Doc's Box

WHAT IS THE OPPORTUNITY IN A PLATEAU?
There are as many paths to losing weight through lifestyle change as there are patients who have ever tried. For most To Life! participants, one event common to many is the "plateau", i.e., that time when your weight loss levels out. It is most always an uninvited event, occurring not when you expected it or wanted it. What is the nature of a plateau? Once we have established that the reason is not medical, i.e., a new thyroid problem, or a medication change that has led to weight gain, we can have a conversation about what might be going on. Here are two common types of plateaus that occur in the To Life!™ Program:

The first I would call the "I'm feeling so good" plateau. You've come into the program, lost a significant amount of weight, and you're really feeling better. You've got more energy, you're lighter on your feet, and you've dropped down at least a size or two. And, of course, people are starting to tell you how great you look. However, you have stopped losing weight. When this happens, here is my general approach:

· Perhaps your exercise program is helping you to increase muscle mass while you are losing body fat. You feel better, your clothes are looser, but the all powerful scale is not changing. A review of the entire To Life! technology often reveals what we need to do next.

· Frequently patients are just happy with how they look and feel, they know they have more weight to lose, but they secretly would just like to take a break for a while before cranking up again. No one loses weight in a straight line. So dividing it up into pieces is often a great idea. Picking a restart date and sticking to it helps avoid waking up every morning with the pressure of ‘having to get started again'.

Let's call the second type of plateau of "I'm feeling overwhelmed" plateau. In this circumstance you've been motoring right along in your program, working on your lifestyle change techniques, and then WHAM! something happens. It doesn't really matter if it's about relationship, money, job stress, new physical problems, etc. Something occurs and suddenly you have lost your edge. What is the approach?

What you can do about it:

· Apply the Success Equation. Always remember that success in weight management is the sum of what you have lost plus what you have not gained. So you've probably done a lot better than you would have in the past, and no doubt what you've done is the best you could do and much better than you used to do.

· Change your conversation: You are here, in a program that works. You know what to do because you've already been practicing your lifestyle change techniques. You are not the same person who started this program.

· Return to your To Life! workbook and your Promise Sheets. Review what you initially said you would do. If you have kept your initial promises and are still keeping them, pick the next thing in nutrition and exercise you need to do, make a promise to yourself, and get started.

· Check your record keeping and portion sizes! These are the two pieces of lifestyle change technique that lead to the most weight loss, and are also the first things to get ‘dropped out' when times get tough. You must, even just occasionally, weight and measure portions, just to make sure you are not sabotaging yourself.

· Get support. Communicate with the people who are most important to you in your personal life about what you are doing, why you are doing it, and how they can assist you. Can your spouse or the kids exercise with you? Have you shown your family your notebook? Are you becoming the lifestyle change coach in your own family? Also, your To Life! team is here to help you. Do you need some counseling? Do you need help with record keeping? Do you need another private appointment with a dietitian or the personal trainer? Go to the person who can help you get moving ahead.

Whether it is just time for a little break before getting started again, or time for a more aggressive or insightful intervention, remember that in an epidemic there is no real cure, but there can be successful management. A plateau is just one of the interesting, manageable stops we make along the way. It is an opportunity for learning, self-compassion, and re-commitment. Use your system, ask for what you need, don't settle for what you get, and you will be just fine.

To Life!

Dr. Pincus

Mind-Body

REINFORCEMENTS
Starting is hard. Staying with it is even harder! We get off track in our efforts to change when the payoff isn't worth the price we have to pay to get it. Health is a reward in and of itself, as is lower numbers on the scale and lower sizes on the labels. But sometimes we need help learning to change what we use for rewards. For most of us, food has served as a primary source of reinforcement. Now, however, it doesn't seem quite right to reward ourselves for a great workout with a Twinkie.

Reinforcement works best if served a bit randomly, but frequently enough to keep its power to motivate. It can take the form of:

§ A verbal pat on the back - from ourselves or others

§ An article of new clothing at the new, lower size

§ A monetary contribution to your "weekend getaway fund" you make with each new level of success

§ A jar of affirmations you have written down, cut out, and draw from when celebration is in order

§ A jelly donut

OK, the last one was just to see if you are paying attention. And since you are, reach around and pat yourself on the back. Do it with each success and the success will keep coming.

Steve Heath, Ph. D.

A number of former To Life! patients have asked Dr. Pincus to see them from time to time in the office, for a lifestyle change centered primary care visit. If you have insurance, you will need your copayment, and that should do it. If you would like to come back into the program for a refresher, e.g., for three months or six months, he would be happy to discuss that with you. If you would like to repeat the Saturday workshop without committing to anything else, please come join us! We have cut the $350 price by half, to $175. We are here to support you, so please give us a call.

Thanks,

Misty Martinez
Office Manager

Saturday Workshop Class

The next Saturday Workshop Class is scheduled for June 27th from 8:30 a.m. to 3:30 p.m. at Methodist Dallas Medical Center Hitt Auditorium located at 1441 N Beckley Ave , Dallas , TX 75208 . The auditorium is off Colorado and N. Bishop near the ER. Parking is free in the parking lot by Hitt Auditorium. The next workshop will be held on August 29th at Methodist Charlton Medical Center , Outpatient Center Auditorium. Call Misty if you have been in the program for a while and would like to repeat the workshop. Also if anyone plans to attend they will need to RSVP.

Lifestyle Change after Weight Loss Surgery Seminar

If you've had weight loss surgery or know someone who has, there is an excellent seminar featuring a number of well-known motivational speakers who have all had weight loss surgery. Here is the link. http://www.makingitalifestyleconferences.com/ Check it out!! The discount code is WLSEC5.

Calorie King Renewal

If your one year subscription to Calorie King is up or about to expire, please call the office and we have a discount renewal number that is cheaper than purchasing on line through the calorie king website.

Need A Phone Buddy?

Need a phone buddy contact or want to be a phone buddy, then please email or call Misty with inquires.

Watch Webcast on To Life! Program

Click on the link below and register to view the free webcast of Dr. Pincus seminar on the To Life! Program.

http://www.methodisthealthsystem.org/frm_weightwebcast2.cfm

Thanks!

FITTING IN FRUITS AND VEGETABLES

We all know the importance of making fruits and vegetables a key component of a healthy eating plan- besides being low in calories; they are filled with disease fighting vitamins, minerals, fiber and phytochemicals. The Food Pyramid recommends that most of us consume approximately 1 1/2 cups of fruits and 2 cups of vegetables per day.

Having trouble getting in all of your daily servings? Here are some suggestions to help you get more fruits and vegetables into your daily diet:

• At breakfast, top your cereal with a banana or berries.
• For a cool treat, make a fruit smoothie using fresh or frozen fruit.
• Fruit makes a great addition to lunches and snacks. Try a piece of fresh fruit or grab an individual container of applesauce or fruit packed in its own juices.
• Add celery, grapes or apples to chicken and tuna salad.
• Have fruit for dessert; add a little fat-free Cool Whip for a special treat.
• Keep a bowl of fresh fruit on the table or counter so that it is easily available to grab and go.
• Cut up fruits like pineapples and melons as soon as you get home from the supermarket and keep them in the refrigerator so they are ready at all times.
• Go for convenience; buy pre-cut fruits and veggies and bagged salads if you are short on time.
• Freeze fruits like bananas and grapes for a cool treat on a hot day.
• Make fruit kabobs (cut up fruit on toothpicks or skewers) for a pretty summer snack or to take to a party.
• If you don't like cooked vegetables, try them raw. They are great served alone or with a dip such as fat-free Ranch dressing.
• Fire up the grill. Vegetables taste great when grilled; cut vegetables such as zucchini, peppers, onions, tomatoes, mushrooms and squash into bite size pieces, spray them with some Pam and season with herbs and throw them on the grill. You can grill fruits too! Grilled pineapple and grilled peaches are a fun addition to any meal.
• Roasted vegetables have great flavor. Cut up vegetables, spray with some Pam or a little olive oil, season with herbs and roast in an oven at 425 degrees for 20-30 minutes.
• Add vegetables to other dishes such as soups, stir-frys, casseroles, omelets, and pasta sauces.

Take a trip to your local Farmer's Market for the freshest summer produce. Or take a trip to Whole Foods or Central Market and try a new fruit or vegetable that you've never had before.

Cynthia Dufresne, R.D.