We started talking about ways to address the weight gain and I stated the obvious: stop eating the junk, no more snacking and get back to exercise.  And therein lies my epiphany.  The weight comes on easily because all it takes to gain is eating too many calories or eating too much of the wrong thing (high fat, high sugar, low anything-good-for-you).   Know what? That’s awfully fun and pleasurable to do, too. 

But losing that weight once it’s in place is a completely different process.  It’s difficult to lose with food restriction alone.  Some will come off, definitely.  But at some point you will stall.  Why? Because when you gain weight you gain fat (unless you’re lifting copious amounts of heavy weights like a bodybuilder).  But when you lose weight, you generally lose a combination of fat and muscle, not just fat alone.  And muscle is what burns calories – it’s what makes up the majority of your “metabolism” in terms of calories burned each day.  So every time you diet, potentially you (a) actually become fatter even if the scale goes down since a larger percentage of your weight is made up by fat and (b) you slow down your metabolism making it harder and harder to lose any more weight without severe calorie restriction.

So is it hopeless? Of course not!  The antidote is exercise.  Weight bearing exercise, whether it’s walking/running/aerobic dance/weight lifting, will halt the loss of muscle while you diet, helping to maintain your current level of muscle (aka lean body mass) and maybe even build a little more.  Every pound of muscle burns extra calories each day- even while you sleep!

So while eating alone will put the fat on, only eating right and exercise together will take it off.  The combination allows you to lose the fat but still maintain your metabolism (your ability to burn calories) as well as maintain a lower body fat percentage (how much of your weight is made up by fat and how much by muscle).  Remember: the higher your body fat percentage, the higher your risk of high blood pressure, heart disease and cancer.  So don’t be a “skinny fat” person – don’t just lose a bunch of weight on the scales, but end up more unhealthy than when you started.  If you do it well, all the benefits of weight loss will be yours and are much more likely to last a lifetime.

Three or so margaritas into the afternoon, we got the bright idea to form a half marathon team in honor of little Zoe and give the proceeds to Arkansas Children’s Hospital (where she had gotten all of her care).  Needless to say, the next morning – in addition to a whopper of a hangover – I now had a commitment to propel my body 13.1 miles forward in space.  How many steps had I run in the previous decade prior to this commitment? Um……none.

But I put on my big girl panties and “trained”.  Sometimes I trained with more vigor, sometimes – like say, the whole month of November – with a lot less.  But I concluded my preparation two weeks before the race with a long “run” of 13.8 miles.  I say “run” because I would slog (slow jog) for two minutes, walk for one, take lots of potty breaks, change the channel…..anything to relieve the “ouch” of the effort.  My time? 3 hours 17 minutes.  Not really good, but the best I thought I could do.  I really wanted to do 2 hours 48 minutes which would be about a 13 minute mile, but I really didn’t see how I would shave a half hour off my time in two weeks so I didn’t worry about reaching that goal too much.

Yesterday, March 7, was the big day.  Half marathon in Little Rock.  Wanna know how I did?  Too bad, ’cause I’m gonna tell ya’ anyway.

2 hours 43 minutes which equals a 12minute 28 second mile. For 13.1 miles!! Five minutes LESS than my “I’ll never be able to do this” goal of 2:48 and about 34 minutes short of my previous “best” effort.

So what did I learn?

(1) Goals: you’ve gotta have goals.  You will never be able to fix what you don’t measure, think about and change.  If my husband (y’all know him as Dr. Hekier) hadn’t pushed me to define what time I wanted to achieve – and what pace per mile I needed to achieve that – then I never would have pushed a little harder on the hills, never would have glanced at anything but the scenery and certainly not at my watch.  If you want to lose weight, define for yourself how much you want to lose and how fast.  Each pound equals 3500 calories.  So how many calories do you need to not eat each day to reach that goal?  A goal you can measure every day or even every meal is realistic to follow and act upon.  A nebulous goal of “I want to be a size 6 by Christmas” doesn’t tell you what to do every time you sit down for a meal.  “I need to eat 400 calories this meal so I can meet my calorie deficit for today to lose one pound this week” is a measurable index.  And if you don’t meet it? Fine, you can meet it the next meal. If your goal is vague you’re much more likely to just give up and not try again next time.

(2)Amazing results don’t only come from amazing effort – sometimes they come from just some effort.  I am not a natural runner.  My legs are short, my endurance is terrible and I tend to stop any activity that starts to hurt.  I can’t tell you how many times I’d stop running and just walk when I got a little winded or tired.  But it didn’t stop me from getting on the treadmill two days later and trying again.  Over 7 months, even these half-hearted efforts made me stronger, faster and more resilient.  You may not want to eat the perfect “in the box” meal each and every day, three times per day.  But just by cutting out the junk – the chips, the sweet tea, the soda, the ice-cream – you will lose weight over time.  The harder you push – the more you stay in the box and the more you exercise- the faster the weight will come off.  But even some effort is better than none at all. 

(3) Be accountable.  I did most of my training by myself which allowed for all of the walk breaks I described earlier.  One reason I kicked tail in the race is because there were a lot of people around me who were exciting and inspiring.  There’s a lot of fun to be had in shared pain (no, really!), a lot of inspiration that comes from seeing someone older/sicker/heavier do something better than you ever could.  But it’s also human nature not to slack off as much when other people are watching you as well as the natural competitive nature that comes from doing something with another person with similar goals.  So many diets fail because we do them alone.  One of the great things about the band is that it gives you a community.  If you go to support group, you can be inspired by others’ achievements, you can get excited by their solutions to problems (e.g. night-time snacking) or if you want, you can find a friend and set up a little competition.  Who can lose the most weight in 4 weeks or who can increase their exercise time the most… or whatever.  And remember, your office visits act as automatic accountability because every 4-6 weeks or so, somebody’s gonna be watching and sending you to the principal’s office if you’re off course.  If that’s not inspiration to straighten up and fly right, I don’t know what is!

(4) Turn to experts-then actually do what they tell you to do.  With my training I did the same thing many bandsters do: I said, “I know, I know”.  I knew I was supposed to gradually increase the distance on my long run every week, I knew I should do some interval speed work on the track to get faster.  But knowing and having a willingness to do something are very, very different.  Speed work hurt, long distances can get boring.  What I wanted to do was sit on the couch and read cheesy novels on my iPhone Kindle app.  But now that I’ve caught the bug, I’m willing to look back at what a really rigorous training program looks like and I’m willing to surrender.  Yes, once per week I’ll go to the track instead of another slow run on the treadmill and I’ll do my long runs when and how they tell me to.  D’you want to lose weight? Stay in the box, eat three meals plus one protein heavy snack per day, take your multivitamin every day and exercise.  Don’t drink with your meals and don’t eat or drink crap.  Do you want to do all that? No.  We repeat it over and over and patients say, “I know, I know” over and over, but until you actually DO it….nothing happens.  I wanna crash and read books, my patients want to drink sweet tea.  We both have to make a choice, which leads me to my last point…..

(5) Success is sweeter than you can even imagine!!  When you really, really, really just don’t want to give up that third slice of pepperoni pizza, stop for just one second and think about your ultimate goal.  I can now tell you from experience that reaching that goal is an absolute slice of pure joy and wonderfulness.  And I’ve got a tangible feeling to carry with me while I train for my next race, even during those dark early morning hours when it’s cold and my nose is running and my ankles hurt.  If you get into a size 6 or 8, then even if you gain a little back, you can hold onto that feeling of goodness that comes with achievement and use it to power your drive to get back there. 

Once you achieve a goal, nobody can ever take that away from you.  If you got to a level of health or fitness or thin-ness that made your toes curl with excitement, then that is who you are.  You are NOT the overweight person you were when you first walked in this office, even if you gain a little back.  You will always and ever after be that person that achieved their goals, you are strong, you are capable but you might have just gotten off course – temporarily.  Let that person be in charge to get you back to where you need to be, not the defeatest person who failed every other diet they ever tried.  I will always be a runner now – because I ran a distance that makes most people shudder.  I wasn’t the fastest, the most graceful, the most challenged – but I was a finisher.  You may never grace the cover of a fashion magazine, but once you lose your weight, you will always be a finisher, too.  If I could, I’d even share my medal with you. Maybe.

But before you take these comments to heart, I want you to consider a few things first.

Remember that people who know you are used to seeing your face a certain way.  They’ve spent years gazing on full cheeks and a round profile.  As you lose weight, you’re not going to look like that anymore.  If they met you for the first time after you had lost weight, they would think you looked perfectly normal and fine.  But since their mental picture of you is with a different amount of fullness to your face, they’re just as inclined to think that it makes you look sick as that it makes you look good.  Not because you do look sick, but because you no longer fit their preconceived portrait of what you should look like (to them).

That’s the most benign explanation.  But of course, there are more insidious reasons that people may want you to feel badly about the weight you’ve lost.  Some may be jealous of the weight you’ve lost (wishing it were them), some may be jealous of the person you’ve become and of the people who now admire your figure.  Friends, spouses, siblings all may get jealous that you’re the cute new thing on the block while they’re still just themselves.  Some people will react to those feelings by putting you down to pump themselves up and make themselves feel better.

It’s this last group I most want you to look out for and avoid reacting to them whenever possible.  Their goals are not in your best interest, and if you let them sabotage your confidence, you’ll never know what you might have achieved.  You look in the mirror – if you like what you see, then don’t worry about the people who try to bring you down.    Trust me, we’ll tell you here in the doctors’ office if we think you’ve lost too much weight (and of course threaten to sit on you and unfill the band a bit, if needed).  Let your own inner voice be your guide, not the misguided or malicious (even if unintended) voices of others.

Oats get a lot of great press for lowering cholesterol and having lots of fiber.  But these benefits really only come from oats that are not super-processed, i.e., not instant oats in a packet.  “Real” oats are called steel cut or Irish oats and can be found in any health food store, and maybe even some groceries.  But they take 20-30 minutes to cook, otherwise it feels like you’re grinding down your teeth with little pebbles.

So here’s the trick: the night before, combine your oats and water and bring to a boil (you can do this while you’re cooking dinner).  As soon as the water boils, cover the pot and take it off the heat.  Now leave it on the stovetop overnight.  In the morning, put the pot back over heat and bring it to a boil.  As soon as it boils (about two minutes), take it off the heat, add some protein powder, Splenda or stevia or whatever other flavorings float your boat and voila! Nearly instant oatmeal with all the benefits of whole oats.

Which reminds me: another trick I’ve learned is that protein powder tends to gum up into little balls if you add it immediately to something super hot (like coffee).  Wait until the oats are a little cooled off, then add the protein about a 1/3 of a scoop at a time instead of all at once, stirring after each addition.  That way, the protein melts into the food instead of glomming up into unattractive, unappetizing blobs.

But then a few weeks pass and dust starts to collect on the parts of the machine that are exposed.  The rest of the machine is of course, covered with clothes.  Suddenly instead of a glorious emblem of fitness, the machine is a convoluted hat-rack.  A very expensive, sometimes guilt inducing hat-rack, at that.

I may just be projecting because this has certainly happened to me with several different pieces of equipment, but I don’t think I’m alone in this.  I’ve talked to lots of people who have bought fitness “stuff” that just ends up sitting around ’til it gets sold in a garage sale at $0.10 on the dollar.

So what to do?  Here are my New Year’s thoughts on actually exercising and using what you’ve got.

1) You’ve got to like exercise before you actually do it.  If you dread it – whatever “it” is – you ain’t gonna do it.  Don’t buy a treadmill because you think using it will make you look like the skinny-Minnie marathoners in the magazines.  Buy a treadmill because you’ve got a stack of movies you’re dying to see and getting on the treadmill will allow you 30+ minutes every day to watch them.  Or better yet, because walking/jogging/running gives you a hit of endorphins that makes your whole day great!  We just got this slippy-slide thing that lets you mimic speed skating in your living room.  It’s a blast, so we use it.  But a stationary bike? Not my speed, so never had one.  Makes my behind sore.  But I’ve got patients that swear by them.

2) You’ve made your choice, now work it! You found something you like – so do it.  You can’t just go through the motions, tho’, you’ve got to actually sweat.  Are you an outdoors person and enjoy walking? Groovy – but 30-40 minute miles while chatting with a friend is called “strolling” not exercising.  If you’re a walker, pump those arms, move those legs, get some huffing and puffing going.  Here is a link to a program that will take you from barely able to walk out the front door to running (ok, slogging, but still!) a 5K. You can do it! http://www.c25k.com/

3) Speaking of intensity, here is one of the great fat burning programs of all times and it will accomodate anyone from the least to most fit, from the idle rich to hardworking folks with no extra time.  It’s called HIIT and it goes like this: warm up for 5 minutes, then for 15-30 sec exercise all out doing whatever you’ve chosen to do (run, swim, walk, jumping jacks, skipping, squats-whatever!), then go back to a restful, relaxed pace for 2-4 times that length of time, then repeat a few times.  For example, you run all out for 15 seconds, walk slowly for 45 seconds to catch your breath and let your  heart rate come down, then you repeat this cycle 10 more times, then cool down for 5 minutes.  Total time: 21 minutes.  For some people, the “all out” phase may be walking briskly, and the rest interval may need to be 5-6 times the length of the high intensity interval in order to do it again.  But you’ll find by doing this several times per week, that you’ll soon expand your exercise tolerance dramatically. Knees hurt too much to do this? Try doing it by tossing a basketball in the air or throwing it hard onto pavement instead.  There are all kinds of upper body-only exercises that will allow you to raise your heart rate in the high intensity phase.

Now get moving!

But let me tell you, starting all at once (with every change that you might need to make) can be a Herculean task (can you tell I signed up for a word-a-day email? herculean means something that would take the strength of Hercules to overcome).  Not even Lance Armstrong could step out his front door one day and run a marathon.  He would have to start with short runs and gradually build up to longer more extensive training as he got stronger.

What does this have to do with you? It’s extremely hard to change all of your habits in one fell swoop.  What would I like to see in an ideal world? I’d like to see all my patients exercise 5 hours per week, I’d like to see 80+% of your meals be within the box and I’d like to see everyone lose 1-2 pounds a week until they reached their goal. 

But Hekier and I just started a new nutrition program ourselves and making all of the changes above would be well nigh impossible given how hard it is for us just to make some minor adjustments in an already healthy lifestyle.  We’re trying to really focus on cutting out “carbs” (e.g. bread, rice, pasta) and focus on fruits and vegetables instead.  Just one little difference, and boy-howdy….. it’s tough!!  And when you don’t succeed it’s really tempting to just give up.  “Well, I already cheated with some toast, might as well just have rice with dinner.”

So my tips for getting started and staying on track-based on recent personal experience-are:

prepare, prepare, prepare: plan out your menu for the week, shop for everything you need, make as much as you can in one day so you don’t spend every day in the kitchen for hours.  Always bring your lunch/snack/dinner with you to work, never leave it to chance to figure out what you’re going to eat

Do a mental clean-up: get rid of any thoughts of who you “used” to be, of what you used to be able to wear or how long you used to be able to exercise.  Figure out where you are NOW, and then celebrate every success, no matter how small.  Doesn’t matter what was, only what is and what will be.

Get your posse behind you: want to start walking on the track? Great! Bring your children and let them run around on the grass in the middle of the track while you walk.  Or even better, let them roller-skate/bike/skateboard on the streets while you run/walk along with them.  Make your spouse vow to eat healthier with you.  Get some friends to join you in signing up for a 5K walk and train together.  The more people you have supporting you, the better you are likely to do.

“Just Do It”: there are lots of times I just don’t want to exercise but I promise myself I can quit after 5 minutes if I’m still not in the mood.  Know what? In the last 10 years, I’ve only quit once.  Once you’ve started, you’ll keep going 99.9% of the time.  If you can just start, you’ll finish.  But if you never start…… you’ll never finish.

So my mistake of the week is this: IF YOU ARE TOO TIGHT, THE BAND WILL NOT RELAX ON ITS OWN

There are some people who actually don’t feel the full effects of a fill for up to two weeks afterwards, but the opposite -m a feeling of being too full (e.g. the feeling that the food is not going down, everything but liquids comes back up as a productive burp, lots of night-time reflux or vomiting)- is NOT going to get better.  As soon as you feel that way, call the office and get an unfill.  If you wait until the weekend, it may be Monday morning before we’re able to see you.  Don’t assume that we’ll be available to meet you in the ER for an unfill or that somebody there will be able to treat you.  If you feel too full, your best bet of being unfilled the quickest is to call or come in during business hours Monday-Friday.

We hope your New Year starts and ends with all the very best things you can imagine!!

with love,

Dr.s Hekier and Keilin, Betty, the two Debs and all the rest of the NoScales crew

Everything in life has plusses and minuses.  Go to a club on Saturday night and have a great time, but have a hangover Sunday morning.  Buy a beautiful fast car with leather seats, pay more in insurance.  Go shopping often and spend most of your paycheck, then have nothing put aside for a rainy day or retirement.

Food is no different.  Yes, there are a lot of perfectly yummy things you can eat that are healthy and won’t make you overweight.  But there are far more things that taste super-fly fabulous, but have no nutritional value and are guaranteed to make you fat.  Does this mean you should never eat them?  No, but you should follow what somebody once told Dr. Hekier is the 80/20 rule.  Eat 80% of your meals for nutrition, 20% for taste.  You simply can’t have the most yummilicious thing to eat for every meal if your version of yummy is chocolate covered peanut butter or fried anything.  You can have treat-ish stuff 20% of the time, or 1 in every five meals, but the other 4 out of 5 meals need to be nutritional and waaayyyy inside the box.  And even that 20% of the time, you shouldn’t go super-ultra wild.  Is pizza your downfall?  Then let your 20% be a slice or two of pizza, but not half the pie (and preferably not a double decker, stuffed crust, meat lovers delight either). 

Learn how to eat to live, not live to eat.  To quote Remy’s father from the Disney movie “Ratatouille”, “Food is Fuel”.  I’m not saying to eat tasteless bland crap 3-4 times per day, but do look at each meal as an exercise in taking in the nutrition you need – the protein, the calories- and not as a chance to find the most fabulously delicious thing on the menu.  Look at a menu trying to find the lowest fat, lowest calorie source of protein on there, not the double battered chicken fried steak with gravy.  If you change your fundamental approach to food, then dieting and maintaining your weight becomes a habit, not something you have to constantly fret over and work on.

OK, so I don’t know what to write about today, I’m having a little writer’s block.  But then again, I think of things to talk about every day that would be a help or provide a little encouragement or support.  Since I’m having trouble remembering any of them right now, I could just say, “I’m too tired to think about it today so I will do it tomorrow”. If I really want to rationalize my way out of writing a post,  I could do so by saying “writing a blog just isn’t part of my job description and I didn’t ask for it anyway!”  But then I start thinking ”writing posts is something I really LOVE doing” and once my mind starts going it’s usually hard to reign it in.

Anyone out there see a pattern here??  Those are all excuses for not doing something I really WANT to do!  People do it every day…..take
more time to figure out the reason they aren’t going to do something or spend more brain power trying to figure out how to get out of something
that they really want in the end.  The point is…..YOU ARE NOT EVER GOING TO GET RESULTS WITHOUT SOME SORT OF EFFORT!  It is imperative that for once in your crazy, busy, stressed out, complicated life you take time for YOU…..to learn how to do right by your band so it does right for you.  If you don’t, then bottom line is that your busy, stressed out complicated life will be potentially shortened due to a controllable illness that you just couldn’t take the time out to prevent. Conditions directly related to obesity include but are not limited to Diabetes, High Blood Pressure, Heart Disease, Stroke, Sleep Apnea, Musculoskeletal disease ie: back fusions, knee replacements…etc.

There comes a time in your life when you have the opportunity to take charge and choose to turn things around.  You already did that….you
had weight loss surgery. But having this doesn’t make you an instant genius.  It takes work and education, trial and error.  You may be on
your own in making the decision of what to choose to put in your body, but you are not on your own when it comes to learning what appropriate
choices are. And best of all…..its free!!!—-meet me at Wadley the second Monday of EVERY month at 7pm……Lori