Healthy Eating during Ramadan

Sabrina Bitar, MS, clinical dietitian and center manager at Diet Watchers^TM in Saudi Arabia, guest blogs about tips for maintaining a healthy diet during Ramadan.

Ramadan is the holiest month of the year for Muslims, but the restrictions on eating can be tricky for people who are trying to lose weight or maintain a healthy diet. With careful planning, thoughtful food choices and self-control, you can stay on track with your weight loss goals during the month of Ramadan.

During Ramadan, Muslims abstain from eating and drinking from dawn till dusk. Although the tradition goes against typical dietary recommendations for small, frequent healthy meals throughout the day, there are ways to sustain your healthy diet during Ramadan.

To maintain a healthy diet during the month of Ramadan, it is important to provide your body sufficient healthy nutrients during the non-fasting hours. That means having your first meal (Sahur) before the fast starts at dawn, an evening break-the-fast snack after dusk (Iftar) and dinner as the last meal of the day.

This guide can help you stay on track with your weight loss goals during Ramadan:

Pre-dawn Meal (Sahur):

The pre-dawn meal or Sahur is essential to jumpstarting your day, so make sure to eat a wholesome, balanced and moderate-sized meal.

A healthy morning meal gives you energy by the providing the nutrients you need to get through the fasting hours. It also reduces unpleasant signs of hunger throughout the rest of the day, including hunger pangs, headaches and sleepiness.

Stick to high-fiber foods and complex carbohydrates, such as grains. It takes longer to digest and absorb these foods, so they help you stay full throughout the day.

A healthy morning meal can include:

• Whole wheat bread with cheese or labneh
• High-fiber cereal with low-fat milk
• Fresh or dried fruit, including bananas and dates
• Unsalted nuts

Breaking the fast meal (Iftar):

Iftar presents the biggest obstacle to maintaining a healthy diet. The best way to approach breaking the fast is to treat Iftar as a light snack to hold you over until dinner instead of as a reward for fasting. That mindset can help you avoid indulging in the rich traditional desserts that are loaded with fat and sugar.

A healthy break-the-fast meal can include:

• Three dates
• Cup of water or low-calorie juice
• Bowl of vegetable soup

Dates and water are traditional Iftar foods and they also have nutritional properties to replenish the body after a long fast. Dates help regulate blood sugar and provide a much needed boost of energy. If dates are not available, you can substitute them with any other fruit. Water rehydrates your body and helps reduce hunger.
 
Dinner:
During Ramadan, dinner is the best chance to get most of your important daily nutrients, so make sure to have a balanced meal that covers all of the major food groups. Plan to eat dinner after the evening prayer or Maghrib to allow sufficient time to digest your food from Iftar.

A healthy dinner can include:

• Soup and salad
• Grilled chicken, fish or lean meat
• Grain such as brown rice, whole wheat bread or whole wheat pasta
• Low-fat yogurt
• Fruit – fruit is a much healthier substitute for the high-fat, syrup-sweetened treats that are common during Ramadan. You can also have fruit as a snack before bed.

Make sure to pace your consumption throughout dinner. It takes 20 minutes for the stomach to tell the brain that it is full, which means you have to allow adequate time for your stomach to send those signals. Try slowing down your eating by taking smaller bites, chewing well and savoring the taste of each bite to avoid overeating.

Most importantly, remember that resisting the temptation to overindulge not only helps achieve your weight loss goals, but also focuses attention on empathizing with the poor and needy, the centerpiece of Ramadan.

- Sabrina Bitar, MS

Penn Weight-Loss Team Most Experienced In Philadelphia Region

When it comes to choosing a bariatric surgeon and program, experience counts. Research shows the more experience a surgeon has and the more procedures he or she performs, the better the outcomes. Penn surgeons in the Penn Metabolic and Bariatric Surgery Program perform more than 500 bariatric surgeries every year, making Penn the most experienced program in the greater Philadelphia region.

In this video, bariatric surgeon Alan Schuricht, MD, talks about the experience of the Penn Metabolic and Bariatric Surgery Team, and why when a patient loses weight, the whole office celebrates.

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.

Why You Might Hire a Personal Trainer

You’ve seen the trainers on “The Biggest Loser” motivate contestants and maybe you’ve begun to think that a personal trainer might be the key to weight-loss success.

And, if you’ve just joined a gym, chances are you’ve been “pitched” to take advantage of personal training services.

A personal trainer is a certified professional who can help you define your weight-loss goals, design a program to meet those goals, and motivate you to work out during one-on-one sessions. While personal training is not for everyone, for those individuals who have never worked out or are not sure how they should work out, a few sessions with a professional might help pave the way to fitness success.

If you fit into one of these descriptions, you might want to consider hiring a personal trainer.

You Are New To Exercise

If you’ve never set foot in a gym, it can be overwhelming. There are free weights, weight machines, fitness classes and pieces of cardio equipment. All the “pros” can be intimidating and you probably don’t know where to start.

If you are an absolute beginner, a personal trainer is your ultimate gym buddy. A personal trainer helps you set goals and builds a routine for you, so you make the best use of your time in the gym. Also, he or she shows you the proper way to exercise, helps you with your form and shows you the best cardio machines to help you reach your weight-loss goals.

You may not need to meet with a personal trainer every week, but meeting with one a few times in the beginning, and then every few months to tweak your routine, can get you on the right path.

You Have an Injury or Health Condition

Just because you have a bad knee or an old shoulder injury that flares up on occasion doesn’t mean you shouldn’t – or can’t – exercise. A good personal trainer helps you identify your weaknesses and designs a program that strengthens your body without putting too much pressure or strain on any one area.

Your trainer also shows you how to safely exercise and look for signs of muscle overuse.

You Need Extra Motivation

Even a seasoned gym rat needs some extra motivation every now and then. Meeting with a personal trainer at a designated time each week can help you stick with a consistent exercise program. Certified personal trainers can provide structure and accountability, and help you develop a lifestyle that encourages health.

Remember, not all personal trainers are created equal. Ask if they are certified by the American Council of Exercise (ACE) or Aerobics and Fitness Association of America (AFAA) or other licensing organization. He or she should also be certified in CPR and have liability insurance.

Finally, find a trainer you like. This is a hired professional, and if it’s not working out with one, find someone else you can feel comfortable with.

Have you used a personal trainer at a gym? What was your experience?

Ready to commit to a healthier you? Register for a free informational session about weight-loss surgery at Penn. 
 

Do You Zumba?

If you are tired of the same old exercise routine at the gym, chances are that your body is, too.

Any fitness professional or personal trainer will tell you that every few months it’s important to change up your routine. That’s because the more you exercise a certain muscle group or do the same type of exercise, the more efficient your body becomes at performing it. And the more efficient your body becomes, the less of a challenge that exercise is. Your body responds by outputting less energy, which means fewer calories are burned.

If it’s time to try something new, it seems like Zumba® is taking gyms and fitness centers across the nation by storm.

Zumba is a Latin-inspired fitness dance program created by dancer and choreographer Alberto "Beto" Perez. Zumba involves dance and aerobic elements, and gets the class moving with hip-hop, samba, salsa belly dance and mambo moves. Some instructors also incorporate light strength training into the class.

But don’t let all the fancy moves intimidate you. Perhaps the best thing about this class is that it keeps you moving and “on your toes” for the duration of the class. You’ll be paying so much attention to following the moves and having fun, you won’t even notice the time pass by.

Zumba classes are offered at many gyms and dance studios, but if you would prefer to exercise at home, there are Zumba DVDs and video games to get you moving in your living room.

Have you tried a Zumba class? What did you think? 

Ready to commit to a healthier you? Penn Medicine can help you lose weight. Learn how Penn Medicine can help you lose weight at a free information session. 

Your Daily Dose: Vitamin B12 Supplements after Weight Loss Surgery

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains the importance of the vitamin B12 supplements after weight loss surgery.

Vitamin B12 is the most common vitamin deficiency people experience after weight loss surgery. That is why it is important to supplement your diet with vitamin B12, especially after gastric bypass and sleeve gastrectomy.

Vitamin B12 is essential for proper nerve function, metabolism and red blood cell production. Deficiency can lead to B12 deficiency anemia, which causes fatigue, rapid heart rate, easy bruising and bleeding, stomach upset and diarrhea or constipation.

If the deficiency remains unaddressed, it can result in permanent nerve damage, including tingling or numbness in fingers and toes, difficulty walking, mood changes, memory loss and dementia.

Weight loss surgery reduces the acidity in the stomach, which makes absorption of vitamins and nutrients more difficult. That is why vitamin B12 deficiency is particularly common after surgery and supplementation is often required long after recovery.

Proper supplementation involves taking a daily form of vitamin B12 that dissolves under the tongue or getting a monthly injection, which is typically done by your primary care physician. 

To prevent vitamin B12 deficiency, follow the dietary recommendations for supplementation after weight loss surgery and get your blood work checked regularly by a primary care physician or bariatric care team.

If you experience the symptoms associated with B12 deficiency, please check with your health care team.

- Cara Stewart, RD, LDN

Getting Enough Protein In Your Diet

Protein is an essential dietary nutrient. It builds tissue and regulates various bodily processes necessary for good health. After weight-loss surgery, all patients follow a liquid diet for two weeks. It is important to include adequate protein intake in the post-surgical diet to facilitate recovery. That is why patients are encouraged to find a preferred protein drink before surgery to ensure optimal nutrition and safe weight loss in the recovery stage.

You can find protein supplements at local supermarkets, pharmacies or specialty nutrition stores. There are a variety of choices and these tips can help you find your favorite, nutritious protein supplement:

• Read the ingredients. Complete protein products containing whey, casein or soy provide more benefit than products that are mixed with less nutritious ingredients, such as collagen.
• Determine if you prefer a powder or liquid protein supplement. There are pros and cons to each type of supplement. Powder products are mixed with eight ounces of water, low-fat milk or another low-calorie liquid to produce a beverage with the recommended concentration of protein. Liquid products come premixed and some have screw tops for easy storage after opening.
• Sample a small quantity of the protein supplement. Purchase a single-serving to taste test before committing to a full container or case of the product.
• Make sure the products are low in fat and sugar. The concentration of protein, fat and carbohydrates varies from product to product. It is important to select a product that is low in fat, calories and carbohydrates. Make sure the product contains 15 grams or less of sugar per serving. Keep in mind that a typical protein drink contains 150 to 200 calories per 8 ounce serving.
• Check the expiration date. Like all food, protein drinks have a limited shelf life. Do not use products that have expired.

Please refer to the “Step-by-Step Diet Guidelines following Weight Loss Surgery” in your diet instruction booklet for a detailed list of recommended protein supplements.
- Karen Buzby, RD, LDN

The Perfect Summer Meal: Arugula, Grape and Sunflower Seed Salad

A refreshing salad can be a perfect meal on hot summer day. To top it off, this recipe combines a variety of healthy ingredients, so the delicious salad also provides the important nutrients your body needs. 

With antioxidants from the grapes, healthy fats and vitamin E from the sunflower seeds and oil, folate and vitamin A from the arugula, it’s hard to beat the nutrition profile on this summer salad.

You can also try topping the salad with a protein like salmon or tuna to make a well-balanced dinner entree.

Nutritional Information:
Amount per serving 

• Calories: 81 
• Calories from fat: 34% 
• Fat: 3.1 g 
• Saturated fat: 0.3 g 
• Monounsaturated fat: 0.5 g 
• Polyunsaturated fat: 2 g 
• Protein: 1.6 g 
• Carbohydrate: 13.1 g 
• Fiber: 1.2 g 
• Cholesterol: 0.0 mg 
• Iron: 0.7 mg 
• Sodium: 124 mg 
• Calcium: 47 mg 

Ingredients:

• 3 tablespoons red wine vinegar 
• 1 teaspoon honey 
• 1 teaspoon maple syrup 
• 1/2 teaspoon stone-ground mustard 
• 2 teaspoons grapeseed or olive oil 
• 7 cups loosely packed baby arugula 
• 2 cups red grapes, halved 
• 2 tablespoons toasted sunflower seed kernels 
• 1 teaspoon chopped fresh thyme 
• 1/4 teaspoon salt 
• 1/4 teaspoon freshly ground black pepper 

Preparation:

1. Combine vinegar, honey, syrup and mustard in a small bowl. Gradually add oil, stirring with a whisk.
2. Combine arugula, grapes, seeds and thyme in a large bowl. Drizzle vinegar mixture over arugula; sprinkle with salt and pepper. Toss gently to coat.

The recipe is courtesy of Maureen Callahan, Cooking Light (May 2008). 

Obesity Facts

Did you know that by losing just 5 to 10 percent of your total body weight, you can bring about significant health gains?

Gains including:

• Lowered blood pressure
• Reduced cholesterol levels
• Reduced risk of type 2 (adult onset) diabetes
• Less chance of stroke
• Decreased complications from heart disease
• Reduced overall mortality

“These operations and the weight loss that comes with them have amazing and almost instant dramatic and rapid results,” says Gary Korus, MD, bariatric surgeon at Penn. “We see a change in some medications within days of surgery. Some of our patients report they were given the ‘okay’ to stop taking certain medications very early in their weight-loss journey.”

Facts About Obesity and Weight Loss in America

Obesity in America is a growing epidemic. Did you know?

• The normal amount of body fat is between 25 and 30 percent in women and 18 and 23 percent in men. Women with more than 30 percent body fat and men with more than 25 percent body fat are considered obese.
• More than a third of U.S. adults — over 72 million people — are obese, according to the Centers for Disease Control and Prevention (CDC). In a study recently released, the rate of obesity in adults in the United States is expected to reach 42 percent by the year 2030. If obesity rates remained stable, instead of increasing, $550 billion could be saved in healthcare expenses over the next 20 years.
• Morbid obesity is defined as having a body mass index (BMI) of more than 40. For men that equates to approximately 100 pounds overweight for women, 80 pounds overweight.
• Severely obese women may experience infertility and pregnancy problems, polycystic ovary syndrome and sexual dysfunction.
• In the United States, roughly 300,000 deaths per year are directly related to obesity, and more than 80 percent of these deaths are in patients with a BMI over 30. For patients with a BMI over 40, life expectancy is reduced by as much as 20 years for men and five years for women.
• According to the CDC, 17 percent of U.S. children are obese.

The most common causes of obesity are overeating and physical inactivity. Other factors that can
contribute to obesity include:

• Genetics (such as leptin deficiency)
• Slow metabolism
• Medications
• Psychological factors
• Diseases (hypothyroidism, Cushing syndrome)
• Ethnicity
• Childhood weight

The Penn Metabolic and Bariatric Surgery team understands that, for many people, the decision to have weight-loss surgery can be a difficult one. That is why the Penn Metabolic and Bariatric Surgery Program is committed to providing prospective and current patients with all the information they need to make informed choices.

Bariatric surgery is not about improving physical appearance, it's about improving overall health.

Clinically severe (morbid) obesity is a chronic disease that can cause a host of health problems and shorten a person's life.

Bariatric surgery offers a way to sustain weight loss and improve obesity-related medical conditions.

Get more information about weight-loss surgery at Penn

Learn if bariatric surgery is right for you by attending 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.

Is Weight-loss Surgery Right For You?

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.
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.

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.

Weightlifting Myths Debunked

If you are new to exercise, or just starting to work out after surgery, it’s important to incorporate both cardiovascular exercise and weight training exercises to maintain overall fitness.

Myth #1: Weight training will bulk me up

If you a woman who thinks weightlifting will make you look bigger, this one is for you.

Many women are afraid to lift weights because they are afraid they will bulk up, like some men do during weight training. Research has shown that most women simply do not have enough testosterone to increase their muscle mass to the point of looking bigger. To bulk up, or lift weights to become bigger, a woman would have to lift heavy weights while taking hormones or drugs to alter the way their muscles respond to the lifting.

Myth #2: Weight training takes too long

It takes is about 30 minutes a few times a week to complete a weight training routine. In fact, some gyms have areas dedicated to 30-minutes routines with equipment positioned so it is easy to go from one machine to the next.

Myth #3: Free weights are harder than machines

Both free weights and weight machines offer advantages and disadvantages. Some people feel more comfortable using machines because they don’t have to think about how they are positioned – the machine does it for them. Others enjoy free weights because they can isolate muscles better.

If you belong to a gym, schedule a session with a trainer to familiarize yourself with both free weights and weight machines. He or she can explain the differences between each type and help you create a routine that meets your needs.

Myth #5: Weightlifting is bad for my joints

Quite the contrary! The fact is, when you strengthen the muscles around your joints you put less pressure on your joints and will increase their health.

Weightlifting is a non-impact activity, which means it is less stressful than running or walking. Lifting weights can also improve your posture taking strain off your back and spine.

Do you lift weights at the gym? What benefits have you seen from weightlifting?

Weight-loss Surgery About More Than Looks

Weight-loss surgery is not just about looks. It's about getting back to a quality of life they can enjoy with their family and friends.

Matt Kirkland, MD, FACS, director of the metabolic and bariatric surgery program at Pennsylvania Hospital talks about weight-loss surgery at Penn in Philadelphia. And how weight-loss surgery helps patients get back to living.

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.

150 Pounds Gone - I Feel Fabulous and Unstoppable!

Jackie Savoy, is a 47-year-old working mom of three. Her weight-loss surgery was performed by David Wernsing, MD, at Penn in February 2011. Here, she talks about how a sleeve gastrectomy procedure helped her lose almost 150 pounds and is helping her cross things off of her “bucket list.”

I chose to have bariatric surgery as a last resort for regaining my life. I’d been overweight ever since I was a child. As a mom and wife, I always put everyone else’s needs before mine. I decided it was time to do something for me and my health so that I could be the joyful, healthy person I wanted to be.

I weighed 328 pounds before I began my weight-loss journey with the Penn Metabolic and Bariatric Surgery Program, and today I credit the program’s team with saving my life.

Happy – On the Outside

Before surgery, I was happy on the outside.

Logistically, I tried to mask the fact my weight affected my lifestyle. I hated airplanes and avoided amusement parks because I was always fearful I wouldn’t fit in a seat or on a ride. I dreaded going to restaurants, because I worried if I had to go to the bathroom, I wouldn’t have enough room to move through the tables. And going to my kids’ schools for “Back to School Night” was a nightmare because I could never fit into the school seats.

I stopped going to my family physician because I was so afraid he would lecture me and tell me to go on a diet. When I finally did go, I learned I had hypertension and needed medication.

Through a sleep study, I also found out I had severe sleep apnea. In fact, while “sleeping” for eight hours, I learned I had only really been sleeping four hours because my breathing had stopped more than 150 times during the night. It’s a miracle I never fell asleep at the wheel of my car.

Finally, as a certified public accountant, I worried my clients wouldn’t trust my knowledge or professionalism. I was fearful everyone was judging me and my professional capabilities based on my weight.

A Team Approach to Weight-loss Surgery

I went to a weight-loss surgery information session at Penn Medicine without telling anyone because I knew this was a decision I needed to make on my own. I was extremely impressed with what I learned at that information session, and made my first appointment with the Penn Metabolic and Bariatric Surgery Program. From that moment, I knew I had a team of compassionate experts on my side to help me reach my goals.

My surgeon, dietitian and support group leader became constant sources of support and encouragement. With their help, I lost 47 pounds before surgery and was ready to begin a new chapter in my life.

Determined to Succeed

Since I joined the Penn Metabolic and Bariatric Surgery Program, I’ve lost almost 150 pounds, and have completely reinvented my life so I can continue to meet my lifestyle goals.

I wake up early to exercise every morning, and challenge myself with different activities. I track everything I eat to make sure I meet my nutritional guidelines. And I am having a ball shopping for my new, size 12 body.

I am also off all my hypertension medications and no longer have sleep apnea. I feel healthy and I have the energy to do the things I once thought I could not.

I’ve begun crossing things off my “bucket list” – things I could have never done before my weight-loss surgery. I took golf lessons, skied, and am training to run my first 5K race.

I feel fabulous and unstoppable!

But, perhaps the biggest difference is that I truly love myself. I put my needs first. I don’t care what other people think about me because I know I am healthy and strong.

I no longer hide in the shadows – I want to be seen and heard!

I never knew how good life could be until the team at the Penn Metabolic and Bariatric Surgery Program helped me start living.

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.

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?

"Like" Penn Medicine Weight Loss on Facebook for inspiration, healthy tips and fun conversations about weight loss.

Yo-Yo Dieter Takes Back Control

Lisa Harris of Clementon, NJ, was a self-proclaimed “yo-yo” dieter her whole life. Moved by her father’s dying request to get healthy, Harris had gastric bypass surgery at Penn Medicine with Alan Shuricht, MD, FACS.

In this blog post, she discusses her decision to have weight loss surgery at Penn, and how the Penn Metabolic and Bariatric Surgery Program team helped her lose 150 pounds (and counting!)

I’ve been a yo-yo dieter all my life. As a kid, I was overweight, but struggled to diet and lose weight from time to time. Kids were cruel, and at one point, my parents pulled me out of public school because I was teased about my weight so much.

When I graduated high school, I was heavy, but it wasn’t until June, 2010 I really paid attention to my weight and my health. My father was very ill, and told me he was worried about my health. Here he was, dying, and worried about the effect my weight was having on my health. It was like someone had snapped me in the back of my head. When he died two months later, I was ready to make a change.

Taking the first steps

I attended an information session about weight-loss surgery at Penn in Cherry Hill. It was there I met Dr. Schuricht, and I knew I was doing the right thing. When I made my first appointment that January, I was 357 pounds.

At 357 pounds, I was not healthy. Two sleep studies revealed I had severe sleep apnea. I was on blood pressure medication and was borderline diabetic. I was only 43, but I felt tired all of the time.

And I wasn’t happy with the way I looked. I could only shop at Wal-Mart because I couldn’t fit into “normal” sized stores. I’d hide behind people if there was a photo being taken, and my body was hurting all of the time. It was no way to live.

I worked with the Penn Metabolic & Bariatric Surgery Program before surgery and lost 15 pounds. I joined a gym, even though I was very self-conscious. I was on my way.

Food is fuel

On the day of surgery, I was calm. Completely confident in Dr. Schuricht’s skilled hands, I was at ease. I was ready.

I had gastric bypass surgery, and when I got home from the hospital, I felt like a new woman. I began to lose weight, and started taking photos of myself each month to document the “shrinking woman” I was. Today, 12 months after surgery, I am down 151 pounds. I’ve gone from a size 28 pants to a size 16.

I don’t have to shop at Wal-Mart for clothing anymore – I can go to the mall and shop in any store I want.

But moreover, I feel healthy. I sleep better, am no longer borderline diabetic, and have gone off all of my blood pressure medications. I only wish my father was alive to see me. He would be so proud.

For me, food was an addiction. But for the first time in my life, I feel stronger than it. I don’t equate food with love; it’s fuel that gives me energy and helps me stay healthy.

Today, I am almost 45 years old, and my 19-year-old daughter struggles to keep up with me. How’s that for winning?

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.

Can You Drink Alcohol After Weight-loss Surgery?

People considering weight-loss surgery often ask if it is possible to safely incorporate alcohol into a healthy diet and lifestyle after surgery. The short answer is “yes,” but gradually and with modifications.

Here’s why:
       
Altered metabolism
Research shows that blood alcohol levels peak higher and faster and take longer to return to normal due to altered metabolism after gastric bypass surgery. In addition, many post-surgical patients consume less food when they’re drinking alcohol, which contributes to expedited absorption of alcohol in the blood stream. For many post-surgical patients, all it takes is a single drink to elevate blood alcohol level to the point of legal intoxication. This is important to remember for maintaining a healthy diet and before getting behind the wheel.

Low blood sugar
Rapid weight loss and low carbohydrate intake can lead to reduced sugar or glycogen in your body. Alcohol consumption further depletes glycogen, which causes your blood sugar levels to drop, putting those who have had bariatric surgery at higher risk for developing low blood sugar.

Hypoglycemia, or low blood sugar, is a dangerous condition that can lead to loss of consciousness, brain and nerve damage or even death if left untreated. As a result, it’s important to be on the lookout for symptoms, which include loss of coordination and balance, slurred speech, poor vision and confusion.

If you experience symptoms of hypoglycemia, drink diluted juice or take a glucose tablet immediately to raise your blood sugar level, and then have a snack with complex carbohydrates and protein to sustain it. If hypoglycemic episodes occur frequently even without alcohol consumption, make sure you seek proper medical treatment.

Excess calories
Alcohol is high in calories and low in nutrients, which is why excess calories from alcohol can slow weight loss or even contribute to weight gain. 

Addiction transfer
Patients with a history of addiction are at higher risk for developing a new addiction. With the dramatic reduction of food consumption after bariatric surgery, some patients may trade their food addiction for other addictive behaviors, including drugs, shopping, gambling, sex and alcohol.

Guidelines for drinking:
Follow these guidelines to re-introduce alcohol without compromising your commitment to a healthy lifestyle after weight-loss surgery:

• Avoid alcohol for the first six months after bariatric surgery.
• When you get permission to start drinking alcohol again, avoid carbonated beverages and sugary drink mixers. 
• Remember that after surgery, even small amounts of alcohol can cause intoxication and low blood sugar. 
• Never drink and drive, even after consuming only minimal alcohol. 
• Only drink with meals or while eating to help slow absorption of alcohol. 
• Be aware of the calorie content of alcohol.
• If you find yourself drinking regularly to cope with emotions or stress, seek help by consulting with your doctor.

- Cara Stewart

Cara Stewart, RD, LDN, is a member of the Penn Metabolic and Bariatric Surgery team.

Lose Weight and Eat Ice Cream? The Real Scoop on the Summertime Staple

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains how to incorporate ice cream into a healthy diet. 


Whether you prefer chocolate, vanilla or a specialty flavor like mint chocolate chip, nothing screams summer like a delicious ice cream cone.

Well, get out your scooper, folks, because ice cream is no longer on the "do not eat" list for people trying to lose weight.

While ice cream can be loaded with calories, saturated fat and sugar, a variety of reduced-fat and light options are now available, which means you can enjoy this summertime treat without sabotaging your diet.

It's easy to go overboard once you start eating ice cream. To prevent overeating, use a small spoon to savor every bite and scoop your ice cream into a bowl instead of eating directly from the container. Another option is to purchase individually packaged treats like ice cream sandwiches or ice cream bars.

Always remember to check out the nutrition label before you dig into your ice cream treat. Even some ice cream varieties with the label "light" can be deceiving, which underscores the importance of reading the nutrition facts. Stick to nutrition labels that follow these guidelines:

• 120 calories or less
• 4 grams of total fat or less
• 3 grams of saturated fat or less
• 15 grams of sugar or less (equal to approximately 3 teaspoons of table sugar)

These are examples of healthy ice cream choices:

• Breyers^® Double Churned light ice cream
• Edy's^® fat free frozen yogurt or Slow Churned light ice cream
• Turkey Hill^® fat free frozen yogurt
• Whole Fruit^® no sugar added sorbet
• Skinny Cow^® low fat fudge bars or ice cream sandwiches
• Healthy Choice^® fudge bars
• Rice Dream^® frozen yogurt

- Cara Stewart, RD, LDN

How to Fight Food Cravings

Food cravings are like waves building on the ocean and ultimately breaking on the beach. Usually, waves slowly build to their strongest point (when, in the case of food, most people give in) and ultimately weaken. Unfortunately, most people forget that the waves or cravings fade over time and, instead, fear that they will become out of control and can only be stopped by eating. Giving into the urge, however, only makes the craving stronger and more frequent with time. Fighting the urge and outlasting the food craving will cause it to fade away.

Almost everyone has a food craving from time to time. Unfortunately, many of these cravings are for foods that are high in calories, sugar and fat.

Dealing with cravings can be difficult. While many people may fight the craving for a period of time, they ultimately give in and, when they do, end up eating a large amount of the desired food.

Here are some tips to beat food cravings or avoid them all together.

1. Change your scenery

Sometimes, just being in a different environment can eliminate a craving. That’s because your surroundings may trigger the brain to crave certain foods.

2. Drink water

Sometimes a craving can be quenched by hydration. Drink a tall glass of water, wait 15 minutes, and if the craving is still there, try something else to fight the urge to eat.

3. Sweat

You work hard to stay healthy and that includes exercising on a regular basis. Why would you want to undo all of your hard work by giving in to a food craving? Resist a craving by going for a walk or working out with a short exercise video. You’ll overcome the craving and do something great for your body.

4. Avoid sugar

Sugar in itself can set a person up for a craving. That’s because when you consume sugar, your blood sugar spikes and quickly falls. This is what some people refer to as a “crash.” When your body “crashes” the instinct is to rebound by eating more sugar. Try eating well-balanced meals and snacks with protein as well as carbohydrates to avoid a crash and burn.

5. Don’t starve yourself

Eating five to six meals a day is recommended to keep your metabolism up, but it also helps with cravings. By eating smaller, well-balanced meals, there is never a time when you feel like you are hungry or “starving” yourself. When you skip meals, you are setting yourself up for trouble because the lower your blood sugar drops the weaker your will becomes and you’ll likely end up eating the foods you crave.

6. Identify your weaknesses

If you have a weakness for chocolate, accept it, and avoid it by not having any in the house. Of course, you cannot always avoid every situation where trigger foods might be present, but knowing your weaknesses can help you prepare.

7. Substitute

Helene shared with us on Twitter“I tend to crave sugary things. So usually I'll just chew some sugarless gum and that takes care of the cravings!”

8. Or go for the real thing

Melissa, also from Twitter, says, “I eat what I'm craving ;) or drink water with lemon” to quiet a craving.

For some people, this may work. Eating a small amount of what you are craving might be enough to satisfy the urge. However, for a lot of people, eating a small amount of what they are craving might sets the stage for a bigger binge.

How do you combat cravings?

Meet Penn Experts in Weight-loss Surgery

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.

Physician Loses 100+ Pounds, Gains Life

Bruce Sachais, MD, PhD, is an associate professor of pathology and laboratory medicine at Penn Medicine. In December 2010, he attended an informational session and decided to have weight-loss surgery. Last March, at the age of 44, his Roux-en-Y gastric bypass surgery was performed at Penn by Noel Williams, MD.

Here, he talks about why he chose to have weight loss surgery at Penn, and how the Penn Metabolic and Bariatric Surgery Program team helped him lose 108 pounds.

I have struggled with weight ever since I was a toddler. As a child, I was never particularly athletic and every year I put on more and more weight. I tried everything under the sun to lose weight, but would often gain it right back – plus some.

I began to suffer from a variety of weight-related health problems. I had high blood pressure, severe gastric reflux disease, high cholesterol and sleep apnea.

As my weight increased, my activity level steadily decreased. I couldn’t walk more than a few minutes without resting. I avoided stairs at all costs, and frequently had to stop walking due to back pain.

I couldn’t even wear my wedding band as my fingers were too big for the ring.

The weight was winning, but I was not ready to stop fighting.

Taking Control

Realizing the increasing impact my weight problems were having on my life, I decided to explore surgical options and attend one of the free, educational sessions at Penn Medicine.

The education provided at this information session, along with my own research, led me to conclude that bariatric surgery at Penn was my best option for a happier, healthier future.

In March 2011, I underwent Roux-en-Y gastric bypass surgery and my experience with the Penn Metabolic and Bariatric Surgery Program team has been wonderful.

My team members have always treated me as person — with respect, compassion and professionalism. They are very responsive to my concerns, issues and needs. Their approach to weight loss and weight control goes far beyond surgery: it encompasses nutritional and behavioral aspects of weight loss as well, which is critical for long-term success in weight control.

Life After Weight-loss Surgery

Since my surgery I’ve lost 115 pounds, and I am still losing.

Today, I am able to walk without difficulty and for long periods of time. I now opt for the stairs, and I can even jog.

I feel like I am back to my normal self, because my weight doesn’t affect my energy levels and sleep. My blood pressure is back to normal, my cholesterol is much improved, and my sleep apnea has improved as well. My reflux disease is gone and I can wear my wedding band again.

My energy level is so much better than before the surgery. I don’t become short of breath nor do I feel aching in my back anymore. As a result of the surgery, everything I do throughout the day is better; more fulfilling. I have more energy for everything that I do.

I actually enjoy food more now, since I eat more slowly and taste all the wonderful flavors.

For the first time in my life, I truly control food…it does not control me.

That is a wonderful feeling.

Advice for Others

I encourage anyone thinking about weight-loss surgery to take the first step and attend an information session at Penn Medicine. For me, learning about my options and the program at Penn was an eye-opening experience. I learned the benefits, potential risks and what I would need to do to be successful and healthy after surgery.

And think about what you want for yourself: define your own health and weight loss goals.

Attend a support group at Penn Medicine. These meetings allow you to hear from and ask questions of a variety of people that have had one of these surgeries. It also allows you more opportunities to speak with members of the bariatric team.

It is important to understand that surgery is not the easy way out or a choice for someone who is weak. On the contrary, it takes commitment and work to be successful after surgery, but it is possible and my experience is a testament to that.

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.

What is Weight-loss 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.

How 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.

3 Proven Weight-loss Plans

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?

Avoid Weight Re-Gain After Weight-loss Surgery

Many people who have weight-loss surgery are excited at the new opportunities for them post surgery. They imagine a life without medical conditions associated with obesity and are ready to begin living without the extra weight.

They are also concerned about the possibility of gaining weight back post surgery.

Unfortunately, over time some people do regain the weight after weight-loss surgery. Therefore, to achieve optimal weight-loss results, it is important to follow the nutritional guidelines provided post-surgery as a part of your new lifestyle.

To prevent weight regain after weight-loss surgery patients must follow a healthy diet plan with the focus on whole foods and continue to follow the guidelines for eating after surgery. Suggestions to stay on track include:

• Eat lean proteins, whole grains, low-fat dairy, fruits and vegetables.
• Avoid foods containing more than 15 grams of sugar per serving.
• Select foods low in fat.
• Track protein intake and get at least 60 to 80 grams/day. Protein containing foods will help keep you full and satisfied.
• Making time to eat, at least 3 times a day. Eating slowly (20 to 30 minutes/meal) is also very important.  
• Make sure your fluid needs are met with 48 to 64 ounces of low or non-calorie beverages.
• Separate eating and drinking by 30 minutes. This is a primary diet principle that must be continued. 
• Continue to take suggested multivitamins and mineral supplements on a daily basis.
• Exercise 250 to 300 minutes per week. This level of activity plays an import role in the maintenance of weight loss.

Poor food choices

In some cases, people who resume eating foods high in fat or sugar regain weight or experience minimal weight loss following weight-loss surgery. Therefore, to achieve optimal weight-loss results, it is important to follow the nutritional guidelines provided post-surgery as a part of your new lifestyle.

Foods to avoid include:

• Milk shakes, malt drinks and all high-calorie liquids
• Cakes and pastries
• Fried foods
• Pudding
• Chips and other high fat snack foods
• Soft drinks
• Ice cream
• Candy

You can also find many healthy recipes after weight-loss surgery on this blog.

Is Lack of Sleep Making You Gain Weight?

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, discusses a recent study that suggests a link between sleep deprivation and calorie consumption.

Approximately 20 percent of Americans get six or less hours of sleep a night, according to the National Sleep Foundation. That figure raises concern given new research that sheds more light on the major toll sleep deprivation can take on your health.

A recent study showed that people who slept less ate more, suggesting a link between sleep deprivation and obesity. The study, conducted by researchers at the Mayo Clinic, followed sleep and eating patterns of 17 healthy young men and women for 11 days.

For the first three days, researchers measured calorie consumption and energy expenditure to establish a baseline. For the remaining eight days, half of the participants slept normally while the others got just two-thirds of their normal sleep. Eating habits remained unchanged in both groups. The findings revealed that those in the sleep-deprived group consumed an average of 549 more calories a day.

Although the study was small, it supports earlier research that linked chronic sleep deprivation with a variety of adverse health effects and illnesses, including cardiovascular disease, diabetes and obesity.  Larger scale studies are needed to confirm these findings and better understand exactly why sleep deprivation leads to increased calorie consumption.

In the meantime, it seems safe to conclude that sleep is an important part of your healthy lifestyle. Just by getting in bed on time, you can cut calories without even trying. Now that’s a diet that is hard to beat!


- Cara Stewart, RD, LDN

No time for a workout? 10 ways to burn 200 calories in less than an hour

“I just don’t have time!”

You’ve heard it before and in fact, have probably said it yourself, but lack of time doesn’t need to be a reason for not exercising.

If your schedule is packed from morning to night, then the drive to the gym may be a waste of your time. A workout that you can do in your own home or neighborhood may be just the ticket for you.

No matter how little time you have, you can squeeze in a quick workout or multitask by incorporating exercise into your daily household chores.

Check out these efficient ways to burn approximately 200 calories without even venturing to a gym:

If you have 10 to 15 minutes:

• Grab a jump rope. Wear quality shoes with a good cushion and jump on a flat surface.

If you have 25 to 30 minutes:

• Take the dog for a walk. Work your way up to a brisk pace of about 4 miles per hour.
• Take the stairs at the office instead of the elevator or head for the stadium steps at the local school for an intense calorie burn. 
• Ride your bike around the neighborhood or on a local trail.  A pace of 10 to 12 miles per hour is moderate intensity for most people. Ride at a faster pace or try going uphill to burn more calories at a faster pace.
• Go for a swim at the local pool. Try freestyle, breast stroke, side stroke or back stroke.

If you have 40 minutes:

• Turn on your favorite music and start dancing. Invite the family to join the dance party or enjoy it all by yourself.
• Clean the house. Keep moving and get your heart rate up while checking off a household chore.  
• Wash your car by hand. Get the hose, bucket, sponge and vacuum for a detailed clean.

If you have 50 to 55 minutes:

• Keep the yard in tip-top shape by weeding, planting flowers and spreading mulch.
• Grab your golf clubs and head to the local golf course. Opt to walk and carry your own clubs instead of taking a cart.

So the next time you’re about to give up on exercising because you don’t have enough time for a full gym workout, throw away those perfectionist tendencies and remember that doing something is always better than doing nothing.

- Cara Stewart, RD, LDN

Start Walking

Rebecca Dilks, RD, LDN, research coordinator at the Center for Weight and Eating Disorders and member of the Penn Metabolic and Bariatric Surgery team, provides tips for starting and maintaining a walking program.

Gym memberships are expensive. Running or biking outside can put stress on the body, especially when starting an exercise program after surgery. But walking? It’s free, convenient and easy on your body. That is why walking is the recommended form of exercise after weight loss surgery.

The following tips can help you get motivated to start and maintain an active walking program:

Lace up your shoes rain or shine
Make a commitment to walk in all kinds of weather. If it is cold, bundle up. If it is raining, carry an umbrella. Don’t let the weather be an excuse for not walking.

Plan ahead
Look at your schedule at the beginning of each week and decide which days to walk. By planning ahead, you help ensure that your busy life does not get in the way of your walking program.

Make walking fun
Just because walking is a form of exercise does not mean it has to be miserable. Make walking fun by starting a walking group and asking friends and family to join you. A lively conversation makes exercise more enjoyable. You might even forget you’re walking for exercise.

Bring a dog
Pets make wonderful companions – even for exercise. Use your exercise time as an opportunity to walk the dog or even borrow a friend’s dog. Dogs are great motivators to keep moving and stay active.

Set a destination
Having a destination in mind makes the walk pass quicker. Before you begin your walk, set a destination such as a flower shop or bookstore. You can even reward yourself by buying a bouquet of flowers or magazine when you get there.

Clear your mind
Walking is a great form of self therapy or catharsis. Use your time walking to clear your mind and channel positive energy.

Keep things new and fun
As soon as a walking path starts feeling routine, change it up. Find a new trail or go to a park you’ve never been to before. Avoiding routine helps keep things new and fun.

Jazz up your walk with tunes
Update your music player with upbeat songs. Music is energizing and sometimes even gives you an extra pep in your step. You can also upload audio books if you prefer listening to books instead of music.

The key to maintaining a long-term exercise program is making it enjoyable instead of a chore. Also, remember that physical activity is a key component of a healthy lifestyle, so make walking a priority and invest in a healthier future.

Make sure to consult with your health care team before starting any exercise program, including walking.

- Rebecca Dilks, RD, LDN

Are You A Perfect Dieter or Realist?

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?