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Better Health D
YOUR BMI: 6 reasons to check it, D2 DIET: What to expect when you start eating healthy, D2 TRAVEL: Welcome to Michigan, D3
| SUNDAY, JANUARY 19, 2020
Psychologist says
mindset is key in
losing
weight By Anne-Gerard Flynn
Special to The Republican
Clinical psychologist Brenda Temblador works with patients preparing for weightloss surgery at Baystate Medical Center, but notes some of the counseling she does can be applied to anyone looking to better manage their weight. “Mindset is probably the most important part of losing weight and trying to be healthy and live healthy,” Temblador said. “We talk about mindfulness all the time in this program. We think about what am I doing, what am I eating? Is this portion of food the right amount for me?” She adds, “We encourage people to think about this not on an anxious, obsessive level but to really pay attention.” “Am I hungry? Am I not hungry? Am I full,” said Temblador who is clinical supervisor in the hospital’s adult outpatient behavioral health department. Additionally, she said it is also “important for people to assess why they want to lose weight and give themselves a clear vision of what goals they have and what are the difficulties going to be in trying to achieve them.” “It is important to pay attention to all of these things before embarking on some kind of eating plan and is really vital for success,” said Temblador who holds a doctorate in her field and has worked at Baystate for more than two decades. She said she talks “a lot about emotional eating” with her patients. “How much of what they are eating and the choices of what they are eating have to do with more emotional motivations rather than I am hungry and I need to eat something,” Temblador said. She said it is good to be aware and to apply mindfulness if “whenever I am having some sort of uncomfortable emotion and I am trying to get rid of it, I find food and the food makes that emotion go away.”
“For example, I am having Temblador said. of cake and at least “feeling all of the stuff you are not a really bad day at work and I “It is more likely you will eat good about that” as opposed supposed to be eating is right am leaving and I think I will the healthy salad that is on the to their past behavior of “eat- in front of your face,” Temblahave some chocolate. The plan then if there is no plan ing much more than that.” dor said. idea of eating chocolate is go- and you are just going to try to Temblador said people “Or, mom comes and says, ing to make me feel better. We fulfill that craving quickly and have different motivations for ‘I made this for you,’ and you all do that to a certain extent easily.” wanting to lose weight. She realize that is not something and that is not problematic,” She also cautions her said a health scare can be the you should eat. We work on Temblador said. patients about “being very “biggest motivator,” but does what is going to motivate you “But when I regularly deal negative or punishing or beat- not always sustain motivation through those situations.” with anxiety or depression ing yourself up – all of those especially if it resolves. She termed “preparing, or sadness by eating then it kinds of things – is not at all “People needing to lose planning ahead, keeping yourbecomes a habit and difficult helpful.” weight in order to have self focused on what you are to change and that is where “The people I see have weight-loss surgery may also doing” as “all of those things mindfulness comes in.” berated themselves all of the be motivated by the desire to that can help people.” She added, “Am I eating just time or been berated for failmove better, play with their She also said that family to feel better? Am I having a ing,” Temblador said. children, get on the rides at support can be a “make or craving that has nothing to do “Every time they do someSix Flags, and embarrassing break kind of thing for a lot with being hungry and time thing wrong, they get on the events that have been very of people” trying to lose or for a meal?” scale and it goes in the wrong crushing to them,” Temblador manage weight. “It is important to pay direction and they feel like a said. “Sometimes I have converattention and guard against failure. It is important to push “Some of these things can sations with folks, asking how that because the does your fammore I do that ily feel about the more I enyou wanting to gage in emotionhave weightal eating and the loss surgery,” easier it will be to Temblador engage in emosaid. tional eating,” “I go into Temblador said. great detail, “Trying to resaying what sist that is going it will mean to be hard but to them if necessary to stop you go to the this emotional Christmas eating habit.” dinner and She helps don’t eat their patients address dish. Would this habit by it make more teaching them sense to talk to “mindfulness them ahead of exercises.” time and say “We can do this this is what I very intensely by am doing so doing things like I am going to eating slowly, have to give up chewing your certain things food and tasting or change Clinical psychologist Brenda Temblador works with patients preparing for weightit as you are eatthings, and can loss surgery at Baystate Medical Center. (ANNE-GERARD FLYNN PHOTO) ing,” Temblador you help me said. with this and “Also, presupport me paring a meal with this?” that aside and figure out what be motivating enough to get and looking at it. Making She said she encourages her them started and maintain decisions on what is the right has happened.” patients “to get family support Temblador added, “Don’t their motivation.” amount of protein, the right and that way they can really berate yourself for doing She added, “Getting started be helpful.” amount of vegetables on my something you feel is not a and keeping motivated is the plate. Being very thoughtful “Families sometimes have good thing, but say, ‘OK, I can hardest thing ever for everyand paying attention.” a hard time maintaining good start right now to change,’ one.” Temblador said she somehealthy habits too, but if they and be again in this moment “I focus with everyone on times asks “people to plan are aware and they are part to move forward and not wait what are the things that are what you are going to eat.” of the plan, there is a better until Monday.” going to keep you motivated “So, when you are having a chance they will stick with She cited the example of when, for example, you are bad day the plan is there that supporting the person,” Temyou will eat a healthy salad,” someone having one slice at Thanksgiving dinner and blador said.
“Just being open and honest a good amount is vital.” She said she sees varied strategies among her patients in terms of social events around food. “Some people will say I just decided to try a little bit of everything and that might be satisfying,” Temblador said. “I have had other people bring a dish to the meal that they can contribute and they will have that rather than the other things. I have had people avoid going to these situations because it will be too hard not to have the foods that are there or avoid having large quantities of it.” She added, “A lot of people I see have had problems with weight for a long time, and have not been able to get it under control and have maybe tried all sorts of different things.” “Some work temporarily but usually none work forever,” said Temblador of diet trends. “For them weight-loss surgery may be the answer.” What does Temblador suggest in general to people trying to better manage weight? Here are some of her tips: “Start with small goals. To say I want to lose 100 pounds is probably not sustainable. Don’t go too extreme with an eating plan. Do one where you can maintain the level of eating. Eating healthy is a main goal for me, though my patients have other goals and this is where I say, ‘What is doable for the rest of your life?’ If having a protein shake twice a day is not your thing, then sustaining that is probably not the tactic you should use. If eating three meals a day with reasonable portions is something you can sustain, then that is what we should try to do and not worry about how much weight you are going to lose or losing a lot quickly. It is about what is sustainable, what you can maintain over the rest of your life.”
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D2 | SUNDAY, JANUARY 19, 2020
Y
ou’ve probably heard the term BMI, but may not understand how it affects every aspect of your life. BMI stands for body mass index, the relationship between your weight and your height. Since everyone is different, a normal weight for a taller person isn’t appropriate for someone with a smaller frame. Calculating your BMI provides a good indication if you’re at risk for a host of preventable health conditions. It’s a great first step toward becoming more informed about your health. Take this quiz to see if you should be concerned about your BMI. If you answer YES to one or more questions, the Weight Management Program at Holyoke Medical Center can provide the tools you need to lose weight and live better.
REASON #1: Has your doctor
recommended that you lose weight? Usually, this is a strong sign that your BMI is a concern. If your BMI is between 25-29.9, you’re considered overweight. If it’s 30 or over, you’re considered obese. Today, nearly 70% of American adults fall into one of those categories. If your BMI puts you at risk, don’t do it alone. You’ll get better results if you enlist the support of medical experts—in weight loss, nutrition, behavioral health and exercise—who can help you develop and stick with an effective plan. The goal: to help you achieve a healthy weight for life.
REASON #2: Have you been diagnosed with one of these conditions? A high BMI puts you at greater risk for lots of other diseases. Excess pounds, especially around the middle, can increase your chance of having heart disease, type 2 diabetes, stroke, high cholesterol, certain cancers and respiratory problems such as asthma. When diagnosed with one of these illnesses, many people assume that medication is the
only treatment available to control their condition. The good news: medical weight loss is often an effective tool in reducing—or even eliminating—the need for certain medications. Patients should always check with their doctor before adjusting any medication dosage.
REASON #3: Do you have
pain in your knees or other joints? A higher BMI puts you at greater risk for needing joint replacement surgery, as well as back pain, osteoarthritis and chronic pain. In fact, obese people are 20 times more likely to require knee replacement surgery. That’s because every pound of weight you gain puts an extra four pounds of pressure on your knee joints, wearing down the cartilage that cushions the joint. A medical weight loss plan increases the likelihood that joint replacement surgery will be a success. It could even eliminate your need for surgery.
REASON #4: Do you have sleep apnea or trouble sleeping? A higher BMI triggers a vicious cycle between sleep and weight gain. Heavier people are more prone to sleep apnea, a condition that affects an estimated 18 million Americans with snoring and frequent waking. Experts say losing even 10% of your body weight can improve sleep apnea. To make matters worse, sleeping less than five hours a night increases your chance of gaining weight, since sleep debt impairs metabolism and disrupts hormones that regulate hunger and stimulate the appetite. Plus, lack of sleep leads to fatigue—and lower motivation to exercise. REASON #5: Are you avoiding some activities because of your weight? Weight often dictates the lifestyle choices we make. You may love to swim, but turn down an invitation to the beach because you don’t want to be seen
in a bathing suit. Or a day with friends in the city that involves lots of walking just seems too strenuous. We may not realize it, but everyday choices—in activities, clothing, furniture selection and even cars—are often dictated by our BMI.
REASON #6: Is your self-esteem suffering? Studies show that being overweight has a direct effect on your self-esteem. In fact, obesity puts you at much higher risk for clinical depression, anxiety and other mental disorders, with one study suggesting that 21.2% of obese women suffer from depressive symptoms. If your weight makes you feel this way, please know that help is available. The weight loss team at Holyoke Medical Center includes behavioral health specialists, as well as support groups where you’ll meet people on the same weight loss journey as you. Together, you’ll take the first steps toward a healthier life. Test your BMI and begin your journey to a healthier weight. Calculating your BMI
the first step toward a healthier life. If the results indicate that you’re either overweight or obese, the professionals at Holyoke Medical Center’s Weight Management Program can help. Attend an informational meeting to learn about our individualized approach and our medical team—doctors, nutritionists and behavioral health experts—who can help you to achieve your healthiest weight. For more information on Holyoke Medical Center’s Weight Management Program, or to register for a free information session, please call (413) 535-4757. Sources: The National Institutes for Health, American Heart Association, the Obesity Action Coalition, the National Sleep Foundation, Mayo Clinic, Centers for Disease Control and Prevention.
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What to expect as you transition
healthy diet to a
For many people, the road to a healthy lifestyle begins in the kitchen. People make changes to their diets of their own volition or at the recommendation of their doctors, and those changes can have a profound effect that might surprise even the most devoted of healthy eaters. According to the Center for Advancement in Cancer Education, 90 percent of all cancer cases can be prevented through environmental and lifestyle choices like deciding to eat a healthy diet. In addition, the Office of Disease Prevention and Health Promotion, a division of the U.S. Department of Health and Human Services, notes that a history of poor eating is one of the biggest contrib-
utors to the various nutritionand physical activity-related health challenges that now face the U.S. population. By simply altering their diets to make them more nutritious, millions of people across the globe can significantly reduce their risk for various chronic diseases, including cardiovascular disease and type 2 diabetes. People who are committed to eating healthier should know that changing diets can produce some adverse, but typically temporary, side effects. The CACE notes that such side effects are predictable, as they are essentially just manifestations of the body’s adjustments as it responds to eating better. People adopting healthier diets should discuss the appearance of the following side effects with their physicians while recognizing that they are not necessarily a cause for concern.
Skin rashes
The CACE notes that people who have histories of recurring skin rashes or eruptions may experience such rashes as they adjust to healthy diets. That’s because the skin is becoming more active and alive due to the healthy diet and expelling toxins that could potentially prove hazardous down the road. Doctors unfamiliar with patients’
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With our medical help, you can reach, and maintain, your healthiest body weight. Our team of experts has the experience and technology to help you achieve your weight loss goals. Equally important, we are committed to helping you keep the weight off — for life. Call the Weight Management Program at (413) 535-4757.
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histories may mistake these rashes for food allergies, so it’s important that patients be open and honest about their medical histories and remind their doctors that they are in the process of changing their diets for the better.
Colds or fevers
Colds or fevers can be another way the body indicates it’s working hard to cleanse itself. Fevers should always be monitored closely, even while in the midst of changing one’s diet for the better. But the CACE notes that colds or fevers, while unpleasant, can serve as a natural form of housecleaning as the body adjusts to a healthy diet. Persistent colds and fevers should be brought to the attention of a physician.
Additional symptoms
Some people may experience withdrawal symptoms like headaches and irritability as they transition from unhealthy diets to healthy ones. Such symptoms may be more likely to occur among people who suddenly adopt extreme diets. A gradual transition may help mitigate these symptoms, as can choosing a less extreme, balanced diet as opposed to one that demands certain foods be avoided entirely right off the bat. Choosing to eat a healthier diet is a smart move that can pay long-term dividends. But the transition may require people to confront potentially uncomfortable side effects as their bodies adjust.