Transcription:
Obesity and the New Beginnings Weight Loss Program

Melanie Cole (Host): Welcome to Say Yes To Good Health with Memorial Hospital. I'm Melanie Cole and today, we're talking about a lot of things. We're going to talk about obesity and the obesity epidemic. But we're also going to talk about the New Beginnings Weight Loss Program for Medicare recipients. We have a lot of stuff to go through today and joining me is Ashlyn Housewright. She's the Executive Director of Community Health and Wellness at Memorial Hospital. She's also a Registered Dietician and Certified Diabetes Care and Education Specialist. Ashlyn, that's a lot of titles you got, but it means that you are an expert in all of these kinds of things. And I'd like to start this show today by talking about what you've seen with and without COVID, as we've seen this pandemic take formerly active people and made them more sedentary, our kids doing school online, as opposed to going in with gym and recess.

Tell us a little bit about what you're seeing as far as obesity in the area, and really, you know, how common this is. What have you seen in the last couple of years?

Ashlyn Housewright, RDN, LDN, CDCES, CLS, CHWC (Guest): So, here in Hancock County, we recently completed our community needs assessment for 2021. It came, you know, data collected from the Community Needs Assessment, you know, always comes back as nutrition indicators and obesity came back as one of the highest indicators on our community needs assessment. So we weren't surprised necessarily by this data. But it just shows us there, there is a need in our community regarding obesity. And we know when someone is obese, they also have other comorbidities as well; diabetes, heart disease, increased risk of cancer. So definitely a need within our community.

Also, one of the things that came back on the survey from the individuals was the need for access to nutrition education and information. That we maybe don't have enough access or need to create more access to that information, specifically when we're talking about our younger individuals within the community. You know, in Hancock County we are seeing an increase in obesity. But we kind of have a plan in place and some things to do over the next three to five years to help our community members and give them the resources that they need.

Host: Well, that's really an important issue that you raise is the nutritional awareness. And so it's not something we always get in school. And then there's, this is such a complex really Ashlyn, there's, there's school and recess, gym, the built environment. There are so many risk factors and causes, and the environment in which we live. I mean, it is huge. If you had to point to one or two things, in our area that you would say, I wish we had, or I wish we could do, or this is a growing problem because; what would you say?

Ashlyn: Two things, you know, food insecurity or access to nutritionally dense foods is one thing that I would love to change. Something I feel like I can be more a part of in our community specifically is education within the school system. Orient to our younger kids and making an impact that way. And also just safe means of exercise, you know, walking and biking paths, playground equipment, you know, reconstruction of some courts and fields and things like that. So we just have more access to exercise, but in a safe matter. We know that one in three children in the United States are overweight and obese. And so how can we, you know, reach children where they are. And a lot of times that's in school. Potentially in outdoor play. So the pandemic has played, made that harder as far as educators getting into the school system. But I know here locally, our administrative staff for our schools is on board with making an impact for kids, but definitely, you know, food insecurity and then access to physical activity.

Host: Well, the American College of Sports Medicine puts out the American Fitness Index every year. And they look at the communities and do just what you're talking about and see where there are bike paths or where there's not, or what schools are teaching various things. Now, when you work with parents and you're looking at the whole family, do you tend to see that if a child is overweight or obese that so is the family and in some cultures as well, you know, it's the type of foods that they eat? So what do you say to parents? Because this isn't an easy discussion I have with some parents, they don't want to hear it.

Ashlyn: Yeah. I often just go back to being the gatekeeper, you know, so, the parent is the gatekeeper in the situation. So the food's purchased or gathered or brought into the home essentially happens by the parent. And so just really educating the family on how this isn't just something the child needs to work on, but it's a whole family approach. And what are some things that we can start to do right now with the resources that we have, to make an impact. And so we're talking about little changes that we can make, you know. Setting one to two goals together on a regular basis of things that could impact the entire family. So, a lot of times just making a change to sugar sweetened beverages is a huge goal. An area that I work on with families is soda, sweetened teas, sports drinks, juices. Those are commonly consumed among young people and adults. So, just trying to make an impact there. When we talk about like goal setting, also increasing access to fruits and vegetables. So we kind of do this 5-2-1-0 approach where we should have more than five servings of fruits and vegetables a day, two hours or less of screen time. That's a huge thing. Especially during the pandemic, children were more sedentary because of screen time. So it's really trying to put a limit on that. Having one hour a day of physical activity in some format. And that should really be above and beyond of maybe what we're even doing in school. So yeah we have PE in school, but can we do something for an hour outside of that? And then really the zero would be no access to sugar sweetened beverages.

Host: Now, obviously we can look at ourselves in the mirror and say, okay, you know what? Yeah, I'm overweight. I know I need to lose some weight. And but they use, pediatricians and, and you registered dieticians use BMI. Can you tell the listeners the difference between being overweight and obese so that how they know and how you use BMI.

Ashlyn: Yeah, so BMI is a marker that we use for diagnosis of obese or overweight. So, in children, if the BMI is somewhere between the 85th and the 94th percentile, they would be classified as overweight. If the BMI in the child is greater than the 95th percentile, they would be classified as obese.

And that is something you can really ask your provider anytime a child's height or weight is taken at every visit; the growth chart really should be reviewed. And so that's something I would encourage parents to discuss with their providers. But then a BMI greater than 30 in the adult population is what we would classify as obese and then a BMI of anything greater than 25 is what we, that 25 to 30 range would be what we'd classify as overweight in the adult population.

Host: One of the things I think, and especially we women, we are negative self-talk all the time. Right. We were always looking at ourselves in the mirror and saying, oh God, when did my thighs get so big? Or, you know, turning around, look, I mean, just our own perceptions and it's important that we don't relay those to our kids.

Right. We don't want them to hear us look in the mirror and say, I'm so fat, my God, or even the words that we use when we're speaking to our kids and saying things like, should you be eating that? Or haven't you put on a little weight? Speak to us, as the educator that you are, about how we are perceiving ourselves and that negative self-talk so that we can create a healthier environment for our whole families; not only for our kids or our spouses, our partners, but for ourselves.

Ashlyn: You really want to just use positive self-talk and that positive body image. And just remember, you know, that others are listening to you when you talk about your body negatively. And I would say that's one thing, you know, as I practice is, parents will come in and we'll start to use terminology that really isn't appropriate for the child to hear. We just want to start to talk about making healthy choices, or doing things that will benefit our body or make us stronger. Or, you know, if there's a goal that someone wants to reach, you know, I'm setting the goal to improve my health. Or make my heart stronger. I think sometimes we do it because we want to, we use goals the other way. Like maybe we want to set a goal to, you know, I want to look better. I want to fit better in these jeans, but overall you want to impact your health. You want to do something that's going to increase longevity for you and reduce you know, risk factors. So, being positive, especially when we're talking in front of young people and having that positive body image and setting goals that are going to impact your overall health and longevity versus maybe an appearance wise, because it's not always about the appearance. Sometimes that can definitely help with self esteem, when we start to see ourselves reach our goal. But definitely being empowering, especially with young ones around, that we're doing this to, you know, make lifestyle type changes, make healthy food choices, so, you know, we can better our health.

So, definitely decreasing the stigma of, of weight and so focused on the scale and weighing, you know, I, in my own practice, I encourage parents not really even to get the scale out or not every visit is about weighing, you know, it's about check-ins and providing support.

Host: What a great point that you just made about weighing because that, you know, a lot of weight loss programs talk about weighing yourself and, you know, in some cases it is a helpful motivator. It's something that can keep you from going off the deep end, you know, or letting yourself get too far out there.

But I really appreciate how you discussed using those particular words. And we want to look in the mirror and say, look at how strong my legs are, or I'm going to eat this because I know I'm going to be like Popeye with the spinach, you know? This is great information Ashlyn. And thank you for joining us for this first part of this show today. You're listening to Say Yes To Good Health with Memorial Hospital.

I'm Melanie Cole, and we're chatting with Ashlyn Housewright about New Beginnings Weight Loss Program for Medicare recipients. We're talking about obesity and healthy eating and nutrition and weight loss. And, you know, it's something that we could all hear because it's about being overall healthy. That really is what it's about. So, Ashlyn, I'd like to talk about some treatment options for people that are affected by obesity, as we discussed in our, before the commercial break.

What is the best way to lose weight, in your personal opinion, if you were to start with somebody brand new and maybe they're not morbidly obese, they're just slightly or a little bit overweight. What is the best way to lose weight?

Ashlyn: I think, you know, when I work with a patient or client for the first time, really, it's just getting to know them, meeting them where they're at and then starting to work on healthy lifestyle changes or behavior changes, maybe picking out one to two things that they know they can start to work on and setting goals around that.

I think a lot of times, individuals are looking for quick fixes or something fast that is going to maybe cause some like maybe some extreme methods to get there and we just know that's not realistic and it's not going to be sustainable forever and ever. And when I'm working with patients and clients, that's what I'm really trying to get them to understand is when we start to work on things together, I want them to pick out things and start to make changes to things they know they can do forever and ever because they're making lifestyle changes.

They're not doing quick fixes, so it's going to be something they can sustain for a long time. And that's going to help them when we start to get to the maintenance phase of their journey.

Host: Well, so as long as we're talking about people of a certain age, if you're old enough to get Medicare, which I am not quite yet, but not far, not far away, you have New Beginnings Weight Loss Program. Tell us a little bit about this program and how Medicare is involved in this.

Ashlyn: Yeah. this is a great offering through Medicare. So, the New Beginnings Program is also known as Intense Behavioral Therapy and Medicare does cover 22 sessions a year with a registered dietician or other health practitioner, like a nurse practitioner, physician assistant, to provide lifestyle change coaching for individuals who have Medicare and a BMI above 30.

And so the, the sessions are segmented by Medicare guidelines. So, an individual does have to come in on a consistent basis. And lose a specific amount of weight by the 16th visit to stay within the program. But one of the things I always describe to people interested is it's just accountability. You know, individuals sometimes just do better when they know they're accountable to somebody, when they have to come in and weigh, talk to someone about maybe the foods or the exercise that they've been doing. And it just helps individuals be more successful. The visits are short, so you can expect to spend less than 30 minutes with the dietician for these visits. And they range like 15 to 30 minutes. The first one sometimes is an hour, but sessions one through four, an individual would come once a week, sessions four through 16, the individual would come every two weeks and at the 16th session, it is a requirement that the individual lose 6.6 pounds, which is very doable.

And then after that, if that goal is reached, then the individual would come once a month. So it's, we're really accountable in the beginning. And then we just loosen the reigns over time. And that just shows to have great benefit on the accountability experience between the patient and the dietician.

Host: Wow, what a wonderful program. Tell us, how do they qualify for this? Is this a referral base? Do they need a physician order? How do they get involved in this awesome program?

Ashlyn: If an individual is interested, there is no physician order needed. We just know that you have to have Medicare and a BMI above 30, and those are all things that we can find out for you or your provider can let you know, engage you in the program, but it's really an easy, you know, way to get scheduled. There's not a long wait period. So it's something, if you're interested today, we can get you started relatively quickly in the program.

Host: Do you have a phone number you can give out for every.

Ashlyn: Yep. They can call us at (217) 357-6540 to get started in the program. And then after that, they'll get scheduled with the dietician and we will schedule appointments from there.

Host: So now tell us where things like exercise, journaling, you mentioned weighing, where do any of these kinds of things fit into the picture of this program? How do you help with that?

Ashlyn: Yeah. So, the program is designed to provide tools, coaching, and support for healthy lifestyle changes and weight management. So, it really is individualized. So, some patients, you know, when they start, they're not ready to, you know, weigh. And so we just don't start off with weighing. We just start off with maybe they know there's something they need to work, work on in they're eating, not every individual wants to journal right when they start. So, maybe journaling takes presence down the road a little bit. Sometimes the patient is gung-ho about journaling and that accountability in the beginning is great because it holds you accountable to myself and gives me you know, a glimpse of what's going on day in and day out with your eating, where I can provide you support and feedback to make change.

And then weighing is something that I say, you know, you never have to do at home. You can essentially just weigh once a week when you come into the appointments with the dietician. It's not something that needs to be done multiple times outside the program, really like once a week, same time, same way is the, is the best way to weigh. You don't need to weigh every day.

But another great portion of the program is there's always education for the patient when they come. So, every session that the patient is involved in, there's also a little bit of education. And so that provides a learning opportunity for the patient. And then we can maybe set some goals related around some of the education that's provided.

So, knowing how many fruits and vegetables we should be incorporating. How to read a food label, some snack ideas, meal ideas, like every week, there's just different components, but we also tailor it specific to the patient because when you're working with a registered dietician, they're also able to provide you support from other health issues that someone might have. So, if someone has diabetes, you know, a registered dietician is qualified to provide education specifically to nutrition related to diabetes, heart disease. If they've had cancer in the past, so those types of things can be enrolled in the program as well.

Host: Label reading is really an underappreciated activity. I mean, we don't know what's in some of the things that we eat from the grocery store. And I say, if it has no label, it's even better. But now when you talked about journaling and accountability, and sometimes it's hard. Cause I, I mean, I did a weight loss program back, you know, right after my babies and stuff. And even though I'm pretty short and I'm pretty active, I wanted to get the weight off and reading to myself what I ate in a day, in the mirror was harder than even talking to one of you professionals, just reading it to myself, you know, that was such an accountability thing, but it was only to me.

Ashlyn: Yeah. And a lot of my patients will say that to me like I had no idea. Because I encourage them to write down everything that they're eating and drinking or putting in their mouth. And they say, well, I didn't realize I went back, you know, to the candy jar or when I passed the candy jar in the living room, I didn't realize I took something every time. And how often, how much that adds up or, oh, I didn't realize like how much sweet tea I was really drinking and then the calories and the sugar that's in the sweet tea. So, it really brings forth a visual for the patient when they are recording. Because they've got to write it down every time, you know, so it's not even just bringing it into me. It's a realization for themselves as well, cause they're not always eating when they're hungry, you know, it's more or less a behavior.

Host: We could do a whole show on mindless eating, mindfulness, right? As we get ready to wrap up, I want you to give us your best advice about weight loss programs, things that are available through Memorial Hospital and the multidisciplinary team approach that you use there at the New Beginnings Weight Loss Program and how Medicare recipients can really get involved.

Ashlyn: So if you're listening and have Medicare and interested in weight loss, I'd highly encourage you to reach out to us at one of our clinics so we can get you paired up with a registered dietician. If you do not have Medicare and you're still interested in weight loss, again, I would encourage you to reach out to your provider so we can get you paired up with one of our registered dieticians.

But again, you know, it's just thinking about it from a healthy lifestyle approach and not looking for that quick fix or that program out there that costs a large amount of money to make you lose weight in a short amount of time. You know, this is just making healthy lifestyle changes to impact your health for the long run. And we would love to be a part of that journey with you at Memorial Hospital and Clinics.

Host: What a great program. I can just hear in your voice, how sweet and understanding and passionate you are Ashlyn. And I just imagine that you are wonderful with people that come in. So, it's so important listeners, that you take charge of your own health and be your own best health advocate. We know if we're overweight, we do. And if you've got Medicare, what a program they've got going at Memorial Hospital. You can get involved in, you can have sessions with a registered dietician. That is not easy to come by. And, you know, you get an appointment with Ashlyn and you know, you're on the road to success. And it's really important for all of those other conditions, too, whether it's diabetes, heart disease, whatever it is.

So to learn more about New Beginnings Weight Loss Program, and if you have Medicare, you can always visit the website at mhtlc.org and search nutrition wellness. You can Google New Beginnings Weight Loss Program, Memorial Hospital. There's a lot of ways to find this. Or you can call 217-357-6540 to get started today.

You make that phone call today and Ashlyn will be able to see you very soon and you can get going right away on that road to better health. That concludes this episode of Say Yes To Good Health with Memorial Hospital. If you have friends that are Medicare recipients and they want to get involved in that New Beginnings Weight Loss Program, give them that phone number, 217-357-6540. We'd like to thank our audience and invite you to download, subscribe, rate, and review on Apple podcast, Spotify and Google podcast. I'm Melanie Cole. Thanks for listening.