@NJSue Although I recommend Weight Watchers to my patients to begin a supervised weight loss regimen, I don’t think they are a successful organization. Their long term success rate hovers at less than 1%; WW only report their short term success rate not their long term rates. However, insiders report it is about 1 in 2000 participants. But once my patients become regular participants in Weight Watchers, I immediately get them to follow the actual successful behaviors from The National Weight Control Registry. Behaviors that have worked long term in these particularly successful people.
Now, 75% reported weighing themselves at lease once per week, 44% weighed themselves daily and 31% at least once per week. “This frequent monitoring of weight would allow these individuals to catch small weight gains and hopefully initiate corrective behavior changes.” So, it may be obsessive, but we are in a calorie rich environment and we may have to be obsessive about our behaviors. I made it natural for my family so it seems like normal behavior. Everyone understands that even a 5-6 pound fluctuation is normal.
But here is the most disappointing news I’ve read in a LONG time. The ability of severely obese patients to reach normal weight is nearly impossible. So, more effort needs to be placed on preventing the obesity.
@JustOneDad I do not agree with the caloric recommendations for children. First, the food lobby has manipulated our guidelines over the past 40 years and made it almost irrelevant.
Secondly, we have no idea how many calories kids need and it may be significantly more or less than 1800 calories per day depending on height, weight, puberty, activity, etc. My children’s pediatrician is very aggressive against overfeeding children. Her attitude is to not feed kids who aren’t hungry and only worry about their calories if they are running into weight issues or nutritional deficiencies. I had a child who had a bmi of 14. I was on her trying to make her eat more. I even tried adding shakes with oil in it. The pediatrician put a stop to it and we worked up her other concerns. Turned out she had narcolepsy which led to the weight issues. With treatment, her bmi increased to 17 in 3 years and I just leave her eating alone. How many calories do kids need? Enough to keep their weight within normal.
So I went and looked at our elementary school menu and today’s meal was chicken teriyaki bites, broccoli, Mandarin oranges, a roll and a fortune cookie. Sounds pretty good to me and when I am at the school, I see kids eating away. If you don’t like it, pack a lunch.
frugaldoctor, I disagree with you. After reading Nina Teicholz’s book, The Big Fat Surprise,
(www.amazon.com/The-Big-Fat-Surprise-Healthy/dp/1451624425), and other articles and discussions about healthy diet and weight control, I think the root cause of obesity is sugar and carbohydrates, and not saturated fats. We’ve discussed this extensively on the Diet/Exercise/Health thread.
Of course everything has to be done in moderation – if all you eat is bacon, french fries, red meat … well, Teicholz actually argues that you would be fine, so skip that argument. The problem is sugary cereals, donuts, chips, soda, cookies and candy, pasta, etc.
To quote Steve Martin…Well excuuuuuuseeee me…When did we pass the responsibility for feeding our kids’ lunch to the school system? Kiddies went to private schools, different levels of ‘quality’ throughout the years. It was NEVER the schools responsibility to provide my kids with lunch…at any cost. It is MY responsibility.
In about 3rd grade lunch packing became a family affair. We’d do 3 days worth at at time. A sandwich or some sort… or tortilla wrap…or if things were really really time constrained, a $5.00 burrito from the local family run taqueria. A piece of fruit (you can buy it twice a week), some nuts and maybe a few pieces of veggies. Carrots, celery, jicama can be cut on Monday and used for a week. Turns out my kids hated standing in the school lunch line, it ‘ate’ up a big part of their lunch period.
Part of teaching kids good and balanced nutrition is having them involved from in the process. Maybe part of the obesity epidemic is that we’ve punted our kids’ nutrition to others… and then gripe when they don’t do it ‘right’.
Was packing lunches a PITA…oh man was it ever. When S finally graduated HS, I posted a FB picture of the last brown bag lunch I would ever pack…I think it came to about 3500 between the two of them…
Was it worth it, yes. Was it less expensive than the (unsubsidized, or course) lunch program…yes…did they benefit…yes.
Increasing body fat should become obvious to someone when his/her trousers feel tighter or do not go around his/her waist. Weighing oneself is not necessary to make this observation.
Your problems are with your local district. Take it up with your school board. If they are serving garbage, certifying it as good and taking the federal money, someone is going to be in trouble.
I loathe, detest, despite and HATE packing lunches. With a raging, virulent passion.
Therefore and thus, I am delirious with joy to pay someone else to feed my kid lunch. Particularly when it is a creative professional who feeds him better than I would and without the griping. Win-win!
I was even fine with paying to have the public school feed the kid back when they actually cooked high-quality, palatable food in the kitchen.
I realize what I’m complaining about, and this is not the same complaint as anyone else and I don’t care if anyone else shares it. I think that if the federal (state/local) government mandates certain things, the onus should be on the mandating body to ensure that every institution has the facilities and resources to comply. The real problem comes from facilities trying to work around rules that were enacted with the assumption that every school could comply. The perfect being the enemy of the good thing again.
My suspicion is that before they tried to make the food more healthy, it was just as cheap, crummy, and poorly prepared. However, it tasted pretty good because it was loaded with salt and sugar, and a lot of it was deep-fried. You just didn’t notice how bad it was. You were being cheated, and you didn’t know it–now you know it. Who should you be mad at about this?
Popular knowledge of basic home cooking and nutrition (what used to be called home economics) is in steep decline, despite the explosion of bourgeois interest in high-end food. People are also much more sedentary (cars, laptops, TVs, video games) and parents are too afraid to send their children out to play unsupervised. Parents work long hours and no longer have the time or the energy to put together economical, palatable family meals, so they rely on processed food. The 50s housewife is a memory. I’m not nostalgic for that time but I remember my mother starting to cook at about 5 to lay on dinner at 6:30, or putting something in the oven at 3 p.m. to be ready for dinner. A lot of women can’t do that today. Obesity is a complex problem with varied origins. The “food addiction” theory is insufficient to account for the explosion of obesity because it ignores the social aspects of food prep and eating.
@fireandrain As a former Adkins and Paleo practitioner, I used to support the high protein and low carb diet myself. It definitely works to help maintain weight. But my 2 stints with those diets gave me skyrocketing LDL levels and that caused my cardiology friends alarm. They told me that the theories conflicted with the realities of their low carb patients. I didn’t believe them then. Well, I was an inexperienced resident.
But now that I’ve covered the cardiology service , I’ve seen it for myself in several patients over the past 2 years requiring stents. Healthy, thin appearing, runners, with no apparent family history or medical history to account for the elevated LDL and coronary artery disease except for diet. These were paleo practitioners including a prominent one with a YouTube channel.
What the proponents of the high protein, high fat, low carb diets don’t tell you is that there is arterial disfunction in response to high fat meals that lasts for hours. That’s when the body is at high risk for plaque deposits. They also don’t tell you that there is a substantial insulin response to amino acids that may exceed the same response to sugar. Even though the static fasting morning cholesterol readings may be low or optimal, those readings do not reflect the dynamic changes. But when damages happen as early as 3 years and may take as long as decades, it becomes an argument that is not worth getting into because patients don’t want to hear it. Until they are on the cath lab table wondering why at 50, with no risk factors, running 50 miles per week, they have coronary artery disease.
Everyone agrees that the annual 75 pounds of sugar we added to our diets over the past 100 years are detrimental. But we also added about that much in fat and proteins too.
Again, I just give the information out based upon the research and what we see on the table. Other than that, I leave it up to the patients to believe whoever they want. It’s no longer worth arguing over it.
^^^ A $25.00 crock pot goes along way towards solving the ‘I don’t have time’ problem.
Salad comes pre-washed, pre-mixed and sometimes with the dressings, croutons and other fun bits included in one ‘tear it open and put it in a bowl’ package. Veggies come precut in little bags. If you are a Costco member…buy two precooked chickens. Pick up a couple of bags of the Asian cabbage salad mixes. Debone the chicken and cut up the meat, it take about 10 minutes. When you get home, throw some the meat into a pan, heat, add a package of the slaw along with the dressing. Heat for a minute. Done, dinner served. Leftovers for lunch…it’s good cold. Our Costco sells fresh spring rolls, the non-fried type. Onions come pre-cut. You can get shredded carrots and celery. It’s PRE-MADE. Mom never had those options…anymore than she had the Happy Meal drive through option. So, we can do it in much less time than Mom could.
I hated and despised packing lunches. Frankly, I really really really hated the self imposed obligation of dinner on the table at 6:30. When the last one left for college I simply STOPPED making meals. However, for the 22 years that the kids were home, their nutrition and well being was my responsibility. Maybe it’s more important to drop one a sport, lesson, ballet class, feed the homeless so I can put it on my college resume project, and make everyone partake in the ‘learn how to feed myself in a reasonable manner’ project.
^^Men as a group have never done much home cooking for a family; it’s a hobby for them, not part of the societal expectation of their role. My point is that society has changed in the last few decades in various ways that promote obesity. Costco memberships are costly. So are gym memberships and fitbits. Obesity in America is is now associated with low income, not wealth.
I am not discounting the role of personal behavior in nutrition, but rising levels of obesity have become a public health problem that requires a more systematic approach to solution.
I’ve cooked the meals in the house ever since my wife and I were dating. My kids grew up thinking that cooking was a job for dads. But the demands of modern corporations (medical and others) have encroached on family time. Just recently, I have not had much time to cook. We made changes including weekly meal delivery from a raw food restaurant, one of my kids becoming a vegan cook, and eating more fruits to maintain a healthy lifestyle. But it would be so much easier to stop at the fast food chains or the supermarket to pick up ready-made food to save time. There just aren’t many good fast food choices out there.
One does not need a gym membership or activity tracker to exercise.
Indeed, the idea of having to go to the gym to exercise, instead of making exercise as part of one’s normal activity*, may contribute to the “no time to exercise” excuse that seems to be common.
Examples:
Walk up and down the stairs instead of using the escalator or elevator.
Walk, run, or bicycle to go places.
Two picnic tables near each other = dip station.
Park with jungle gym or tree with strong branch = pullup bar.
Of course, rising calorie intake (high fat and high carb) over the years is also a big contributor to rising obesity. But one does not need to go to Costco to buy healthier food (although it is true that some low income areas do not have any grocery stores).
A Costco membership run $55/$110 a year. That’s about the cost of one doctor visit, two non-fast food meals for a family of 4 at a less than optimal eatery. Grocery stores deliver. Pick the good stuff and have it brought to your door.
And yes, exercise as a ‘separate from the rest of my life, must do this and then get back to the chair/car/couch’ is part of the problem. My first real job was in a high rise. My office was on the 14th floor. It was the 80’s, high heels and wool skirts. I still managed to take the stairs several times a day…just in the upward direction …downward was suicide in heels.
Yes, of course you can “just do it.” What I’m trying to say is that changes in family structure, adult work time, and technology have now required people who want to stay healthy to make a conscious, deliberate effort to set time and energy apart to exercise. Do people really think this has no effect on overall rates of obesity in this country? Above, a poster pointed out that free gym time and recess, a time when kids traditionally ran around and let off steam, jumped rope and shot baskets, has been all but abolished in our schools. In part it’s because school employees are afraid of the legal liability for what happens when children are relatively unsupervised. In part it’s because of the need to prep children for constant standardized testing. Home economics requirements are a thing of the past too, along with other
“prep-for-life” stuff like high school civics. The results have not been that good. We used to understand that a lot of kids in this country would not cultivate healthy habits unless they were inculcated by the schools, but it’s probably considered elitist now to admit it.