THE SPECIALIST
As the director of the Mount Sinai Weight Management Program, Dr. Robert Yanagisawa is an endocrinologist who specializes in helping patients lose weight, generally more than 30 pounds. His multidisciplinary program treats more than 150 patient visits a year.
WHO’S AT RISK
Now that the gluttonous holiday indulgence is over and our New Year’s resolutions are freshly minted, it’s time to reverse the damage done by all those Christmas cookies and eggnog. “It’s a good time to recognize if you’re gaining weight and halt that process,” says Yanagisawa, “because it’s much easier to stop gaining weight now than to lose the extra weight later.”
The latest statistics show that two-thirds of adult Americans are overweight and one-third are obese. “In our culture, anyone is at risk of weight gain, especially during the winter holidays when rich foods are traditional and it’s easy to stay inside and be sedentary,” says Yanagisawa. “But the people who are at particular risk have a metabolic issue like diabetes, high-blood pressure or cholesterol, heart disease or sleep apnea.” These conditions are all associated not only with weight gain but a predisposition to more severe complications.
It’s tempting to turn a blind eye to weight gain, but that only makes things harder down the road. “The biggest thing is not to ignore obvious weight gain and increases in clothing sizes,” says Yanagisawa. “Try to weigh yourself every week or so, and keep in mind that even modest weight loss or stopping weight gain can do a lot for your health.”
SIGNS AND SYMPTOMS
Ultimately, keeping track of whether you’ve gained excess weight is a simple numbers game. “To identify whether patients are overweight or obese, we use the Body Mass Index (BMI), a mathematical calculation of weight in kilograms over height in meters squared,” says Yanagisawa, “BMI can overestimate or underestimate, but generally a BMI over 25 is overweight and over 30 is obese.” The Center for Disease Control (CDC) and many other websites will help you calculate your BMI online.
TRADITIONAL TREATMENT
When it comes to maintaining a healthy body weight, prevention is the way to go. “I recommend setting your diet strategy in advance,” says Yanagisawa. “Don’t go to parties hungry and try to fill your plate with low-calorie vegetables and sparing portions of meat and starch.”
It’s a good idea to add some non-food-centered activities into your social life. “If you’re going to see your friends, try to steer away from the food and drink scene and toward an activity that involves moving around, like going to a museum or to the mall,” says Yanagisawa. “We can’t avoid all social eating, but we can plan it strategically.”
Make a plan for how to handle big family meals. “If you keep your plate full with the healthy, low-calorie options like salads, vegetables and fruits, you can nibble on it all day without overeating,” Yanagisawa says.
For most people, going it alone is not the best way to maintain a healthy diet or lose weight. “Working with the doctor, nutritionists, fitness trainers, with a weight-loss program, and having social support is really helpful,” says Yanagisawa. “Setting realistic goals is key, and for most people cutting about 500 calories a day is enough to lose a pound a week.” There’s no single diet that works for everyone. “The best diet is the one you feel you can stick with, not just for two weeks, but as part of forming healthy food habits,” says Yanagisawa.
Exercise and diet go hand in hand for weight control, though exercise alone isn’t an efficient way to weight loss. “The combination of diet and exercise is key because exercise helps you maintain muscle mass and keep your metabolism up,” says Yanagisawa. “If you’re losing weight without exercising, you’ll lose both fat and muscle, and your metabolism will drop.” Exercising for 30 minutes a day, three times a week is a good starting point.
RESEARCH BREAKTHROUGHS
There’s still no magic pill to trigger weight loss, but researchers are steadily adding to our understanding of how weight interacts with the metabolic processes of the body. “What we’re seeing in the research is that obesity and weight gain need to be looked out holistically, in terms of things like inflammatory markers and cardiovascular effects,” says Yanagisawa. “Even a 5%-10% weight loss can make a huge difference in terms of cholesterol or insulin resistance or blood pressure.”
QUESTIONS FOR YOUR DOCTOR
For most people, a team approach works best when it comes to weight loss and control. Ask, “Can we work together on my weight?” Follow up with “What impact is my weight having on metabolic conditions?” “Often people (express) huge relief when I can show them how improved their cholesterol is, even after losing modest amounts of weight like five or 10 pounds,” says Yanagisawa. “It’s not that the doctor is watching everything you eat, but it’s a partnership that patients find can really help them stick to a plan and form healthier habits.”
WHAT YOU CAN DO
Get informed.
The Centers for Disease Control and Prevention hosts helpful tips and tools like a BMI counter at (www.cdc.gov/obesity/), and the Mount Sinai Weight Management Program has patient information at www.mountsinai.org/weight
Use an easy app.
Smart-phone apps like Calorieking and Loseit make it easier and even fun to keep track of what you’re eating and calorie counts. Pen-and-paper people can opt for jotting down calories in a notebook
Exert portion control.
A single portion should fit on your palm; a restaurant meal is usually the size of multiple portions.
Don’t go to parties hungry.
Eating a healthy snack of salad, fruit or vegetables before you go allows you to pick and choose sensibly and not overeat once you’re there.
BY THE NUMBERS
–1/3 of Americans are obese
–More than 2/3s of Americans are overweight
— Obesity increases your risk of developing diabetes by 10 times
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