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Brandywine Family Medicine Blog

Obesity

Published 06.11.2021

Obesity is defined as a BMI, body mass index, greater than 30. This is calculated by your height and weight. You can find yours on the chart below or check your patient portal to find this. A normal BMI is up to 25, you are overweight between 26 and 30, you are obese if you are between 30 and 40, and morbidly obese if you are over 40 BMI. I struggle with obesity and know how difficult it can be, but everyone can lose weight. You have to eat less calories than you are burning off. If you are overweight you eat too much. Most women should eat between 1200 and 1500 calories a day and most men should eat between 1500 and 1800 calories a day if they are moderately active. If you do a lot of aerobic exercise you can consume more calories and stay at a healthy weight. Being obese is bad for your body, it increases your risk of cancer, heart disease, stroke, diabetes, arthritis in your back, hips, and knees, and depression. Sure there are skinny people out there who seem to be able to eat anything they want but usually they have a lot of nervous energy and never sit down either. Look at the cart of a thin person in the grocery store, usually there isn’t a lot of junk food in that cart. To lose weight you want to cut back on your calorie consumption by about 500 calories a day and increase your exercise so you burn an extra 300-500 calories a day. This will give you a weight loss of about two pounds per week.

Fad diets don’t work. Sure you can lose a lot of weight in a short time doing Atkins, keto, cabbage, or whatever the latest is but you tend to regain most if not all of the weight you lose when you go off of it. Keto diet is just not sustainable and if you don’t stick very closely with the very restrictive diet you can actually gain weight and make your cholesterol increase significantly. I have seen people have pretty big personality changes with keto diet, loose lots of hair, get gallbladder disease from the high fat content. Look at it as a lifestyle change that you are going to do for the rest of your life.

Over the 30 years I have been a doctor the people I have seen be most successful at long term weight loss have changed their lifestyle. They cut out junk food and eat healthier and increased their daily exercise in a way that they can maintain the new lifestyle for good. Just make it a goal to eat 5 servings and fruit and vegetables daily and everything else sort of falls in place. It is easier to have a positive goal than a negative one. Obviously, the vegetables can’t be roasted in olive oil and topped with parmesan cheese and bread crumbs and French fries do not count as vegetables. You can eat carrots and apples all day and not gain weight. I think we all know what we should be eating and not be eating, the bad stuff is just easier and tastier. Our portion sizes also need to be seriously decreased. We just can’t eat stuff topped with cheese and oil, or hunks of meat, or portions enough for two people.

You should use an 8-inch plate for food and there should be space between the different items on your plate. Roughly half the plate should be non starchy vegetables like carrots, squash, peas, green beans, onions, broccoli, asparagus, cauliflower, or spinach, a quarter protein like meat, fish, or eggs, or beans, and a quarter starch like bread, rice, pasta, corn or potatoes. Dessert should be plain fruit, not fruit pie or baked apples. A snack is a fruit or a serving of nuts.

When you are grocery shopping stop and look at your cart before getting in line. It should be about a 1/4 protein, 1/4 whole grains, and 1/2 fruit and vegetables. Put the junk back. Have a couple of treats in single serving packaging if possible so you don’t go insane. If it isn’t in the house you can’t eat it.

Don’t let someone sabotage you. If your partner keeps bringing home junk, you should start doing the shopping. Kids don’t need junk either. Be a good role model and teach them healthy eating.

Breakfast should be something like a bowl of cereal that has at least three grams of fiber per serving. Add fruit on top of the cereal and measure out what a serving looks like. A piece of toast and an egg, a bowl of oatmeal, or a yogurt, are all good choices.

Lunch can’t be a burger and fries, an 8 inch or more piece of sub, or a couple of pieces of pizza. You can have a burger alone with a non sugary drink, a four inch piece of sub or steak sandwich, or one piece of pizza.

Salads can be very deceiving. Iceberg lettuce has no nutritional value and doesn’t make something healthy. Salads that have greens like spinach and lots of veggies like red and green peppers, cucumbers, carrots, onion, or grilled chicken or fish are good. Salads that have cheese, croutons, nuts and seeds, breaded chicken or lunch meat on top are not. Small amounts of low fat dressing or oil and vinegar are ok but regular salad dressing like blue cheese, French, Italian, or regular balsamic are not. Commercial salads can easily have more fat and calories than a burger and fries.

If you need more help I recommend Weight Watchers. They are the best commercial plan. They teach you to make better choices long term and to work on exercise more. Yeah you can have the burger for dinner but you can’t have much the rest of the day to make up for it. It teaches you is that treat really worth it.

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