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“To be able to lose weight and not be hungry is the Holy Grail of weight loss.” — Michelle Swader-Harnisch, UW Health registered dietician nutritionist
Chances are you or someone you know has tried to lose weight by dieting. Chances also are that it didn’t work, or if it did, the weight came back once the diet was stopped, hence the phrase “yo-yo dieting.”
Dr. Compton Kurtz, a UW Health medical bariatrician, helps patients who are looking to not only lose weight but enjoy a happier, more fulfilling lifestyle.
“Obesity is associated with 232 diseases or conditions, from diabetes to hypertension to high cholesterol to fatty liver disease,” said Dr. Kurtz. “These, in turn, contribute to heart disease and stroke. There are also 13 cancers associated with obesity, as well as more depression and anxiety. Imagine how much of this we can prevent — simply by thinking more about what we eat and how we eat.”
The best news, said Dr. Kurtz and Michelle Swader-Harnisch, a UW Health registered dietician nutritionist, is that you don’t have to torture yourself to lose weight and feel better.
Some patients who suffer from obesity opt for weight loss surgery, but for those who either are ineligible or don’t want to undergo surgery, the UW Health Metabolic Weight Management program is a wonderful option.
Patients receive their own weight management plan
Each patient who enrolls in the program receives a customized weight management plan. Some might also benefit from medications that can be tools to help reduce hunger and food cravings. They can make people feel fuller for longer, resulting in less consumption. Regular exercise, which boosts overall wellness more than it helps people lose weight, also is emphasized based on each patient’s capacity for activity.
In terms of nutritional principles, some of the essential recommendations include:
Keeping carbohydrates to a minimum, with sugary sodas being the No. 1 target for elimination. This is key to achieving the best long-term outcome, because carbs — especially processed carbs that lack fiber — do not make you feel “full” for long, so you crave more food in little time. The program offers plenty of strategies for reducing carb intake.
“Foods with fiber, such as broccoli, cauliflower and other above-ground vegetables are best,” said Swader-Harnisch, “but beans, steel cut oats, quinoa, berries and bananas are much healthier than processed carbs like baked pastries, cereals and most breads."
“Whole grain carbs, such as those made from whole wheat, are much better than processed carbs like white bread, white noodles, regular pasta or white rice. Cauliflower rice is a great substitute."
Limiting alcohol. Alcohol has calories that must be metabolized even before carbs. It also stops your body from burning fat and tends to make us crave unhealthy foods that are high in fat and sodium.
Eating healthy fats, such as those that come from plants or fish. Foods such as salmon, tuna, olive oil and most nuts are great sources of healthy fats.
“For decades, we’ve been told that all fat is bad,” Dr. Kurtz said. “Healthy fats are not only good for you but help you feel “full” longer.”
Consuming plenty of protein, which is essential to good nutrition and feeling satisfied. Good sources of protein include the aforementioned healthy fats, as well as beans, eggs, meats (white meat is generally healthier than red), fish, cheese, Greek yogurt, nuts and seeds.
Kurtz says that one of the greatest hurdles he faces is reversing the dietary mind-set that has been ingrained in people since childhood.
“Many of us remember being told to clean our plates because there are starving children in the world,” he said. “So in order to get your ice cream or cookie for dessert, you had to eat everything on your plate. Your ‘reward’ for eating lots of calories was more calories.”
'Food pyramid' was misguided
Kurtz also says the “food pyramid” promoted by the government starting in 1980 was not based in science.
“It called for six to 11 servings of carbs each day and very little fat,” Kurtz said. “So many of us grew up believing that all carbs were good and all fats were bad. It’s just not scientifically valid.”
Another commonly shared habit is eating a bowl of cold cereal, Kurtz said.
“We remember the TV ads that aired during cartoon shows promoting cereal as being ‘fortified with vitamins and minerals,’” he said. “This sounded good to kids and parents. What they didn’t tell you is that most boxed cereals are ultra-processed with added sugar and that ‘fortified’ means nutrients are added that don’t naturally occur in cereal.”
Another myth, Kurtz said, is that "breakfast is the most important meal of the day." What’s more important, he said, is what is consumed when that fast is broken. It doesn’t have to be breakfast first thing in the morning.
Eat when you’re hungry; don’t eat when you’re not
“If you wake up and feel hungry, a healthy breakfast is great, but meals should not be eaten just because it’s ‘that time of day,’ " Dr. Kurtz said.
Intermittent fasting, Kurtz said, gives you the opportunity to burn stored fat and in turn, lose weight. Some people find success by fasting between their evening meal and the next day’s lunch, giving their metabolism cycle a 16-hour break. Others may try a 5:2 approach, in which they eat three meals on five days during the week and one meal a day on the other two.
Even small steps, Kurtz said, such as avoiding evening snacking, can be effective.
“If you normally eat dinner around 6 or 6:30 p.m., avoid the evening snacks," he said. "Many of us snack because it’s habitual to munch on something while watching TV at night, not because we feel hungry.”
Swader-Harnisch said another easy change to make is avoiding “mindless eating” such as grabbing a treat from the break room brought in by a co-worker. “We eat things like that simply because they’re there,” she said.
The Metabolic Weight Management Program, Swader-Harnisch said, is about getting fit, healthy and happy.
“We’re not about body image or getting you back to your high school weight,” she said. “We want you to celebrate the victories whether they are on or off the scale. Maybe that victory is getting below 300 pounds or perhaps it’s being able to walk up a flight of steps or around the block for the first time in years.”
For Dr. Kurtz and his team, the rewards are just as plentiful as they are for his patients once they start achieving their goals.
“It’s hard to put into words how good it feels when you help people start feeling better in all aspects of their lives,” he said. “It really is the greatest reward for what we do.”