How did we get here?

Chris Tilden, director of Community Health for Lawrence-Douglas County Health Department, said there is no simple answer, but the root of the problem clearly lies with a lack of healthy diets and many Americans living sedentary lifestyles.

"Even if you don’t sit down in front of TV at home, we spend a lot of time sitting down in the workplace," Tilden said.

Technology allows people the ability to work from a desk and rarely have to get up to complete a task. Instead of seeking out a person in the office, workers can send an email or call. Conference calls have replaced physical meetings, and jobs that used to require a person can be done with machines and computers.

"We’ve engineered our environments so we’re not as active," said Jennifer Church, WIC coordinator and nutritionist for Lawrence-Douglas County Health Department. "We have to actively seek out opportunities to be active, and that takes motivation."

Church said there isn't a definitive answer to what is causing Americans to be so overweight, and there's no quick fix answer to solve the obesity epidemic.

"Public health (officials) have been trying to pin down what the cause of obesity is," Church said. "Schools are targeted, fast food is targeted, all these things are targeted."

Tilden said he believes it is time to stop focusing on the idea that Americans are overweight and begin focusing on how to improve health.

"We need to think about changing attitudes and behaviors, and we need to think of physical activity and healthy eating not as part of a weight-loss program, but as part of a healthy lifestyle," Tilden said.

Creating a healthier lifestyle

For many who want to make the commitment to lose weight or get healthy, the thousands of books and articles on the subject make it hard to know what diet and exercise plan to follow. Diets can vary from low-carb to gluten-free to meat-free, and unless you're an expert, picking the right one is difficult.

"There's no big, easy solution," Church said. "For the most part, it's being in tune with yourself, trying to stay in balance, and avoiding those foods you have trouble controlling yourself with."

Church says one of the most important parts in trying to lose weight is not to get discouraged or give up.

"In terms of people making realistic plans, part of the problem is you see these sculpted bodies (in magazines)," she said. "First off, that’s not that motivating for long, and after a week, if you're lucky, you’ve lost a pound and you look in the mirror and think, 'I don’t look like that.'"

Taking the focus off losing weight can be a good way for people to avoid any frustration that comes with a new health regimen. Church said it helps to focus more on healthy lifestyles and a healthy diet, and the weight can be a side benefit that happens naturally.

Small changes to an everyday routine can result in big benefits, and walking more is a free and simple way to get started.

"It doesn’t take fancy equipment or a gym membership," Tilden said.

Walking up the stairs at work, setting a computer to print across the office and drinking water out of a small cup so it has to be refilled more often are all easy and free ways to be more active.

"Walking is the best activity out there," Church said. "Forty-five to 60 minutes of moderate to vigorous walking, building muscle along with aerobic activity — it doesn’t take much more than that."

For those out of shape, 45-60 minutes may be too hard and could be painful or unpleasant, but Church says to take it slow and work up to a longer amount of time.

"If isn't pleasant, you're not going to keep doing it. Once you build up to it, it feels good," she said.

As for a healthy diet, Church recommends making changes that are sustainable. If a person can't control themselves around a specific food, he or she should avoid it, but other than that nothing has to be completely off-limits.

Other tips to eating better:

• Don't drink soda

Not only is soda high in calories, but it doesn't trigger the same satiating cues as other foods do.

A person can drink 400 calories worth of soda before a meal and still eat the full meal, whereas if they ate a bowl of soup or salad before, they likely would eat less during the meal. There are many alternative beverages to soda, such as carbonated water.

"Usually the carbonated, flavored waters don’t have sugar and not as many chemicals, no caffeine, and in general, the soda has a bunch of words you don’t recognize on the label," Church said.

• Use smaller plates

Many times a person isn't eating the correct portion size of foods. Smaller plates help a person to still fill their plate but to decrease portion sizes.

Church suggests adding more vegetables to a meal as well so it feels as if you're getting the same amount for less calories.

• Measure out snacks

Put snacks in a bag or bowl to avoid eating more than one serving, and have a specific snack time to keep yourself from snacking throughout the day.

• Split a meal with someone

When eating out, it is important to enjoy the meal, which doesn't always mean ordering a healthy entree. Church says to split a meal with a friend or have the waiter or waitress automatically put half in a to-go box.

"Most likely, if you think you'll take half home of your meal and it's in front of you, you'll eat the whole thing," she said.

Drinking water or iced tea without sugar and ordering steamed veggies instead of a fried side can also be ways to cut calories down while eating at a restaurant.

Comments

Chris Tilden 1 year, 10 months ago

Thank you, Meagan, for keeping this important issue front-and-center in our community and providing the Health Department the opportunity to participate in the dialogue. Physical activity and access to healthy foods were two of five topics identified as health priorities in the recently completed Douglas County Community Health Assessment (http://ldchealth.org/information/about-the-community/community-health-improvement-plan/). Both of these priorities will be featured prominently in a Community Health Plan that will be published later this spring by the Health Department on behalf of stakeholders throughout the community who have been part of five workgroups. These workgroups have been meeting to provide input into the development of community strategies.

A key theme of the Community Health Plan will be that a focus on individual lifestyle and behavior change is not enough. We also have to tackle this epidemic at the community level. Businesses, schools, planners and developers, health professionals, government officials — we all have to prioritize the promotion of physical activity and healthy eating. We must continue to increase access to public places that encourage physical activity – parks, trails, sidewalks and recreational centers. We also must reduce unhealthy food and beverage options and increase access to healthier choices at competitive prices.

Obesity-related illness is estimated to carry an annual cost of $190.2 billion in the United States, and these costs are expected to grow. If we want our county to grow and prosper, we all have to make this a priority.

Ron Holzwarth 1 year, 10 months ago

This article is fine as far as it goes, but it leaves out a rather recent medical advance - the recent FDA approval of Topiramate (brand name Topamax), in combination with another medication for weight loss. This is the first time since the 1960s that there has been any medication at all for weight loss that has been approved, ever since amphetamines were withdrawn in about 1970, due to side effects and the fact that the weight returned as soon as the medication was withdrawn.

Topamax had been used off label for weight loss before FDA approval was obtained.

Here's what a few people had to say about it:

"This stuff just turns you off of food for some reason, seriously! My doctor told me one patient of his had lost 7 pounds in 2 days taking this stuff and I thought yeah right good for her."

"I have been on Topamax for 3 yrs. I am 26 yrs old college student. It has been the roughest drug I have ever been on. However at the same time I have lost over 100lbs. on this med. I used to be 220 standing @ 5'0. I now weigh 95; my ideal weight for my hieht. that is what keeps me taking the medication that and I need it for a mood stabilizer as well. Now the bad side of Topamax actually get pretty intense. I developed a skin condition I think that is referred to as Rehniods. Where in mild wheather your hands and feet lose blood circulation,turn white and go numb...then get very painfull.and I now may have permenant nerve damage. Other side effects include severe hairloss, memory loss and brain fog, cognitive incapalitites as well. My over all oppinion of this drug is that it's not worth the easy weightloss, while sacrificing your mind, pain, and hair. It's a horrible comprimise." (Note: She did not note the dosage she is being given.)

"i've been on topamax for months for severe migraines-maybe it's becausse i'm on such a low dosage (25mg-twice a day), but I haven't lost any weight or noticed any difference in that area. The good news is I don't have the migraines anymore. :) "

"Ok I will send you a little jolt! I am on 50 mg once a day foe 10 weeks now, I have lost 44 pounds. Went to the doctors yesterday and he told me I was underweight and to put some weight on! This stuff shuts turns your food switch off! I am not joking. It is like an eating disorder in a pill, run as fast as you can. It is not healthy weight loss."

As with any medication, there will be benefits and liabilities. Do not ever take a medication, unless it is over the counter, without talking to your doctor first. But if your weight is a danger to your health, discussing the possibility of a prescription for Topomax might be a good idea.

It is used to treat Migraine, Pain, Seizure, Bipolar disorder, Tonic–clonic seizure, Focal epilepsy, and Infantile Spasms, and its side effects can include Weight loss, Somnolence, and Anorexia.

Jean Robart 1 year, 10 months ago

I used to take Topamax, and it screwed up my taste buds for over a year. All I could taste of DIET soft drinks was the chemicals. It was terrible.

Ron Holzwarth 1 year, 10 months ago

I used to love avocados, and stuffed myself with them whenever I could buy them at a reasonable price. Even when they were a bit overripe I liked them.

Then the doc put me on Paliperidone (Invega).

Now avocados are sickening. Why do people waste money on them? I can barely stand guacamole!

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