1. Eat Chewable Food—Not “Mush”

-Chewing food provides more satisfaction when eating. Eating soft mushy foods that don’t require chewing will decrease your satisfaction after a meal and result in less satiety.

2. Eat 2-3 meals per day and 2-3 snacks per day. (eat 5-6 times/day)

-Eating regularly during the day will maintain a higher metabolism. Skipping meals will also result in fluctuations of your blood sugar and energy level and may cause cravings and headaches. Always eat breakfast!

3. At least three of the meals should be high protein meals.

-Remember, “protein first.” Protein causes more satiety than carbohydrates. When eating smaller portions, following a pattern of starting with protein-based foods (meat, fish, eggs, etc…) will also ensure better nutrition.

4. Drink at least 2 quarts of calorie-free beverage per day, and drink 1 glass (8oz) of water, 30 minutes prior to regular meals. Do not drink during meals.

-Dehydration will often be mistaken as hunger, resulting in a need to eat more. Drinking a thirst-quenching liquid prior to meals will also eliminate the feeling of a need to drink during the meal.

5. Eat good tasting, flavorful food; chew well and eat slowly.

-This is very important. You will be eating slowly and chewing for a longer time, and therefore you need to make sure that you have good tasting food that you enjoy. This is an important part of feeling satisfied after a meal.

Dr. Quebbemann is a renown weight loss expert and he often receives interview requests and invitations to speak on a variety of topics related to weight loss. One topic that is often addressed by Dr. Quebbemann is metabolism. He recently spent some time responding to some questions about it. Here are some of his responses:

1. Medically speaking, what is “metabolism”? What role does it play in weight loss?

Metabolism is the way our body takes in, modifies and uses the calories we eat and drink. Our bodies carefully regulate our metabolism through hormones and other mechanisms to ensure that we have enough energy to survive and to be physically active.

Experts in metabolism distinguish two general types of metabolism, resting metabolism, also called resting metabolic rate, or RMR, and active metabolic rate. Your resting metabolic rate represents the calories your body burns when you’re at rest during the day, where your active metabolic rate, AMR, includes the calories you burn while active, whether brushing your teeth, doing housework or weight lifting.

Since your weight depends on the balance between calories taken in by eating and drinking, and calories burned throughout the day, your active and resting metabolic rate will affect your weight.

If your overall metabolism is higher, you will burn more calories throughout the day, and tend to accumulate less body fat. If your total daily energy expenditure is greater than the calories in the food you eat, then you will lose weight.

2. What are some of the things that people/patients often don’t know about metabolism?

A common misconception is that many people are overweight due to a low metabolism; this just isn’t true. Experts in weight loss know that excess weight and obesity is caused mainly by eating too many calories and getting too little physical exercise.

However, metabolism is affected by muscle tone and by the amount of excess body fat a person has. People with excess body fat generally have hormone imbalances that affect their metabolism, slowing it down, and making it more likely that they will gain even more weight.

3. What can cause metabolism to slow down?

The most common cause of a slower metabolism in America today is lack of exercise.

4. How does aging affect metabolism?

Age tends to result in a decrease in growth hormones as well as a change in your sex hormones, all of which will decrease your metabolism. The effect of aging on your metabolism varies from person to person and is determined to a large extent by your genetics. However, remaining active, and maintaining your muscle tone and aerobic conditioning will do a lot to decrease the effects of aging on your metabolism, allowing you to keep your metabolism high well into your older years.

5. What are some medical conditions that can cause metabolism to slow or speed up?

The most commonly recognized disease that causes your metabolism to slow down is hypothyroidism. However, many other conditions will cause your metabolism to slow, including decreased testosterone or “low-T”, menopause, poly-cystic ovarian syndrome and even stress.

6. What are some foods that can affect metabolism?

The type of food you eat has only a small effect on your metabolism, but some food requires a lot more energy to digest and absorb into your system. Food that takes more calories to digest results in less calories being available for your muscles to use, but also less calories that cause weight gain.

Foods that digest easily, such as high glycemic index foods like sugar and processed carbs, cause a sudden spike in blood sugar and a subsequent spike in production of insulin. If you’re burning off these calories at a rapid pace, such as during a triathlon, your body will rapidly metabolize sugar in your muscles and liver, generating energy. If you’re not actively burning up these calories, the increase in the hormone insulin in your body will result in accumulation of calories in the form of fat, even within your muscles

A “double whammy” occurs when you eat high glycemic index food, like frosted corn flakes, when you’re sitting around, resting, because high blood sugar levels cause a decrease in growth hormone. Decreased growth hormone further drives down your metabolism, limits your “energy level” and decreases your ability to maintain lean muscle mass.

7. Can the manner in which you eat affect your metabolism (eating regularly throughout the day vs. starving and gorging, for example)?

The way a person eats does have some effect on metabolism, but it’s a small effect in general. Fasting for long periods will result in a decrease in a person’s basal metabolic rate, but this is not a common problem.

Short term fasting, on a daily basis, such as skipping meals, will also result in an intermittent decrease in resting metabolic rate.

8. Can exercise affect metabolism – for example, can your overall metabolism be elevated by exercising regularly?

Mild, easy activity, such as relaxed walking, has little effect on your hormones. More strenuous exercise, the kind that makes you sweat, causes an increase in the levels of many hormones in your body, including Growth Hormone and Testosterone, both in men and in women. This results in increased calories being burned, not only during exercise, but also afterwards as your muscles repair themselves and grow stronger and bigger. As a result, not only does your metabolism dramatically increase during strenuous exercise, but your basal metabolic rate increases, meaning you burn more calories in between workouts as well.

A little known, but very important fact, is that excess body fat causes your overall metabolism to decrease. Your muscles lose their normal ability to metabolize the calories that you eat, and instead your those calories get stored in your body as fat. So, as people lose muscle tone, and become more overweight, their tendency to accumulate fat increases.

9. Is gender a factor in metabolism?

Gender is a definite factor in metabolism, but not much of a factor in energy balance. Men have more testosterone which results in an increased energy level and helps to build muscle, resulting in increased basal metabolic rate, and increased calorie burning during exercise. This simply means that men need more energy intake to balance out calories burned. However, men are just as likely to consume more calories than they need, resulting in an imbalance that causes weight gain.

10. Can hormonal issues affect metabolism, and how?

Hormones are molecules produced by our body that control everything from when we sleep, to energy level, sex drive, hunger and also metabolism. Diseases such as hypothyroidism (too little thyroid hormone) and Cushing’s syndrome (too much cortisol) change your metabolism causing weight gain. But, more commonly, hormone levels are changed slightly by how we live; in other words our lifestyle and physical health significantly changes our hormones. Increase stress, lack of exercise, poor muscle tone and obesity will all cause an imbalance in testosterone, cortisol, insulin and growth hormone resulting in abnormal mood swings, decreased sex drive, low energy, and weight gain. Keeping fit, helps maintain a normal hormone balance, preventing many of these problems.

If you are having difficulty achieving permanent weight loss, The N.E.W. Program team is here to help! Our team of physicians are experts in weight loss and have experience working through all obstacles to help you lose weight. We have helped thousands of patients who thought they had lost their battle with weight, regain the upper-hand and conquer it! If you would like us to join your weight loss team, call us! 949-722-7662

U.S. News posted an article last month wherein our Dr. Quebbemann was asked to give some tips on what people can do before they start a weight loss plan. Just like most things in life, accomplishing weight loss goals gets a lot more effective when you have a plan to win. Identifying diet weaknesses and looking for preparation activities that will help you succeed are well worth your time as you begin you journey towards fitness. The U.S. News article gave these tips:

1. Raid the kitchen-Get rid of the junk food in the house

2. Fill the right fruit bowl-You are more likely to eat fruit if it is in a clear bowl

3. Gear up for your workouts-schedule your workouts in advance and pack your gym bag

4. Think through you food splurges-Dr. Quebbemann is quoted:

We all know that splurges are going to happen. And more than that, they should happen, Quebbemann says. Regular “cheats” can keep you from feeling deprived and make healthy eating more doable over the long term. But rather than make all of those splurges impromptu, plan small treats for yourself every day. It could be a square of chocolate, a slice of birthday cake or a glass of eggnog. But by planning them out, you make sure that you never feel deprived or, on the flip side, wind up having 10 splurges in one day.

5. Plan and prep your meals-Preparing your meals when the week starts can keep you diet healthy

6. Get to sleep early- A bad night’s sleep can make you over-eat

7. Store snacks everywhere-Dr. Quebbemann is quoted:

Wherever you are, protein-rich snacks should be there, too. “They’ll take care of your hunger and keep you from nibbling on junk, simply because you feel starved and have nothing healthy to eat,” Quebbemann says. Plus, protein sticks around longer in your stomach to keep you feeling fuller longer than any cereal bar will. Store protein bars, nuts or turkey jerky in your desk drawer, bag and car. Plus, if you have access to a fridge at work, cheese, Greek yogurt, lean meats and hardboiled eggs all make great mid-day snacks.

8. Buy smaller plates-Using a small plate can help control your portion sizes

9. Buy a refillable water bottle-Dr. Quebbemann is quoted:

That way, you’ll be able to drink up all day long. Staying hydrated is vital to keeping your body functioning properly, and the many of hallmarks of hunger – fatigue, stomach growls, moodiness – also occur when you’re thirsty, Quebbemann says. So by keeping yourself hydrated, you can make sure that you don’t reach for a second serving of mashed potatoes when all your body really wanted was a glass of water.

10. Download a food journaling app– Keeping a food journal can help you identify irregular food behaviors

The article is summed-up by this quote:

“The single most important thing for people to do if they want to succeed at weight loss over the long term is prepare,”- Brian Quebbemann

I’m writing this blog backed by over 25 years of clinical observation and thousands of scientific studies reported in the medical literature. I’ve also included advice from real patients who have “been there,” and then succeeded. During my years as a weight-loss doctor, offering surgical and non-surgical weight loss counseling, I’ve interviewed thousands of weight-loss clients. I’ve observed their habits and studied the patterns that result in success or failure. As I observed weight-loss surgery patients become successful, I saw that the habits resulting in their success were the same habits followed by people who had maintained fitness their entire lives. It became clear that my job wasn’t to come up with some strange and unique rule book that needed to be followed by “fat people” in order to help them lose weight; my job was simply to help weight-loss patients find their way to a fitness lifestyle. Nothing more.

Time has proven my approach.

Early in my practice, in 1997, I began to perform bariatric surgery. With formal bariatric surgery training during my residency I turned out to be the only formally trained bariatric surgeon in the area. At that time, bariatric surgery was still considered a radical approach to weight loss and many doctors doubted my prospects for long-term success.

The first procedures I performed were all revisions of prior bariatric procedures that had resulted in complications. What I noticed was that the patients being sent to me had undergone bariatric surgery without any real understanding of what the surgery entailed. These patients had no chance of success because nobody had explained to them how the surgery worked or what they needed to do to make the surgery successful. They had been led to believe that weight loss surgery was magical and would “change” their diet, somehow, making them thin for life. To me, this was no different than the magic diet pills on TV that made you “melt away fat in your sleep. I decided that the entire field of weight loss, whether through surgery or not, was hugely dependent on the patient modifying his or her behavior. This, in my opinion, involved the patient understanding their role prior to surgery, and then choosing to participate in the system.

In order to provide this prior understanding, combined with post-operative support, I decided to first put together what I called a Nutrition, Exercise and Wellness program (The N.E.W. Program) and then to add on surgery, when patients chose surgery as their best option. Patients could choose either a surgical or a non-surgical path, and I had every patient set his or her own goals and identify the people in their lives that were capable of support. I made one additional stipulation that I felt necessary for success: I insisted that each patient accept full responsibility for developing a combination of eating and exercise habits that would make the surgical approach successful.

Were all my patients successful? No. No process can claim a 100% success rate. But this N.E.W. lifestyle approach, combined with surgery, was more successful than simply doing the surgical procedures alone, and far more successful than any diet-and-exercise program out there. Period!

In the 20+ years since my first patient, I have developed a set of guidelines that has resulted in success for thousands of overweight individuals. These guidelines are described in the book. The book also contains invaluable insight into why people choose weight loss surgery, and how your friends, family and your physician should think about the problem of severe obesity.

Define your New Normal Diet

A very useful tool to use in discovering a new eating pattern that you enjoy is my Dietary Rebuild™ Program. The Dietary Rebuild is not a diet, it’s a method of identifying a personalized eating pattern that will be your new normal eating pattern.

Why a Dietary Rebuild?

Thousands of patients have come through my weight loss clinic and, once they’ve lost their excess weight, I’ve watched many of them struggle with developing a new set of eating habits that is enjoyable, sustainable and will not result in weight regain. Weight often comes off rapidly with a very low-calorie diet (VLCD), or after surgery, but once people get back to eating regular food, weight regain can begin. This does not have to happen!

The problem is that as soon as clients start eating their “normal foods” again, their normal eating habits that they identify with are the eating habits that resulted in their weight gain in the first place. This problem commonly occurs after commercial weight loss programs, physician-run weight loss programs, self-imposed diets, and even after surgical weight loss.

After losing weight, most people want to be given “the rules” for keeping the weight off and they expect a set of rules that will magically work for everyone. Amazingly, they are willing to listen again and again to the same failed rules they’ve been given after every diet in the past. Examples of these rules are:

1) Count your calories

2) Practice portion control

3) Always eat protein first

4) Avoid eating sweets, etc.…

These are the same or similar rules that were given to them by dietitians, doctors, nutritionists and others telling them which foods to avoid, which foods to minimize, and which foods are “bad.” This advice is easy to get, almost every diet program dredges this stuff up at some point. But, if this advice was so great, you would have succeeded long ago!

No matter how many rules you are given, no matter how much healthy eating advice you absorb, your prior diet (your past normal) will almost always creep back in and result in significant weight regain. And no matter how many “rules” you try to live by, your normal eating habits that resulted in your excess weight before, will become your eating habits again.

To solve this problem, I’ve designed a unique process that will reset my patient’s baseline, and help them to identify a new, personalized diet that works for you long-term. I call this process Dietary Rebuild™, Rebuilding your New Normal Diet™.

So, what was your new normal?

Dietary Rebuild™ is a structured process that I use to coach my patients to an eating pattern that is fundamentally healthy, satisfying, and personalized. The process involves throwing out all your old eating habits and starting with a basic dietary platform that you follow for the initial step. We then work together to rebuild your new normal diet back, one step at a time, until you define an eating pattern that you like and can succeed with long-term. This is the essence of the “Dietary Rebuild™ Program.” I start you with a broad, but very well-defined eating pattern for a period of 4 weeks. Then using a structured, step-wise approach, you “rebuild” your eating pattern back to a full-fledged diet with all the options and food choices that are available.

You are in ultimate control over the rebuild process, including how much of each type of food you wish to eat, and how often you eat it. In the end, no type of food is off limits, but your “New Normal Diet” is the eating pattern that you will think of as your normal diet going forward. Every patient has independent decision-making power in defining their new normal.

Defining your new normal diet is a critical step for you to succeed with permanent weight control. Remember, the goal is for you to achieve your best weight, and this means that you’ve found healthy eating habits that you are comfortable with, that do not result in weight regain. It also means that you’ve found an exercise program that they enjoy.

The combination of weight loss from the N.E.W. Fit Program and identification of your new normal diet from the Dietary Rebuild Process puts permanent weight control within your grasp!