Quote for the day

Most people are willing to change, not because they see the light, but because they feel the heat.

The past should be a springboard, not a hammock.

--Edmond Burke

Eating out: Chinese Food

Ask that  your dish be prepared without MSG, the flavoring agent often used in Chinese cuisine.  While it's made from beets, a healthy vegetable, MSG has a very high glycemic index (GI).  Try egg drop soup or any combination of steamed fresh vegetables prepared with small amounts of meat, poultry or seafood.  Stay way from:  rice; the deep-fried, crispy noodles; egg rolls; fried dumplings; spareribs; lo mein; moo goo gai pan; Peking duck; and entrees described on the menu as "crispy" or "sweet and sour."  Also, many sauces may be thickened with cornstarch.

The South Beach Diet  Good Fats, Good Carbs Guide, Arthur Agatston, M.D.

Eating Out: Italian Food

Not order pasta?  At an Italian restaraunt?  Actually, it's easier than you think--there are usually several choices right for you.  Try salads dressed with oil and balsamic vinegar; clams steamed in white wine; clear soups; grilled meat, poultry, or fish; scallops sauteed with mushrooms and marsala wine sauce; or escarole or broccoli rabe (two types of greens) sauteed in garlic and olive oil.

If you must have pasta, ask for whole wheat pasta and order a side serving sauteed in olive oil and garlic or topped with plain tomato sauce and good proteins (clams or shrimp) or vegetables.  Stay away from bread or garlic bread and anything described on the menu as "carbonara/alfredo" (prepared with full-fat cream and cheese) or parmigiana (breaded, fried and smothered in full-fat mozzarella).

The South Beach Diet  Good Fats, Good Carbs Guide, Arthur Agatston, M.D.

Eating out: Mexican Food

Most Mexican food at chain restaruants and Mexican fast-food places is prepared American-style, which menas an abundance of bad fats.  Yet it is possible to go Mexican and eat healthfully.  Try grilled chicken or fish, pescado Veracruzana (fish in a tangy sauce of olive oail, grilled onions, green olives and capers), mole pollo (boned chicken breast served in a hot and spicy sauce), mojo pollo (chicken in a tangy citrus sauce), or camarones de hacha (shrimp sauteed in a red and green tomato sauce).  Stay away from deep-fried tortilla chips; anything topped with cheese, sour cream, or guacamole; refried beans (commonly fried in lard); chimichangas (deep-fried flour tortillas filled with meat and cheese); the Mexican sausage called chorizo; and deep-fried taco-shell bowls.
The South Beach Diet  Good Fats, Good Carbs Guide, Arthur Agatston, M.D.

Golden Rules of Eating after Surgery

aka…The 10 Commandments of Bariatric Eating


adapted from http://www.lap-band-surgery-site.com/bariatric-eating.html

#1: You Shall Eat Your Protein First
Protein rich foods delay stomach emptying and will help keep you feeling full long after you're done with your meal.
Post bariatric eating involves protein at every meal and snack.
Be sure to eat your protein first. Avoid filling up on other foods and leaving no room for your protein!
#2: You Shall Choose Solid Foods Over Soft, Mushy, or Liquidy Foods
"Solid" foods will fill up your pouch and stay in your pouch longer than soft, mushy, or liquidy foods do. You'll require more food to feel full when the consistency of your meal is soft, mushy or liquidy.
More food = more calories = slower weight loss!
Examples of "solid" foods: chicken, turkey, fish, beans, whole fruits and vegetables, salad, whole wheat bread, brown rice, etc.
Examples of soft, mushy, or liquidy foods: soup, frappuccinos, milkshakes, ice cream, etc.
#3: Avoid Eating and Drinking at the Same Time
Solid food + liquid beverage = slushy, mushy consistency. (Refer to Commandment #2!)
#4: You Shall Avoid Drinks/Liquids With Calories
Liquids pass through the pouch fairly quickly without giving you a feeling of fullness or satisfaction. Drinks like regular soda pop, juice, milkshakes, coffee drinks, and sweetened beverages contain a lot of calories.
You can drink a lot of liquids without getting full and that means you can take in a lot of calories without ever feeling full if you're not careful to choose zero calorie beverages.
#5: You Shall Take Small Bites
Take bites only as big as a pea, pencil eraser, or a dime when eating after bariatric surgery. A small bite of food in your mouth guarantees only a small bite of food will find its way down to your stomach.
Having only a small amount of food trying to pass a gastric band (or through the new opening created between the pouch and small intestine by a gastric bypass) will lessen your chances of causing an obstruction.
#6: You Shall Chew Thoroughly
Chewing thoroughly help you slow down, avoid overeating, and minimize the chance of obstruction caused by large food particles.
Bariatric surgery eating requires that you chew each bite 25-30 times or until the food in your mouth is unidentifiable.
#7: You Shall Eat Slowly
This will prevent you from overeating which can cause you to vomit and/or cause your pouch to stretch. A stretched pouch means you'll need more food to feel full.
Try putting your fork or spoon down between bites and allow 20-30 minutes to finish a meal.
#8: You Shall Stop Eating as Soon as You Feel Full
If you don't, you can get sick...
...as in vomit...yuck!
Persistent over eating after bariatric surgery can also cause your pouch to stretch which means you'll need larger portions of food to feel full.
#9: You Shall Stay Hydrated
Drink 6-8 cups of calorie free fluid every day.

• water
• Sugar free, non-carbonated, caffeine free or decaffeinated beverages:
  • Diet Snapple
  • Sugar free Kool-Aid
  • Decaf tea or coffee
  • Herbal tea or coffee
  • Artificially sweetened flavored water
  • Crystal Light

Drinking adequate fluid will prevent dehydration and constipation. Remember to drink between meals...not with meals.
#10: You Shall Take Your Daily Vitamins
YES! You will need to take bariatric vitamins after weight loss surgery...
...every day for the rest of your life!
You Shall Follow The Commandments of Eating After Bariatric Surgery if You Want to be Successful
Do you know the #1 reason why people don't lose all the weight they want or even gain weight after going through bariatric surgery?
Not following the post-op bariatric diet!
Make a commitment to following the "commandments" and make a regular date for yourself and a notebook on the first of every month to "check in" and assess how many of the 10 you're actually following.
Should your weight loss slow, stop, or start moving in the wrong direction, re-commit yourself to following ALL 10 Commandments!

YOU’RE NOT THE BOSS OF MY BODY! SUPPORT HEALTHY HABITS IN CHILDREN

By Michelle May, M.D.

www.AmIHungry.com A voice of reason for a society consumed by dieting, weight, food, and eating. Vol. III Issue 2

We live in an abundant food environment; food is fast, convenient, often highly processed, and relatively inexpensive. As a result, many of our children are overfed but undernourished.
To protect our children from becoming victims of our current environment, we must make sure they have the tools to thrive while maintaining a healthy weight.
The good news is that children are born with the most important skill—the instinctive ability to know how much food their body needs. Instinctively, babies cry to let their parents know when they're hungry. Toddlers in perpetual motion eat only small amounts of food but manage to eat frequently enough to meet their needs. During periods of rapid growth or activity, they may be hungry all the time. When their calorie requirements decrease, they lose interest in food.
The bad news is that we can destroy their instinctive skills with our good intentions. If parents or other caregivers feed a baby to calm every cry, the baby may learn that eating can soothe any discomfort. When they're given food to keep them quiet or busy, they learn that they can distract and entertain themselves with food.
Once a child is old enough to sit at the table, well-intentioned parents will play games and praise the child to encourage them to eat. They may say "Good boy! You ate all your dinner!" This is a wonderful time for creating positive feelings about mealtime but it also teaches the child that eating makes mommy and daddy happy.
Parents sometimes coerce older children to eat everything they were served by saying "clean your plate or you don't get dessert." Children may decide that since their parents have to bribe them to eat it, the dinner must be the "yucky stuff" and sweets are the reward for eating more than they were hungry for. The result is a lifetime
membership in the Clean Plate Club.
The bottom line is that although meeting the basic nutritional needs of your children is critical, it's important to provide meals and snacks in a way that respects their hunger and fullness cues and teaches them that while eating should be enjoyable, food is primarily for nourishment. If not, the stage is set for food and weight problems in the future.
Here are the keys to helping children thrive in our abundant food environment.

• Children are born with the ability to naturally regulate their food intake to meet their caloric needs. Pay attention when they say they are hungry or full.
• Don't force children to clean their plates or bribe them with dessert for finishing their meal.
• Never use food as a reward. Reward desired behavior with praise, extra attention, and privileges.
• Don't comfort your child with food. Use understanding words and hugs instead.
• Help your child develop interests and skills that increase their success and pleasure so they will be less likely to turn to food for fulfillment.
• Teach your children to cope with their emotions effectively so food won't serve that purpose for them.
• Don't impose stringent food rules since this may lead to rebellious eating when your children are out of your control.
• Avoid labeling some foods as "good" and others as "bad." Instead, teach your children how to balance eating for nourishment with eating for enjoyment.
• Involve children in shopping, meal planning, and preparation. This is a great opportunity to teach them about nutrition—and they're more likely to try new foods they picked.
• Sit down and eat together as a family. Mealtimes should be a pleasant time to reconnect with one another and model healthy eating and conversation.
• Help your child build a lifetime activity habit by reducing the amount of time your family spends in sedentary activities like TV and video games.
• Plan fun activities that provide everyone with exercise, enjoyment, and time together.
• Be a positive, encouraging role model for your family. When your children see you enjoying healthful foods and physical activity, they are more likely to do the same.

Prevention of food issues and the development of lifetime healthy eating and physical activity habits begins in childhood. It is never too late to learn these skills!
Michelle May, M.D. is a recovered yoyo dieter and the award-winning author of Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle. Find other articles and resources Copyright 2010, Michelle May, M.D. All rights reserved. For permission to reprint, email enews@AmIHungry.com

Quote for the day

"Failure is not neccessarily at the end of the road.  Many times it is the beginning of a new and more exciting trip."  Zig Ziglar

Quote for the day

"Obstacles are the things we see when we take our eyes off our goals."
Zig Ziglar

Stage 4 Soft Nutrition diet

Guidelines
• Chew, chew, chew! You cannot over-chew your food.
• Drink, drink, drink! But do not drink while eating. Wait at least 30 minutes after a meal before drinking fluids. When you do drink, sip—don't gulp or use straws. Do not drink alcohol.
• Stop eating when you feel full. If you keep eating, you may vomit. Overeating also stretches the pouch and may keep you from losing weight.
• Get enough protein. At meals, always eat protein first. Continue to use a liquid protein supplement.
• Eat several small meals every day.
• Take your vitamins every day.


Recommended Foods
High-Protein Foods
• Light (low-sugar) yogurt
• Low-fat cottage cheese
• Shredded low-fat cheese
• Tuna packed in water
• Crab, fish, scallops, and oysters (avoid fried)
• Skinless chicken or turkey, cooked until very tender and cut into small pieces
• Lean pork or beef, cooked until very tender and cut in small pieces
• Beans and lentils
• Low-fat deli meats
Other Healthy Choices
• Cream of wheat, oatmeal, or Malt-o-Meal with added protein powder
• Cold cereal soaked in milk until soggy
• Cooked tender vegetables without peels or seeds
• Ripe banana; fruit canned in its own juice or water (not canned in syrup)
• Low-fat soups with added protein powder or strained meat


Foods Not Recommended
"Sticky" Foods
• Soft bread (it can make a dough ball that could plug up the pouch outlet)
• Sticky or sweet rice
• Spaghetti and other pasta
• Macaroni and cheese
• High-fat cheese, melted cheese
• Raisins, prunes, and other dried fruits (these are too sweet)
Crunchy Foods
• Granola and other cereals with nuts
• Raw vegetables, salad
• Nuts and popcorn
• Chips
Tough Foods
• Tough or chewy meat
• Whole pieces of corn or whole peas (puree these foods before eating them)
High-Fat Foods
• Butter, margarine, and oil
• Regular mayonnaise, sour cream, cream cheese, salad dressing
• Whole milk and half-and-half
• Ice cream, cakes, cookies, pies, and other desserts
• Bacon
• Sausage
• Luncheon meats
• Gravy
Foods with Seeds, Peels, or Husks
• Strawberries and other berries
• Corn (unless pureed)
• Peas (unless pureed)


Sample 1-Day Menu
Take 15 minutes to eat each meal. Do not drink fluids at meals or for 30 minutes after the meal.
7:00 am 1 egg, poached or scrambled without added fat ½ cup oatmeal with 1 scoop protein powder,1 chewable multivitamin tablet
8:00 am 1 cup skim milk—Sip slowly (¼ cup every 15 minutes)
9:00 am 1 cup decaffeinated coffee—sip slowly (¼ cup every 15 minutes)
10:00 am 1 cup liquid protein supplement—Sip slowly (¼ cup every 15 minutes).
11:00 am 1 cup sugar-free lemonade—Sip slowly (¼ cup every 15 minutes)
12:00 Noon 2 to 3 tablespoons strained beef, 2 tablespoons mashed potatoes, 2 tablespoons pureed green beans,
1 chewable calcium tablet
1:00 pm 1 cup water—Sip slowly (¼ cup every 15 minutes)
2:00 pm 1 cup decaffeinated tea with sugar substitute—Sip slowly (¼ cup every 15 minutes)
3:00 pm 1 cup liquid protein supplement—sip slowly (¼ cup every 15 minutes)
5:00 pm 2 to 3 tablespoons strained turkey, 2 tablespoons mashed potato, 2 tablespoons pureed carrots,
1 chewable multivitamin tablet
6:00 pm ½ cup sugar-free instant pudding, made with 1 scoop protein powder
7:00 pm 1 cup liquid protein supplement—sip slowly (¼ cup every 15 minutes)
8:00 pm 1 cup water—Sip slowly (¼ cup every 15 minutes)
9:00 pm ¼ cup low-fat cottage cheese, ¼ cup unsweetened applesauce with a sprinkle of cinnamon
1 chewable calcium tablet
10:00 pm 1 cup water—Sip slowly (¼ cup every 15 minutes)

Stage 3 Blended/Pureed Nutrition diet

Follow this nutrition therapy, blending everything to the consistency of applesauce, until your dietitian gives you new instructions. This will usually happen at your first doctor's visit after surgery.


Goals
􀁹
To help you lose enough weight after gastric lap-band or Roux-en-Y surgery
􀁹
To provide enough protein, fluid, vitamins, and minerals to keep you healthy
􀁹
To decrease side effects of surgery


Beverage Guidelines
􀁹
Drink 48 ounces or more of low-fat, low-sugar liquids every day. To drink this much, try sipping 1 ounce (2 tablespoons) every 15 minutes.
􀁹
About half of what you drink (24 ounces per day) should be high-protein drinks or strained cream soups. These should have at least 15 grams protein, less than 20 grams carbohydrate, and less than 5 grams fat per cup (8 ounces).
􀁹
At least half of what you drink (24 ounces or more per day) should be sugar-free liquids.


Good choices include the following:
o Water
o Decaffeinated coffee or caffeine-free tea without sugar (you may use sugar substitute)
o Sugar-free, noncarbonated drinks, like Crystal Lite or sugar-free Kool-Aid,
or "flat" sugar-free soda pop
o Diet V-8 Splash
o Low-calorie cranberry juice
o Sugar-free Jell-O (¼ cup = 2 ounces)
o Sugar-free Popsicles
o Broth


􀁹
Do not drink liquids with a meal or for 30 minutes after a meal. This can cause the pouch
to stretch, and you will not lose all the weight that you can. You are also more likely to
regain weight later.
􀁹
Do not drink alcohol. It is dehydrating and has no nutrients.
􀁹
Do not drink carbonated (bubbly) drinks. The bubbles may give you gas, cause bloating,
and stretch the stomach pouch.


Meal Guidelines
􀁹
Stop eating when you first feel full.
􀁹
All foods must be blended or pureed.
􀁹
Take 15 minutes to eat each meal.
􀁹
If you had lap-band surgery, eat three meals per day.
􀁹
If you had Roux-en-Y surgery, eat six to eight meals per day.
􀁹
Eat foods in this order:
o Have protein foods first. Foods with protein include pureed or strained baby foods
(meat, fish, and poultry types) and eggs.
o Then eat vegetables and fruit.
o Have starchy mashed potatoes and strained cooked cereal last.


Vitamin and Mineral Supplements
􀁹
Take two chewable multiple vitamin/mineral supplements daily. You must do this
forever! Do not quit taking your vitamins, no matter how good you feel.
􀁹
Take other supplements, including calcium, vitamin B-12, and iron, if you need them.
Your doctor or dietitian will tell you what to do.


Dumping Syndrome
Dumping syndrome is a condition where food does not stay in the stomach for long enough.
Instead, it is "dumped" into the small intestine. This can make you feel weak or dizzy, get a
headache, turn red, or have diarrhea.
To avoid dumping:
􀁹
Do not drink liquids with a meal.
􀁹
Do not drink liquids within 30 minutes after a meal.
􀁹
Do not eat or drink foods made with sugar.
􀁹
Avoid high-fat and greasy foods.


Other Tips
􀁹
Do not chew gum. If you swallow it, gum can block the stomach opening.
􀁹
Do not drink from a straw. Straws make you swallow air. That causes bloating and can
stretch the pouch.


Sample 1-Day Menu
8:00 am 4 to 6 tablespoons cooked cream of wheat, with 2 tablespoons skim milk to thin cereal 1 chewable multiple vitamin tablet
9:00 am 1 cup skim milk—Sip slowly; have 2 ounces every 15 minutes.
10:00 am 1 cup low-calorie cranberry juice—Sip slowly; have 2 ounces every 15 minutes.
11:00 am 3 tablespoons cottage cheese and 1 tablespoon strained peaches
12:00 Noon 1 cup sugar-free lemonade—Sip slowly; have 2 ounces every 15 minutes.
1:00 pm 2 to 3 tablespoons strained beef, 2 tablespoons pureed green beans 2 tablespoons mashed potatoes 1 chewable calcium tablet (if prescribed)
2:00 pm 1 cup caffeine-free tea with sugar substitute—Sip slowly; have 2 ounces every 15 minutes.
3:00 pm 1 cup liquid protein supplement—Sip slowly; have 2 ounces every 15 minutes.
5:00 pm 6 tablespoons sugar-free instant pudding made with 1 scoop of protein powder
6:00 pm 2 to 3 tablespoons strained turkey, 2 tablespoons pureed carrots, 2 tablespoons mashed potato, 1 chewable multivitamin tablet
7:00 pm 1 cup skim milk—Sip slowly; have 2 ounces every 15 minutes
8:00 pm 3 tablespoons cottage cheese and 3 tablespoons applesauce with a sprinkle of cinnamon 1 chewable calcium tablet (if prescribed)
9:00 pm 1 cup high-protein cream of chicken soup
10:00 pm 1 cup decaffeinated coffee—Sip slowly; have 2 ounces every 15 minutes


Remember:
􀁹
Take 15 minutes to eat each meal.
􀁹
At meals, always eat protein (meat, eggs, fish, or poultry) first!
􀁹
Do not drink liquids at meals.
􀁹
Wait at least 30 minutes after a meal to start drinking fluids. Aim for 48 to 64 oz (6 to 8 cups) of fluids daily.
􀁹
Stop eating or drinking when you are full.
􀁹
Do not drink alcohol.
􀁹
Do not drink from a straw.
􀁹
Sip, don't gulp!

Stage 2 Liquid Nutrition diet

Follow this diet for two weeks before your surgery and for the first two weeks after surgery.
Goals

• Adequate protein to promote healing after surgery and help build lean body mass; 60-70 grams protein per day for women and 70-80 grams per day for men
• Adequate fluid to prevent dehydration 48-64 oz per day initially after surgery; 4-5 days post-op increase to 64-96 oz sugar free, caffeine free fluids per day
  • Do not drink 30 minutes before or 30 minutes after a meal
• Begin taking a chewable Multivitamin (MVI) with iron to prevent nutrient deficiencies
  • Centrum chewable or Flintstones Complete are two chewable MVIs with iron you may try
  • Take your MVI with iron twice a day
• Begin taking a chewable calcium + Vitamin D supplement
  • Should be in the calcium citrate form (such as Citracal) 500 mg three times per day for a total of 1500 mg per day
  • Take calcium and MVI with iron at least two hours apart
• Caloric intake should be 800-1000 calories per day for the post-op stage
• Pre-op calories are not limited
• Keep a food diary    
  • Write down everything you eat and drink during the day; this will help you stay within your calorie goal, and help you determine if you are getting enough protein and fluid
  • There are various websites that can help you track your caloric intake including:
    • www.mypyramid.gov, http://www.fitday.com/, and http://www.sparkpeople.com/

Examples of Sugar Free (or No Sugar Added) Full Liquids

• Skim milk and/or light soy milk
• HEB Mootopia milk—lactose free and 50% more protein than regular skim milk
• No sugar added Carnation Instant Breakfast
• Isopure or IsopurePlus Zero Carb beverages
• Dannon Light and Fit yogurt
• Low fat strained cream soups
• Low fat broth (with a scoop of unflavored protein powder)
• Sugar Free Popsicles
• EAS Light
• Resource OptiSource High Protein (can be found at CVS online)

Tips for the Liquid Stage

• Get creative with your protein drinks! You won't drink it if you don't like it
  • Try http://www.bariatriceating.com/ or http://www.unjury.com/ for protein drink recipes and ideas
• Purchase an unflavored protein powder such as Beneprotein
  • This can be added to most foods including soups, yogurts and beverages
  • It is available at the Davila Pharmacy downtown San Antonio or also through a commercial pharmacy such as CVS or Walgreens
  • This product is in stock at Davila but has to be ordered from CVS or Walgreens
    • Can be ordered through CVS/Walgreens online
• If you find that you have become lactose intolerant try lactose free milk or a lactase supplement before eliminating dairy from your diet
  • Dairy is a great source of protein calcium and vitamin D!
• Avoid sugar alcohols
  • Half of the calories from sugar alcohols are absorbed
  • Too much can cause diarrhea
• Avoid foods that are high in fat and (real) sugar—these foods will cause dumping syndrome
• If you are taking a calcium supplement take it separately from your multivitamin with iron
  • You should be taking 1500 mg of calcium citrate
  • Divide the dose up into 500 mg three times throughout the day, this helps your body absorb the calcium more efficiently
• If you have questions about your diet contact
  • You may also call the Outpatient Nutrition Clinic at 292-7578

Weight Management Myth or Fact: You Have to Eat Breakfast

By Michelle May, M.D.

www.AmIHungry.com A voice of reason for a society consumed by dieting, weight, food and eating. Vol. I Issue 7

In our information-driven society we receive a constant stream of news reports, research and expert advice telling us what to do. Don't get me wrong. Smart choices based on a solid foundation are important. But to make long term lifestyle changes, it's essential that you THINK about how information applies to you. Think about this common rule:

You HAVE to Eat Breakfast

Complete this sentence: Breakfast is _________________________________.

I'll bet you said "…the most important meal of the day" right? This piece of wisdom is supported by numerous studies that have shown that people who eat breakfast:

• Function better (and in the case of children, perform better in school)
  
• Are less likely to overeat later in the day
  
• Weigh less than breakfast skippers
  

You might think, "What's the big deal? I only skipped ONE meal!" Well, if you ate dinner at 6:00 pm, skipped breakfast and ate lunch at 12:00, you have gone 18 hours without eating.

That IS a big deal because that first meal after sleeping literally breaks your fast and prevents you from being too hungry to make mindful decisions later. In addition, eating breakfast reassures your metabolism that there's a reliable fuel supply so it doesn't need to slow down and conserve energy.

Maybe you're thinking, "But when I eat breakfast, I'm hungry all day." Of course! When you kick start your metabolism with breakfast, your body will freely use the fuel then ask for more. The kind of fuel and the amount you eat will determine how often you get hungry.

So what's the myth? When I speak at any conference about the non-diet approach and hunger-based weight management, someone always asks, "So if a person isn't hungry for breakfast, they don't have to eat it, right?"

Right. But why aren't they hungry? They have to answer that question first to figure out how breakfast might help them with their health and weight management goals.

The Chicken or the Egg

The association between lower body weight and eating breakfast might be a case of which came first. People who skip breakfast generally weigh more—but perhaps it's because they overeat in the evening due to triggers like TV, boredom, habits or stress—so they don't feel hungry when they first wake up.

Some people even get up and eat at night so there is no "fast" to break. Is breakfast important for them—or is it more important to address why they're eating at night?

Self-Fulfilling Prophecy

In other cases, people who struggle with their weight skip breakfast because they're aftraid that once they start eating, they won't be able to stop. This becomes a self-fulfilling prophecy. When they do finally eat, they're overly hungry so they feel out of control. That can lead to guilt and even more eating the rest of the day and into the evening. They go to bed determined they will "be good" tomorrow but wake up and repeat the cycle all over again.

If this sounds familiar, become aware of your overall eating pattern and remember to ask the question, "Am I hungry?" before you eat. Learning other ways to cope with head hunger, like finding something else to do besides eat in front of the TV at night, will allow you to feel hungry in the morning for breakfast. With practice you can break the cycle of skipping breakfast then overeating the rest of the day.

The Morning After

Even people who eat instinctively will sometimes have a heavy evening meal, for example, at a favorite restaurant for a special occasion. When they do, they're usually not as hungry the next morning. Skipping breakfast on occasion won't harm your metabolism and it allows you to intuitively balance your intake over the course of 24 hours or so.

Not a Morning Person

For some people it takes a little while for their body to wake up and give them the "eat" signal. That's ok. You don't have to eat within minutes of your feet hitting the floor. Just check in with yourself again in an hour or so to see if you're noticing hunger. Be prepared with a light breakfast as you retrain yourself to eat in the morning. Soon you'll have a healthy new habit.

Rush Hour

Maybe you feel too stressed in the morning to eat breakfast. So instead you slam a couple of cups of coffee while you're getting ready, rush around to get the kids to school, then race off to work and stress out in a traffic jam. All that caffeine and adrenaline might mask your hunger but skipping breakfast will make you even more irritable and less productive.

The obvious solution is to give yourself a little extra time in the morning to eat. Alternatively, have quick, healthy items on hand like a scrambled egg wrapped in a whole wheat tortilla or a baggie of low fat granola, almonds and dried cranberries to munch on.

Wake Up Call

Some people eat breakfast but choose foods that are high in saturated fat, sugar, refined carbohydrates and calories but low in nutrition—donuts, Danishes and drive-throughs fall into this category. Some people eat more than they really need, like a large bagel or a stack of pancakes, then feel sluggish afterward.

Some people don't eat breakfast—they drink it instead. A fancy coffee drink usually has very few nutrients but loads of empty calories.

Fact: Breakfast kick starts your metabolism and your day. But it's also a convenient time to eat nutrient dense foods like bran cereal, low fat or skim milk, whole grain toast, peanut butter, hard boiled eggs, yogurt or fresh fruit.

So is breakfast the most important meal of the day? Now that's food for thought!

Michelle May, M.D. is a recovered yoyo dieter and the award-winning author of Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle. Find additional articles and resources at http://AmIHungry.com/. Copyright 2010, Michelle May, M.D. All rights reserved. For permission to reprint, email enews@AmIHungry.com

New Family Fitness Room

Medina Fitness Center now features a Family Fitness Room featuring cardio equipment and a great space for kids to play or watch movies while parents burn calories.  Call 671-4477 for details.

Paint-By-Number or Masterpiece: Restrictive vs. Healthy Eating

By Michelle May, M.D.
www.AmIHungry.com
A voice of reason for a society consumed by dieting, weight, food and eating. Vol. I Issue 6

There is a harmful idea virus that has become so widespread, so ubiquitous, that it is accepted as normal. It has subtly integrated itself into our beliefs, our thoughts, our language, our behavior and our reality. It's so pervasive that it has become "conventional wisdom" and almost no one questions it.

So What Is This Idea Virus?

It is the belief that restrictive eating is healthy eating. It usually starts with information about nutrition or weight management that mutates into rules and restriction. But the blurring of the line between healthy eating and restrictive eating is the difference between a work of art and paint-by-number. Either way, you end up with a nice picture—until you get up close to take a look.

Healthy Eating
vs. Restrictive Eating

In Charge        In Control

Nourishment         Diet

Fuel            Calories

Quality            Points

Healthy             Skinny   

Aware            Preoccupied

Conscious         Consumed

Mindful            Vigilant

Information         Dogma

Guide            Rules

All foods fit         Good or bad

Balance            Perfection

Variety            Temptation

Moderation        Deprivation

Choosing         Earning

Deciding             Rationalizing

Flexible             Rigid

Hunger based         By the clock

Comfort            Portion sizes

Physical Activity        Penance

Effortless         Willpower

Trust            Fear

Learning            Failing

Self-acceptance        Condemnation

Enjoyment        Guilt   

Pleasure            Shame   

Freedom            Bondage

 

The main reason that this virus is so powerful is that it has a built-in protective mechanism: the underlying belief that people who are overweight are incapable of handling freedom or choice. This belief ensures the survival of the virus because when you try to restrict yourself (or others) it actually leads to more cravings for the foods you've labeled "bad." When you finally "give in," you're more likely to overeat, proving that you are incapable of handling freedom or choice leading to more restriction.

One of the reasons that this idea virus is so successful at replicating itself is that it initially appears to be beneficial to its host so many people will intentionally seek out. For many people that promote health, wellness and weight loss, "lifestyle change" and "healthy eating" have become euphemisms for "you're going to be on this diet for the rest of your life." The virus is so subtle and so ingrained that they usually don't even realize that restriction is at the core of their message.

How is this Idea Virus Spread?

You are most prone to this virus if you're overweight (or think you are). Everybody else that has the virus tries to give it to you in an effort to help you (or sell you something). It takes the form of rational suggestions, loving advice and even harsh criticism.

The idea virus spreads vertically through advertising, television, magazines, books, the Internet and medical research. It is propagated by marketers, models, celebrities, reporters, experts, bloggers, researchers and legislators. It then spreads horizontally from doctor to patient, dietitian to client, friend to friend, wife to husband and parent to child. This virus is also swiftly moving from the United States to the rest of the world.

How to Cure This Virus

Take a close look at the "picture of health" you're painting. Is it constrained by rigid lines and someone else's choice of colors? Or does it express your individuality, your preferences and your lifestyle? Choose now how you want to create your work of art. Here are some specific steps to rid yourself of the "restrictive eating is healthy eating" virus.

1. Diagnose the virus. Filter everything you read, hear and say by asking, "Is this restrictive in nature?" (You might be surprised when you start to notice just how pervasive it really is!)
   
2. Begin to monitor your little voice. (This virus is sneaky so it may be helpful to journal so you capture the real essence of your beliefs, thoughts, feelings and choices.) When you notice restrictive eating thoughts from the second column above, gently replace them with true healthy eating thoughts from the first column.
   
3. The virus may have you convinced that you are incapable of managing your weight without rigid rules. Find role models, health care providers and non-diet approaches that don't propagate the virus. With time, support and new tools you can do it!
   
4. Use nutrition information as a tool not a weapon. Remember, all foods fit into a healthy diet.
   
5. Make the healthiest choice you can without feeling deprived. All foods fit using balance, variety and moderation.
   
6. Let go of the belief that you need to eat perfectly – that is the virus talking. Accept that you'll sometimes regret certain choices you make – that is part of healthy eating. When you don't get caught up in guilt and shame, you're able to learn from your experiences.
   
7. Repeat this often: "It's just food and I can learn to trust and nourish myself without restriction."
   
8. Discover joy in creating your own masterpiece!
   

 

Michelle May, M.D. is a recovered yoyo dieter and the award-winning author of Am I Hungry? What to Do When Diets Don't Work. Find additional articles and resources at http://AmIHungry.com/. Copyright 2007, Michelle May, M.D. All rights reserved. For permission to reprint, email enews@AmIHungry.com

WHAT TO EAT - THREE QUESTIONS TO ASK YOURSELF

By Michelle May, M.D.

www.AmIHungry.com A voice of reason for a society consumed by dieting, weight, food and eating. Vol. II Issue 5

We are bombarded with conflicting messages about what to eat—often side by side on the same magazine cover. These confusing messages create internal conflict when what you want to eat must face off with what you should eat according to the latest expert.

Ironically, the definition of "good" and "bad" foods changes every few years so people feel confused and overwhelmed by all the conflicting and often arbitrary messages about what they are supposed to eat.

However it is possible to strike a balance between eating for nourishment and eating for enjoyment. In fact, one of the keys to optimal health and lifelong weight management is to nurture your body and your soul with the foods you eat.

So how do you drown out all the noise and find that balance when deciding what to eat? Start by asking yourself three simple questions when you're hungry: "What do I want to eat?" "What do I need to eat?" and "What do I have to eat?"

What Do I Want to Eat?

The first question, "What do I want to eat?" may come as a surprise. But what happens when you try to avoid food you really want-like those Girl Scout Cookies that were delivered after you started your new low-carb diet?

First you check the label and confirm that they're off limits so you put them in the freezer. Two days later they whisper to you from their hiding place, "Pssst. We're in here!" You manage to resist them, instead munching on some olives, four cubes of cheese, a hunk of leftover meatloaf with a side of celery sticks, two pieces of low-carb toast—and yet you still don't feel satisfied.

"Hey! We're in here and we taste great frozen!" You finally give in to your urge and have two Thin Mints®. Blew it again! Might as well eat a few more—and a bowl of ice cream—and start over tomorrow. Sound familiar?

Thinking about what you really want to eat without judging yourself will keep you from feeling deprived and out of control when you choose to eat certain foods.

You might be worried that if you ask yourself what you're really hungry for, you'll always choose foods you "shouldn't." At first this might seem true since cravings tend to get stronger when you try to ignore them for too long.

However, once you let go of the guilt about eating certain foods they lose their power over you. Learn to trust your body wisdom and you'll soon discover that you want to eat a variety of foods to feel healthy and satisfied.

What Do I Need to Eat?

The next question to ask yourself is "What do I need to eat?" While food decisions aren't "good" or "bad," clearly some foods offer more nutritional benefits than others.

As you consider what food to choose, ask yourself, "What does my body need?" Keep in mind the principles of variety, balance and moderation when deciding what to eat. Consider nutrition information, your personal health issues, your family history, what else you will be eating and doing that day, and how your body responds to certain foods.

Enjoy your healthy choices by focusing on fresh foods, appealing combinations, new flavors and interesting recipes.

What Do I Have to Eat?

The key to the final question, "What do I have to eat?" is planning. If you feel hungry and the only thing available is a vending machine, you're likely to choose a snack food that may not be very healthy, may not taste very good and may not really be what you were hungry for anyway.

Instead, strive to have a variety of foods available that are healthful and appealing but not overly tempting. These are foods that you enjoy when you're hungry but won't be calling out to you from their storage place saying, "Come eat me!" 

Of course, you're not always in control of which foods are available. At a restaurant, office potluck, or friend's house, simply see what's available and ask yourself, "Is there a healthy choice that will meet my needs without feeling deprived?" For example, could you be happy with frozen yogurt instead of ice cream this time?

Matching the food you choose to what you're really hungry for and what your body needs leads to greater satisfaction and more enjoyment-with less food.

Balanced eating is simply the result of all of the individual decisions you make. Eating food you truly enjoy while taking good care of your body is the best way to make long term changes that you can live with.

Michelle May, M.D. is a recovered yoyo dieter and the award-winning author of Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle. Additional articles and resources: www.AmIHungry.com. Copyright 2010, Michelle May, M.D. All rights reserved. For permission to reprint, email enews@AmIHungry.com

 

 

Recipe for Overeating and Instinctive Eating

Original content at http://amihungry.com/Am-I-Hungry-E-news-0912.shtml

Eat Mindfully, Live Vibrantly!

By Michelle May, M.D.
www.AmIHungry.com 
www.MichelleMayMD.com 


Recipe for Overeating

Ingredients:
1 batch, bag, box, or large plate of food
2 tablespoons of deprivation
1 heaping teaspoon of guilt
Sprinkle of shame
Optional: fatigue, stress, resentment, loneliness, boredom

Directions:

1. Run yourself down physically by not sleeping, exercising, eating when you're hungry, or consuming nutritious foods. Alternatively, wear yourself out by working too hard, being all things to all people, and trying to make everything perfect.
   
2. Place emotions on medium-high. Cover and simmer; do not allow steam to escape.
   
3. When you crave something you love, remind yourself that it's bad, fattening, or high in carbs.
   
4. When your cravings grow stronger, tell yourself that you're bad for wanting bad food.
   
5. Wait until an influential person such as your grandmother or co-worker insists you eat that food anyway to please them. Alternatively, sneak the food when no one is watching.
   
6. Sit down in front of the T.V. or choose another activity to distract yourself while you eat.
   
7. Before eating, garnish the food with guilt. If it's still enjoyable, stir in some shame to ensure that the food is completely ruined.
   
8. Eat as quickly as possible to avoid tasting or enjoying the food.
   
9. You're done when you feel sick and uncomfortable.
   
10. Repeat steps 1-9 until can't stand it anymore. Try the Recipe for Instinctive Eating.
    

Recipe for Instinctive Eating

Ingredients:
1 or 2 servings of food you love
2 tablespoons of intention
1 heaping teaspoon of attention
Sprinkle of trust
Optional: pleasure, enjoyment, celebration, tradition

Directions:

1. Care for yourself physically by getting adequate sleep, exercise, and nutrition.
   
2. Create a self-care buffer zone by regularly nurturing your body, mind, heart, and spirit.
   
3. When you're hungry, consider what you want, what you need, and what you have to eat before choosing food.
   
4. Decide how you want to feel when you're finished eating; serve yourself accordingly (or adjust the portion if someone else served you).
   
5. When the food you crave isn't particularly healthful, omit all guilt and shame. Remind yourself that all foods fit when you practice balance, variety, and moderation.
   
6. Sit down to eat and minimize distractions.
   
7. Savor the appearance, aromas, textures, and flavors as you eat.
   
8. Eat slowly and mindfully for maximal enjoyment from every bite.
   
9. Stop when you feel content and energetic.
   
10. Repeat steps 1-9 for the remainder of your life. 
    

(For complete guide and techniques: Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle.) 

 



 

Head Hunger: Coping with Your Triggers for Overeating part 8

By Michelle May, M.D.
http://www.AmIHungry.com

Why am I hungry all the time?

If you find yourself thinking, "Why am I hungry all the time?" you may be confusing "head hunger" with "body hunger." If you're someone who's sensitive to food cues, weight management will be challenging until you are able to recognize the overeating triggers in your environment and break the associations that lead you to overeat simply out of habit.

Let's take a look at just a few of the common overeating triggers and strategies for coping more effectively with head hunger.

FORBIDDEN FOOD SYNDROME: Although it's a popular topic of conversation, the mere discussion of dieting can trigger feelings of deprivation and cravings. Just thinking about restrictive dieting has been shown to increase food intake.

Strategy:  Decrease the amount of time you spend talking about food, weight and dieting. Depend on your physical hunger cues to let you know when it's time to eat.

So if you've wondered, "Why am I hungry all the time?" it's time to develop new strategies. By learning to recognize and decrease your overeating triggers, distracting yourself and coping effectively with head hunger, you'll soon break free from old habits. You'll find yourself eating less, feeling more satisfied and more fulfilled. 

Discover what you need to know to change your destructive patterns for good in these nine "easy-to-read over a cup of coffee" e-book chapters from I'm NOT Hungry - What Now?
 

Michelle May, M.D. is a recovered yoyo dieter and the award winning author of Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle (download the first chapter free). She conducts corporate workshops and speaks throughout the country on mindful eating and vibrant living.

  
 

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