Solving the different behaviors that lead to obesity

All kinds of behaviors can have an effect on your weight, and the solution to each is different.

Maybe portion size is your biggest issue. Maybe it’s hard to get moving, even though you know you need to get some exercise. Maybe you have a sweet tooth that you can’t shake. Maybe you’re completely stressed out, and you never get a decent night’s sleep. Maybe you are a nighttime snacker. Or maybe it’s some combination of these.

How do you know which of these applies to you? Be honest with yourself. Check the ingredient list of everything you eat, and keep a log for a week. Can you actually say that there is very little sugar or virtually no corn syrup in your diet? It may be hard to believe, but it’s in yogurt, breads, ice cream, salad dressings, sodas and sports drinks, muffins, non-dairy coffee whiteners, and even some kinds of dark chocolate. If you’re doing a fairly good job avoiding it, then it’s not number one. But maybe it’s number two. I have no problem with a treat now and then, but I want to know when I choose it, and I don’t want to eat “hidden sugar.” It spikes your insulin levels, packs on the fat, and makes you crave more.

American portions are out of control, and not just yours. Bagels have tripled in size since the 1960s. There’s always room for dessert. You can get a bucket of soda for ten cents more, so why wouldn’t you? Just super size me, you know? But I don’t want people to feel hungry, or denied. Eating well and being satisfied are synonymous. Luckily, there are good solutions to hunger, and they are called fiber, fat, and protein. Fruits and vegetables and beans are delicious and filling. Fat is flavorful and satisfying. Protein keeps you going.

Exercising your right to free speech more than anything else? Getting exercise can be difficult, but it’s not impossible. First, remove as many obstacles as possible: Sleep in your T shirt and shorts, and put the gym shoes by your bed so you have to step over them to get up. Ride an exercise bike at home instead of having to drive to the gym. Commit to meet a friend and walk together, so you don’t keep one another waiting. Secondly, reward yourself, with a chart and gold stars if necessary, and then redeem those gold stars for something you’ve been dreaming about. Think about what it will take to get you moving, and do whatever it takes. Make it worth your while. If your knees bother you, then take a Tylenol beforehand. As I tell my patients, “I’ll pay any price to keep you mobile.”

On a scale of one (always relaxed and focused) to ten (frighteningly freaked out and finding it hard to think), how stressed out are you most of the time? Know that a very important part of being healthy is relaxation, in both daytime and nighttime. If you rate your stress level almost always as lower than four, keep up the good work, and continue to work on protecting your relaxation time. If it’s higher than four, you may find that walking helps, or meditation, or yoga, or talking about it with friends. If your stress level is higher than six, you may want to schedule an appointment to talk about it with your doctor. Your doctor should be able to refer you to a professional with expertise in stress management.

If you’re having difficulty sleeping, learn about “sleep hygiene” and see if you are doing something that is actually making it worse. Are you finding it hard to fall asleep because you can’t turn off your mind? Do you wake up in the early morning hours and have difficulty returning to sleep? Maybe you aren’t getting enough sleep, period. Any of these can derail weight loss efforts.

Have you been eating a big bowl of cereal before you go to bed? A peanut butter sandwich or a candy bar? That’s a problem. Start working on this issue by trying to eat a bigger breakfast and lunch, thereby getting in more calories earlier in the day. You may still want a nighttime snack, but it can be a healthier one. Eat berries, for example, which are sweet and satisfying, but low in practically everything else (except fiber).

See how these apply to you, and start thinking about the one that resonates most with you. One step at a time, one day at a time, one issue at a time. I don’t believe in quick fixes. I believe in slow, sustainable progress, so that someday you can say, “Wow, I really eat differently than I used to.”

Roxanne Sukol is an internal medicine physician who blogs at Your Health is on Your Plate.

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