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October 2005 The joy of discovering that she did not need a diet. |
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September 2005 The problem of regaining after every weight loss attempt. |
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James, age 33, an office worker came to this practice because, as he said, "I can lose weight OK but it goes straight back on. How do I avoid regaining each time?" He said he lost weight using a diet and the gym, mainly treadmill and weights. Having achieved the weight he wanted was always followed by a loss of focus. He drifted away from correct food choices and from attending the gym. I said that a new approach could work.
True to his word James lost weight consistently. As he lost the weight we debated how to avoid regain. I mentioned to James that, in my experience, the motivation to keep up the exercise and dieting always wore out if weight loss was the only reason for the exercise. We stumbled upon his interest in photography. James suggested that upon losing the weight he would immediately go on that trip to New Zealand. He had long wanted to photograph the bays of the North Island.
This looked like a good plan. I suggested he also plan a trip after NZ, even if it was 6 months away, so that he had a reason for continuing attention to foods and the gym after the trip to NZ.
This turned out to be a pleasant task. James planned his next holiday - for 6 months later, to be in Canada in the Rockies, with his camera. He has not regained.
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| 3. |
August 2005 Needing to eat more often was one change he needed. |
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Kevin, age 38, came in complaining that he seemed to be doing all the right things but still he didn't lose weight. He said, "Why does my wife eat and drink more than me and not put on weight?"
Kevin clearly had a genetic tendency to weight gain. His wife Sarah, on the other hand, came from a long line of very slim people.
This didn't help Kevin. He couldn't change his parents. However, this knowledge did help to influence his weight loss routine.
Most of Kevin's habits were good. Two things looked like possible helpers. Kevin did skip meals and this lowers metabolic rate. Lowering metabolic rate was the last thing Kevin needed because it looked like he already had a genetic tendency towards lower metabolic rate. I explained to Kevin how difficult it is to change an established eating pattern. Like many men Kevin took this as a challenge and he worked hard at eating regularly - avoiding long gaps between meals. He also used Xenical to test whether the fatty foods were low enough for weight loss. He lost weight. He still curses his wife for her good luck but at least he is now losing weight.
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| 4. |
July 2005 Maintaining weight was easier than losing weight. |
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Libby, at age 62, had lost 8 kg but needed to lose another 12 kg. A heart attack made her get started on weight loss. She had taken 4 months to lose the 8 kg but had then stayed on that weight for another 4 months. When she first came to this office her question was, "I'm doing the same things now as when I lost the 8 kg. Why am I not losing weight?" I explained that this is a common story.
After 8-12 kg weight loss most people come to a plateau phase. Weight loss stops.
Libby was very frustrated. Explaining the reasons for the plateau eased her mind a little. But dropping out of weight control was a real risk for Libby, such was the frustration.
I explained to Libby that the good point was that she had demonstrated the ability to stay at the present weight; that she was not regaining. This might mean that she would find weight maintenance easier than weight loss.
Because Libby had high blood pressure and because of the recent heart attack, some medications for inducing weight loss were not suitable. I explained to Libby that one possible approach for her was the idea of combining several techniques, at the same time, and hoping that the weight loss happened.
It did. For 4 weeks Libby increased exercise by one session per week, quit alcohol entirely, reduced her main meal by about 20 % in size and increased water intake by an extra litre per day. She lost 3 kg. More importantly she was inspired to go on with weight loss and made more changes, on her own, to keep the weight loss going.
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