I have frequently been accused of making my patients obese. Reports of patients eating almost no calories yet gaining or maintaining weight while on my medications is a daily event. In my defense, clinical practice has required keeping my knowledge of nutrition current since my college days at Cornell. So what has been my observation about weight loss? It appears that emotional eating is alive and well in my practice.

When quizzed, my patients often reveal that they have quirky diets or they eat too much and do not exercise. Consider my favorite question, “What did you have for breakfast yesterday?” Most often I am told that my patient does not believe in eating breakfast or had consumed coffee and a carbohydrate such as a bagel or toasted bread with butter. The bread selection was white, which has minimal nutritional value. Meanwhile, that same patient will complain of a lack of energy. Many of my patients are befuddled by the knowledge that the brain needs nutrition in order to function in the morning. Caffeine alone will not provide the carbohydrates, fats, and proteins required for optimum performance.

So what is the latest information in the weight loss world? The answer seems simple but may be very hard to do: write down the calories you consume during the day. A Kaiser Permanente study published in the American Journal of Preventive Medicine reports that participants who wrote down their daily food intake lost the most weight. Weight Watchers has been aware of this simple well known fact since their inception, requiring members to write down their intake for optimal results.

The Kaiser study included an ethnically diverse racial population of 1,685 people who were designated as obese or overweight at age 25 or older. It discovered that the most powerful predictor of weight loss was how many days per week diary entries were recorded. The author, Stevens, concluded that visualization of food intake allows for accountability and awareness of said intake.

What does this mean for you? Writing down everything you eat in a disciplined fashion requires determination as well as identification of a method that works for you. I have heard that some patients use colorful index cards placed in their pockets. Others have identified online sites for recording on the internet. Still others use pocket composition notebooks found at local office supply stores. Whatever method you use, just use it consistently in order to have the best weight loss success story.


http://www.mypyramidtracer.gov/

As a psychiatrist who treats adults, I have repeatedly noted that food habits are tough to change, but not impossible. Starting any plan to change your food relationship requires mood stability. The complexity of food and mood, in my opinion, requires emotional stability for successful negotiation with changing food patterns. If emotions are out of control with life stress, there are too many triggers for mindless eating.

Why is food so tricky? The happy hormone of serotonin, known for its calming effect, can be released by eating carbohydrates. So saying “no” to a quick emotional pick me up requires emotional will power. Also, the tongue can be sensitive to texture as well as content. At times, a desire for a crunch needs to be satisfied. So what does this mean for weight control? Reading the FDA’s nutrition facts label on every package is a good starting place.

First, portion size can be a problem. If you wait until you are starving when you eat, managing your portion size will be more difficult. With starvation status, the brain will signal your body to store fat. In storage mode, your body will hold onto your weight as a secure energy source. An easy way to learn portion size is to start by buying a couple of frozen low fat and low calorie entrees from the supermarket. Eat a couple to determine a portion size and then use the container as a guide for your home prepared meals.

Second, start to read the nutritional label on every food item. Look at the serving size on packaged food. Many times you might assume the package contains one serving when it is actually two. For instance, one bottle of soda may be two servings of food. You have to decide if 300 calories is worth it to you for one drink, especially if your total per meal is 500 calories.

Third, once you have determined your correct portion size, then check your low cost calorie fillers. Watch for food with added sugars such as sucrose, glucose, high fructose corn syrup and maple syrup. These all can provide added calories without nutritional content. Water is always the best thirst quencher, but if you would like something else like fruit juice or soda, be sure to read the label and decide if it is worth the calories. Also, certain salad dressings can add a lot of unnecessary calories when drenched on a salad.

Fourth, be careful of mindless eating. A Kaiser research study highlighted the importance of writing down daily food consumption and how keeping this written record increases the likelihood of sustaining weight loss. The Food and Drug Administration has created an interactive and multimedia website that has a variety of tools for weight management. A meal planner, tip for the day, and podcasts are some of the resources found on www.mypyramid.gov.

Fifth, input equals output. The President’s Council on Physical Fitness, http://www.fitness.gov/, provides guidance and exercise tools for all ages. Additional exercise tools can be found in the following two websites: www.health.gov/paguidelines/adultguide/default.aspy andhttp://www.presidentschallenge.org/. Eating, eating, and more eating without doing any exercise can promote weight gain. I have observed patients who are prescribed my psychiatric medication successfully lose weight. Common stories of weight lost after sustaining the mood stability required to negotiate emotional eating, portion control, sensible food selection, and physical activity is a frequent observation. Therefore there is hope! Patients can lose weight while taking prescribed psychiatric medication often known for weight gain. It appears that a common thread among these weight loss patients is mood stability and a willingness to change their relationship with food. This is America and anything is possible.