Johns Hopkins Press Health Book, Weight Loss for Life

A JOHNS HOPKINS PRESS HEALTH BOOK

Weight Loss Living Your

Best Life

F R LIFE From Survive with

Mental Illness

The Proven Plan for Success

to Thrive

WHY SCIENCE SAYS THAT DIETING IS NOT ENOUGH

Margaret S. Chisolm,

MD

Lawrence J. Cheskin W I T,HMD JOHN HANC & Kimberly A. Gudzune, MD, MPH Foreword by Cal Ripken Jr. | Illustrated by Natasha Chugh

WEIGHT LOSS FOR LIFE The Proven Plan for Success LAWRENCE J. CHESKIN, MD, and KIMBERLY ANNE GUDZUNE, MD, MPH

In Weight Loss for Life, Lawrence J. Cheskin, MD , and Kimberly Anne Gudzune, MD, MPH from the Johns Hopkins Healthful Eating, Activity & Weight Program provide you with all of the information you need on your weight loss journey.

They bring together leading experts in behavioral health, nutrition, exercise, and nursing to help you develop a plan that works best for you—and that’s not focused on just restricting calories or certain foods. Anyone struggling with unwanted weight gain or obesity will find this program to be helpful, compassionate, and clear.

A central feature of the program is a Personal Plan of Action to help you set reachable goals, plan your meals, and make time for movement. All the recommenda tions are customizable based on your personal health and needs. You’ll enjoy the interactive features, too, with surveys throughout asking you to reflect on your own eating habits as well as barriers to success. And unlike other works on the market, Weight Loss for Life covers it all: supplements, prescription medications, med spas, and surgical options. If you struggle, it can help you get back on track. Throughout, testimonials from others who have followed the program along with hundreds of photographs and drawings will help educate and keep you motivated along your weight loss journey.

Weight Loss for Life is the guide to the science and art of achieving and maintaining a healthful weight.

This is not a fad diet book. This is the most comprehensive, scientifically based program to lose weight and keep it off, with practical details about diet and nutrition, movement and motivation, medications, supplements, surgery, and more.

“This evidence-based, easy-to-understand approach to weight loss provides readers with the appropriate tools they need to be successful long term in reaching their own individualized goals. More comprehensive than other weight loss books on the market, this book is a valuable resource for anyone wanting to lose weight safely and effectively.”

“The lessons I learned from Dr. Cheskin and his team—including the importance of regular, daily exercise—have improved my health dramatically. This book will be a great resource for others wanting to lose weight and keep it off.”

—Margaret S. Chisolm, MD, FAMEE, FACP,

“This is a reference that I’d be eager —Virginia Quick, PhD, RDN, to recommend to my patients. Drs. Rutgers University Cheskin and Gudzune, who are are wellestablished leaders in obesity medicine and weight management, have written a great resource for learning about the science and practice of healthy weight management. Weight Loss for Life is science-based, well-researched, and a thorough and valuable guide.”

—Scott Kahan, MD, MPH National Center for Weight and Wellness, coeditor of Health Behavior Change in Populations

Written by Johns Hopkins University experts, this book is an individualized guide to the science and practical tools of weight control, weight loss, and weight maintenance after losing weight.

LAWRENCE J. CHESKIN, MD, (BALTIMORE, MD) is an adjunct professor of medicine at Johns Hopkins School of Medicine and a professor and the chair of nutrition and food studies at George Mason University. He is the author of Healing Heartburn and Losing Weight for Good: Developing Your Personal Plan of Action. KIMBERLY ANNE GUDZUNE, MD, MPH (BALTIMORE, MD)

is an associate professor of medicine at Johns Hopkins School of Medicine, where she is the director of the Johns Hopkins Healthful Eating, Activity & Weight Program.

Readers will enjoy the interactive features with surveys throughout asking them to reflect on their own eating habits as well as barriers to success.

Reading a book can be a helpful way to combat stress

situation. You may have to experiment a bit to find the best techniques for you.

Having a flexible repertoire of alternatives to eating in response to emotions will serve you well in your Personal Plan for lasting weight management.

To see how strongly your eating is affected by your emotions, complete the following questionnaire on emotional eating.

In addition to negative emotions, neutral or positive emotions can also trigger overeating. For example, Joe eats when there is nothing better to do. You might say he eats out of boredom. When he gets home from work, he settles in front of the TV and eats. If there’s nothing on TV he wants to watch, he may find himself standing by the counter, eating a snack. He usually does this after dinner, but it also happens when he’s home during the day. He says he eats because he’s hungry, but upon further questioning he reveals that he does not experience physical hunger at all. He is eating because it is his habit to eat when alone.

Eating when alone is a common pattern, and eating in front of the TV or computer is a variation on this theme. With TV it is pretty clear why eating is a frequent accompaniment.

A large proportion of the commercials are designed to put you in the mood for food.

Unfortunately, your body may not need food when you are being urged to indulge. Also, commercials tend to hawk fat-laden convenience foods, perfect for eating on a whim Don’t eat when you are distracted when you are bored and not really hungry.

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BOX 5 - 6

Eating Behavior Questionnaire: Emotional Eating Scale Directions: Circle the numbered answer that most closely matches your behavior.

Do you have the desire to eat when . . .

Never

Seldom Sometimes

Often

Very Often

1 You’re iritated?

1

2

3

4

5

2 You have nothing to do?

1

2

3

4

5

3 You’re depressed or discouraged?

1

2

3

4

5

4 You’re feeling lonely?

1

2

3

4

5

5 Someone lets you down?

1

2

3

4

5

6 You’re angry?

1

2

3

4

5

7 You’re about to experience something unpleasant?

1

2

3

4

5

8 You’re anxious, worried, or tense?

1

2

3

4

5

9 Things are going against you or when things have gone wrong?

1

2

3

4

5

1

2

3

4

5

11 You’re disappointed?

1

2

3

4

5

12 You’re emotionally upset?

1

2

3

4

5

13 You’re bored or restless?

1

2

3

4

5

10 You’re frightened?

Interpretation: Add the total to get your score, and use the following information to interpret the meaning of your score. For this scale, the average adult who is not overweight scores 17 (men) and 20 (women). Scores higher than 25 may mean that you have a higher tendency to eat in response to emotional cues than most people do.

SOURCE: Adapted from T. Van Strien, J. E. R. Frijters, G. P. A. Bergers, and P. B. Defares, “The Dutch Eating

Behavior Questionnaire (DEBQ) for Assessment of Restrained, Emotional, and External Eating Behavior,” International Journal of Eating Disorders 5 (1986): 304. Nederlandse Vragenlijst voor Eetgedrag (NVE).

Copyright 1986 by Swets and Zeitlinger, B.V., Lisse. Reprinted by permission of John Wiley & Sons, Inc. © 2021 THE JOHNS HOPKINS UNIVERSITY PRESS UNCORRECTED PROOF DO NOT QUOTE FOR PUBLICATION UNTIL VERIFIED WITH FINISHED BOOK. STR ATEG IC STR E S S MANAG E M E NT ALL RIGHTS RESERVED. NO PORTION OF THIS MAY BE REPRODUCED OR DISTRIBUTED WITHOUT PERMISSION. NOT FOR SALE OR DISTRIBUTION

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“invisible” calories like these will play an important role in weight loss and keeping Tips for Weight weight off long term.

Management Keep in mind that making healthy food choices for weight loss or maintenance is View the following as fun challenges not just what you do eat—it’s also what that will help you lead a healthier you do not. Within the concepts of nutrilifestyle: ent density and calorie control, there is • Eat no more than one meal per not much room for fast food, fried foods, week prepared away from home. sugary foods, added sugars, sodas, fancy coffee drinks, and the millions of prepared • Drink no more than one 12-ounce and processed foods that currently make soda per day (even that is a lot). up the bulk of the typical American intake.

• Cut way back on animal fats and Although there is nothing wrong with fried and processed foods. the occasional use of any of these foods, Fill half your plate with fruits or • we are simply at a place right now where veggies at every meal. our population relies so heavily on these calorie-laden choices that anyone who cuts • Choose whole grains most of back even just a bit is likely to feel better, the time. have more energy, and even lose weight (or at least stop gaining). Is there any room for birthday cake and pizza? Sure. But not in huge quantities, and not every day.

While the focus of the Choose My Plate icon is on a meal, many people overlook the additional contribution of calories consumed in between meals. As discussed in chapter 5, snacking in between meals or grazing on food throughout the day can also be important factors to consider when managing your weight. Be aware that eating outside of designated mealtimes, which is often done for reasons other than hunger, can contribute significant unwanted calories that can derail your weight loss efforts. As previously discussed, the influence of our modern food climate encourages these behaviors, and it is important to take steps to reject these negative influences as much as possible.

BOX 6 -14

Eating Healthy Portion Sizes Many of our patients have said, “I try to eat only heathy foods, but my weight isn’t changing.” They feel confident that they have already cut back on total fat, reduced sodium intake, limited alcoholic beverages, and significantly cut down on

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Helpful, compassionate, and clear.

sugar and processed foods. What they may not realize, however, is that they haven’t reduced the total calories consumed; in fact, for most Americans, average caloric intake has steadily increased.

The upswing in caloric intake over the past three decades is partly due to a lack of understanding of the size of reasonable portions of food. We have no visual concept of how much is enough. How many calories should be found in a typical meal, and what does that meal look like on a plate? How many calories do we really need? Generally, we have lost track of a visual sense of what healthy portions look like.

The food and restaurant industries in the United States have gradually marketed larger and larger servings and packaging of all kinds of foods, meals, and even sizes of plates, cups, and containers in which our food is served. In terms of calories, most of us have little idea how many calories a single food contributes and are therefore unable to estimate how any food choice might factor into a day of appropriate calorie intake.

For example, when canned soda first became available in the 1940s and 1950s, it was sold in 8- or 12-ounce bottles. Now, the typical vending machine stocks 20-ounce plastic bottles, and we have doubled our rate of consumption since the introduction of plastic bottles and vending machines in the 1970s. Not coincidentally, the rate of obesity doubled along with our consumption habits. If you asked the typical person today if they want a soda, they accept a 20-ounce bottle as normal and refer to an 8-ounce can as “a mini.”

Here’s another way to look at it. Let’s say a woman was gradually trying to lose weight by eating approximately 1,500 calories each day. But if she didn’t recognize © 2021 THE JOHNS HOPKINS UNIVERSITY PRESS UNCORRECTED PROOF DO NOT QUOTE FOR PUBLICATION UNTIL VERIFIED WITH FINISHED BOOK. D E S I G N I N G YO U R DI E TARY P L AN ALL RIGHTS RESERVED. NO PORTION OF THIS MAY BE REPRODUCED OR DISTRIBUTED WITHOUT PERMISSION.

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PUBLICATION DATE DECEMBER 2021 A Johns Hopkins Press Health Book 384 pages 7 x 10 131 color photos, 10 color illus.

978-1-4214-4194-8 $29.95 £22.00 hc Also available as an e-book

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