Doctor for Life Blog

Self-talk is the ongoing pitter-patter of thoughts running through your brain everyday. all of us keep a running dialogue with ourselves. Whether it's personal commentary, thoughts on life, the circumstances of your day, you are on control of your thoughts. Learn how you can change your outlook on life with positive thoughts that increase your self esteem. Positive self talk makes you feel good about yourself, it is an optimistic voice in your head that encourages you to look at the bright side, pick yourself up when you fall and recognize when you fail. Often, we take negative things people say to us and replay it in our heads over and over. We hear the message so often that we start to feel angry, fearful or even guilty. Common tendencies of people who fall in the negativity trap: a. You always foresee disaster. You’re Chicken Little: always expecting the worst. For example: You try on your jeans and they feel a bit snug. Rather than chalking it up to fluid shifts, you automatically assume you’ve plateaued on your weight loss plan and won’t lose any more weight, no matter how hard you try. b. You filter. You block out all of the positive elements of a situation. Meanwhile, you magnify the negative until it overwhelms you. For example: You had a great day on your medical weight loss plan. You ate healthily all day, took a walk after work, and drank lots of water. But then that evening you ate a cookie. At bedtime, all you can focus on is your lack of ‘willpower.’ You forget about all the great things you did and figure you should just throw in the towel. c. You make it personal. You always place blame on yourself when something bad happens. For example: When your exercise buddy cancels on you two weeks in a row, you assume it’s because she doesn’t like you. d. You see only black and white. Ms. (or Mr.) Perfect. Things can only be ‘good’ or ‘bad’ to you, with no happy medium. If you’re not perfect, that means you're a total failure. For example: you set a goal of losing 8 pounds per month. When one month you lose only 7 pounds, you berate yourself and become even stricter with your eating and exercise to get back into the ‘perfect’ category. Here's how to turn negative self talk into positive self talk: Negative Self Talk Positive self talk "I’ve never been able to lose 50 lbs" to "This is a new weight loss plan and an opportunity to learn and develop new skills" "I’ve failed at staying away from sweets" to "I’ll give it another try" "This recipe is too complicated to follow" to " I’ll see if my husband and I can work together on it" "I’m too lazy to exercise" to " I wasn't able to fit it into my schedule but will work on making it a top priority " "It’s too radical a change in my eating habits" to "I’ve never try this kind of change, and I’m giving it a chance " 'I’m a total failure" to "Like everyone else, there are areas of my life that are working well and others I’m working on changing " Your thoughts can make or break you, and the objective here is to make your self-talk as positive as possible. Research shows positive thinking can actually ‘rewire’ your brain, making you more optimistic and helping prevent depression. This in turn can help you stay more focused and positive on your medical weight loss program. Therefore, loving or hating the life you are living is solely all in your repeated self talk!

It's weekend and you've worked hard, you deserve a break! It may be tempting to lounge on the couch but healthy weekend activity and eating is equally as important as weekdays. Eating healthy Monday through Friday is easy. You’re on a schedule, motivated, determined, and have few distractions. But on weekends your weight loss plan is put to the test, especially if you go out to dinner. Before you know it, you find yourself indulging in the bread basket, a few glasses of wine, and maybe even a decadent dessert. That work week discipline seems to have disappeared! You’re not alone. A study published in the journal Obesity found people who stuck with a strict diet all week, then overindulged on the weekends, not only lost weight slowly, but actually gained an average of nine pounds per year. You don’t have to fall into the trap. You just need to be in the right mindset. Ways to indulge the healthy way during weekends: Get Outside: Work schedules don’t allow you to see much daylight during the week, so you have to take advantage of the opportunity on the weekends. Studies show connecting with nature makes you happier and even motivates you to move. Taking a walk, riding your bike, or going on a hike to connect with nature’s greens is a great way to clear your head. It literally takes your mind off food and gives your body much-needed exercise. Limit Liquid Calories: It’s easy to down an entire bottle of wine or indulge in a few too many cocktails after a long week, but this weekend eating habit can pack on the pounds. One five-ounce glass of wine has about 125 calories, and if you finish the bottle it’s like eating a whole meal. It’s OK to treat yourself, but try to keep the cocktails to one glass. Eat out, but eat smart: Going out for a meal is great way to reconnect with family and friends, and it can be a part of your weight loss plan by making sensible decisions. If you can’t resist the bread basket, don’t ask for a refill, or ask not to have it brought to the table at all. If you show up to a restaurant ravenous, you’re going to eat the first thing in sight, so plan ahead by having a healthy snack, like a piece of fruit, before you leave. You should also have an idea of what you’re going to order, so you don’t make a last-minute, fattening decision. Use it as time to meal prep: Cook on the weekend, eat for the week. Use your extra time to try a new, healthy recipe. Make the recipes, then double them to have leftovers during the week. You’ll avoid the temptation of fattening restaurant dishes all together, and you won’t have to hit the fast-food joints on days you have to work late the following week. It’s a win-win. Be social: If you’re at party, don’t focus on food. Focus on socializing. It’s hard to eat when you’re running your mouth. Use the time to catch up with a friend you haven’t seen in a while or make a new friend. It’s the real reason you came to the party in the first place. Stick to your schedule: It’s tempting to sleep in, but rising at the same time on the weekend will make it easier to stick with your traditional eating schedule. Try to eat three meals a day, just like you would during the week, to avoid overindulging at dinner. Think about it: You feel great during the week, so why would you change your weekend eating plan? Splurge: That’s right. After a long week you deserve a treat—it doesn’t have to be edible. Go shopping for a new outfit, book a massage, or see a movie instead of eating a bag of chips or an entire cake. You won’t regret your splurge, and you’ll keep your weekend eating on weight loss track.

If you’ve found losing weight to be an uphill battle, then it’s time to break the psychological cycle that may be holding you back from your goal. It’s a fact that accomplishing any goal, large or small, requires a mind that is clearly focused on the desired end. The Psychological Cycle of Weight Gain Social stigma: In a world where thin is a fad, it’s not unusual for people who are overweight to carry the burden of lower self-esteem. Add to that the social stigma or prejudice that overweight individuals encounter and a psychological cycle for weight gain can be set in motion, or unhealthy eating disorders (bulimia, anorexia) can develop. Stress: People, overweight as well as thin, often eat in response to stress, depression, loneliness, and anxiety. This stress-induced or emotional eating can lead to weight gain which in turn leads to lower self-esteem, depression, and anxiety, which leads to more stress-based eating and additional weight gain. Inactivity: Compounding the problem is the fact that individuals who are overweight have less energy, and therefore find it harder to be active, so the risk of gaining weight again increases. A cycle of inactivity and further weight gain can develop: the less active person gains weight and so becomes less active, thereby gaining more weight and so on. Also, life stresses, which are normally alleviated through exercise, start building up, which triggers more stress-based eating. Mental Health: Individuals who try to lose weight and fail may feel depressed, frustrated, and even guilty or ashamed, and may rely on comfort foods as a way to feel better. The same is true of those who succeed in losing weight, only to gain it back. Anxiety, depression, and guilt can produce a feeling of hopelessness that hinders efforts to lose weight. Seven Steps to Breaking the Cycle 1. Allow yourself small indulgences that are satisfying and will help you avoid harmful binging. Stop Diet Deprivation. Diets that put severe restrictions on what you can eat often arouse binge eating. While you may hold out for a while, one day you’ll decide depriving yourself is not worth it, or you can’t take it anymore, and you dig into the refrigerator, freezer, or snack cabinet with a vengeance. 2. The best way to avoid slipping is through pre-planning. Plan Ahead. So, if you’re off to a backyard barbeque or family gathering, decide ahead of time what your plan is. Eat something healthy and filling before you go out and then allow yourself a few special treats at the party, but exercise portion control. If you know that Aunt Mary is making your favorite dessert, plan on having a small slice and savor it. Managing your weight and enjoying life should go hand in hand. 3. Slow but sure is the best approach. Set Realistic Weight Loss Goals. To avoid the frustration of failing, don’t overstress yourself with unrealistic weight loss goals. You gained weight slowly over time and it will take some time to gradually lose that weight. 4. Choose Healthy Outlets for Emotions. Instead of opening the refrigerator when you’re upset, try phoning a friend or taking a walk instead. Discover something that makes you feel calmer or happier – something other than food or alcohol. Do yoga, dance around your living room, meditate, or go out bowling with a friend. 5. Work through issues that are upsetting you. Stop Harboring Hurts. Know your triggers. Talk to a therapist or even a friend. Don’t let hurts, old wounds, or patterns that reach back into your childhood affect you and your relationship with food. 6. Keeping the goal in mind is critical to your weight loss success. Remember Why You’re Dieting. It helps to stop and remember why you’re dieting in the first place. Is it to have more energy, look and feel better, alleviate health problems, or increase your self esteem? 7. It’s all in YOU. The power to lose the weight rests with you. Use Your Mind to Break the Cycle. Believe you can succeed and you will succeed. Start by turning all of your negative self talk into positive affirmations. Instead of saying: “Look at that fat belly. It just won’t go away.” Think positive: “Yes, my belly is fat now, but it won’t always be. I plan to be fit, not fat. I’m heading to the gym after work today.”

According to the American Psychological Association STRESS is the #1 reason goals are not accomplished and positive change is not achieved. Believing that stress is bad for you is the 15th largest cause of death in the United States last year, killing more people than skin cancer, HIV/AIDS and homicide… People who experienced a lot of stress in the previous year had a 43 percent increased risk of dying. But that was only true for the people who also believed that stress is harmful for your health. People who experienced a lot of stress but did not view stress as harmful were no more likely to die, they had the lowest risk of dying of anyone in the study, including people who had relatively little stress. The power of positive thinking goes beyond helping you lose weight, too. Studies show that negative thinking can depress your immune system and increase stress, which negatively impacts your health and well-being. And being stressed or sick certainly doesn’t make losing weight easier! Symptoms of stress can be a good sign... Your heart might be pounding, you might be breathing faster, your heart rate goes up, and your blood vessels constrict, and you maybe breaking out into a sweat. And normally, we interpret these physical changes as anxiety or signs that we aren't coping very well with the pressure. And this is one of the reasons that chronic stress is sometimes associated with cardiovascular disease. It's not really healthy to be in this state all the time. But in the study, when participants viewed their stress response as helpful, their blood vessels stayed relaxed. Their heart was still pounding, but this is a much healthier cardiovascular profile. It actually looks a lot like what happens in moments of joy and courage. Over a lifetime of stressful experiences, this one biological change could be the difference between a stress-induced heart attack at age 50 and living well into your 90s. And this is really what the new science of stress reveals, that how you think about stress matters. The next time your heart is pounding from stress, you're going to think to yourself, this is my body helping me rise to this challenge. If you viewed them instead as signs that your body was energized, it’s preparing you to meet this challenge. Now that is exactly what participants were told in a study conducted at Harvard University. Before they went through the social stress test, they were taught to rethink their stress response as helpful. That pounding heart is preparing you for action. If you're breathing faster, it's no problem. It's getting more oxygen to your brain. And participants who learned to view the stress response as helpful for their performance, well, they were less stressed out, less anxious, more confident, but the most fascinating finding to me was how their physical stress response changed. Can changing how you think about stress make you healthier? When you change your mind about stress, you can change your body's response to stress. For every major stressful life experience, like financial difficulties or family crisis, that increased the risk of dying by 30 percent. But -- that wasn't true for everyone. People who spent time caring for others showed absolutely no stress-related increase in dying. Zero. Caring created resilience... Chasing meaning is better for your health than trying to avoid discomfort. One of the most under-appreciated aspects of the stress response, and the idea is this: Stress makes you social. The Feel Good Stress Hormone Oxytocin is a stress hormone like Adrenaline. It fine-tunes your brain's social instincts. It primes you to do things that strengthen close relationships. Oxytocin makes you crave physical contact with your friends and family. It enhances your empathy. It even makes you more willing to help and support the people you care about, to become more compassionate and caring. It also acts on your body, and one of its main roles in your body is to protect your cardiovascular system from the effects of stress. It's a natural anti-inflammatory. It also helps your blood vessels stay relaxed during stress. Your heart has receptors for this hormone, and oxytocin helps heart cells regenerate and heal from any stress-induced damage. This stress hormone strengthens your heart. And the cool thing is that all of these physical benefits of oxytocin are enhanced by social contact and social support. So when you reach out to others under stress, either to seek support or to help someone else, you release more of this hormone, your stress response becomes healthier, and you actually recover faster from stress. Your stress response has a built-in mechanism for stress resilience, and that mechanism is human connection. The best way to make decisions, is go after what it is that creates meaning in your life and then trust yourself to handle the stress that follows. The harmful effects of stress on your health are not inevitable. How you think and how you act can transform your experience of stress. When you choose to view your stress response as helpful, you create the biology of courage. And when you choose to connect with others under stress, you can create resilience. Stress gives us access to our hearts. The compassionate heart that finds joy and meaning in connecting with others, and yes, your pounding physical heart, working so hard to give you strength and energy. And when you choose to view stress in this way, you're not just getting better at stress, you're actually making a pretty profound statement. a belief about stress can make so much difference to someone's life expectancy. You can trust yourself to handle life's challenges. And you're remembering that you don't have to face them alone.

The hunger hormone Ghrelin, is a hormone with a somewhat scary sounding name, but it is all too fitting. Ghrelin, known as the “hunger hormone,” can act as a real gremlin to your weight loss efforts. But there are ways to beat it at its own game with basic lifestyle changes The role of ghrelin is simple. It travels from the stomach to the brain to stimulate feeling of hunger. On its surface this makes sense. Everyone needs food to live. Food gives us energy and vitality to do the things we need and want to accomplish. However, the darker side of ghrelin is that it slows down metabolism, strains the body’s ability to burn fat and promotes the storage of fat in the abdominal are (the dreaded and dangerous belly fat). To top it all off, the more we weigh, the more susceptible we are to ghrelin’s influence by craving high-fat, unhealthy foods. And it is even the cause of that scary stomach growling when we are hungry! This hormone is just plain frustrating. Here are some ways to reduce the production and release of ghrelin to control your appetite: 1. Eat Protein and (Healthy) Carbs. Ghrelin is suppressed when food is in the stomach. Protein and healthy carbs rich in fiber and nutrients take longer to digest, naturally suppressing ghrelin better than any other type of food. This means you won’t get hungry as quickly and you’ll probably eat less. - If you’re hungry in less than 2 hours after your last meal, it meant you didn’t eat enough of proteins - If you’re still full more than 2 hours since your last meal, it meant you ate too much proteins - If you’re hungry in about 2 hours since your last meal your portions are just right. 2. Increase Activity. Exercise can be a useful tool in appetite control. A study published in the American Journal of Physiology found that 60 minutes of aerobic exercise suppressed appetite and lowered ghrelin levels. 3. Get your sleep! If you are sleep deprived, chances are you may feel hungrier than if you had a full night’s sleep. A sleep study published in PLOS Medicine found that participants getting five hours of sleep or less produced 15 percent less leptin (the “stop eating food” hormone), and over 15 percent more ghrelin. If you are really having a difficult time with controlling hunger, you may want to speak to your medical provider about a prescription for an appetite suppressant. But it should be noted that appetite suppressants are most impactful only in the initial stages of weight loss. They lose their potency over time and are not meant for long-term use. And of course, they should always be administered and monitored by a trained medical professional. So take that ghrelin! You’re not so frightening after all!

Food addiction is real, and it's negatively affecting your health. Why we eat? 1. Eating that promotes Homeostasis or balance 2. Eating for pleasure 3. Eating is a decision New brain research is revealing why fats and sugars may be driving more and more people toward obesity. New science shows that overeating is not a behavioral disorder, such as a lack of self-control. Instead foods rich in fat and sugar can supercharge the brain's reward system, and is caused by a hormonal imbalance which can overpower the brain's ability to tell an individual to stop eating. In these cases, the more someone eats, the more he or she wants. Sodas and Doritos: The single greatest source of added sugar in the American diet is from soda and fats is from processed foods. The sound of cracking opens a can of soda. The fizz. The sugar. The caffeine. The refreshing taste on a hot day. The sound of crackling opening a bag. The crunch. The saltiness and the full texture of fats in your mouth. The description of it alone makes us want to run to the closest convenience store and demand some “liquid candy,” or some "white powder", but that’s not the point. The point is the addiction to ultra processed food is real, and it’s affecting your health, so it’s time to break the addiction. Just imagine how many calories you’ll save! Eating for Pleasure: Obesity may be caused by hedonic overeating that hijacks the brain's reward networks. Like addictive drugs, overeating creates a feedback loop in the brain's reward centers—the more you consume, the more you crave, and the harder it is for you to satisfy that craving. Hedonic overeating can induce a drug-dependence-like state. Morphine and other opiates mimic the effects of neurotransmitters (brain chemicals) such as endorphins that are naturally produced in the brain to stimulate feeding behaviors. Hedonistic Food Behaviors: Food dense in fat and sugar and often visually appealing—affect reward systems strongly enough to override the appetite-suppressing hormones, thus promoting us to overeat. We have evolved an efficient brain system to help maintain a healthy and consistent body weight by signaling when it is time to eat and when it is time to stop. But highly appetizing foods can often override these signals and drive weight gain. Experimental rats eating the bland chow would quickly stop and scramble away, but the obese rats continued to devour the rich food, ignoring the warning they had been trained to fear. Their hedonic desire overruled their basic sense of self-preservation. FOOD ADDICTION VERSUS FOOD DEPENDENCE Until the early 1990s, society viewed obesity solely as a behavioral disorder: overweight individuals lacked willpower and self-control. This cycle of engaging in a bad habit that gives short-term pleasure, then attempting to abstain from it and eventually relapsing, sounds disturbingly like drug addiction. A hormonal imbalance could lead to overeating; indeed, obesity runs rampant in certain human families that have a genetic deficiency in leptin. The appetite suppressing hormones become progressively less effective as the body develops tolerance to their actions. The hormonal and metabolic disturbances in obese individuals may be a consequence of weight gain rather than a cause. If obese individuals must eat more and more to overcome reduced activation of reward networks in the brain, that sounds a lot like tolerance. And weight loss can trigger negative mood and depression, much like that experienced by former addicts who try to practice abstinence, suggesting that withdrawal may be in effect. Other experts have argued that the entire notion of food addiction is preposterous because we are all, in a sense, addicted to food. If we were not, we would not survive. The 5 Rs - Reduce, Replace, Remove, Record, Reflect: > Reduce. Slowly wean yourself off. If you’re downing five cans of soda a day, breaking your soda addiction won’t happen overnight. A study published in the European Journal of Social Psychology found it takes 66 days to form a new habit. Start by weaning yourself off in small increments, say, one less soda per week. Replace that soda with nature’s finest: H2O. Stay focused, remind yourself how much your body will thank you, and watch your soda addiction fade. > Replace. Make substitutions. Soda isn’t the only tasty beverage on the market. In fact, you can get your fizz fix without gulping down liquid calories. Try carbonated water with a splash of orange or cranberry juice for natural sweetener or an iced tea with freshly squeezed lemon. > Remove. Stay away from diet soda. Just because the nutrition label says zero calories doesn’t mean it’s off the hook. The sugar-free stuff comes with its own set of side effects you don’t want to mess with, including an out of whack metabolism, weight gain, diabetes, and stroke. You have to ask yourself, “Why are there so many ingredients but so few calories?” To really kick your soda addiction to the curb you have to wean yourself off all versions of the caramel-colored bubbles. > Record. Write down your habits. Journaling isn’t just for food. Keep a record of each soda you drink and how many calories you’re consuming. Seeing the numbers may make it easier for you to say no. (Think about what you could eat for 500 calories!) Keeping a soda log will help you recognize when you crave your fix and force you to be mindful when you guzzle the sugary stuff. > Reflect. Determine what sparks your craving. Knowing your triggers is key to breaking your soda addiction. Are you stressed? Bored? Sleepy? Thirsty? Your triggers will help you determine a healthier alternative. If you’re stressed, go for a walk. Tired; opt for tea. Thirsty; your body is craving water. Bored; ask your boss if you can help with a new assignment. Pharmacotherapy: As with alcoholics and drug addicts, the more they eat, the more they want. Whether or not overeating is technically an addiction, if it stimulates the same brain circuits as drug use, in the same way, then medications that dial down the reward system could help obese people to eat less. These new generations of drugs are safe and FDA approved for long-term use.

How Lack of Sleep impacts your Health? For some, people wear it as a badge of honor that they can get by on not enough sleep. But many people say they can’t get enough sleep because they’re too busy and need to get too many things done. Others are sleep-deprived for a medical reason – they may have sleep apnea, a condition where the muscles in the back of the throat close up at night when they’re sleeping and the body gets deprived of oxygen temporarily. This causes someone to wake up gasping for air, sometimes five or six times a minute. Not only will this make the person more tired and possibly lead to weight gain, but it also increases risk of cancer and other diseases. This is because the body does not get the chance to go into the deeper sleep called REM (rapid eye movement), when the immune system can do surveillance and destroy cells that may lead to cancer. Sleep deprivation can cause people to develop metabolic syndrome, a cluster of conditions that may include insulin resistance, hypertension, morbid obesity and hyperlipidemia. Poor sleep is linked to diseases like Alzheimer's, cardiovascular disease, stroke and diabetes. And if you go untreated with a sleep disorder like sleep apnea, you're more likely to get many of these illnesses. This all adds up to a real health crisis. Did you know about sleep's impact on your mental states? Poor sleep makes us make risky, rash decisions and is a drain on our capacity for empathy. When sleep deprivation literally makes us more sensitive to our own pain, it's not so surprising that we have a hard time relating to others and just generally being a good and healthy person when we're sleep-deprived. Quality of sleep: Many scientists believe the most regenerative stage of sleep is deep sleep. There are three stages of sleep: light sleep, rapid eye movement or REM and deep sleep. In light sleep and REM, our brain waves are very similar to our brain waves in waking life. But our brain waves in deep sleep have these long-burst brain waves that are very different from our waking life brain waves. These long-burst brain waves are called delta waves. When we don't get the deep sleep we need, it inhibits our ability to learn and for our cells and bodies to recover. Deep sleep is how we convert all those interactions that we make during the day into our long-term memory and personalities. As we get older, we're more likely to lose these regenerative delta waves. So in way, deep sleep and delta waves are actually a marker for biological youth. Optimal sleeping time: Studies show that people who don’t get at least seven hours of sleep a night put themselves at higher risk of developing insulin resistance and tend to weigh more than people who get more sleep. For example, the Quebec Family Study published in the journal Sleep in April 2008 showed that study participants who slept for 5-6 hours a night gained 88 percent more weight over six years than people who slept seven to eight hours a night. Interestingly, the people who slept more than 9 hours a night also gained 71 percent more weight, enough to suggest there may be an optimal sleeping time to prevent obesity. Why would this be? There are several possible reasons: • Getting an adequate amount of sleep puts the body into a better hormonal balance. • People crave carbs if they don’t sleep well at night and overconsumption can lead to excess weight. • Not getting enough sleep can make people too tired to exercise. What if you can make your sleep more efficient?: • Stick to a sleep schedule. Try to go to bed and get up at around the same time every day, even on weekends. This can help you fall asleep more easily at night. • Don’t eat or drink large amounts before bedtime. Try not to eat within two hours of sleep. If you often have heartburn, avoid spicy or fatty foods that could affect the quality of your sleep. • Get regular exercise. Aerobic exercise can help you fall asleep faster and have a more restful sleep. Just be sure to avoid exercise within two hours of going to bed. • Use bedtime only for sleep and sex. Avoid working or watching the news, movies while in bed • Start a relaxing bedtime routine. Do the same things each night to let your body know it’s time to wind down. This could include reading a book, listening to music, sound waves or taking a warm bath or shower 90 minutes before you go to bed. • Stimulants e.g alcohol and nicotine, even some of your medicines may affect your sleep . Try switching the times when you take these. If you’re sleeping at least eight hours a night and still feel fatigued, talk to your doctor about being tested for sleep apnea – an overnight sleep study is the best way to diagnose this condition. At Doctor for Life, sleep medicines are also prescribed but only if necessary.

A person whose weight is higher than what is considered as a normal weight adjusted for height is described as being overweight or having obesity. BMI is related to the amount of fat in their bodies, which can raise the risk of many health problems. Fast Facts: According to data from the National Health and Nutrition Examination Survey (NHANES), 2013 More than 1 in 3 adults were considered to be overweight. More than 2 in 3 adults were considered to be overweight or have obesity. More than 1 in 3 adults were considered to have obesity. About 1 in 13 adults were considered to have extreme obesity. About 1 in 6 children and adolescents ages 2 to 19 were considered to have obesity. Weight management could be beneficial to all people with obesity irrespective of their metabolic profile. The term "Metabolically Healthy Obesity" is defined as having a BMI of at least 30 and at least 4-6 metabolically healthy criteria: blood pressure, C-reactive protein, triglycerides, LDL, HDL and A1c. They are not actually healthy. Obesity is pandemic in proportion. It is a chronic disease which requires lifelong treatment. It is It is driven by pathophysiologic processes. Obesity, like Diabetes is also never "cured," although a patient's body mass index (BMI) can be under excellent control. Patients still have the disease of obesity, even though they no longer meet the definition of obesity due to metabolic abnormalities. Obesity carries substantial adverse health risks - diabetes, atherosclerotic cardiovascular disease, heart failure and respiratory diseases. UNDERSTANDING OBESITY: Common Myth: a. Weight loss is as simple as balancing the calories input and output, unfortunately, this is incorrect. b. Weight loss is more than just a diet, this is correct The central nervous system regulates a person’s weight, with many variables in play. Just because a person eats lean proteins, whole grains, fruits and vegetables doesn’t necessarily mean they will have a lean body. Physical activity alone, meanwhile does more to help patients maintain weight than to lose it. Sleep habits, sleep quality and duration can affect the body’s weight regulation. There are medications that cause weight gain and might be also interfering with your sleep. KNOW YOUR RISKS: Factors that may contribute to weight gain among adults and youth include genes, eating habits, physical inactivity, TV, computer, phone, and other screen time, sleep habits, medical conditions or medications, and where and how people live, including their access to healthy foods and safe places to be active. a. External Factors-- Hyperactivity to environmental food cues, Delayed satiety, Disordered eating b. Internal Factors-- Gut microbiota can decrease energy expenditure, Thermogenesis ,Physical disabilities c. Combination of Factors – Genetics, Epigenetics, Age related changes – menopause, Mood disturbances – depression/anxiety d. Factors that increase intake-- Environmental and chemical toxins, Sedentary time, Labor saving devices e. Increase Intake and decrease expenditures-- Stress, weight cycling, maternal/paternal obesity – 50-85% likelihood even when optimal behaviors adopted FOUR PILLARS OF TREATMENT: Treatment for obesity usually takes a graduated approach Lifestyle modification (diet and exercise) ---pharmacotherapy ---metabolic and or bariatric surgery @ Doctor for Life, we use strategies that lower energy density that are flexible and can be applied to a multiple dietary patterns to met our patients’ individual energy needs, taste preferences, and cultural background

What can we expect our kids to learn if their diets are full of sugar and empty of nutrients? What can they possibly learn if their bodies are literally going hungry? Are we really setting our kids up for success? WHAT CONNECTS A CHILD’S GROWING MIND AND THEIR GROWING BODY? Food is that place where our collective efforts can have the greatest impact. One in six Americans are food insecure, including 16 million children -- almost 20 percent. Diet and nutrition is the number one cause of preventable death and disease in this country, by far. And fully a third of the kids are on track to have diabetes in their lifetime. So they fill up on the unhealthy and cheap calories that surround them that their families can afford. By the end of the month, food stamps run out or hours get cut at work, and they don't have the money to cover the basic cost of food. CHANGING MENUS AT SCHOOL CAFETERIAS Research shows that when kids have a consistent, nutritious breakfast at school, their chances of graduating increase by 20 percent. Increase in math and reading scores by 17.5 percent. When we give our kids the nourishment they need, we give them the chance to thrive, both in the classroom and beyond. A school that serves a nutritious breakfast to all of their kids, one with fruit and milk, one lower in sugar and salt will have kids: - a lower rate of obesity than the average kid - visit the nurse less - lower levels of anxiety and depression - better behavior - better attendance - show up on time more often - much better health than the average school kid - not feeling hungry. Those who doesn't have a nutritious breakfast waiting? - lower math and reading scores - it's more likely will have to have repeated a grade - have poor cognitive function overall By changing the school menu, a football team (the Bears) not only won their division, they went on to win the state championship, beating their opponent (Peach County Trojans) 28-14. A HEALTHY FUTURE If we focus on the simple goal of properly nourishing ourselves, we could see a world that is more stable and secure; we could dramatically improve our economic productivity; we could transform our health care and we could go a long way in ensuring that the Earth can provide for generations to come. Resource: Sam Kass, White House Senior Policy Advisor for Nutrition