2. Objectives
❖ Understand the physiologic process of metabolic
positioning towards sustainable fat loss
❖ Identify 2 ways to optimize metabolism, which
contributes towards sustainable and permanent weight
loss
❖ Identify the three basic psychological needs necessary
for internal motivation
❖ List action-oriented differences between motivation and
commitment
3. Myth vs. Fact?
❖ I can eat food after 8 PM without gaining weight?
❖ It’s best to cut out all carbs and fat, and skyrocket protein?
❖ Eating more frequently really does ramp up my metabolism?
❖ “Clean eating,” gluten-free, natural, detoxing, or non-GMO
foods really are healthier for me?
4. Obesity Trends
1990
• 10 states had a
prevalence of
obesity less than
10%
• No state had
prevalence equal to
or greater than 15%
2000
• No state had a
prevalence of
obesity less than
10%
• 23 states had a
prevalence between
20-24%
• No state had
prevalence equal to
or greater than 25%
2010
•No state had a
prevalence of
obesity less than
20%
•36 states had a
prevalence equal to
or greater than 25%
•12 states (KY in
top 10) had a
prevalence equal to
or greater than 30%
18. References
❖ Alexandraki, I., Palacio, C. & Mooradian, A. D. (2015). Relative merits of low-carbohydrate versus low-fat
diet in managing obesity. Southern Medical Journal, 108(7), 401-416.
doi:10.14423/SMJ.0000000000000308
❖ Butryn, M. L., Thomas, J. G., & Lowe, M. R. (2009). Reductions in internal disinhibition during weight loss
predict better weight loss maintenance. Obesity, 17, 1101-1103. doi: 10.1038/oby.2008.646
❖ CDC. Vital signs: State-specific prevalence of obesity among adults: United States, 2009. MMWR
2010;59:1–5.
❖ Mann, T., Tomiyama, A., Westling, E., Lew, A., Samuels, B., & Chatman, J. (2007). Medicare’s search for
effective obesity treatments: Diets are not the answer. American Psychologist, 62(3), 220-233.
doi:10.1037/0003-066X.62.3.220
❖ Reed, W. D., et al. (1984). The effects of insulin and glucagon on ketone-body turnover. Biochemistry, 221,
439-444.
❖ Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social
development, and well-being. American Psychologist, 55(1), 68-78. doi:10.1037110003-066X.55.1.68
❖ Whitney, E. N., & Rolfes, S. R. (1996). Understanding nutrition, (7th ed.). St. Paul, MN: West Publishing
Company.
❖ Yamada, T., et al. (1995). Textbook of gastroenterology, (2nd ed.). Philadelphia, PA: J.B. Lippincott.
Editor's Notes
Welcome and professional introduction.
As we dive into the presentation, I’d like for you to be thinking about what is compelling you about tonight’s content. While it may be for the sole purpose of earning CEUs, which is completely fine, but if perhaps you are an individual or know of one who may be struggling with sustainable health habits, then I ask you to start answering these questions: why would now be the time to change some health habits? Why is today different than any other time to focus on your health? Whom are you doing this for, and why? Feel free to write down your personal commitment to yourself, make that promise, and carry it with you. That’s your commitment; follow through and don’t settle - don’t quit until you do. I’d love to hear one year from now how each one of you have progressed as we know we can change a lot in such a short span of time. Make it happen - be the health leaders that you are!
After the presentation, I’ll be available for Q&A, so feel free to jot down any questions in the meantime that come to mind.
A new study published just this summer tested the effectiveness of individuals on a low-carb or low fat diet for a minimum of 6 months. By just looking at the statistics, there was a significant benefit to the low-carb diets. However, here’s the silver lining, the absolute difference at 6 months was only about 3 pounds leading to conclude the mean difference in weight change between a low-carb diet and a low fat one was too small to have a meaningful impact on weight loss. What’s the bottom-line to this? There’s no need to fear carbs and reduce them to negligible amounts. For every action, there’s an equivalent reaction. When one swings hard to one side of the dieting continuum, he/she is bound to swing harder to the opposite side. Aside from cookie-cutter plans, this is also why diets have a high failure rate and lead to the yo-yo effect. Studies have indicated that not only are weight loss interventions rarely effective in the long-term, but that dieting is a consistently strong predictive of future weight gain. A diet needs to be a lifestyle for wellness reasons, not just to lose weight, so a nutrition plan ought to be something you can adhere to over the long-term - something that is empirical, practical, and easily applicable to your lifestyle and preferences.
As you see from the slide, things were decent in 1990. Obesity was prevalent, but not out of control. The next ten years, however, proved to show that things were starting to escalate quickly; the country still had some control. In wasn’t until a few years ago when each state was at least 20% or more obese. Unfortunately, our state is one of 12 that has a 30% or greater obesity rate, and it’s only climbing.
The CDC proposes 50% of the country will be obese by 2030. In our country, 98% of those who diet will gain their weight back within 1-2 years.
ASK QUESTION: Anyone have a guess as to why things have continued to rise despite the weight loss industry surpassing more than $20 billion dollars on awareness and education? (expand on any answers [low-fat, low-carb, no sugar, etc.])
Essentially comes down to lack of healthy nutrition, a sedentary lifestyle, an increase in stress and life demands, and improper coping or stress-handling mechanisms.
All of these factors (nutrition, exercise, self-confidence, and motivation) come into play, some more than others because we’re all unique, but they’re essential to the overall health and wellness. One compliments one another, and if one is off-balance, the rest follow in line. That’s where the silver lining falls because most individuals focus on only ONE aspect in regards to weight loss. It’s usually exercise, and I can tell you personally from my experience it can only take you so far. We can’t outrun a poor diet. After all, nutrition is health; exercise is fitness. Two separate concepts, yet we shouldn’t go without one or the other. Nutrition lays the foundation to better health. Our body needs nourishment and that only comes from what we eat. When we perform, think, focus, and sleep better, we’re more motivated to exercise or at least stick to it. At that point, we start developing self-confidence and empower ourselves by wanting to know more. We get excited because we’re seeing results and noticing improvements, which re-ignites our motivation, and that perpetuates the cycle. So we keep going, continue to push and improve, and that momentum builds over time. We all have the capability to achieve this.
ASK QUESTION: What have been some barriers for you in your personal health goals?
One size does NOT fit all; metabolism is very dynamic. Thus, the energy continuum is very unique and specific for each individual. How can one best achieve metabolic positioning sustainably in the most healthy approach? There are a couple factors that need to be discussed in order to best determine one’s starting, That’s where the concepts of genetics, metabolism physiology, and context of meals/choices come largely into play. Let’s start with genetics.
Next concept is putting those genetics into the context of one’s unique metabolic rate. With the understanding of one’s genetic/body type, this determines your basal metabolic rate. It’s fixed and something we can’t control or influence - even though it’s very commonly stated and promoted among the health industry.
ASK QUESTION: Would anyone like to take a guess as to how many calories a female and male burn at rest, to maintain weight? [1350 for female; 1650 for male] It’s not as high as what we would think or like it to be; however, the figure is very subjective based on the many factors that are to be shared.
It’s a misnomer that you can change your metabolism. I’d like to mention that whether you are genetically gifted or not, you can positively or negatively influence your functional metabolic rate with correct exercise training and nutrition within the context of your body demands and goals. In fact, for weight loss purposes, one can lose up to 50% faster eating the same amount of calories just by understanding the principles of nutrition and meal composition/timing.
When we digest a meal, we raise our functional met rate – this is the definition of thermogenesis – but the only way to sustain this elevated rate is to eat more food in total. That’s not necessarily in the best interest for someone who’s trying to lose weight, so what can one do or control? We can control: meal spacing, meal composition, overall quantity of food, exercise variables, stress, medical factors, individual amount of macronutrients – all of these have a huge influence on our functional met rate.
To further expand on this, each macronutrient has a purpose and thermogenic effect. This is useful and advantageous towards weight loss. Fat has the lowest effect (0-5%). Protein is the most metabolically stimulating, but only within the confides of our body demands (20-30%). Once we reach that cap amount, carbs then can work just as effectively in stimulating our metabolism (5-30%). Fat is burned in the flames of carbs. This is one reason why low-carb diets, or other fads with that said, are not sustainable nor physiologically practical.
You can now take the concept of thermogenesis and apply it to formation of a meal, while considering the big picture or total energy/caloric intake in mind. The thermogenic effects of individual meals are certainly important and useful within the context of the day, but the biggest bang for your buck is to channel that focus towards the total daily volume of food eaten, while remaining within the best macronutrient ranges designed for you and for your goals. Evidence shows the number of meals per day, not the amount of food volume, largely makes no difference even though the health industry claims it will ramp your metabolism.
In fact, some studies suggest having smaller meals more often makes it harder to feel full, potentially leading to increased food intake and weight gain secondary to overeating/binging. However, there is a known benefit to eating frequently throughout the day in that it can help keep you ahead of the hunger curve. That naturally segues into the next slide on glucose/insulin stabilization...
Parallel to Thanksgiving meal and consequences of fat storage.
When glucose levels are stable, we feel satiated, focused, and energetic. Anytime this balance balance swings to the low side, typically as a result of not eating enough or as frequently, it puts one at risk for over-eating in order to balance the sugar.
Discuss how the body can retrieve reserved body fat when factors are controlled and appropriate
The body is a continuous state of retrieving and storing, called the feed-fast cycle. It’s a dynamic continuum as the slide shows. We can waver from one side to the other based on context and situations we’re placed. Similar to fat loss and weight gain, there are extremes, which I’ll go elaborate shortly. How we go about the process though depends on the knowledge of nutrition, the understanding of your body requirements, and remaining attuned in the present, determined to make the best choice with what we’re provided and goal at hand. Feel free to start a counter of the times I mention “anything within context.”
To essentially bring everything together into one slide, there is nutritional dogma everywhere. We all want the next sexy, quick, extreme method to achieve weight loss and ultimate health. While any plan or program will work – our country doesn’t have a problem losing weight – it’s how can we make habits and choices sustainable and practical. If you don’t see yourself eating the way you do in 3 months, 6 months, or 5 years, then it’s not sustainable. We need to a plan that doesn’t require a lot of self-control, because lets admit it, it can be exhausting. If your food is exhausting, it’s not sustainable.
Without an understanding of one’s genetics, education on the science of human physiology and nutritional concepts based on the context of one’s lifestyle, accounting for activity levels, and encouraging a growth mindset, self-sabotaging behaviors are inevitable to return and any nutrition plan will falter. I wish I could say something groundbreaking to you, but it really is nothing fancy. Just good old consistency and determination. Shift to delayed gratification for the long-term investment in yourself. Similar to academics, each course, each semester accumulated towards the earning of a degree, the process to achieve permanent weight loss is no different. Keep trying, keep failing, remain persistent. It’s a matter of how important it is for you to continue showing up. How valuable is your health, and what does it mean to you?
Emotional regulation/awareness, which we’ll discuss next.
ASK QUESTION: What makes the difference between short- and long-term results? What has helped you to persevere in obtaining meaningful goals? What helped us to remain focused in nursing school?
Necessary to understand your driving internal motivations. Once these are identified, it makes our actions and goals more meaningful, purposeful, and deliberate.
Parallel nursing actions/skills to self-determination theory.
What happens when threatened?
What about this situation can I influence?
The importance of environmental triggers as threats.
ASK QUESTION: What are common reasons or objections you face in your daily lives?
ASK QUESTION: Now what if it involved your children or something/ someone you cared about, how would you respond differently? Why so? Parallel to weight loss/health goal.
ASK QUESTION: How have you used commitment to succeed in some valuable goal - marriage, family, career, academics, health, spirituality? How would they differentiate between commitment and motivation? [Parallel to studying for exams - the commitment to the degree ultimately dictated my choice to study whether I wanted to or not.]
Motivation operates on a continuum. It waxes and wanes. It’s influenced by a mood or thought, but it doesn’t mean we must act upon it every time we have one or feel a certain way. We must remain present, intentional, and emotionally intelligent as Ashley had discussed. Those who succeed are committed to change and challenging themselves. When we assess our strengths and weakness from an objective point of view - a very “what are the facts” approach - we are better able to focus on the situation and thus take responsibility for the behavior towards the ultimate goal. When we fail at opportunities, we visualize them as just that. It’s not necessarily an outcome, but a moment of reflection for a new understanding. This style of internal motivation will ease us into wallowing less when we have a bad day or don’t feel like doing whatever said act, so we continue to persevere, remain aware of the circumstance, and that’s commitment.
ASK QUESTION: Going back to what I asked you all at the very beginning of the presentation, how are you more compelled now to change? Whom are you doing this for now, and why? Where’s your commitment level at now?
Change is inevitable, but growth is optional. What will you learn about yourself in the process, and what can you do about it? Your health doesn’t stop working for you, and you shouldn’t stop work for it. Just simply start; do it for yourself. Just because a path wasn’t there, doesn’t mean it never existed.
