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Maintaining a Healthy Weight

Being overweight increases your risk of developing high blood pressure. In fact, blood pressure rises as body weight increases. Losing even 10 pounds can lower blood pressure — and it has the greatest effect for those who are overweight and already have hypertension.

Being overweight or obese are also risk factors for heart disease. They increase your chance for developing high blood cholesterol and diabetes — two more major risk factors for heart disease.




Am I overweight?

Two key measures are used to determine if someone is overweight. These are the body mass index, or BMI, and waist circumference.

BMI relates weight to height. It gives an approximation of total body fat — and that's what increases the risk of obesity-related diseases. Overweight is defined as a BMI of 25 to 29.9; obesity is defined as a BMI equal to or more than 30.

Calculate your body mass index (BMI)

But BMI may overestimate body fat or inaccurately estimate total body fat in muscular persons or those losing muscle. For example, older persons often have lost muscle mass and, so, have more fat for a given BMI than younger persons do. That's why waist measurement is often checked as well. Another reason is that too much body fat in the stomach area also increases disease risk. A waist measurement of more than 35 inches in women and more than 40 inches in men is considered high.


Should I Lose Weight?

For people who are considered obese (BMI greater than or equal to 30), or for those who are overweight (BMI of 25 to 29.9) and have two or more risk factors, the guidelines recommend weight loss. Even a small weight loss (just 10 percent of your current weight) will help to lower your risk of developing diseases associated with obesity. Patients who are overweight, do not have a high waist measurement, and have less than 2 risk factors may need to prevent further weight gain rather than lose weight. Talk to your doctor to see if you are at an increased risk and if you should lose weight.


How Can I Lose Weight?

There is no magic formula for weight loss. You must eat fewer calories than you burn. Just how many calories you burn daily depends on factors such as your body size and how physically active you are.

If you have to lose weight, it's important to do so slowly. Aim for losing no more than one-half pound to 2 pounds a week. One pound equals 3,500 calories. So, to lose 1 pound a week, you need to eat 500 calories a day less or burn 500 calories a day more than you usually do.

Try starting with a weight loss of 10 percent of your current body weight over 6 months. This is the healthiest way to lose weight — and importantly — it offers the best chance of long term success.

The DASH eating plan is a healthy plan and can be made lower in calories for those who need to lose weight.


Tips for Eating Out

So, if you're treating yourself to a meal out, here are some tips to help make it a dining experience that is both tasty and good for you.

Will the restaurant:

  • Serve margarine rather than butter with the meal?
  • Serve fat free (skim) milk rather than whole milk or cream?
  • Trim visible fat from poultry or meat?
  • Leave all butter, gravy or sauces off a dish?
  • Serve salad dressing on the side?
  • Accommodate special requests?
  • Use less cooking oil when cooking?

Select foods which are:

  • Steamed
  • Garden fresh
  • Broiled
  • Baked
  • Roasted
  • Poached
  • Lightly sauteed or stir-fried

Healthy Shopping

The new National Heart, Lung, and Blood Institute Obesity Guidelines say that you can reduce the time you spend cooking healthy by using a shopping list and keeping a well-stocked kitchen. Read the labels as you shop and pay attention to serving size and servings per container. Compare the total calories in similar products and choose the lowest calorie ones.

So, shop for quick low fat food items and fill your kitchen cupboards with a supply of lower calorie basics like the following:

  • Fat free or low fat milk, yogurt, cheese, and cottage cheese
  • Light or diet margarine
  • Eggs/Egg substitutes
  • Sandwich breads, bagels, pita bread, English muffins
  • Soft corn tortillas, low fat flour tortillas
  • Low fat, low sodium crackers
  • Plain cereal, dry or cooked
  • Rice, pasta
  • White meat chicken or turkey (remove skin)
  • Fish and shellfish (not battered)
  • Beef: round, sirloin, chuck arm, loin and extra lean ground beef
  • Pork: leg, shoulder, tenderloin
  • Dry beans and peas
  • Fresh, frozen, canned fruits in light syrup or juice
  • Fresh, frozen, or no salt added canned vegetables
  • Low fat or nonfat salad dressings
  • Mustard and catsup
  • Jam, jelly, or honey
  • Herbs and spices
  • Salsa
  •  

    These low-calorie alternatives provide new ideas for old favorites. When making a food choice, remember to consider vitamins and minerals. Some foods provide most of their calories from sugar and fat but give you few, if any, vitamins and minerals.

    This guide is not meant to be an exhaustive list. We stress reading labels to find out just how many calories are in the specific products you decide to buy.

    Higher-Fat Foods

    Lower-Fat Foods        

    Dairy Products
                 
    Check Box Evaporated whole milk Check Box Evaporated fat-free (skim) or reduced-fat (2%) milk
    Check Box Whole milk Check Box Low-fat (1%), reduced-fat (2%), or fat-free (skim) milk
    Check Box Ice cream Check Box Sorbet, sherbet, low fat or fat-free frozen yogurt, or ice 
    Check Box Whipping cream Check Box

    Imitation whipped cream (made with fat-free [skim] milk) 

    Check Box Sour cream Check Box Plain low-fat yogurt
    Check Box Cream cheese Check Box Neufchatel or "light" cream cheese or fat-free cream cheese
    Check Box Cheese (cheddar, Swiss, jack) Check Box Reduced-calorie cheese, low-calorie processed cheeses, etc.
        Check Box Fat-free cheese
    Check Box American cheese Check Box Fat-free American cheese or other types of fat-free cheeses
    Check Box Regular (4%) cottage cheese Check Box Low-fat (1%) or reduced-fat (2%) cottage cheese
    Check Box Whole milk mozzarella cheese Check Box Part-skim milk, low-moisture mozzarella cheese
    Check Box Whole milk ricotta cheese Check Box Part-skim milk ricotta cheese
    Check Box Coffee cream (1/2 and 1/2) or nondairy creamer (liquid, powder) Check Box Low-fat (1%) or reduced-fat (2%) milk or non-fat dry milk powder
           
    Cereals, Grains, and Pastas
           
    Check Box Ramen noodles Check Box Rice or noodles (spaghetti, macaroni, etc.)
    Check Box Pasta with white sauce (alfredo) Check Box Pasta with red sauce (marinara)
    Check Box Pasta with cheese sauce Check Box Pasta with vegetables (primavera)
    Check Box Granola Check Box Bran flakes, crispy rice, etc.
        Check Box Cooked grits or oatmeal
        Check Box Reduced-fat granola
           
    Meat, Fish and Poultry
           
    Check Box Coldcuts or lunch meats (bologna, salami, liverwurst, etc.) Check Box Low-fat coldcuts (95 to 97% fat-free lunch meats, low-fat pressed meats)
    Check Box Hot dogs (regular) Check Box Lower-fat hot dogs
    Check Box Bacon or sausage Check Box Canadian bacon or lean ham
    Check Box Regular ground beef Check Box Extra lean ground beef such as ground round or ground turkey (read labels)
    Check Box Chicken or turkey with skin, duck, or goose Check Box Chicken or turkey without skin (white meat)
    Check Box Oil-packed tuna Check Box Water-packed tuna (rinse to reduce sodium content)
    Check Box Beef (chuck, rib, brisket) Check Box Beef (round, loin) (trimmed of external fat) (choose select
    Check Box Pork (spareribs, untrimmed loin) Check Box Pork tenderloin or trimmed, lean smoked ham
    Check Box Frozen breaded fish or fried fish (homemade or commercial) Check Box Fish or shellfish, unbreaded (fresh, frozen, canned in water)
    Check Box Whole eggs Check Box Egg whites or egg substitutes
    Check Box Frozen TV dinners (containing more than 13 grams of fat per serving) Check Box Frozen TV dinners (containing less than 13 grams of fat per serving and lower in sodium)
    Check Box Chorizo sausage Check Box Turkey sausage, drained well (read label)
        Check Box Vegetarian sausage (made with tofu)
           
    Baked Goods
           
    Check Box Croissants, brioches, etc. Check Box Hard french rolls or soft brown ’n serve rolls
    Check Box Donuts, sweet rolls, muffins, scones, or pastries Check Box

    English muffins, bagels, reduced-fat or fat-free muffins or scones 

    Check Box Party crackers Check Box Low-fat crackers (choose lower in sodium)
        Check Box Saltine or soda crackers (choose lower in sodium)
    Check Box Cake (pound, chocolate, yellow) Check Box Cake (angel food, white, gingerbread)
    Check Box Cookies Check Box

    Reduced-fat or fat-free cookies (graham crackers, 

          ginger snaps, fig bars) (compare calorie level)
           
    Snacks and Sweets
           
    Check Box Nuts Check Box Popcorn (air-popped or light microwave), fruits, vegetables
    Check Box Ice cream, e.g., cones or bars Check Box Frozen yogurt, frozen fruit or chocolate pudding bars
    Check Box Custards or puddings (made with whole milk) Check Box Puddings (made with skim milk)
           
    Fats, Oils, and Salad Dressings
           
    Check Box Regular margarine or butter Check Box Light spread margarines, diet margarine, or whipped butter, tub or squeeze bottle
    Check Box Regular mayonnaise Check Box Light or diet mayonnaise or mustard
    Check Box Regular salad dressings Check Box Reduced-calorie or fat-free salad dressings, lemon juice, or plain, herb flavored, or wine vinegar
    Check Box

    Butter or margarine on toast or bread

    Check Box Jelly, jam, or honey on bread or toast
    Check Box Oils, shortening, or lard Check Box Nonstick cooking spray for stir-frying or sautéing
        Check Box As a substitute for oil or butter, use applesauce or prune puree in baked goods
           
    Miscellaneous
           
    Check Box Canned cream soups Check Box Canned broth-based soups
    Check Box Canned beans and franks Check Box Canned baked beans in tomato sauce
    Check Box

    Gravy (homemade with fat and/or milk)

    Check Box Gravy mixes made with water or homemade with the fat skimmed off and fat-free milk
    Check Box Fudge sauce Check Box Chocolate syrup
    Check Box Avocado on sandwiches Check Box Cucumber slices or lettuce leaves
    Check Box Guacamole dip or refried beans with lard Check Box Salsa

    Your Weight Is As Important To Us As It Is To You!

    Over the past few years it has become clear that weight is an important health issue. Being overweight is a risk factor for health problems such as diabetes, high blood pressure, high cholesterol and triglycerides, arthritis, gall bladder disease, gynecologic problems, some cancers, and even lung problems. Some people who need to lose weight for their health don't recognize it, while others who don't need to lose weight, want to get thinner for cosmetic reasons. We understand that in some ways your weight is different from, for example, your cholesterol level or your blood pressure, because you can't see what these are by looking at someone. Many patients have had health-care providers who approached their weight in a less-than-sensitive or helpful manner. Some patients may have had health-care encounters in which they felt blamed, but not helped. Please be assured that when we bring up your weight, it's because we know that this is an important aspect of your overall health care. We understand, though, that successful weight management is a long-term challenge.

    By the same token, we may discuss weight goals that are different from those you select. Weight can affect a person's self-esteem. Excess weight is highly visible and evokes some powerful reactions, however unfairly, from other people and from the people who possess the excess weight. The amount of weight needed to improve your health may be much less than you wish to lose when you consider how you evaluate your weight. If we suggest an initial weight goal that seems too heavy for you, please understand that our major emphasis is on your health and that your health can be greatly improved by a loss of 5-10 percent of your starting weight. That doesn't mean you have to stop there, but it does mean that an initial goal of losing 5-10 percent of your starting weight is both realistic and valuable.

    Behaviors That Will Help You Lose Weight and Maintain It

    Set The Right Goals
    Setting the right goals is an important first step. Most people trying to lose weight focus on just that one goal: weight loss. However, the most productive areas to focus on are the dietary and exercise changes that will lead to that long-term weight change. Successful weight managers are those who select two or three goals at a time that they are willing to take on, that meet the following criteria of useful goals:

    Effective goals are 1) specific; 2) attainable; and 3) forgiving (less than perfect). "Exercise more" is a commendable ideal, but it's not specific. "Walk five miles everyday" is specific and measurable, but is it attainable if you 're just starting out?" Walk 30 minutes every day" is more attainable, but what happens if you're held up at work one day and there's a thunderstorm during your walking time another day? "Walk 30 minutes, five days each week" is specific, attainable, and forgiving. In short, a great goal!

    Nothing Succeeds Like Success

    Shaping is a behavioral technique in which you select a series of short-term goals that get closer and closer to the ultimate goal (e. g., an initial reduction of fat intake from 40% of calories to 35% of calories, and later to 30%). It is based on the concept that "nothing succeeds like success." Shaping uses two important behavioral principles: 1) consecutive goals that move you ahead in small steps are the best way to reach a distant point; and 2) consecutive rewards keep the overall effort invigorated.

    Success (But Not With Food)

    Rewards that you control can be used to encourage attainment of behavioral goals, especially those that have been difficult to reach. An effective reward is something that is desirable, timely, and contingent on meeting your goal. The rewards you administer may be tangible (e. g., a movie or music CD or a payment toward buying a more costly item) or intangible (e. g., an afternoon off from work or just an hour of quiet time away from family). Numerous small rewards, delivered for meeting smaller goals, are more effective than bigger rewards, requiring a long, difficult effort.

    Balance Your (Food) Checkbook

    Self-monitoring refers to observing and recording some aspect of your behavior, such as calorie intake, servings of fruits and vegetables, exercise sessions, medication usage, etc., or an outcome of these behaviors, such as weight. Self-monitoring of a behavior can be used at times when you're not sure how you're doing, and at times when you want the behavior to improve. Self-monitoring of a behavior usually changes the behavior in the desired direction and can produce " real-time" records for review by you and your health care provider. For example, keeping a record of your exercise can let you and your provider know quickly how you're doing, and when the record shows that your exercise is increasing, you'll be encouraged to keep it up. Some patients find that specific self-monitoring forms make it easier, while others prefer to use their own recording system.

    While you may or may not wish to weigh yourself frequently while losing weight, regular monitoring of your weight will be essential to help you maintain your lower weight. When keeping a record of your weight, a graph may be more informative than a list of your weights. When weighing yourself and keeping a weight graph or table, however, remember that one day's diet and exercise patterns won't have a measurable effect on your fat weight the next day. Today's weight is not a true measure of how well you followed your program yesterday, because your body's water weight will change much more from day to day than will your fat weight, and water changes are often the result of things that have nothing to do with your weight-management efforts.

    Avoid A Chain Reaction

    Stimulus (cue) control involves learning what social or environmental cues seem to encourage undesired eating, and then changing those cues. For example, you may learn from reflection or from self-monitoring records that you're more likely to overeat while watching television, or whenever treats are on display by the office coffee pot, or when around a certain friend. You might then try to sever the association of eating with the cue (don't eat while watching television), avoid or eliminate the cue (leave coffee room immediately after pouring coffee), or change the circumstances surrounding the cue (plan to meet with friend in non-food settings). In general, visible and accessible food items are often cues for unplanned eating.

    Get The (Fullness) Message

    Changing the way you go about eating can make it easier to eat less without feeling deprived. It takes 15 or more minutes for your brain to get the message you've been fed. Slowing the rate of eating can allow satiety (fullness) signals to begin to develop by the end of the meal. Eating lots of vegetables can also make you feel fuller. Another trick is to use smaller plates so that moderate portions do not appear meager. Changing your eating schedule, or setting one, can be helpful, especially if you tend to skip, or delay, meals and overeat later.

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    This site is for informational use only. It is not intended to substitute professional medical advice.

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