Integrated Health Center of Los Angeles - HEALTHY WEIGHT LOSS

1. HEALTHY WEIGHT LOSS Integrated Health Center of Los Angeles

2. 165,000,000 # of Americans who want to lose weight 70,594 # of diet or weight loss books on Amazon.com

3. Healthy Weight Challenges ~ My diets never really work. ~ I tried many diet and exercise routines, they never seem right for me. ~ Many weight loss plans seem like fads. ~ I gained weight after having children. ~ I’m always unhappy when I’m dieting. ~ I never have time to exercise. ~ Even when my diets do work, I can never keep the weight off - I always gain it back.

4. Goals For Today √Help you get started on the road to a healthy weight. √Help you set realistic healthy lifestyle goals you can stick with. √Help you choose diet and exercise routines that are right for you. Remember history different so please make sure that you talk with your doctor and a registered dietitian for advice about the diet and exercise plan that’s right for you. that nutritional health are everyone’s and needs

5. The Road to Healthy Weight Loss Healthy Healthy Weight Weight Loss Loss What is a healthy weight? And why is it so important to you? The wrong path. Biggest weight loss mistakes. The right path. Before you get started. 10 steps to a healthier you

6. HEALTHY WEIGHT What is a healthy weight? The number doesn’t really tell the story… Physical Appearance ◘ How we look and how we feel about our looks. Energy Level ◘ Our ability to participate in the activities that we like. Overall Health ◘ Will we stay healthy? ◘ Can we avoid chronic illnesses? ◘ Will we have a long productive life?

7. 20% HEALTHY WEIGHT What is a healthy weight? The ideal body weight myth… Healthy Weight Over Weight Over Weight (Obese) 97 - 123 128 - 148 153 + 5’ There is no single ideal weight 5’ 4” 110 - 140 145 - 169 174 + ◘ Healthy weight ranges are 20 -30 pounds. ◘ Your healthy weight range is based on your height & can vary based on other factors. 5’ 7” 121 - 153 159 - 185 191 + Interpreting the numbers ◘ There are multiple “categories” for weight (Underweight, healthy weight, overweight, obese) 5’ 9” 128 - 162 169 - 196 203 + ◘ Weight range charts can help you understand your healthy weight range. ◘ But one number never tells the whole story. (Unintentional slow or sudden change in either direction is a cause for concern even if you’re within a healthy weight range, and other health factors are always important – weight is just one very important factor) 140 - 177 184 - 213 221 + 6’

8. HEALTHY WEIGHT Why is it so important? Your weight affects your health… If you’re overweight you’re at risk for: ◘ High blood pressure (twice as common in obese adults) ◘ Type 2 diabetes (9 out of 10 newly diagnosed are overweight) ◘ High cholesterol levels ◘ Coronary heart disease ◘ Stroke ◘ Gallbladder disease ◘ Some cancers like breast & colon (a 20 pound weight gain after age 18 can double the risk of post-menopausal breast cancer) ◘ Osteoarthritis (for every 2 pounds increase in weight, the risk of developing arthritis is increased by 9-13%) ◘ Sleep apnea and respiratory problems like asthma

9. The Road to Healthy Weight Loss Healthy Healthy Weight Weight Loss Loss What is a healthy weight? And why is it so important to you? The wrong path. Biggest weight loss mistakes. The right path. Before you get started. 10 steps to a healthier you

10. THE WRONG PATH Weight Loss Mistakes Quick Fixes (without doctors supervision) are not a healthy approach for most people: ◘ Unsustainable fad diets − Liquid diets, e.g. cabbage soup diet, grapefruit diet, maple syrup or lemon detox. − Meal replacement shakes, mixes or bars. − Fruits & veggies only diets. ◘ Banning foods or food group diets − No carbs. − Avoiding food types based on blood type. ◘ Crash diets for quick weight loss − Very low calorie diets, fasting or cleansing. ◘ Miracle cures to suppress hunger, increase metabolism or block absorption. − Ephedra, Heartleaf, Hoodia: Appetite suppressants. − Green tea extract and Chromium: Metabolism boosters. − Chitosan: Fat absorption reduction.

11. The Road to Healthy Weight Loss Healthy Healthy Weight Weight Loss Loss What is a healthy weight? And why is it so important to you? The wrong path. Biggest weight loss mistakes. The right path. Before you get started. 10 steps to a healthier you

12. THE RIGHT PATH Before you get started A. Think differently for different results ◘OLD: Short-term crash diets ◘NEW: Long term lifestyle changes ◘OLD: Attempting rapid weight loss ◘NEW: Slow & steady to your weight goal ◘OLD: Trying the latest fad diets ◘NEW: Eating balanced meals with all food groups ◘OLD: Surrounded by unhealthy “junk” foods ◘NEW: Surrounded by healthy foods at home & away ◘OLD: Going it alone ◘NEW: Getting support from family, friends & experts ◘OLD: Doing little or no exercise. ◘NEW: Finding an exercise routine that’s right for you ◘OLD: Expecting too much, too fast ◘NEW: Setting realistic goals

13. THE RIGHT PATH Before you get started B. Understand your calorie needs ◘ Average daily calorie needs. • Women – 2,000; Men – 2,500 ◘ Calorie needs vary by age, gender, height, weight, and activity level. ◘ Your weight loss goals influence the number of calories you need. ◘ Weight loss is all about calories “in” and calories “out” Example: If you plan to lose a pound a week you need to eliminate or burn 500 more calories a day (3,500/week): • Example: by burning 250 calories by exercising and eating 250 fewer calories/day ◘ To calculate the number of calories that are right for you, go to www.choosemyplate.gov and type in your age, sex, height, weight, activity level .

14. THE RIGHT PATH Before you get started C. Set realistic goals & build a plan ◘ Realistic goals are achievable and measurable: • So you can track progress over time, (example: build up to a 20 minute walk every day by the end of one week.) ◘ Create a step by step plan. • Focus on a few small changes that you can sustain over the long term, (example: eat a green vegetable every day at dinner and eat a whole grain food at every meal.) ◘ Put your plans in writing. • A start date, specific goals, key changes, coaches, etc. ◘ Share you plans with family and friends and ask for help. ◘ Plan for setbacks • Expect that you will need to adjust some goals from time to time.

15. HEALTHY WEIGHT TOP TEN STRATEGIES 1. Avoid portion distortion 2. Start every day with breakfast 3. Improve your carbs and curb your hunger 4. Watch your fats 5. Don’t drink your calories 6. Snack smart 7. Get active 8. Get support 9. Change your environment 10. Build on your successes

16. STEPS TO SUCCESS 1. Avoid Portion Distortion Right sizing portions is key to weight loss success Get a frame of reference ◘ Use measuring cups and spoons to see how your portions compare to recommended serving sizes. ◘ Keep recommended serving comparisons in mind: - Meat/Chicken - Potato - Pancakes - Apple - Cereal flakes Deck of Cards Computer Mouse DVD Baseball Fist Portion control habits at home ◘ Pre-plate your meals instead of eating family style. Use smaller plates and taller/narrower drinking glasses (servings appear larger than they really are) ◘ Never eat directly from a package, portion the amount to be eaten into a bowl instead. ◘ Portion control habits for eating out ◘ Avoid the “while you wait” foods on the table like the bread, Chinese noodle or tortilla chip baskets. ◘ Ask for sauces, dressings, and gravies “on the side” to control the amount you eat. Share your meal or take some home. Restaurant portions can sometimes be large enough for two. ◘ At the buffet, be sure to keep portion size in mind. ◘

17. STEPS TO SUCCESS 2. Start every day with breakfast People who eat breakfast actually weight less than those who don’t Make it ‘light’ (300 - 400 calories) ◘ Spread a little reduced fat cream cheese onto ½ bagel. ◘ Prepare an egg white and veggie omelet in a non-stick pan with cooking spray. ◘ Add fresh fruit to your whole grain cereal (with skim or low fat milk). ◘ Top your low fat yogurt with frozen, canned or fresh fruit and a sprinkle of granola. Make it ‘complete’ ◘ Combine protein, whole grains and fruit. ◘ Get your proteins from eggs, low fat dairy, or peanut butter. ◘ There’s a whole grain food for every taste. Choose from a variety of cereals and baked goods. ◘ Include fruit that’s fresh, canned or juice.

18. STEPS TO SUCCESS 3. Improve your carbs, curb your hunger Nutrition dense, less refined is the key! Fill up on fruits and vegetables ◘ Fruits and veggies are low in calories and packed with nutrition so you can eat more of them. ◘ Prepare your veggies the healthy way – grill, stir fry in a little healthy oil, steam without butter or add to casseroles. ◘ Snack on any fruit – fresh frozen or canned. ◘ Snack on raw veggies – spice up your carrot and celery sticks with bell peppers. Include hearty whole grains at each meal ◘ Snack on whole grain crackers, graham crackers, pretzels, oatmeal cookies, or popcorn. ◘ Replace white potatoes at dinner with brown rice, wild rice or corn. ◘ Try a sandwich on whole wheat bread, bagel, pita or tortilla at lunch. ◘ Try shredded wheat, oatmeal or total at breakfast.

19. STEPS TO SUCCESS 3. Improve your carbs, curb your hunger Nutrition dense, less refined is the key! Eat more ‘good carbs’ - Whole Grains Eat high fiber whole grains at each meal. They fill you up so you eat less in between meals ◘ Replace white potatoes at dinner with brown rice, wild rice or corn. ◘ Try a sandwich on whole wheat bread, bagel, pita or tortilla at lunch. ◘ Try shredded wheat, oatmeal or total at breakfast. Eat more ‘good carbs’ - Fruits and Veggies Fruits and veggies are low in calories and packed with nutrition so you can eat more of them. ◘ Prepare your veggies the healthy way – grill, stir fry in a little healthy oil, steam without butter or add to casseroles. ◘ Snack on any fruit – fresh frozen or canned. Eat less ‘bad carbs’- sugar & sweet treats Added sugar adds empty calories. Keep food and beverages with added sugars to a minimum. ◘ Favorites like frosted cereals, candy, cakes, pies, ice cream, should be occasional treats in small amounts. Avoid sweetened beverages.

20. STEPS TO SUCCESS 4. Watch your fats Fat has more than twice the calories… (compared to carbs or protein) Beware of hidden fats in some foods ◘ Baked goods like biscuits, donuts, muffins, croissants, cakes and pies ◘ Dairy products that are made from whole milk like ice cream and yogurt ◘ Many battered or breaded frozen items are fried ◘ Creamy spreads and salad dressings ◘ Foods and beverages made with coconut cream, shredded coconut or coconut milk ◘ Ground beef and cold cuts Actively reduce the fat in your food High fat foods are high in calories so choose small amounts as occasional treats. Use light versions of spreads like low-fat mayonnaise, margarine or cream cheese. Skim fat from stews, soups or sauces before serving. Trim visible fats from meats and remove skin from poultry before cooking. Avoid pouring dressings onto salads, Try salad dressing spray bottles or dip your fork into dressing before each bite. Read nutrition facts labels. Look for products that provide less than 20% daily value from total fat. ◘ ◘ ◘ ◘ ◘ ◘

21. STEPS TO SUCCESS 5. Don’t drink your calories STEPS TO SUCCESS 5. Don’t drink your calories A 20 oz. sweetened beverage = 250 calories A 20 oz. sweetened beverage = 250 calories Kick the sugar habit ◘ Replace sugary drinks (soda, fruit punch, energy and sports drinks) with unsweetened beverages. ◘ Add lemon or a splash of fruit juice to water or seltzer for a very low calorie thirst quencher. ◘ Plain herb teas are packed with flavor. They’re great without sugar. ◘ Avoid gourmet coffee drinks made with syrup and whole milk - they’re loaded with calories. ◘ Go easy on diet drinks, drink more water. If you drink, keep alcohol to a minimum Experts recommend no more than one drink per day for women and two drinks per day for men ◘ Typical drinks contain 100 to 150 calories  can of beer (12 ounce) = 150 calories,  glass of wine (5 ounce) =100 calories  vodka, gin (1 shot) = 100 calories Mixed drinks that include soda, fruit juice, cream and sweet liquors contain 200-400 calories  rum and coke (12 ounces) = 360 calories  vodka & orange juice (7 ounces) = 210 calories  pina colada (8 ounces) = 310 calories  Margarita (6 ounces) = 330 calories ◘ ◘

22. STEPS TO SUCCESS 6. Snack smart Healthy snacks can actually help you reach a healthy weight! Healthy snack survival guide ◘ Treat snacks as small meals and plan ahead. ◘ Keep snacks under 300 calories and count snacks into your calorie budget. ◘ Be ready for emergencies. Carry dried fruit & nut trail mixes or granola bars in your bag. ◘ Keep fresh whole fruit on your desk at work and on the kitchen counters at home. ◘ Snack only when you’re hungry, beware of mindless snacking when you’re stressed. ◘ Avoid snacks at night after dinner. Healthy snacks that satisfy ◘ Blend a smoothie made from fat free yogurt, milk and fruit. ◘ Make your own trail mix from almonds and raisins. ◘ Top your cut-up fresh fruit with a little fat free vanilla pudding. ◘ Make a mini sandwich (spread mustard on a whole grain dinner roll, add a slice of turkey and a slice of low fat Colby cheese). ◘ Have a small oatmeal cookie with a cup of hot chocolate made with low fat or fat free milk.

23. STEPS TO SUCCESS 7. Get active All the research shows it’s critical to achieving a healthy weight and healthy life! Live the all day active lifestyle Run errands by walking – walk to the store, the post office, the cleaners, the bank. ≈ Walk your kids to school or walk to work if you live within walking distance. ≈ Keep up with household chores like dishes, laundry, vacuuming, sweeping, making beds. ≈ Take the stairs instead of elevators or escalators as often as you can. ≈ Take lunch time walks with your co-workers. ≈ Set aside time for aerobics ≈ Take a brisk walk and burn up to 400 calories. ≈ You may prefer to swim, run, or ride your bike. ≈ Aim for at least five days per week Try some resistance training ≈ Improve your core muscle strength with sit-ups. ≈ Lift weights or use resistance bands. ≈ Aim for 2 or three times per week

24. STEPS TO SUCCESS 9. Change your environment Old habits are hard to change if you’re surrounded by unhealthy temptations! At home ◘ Keep some rooms off limits to food. Store fresh fruit in a bowl on the kitchen counter. ◘ Keep ready to eat, peeled, cut-up fruit in the refrigerator. ◘ Stock your refrigerator with water and other unsweetened beverages. ◘ Stock your cupboards with lower calorie snacks like pretzels, popcorn and baked chips . ◘ Store sweet treats like cookies in single serve packages. ◘ Commit to eating meals with the family as often as possible. ◘ At work Gently encourage your co-workers to move the office candy dish or snack tray to a new location. ◘ Always have a planned snack and emergency snack on hand: nuts, graham crackers, granola bars, fresh fruit, etc. ◘ Keep a bottle filled with water on your desk, for sipping during the day. ◘

25. STEPS TO SUCCESS 10. Build on your successes It’s one of the most important things you’ll ever do! Stay on track ◘ Stick with consistent eating patterns day-to-day and week-to-week. ◘ Avoid being ‘on’ on weekdays and ‘off’ on weekends, vacations and holidays. ◘ Plan for temptation. ◘ Problem solve and develop tactics to deal with cravings for indulgent foods . Work on your coping skills to avoid using food to relieve stress or regulate mood. Be confident in the knowledge that food cravings lessen over time as you continue to improve your eating habits. ◘ Be careful when you eat out. ◘ Choose menu items that fit in with your step by step plan. Avoid high fat high calorie fast food. ◘ Stay connected to your support network. ◘ Support of family/friends is essential for long term success. ◘ Upgrade you goals and step by step plans with the guidance of you physician and registered dietitian. ◘ Monitor your weight ◘ Step on the scale only once per week during the weight loss phase, fluctuations are less meaningful. Weigh yourself more often during weight maintenance phase. Aim to stay within 5 pounds of your weight goal. ◘ Celebrate your successes. ◘ Reward yourself with non-food treats like a trip, a concert, going out dancing, etc. ◘ ◘ ◘ ◘

26. EVALUATING WEIGHT LOSS PROGRAMS Which program is right for you? Credible programs provide information on… ◘ What’s involved in following the program The types of foods and how many calories you will be eating each day ◘ The staff qualifications ◘ Credentials and experience of the staff members who provide advice and counseling ◘ Risks of using the product or service ◘ Side effects of any drugs that may be a part of the program ◘ Recommendations for medical supervision for very low calorie diets. ◘ Avoid fasting, purging or laxatives. ◘ All costs of the program ◘ Membership fees, weekly visits, food, supplements, meal replacements or other products. ◘ The chances of keeping the weight off ◘ Share difficulties that program participants have with keeping weight off. ◘ Documented success rates ◘ Percentages that successfully complete the program ◘ Percentages who keep the weight off ◘

27. Additional Questions ?