WPWI Perspective

Jennifer K. Hendrix
  • 5.0 (8)
  • HEALTH & FITNESS

Much to do about everything weight loss.

Episodes

  1. 02/20/2020

    Pathophysiology of Obesity: Applied.

    This past weekend I gave a lecture at the Physician Moms Group medical conference covering the pathophys behind obesity. While I still will put something more technically together, today I had an interesting conversation that gave me the idea of posting about how this information is can be used and explained in “real-life” terms.   As always these audio recordings are for education purposes only, and not meant to act in any way as medical advice. Please consult your personal physician for your personal medical advice.

    34 min

  2. 04/14/2019

    3min Audio: The Art of Being Healthful

    Ok, my new little speaker kind of stinks. I could have been hitting it with my hand as I paced around speaking though!?! But, the good news is I know out of all the people out there, my group knows nothing is perfect. #nofancybellsorwhistleshere 😉

    3 min

  3. 01/25/2019

    The Obesity Paradox

    Obesity Paradox The idea that a high BMI appears to be protective and decreases death in people, but also is associated with increased risk of death.    ***More simply put – there is data out there that shows being overweight can be a good thing for some, yet a bad thing for others*** Acronyms HTN : hypertension Normal BMI (Nml) = 30 Evidence showing OW+ is bad for our health: Tons of it out there, I don’t think I need to list too many. But here are some as it is still important to remember this. Arch Intern Med. 2002 Sep 9;162(16):1867-72. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience.Wilson PW1, D’Agostino RB, Sullivan L, Parise H, Kannel WB. Looked at relationships between BMI and CVD risk factors, CVD endpoints prospectively from the Framingham HEart Study of ppl 35-75 who were followed for up to 44 years. CV endpoints the looked at: Angina, MI, Coronary hrt dz, or stroke. Conclusions: the overweight category is assoc with increased relative and population risk for HTN, and CVD. Ob risk of HTN was 42% OW risk of HTN was 27.8% Nml  risk of HTN 15.3%   NHANES III (1988-1994) to NHANES III (1999-2000) Showed increase prevalence of Metabolic Syndrome (MetSyn) and that weight was associated with increased risk of MetSyn: Nml 5% OW 22% Ob 60% http://care.diabetesjournals.org/content/34/1/216.long N Engl J Med. 2002 Aug 1;347(5):305-13.Obesity and the risk of heart failure.Kenchaiah S1, Evans JC, Levy D, Wilson PW, Benjamin EJ, Larson MG, Kannel WB, Vasan RS. 5881 participants in Framingham. Used Cox proportional-hazards model Found: For each 1 unit increase in BMI women’s risk of heart failure increased by 7%, 5% in men. Nurses’ Health Study https://www.ncbi.nlm.nih.gov/pubmed/7872581 114,281 female registered nurses aged 30 to 55 years who did not have diagnosed diabetes mellitus, coronary heart disease, stroke, or cancer in 1976. Over 11 states. Findings: BMI 35 was associated with 6X higher “relative risk” of T2DM Look AHEAD study and others Have shown that even a 5% weight loss can improve risk profiles for diabetes and cardiovascular health Lancet. 2014 Aug 30;384(9945):755-65. doi: 10.1016/S0140-6736(14)60892-8. Epub 2014 Aug 13.Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5·24 million UK adults.Bhaskaran K1, et. al. “Assuming causality, 41% of uterine and 10% or more of gallbladder, kidney, liver, and colon cancers could be attributable to excess weight. We estimated that a 1 kg/m(2) population-wide increase in BMI would result in 3790 additional annual UK patients developing one of the ten cancers positively associated with BMI.” ***granted i’m not sure any paper should have been published that uses the world “assume.” After all that just makes a “bleep” out of you and me. But as other studies do seem to show an assoc we’ll let it slide*** ************************************************** So there is a lot of data out there that shows associations between excess fat mass and MetSyn, HR, cancers, and 200+ diseases. From some evidence you would conclude that obesity does cause health problems. The Obesity Paradox: The strange thing is of the people getting diseases, the people who have the better prognosis are the ones overweight!!! And while all the above more talk about risk factors, we still do see patients of normal weight getting HTN, having coronary hrt disease, T2DM, getting the other 200+ diseases. Am J Med. 2007 Oct;120(10):863-70.Obesity paradox in patients with hypertension and coronary artery disease.Uretsky S1, et. al. 22,576 ppl with HTN and CAD Outcomes looked at:  first occurrence of death, nonfatal myocardial infarction, or nonfatal stroke. Obese Class I(30-35) had a HR of 0.68 compared to Nml BMI patients. Lancet. 2006 Aug 19;368(9536):666-78. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies.Romero-Corral A, et al. Method: selected cohort studies that provided risk estimates for total mortality, with or without cardiovascular events, on the basis of bodyweight or obesity measures in patients with CAD, and with at least 6 months’ follow-up. Found:  found 40 studies with 250,152 patients that had a mean follow-up of 3.8 years. Patients with(BMI) (ie, or =35) did not have increased total mortality (1.10 [0.87-1.41]) but they had the highest risk for cardiovascular mortality (1.88 [1.05-3.34]). Am Heart J. 2008 Jul;156(1):13-22. doi: 10.1016/j.ahj.2008.02.014. Body mass index and mortality in heart failure: a meta-analysis. Oreopoulos A1 METHODS: searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Scopus, and Web of Science to identify studies with contemporaneous control groups (cohort, case-control, or randomized controlled trials) that examined the effect of obesity on all-cause and cardiovascular mortality. RESULTS: Nine observational studies met final inclusion criteria (total n = 28,209). Mean length of follow-up was 2.7 years. both overweight, RR 0.84, 95% CI 0.79-0.90) and obesity, RR 0.67, 95% CI 0.62-0.73) were associated with lower all-cause mortality in pts with CHF Logue J, Walker JJ, Leese G et al (2013) The association between BMI measured within a year after diagnosis of type 2 diabetes and mortality. Diabetes Care 36: 887–93 Study of 106 640 participants in Scotland. The lowest risk of mortality was in those diagnosed with type 2 diabetes and a BMI of around 30 kg/m2 , and those with a BMI between 20 and 25 kg/m2 at time of diagnosis had a 20–30% increased risk of death during the follow-up period. Obesity Paradox in End-Stage Kidney Disease Patients. Prog Cardiovasc Dis. Author manuscript; available in PMC 2016 Jan 31. Jongha Park, MD, et al. 9,714 patients 4yr f/u Mortality as outcome Class 1 Ob had the best relative risk of .73, BMI lots of downstream bad things.  Fat cells that developed in the thighs for example have the least amount of propensity to become “dysfunctional,” vs fat around the heart and liver tend to be the worst. And even relatively small amounts of dysfunction fat can be more detrimental, compared to larger volumes in the thighs, for example. This could explain why a “thin” patient with a small “belly pouch” could have a worse outcome could when compared the the guy next door but with more a pannus(subcutaneous abdominal fat). Especially after some hypotensive event where the fat cells are now exposed to a low oxygen environment they otherwise would not have been exposed to. 3. The Metabolically healthy obese person –  These people are thought to have a higher capacity to store fat that is less “metabolically active,” to have “benign” fat essentially. Side note: one might be able to improve our genetic expression of factors to help promote good fat….exercise! “A metabolically healthy obese phenotype can be promoted by exercise, but is also linked with intrinsic AT(adipose tissue) molecular characteristics such as efficient fat storage and lipid droplet formation, high adipogenesis capacity, low extracellular matrix fibrosis, angiogenesis potential, adipocyte browning and low macrophages infiltration/activation. Such features are associated with a secretomic profile of human AT which is protective for the cardiovascular system. In the present review, we summarize the existing knowledge on the molecular mechanisms underlying the ‘obesity paradox’ and whether fatness can be healthy too.” study link: https://www.ncbi.nlm.nih.gov/pubmed/28549096 ************************************************** So what to do with all this?? After all, we still pretty much know a Nml BMI is associated with decreased risk of pretty much all cause morbidity and mortality compared to a high BMI, and not only that we do see health benefits in decreasing abnormally high BMIs. Basically I see this information as being helpful in two basic ways: Stop thinking about weight loss in terms of body image. It is easy to get lost in how we “should” look based on cultural pressure. But how many times have culture pressures been wrong?…many, many times through history have people gotten things wrong…like lots. And thus a good reminder weight loss is not all about the scale. Each person is different. And also for my own personal admin of WPWI, with recent posts…there is no way for me to screen everyone, know everyone, know their medical and family hx. All we know is pretty much what you have let us know about you through your posts and pictures. That is it. For my first official Friday Informational 😉 I didn’t want it to seem like I am “picking” on normal weight ppl by posting information of why we do not support weight loss in people with nml BMIs.  So to prove I am not out to “pick” on anyone, which I have been accused of, I thought I would start with an actual presentation that even in some overweight/obese people weight loss might not actually be the key to improving outcomes! Probably not all OW/Ob people, but in some people…like that female who does not smoke with HTN, BMI 27, maybe she is wasting her time and mental happiness always worrying about weight. Maybe she should more be taking the time making sure she knows about more just eating healthy, and exercise. Exercise not to lose weight, but more to decrease CV risks, but also now to continue to, or continue to have her body promote fat mass being stored in thighs, vs in visceral tissue. Next week, yes we will be talking more, presenting evidence about why WPWI is a support group of those with a history of having elevated BMI to lose weight for potential health benefits. #headsup    ***As always please being kind and forgiving of grammatical errors,a physician women only has so much time in her day. #editingstinks ***

    34 min

  4. 10/24/2018

    Thinking Twice: Feast and Famine

    Why Feast And Famine Might Not Be Working ****definition of a diet “working:” ability to lose weight and then maintain that weight loss. So in this instance will people be able to lose weight using this theory AND then maintain it. The quick and dirty if you don’t have time: To quote Dr. Jason Fung’s website, “Eating is a celebration of life. Any diet that does not acknowledge this fact is doomed to failure.” These two sentence he argues support his theory, I would actually argue are the downfall of his theory. My rebuttal would be any diet that does not acknowledge the potential for food addiction, binge eating disorder, and or hedonic obesity is “doomed for failure” to use the above quote. A.) Food “Addiction” The thing is for people who been exposed to “adiposity” maintaining the sense of food as a reward is quite often dangerous. This sort of mentality can maladaptively accidentally place food up on some pedestal, when really food should “just be food.” Especially with those out there who know, but may not want to admit that food, and more likely carbs, are addictive. Currently, we have not technically “proven” food is addictive in humans, but we are finding it more and more true in mice. Unfortunately we may never be able to actually prove it in humans, as the dirty truth is we can’t do trials on humans as we can on tiny little animals, who take up a small amount of space, eat a relatively small amount of food, who then can be sacrificed to an autopsy at the end of the the study. So we likely are going to more just go on, and lean towards an educated guess that food, especially hyper caloric carbohydrate food is addictive. And if you still can’t get yourself to say it, if you are a, “but how can food be addictive, we need it to live,” at the very minimum you could maybe admit that some food has addictive qualities. The question is will you really be able to fast the next day, I mean really? With food still be around everywhere, will you be able to? It may not just be in your house, but it still is likely within about 5 mixtures of your house. Will you be able to just cold turkey say no to food, especially after you just showered you brain with all kinds of “feel” good hormones released from being exposed to those “celebration foods” you just feasted on?  Some might say yes, I can totally do it. Others, I am betting if you think about it, really sit and be honest with yourself, the answer is likely going to be “no.” One thing I love to point out is to think to yourself, “will one night’s sleep change me as a person.” Will sleeping with this belly full of food really stop me from eating tomorrow?” Haven’t I gone to bed with a full belly in the past? Did I wake up the next morning not hungry? Or have I ever noticed the more I eat the more I become hungry? Interesting studies I will interject here: Basically, in this study obese and non obese participants where allowed to eat at a buffet, no meal before. Then they came back to the same buffet, on another day, but this time they were all given a chocolate shake to drink before the buffet. The non obese people ate less, the obese people ate more! [Finding study link…my bookmarks where erased!!!! 🙁 ] Others: Brain Cogn. 2016 Dec;110:53-63. doi: 10.1016/j.bandc.2015.08.006. Epub 2015 Oct 1. Eating with our eyes: From visual hunger to digital satiation. Spence C1, Okajima K2, Cheok AD3, Petit O4, Michel C5. “In the fasting state, obese individuals demonstrated increased neural activation in those areas that are known to be associated with the anticipation of reward.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1864961/   Effects of binge eating on satiation, satiety, and energy intake of overweight children “Results: After the overnight fast, children in the binge-eating group consumed more energy [x (±SD): 1748 ± 581 compared with 1309 ± 595 kcal; P = 0.04] and exhibited a shorter satiety duration (194 ± 84 compared with 262 ± 89 min; P = 0.03) than did children in the non-binge-eating group. After the standardized breakfast, binge-eating children reported a shorter satiety duration (75 ± 62 compared with 132 ± 62 min; P = 0.01) and consumed more energy at the postbreakfast meal (1874 ± 560 compared with 1275 ± 566 kcal; P = 0.004).” B. )Hedonic Obesity: “In hedonic obesity, the obese body weight is maintained by consistent overeating due to impairments in the reward system, although the set point is not elevated.” (Yu)https://www.ncbi.nlm.nih.gov/pubmed/28093902 This one shocks me too, as from what I have seen/read of the material Fung puts out there, he really pushes this theory of “set point.” But never, at least I have I seen, has he ever mentioned that obesity isn’t all about set point. For me it is these people, who have a component of “hedonic obesity,” that in particular could actually be making themselves off worse if they grab hold of the idea that they should be able to freely accept food as a reward, accept food as a celebration in itself. For these people, I would more push them to seeing life as the reward, that for them not eating food for a celebration is the true accomplishment. Example….we can eat good food while on vacation, but we do not go on vacation to eat good food. The Power of Food Scale: The PFS assesses the psychological impact of living in food-abundant environments. https://linkinghub.elsevier.com/retrieve/pii/S0195-6663(09)00535-2 Blaming the brain for obesity: Integration of hedonic and homeostatic mechanisms. Hans-Rudolf Berthoud, et. al. Gastroenterology. 2017 May; 152(7): 1728–1738. C.) Undiagnosed Binge Eating Some out there might initially say, “wait, but in some binge eating treatment circle, they tell binge eaters to feast? So Would this throes help them?” What I would point out is that yes, in actual binge eating (definition below) there is a therapy plan that has binge eaters, binge, freely. It is more of a desensitization technique. This more help them stop seeing as a reward, to just see food as food. To take away the feeling of restriction. As in many the feeling of restriction actually pushed them to eat more and more. So telling a person with binge eating to go fast and then purposefully restrict yourself so you can use food as a reward seems like you are setting them up for failure. And replacing one problem (not coping with restriction, with using food as a reward). Link describing diagnosis criteria of binge eating: LINK HERE https://www.ncbi.nlm.nih.gov/books/NBK338301/table/introduction.t1/ Fung’s website: https://idmprogram.com/feasts-and-fasts-the-cycle-of-life-fasting-part-11/ My conclusion: Could feast and famine work? yeah sure, but just because it can work for some, does not mean it can work for all people. I would think more as a tool for those who have never had issues strugglingly with being overweight or obese. For those who have struggled with their weight, struggle with saying “no” to food, those who easily turn to food to combat stress…I would say this lifestyle food intake theory is risky. I do worry that trying to stick to this plan may only be reinforcing food reward pathways, and will only make the future a bit more difficult. ****definition of a diet “working:” ability to lose weight and then maintain that weight loss. So in this instance will people be able to lose weight using this theory AND then maintain it.

    17 min

  5. 10/06/2018

    Bone Broth Versus Broth

    The way I think about the difference is: how long did they boil the water in with the bones? The longer boiled the more of the “good stuff” from the bone will come out. For example, more calcium and collagen will come out the longer boiled, except in the case of the rib bone, according to the study below at 8 hours it doesn’t seem to give off more calcium, but femur(leg) will. Super quick summary: The containers of “broth” at the store lean more towards a water in that they have less protein, 2gm in my jar (from the collagen), and fewer vitamins/minerals. #notboiledaslong and the get the fat out. Whereas the “Bone broth” leans (keyword is just “leans,” as no one would argue 45Cals is a meal) more towards a meal in that my jar had 9gm of protein and 45. #boiledlonger     “Bone” Broth: “American Pantry Chicken Bone Broth” Chicken Soup Broth Label: “Ferrer Chicken Broth”   Other Interesting tidbits: not mentioned in the audio: Calcium and Bone Broth: https://www.ncbi.nlm.nih.gov/pubmed/8082052 Calcif Tissue Int. 1994 Jun;54(6):486-8. Chicken soup revisited: calcium content of soup increases with duration of cooking. Rosen HN1, et al. Abstract Because low dietary calcium intake may accelerate bone loss, patients often are advised to increase their dietary intake of calcium. However, some patients may be unable to tolerate good calcium sources such as dairy products. We postulated that the calcium content of soups and stews could be increased by prolonged cooking with a beef bone. Three experiments were done to prove this theory: (1) a bone soup made with a beef bone and distilled water, cooked for 24 hours; (2) a bone-vegetable soup cooked the same way; and (3) a vegetable soup made the same way but without the bone. It was concluded that prolonged cooking of a bone in soup increases the calcium content of the soup when cooked at an acidic, but not at a neutral pH. Rib vs femur(leg): “more (p  8 h, yielded significantly higher (p  0.05) Ca and Mg extraction than shorter cooking times. The extraction characteristics of metals, particularly Ca, Mg, Cu and Al, from the leg and rib bones differed. The between-species variations in extraction were larger than those of within-species.” Conclusion: “…Like increasing acidity and simmering time, as demonstrated herein, the dissolution of bone mineral has also been found to be positively associated with many other factors, such as temperature, surface area and agitation. Additionally, variation in bone tissue microstructure and mineral distribution across animal bones also affects the mineral levels available for extraction. Therefore, bone minerals that are extracted in broths may be affected by these factors and so be difficult to standardize. The calcium and magnesium levels in home-made or commercial broth/soup, according to the literature and current study, are no more than low tenths of a milligram per serving. These levels are generally a few percent of the DRIs, and so their contributions to daily Ca and Mg requirements are considered to be small. The heavy metals such as Pb and Cd that are present in commercial broth/soup were found herein to have concentrations in the range of a few micrograms per serving. Thus the hazard quotients are low and so the risks that are associated with ingestion of heavy metals from broth are considered minimal.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5533136/ Food Nutr Res. 2017; 61(1): 1347478. Published online 2017 Jul 18. Essential and toxic metals in animal bone broths. Der-jen Hsu, et. al. Even More: McCance RA, Sheldon W, Widdowson EM. Bone and vegetable broth. Arch Dis Child. 1934;9(52):251–11. [PMC free article] [PubMed] Hopkins AB. Chicken soup cure may not be a myth. Nurse Pract. 2003;28(6):16. [PubMed] Saketkhoo K, Januszkiewicz A, Sackner MA. Effects of drinking hot water, cold water, and chicken soup on nasal mucus velocity and nasal airflow resistance. Chest. 1978;74(4):408–410. [PubMed] Rennard BO, Ertl RF, Gossman GL, et al. Chicken soup inhibits neutrophil chemotaxis in vitro. Chest. 2000;118(4):1150–1157. [PubMed]  Monro JA, Leon R, Puri BK. The risk of lead contamination in bone broth diets. Med Hypotheses. 2013;80(4):389–390. [PubMed] Chan SM, Nelson EA, Leung SS, et al. Special postpartum dietary practices of Hong Kong Chinese women. Eur J Clin Nutr. 2000;54(10):797–802. [PubMed] Rosen HN, Salemme H, Zeind AJ, et al. Chicken soup revisited: calcium content of soup increases with duration of cooking. Calcif Tissue Int. 1994;54(6):486–488. [PubMed] Rosanoff A, Calloway DH. Calcium source in Indochinese immigrants. N Engl J Med. 1982;306(4):239–240. [PubMed] Ross EA, Szabo NJ, Tebbett IR. Lead in calcium supplements. Jama. 2000;284(24):3126.[PubMed]

    7 min

  6. 10/01/2018

    Combating Cases of the “I Don’t Cares”

    Floundering? One of the hardest things I do is to point out to people what is wrong! Because in the “eating world” what I am really pointing out is how the person is thinking wrong!!! And let’s face it no one likes to be told he or she is thinking wrong!!! First off it is normal to “flounder” when it comes to change…especially when it comes to trying to break old eating behaviors!! Just because we flounder does not mean we aren’t awesome people!!! I know many crazy awesome people, people I admire for many reasons who “flounder.” We all pretty much know what we should eat, we all know if we eat hypercaloric foods we will not lose weight. We all know we should eat more veggies, more fiber. We all want to be a role model for patients, for kids…we know all these things, we want all these things!! So why is knowing something not translating into actions?? Why is this knowledge not translating into the effort, into work, into motivation? We tell ourselves what to do, but then we don’t do it, or we don’t do it long enough to create change. “What is our problem???” “What is wrong with me??” I honestly think asking these 2 questions is in itself part of the problem!!! As my answer would be, “you have no problem, nothing is wrong with you.” And I am not trying to blow good feelings up places it does not belong. I BELIEVE THIS. NOTHING IS WRONG WITH YOU. The only thing that is really wrong is thinking you are the problem. The real issue is likely your “practice.” Would a dermatologist be prescribing a statin(high cholesterol drug), would a cardiologist be taking out a hot appendix. No! Do some people need to be placed on a statin, or have their appendix out, yes. BUT, each specialty “practices” medicine based on what is right for their specialty, their background. One practice will work for a cardiologist, but would be out of the scope practice by derm…but this does not mean the cardiologist is wrong. WPWI 15% off discount Keto/Glucose Monitors Read More This concept of medical practice also applies to our “lifestyle practice.” There are many many ways to live life, there are many ways to treat cholesterol, there are many ways to view food, many food behaviors to practice also!! So it is not that something is wrong with you, it’s more you just have not found the right practice for you, and then….practiced the new practice!!! Next issue with “what is wrong with me,” “why can’t I do it, everyone else is doing it,” “what is my problem I just can’t do it.” There is no self-love here!! I know “self-love” sounds so hoaky, but it really comes into play on all kinds of different levels. Labeling this as some issue specific to yourself, isolating yourself, taking a sense of power away from yourself ultimately leads to bad places, especially when it can lead to a sense of loss of control. Did anyone become a practicing physician in 3 months, 1 year, 5 years? No at the minimum it took 7 years. And even then I can guarantee your “practice” is still dynamic and changing based on many things. Based on your experience, based on your patient population, them aging, you aging, and new evidence that comes out all the time! Not only that what did we do work, work, more work and repeat!! Repetition is key to making a change. Having a bad “nutritional” day, and then going to sleep thinking tomorrow will be different based on no work the day before, no repetition, no practice… will that plan ever work? Has that plan ever worked? When you think about it does that seem logical, that one night’s sleep will change you? Or is change really created by practicing doing a wanted behavior? I would challenge you to look at your stress eating practices? Is your practice, again this is for people who are feeling that sense of floundering/trying all the time but never able to actually do, more about talking yourself into reasons to eat, is your practice good at arguing for justifications? Just to clarify, this is not about the actual food choices. We already know the difference in macros, what’s inflammatory, what will make insulin/glucose spike, etc etc. This is about thought practices. What thoughts are being built that lead to eating and not caring about what we eat. Example: Thought: I’ve had a long day, I have charts left over, I am tired…I don’t even care, I am too tired. Action based off justifying thoughts: order out This is about changing and practicing thoughts that are more productive. Thought practices that can lead us to physically being healthy.  I’m not talking exercise, literally physically continuing to stand up and cook a meal that in line with your ultimate goals, despite the truth that we are tired and stressed. Practice Pointers: When you are reaching for something you know will not help your goal, what are you thinking? What was the conversation you just had the moment you reached for the item? At this point, it probably was a quick one-liners, because at this point you are likely pretty practiced and negotiating or justifying with yourself. I mean the ability to very quickly fall back on “I’m tired” “effit” “I am stressed” “I deserve this” is likely so practiced you almost don’t even hear the whole sentence in your head, as it likely has been boiled down into more of a feeling. We are not looking to run a marathon on day two of training….we have to practice, practice and practice again.  Anticipate being able to eat more mindfully, away from emotional urges, will take time. There is nothing wrong with you yourself, that’s like getting mad at a 2nd year med student for not being able to do a c-section. Could that same med student get a baby out in t-minus 60 seconds 4 year from now? Sure, but ultimately it depends upon the repetition, it depends on the number of exposure to the practice of a c-section. ***Key: number of exposures #practice*** Emotional Eating practice tips: Here the repetition will likely first be just learning to pause..just pause! Even if just for second while reaching for some item. #increasingawarenesstoabehavior Then comes the repetition of thinking and identifying what is happening? Why am I reaching for this food? #increasingawarenessmore Then Identifying truths(plural): is the reason you just discovered causing you to reach for the food true!! Yes I know it seems like this would have been part of the step just above this, but it is not. Especially if you are a person who has gotten really good at creating multiple truth’s!! Afterall what is truth, but our own reality we create. So here it more is about acknowledging multiple truths and weeding out fake truths. Example: The scene: Standing in pantry reaching for cookies, 10:30pm, after a long work day. The initial pause: Hand reached out, “wait what am I doing here, really?” Identify what is happening: “I am tired, I am stressed, I don’t care” Identifying truths: I am tired: Will this cookie wake me up? No, not actually that’s not how energy and alertness work, the only thing that would actually wake me up is caffeine, a stimulant, ingesting sugar itself will not make me feel energized.” So now we can kick out “I am tired” as that is not a truth causing me to ear. I am stressed: Ok this food will acutely help me, it will release some good feeling hormones. You got me, but… But another truth is every time I use food to treat my stress I am only creating maladaptive patterns. So now we have at least two truths to be had here. I can now acknowledge mindfully more, take into account more, and guide myself better. I don’t care: What do I not care about? I don’t care about losing weight…not true. I don’t care about staying on this diet? Immediately maybe true, but this is really more related to the stress? I only don’t care about this choice because if the stress? So we can kick this thought out, it does nothing to add to the basket leading towards eating. I don’t care about my family? I don’t care about having more time on earth? I don’t care about prevention of disease some foods can cause? —probably all answers to this are untruths. “I can’t” Not true…likely what is truer “I don’t want to.” So then “what else is do you want?”   Then after addressing your initial thought that brought you to the pantry, go deeper. Finding and see other truths: “Will I be tired tomorrow, won’t I always have charts?” “When will I start finding a more adaptive way to handle this stress?” “If not now, when?” “Every time I eat to treat my stress I am only reinforcing this habit?” “What am I missing, what am I not thinking of?” “Will this create other problems?” “Am I kicking the can down the street?” Now that you see all the different truths now the empowerment!! Stand up straight, pull the shoulders back, take a big breath in and out. And then make a more mindful decision if that hand is going to leave with food in hand, or are you going to spin around and just leave? If you leave with food, fine…the inactive person is not going to run a marathon. #practiceyourpractice The beauty about this is…..there is no shopping, no planning, no grocery lists to take more of your time. This really is about practicing…no prepping. This is not an all or nothing thing. A person who has not walked a mile in years is not going to wake up and run a marathon. Just thinking about walking a mile or running a marathon will never translate into the action of running a marathon. Shoot even just buying new activity clothes will not do it. Only after actually practicing will they get closer to a goal.       Note: I am going to think that some of my posts might seem a bit redundant, but this is purposeful, as I am a creature of repetition. I think for these issues saying things in different ways, even the same things many

    37 min

  7. 09/19/2018

    The Vacation Sabotage

    Vacation Perspectives to Ponder Goal evaluation: Why do we go on vacation?? Do we go to de-stress, to gain some sort of mental health back, to relax, ultimately decrease stress, to extend life? Or do we vacation to eat? Some people may say life enjoyment does involve eating. But the question to be asked is… Will the overindulging that is associated with vacation actually bring happiness? Or does it actually bring more stress, more guilt, more struggle? Should we eat for pleasure on vacation, or should we eat good quality tasty food so we can be happy at that moment, feel pride in taking care of ourselves, and promote happiness when we go back home? The vacation yo-yo sabotage I see many people use vacation as a motivation to lose weight, weddings are another one that falls into this category. And using vacation as a motivational tool does absolutely work, but it comes with a real danger. Many to do anticipate or realize that after a weight loss your body will have adaptive changes that will promote weight gain!! Your body will release more hunger hormone, it will decrease satiety hormones, and can even decrease your metabolic rate. All three are the perfect storm for putting back on weight at a faster rate than before.  But then if you combo these 3 with the “I deserve this I am on vacation” or the “effit I am on vacation” type of thinking, you can imagine the devastation that can occur   ***little side note: did you know your body(your GI tract) can upregulate fructose receptors after 3 days of having an increased exposure to fructose. Meaning if you were on a weight loss regimen and you have been eating low sugar, after going back on sugar for 3 days your body will be able to absorb a larger percentage of what you actually eat!!! Just another way you can continue to even have the same caloric intake, but gain weight!!***   Vacation and family I personally think one of the most difficult parts of losing weight is trying to break the habit of using food as a reward. So if you need an extra level of motivation think of your kids. If you take them on vacation and just eat a bunch of junk all the time you are teaching them: -to associate junk food with happiness -to create behavioral pathways that promote using food as a reward Instead show them how to go on vacation, and more enjoy food to enjoy the vacation. Not the enjoy food, just because food brings us enjoyment. If nothing, else help them not have the same food reward system you might have. Make it normal to go on vacation, have fun, and just eat to eat.   Is vacation about eating hyper-palatable hyper-caloric food? Or is a vacation a way to improve your life. Will the food you eat improve your life?

    12 min

  8. 09/18/2018

    Sabotage: FOMO

    FOMO “Fear Of Missing Out” Biggest example: FREE FOOD When the plate of cookies is sitting there, you start to feel a bit anxious. There is an underlying anxiety of missing out on something that is “free.” This is really all based on FEAR. But the thing is this is not an actual thing…it is YOUR anticipation of something. You anticipation of “missing out.” Goal: work on your perception Perception of seeing things fearfully VS from a place of love Perception of missing out on something. What are you REALLY missing out on? What is the ENTIRE picture here? Ex: The Pharm Rep Lunch Is that pharm rep lunch really free? Or did it come with the price of having to sit and listen to a stranger try to sell you something. To have to sit there and act interested even though you really know this pharm rep is entirely biased and you are just trying to be nice, not to call them out on their bias. Plus you feel pressure as the staff usually loves the type of food the pharm rep brings in #hyperpalatable #hypercaloric as even the staff gets to splurge…”after all it is ‘free.'” Ex: Food at a conference “I paid for this conference, the food was included, I don’t want to miss out on this food I already paid for.” -but is that food actually good food? Or is it the cheapest thing they could serve because they are trying to save money…is that plate of food really only worth maybe $3 (one serving of the giant volume of lettuce maybe 20 cents, dressing, 10cents, one chicken breast bought in bulk $1.50, some pasta something 75cents, one roll made in bulk 10cents, cookies at the end 20 cents). Is this $3 really worth it? Or is this plate of food actually causing you to miss out on something else? Ex: The Sale “I am missing out on XYZ sale.” (this applies to anything, shoes food, anything) —> Or, am I missing out on money I likely wouldn’t have spent if it were not on sale. If this was full price would I have bought it?  If it was normally $7 and now it’s on sale for $4, I am saving $3!!! Really or did you just waste $4 on something you didn’t really need.  “Those wings are half off tonight” —> Would you really be missing out if you knew that basket of wings really cost the restaurant next to nothing to provide..that is why they can afford selling them half price!! That or they know you will likely also buy a soda, or dessert too, they just need to get you in the store. Have you noticed there is never “half of salmon night,” or half off chicken breast with quinoa night.  Some may superficially say, oh well there is not a market for that….but I would disagree. It is these are expensive to buy, expensive to prep, and “coincidently” the better/healthier food options. But a restaurant cannot have sales on these items, as they will lose money.    FOMO = narrow perspective. Fear is suppose to protect you, but are you really in trouble? Open up your perspective…will you act out of fear, or act from a place of love?   If having trouble flipping from a fearful motive to a loving motive than open up that fear and make the fear actually adaptive, instead of maladaptive. Examples: I could have wine, but I’m afraid I will miss out on all the benefits of being “on point” with my plan. I am missing out on my progress if I have that wine.  I could have those cookies, but then I am missing out on being happy tomorrow. I am missing out on hitting my goal. The ultimate…”I could ‘effit’ and eat whatever, but will I miss out on an opportunity to change.”

    10 min

  9. 09/14/2018

    Why do we get fat? Why Comparison Can Be the Thief of Happiness

    ***Disclaimer: this podcast is for informational sharing only. It is not meant and does not give medical advice. Always consult your physicians or healthcare provider for medical advice.*** A quick look into why do we overeat, not just the “we are fat because we overeat” mentality. Notes: Set Point: This is a very complex pathway, but to very much oversimplify it… leptin is a large player. As fat cells increase in size they will increase leptin release from the fat cell. Leptin goes to the brain(Hypothalamus) to turn on POM-C —-> Increase energy expenditure and decrease food intake—–>decrease weight back to the set point, bringing your body back to homeostasis essentially. Or Fat cells decrease—>decrease leptin—->HRP neuron activated—–>decrease energy expenditure and increase food intake—->weight gain back to homeostasis The problem is food regulation is also controlled by a subconscious area in the brain (Subcortical, mesolimbic). If this subconscious area is stronger because of a genetic predisposition or if just becomes stronger from using food as a reward for too long this will essentially override your “set-point.” (Reward food general tends to be hyperpalatable hypercaloric processed foods.) Then over time we can get things like leptin resistance, decreased functioning of the protective POM-C area, inflammation, reactive gliosis and aging of the hypothalamus so now your body has become metabolically changed allowing your body to have a new set point and to protect the new fat mass. This state or having a component of these changes is termed “metabolic obesity.” Hedonic Obesity is when a person reward circuitry is now maladaptive and strong. Different people who are overweight or obese can have one or the other pathways starting to form or formed. And different people can have different severities of these two mechanisms An example: A woman who has never been overweight becomes pregnant. Hormonal changes end up upregulating her food intake. She otherwise does not have a genetic predisposition to obesity, she gains 20lbs, has the baby, 6 months later she loses it. People are amazed. But the same women this time has horrible stress during the pregnancy while increasing food intake from pregnancy-related changes, she also increases food intake to cope with stress. She starts towards “maladaptive” ways of eating to cope with her environment. She has the baby…this time her outcome is very multifactorial. Did the stress go away, did it stay and she continues to rely on food. Maybe still due to some lucky genetics despite prolonged exposure to overeating, she is not pre-dispositioned to leptin resistance etc, etc. She was lucky to not start down the pathway of metabolic obesity, but more is heading to mild hedonic obesity. Hopefully, the stressor goes away, she stops using food as a reward before maladaptive pathways are too strong. She relatively easily loses the weight over the next 6 months. I say relatively because it is still difficult to turn down hyperpalatable hypercaloric food, but at least she is not also having to battle the other metabolic obesity components as discussed above. No to mention other changes that happen in the brain that are not discussed here, but have been found on functional MRI when comparing a brain that has been exposed to high levels of fat mass for years to a brain that has not been exposed to high levels of fat mass. But if her rewards circuitry became too strong then she will continue to struggle with using food as a reward, continue to struggle with weight gain, feel more and more “out of control” and over time increase risk of then also being metabolically obese. Some light reading: Metabolic vs. hedonic obesity: a conceptual distinction and its clinical implications https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053237/ Y-H Yu. Making sense of metabolic obesity and hedonic obesity. J. Diabetes 2017 Jul;9(7):656-666 Berthoud HR. Metabolic and hedonic drives in the neural control of appetite: who is the boss? Curr Opin Neurobiol 2011; 21: 888–896. Considine RV, Sinha MK, Heiman ML et al Serum immunoreactive‐leptin concentrations in normal‐weight and obese humans. N Engl J Med 1996; 334: 292–295. Vasselli JR, Scarpace PJ, Harris RB, Banks WA. Dietary components in the development of leptin resistance. Adv Nutr 2013; 4: 164–175. Y-H et. al. Metabolic vs. hedonic obesity: a conceptual distinction and its clinical implications. Obes Rev 2015.16(3):234-47 JC Halford & JA Harrold. Satiety-enhancing products for appetite control:science and regulation of functional food for weight management. Proc Nutr Soc. 2012 May;71(2):350-62 K Simpson et. al. 2012 CCK, PYY and PP: The control of Energy Balance, In Appetite Control. Editor H-G Joost p209-230 https://neuroendoimmune.wordpress.com/2013/09/17/its-all-in-your-head-the-neurocircuitry-of-addiction/ Berridge KC, Ho CY, Richard JM, DiFeliceantonio AG. The tempted brain eats: pleasure and desire circuits in obesity and eating disorders. Brain Res 2010; 1350: 43–64. Schwartz GJ, Zeltser LM. Functional organization of neuronal and humoral signals regulating feeding behavior. Annu Rev Nutr 2013; 33: 1–21. [PubMed] Y Zhang and RL Leibel. 2017 Leptin and Body Weight. In Eating Disorders and Obesity: A Comprehensive Handbook, 3rd edition(ed KD Brownwell and BT Walsh) RL Leibel et. al. Changes in energy expenditure resulting from altered body weight. N Engl J Med 1995; 332:621-628 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3380241/ Speakman JR, Levitsky DA, Allison DB et al Set points, settling points and some alternative models: theoretical options to understand how genes and environments combine to regulate body adiposity. Dis Model Mech 2011; 4: 733–745. Harris RB. Role of set‐point theory in regulation of body weight. FASEB J 1990; 4: 3310–3318. Pierce RC, Kumaresan V. The mesolimbic dopamine system: the final common pathway for the reinforcing effect of drugs of abuse? Neurosci Biobehav Rev 2006; 30: 215–238.

    13 min

  10. 09/07/2018

    Mindful Eating: why a simple change can make big changes.

    DISCLAIMER: This podcast is meant to share information, perspectives, and experiences. It does not provide medical advice, and it is not a substitute for advice from your physician or healthcare professional. So we have gone over self evaluation of the reasons WHY we eat. But we did also go through this skill being something that has to be trained, it has to be strengthened…so in the meanwhile you still are eating, not losing weight, maybe even gaining, so what do I do now???   Ok so first we need to talk about “over promising” and “expectations.” Too many of us have that mindset of 100%. I am going to wake up tomorrow and 100% do it..I’l going to wake up at 5:30, do an hour workout…even though I have never done this…I am going to stick to my entire nutritional plan…I am going to be positive the entire day!! We in general are “go getter” “high expectationers of ourselves.” That when we do something we have do it all, all at once, as fast and perfectly as humanly possible!!   But have you ever done this…or are you stuck.. You find yourself saying.. “I just can’t do it” “It is too hard” “That is not the lifestyle for me”   But this way of trying to make a change make no sense on many FUNDAMENTAL levels!! So I try to stick to evidence-based info when I bring you things, because we are evidence-based people. Decisions we make for other people can change that other person’s life, so we try as much as possible to make an educated decision basing it on evidence.   So apply your evidence to yourself. The beauty is it does not matter that it is an N of one….because it is your “one.” should you give your evidence of you based on your one to someone else…probably not, they are not you. I hope that made sense….   Anyway, how many times have you started a program “all in.” Breakfast, lunch, dinner, snack…all in…and in the end at 1 month, 3 months, 6 months how did that work out? I imagine not great as you are listening!     Buuut   How many times have you gone 1/4th in, and did the ¼ bit of the plan daily most days of the week….. I’m going to go out on a limb here and say the answer for 99% of people is going to be never.   Why….because we are “all in people,” “all or nothing” people. The crazy part when it comes to weight loss doing “all” ends up leading to nothing!!! I know…mind blown right!!!   So with that in mind think about this small change… When you want to eat, eat at the table! Huh, what that’s too simple, it won’t give me the changes I want……and there it is…kipping over the simple things!! So please hear me out on this…. if you want to have a snack get a plate or a bowl out, nothing paper, a legit plate that can be broken and has to be washed (ie something that will create a bit of work for you down the line).  Go to the store “Ross” super cheap plates that match this description there.”   So get out the plate, utensils you will need, and EAT IT what you are wanting to eat! BUT….no distractions!! No TV, no music, no podcasts, NO PHONE.   And boom…You are officially eating “mindfully!” You are eating what you wanted, and eating it mindfully!!! You can’t ignore your thoughts on it, you can’t overlook how it tastes!! You are sitting there bite after bite paying attention to your food. I don’t even need to tell you what question to answer while you eat your food…you will have revelations about your food as you eat it.   Revelations that hopefully help you make future choices about what was worth taking the time to sit, eat and wash a dish vs food that is not worth it!!!   This SIMPLE thing can work on different levels, and does not have to be “all or nothing.” You will work on putting time into “working on yourself,” caring for yourself. You will work on mentally thinking about your relationship with food, what food was worth your time, vs food that is easy to eat, but really not worth your time You are working on sensing when you are actually physically hungry…as I can just about guarantee you if you are actually physically hungry you will take the time to sit, give up internet, give up TV to just sit and eat!! Shoot you will likely even work on teaching your kids to not create the habit of mindLESS eating too. You likely will also be inadvertently cutting out some processed food you would have eaten before…the handful of goldfish here, the kids leftover snacks there. The fast-food stop while running an errand there. It happened to me today! I was running around town, a part of town I usually am not in…I saw my double secret super unhealthy fast food chain…and oh man did I want to stop. I asked myself…ok I can have it but I have to… Get down to order, drive it home (15-20min)…get a plate out, sit quietly at the table alone losing time to get work done as school is about to get out soon, no TV, no Internet, no you guys!!! And what happened I drove by it!!! No it was not worth feeling the abd pain I know I would get, losing valuable time, getting more behind on work, plus I would have had the torture of not eating it, having to smell in the car on the drive home, plus it would have been soggy..no not worth it drove by. Beauty too is this debate in my head took not long, maybe a minute or two, but that time also helped my physically pass it, so if I did want it that bad I would have had to turn around and lose even more time!!!! So even just having this pros and cons thought processed helped add to me coming to the decision….no not worth it today. Next, will I come to this decision I don’t know!! But who cares…today I won!! #smallchanges   Tips on implementing this… Do you need to do this all day long no!! This is why this is a small change! In the perfect world, you would do this at your normal “splurge” time….which is usually at home in the evenings for most people. Do not do this “all in” do not think oh I should do this all the time 24/7, no it will not work!! Try to do it every day and when you are most likely to mindlessly eat…. Just got home from work While cooking Before dinner Evenings when watching TV (yes you will have to stop)…we will talk about loved ones and interacting with them in the guided group. Driving around When you are bored At night While charting   Embrace these times in particular. Doing this practice during times you usually are sitting and eating this will not work…as it’s not really you making a change.   Just remember change is NOT “all or nothing” do not overcommit yourself to change! Change happens in small increments!!! No way in heck would you go run a marathon tomorrow. Why on earth would you expect to go from eating every 3 hours to not eating anything for 16 hours, or going from eating likely about 400 carbs per day to 20….no way, no how. To do that you will likely need some external stress forcing you to do it…ie you just spent thousands of dollars on a program, you have a beach vacation coming up, and your old highschool friends will be there type of pressure.   But for the rest of us who are living our daily lives…no way. And if anything, learn from YOUR PERSONAL N of one.   Small changes…persistently and daily!! Build a new lifestyle for yourself…just like you would have to build muscle and endurance to run a marathon. It is NOT all or nothing.

    24 min

  11. 09/06/2018

    Guided Group Day 1

    DISCLAIMER: This podcast is meant to share information, perspectives, and experiences. It does not provide medical advice, and it is not a substitute for advice from your physician or healthcare professional. Super quick reminders…. Weight loss and health are cultural….post, interact. Do not be a silent stalker! Transformation and change will take time and work #sayitaintso 😉 Don’t be afraid to give others your perspective on something when they are struggling. Everyone is in the group to change, change is only going to happen once we change our way of thinking too. You giving your perspective will help you reflect on you, and it might be just what the other person needed!!!! Mondays: We have our weekly weigh-ins. This is a chance to have accountability, AND to reflect on last week, how it went well, how it did not go well. AND also gain perspective on how to change the next week so we can continue to move towards our ultimate goals. Today’s HW: post who you are, starting weight, something about you. Other HW…sabotage…today if you are having trouble if you are about to reach for something that is “off plan” pay attention to the reason you are about to ignore your plan and eat it. Listen to the argument in your head…learn how you are able to convince yourself.

    7 min

  12. 09/05/2018

    Sabotage: An Intro – Episode 1

    DISCLAIMER: This podcast is meant to share information, perspectives, and experiences. It does not provide medical advice, and it is not a substitute for advice from your physician or healthcare professional. Sabotage Vs. Living What is self-sabotage? How do I know I am self-sabotaging or just living a moderate lifestyle occasionally??? Quick and dirty answer: Moderate Lifestyle = Indulging and making more just moderate lifestyle choices ***moderate lifestyle = the freedom to “just have one serving here and there”*** Deciding to eat it knowing the pros and the cons. No emotions! No emotions? Yeah for some people out there this idea of eating moderately not based on emotions seems like a foreign concept!!! Eating with eye wide open Eating without feeding (no pun intended) a negative behavioral feedback loop If it seems like a foreign concept….you are likely “sabotager.” Sabotage = “Effit” = Negative Emotion attached “I don’t care” “Don’t talk to me about what I am eating Using food to fix “xyz”….sleep, anger, frustration, sadness, guilt Using food in a maladaptive way Wishing we had more control, association eating with a negative “desire for more control”

    14 min
  • 12 Episodes

Ratings & Reviews

5
out of 5
8 Ratings

About

Much to do about everything weight loss.

Information

  • Creator
    Jennifer K. Hendrix
  • Years Active
    2018 - 2020
  • Episodes
    12
  • Rating
    Clean
  • Copyright
    © 2018 WPWI Perspectives, Physicians Weigh In LLC
  • Show Website
    WPWI Perspective