Most moms want to lose the pregnancy weight, but who can find time to start a weight loss “program”? It seems it is more difficult than ever to lose weight these days on your own. Foods are more delicious, higher in calories, and more tempting than ever before. A new mom’s life is also busier than ever, and finding time to exercise seems a nearly impossible task most days. But did you know that one of the best things you can do to successfully lose weight is get a good night’s sleep?

Research has shown that the lack of a good night of sleep leads to more weight gain. The mechanism is thought to be related to an increase in hunger and a decrease in some of our internal impulse control mechanisms. After a night of little sleep, moms are tired, hungrier, less mindful of food and snack consumption, and more apt to give in to temptation around food. To make matters worse, tired moms do not have the energy or motivation to exercise. Bad combination: eating more treats and exercising less! No wonder lack of sleep is associated with weight gain and obesity.

So what can you do about it? Here are ten important practices you can undertake today that will maximize better sleeping and therefore help you in your journey to a healthier weight.

• For starters, don’t consume caffeine or other stimulants in the afternoon or evening.
• Establish a routine in which you sleep in a safe and comfortable environment that is controlled to your liking, paying attention to the temperature and darkness.
• Avoid alcohol beyond two or three ounces of wine. Alcohol makes a mom drowsy at first but causes a rebound effect that often wakes her up in the wee hours and impairs rest.
• Avoid eating a large late night meal. This means a light dinner and no food after 8 PM.
• Negotiate some nighttime help from your partner so you may sleep more. If he is not a “50-50” parent and objects to this idea, offer win-win solutions like his favorite meal on the weekend or going to a ballgame.
• Find 30 minutes for a brisk walk or other exercise in your day or evening and you will sleep much better. Push that stroller or strap on the baby carrier.
• If you are breast-feeding and you feel comfortable doing so, pump and save milk during the day so that your partner can do some of the nocturnal feeding.
• Establish your bedtime and stick to it every night. Try to minimize emotionally charged events like, arguing with your partner about house cleaning, that occur close to bedtime.
• Set a goal of six to eight hours every night and stick to it. Once a week allow yourself to sleep longer and erase that sleep debt.
• Use babysitters, grandparents, partners and friends to allow a few extra hours of sleep for yourself. Don’t feel guilty about this; you need to be healthier for your child.

Importantly, many of us have unrecognized sleep disturbances that can only be diagnosed by a formal sleep study that is ordered by your doctor. The most common among these is called obstructive sleep apnea (OSA), a common condition that usually occurs as a result of weight gain, such as with pregnancy. OSA afflicts over ten million Americans and is on the rise. It results from airway obstruction by the soft tissues of the neck and throat. If you snore, cease breathing for ten seconds or more during sleep, sleep restlessly, wake up often in the night, experience morning headaches, or simply feel tired all the time, you may need a sleep study. And you may want to talk to your doctor about things like post-partum depression and alcohol use that impair sleeping.

Often, lack of sleep just seems like a necessity with all the other responsibilities of motherhood that take up time. If you need to lose weight, then sleeping more hours needs to become a priority. So, consider it a good day when the doctor tells you that the first item on your To-Do list toward losing weight is to sleep more hours. Enjoy those extra Z’s and you will feel better and more energetic, and you will be far better positioned to succeed in achieving your weight loss goal.

So sleep more; it’s Doctor’s Orders.

In a new study released by the University of California, Davis has found a proposed mechanism by which bariatric surgery resolves type 2 diabetes in humans. In the study, a specific line of rats known as the UC Davis type 2 diabetes mellitus rat was studied. A model was created which a surgical procedure that mimics malabsorptive human bariatric surgical procedures was employed in this special group of rats. After the procedure, a dramatic reduction in the onset of type 2 diabetes was noted 120 days later. 78% of the control group rats developed the diabetes as expected while only 38% of the rats that had undergone the surgical procedure developed diabetes.

The researchers described a hypothesis in which two specific hormones are implicated in the resolution of diabetes or the prevention of type 2 diabetes. These two hormones are known as GLP1 (Glucagon- like peptide-1) and PYY (peptide YY). These two hormones have been previously identified and are involved in regulation of insulin secretion and appetite. GLP1 is believed to increase insulin secretion and increase insulin sensitivity in the tissues, which would lead to improvement or resolution- or in this case prevention- of type 2 diabetes.

The study is important in part because some of the findings about blood sugar regulation after weight loss surgery appears to contradict the hypothesis that the phenomenon is purely weight related. While long term studies of gastric banding and gastric bypass demonstrate similar rates of diabetes resolution, short term studies indicate the gastric bypass, a malabsorptive procedure with greater hormonal changes, produces faster and earlier improvements in type 2 diabetes. The explanation for this phenomenon may lie with hormonal changes such as those that occur with GLP-1.

Undoubtedly future studies on these hormones in both animals and humans will shed greater light on the subject and help us understand how and why weight loss surgery exerts is powerful effects. In addition, such studies may lead us to new drugs, pharmaceutical solutions to the problem that will involve drugs that mimic the actions of GLP-1 or block other hormones that create harmful effects and perhaps allow a way to chemically produce the effects of weight loss surgery.

Some researchers in the field of obesity postulate that within ten years we will have a whole array of new drugs that produce some of these effects, but obesity is likely to remain a complex, multi-factorial disease with many psychological, behavioral, genetic and cultural factors that play a role.

Researchers in the United Kingdom have been studying a fibrous material in seaweed or sea kelp known as alginate. They have found this material is quite affective at preventing fat absorption. Researchers performed laboratory studies that modeled fat absorption within the human intestine and demonstrated that alginate will bind the fat and prevent its absorption into the body. The researchers believe when this material is added into commonly consumed foods such as breads and other staples that up to 75% of dietary fat would pass through the intestinal system without being absorbed into the human body.

Anyone who has taken Xenical will know that blocking absorption of fat into the body means one thing: it passes out the stool, usually in the form of diarrhea or a special greasy form of diarrhea known as steatorrhea. The appeal of fat blockers stems from the fact that fat is a very calorie dense nutrient containing 9 calories per gram of food.

However, research that has focused on reduction of fat has lead to very disappointing results for the outcomes that matter: weight loss and resolution of obesity related conditions like diabetes. Research involving fat blocking drugs such as Xenical have shown very mild weight loss and to such a low extent that most professional weight loss physicians only recommend the drug (also sold as Alli over-the-counter) when a weight loss patient is suffering from constipation.

So seaweed might have an interesting role in cutting down some calories we absorb. Reducing fat calories will help the overall cause, however it is quite unlikely that reducing fat calories is going to solve obesity for most people. The epidemiological evidence points strongly toward carbohydrate over-consumption as the main culprit so unless we discover a seaweed that is a “carb blocker “then it is unlikely to make a dent in the obesity epidemic

There is really no end to the silly things that people will spend money on if the lure of weight loss can be made attractive enough. In a recent such example the Mexican “Diet Ring” is slipped around one’s finger and produces up to 38 pounds of weight loss in one week. The ring is of course developed by “oriental scientists” and retails for 399 pesos.
Believe me, I wish with all my heart that such a thing were actually true and that I could help thousands of people in my own community and in my own practice lose weight and become healthier. The truth is more complex and a bit harder. But ultimately, there is a solution to successful, long term weight loss and you can lose weight and keep it off without wasting your money on gimmicks, fad diets and “miracle” cures and solutions that are nothing more than marketing schemes, gimmicks and somebody’s get rich quick idea.
Stick with what works, what is authentic, what has been studied and what is recommended by people who sincerely want you to get healthier.

So this may seem like discouraging news to some, but a recent study from the Brigham and Women’s Hospital demonstrated that average middle age women need to exercise a full sixty minutes every day in order to avoid weight gain through the course of the year. That’s right, that is the amount of exercise simply to maintain your current weight, and that is if you are currently living at a reasonably normal weight.
For a lot of women with busy lives including chauffeuring children around to schools and lessons, maintaining a household and managing their own jobs and careers, a full hour of exercise everyday is practically unthinkable. Yet, those seem to be the facts.
But what about women who are already overweight or obese (and this is becoming most women and most men)? Well, guess what, sixty minutes was actually not enough. Yes, while maintaining their regular diet, overweight and obese women would have needed to exercise more than sixty minutes a day to avoid further weight gain.

How do we use this information? Well, I have put this question to a number of women who fit the demographic of “middle age” around my own office. Most of them feel as though these data indicate they would have to undertake a major lifestyle change in order to successfully maintain weight or lose weight. An hour or more of exercise everyday simply does not fit into their current busy life and lifestyle. What sort of lifestyle change would this involve? Well, some suggest it would involve working less, not likely, given the current financial realities and the current economy. For others it would involve simply changing and reorienting one’s life toward one that acknowledges a balance and celebrates physical activity to a much greater degree. It involves orienting one’s life much more athleticism and exercise. Alternatively, or let’s call it complimentary to this idea, would be the parallel notion of reducing caloric intake. This is really the main way to maintain weight and lose weight. Keep in mind that an entire hour of exercise may burn somewhere in the neighborhood of 700 calories if done vigorously for most people. And then think how easy it is to consume 700 calories in a few quick bites.

So my advice is to focus on both: markedly reduce calories by cutting out carbohydrates and high calorie foods, drinks and snacks. Then seek to slowly incorporate more and more exercise and activity into your daily routine and aim for the full one hour of daily exercise. If you are significantly overweight or obese then you must do even more: cut calories even further and increase exercise even more. It is difficult, it’s painful, but there are tools to help.

Mother’s Day, May 9th, 2010, kicked off National Women’s Health Week. A special week promoted by the U.S. Department of Health and Human Services and their office on Women’s Health. This year the theme of the week long campaign is called “It’s your time” and the idea is for women to take steps to improve their health and to make their health a top priority.
While there are many important things that women can do to improve their health, number one among them in this day and age is to maintain a normal body weight and avoid weight gain and obesity. If a woman has crept up to a body mass index greater than 25 than a serious effort at calorie reduction and increased exercise is in order. For a body mass index greater than 30, a more rigorous and structured program is warranted, and the evidence strongly favors taking a very proactive and serious approach including consideration of a Lap-Band operation in conjunction with such a program. For a body mass index of 35 and greater, a small percentage of women can lose the weight successfully without weight loss surgery, but for more this would be a very challenging undertaking. Even with weight loss surgery, successful return to normal body mass index will require diligence, hard work and a structured program. But these efforts are well rewarded with vastly improved health, longevity and quality of life.
Various events are planned around the country to celebrate National Women’s Health Week and these can be found at:
http://www.womenshealth.gov/whw/events/
The Surgeon General, Dr. Regina Benjamin emphasizes the importance of empowering women to make their own health a top priority.
Our recent Health Moms campaign dovetails importantly with National Women’s Health Week and the project this summer aimed at helping moms lose the pregnancy weight and promoting health families in obesity prevention among children will succeed in improving the health of not only women in our community, but the entire families that women lead.

So where do we get the motivation? Where does it come from? Because, if there were a place, a shelf perhaps somewhere some identifiable reservoir in our consciousness or bodies, how do we find it? How do we tap into it? How do we keep finding it and accessing it long after the initial enthusiasm for a new goal has long since waned?
These are some of the most challenging aspects of long term weight loss. In one moment we may think, we may know, in fact, that we will feel better. That our lives will be better if we can lose weight and keep it off. Our health will improve, our relationships may improve, we may feel more energetic, we may get more things done, we may accomplish more, make more money, look better, etc, etc. And in that flash, some motivation is tapped and we may even act upon it. But the process of losing weight is not like the process of accomplishing a project around the house or acting upon the one lingering item that has been sitting upon our desk. It is a long term process, a long term process, a journey, really. So how do we tap into that reservoir of motivation so that we may succeed in such a long term journey?
Our patients have taught us a few things and I will share a few of them with you here. One of them is a simple notion that the ideas that we keep in our consciousness are fairly few at any given moment. And each of us is certainly bombarded with many other messages through the course of our day and through the course of our week. Think of all the countless messages about food, snacks, eating at restaurants and buffets and desserts that we experience on a daily basis. Now think how often do you go out of your way to reinsert thoughts of your long term weight loss goals? When you add it up this way, it becomes quickly apparent that our own noble thoughts about change are often drowned out by these other messages we are bombarded with. So what’s the solution?
Well, here’s a simple one. Write down your main goal. Keep it very simple. “Lose 20 pounds by October 1st.” Write it on a note card in big black magic marker and post it where you will see it very single morning. In fact, make three and post one in a place on your dashboard in your car, one on your computer above the screen and one at home in the bathroom mirror. That way you are forced to think about your goals at least several times a day.
Then there is more. It involves digging very deep into what truly motivates us. This is more than simply that you would like to look trimmer. It is the important stuff such as the specific ways in which you would like to be a better parent, or a better partner. It is achieving personal goals like riding your bicycle with your kids or completing a 5K race or some of the other hundred things you would like to do before you die. It means recapturing and not giving up on your dreams. So spend a little time and dig deep and find out what you would really like in life and how being overweight is keeping that from happening. Then put pen to paper and write down some of those deeper, more important goals, the good stuff; the things that make life really wonderful and worth living. Now you have something powerful that you can refer to and tap into when your motivation is ebbing.

A recent study out of Singapore, which examined over 60,000 people over the course of fourteen years, found that those subjects who drank two or more sugared soft drinks per week had doubled the risk of developing pancreatic cancer than those who did not.

It is not known why increased soft drink consumption could lead to an increased risk of pancreatic cancer or whether this effect is going to be born out in other studies. Some facts we do know about cancer: many cancers are markedly increased in obesity. Colorectal, breast cancer, endometrial cancer and others double or more than double among obese individuals when compared to normal weight individuals. We know there is an association between soft drink and sugar consumption in obesity, so it stands to reason that some link may exist between the soft drinks and cancer development. Pancreas cancer in particular may be one that has some special sensitivity to the elevations and hormonal surges of insulin, leptin and other hormones associated with carbohydrate consumption and obesity.

Whether some subtle toxin could be present in soda cans or whether there is something specific about the soft drinks as opposed to other sugar drinks like fruit juices remains to be seen.

What is known is that drinking lots of sugared soft drinks is bad for your health. It leads to weight gain and obesity, which increases cancer risks markedly. This latest study is one more, small piece of data that should discourage drinking high carbohydrate soft drinks.

A real energy drink should give good, solid energy for a period of many hours.

A real energy drink should not make you jittery and “hyper” and impair your concentration; it should focus it.

A real energy drink should definitely not lead to a short spike in energy followed by a big fall in your energy level – instead it should give good, long, sustained energy that is even.

The ideal energy drink would have a few other characteristics too. It would come from natural ingredients. It would not only provide some energy, some calories, but also some other important nutrients like vitamins and minerals. And for the vast majority of us who want energy, but not in the form of empty carbohydrate calories that lead to weight gain and obesity, it should help us maintain a healthy weight and healthy, long term energy. A true energy drink should not leave you craving more food, more calories, more energy drinks shortly after you have consumed one. It ought to provide some real, solid satisfaction. Also, an energy drink can have a little caffeine, that’s fine, but not hundreds and hundreds of milligrams of caffeine. Those kinds of doses are shown to cause tremors and make one feel jittery. They also often interfere with sleeping and actually make people more tired through the course of the week.
Oh yeah, and it should taste great.
So for my money the best energy drink is going to be a nice mixture of vitamins, minerals and natural whey protein to give a clean energy boost instead of all that sugary, make you fat and tired kind of energy that the big drink companies have promoted in the past.

It’s not that we want to be fat. In fact most of us find ourselves gaining weight and are struggling to find ways to stop it. But these energy drinks, sport drinks and just plain ole’ drinks taste so good and are so cleverly marketed to us that we can’t stop drinking them. At least we can’t stop drinking them unless we think about it and use our own free will a little bit.
What a lot of people don’t realize is that big jolts of simple carbohydrates make us fat. Not immediately of course, not that day or that week even, but over time. Big doses of simple carbohydrates, say those in the sucrose and high fructose corn syrup of an energy drink or other soft drinks, the simple carbohydrates are digested quickly and enter the blood stream quickly and result in a very rapid surge of circulating blood sugar or serum glucose level. This also leads to a rapid spike in the important hormone insulin and leptin followed by a rapid fall of the blood sugar level. The next step is a sense of hunger which is often even stronger than before the jolt of sugar. It is no wonder this cycle leads to obesity as it repeats itself over and over.
The make-you-fat drinks have awesome, inspired and expensive Madison Avenue advertising and marketing. They look cool, we think they’re cool and, of course, they taste great. Some of us even like that rapid spike and jittery feeling; the surge of energy, even if it is very short lived, but with a little thought we could all do a lot better.