Transcription:
How to Lose Weight (the Healthy Way) and Keep It Off

Michael Carrese (Host):  Welcome to Live Greater. The health and wellness podcast brought to you by the University of Maryland Medical System, who put knowledge, care within reach so you have everything you need to live your life to the fullest. This episode is sponsored by UM Upper Chesapeake Health. Through an unparalleled combination of high quality care and leading edge technology; UM Upper Chesapeake is improving the health of northeastern Maryland residents by providing an exceptional patient experience for every person, every encounter, every day. I’m Michael Carrese and pretty much everyone either needs to do it or wants to do it but it can be really hard to make it work. I’m talking about weightloss and on today’s show, we’re going to learn how to go about it the healthy way so you can keep the weight off with our guest Registered Dietician Suzanne Ishak, an Outpatient Dietician for UM Upper Chesapeake Health. She sees patients out in the community and she also works with the bariatric surgery program. Welcome Suzanne.

Suzanne Ishak, RDN, LDN (Guest):  Thank you.

Host:  So, as we all know, there’s just a ton of information out there about how to lose weight, lots of weightloss programs. But I thought before we get into any details; it would be good to have you tell us what your overall philosophy is about weightloss.

Suzanne:  I think my overall philosophy with patients is talking to them and giving them a lot of facts, because like you said, there is a lot of confusing information out there, really focusing on based on what their medical diagnosis is or why I am seeing them, foods that they can include in their diet to still enjoy their meals while getting the health benefits that they want to get and to meet their goals. So, definitely instead of focusing on things that you can’t have, foods to eliminate; I try and have a more positive approach and really incorporate a lot of the foods that they still – people still can have and creating meals and snacks and that type of thing so that they do reach their health goals.

Host:  So, they are not just thinking about oh here’s all those things I have to give up now?

Suzanne:  Correct. Now we focus on here’s what you can have, but this will – even if we sometimes need to be a little bit more strict up front to get to their health goals and then you can be a little bit more liberal. But now is focusing on here’s what I can have. Grocery store tours are also really helpful because you can walk around the store and actually show them and create meals and fill their cart and then they can kind of know how to stock their pantry, stock their fridge so that they always have delicious foods that are really nutrient dense, and they enjoy.

Host:  I’ve heard the advice that really the way to eat healthy is to only buy stuff along the perimeter of a grocery store where they have the vegetables and they have natural products as opposed to the middle aisles that have all the processed foods. Does that make some sense to you?

Suzanne:  I don’t really go along with that because I feel like in the aisles, there’s a lot of whole grain options, a lot of different kinds of side dishes. There’s rice, there’s different kinds of beans. There’s whole grain cereals. So, I think the perimeter yes is important and I find myself too if I’m in a rush, just grabbing things around the perimeter to kind of get you through. But the aisles have a lot of really good ingredients and healthy for example olive oils are going to be found in the aisles as well as different nuts and seeds. So, I kind of personally, like to recommend the entire grocery store but also agree that if you don’t have much time and you just need to run in, there’s a lot that you can find around the perimeter in addition to fruits and vegetables, yogurts and your dairy and your orange juice. So, yeah, the outside has a lot, but I think the entire store is really comprehensive.

Host:  So, what are the top reasons in your experience, why people have trouble losing weight or why they lose weight and then gain it back?

Suzanne:  Some of the most obvious reasons that I hear, and a lot of people know that this is something that they’re doing is the more higher sugar, high fat snacking or sugary beverages, beverages with calories. These things that typically especially if somebody is not exercising a lot can cause you to gain weight and hold on to weight. Some reasons that I find that may not be as obvious are people sometimes are unsure of the amount of calories that are actually in restaurant foods which typically tend to cook with more fat, maybe not the leaner ingredients all the time. Portion size is something that we talk about a lot and also sometimes the opposite if people are a little bit too restrictive, maybe skipping meals and then tend to overeat later in the day. Because I think a lot of times, people think if they are dieting for the purpose of weightloss; skipping breakfast, skipping lunch is common but then you sometimes tend to overeat later in the day.

So, those are a lot of reasons some of the more obvious ones but then also ones that people may not realize are causing some of the trouble losing weight. Sometimes too, the added fats. So things such as salad dressings, mayonnaise, different kinds of spreads used in cooking. Sometimes people may not realize how quickly those calories from what we call added fats are put into the food which then just makes the foods that they are eating a lot higher in calories.

Host:  Right. I’ve made that mistake too. Like well I’m eating salad, but I don’t think about the Ranch dressing that’s on it. So, tackle one of those. You talked about people trying to hold off during the day and eat less food and all that and then they get hungry and over do it. What’s your strategy that you give people for avoiding that pitfall?

Suzanne:  Really meal prep and fitting easy meals into their lifestyle. A lot of people say that they don’t have time to cook and especially in the morning before work. So, we may talk about doing something like some hummus and whole grain crackers with some fruit, things that work with their lifestyle so that it’s not actually sitting down and cooking because again, people I find a wide variety of how much or how little people like to cook and do food prep. So, individualizing it I think is really important. And working with the time of day. I commonly hear people aren’t hungry right when they wake up in the morning and typically for most people that’s fine. If you can eat maybe at 9:30 or 10:00 your breakfast. You don’t have to eat at 6:30 or 7:00 in the morning.

So, I think really individualizing it again with well balanced meals but once you have stocked your pantry, stocked your fridge and have things that you can take quickly, yogurt, maybe a whole grain cereal and a couple of hard boiled egg whites or something like that, that’s easy but keeps you full. Lean proteins, the whole grains and some of the added fats that we need, not a lot but some of them really keep you full until the next meal. So, meal prep is important. And then hopefully, meals that you enjoy and incorporating those three meals a day to promote that weightloss.

Host:  So, a lot of good strategies there and how would you contrast that sort of approach that you help your patients take to what is out there for other ways of losing weight?

Suzanne:  I just usually tell people be careful of gimmicks or I call them myths that are out there with weightloss, products that promise certain results. Sometimes the results may be really fast but a lot of times, they are not the results that last long term. I tell people always to make sure that the sources that you are reading and things that you are buying are credible sources to help you from getting confused. And just again, always be careful of gimmicks or things that seem too good to be true. I tell people also too if you are going to be doing a type of diet that is either very restrictive, very low calorie or eliminate certain food groups; I would always talk to your physician or dietician to get advice based on what is going on with that person individually. Typically there is not one diet for everybody. I think it’s really important to individualize so that you have success.

Host:  Yeah, as I’m listening to this, I’m thinking there’s those approaches where only eat this or eliminate that completely. That one thing, meat or whatever it is and that’s the approach. So, you’re saying there that this really probably is not the way to go. You need much more of a balanced approach than that.

Suzanne:  Yeah, I think you need a balanced approach and again, I like to keep it flavorful and nutrient dense because each food group has so much in it that another might not. Proteins have certain things in it that vegetables do not. And you can kind of do that with any of the food groups. So, they are all really important for different reasons. So, yeah, so being super restrictive or eliminating certain food groups unless of course there is like a food allergy or medical reason to do so; I try to not practice with patients and again, within every food group – people a lot of times start out with well I don’t like vegetables, I don’t like this or that; but we can typically come up with even if it’s two or three vegetables that they do like, ways of incorporating them into their diet.

So, again, I think individualized is super important.

Host:  So, when it comes to eating healthy, a lot of people say it’s just expensive or it’s not easy for them to access fresh produce and other healthy foods. What’s your advice to them about that?

Suzanne:  So, I do have people who say that. Definitely I understand that. I think if we first really kind of talk about their budget and see maybe what part of their budget they don’t realize might be going to the sugary beverages or the high sugar, higher fat snacking that we can kind of incorporate less of that and focus more of their budget on the healthier foods. Certainly I tell people canned fruit, canned vegetables if you get the ones that don’t have a lot of sugars and salt in them are much more economical and can work with a healthy meal plan as far as the nutrients in them. Things like rice, potatoes, different kinds of beans, yogurt. There’s a lot of good foods that definitely can fit into anybody’s budget and that is something that comes up fairly often that we need to work with budget.

I also, if people are able to go to more than one grocery store; look at the different flyers and look who has what on sale and kind of plan your meals that week. So, say salmon is on sale somewhere or lean ground turkey is on sale somewhere, the 90 or 93% lean; try making your meals using those ingredients and that also helps you to work within your budget.

Host:  So, as we wrap up here, do you have some general advice for folks? I mean it seems to me that planning is a really important piece of this.

Suzanne:  Planning, meal planning is really important. A lot of times when you don’t plan and then you have to run, and you grab something out that kind of puts the kybosh on all the hard work that you’ve done. So, definitely meal planning on a day of the week where you have a little extra time. Come up with great flavorful, nutrient dense meal ideas, eat three meals a day, nice and well balanced so that you stay full and really enjoy your food.

Host:  Well that’s a really good point to end on. We are going to have to leave it there. Our guest today has been Registered Dietician Suzanne Ishak. She’s an outpatient dietician for UM Upper Chesapeake Health. She sees patients out in the community and also works with the bariatric surgery program. To talk to a primary care doctor about your weightloss concerns you can visit www.umms.org/find-a-doctor. That’s www.umms.org/find-a-doctor. Thank you for listening to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We look forward to you joining us again.