What Kind of Dieter Are You?

If you’ve failed at dieting and weight-loss programs, the cause may be your personality and not the kind of diet you’ve tried. Which one of these diet personalities fits you?

The All-or-Nothing Dieter

The All-or-Nothing dieter doesn’t believe in moderation – he can either have something or not, not even a small portion or a taste. This extreme thinking can be dangerous, and often sets the person up for a binge on the “forbidden foods.” One slip is all it takes for this dieter to deem himself a failure.

Ideas for Change

Even dieters can treat themselves every once in awhile.  Portion control is the key as is selecting the low fat version of your favorite treat.

The Instant Gratification Dieter

This dieter is gung ho…for about a week. She spends hours at the gym, eats only salad, and wants one thing: To fit into a dress or look good for an event. This dieter is setting herself up for failure too, as it is difficult to maintain this kind of momentum for the long term.

Ideas for Change

Make changes you can stick with. Be realistic as weight loss takes time.

The “Perfect” Dieter

This dieter has a clear image of everything he has eaten all day – and all of it is good. He  “forgets” the chocolate nibbled on after dinner, “doesn’t count” the dressing used on the very, healthy salad, and “loses” his food journal. But he steps on the scale, and can’t figure out why he is not losing weight.

Ideas for Change

Research shows keeping a food diary, either paper or electronic is a must to help you achieve your weight loss goals.

The Realist

The realist dieter knows what she’s doing. She tracks her food – even if she makes less-than-nutritious food choices. She is prepared; her pantry is filled with whole grain snacks, and her refrigerator is filled with fruits and vegetables. She is honest, and accepts the fact that weight loss is a slow process, and a lifelong learning experience.

Ideas for Change

You’ve got it!  Continue to practice mindful eating.  Make exercise a part of your routine.

What kind of dieter are you?

Learn more about how Penn can help you meet your weight-loss goals. Join us for a free information session about weight-loss surgery at Penn. 

Are You a Binge Eater?

David Sarwer, PhD, director of clinical services at the Center for Weight and Eating Disorders and member of the Penn Metabolic and Bariatric Surgery team, explains binge eating.

It seems simple. You want to lose weight. You stick with your meal plan, exercise and drink plenty of water. Then, when you get home from work, you have an uncontrollable urge to eat everything in sight. You give in and before you know it, you’ve eaten an entire bag of chips and a box of cookies.

You might claim it’s a rare occurrence, but the fact is that this happens at least a couple of times each week. You feel hopeless and ashamed, however, you are not alone.

While most people overeat from time to time, binge eating — as it is called — affects a large number of people. Triggered by anything from stress to sadness, or even happiness, binge eaters usually try to maintain an appearance of healthy eating. But, when they are alone, they begin eating all the things they’ve been denying themselves – and sometimes, cannot stop until they have a “food high” or even pass out.

Most people will overeat from time to time. The difference between binge eating and overeating is that many binge eaters use food to help them deal with feelings of anxiety, sadness or loneliness.

Signs of binge eating 

Here are some common symptoms of someone with a binge eating disorder:

• Eats large amounts of food when not physically hungry. 
• Eats much faster than normal. 
• Eats until the point of feeling uncomfortably full. 
• Often eats alone because of shame or embarrassment. 
• Has feelings of depression, disgust, or guilt after eating. 
• Has a history of marked weight fluctuations. 

When we are working with individuals who binge eat, we first try to help them eat appropriate sized meals and snacks throughout the day and so they don’t become overly hungry. Once we help normalize their eating behaviors, we often address the underlying emotional issues that trigger the binge eating and help individuals find a more appropriate way to deal with those emotions.

Before someone has weight-loss surgery at Penn, they go through a complete psychological evaluation that looks for the presence of emotional eating as well as binge eating. Someone with an untreated binge eating disorder is thought to be at increased risk to gain back the weight they lose through surgery.

Penn also has weight-loss surgery support groups to help those who have had bariatric surgery at Penn stay on track and continue to lead healthy lifestyles.

Penn Can Help

If you’d like more information about weight-loss surgery at Penn, please join a free information session to learn more about how Penn can help you lose weight and get control over binge eating.

Can Facebook Help You Lose Weight?

For many people, dieting can be isolating. They feel like they are the only ones who are being deprived of their favorite foods. They may even avoid social situations for fear they will indulge in too much food or drink.

But for some dieters, websites like Facebook and Twitter may provide outlets of support from family, friends, professionals and even strangers who are having the same experience.

Today more and more people are sharing everything on line – from births and new jobs, to what they had for breakfast and what they did for exercise.

“It’s very motivating for people to share what they are doing to keep on track,” says Gary Korus, MD, FACS, bariatric surgeon at Penn Medicine. “Many people start blogs to chronicle their weight-loss journey and build a support system for themselves in the process.”

Bloggers are doing more than sharing tips and weight-loss success stories – they are opening themselves up and connecting with other people who share the same struggles.

“Weight-loss bloggers are gaining support from their readers, and they are also inspiring others to lead a healthier lifestyle,” says Dr. Korus. “As a friend or a fan, when you see someone blogging about their weight loss, or posting a comment about their exercise routine on Facebook, it can be very inspirational. Plus, it is a great way to offer support.”

Do you share your struggles with weight online? What are your favorite websites or bloggers that are sharing their own weight-loss stories?

Three Weight Loss Plans that Work

Juicing, fasting, low-carb, high-fat… Have you tried everything to lose weight?

“It seems like every few months, another book comes out that spurs a diet trend,” says Karen Buzby, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team. “Weight loss comes down to one thing: creating a calorie deficit by eating less and being more active."

A plan may help some people stay on track. Are you one of them? Then read below for three weight-loss plans that might work for you.

Weight Watchers®

Weight Watchers uses a points system to track food, calories and exercise. Founded in 1963, Weight Watchers has outlasted every fad diet by allowing you to eat anything you want, as long as you stay within your daily point allotment.


“The new Weight Watchers Point Plus program encourages the selection of nutrient-rich foods that are low in calories,” says Buzby.  “Fresh fruit and non-starchy vegetables are unlimited on the new plan. It is these fiber containing foods along with lean proteins that promote a sense of fullness and a healthy slow weight loss.”

One thing Weight Watchers offers that some other plans do not is weekly meetings.

“The weekly Weight Watchers meeting is a great way to hold yourself accountable for what you’ve eaten the previous week,” says Buzby. “It’s also a great time to get peer support from other people trying to lose weight.”

Pros: Points system makes it easy to know how much you are allowed to eat, meetings provide support, online tools.
Cons: Cost – monthly fees can vary depending on how you want to pay.

The Biggest Loser® Diet

Made famous by NBC’s reality show “The Biggest Loser,” this plan is modeled after the same diet and lifestyle changes the show participants follow. The diet and exercise guidelines are straight forward: the calorie controlled meal plan focuses on eating small frequent meals of whole foods and the exercise plan emphasizes starting a cardio and a strength training program.

“If you follow the Biggest Loser guidelines, yes, you will lose weight,” says Buzby. “The problem for many of us is that without a personal trainer it may be hard to stay motivated to exercise 60 minutes a day.”

The Biggest Loser books tell inspirational stories from people who have been on the show as well as give guidelines for implementing the diet and exercise plans.

“Online support is available to help you stay motivated and reach your goals,” says Buzby.

Pros: Inspirational, balanced diet and exercise plan that includes healthy foods.
Cons: Weight loss will most likely be slower than the results achieved by TV contestants.

The DASH Diet for Weight Loss

The Dietary Approaches to Stop Hypertension (DASH) Diet was originally developed to help people make dietary changes to lower their blood pressure.  However, following the DASH  diet’s calorie guidelines can also help promote slow and steady weight loss.  The diet is based on an eating plan that focuses on fruits and vegetables, balanced with protein and low fat foods.  The book, The DASH Diet Action Plan, provides calorie adjusted menus and shows you how to implement the plan.

“Research studies show this diet has heart-healthy benefits, lowers the risk of certain diseases and improves health. “I like this plan because it is a healthy, nutritious diet that the whole family can enjoy,” says Buzby.

Pros: Diet based on tasty foods that promote fullness and improves health.
Cons: The primary focus is on heart health and reducing hypertension lower, calorie levels may be needed for weight loss in some individuals.

What diets have you tried? Which ones have worked for you?

Regaining Weight After Bariatric Surgery

David Sarwer, PhD, director of clinical services at the Center for Weight and Eating Disorders and member of the Penn Metabolic and Bariatric Surgery team, explains why some people gain weight after weight-loss surgery, and how support groups at Penn can help avoid post surgery weight gain.

It’s hard for a lot of people to understand, but the fact is some people who have bariatric surgery – whatever the type of surgery – regain the weight they lost. People regain weight after bariatric surgery for a number of reasons, one of which is emotional eating.

We all eat and drink for different reasons. Some people turn to food in times of stress – or happiness – and use food as a coping mechanism. Their emotions surrounding food and eating have not been addressed and new eating patterns revert back to old habits.

This is why every patient considering weight-loss surgery at Penn is required to undergo a psychological evaluation before bariatric surgery. The evaluation is an opportunity to identify motivations, address psychological challenges that may contribute to their obesity or impact preparedness for surgery and arrange for appropriate follow-up support. It is not designed to be a barrier to surgery.

If you have gained weight after bariatric surgery, you are not alone. Returning to one of the program’s support groups may help you get back on track. Others may work with the program’s dietitians to improve their diet. Still others may benefit from revisional surgery for weight loss.

Penn Can Help You Lose Weight

Learn more about weight-loss surgery at Penn by attending a free information session at a location near you.

Best Exercises to Burn Calories

Whether you are a seasoned pro at the gym or new to an exercise regime, chances are you’ve probably wondered what the best exercises are to burn calories.

Is it better to run or walk? Bike ride or train on the elliptical?

The good news is that there is no such thing as a bad cardiovascular workout. Any workout that you enjoy and do regularly is the best workout to burn calories.

Best exercises to burn calories

So, if you are ready to start working out and want to get the best bang for your buck at the gym, what are the best exercises for weight loss?

Fitness experts say aerobic exercise is the best way to burn calories.

Aerobic exercise is physical exercise of relatively low to moderate intensity that depends primarily on the aerobic, energy-generating process in the cells of the body. This process uses carbohydrates (sugars) stored in the body as its main source of fuel during physical activity. During aerobic activity, calories are burned.

Some examples of moderate-intensity aerobic activity include:

• Walking two miles in 30 minutes
• Basketball - shooting baskets for 30 minutes
• Bicycling five miles in 30 minutes
• Dancing fast, socially for 30 minutes
• Swimming laps for 20 minutes
• Running 1 ½ miles in 15 minutes
• Walking stairs for 15 minutes
• Jumping rope for 15 minutes
• Benefits of aerobic activity

Benefits of Aerobic Activity

As carbohydrate stores are used up during aerobic activity, fat metabolism is increased. In other words, the body becomes more efficient at burning fat, thus creating an energy deficit and promoting weight loss.

To put it simply, the more aerobic exercise you do, the more calories you burn. That deficit combined with healthy eating promotes weight loss.

Other benefits of aerobic activity include:

• Better breathing and lung function
• Strengthening the heart and improving resting heart rate
• Strengthening the muscles used during exercise
• Improving blood pressure
• Reducing stress – some people report aerobic exercise helps them “clear their heads”
• Lowering the risk for diabetes

Ready, Set, Sweat!

Always speak with your physician before starting an exercise program. Once you get the “okay,” make exercise a routine. Start with realistic expectations, and build gradually. To effectively lose or maintain weight some people may need up to 300 minutes a week of moderate-intensity physical activity.

A good way to judge the intensity of your workouts:

• Low Intensity: You should be able to carry a conversation or sing while you workout.
• Moderate Intensity: You should be able to speak brief sentences or phrases, but not for extended periods of time. Learn more about moderate intensity exercises here.
• High Intensity: Reserved only for “short spurts” of energy, you should be able only to say a word or two. This is not recommended for long periods of time.

In general, to burn fat you should spend most of your workout in the low to moderate intensity range. Once your body gets used to activity, gradually increase time and/or intensity.

Learn more about obesity, and how Penn can prevent obesity-related conditions.

A Guide for Making Healthy Fast-Food Choices

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, provides a guide for how to make a fast-food meal as healthy as possible.

There’s no denying that preparing food in your own kitchen is the easiest way to lose weight. When you cook at home, you control exactly what goes into your meals and you can stick to pre-planned portion sizes.

But the reality is that eating at home isn’t always possible. Whether you’re tight on time, out of groceries or just not in the mood to cook, it is possible to maintain a healthy diet while occasionally eating fast food.

This guide helps you make the healthiest possible fast-food choices.

Choose:

• Salads
• Grilled chicken sandwiches
• Open-faced sandwiches
• Chili, bean and broth soups
• Water or other unsweetened beverages 

Avoid:

• Fries
• Chips
• Cream soups
• Sugar-sweetened soft drinks
• Fried, crispy or crunchy sandwiches
• Upsized meals
• Double meat
• Bacon

You should also feel comfortable making special requests. You can modify many fast-food meals to reduce the calories or fat as well as increase the healthy nutrients.

Here are some examples of healthy special requests.

Ask for:

• Light salad dressing
• Hold the mayo or other special sauces
• Whole wheat bun
• Hold the cheese
• Grilled not fried
• Extra vegetables on sandwich
• Fruit on the side

While it is possible to incorporate fast food into a healthy diet, it is important to remember that fast-food meals must be an occasional occurrence and not a staple of your diet.

Also, keep your eyes peeled for new, healthy options on fast-food menus. More people are becoming interested in weight loss and healthy eating, and restaurants are paying attention. Healthy items like yogurt, veggie burgers and fruit are appearing on menus around the country, giving you more options for healthy food choices than ever before.

- Cara Stewart, RD, LDN

Five Awesome Apps to Help You Lose Weight

Research shows that people lose more weight when they track their food and exercise and receive a lot of motivation and support throughout their entire weight-loss journey.

Since it seems no one is without their smartphone or iPad these days, we’ve come up with five of our favorite apps for weight loss.

My Fitness Pal (iTunes®, free)

This app was designed to support the features of the website, My Fitness Pal. With its large database of foods, and simple design and functionality, you can track food and exercise, take photos of bar codes to identify foods and servings, and share your success with friends.

Weight Watchers® Mobile (iTunes, free)

You don’t have to be a Weight Watchers member to enjoy the perks of this weight-loss app. If you are a Weight Watchers member, you have access to the full benefits of this application. It helps you track your points, find recipes, locate a meeting, and track your weight. Not a Weight Watchers member? No worries. You can still use some of the features this app offers like recipes and Weight Watchers articles.

LIVESTRONG® MyPlate Calorie Tracker (iTunes, $2.99)

If you’re a fan of LIVESTRONG brands, you might enjoy this app for counting calories, too. LIVESTRONG MyPlate Calorie Tracker helps you determine your calorie needs based on your weight and weight goal. It has an extensive database of foods to help you track, and an easy-to-read design that inspires you to be well and eat nutritiously.

Lose It!® (iTunes, free)

Lose It! is another app for tracking food and exercise. While the database is not as large as some other apps might be, its barebones and simplistic approach to logging food and exercise keeps people motivated to lose on the go.

The Eatery® (iTunes, free)

The Eatery lets you take advantage of your phone’s camera to decide if you are eating balanced meals. What we like about this app is that it forces you to look closely, and think about what you are eating. While other people’s reviews of your plate may not be inspiring, we think it’s a great way to be mindful of how and what you eat.

Have you used an app to help you lose weight? What would you recommend?

Note: Penn Medicine does not specifically endorse any of these recommended apps. 

Penn Medicine can help you lose weight with weight-loss surgery. Learn more about weight-loss surgery at Penn in a free information session about weight-loss surgery. 

Are You Getting Enough Water?

When it comes to healthy eating and drinking, nothing beats a tall glass of water.

Staying hydrated is important because every system in your body needs it to perform at its best. Water flushes toxins out of your body, keeps cells hydrated and provides a sense of satiety or fullness.

In fact, if find yourself hungry, you might want to ask if, instead, you are thirsty.

How much water do you need every day?

So, how much water does your body need to perform at its best? It all depends. If you are a man, it’s recommended that you drink about 13 cups of liquid a day. If you are a woman, that number dips to nine cups.

But there are other factors that play into hydration.

If you exercise or engage in any activity that makes you sweat, you lose a lot of water. Exercise lasting for more than an hour, for example, requires a lot more fluid than if you are engaging in a quick workout. And if you are doing yard work in the hot sun, you probably need more water to perform at your peak.

Your environment also plays a big part in hydration. In the summer, the heat of the outdoors can zap hydration from your body’s stores. In the winter, the dry air associated with heating systems can cause your skin to lose moisture. And where you live makes a difference, too. Higher altitudes may cause you to become dehydrated quicker.

Breastfeeding or pregnant women especially need to make sure they drink enough liquid. That’s because their bodies are working overtime preparing a baby for birth, or feeding that baby for growth.

What liquids to choose?

You have heard the advice “don’t drink your calories.” Calories that come from juices or sodas are considered “empty” and have no real nutritional value.

Beverages such as coffee and teas do have a diuretic affect, which make you urinate more and lose water. These types of beverages should not make up a big portion of what you drink each day.

The best bet for staying hydrated is water. It’s calorie free, and you can get it just about everywhere.

Bottom line: Reach for water with and in between meals and before, during and after exercise. 

How much water do you drink every day?

Pregnancy After Weight-Loss Surgery

Did you know that being obese or overweight can affect fertility?

Research has shown that obesity can affect when and how a woman ovulates, thus affecting her chances of getting pregnant.

The good news is that weight loss surgery can help. In a 2005 study published in the Journal of Clinical Endocrinology and Metabolism, researchers found that surgical weight loss for women with polycystic ovary syndrome (PCOS) often resolved their reproductive and metabolic abnormalities.

Also, women who lose weight have healthier pregnancies. Conditions like high blood pressure and gestational diabetes may be less of a risk, which is healthier for mom and baby.

Prenatal care after weight-loss surgery is very important. Since women who have weight-loss surgery lose weight at a rapid pace, it is best to wait at least 18 months after weight-loss surgery before getting pregnant. It’s also important to seek prenatal care from a high-risk obstetrician experienced in managing the unique needs of women who have had weight-loss surgery.

Weight Gain With Pregnancy

Weight gain during pregnancy is not only normal, it is healthy. Weight gain is important for the baby’s nutrition, but it is important to get a balanced and nutritional diet throughout your entire pregnancy.

The Penn Metabolic and Bariatric Surgery Program offers lifelong follow-up care and nutritional support for patients who have had weight loss surgery. Women considering having a baby after weight loss surgery should discuss their plans with the bariatric surgery team.

Get more information about weight loss surgery at Penn

Learn if bariatric surgery is right for you and attend a free information session about the Penn Metabolic and Bariatric Surgery Program.

At this free session, you will learn more about weight-loss surgery at Penn, and meet physicians and team members from the Penn Metabolic and Bariatric Surgery Program.


Register for this free event here.

Benefits of Ongoing Support

Support – both before and after weight-loss surgery – is vital to the success of weight-loss surgery.

The Penn Metabolic and Bariatric Surgery Program hosts monthly pre- and post-surgical support sessions for its patients. During these meetings, patients share their experiences with one another and receive support from the Penn bariatric community.

“Having bariatric surgery leads to much more than a physical transformation, it’s a complete lifestyle transformation for an individual who may have spent his or her life identifying with being obese,” says Jim Henry, RD, LDN, registered dietitian with the Penn Metabolic and Bariatric Surgery Program. “That change can be very stressful and overwhelming. For someone who has used food as a coping mechanism to deal with stress, it can lead to a lot of negative feelings and disordered eating.”

Penn clinicians understand the unique needs to bariatric surgery patients. That’s why Penn offers its bariatric surgery patients support before and after weight-loss surgery.

“Research has found that the more support people have throughout the process, the more likely they will be to succeed,” says Henry. “More support leads to better outcomes. It’s because of support programs like those we have at Penn that our patients are so successful.”

Learn more about the support services available through the Penn Metabolic and Bariatric Surgery Program's Patient Support Network.

Get more information about weight loss surgery at Penn

Learn if bariatric surgery is right for you and attend a free information session about the Penn Metabolic and Bariatric Surgery Program.

At this free session, you will learn more about weight loss surgery at Penn, and meet physicians and team members from the Penn Metabolic and Bariatric Surgery Program.


Register for this free event here.

Best Snacks for Weight Loss

When it comes to eating healthy, “snack” is not a bad word. In fact, many nutrition experts suggest shifting away from the traditional three-meals-a-day diet, recommending you eat small, nutritious meals every three hours or eating five to six times a day.

The key to healthy snacking is choosing healthy portions that have a good balance of protein, healthy fats and good carbohydrates to avoid spikes in blood sugar and keep your energy levels up longer. Also, when you have a healthy snack, you avoid getting too hungry. When you are too hungry, it is easy to make poor food choices.

So what is a healthy snack? Here are some healthy snacking suggestions that include a mix of complex carbohydrates and protein.

• One serving Greek yogurt with fresh fruit
• One cup homemade vegetable soup
• ½ whole wheat English Muffin with pesto, 3 oz. canned salmon and diced tomatoes
• Three handfuls of air-popped popcorn seasoned with spray butter and herbs
• ½ whole wheat English Muffin topped with a sliced hard-boiled egg, 1 tsp. light mayo and fresh herbs

What gets you through the day in between meals? Share your healthy snack suggestions in the comments below. 

Penn Medicine can help you lose weight. Find out how Penn can help you lose weight at one of these free information sessions about weight-loss surgery at Penn. 

Is Weight-Loss Surgery Expensive?

Weight-loss surgery at Penn Medicine can be an affordable decision.

Bariatric surgery procedure costs depend upon the patient, the surgery, and any post-operative difficulties that may occur.

In many cases, insurance companies cover the cost of the surgery since morbid obesity can be a life-threatening condition. You should speak with your insurance company to confirm that the surgery and any related expenses are covered.

Another thing to consider is the health benefits of weight-loss surgery. Research has shown that weight-loss surgery can control chronic diseases like type 2 diabetes, as well as other obesity-related conditions such as sleep apnea and hypertension.

Get more information about weight-loss surgery at Penn

Learn if bariatric surgery is right for you, and attend a free information session about the Penn Metabolic and Bariatric Surgery Program.

At this free session, you will learn more about weight-loss surgery at Penn, and meet physicians and team members from the Penn Metabolic and Bariatric Surgery Program

Register for this free event here.

How to Start a Running Program

You see them on the side of the road – effortlessly jogging at a comfortable pace – and you wonder, how do they do it?

If you hate running, it might be because you never properly began a running program.

“Often times, people get motivated to start a running program and jump into it without giving their body a chance to ‘learn’ this new exercise,” says Jim Henry, RD, LDN, registered dietitian with the Penn Metabolic and Bariatric Surgery Program. “They get out of breath, strain something or get hurt, and get frustrated and quit without ever really giving it a chance.”

Running can be a great way to burn calories, but it’s also the perfect activity to help you set weight loss goals.

“Training to run a 5K can be very inspiring and motivating,” says Henry. “Plus, running is very communal because it’s an activity people can do as a group, motivating each other to get to the finish line.”

Before You Hit the Road Running

The key to beginning a running program involves a lot of… walking. If you are new to any type of physical activity, it’s a good idea to start slowly. In fact, a beginning running program is really a walk/jog program. The idea is to train your body to run a little at a time so by the end of the program, you are running 30 to 35 minutes, or approximately a 5K without stopping.

It’s also important to wear the proper shoes fit for your body.

“I tell people to find a reputable running shoe store to get their shoes. Many times, the sales people are runners themselves,” says Henry. “It’s important to find a shoe that fits well, provides ample cushioning and has the right amount of support.”

Ready, Set, Run

After you’ve gotten the “okay” from your physician, start your walk/jog program three times a week.

You might like the “Couch to 5K” program, a beginner’s running program from Cool Running.  The schedule can help your body love to run.

Week One
Run 1: 5-minute warm up walk, then alternate 60 seconds of jogging and 90 seconds of walking for a total of 20 minutes.
Run 2: 5-minute warm up walk, then alternate 60 seconds of jogging and 90 seconds of walking for a total of 20 minutes.
Run 3: 5-minute warm up walk, then alternate 60 seconds of jogging and 90 seconds of walking for a total of 20 minutes.

Week Two
Run 1: 5-minute warm up walk, then alternate 90 seconds of jogging and 2 minutes of walking for a total of 20 minutes.
Run 2: 5-minute warm up walk, then alternate 90seconds of jogging and 2 minutes of walking for a total of 20 minutes.
Run 3: 5-minute warm up walk, then alternate 90 seconds of jogging and 2 minutes of walking for a total of 20 minutes.

Week Three
Run 1: 5-minute warm up walk, then two repetitions of the following:

• Jog 90 seconds
• Walk 90 seconds
• Jog 3 minutes
• Walk 3 minutes

Run 2: 5-minute warm up walk, then two repetitions of the following:

• Jog 90 seconds
• Walk 90 seconds
• Jog 3 minutes
• Walk 3 minutes

Run 3: 5-minute warm up walk, then 2 repetitions of the following:

• Jog 90 seconds
• Walk 90 seconds
• Jog 3 minutes
• Walk 3 minutes

Week Four
Run 1: 5-minute warm up walk, then:

• Jog 3 minutes
• Walk 90 seconds
• Jog 3 minutes
• Walk 2 ½ minutes
• Jog 3 minutes
• Walk 90 seconds
• Jog 5 minutes

Run 2: 5-minute warm up walk, then:

• Jog 3 minutes Walk 90 seconds
• Jog 3 minutes
• Walk 2 ½ minutes
• Jog 3 minutes
• Walk 90 seconds
• Jog 5 minutes

Run 3: 5-minute warm up walk, then:

• Jog 3 minutes
• Walk 90 seconds
• Jog 3 minutes
• Walk 2 ½ minutes
• Jog 3 minutes
• Walk 90 seconds
• Jog 5 minutes

Week Five
Run 1: 5-minute warm up walk, then:

• Jog 5 minutes
• Walk 3 minutes
• Jog 5 minutes
• Walk 3 minutes
• Jog 5 minutes

Run 2: 5-minute warm up walk, then:

• Jog 8 minutes
• Walk 5 minutes
• Jog 8 minutes

Run 3: 5-minute warm up walk, then:

• Jog 2 miles, or 20 minutes, with no walking

Week Six
Run 1: 5-minute warm up walk, then:

• Jog 5 minutes
• Walk 3 minutes
• Jog 8 minutes
• Walk 3 minutes
• Jog 5 minutes

Run 2: 5-minute warm up walk, then:

• Jog 10 minutes
• Walk 3 minutes
• Jog 10 minutes

Run 3: 5-minute warm up walk, then:

• Jog 2 ¼ miles, or 22 minutes, with no walking

Week Seven
All runs: 5-minute warm up walk, then jog 25 minutes

Week Eight
All runs: 5-minute warm up walk, then jog 28 minutes

Week Nine
All runs: 5-minute warm up walk, then jog 30 minutes

Congratulations! You did it!


Penn Medicine can help you lose weight with weight-loss surgery. Find more about weight-loss surgery at Penn at one of these free, information sessions.

Asian-Inspired Sesame-Miso Cucumber Salad

It’s the perfect way to kick off the summer – refreshing, tangy and good for your waistline, too. Made with miso, a thick soybean paste that has a salty, slightly sweet flavor, and sesame seeds, which are high in protein and omega 6 fatty acids, sesame-miso cucumber salad makes the perfect summer side dish. You can find miso in the refrigerated section of your supermarket.

And the best part? This Asian-inspired dish only takes 20 minutes to prepare from start to finish.

Nutritional Information:
Amount per serving

• Calories: 60
• Fat: 2.7 g
• Saturated fat: 0.2 g
• Monounsaturated fat: 0.6 g
• Polyunsaturated fat: 0.7 g
• Protein: 1.9 g
• Carbohydrate: 7.2 g
• Fiber: 1.6 g
• Cholesterol: 0.0 mg
• Iron: 3.8 mg
• Sodium: 182 mg
• Calcium: 12 mg

Ingredients:

• 1 1/2 tablespoons sesame seeds, toasted
• 2 tablespoons white miso (soybean paste) or low-sodium soy sauce
• 1 tablespoon rice vinegar
• 1 tablespoon honey
• 1 tablespoon hot water
• 1 teaspoon crushed red pepper
• 2 teaspoons dark sesame oil
• 4 cups thinly sliced seeded cucumber

Preparation:

1. Combine first 7 ingredients in a large bowl, stirring with a whisk.
2. Add cucumber; toss to coat.

Total preparation time is 20 minutes.

This recipe is courtesy of Maureen Callahan, Cooking Light (May 2011).

Are You a Candidate for Weight-Loss Surgery?

Although it may seem like a quick fix to a lifelong struggle with weight, bariatric surgery, or weight-loss surgery, is a major step toward leading a healthy life.

Bariatric surgery is an operation that reduces the size of the stomach using one of a variety of procedures such as adjustable gastric band, gastric bypass, sleeve gastrectomy or robotic-assisted bariatric surgery.

Research has shown that bariatric surgery can cure, or help patients prevent, obesity-related conditions such as hypertension, type 2 diabetes, heart disease and sleep apnea.

Is Weight-loss Surgery Right For You?

If dieting hasn’t worked for you in the past, you may be considering weight loss surgery. Because the decision to have bariatric surgery can be a difficult one, the Penn Metabolic and Bariatric Surgery Program provides prospective and current patients with all the information they need to make informed choices.

All patients considering bariatric surgery at Penn must meet specific criteria before being scheduled for a screening evaluation.

These criteria are based on universal standards established by the National Institutes of Health and include:

• Exceeding your ideal body weight by more than 100 pounds or 45 kg
• Body mass index (BMI) greater than 40 or BMI greater than 35 with medical complications related to obesity, including high blood pressure, type 2 diabetes, sleep apnea and high cholesterol
• A documented history of weight management and weight loss attempts with supervised diets and exercise programs
• No indication of active alcoholism, active drug addiction or major psychiatric disorder

Patients must undergo a complete pre-operative evaluation that includes physical and psychological assessments.

Get more information about weight-loss surgery at Penn

Learn if bariatric surgery is right for you and attend a free information session about the Penn Metabolic and Bariatric Surgery Program.

At this free session, you will learn more about weight loss surgery at Penn, and meet physicians and team members from the Penn Metabolic and Bariatric Surgery Program.


Register for this free event here.

What You Need to Create a Home Gym

One of the biggest roadblocks to committing to an exercise regimen, is finding time to go to the gym. Even the most dedicated exercisers can find it difficult to get to the gym before or after work.

For busy families, finding time to get to the gym during the morning rush out the door can seem impossible. And a lot of people just want to get home after work to have quality time with your spouse or children.

The good news is there are a lot of exercises you can do at home without sacrificing time with family or spending a lot of money to set up a home gym. In fact, by showing your family you are making time for yourself and are committed to leading a healthy, active lifestyle, you can inspire them to lead healthier lives as well.

Here is what you need to create a home gym without spending a lot of money or using a lot of space.

Cardio equipment

Cardiovascular, or aerobic, exercise is important for weight loss and hearth health. While it burns calories, it also improves the way your heart functions and moves oxygen through the blood. This means your body becomes more efficient at doing things like breathing and pumping blood through your veins, which in turn, improves lung function and lowers your blood pressure.

If you only have a little money, look for low-priced items to get fit. A jump rope can be a great tool for interval training, or pop in a fitness DVD. Alternatively, if your cable company offers “On Demand” services, many quick workouts are available for free.

If you’re ready to spend more (and have the room) there are a lot of elliptical trainers, bikes and treadmills on the market that are small enough to use at home. Pick a machine that you enjoy using, and commit to using it at least 60 minutes a day, five days a week.

Finally, take your home gym… outside. Invest in a good pair of walking or running shoes and hit the pavement. But be safe and make sure you wear reflective clothing, and walk on sidewalks, or against traffic.

Or, dig up your old bike from the garage and take it to a bike shop for a tune up. Again, be safe and invest in a good helmet and always obey traffic laws.

Strength-training equipment

Penn fitness experts recommend you incorporate at least two strength-training sessions per week into your workout. The good news is once you invest in a small collection of free weights in various pounds, you can train virtually any part of your body. Also, you don’t need a lot of room in your home to strength train.

If you are new to strength training, choose light weights for smaller muscle groups like your arms, and heavier weights for larger muscle groups like your legs.

Creating a home gym is empowering because it lets you fit exercise into your lifestyle without making time to get out the door to the gym. When you work out at home, you save money on gym fees and maybe inspire the entire family to get healthy with you.

Penn can help you lose weight with the Penn Metabolic and Bariatric Surgery Program. Learn more about how Penn can help you lose weight at a free information session about weight-loss surgery.

What is Bariatric Surgery?

Bariatric surgery is a type of weight-loss approach that uses surgical procedures to help patients lose weight, avoid or reverse some diseases such as type 2 diabetes and high blood pressure, and improve overall health.

Because every patient considering bariatric surgery is unique, the Penn Metabolic & Bariatric Surgery Program offers a full range of bariatric surgical options. This ensures that patients receive the bariatric surgery that will provide them with the best possible results.

Here are four types of bariatric surgery at Penn.

Sleeve Gastrectomy

Sleeve gastrectomy is typically considered for patients with a body mass index (BMI) of 50 or higher. During the surgery, a sleeve–shaped tube is created from a small portion of the stomach and the majority of the stomach is removed. The small intestine is not surgically altered. Sleeve gastrectomy may require a second operation like conversion to Roux-en-Y gastric bypass (see below) if even more weight loss is required to improve a patient's health.

Robotic-assisted Bariatric Surgery

All procedures performed by Penn bariatric surgeons are available using a minimally invasive approach called laparoscopic surgery. Laparoscopic surgery offers many benefits for patients including shorter recovery times and less post-operative pain. In addition, Penn performs robotic-assisted bariatric surgery for the adjustable gastric band and sleeve gastrectomy procedures. Penn's bariatric specialists are highly experienced in robotic-assisted surgery and have performed more than 500 robotic LAP-BAND® and sleeve gastrectomy procedures.

Roux-en-Y Gastric Bypass (RGB)

The most common type of bariatric surgery performed in the United States, during the Roux-en-Y procedure a Penn surgeon divides a small gastric pouch from the upper portion of the stomach and attaches it directly to the small intestine, completely bypassing the larger part of the stomach.

Adjustable Gastric Band

The adjustable gastric band does not divide or reattach any part of the gastrointestinal tract. During the procedure, a Penn surgeon places a band around the upper portion of the stomach creating a small pouch with a narrow opening to the lower stomach. The food eaten stays in the small pouch for more time, so the patient feels full longer. The band is adjustable, which means it can be tightened or loosened after surgery as needed.

Get more information about weight-loss surgery at Penn

Learn if bariatric surgery is right for you and attend a free information session about the Penn Metabolic and Bariatric Surgery Program. 


At this free session, you will learn more about weight loss surgery at Penn, and meet physicians and team members from the Penn Metabolic & Bariatric Surgery Program.

Register for this free event here. 

Study Shows Weight Loss Supplements Are No Magic Pill for Weight Loss

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, discusses a recent study about the safety and effectiveness of weight loss supplements.

Supplements that promise quick, easy and permanent weight loss can be tempting, but a new study published in the International Journal of Sport Nutrition and Exercise Metabolism proves the old adage: “If it sounds too good to be true, it probably is.” It turns out that weight loss supplements are no exception.

A recent study showed that there is no evidence of a link between supplements and significant weight loss. In fact, some products produce detrimental side effects, such as increasing the risk of stroke or heart problems.

Led by researchers at Oregon State University, the study looked at hundreds of weight loss supplements, including chitosan, caffeine, conjugated linoleic acid and soluble fiber. They found no direct link between these products and significant weight loss. They did find that a few products, including green tea, fiber and low-fat dairy supplements, showed modest weight loss of three to four pounds, but only when combined with a reduced-calorie diet.

The bottom line is that there is no magic pill for successful and sustained weight loss. If you have had weight loss surgery, and even of you haven’t, the key to losing weight and keeping it off is a healthy diet and regular exercise program.

- Cara Stewart, RD, LDN

Nutrient-Rich Wheat Berry Salad with Raisins and Pistachios

Wheat berries are a health buff’s dream come true. The whole wheat kernels are filled with fiber, protein, iron, vitamin E and magnesium and remain virtually unprocessed, packing a nutrient-rich punch to your diet.

Wheat berries can be ground into whole wheat flour and develop a chewy consistency with a nutty, mild taste when cooked whole. You can add wheat berries to hot cereal, as a healthier alternative to rice or to make a creative salad.

In addition to its delicious taste, you can prepare all of the ingredients for this salad while the wheat berries cook.

Nutritional Information:
Amount per serving

• Calories: 240
• Fat: 8.9 g
• Saturated fat: 2.3 g
• Monounsaturated fat: 4.8 g
• Polyunsaturated fat: 1.3 g
• Protein: 7.2 g
• Carbohydrate: 36.8 g
• Fiber: 5 g
• Cholesterol: 4 mg
• Iron: 0.7 mg
• Sodium: 284 mg
• Calcium: 28 mg

Ingredients:

• 1 cup uncooked wheat berries (hard winter wheat)
• 3/4 teaspoon salt, divided
• 3 tablespoons pistachios, shelled
• 2 tablespoons olive oil
• 2 tablespoons fresh lemon juice
• 2 teaspoons honey
• 1/2 teaspoon ground coriander
• 1/2 teaspoon fresh ginger, grated and peeled
• 1/2 cup golden raisins
• 1/4 cup thinly sliced green onions
• 2 tablespoons fresh cilantro, chopped
• 1/2 cup (2 ounces) crumbled goat cheese

Preparation:

1. Preheat oven to 350 degrees.
2. Place wheat berries and 1/2 teaspoon salt into a medium saucepan. Cover with water to 2 inches above wheat berries and bring to a boil. Cover, reduce heat to medium-low and simmer for 1 hour or until tender. Drain.
3. Place pistachios on a baking sheet. Bake at 350 degrees Fahrenheit for 8 minutes, stirring once. Cool slightly and chop.
4. Combine oil, juice, honey, coriander, ginger and remaining 1/4 teaspoon salt in a large bowl, stirring with a whisk. Add hot wheat berries and raisins; stir well to combine. Let stand for 20 minutes or until cooled to room temperature.
5. Add nuts, 1/4 cup green onions and cilantro to wheat berry mixture. Transfer to a serving bowl and sprinkle with goat cheese.

This recipe is courtesy of Jackie Mills, MS, RD, Cooking Light (April 2010).

Adjustable Gastric Band: A Tool for Weight Loss

Samantha Warner-Grimsley, RN, CBN, member of the Penn Metabolic and Bariatric Surgery team, provides tips for achieving weight loss success with an adjustable gastric band.

If you have or are considering an adjustable gastric band as a way to lose weight, it is important to remember that the band is just a tool for weight loss. Like most tools, it requires proper management to function optimally.

Making the most of your adjustable gastric band requires a combination of lifestyle and dietary changes along with gastric band adjustments.

Follow these tips to to achieve the best results from your adjustable gastric band surgery:

Set reasonable, incremental goals for weight loss.
Aim to lose one to two pounds per week.

Follow the postoperative dietary guidelines.
For four to six weeks after surgery, follow the postoperative dietary guidelines provided by the dietitian. Slowly advancing from a liquid to solid diet gives your stomach the chance to heal while keeping the lap band in the right position.  It may take up to one month for your stomach to fully heal from surgery.

Re-introduce solid food gradually.  After the initial postoperative period, slowly re-introduce soft and then solid foods to your diet.

Take small bites and eat slowly. Always remember to take small bites, eat slowly and chew well. Developing these habits teaches you to recognize when you are satisfied and prevent stomach upset.

Adjust the gastric band to manage symptoms.The band can be tightened or loosened to manage symptoms or help you achieve better portion control to expedite weight loss. Symptoms that should be reported to your health care team include:

• Painful or difficult swallowing
• Severe abdominal pain
• Heartburn
• Food sticking in the esophagus
• Frequent regurgitation or inability to tolerate solid foods
• Vomiting

Remember that success is a team effort.
Schedule regular follow-up visits with your surgeon or nurse practitioner and dietitian. The Penn Metabolic and Bariatric Surgery Program recommends visits every six to eight weeks.

Exercise regularly. Make sure to exercise regularly but within your limitations. For the best results, add 30 minutes of moderate exercise into your daily schedule. Keep in mind that every minute of exercise counts, so even 10 or 20 minutes of exercise is better than nothing.

Get support. Attend support group meetings to connect with other people who have adjustable gastric bands, share your experiences and exchange ideas. For a list of support group meetings at Penn Medicine, click here.

- Samantha Warner-Grimsley, RN, CBN