Friday, December 28, 2012

Holiday Happenings,...

 Hello Bloggers:

The months of November and December sure fly by!  I am finally taking a moment to sit down and update my blog.  What a beautiful, busy, potentially stressful, yet sentimental time of year! 

I love living in California!  There is so much to see and do, and the mountains are so picturesque!  I also love visiting my friends and especially family, back home in Wisconsin!
NOVEMBER marked my first time traveling out of state for an extended period of time while on the HMR Decision Free program.  That was an interesting venture!  I was gone for just about two weeks, and over the Thanksgiving holiday.  The HMR staff wanted to switch me over to the Phase II part of the program as I wouldn't have to be medically monitored plus the addition of fruits and veggies might have made the travel experience easier.  However, I had been having such success with the Decision Free program that I didn't want to switch.  It took some persuasion, but the staff finally agreed to allow me to stay on Phase I of the Decision Free HMR Program.  It also helped that I found a medical clinic that offered the HMR Program in the Fox Cities area of Wisconsin that I was traveling to.

CHEESEHEAD HMR Staff and Participants were really warm and kind.  (Yes, I know that's not politically correct, but I'm a Cheesehead by birth and by heart, so some allowances are in order.)  It helped to have the support.  It was also interesting to see how the program was run in another state.  It was very similar; Order food, weigh-in, get blood pressure checked, then attend the meeting/lecture, and sample new HMR recipes.  The group was quite small the two days that I was there, with approximately 3-4 participants.  The only other main difference in how the group was run was that it was held around a large conference table vs. classroom style.  Of course the Cheesehead dialect around the table sounded so pronounced, which tends to happen when you've been away from it for so long (don'tcha know).  It was nice to meet other people on similar journey's with their weight loss goals.  The people I did meet were very friendly and supportive.  And I must say, I was so glad to be amongst people who didn't give me a strange look when I asked where I could find a "bubbler".

WHAT WORKS for me best on the Decision Free program is that there is no real thought that has to go into menu planning.  It is also a great way to ward off peer pressure to eat foods that will keep a person from meeting their weight loss goals.  I found out that it worked well to tell my family and friends in advance of the program I was on, and why it was important not to stray.  "I am on a strict medically monitored diet" became my motto.  You won't believe the level of relief that results from not having to deal with the pressure of making wise food decisions, ESPECIALLY during the holidays.  There is way too much temptation out there.  When I resigned to the fact that I agreed to this lifestyle (temporarily), the decision making headache was gone.  I no longer had to question "one dessert or two"?  And I didn't have to feel rude about turning down a care package of leftovers.  It was just assumed that I wouldn't take any.  (I am a sucker for Thanksgiving mashed potatoes and gravy, and I normally cannot resist.  Although they smelled and looked good this year, I did not feel the irresistible urge to eat a mountain of them or take any home.  I had my own meals which were more than satisfying.)
BUFFETS:  Can you hit up the Golden Corral on occasion on this diet?  I don't recommend it, lol.  But I actually went with my family.  I did not want to miss out on the rare occasions when we are all together: my father, his wife, two of my three brothers and their wives.  So I PLANNED AHEAD!  I called the restaurant to explain the situation and find out if it was okay if I still came in the restaurant to be with my family, even though I would only order coffee and hot water for my prepackaged oatmeal.  The restaurant manager cheerfully responded, "Sure!  Of course you can!"  And no employee made a stink when I was there!  That was neat, and probably a bit unusual.  Our society is not set up to accommodate people on special diets (as a family member with PKU can well attest).

FAMILY and FRIENDS probably felt the most uncomfortable adjusting to my new eating patterns.  I found myself educating them on the fact that I am truly not feeling hungry or neglected on this diet.  Do I have occasional cravings?  Oh sure!  But I don't typically feel tortured when I sit with others who are eating "regular" food.  I think that's what they must have thought or felt.  (I would probably feel the same.)  Even my dad affirmed that there might be a shared feeling of guilt felt for eating in front of me.  I had to remind others that they didn't have to feel bad for me.  If a certain function involving food would feel too tempting or overwhelming, I would simply choose not to go right now.  I can go another time, when I am not on the diet.  Other people have commented that I should "get on a different diet program!".  But why?  That reaction is more about them and their level of discomfort than it is about me.  I like the program I am on.  I feel good on it.  My doctor approves of it.  It is healthy, and it is working.  Why on earth would I want to quit?   

SOME RESTAURANTS are not as accommodating.  That is okay.  Most have been very understanding.  But restaurants do have health codes and rules they have to abide by.  The ones that turn the other way and make exceptions, however, are usually the ones who get the larger tip!  :)  But I find if restaurant staff show any discomfort, I am fine just ordering my coffee or tea and enjoying the company.  I really do enjoy that social time more than ever.  It is not just about the food.             
TRAVEL is always a challenge.  I found it best to plan the travel days ahead.  I had bars, shake packets, and shaker bottles packed for the plane ride.  I even found staff at a sub place at the airport who were willing to heat up my entree in their microwave.  Of course I agreed to buy their $3 bottle of water.  I hope the staff who went out of their way to bend the rules and stick an entree in their microwave realize how much they were appreciated!  Those little gestures mean a lot to people on specialized diets. 

DECEMBER has brought about many challenging moments.  My spouse and I are dealing with some personal issues.  And my dear Sister-in-Law (brother's wife) suffered a severe stroke.  We were so fearful of losing her.  But each day she gets stronger.  And each day I am reminded of how very precious life is.  How very precious is the gift we are given.  We need to support and love each other, even through the tough times, even if relationship dynamics change, even though we are miles apart.  Family is so very important.  As we appreciate them, we also have to honor and care for ourselves.  It is out duty to take care of the one body that will support us through this short precious gift of life.

CHEATING:  Have I?  Well, [blush], yes, on 3 occasions since starting HMR.  I found I was perseverating on two specific cravings: buttered popcorn and Cabernet,... and always on a Saturday night.  So I gave in a few times.  My HMR Educator reminds us that if we do cheat, or go "outside of the box" as the catch phrase is in HMR, we will be in Phase I longer, and I really don't want to be in Phase I of this diet forever.  I want to stay "in the box" so that I can move on to the next phase of the plan sooner, and enjoy more foods.  Even though I lost weight on the weeks that I did cheat, I could have lost even more if I was "in the box".  I am happy to report I have not cheated once during the past week and a half.   

WEIGHT LOSS RESULTS:  I almost forgot!  Here is my progress since starting the HMR program:

Day/Date:
Weight (pounds):
Amount Lost:
Total Amount Lost:
Monday, 10/08/12
213.9
n/a
n/a
Thursday, 10/11/12
211.0
2.9
2.9
Thursday, 10/18/12
209.2
1.8
4.7
Thursday, 10/25/12
204.0
5.2
9.9
Thursday, 11/01/12
203.4
0.6
10.5
Thursday, 11/08/12
198.4
5.0
15.5
Thursday, 11/15/12
197.6
0.8
16.3
Thursday, 11/22/12
194.6
3.0
19.3
Thursday, 11/29/12
194.0
0.6
19.9
Thursday, 12/06/12
192.2
1.8
21.7
Thursday, 12/13/12
190.6
1.6
23.3
Thursday, 12/20/12
188.8
1.8
25.1
Thursday, 12/27/12
185.4
3.4
28.5

Prior to starting on the HMR Program, I lost weight through other means, including Weight Watchers, Clean Eating, juicing, healthy eating on my own, and liposuction.  It was so easy to put on weight over the years.  I was averaging 10 lbs a year or so since about the time I got married in 2000, and had been on a slower gain prior to that.  When I began my second bout of grad school in 2005, I decided to join Weight Watchers just so I could hope to maintain during that stressful period of time.  Rather than maintain, I did end up gaining 10 lbs, but that was over the course of 4-5 years (rather than 10 lbs per year), so WW was successful at helping me slow down the weight progression.  And I made some good friends through an online support forum.  (Hi Dimers!)

I thought that once I completed my doctorate degree in 2010, weight loss would come easier.  However, I soon realized the study madness was just beginning, as I dealt with the nightmare that psychologists call licensure (and EPPP, CPSE, and all the stressful months of preparation that go along with that).  My graduation present to myself was a large volume liposuction procedure that helped even out a very disproportionate body shape.  I dropped 10+ pounds from the procedure, but the way it made me feel was transforming!  It really helped to jump start my weight loss journey.  Here is a recap of the weight lost since then:       


Day/Date:
Weight (pounds):
Total Amount Lost:
Wednesday, 10/06/10
245.2
-
Thursday, 12/27/12
185.4
59.8
    
My Journey, I feel, is just beginning.  I have a long way to go, but also appreciate where I've been.  I am excited for the future on so many levels.

Love to you all!  Take care of yourselves!  

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Saturday, November 10, 2012

Down Another 5 lbs!


I am in the process of getting ready to travel back to the Midwest for a few weeks to spend time with family and friends, and in celebration of Thanksgiving.  But I had to take a minute away from packing to share my good news:

At weigh-in on Thursday, I lost another 5 pounds!  Coupled with the 0.6 from the week before, that is a total of 15.5 lbs down since I started the HMR plan!
I am now officially under 200 lbs and in ONE-derland!  Feels great!

Okay, I've got to get back to the packing.  I will post again as soon as I am able!

Enjoy your Saturday!


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Saturday, October 27, 2012

Down Another 5.2 lbs!

Thursday's weigh-in was much more positive than last week's!  I was down another 5.2 pounds in the week, for a total of 9.9 lbs in 17 days.  Nothing succeeds like success!  It sure helps to see the scale moving in the right direction!
I am starting Day #20 and have been religiously journaling my number of shakes/oatmeal packets and entrees consumed, as well as physical activity (PA) calories burned.  I am staying "in the box" daily, meaning NO cheating by eating foods outside of the program.  That is really important during Phase I, even during the holidays.  There is a zero tolerance for cheating.  If you want the program to work, you will live by the rules.  It really is that simple.

Weekly Meeting: During Thursday's clinic visit, the nurse took labs and blood pressure readings.  (Mine was 110/70 sitting and 108/84 standing; so much better than my pre-atenolol BP.)  The interactive meeting portion was fairly short as participants did not have a whole lot to process.  I glanced at the wipe board in the front of the room, where everyone had entered their statistics, and noticed the weight losses for the week, which was anywhere over one pound, to over 5 pounds; total weight losses ranged from about 10 to over 70 pounds.  Nobody at the meeting was maintaining or gaining.  Everyone was finding success on this program.  That alone was encouraging!  We sampled a thick chocolate peanut butter shake, which was quite tasty.

Phase II:  At Thursday's meeting, we also watched a short video about clients who were in Phase II of the program.  One woman from the dvd was participating in the diet for the second time, as she decided not to enter into Phase II the first time through.  She felt by that time she had lost the weight she wanted and could do this on her own.  She lost about 40 lbs during Phase I but gained about 20 back after she quit.  Those that agreed to enter the gradual step-down of Phase II were much more successful.  In fact, our educator advised, "research shows that if you don't gain for at least 2 months after Phase I ends", you are much less likely to gain a substantial portion of the weight back.  Phase II was considered to be even more important than Phase I.  It's not to say that losing the substantial portion of weight in Phase I isn't important.  However, gradually adding in regular, healthy foods over the course of the next year, along with utilizing meal replacements really served to help anchor in the habits necessary to maintain long-term behavioral and lifestyle changes.    

I have enjoyed a few more recipes this week:

Last night I tried the Pistachio Mousse!  That was a refreshing dessert!
The night before, I added some Bourbon Vanilla extract, along with cinnamon, nutmeg, and pumpkin spice for a thick holiday shake.  This one was also very tasty!  Although one of the benefits of the HMR's Decision Free Diet Program is that you don't have to think much about the menu choices, preparation, or options during the first phase.  At the same time, it leaves room for being creative with the shakes and entrees if you so choose.

Recap on the HMR Program:
The HMR Program offers several options for people.  There are the Clinic Programs, for people who live nearby one of the hospitals or clinics that offer this program.  Through the clinic programs, the programs offered are the Decision Free option, such as what I am participating in.  This option is for people who are trying to lose a significant amount of weight.  The average weight loss on this program is about 50-60 pounds, but many people lose over 100 pounds.  If you choose this option, you must be near one of the participating medical hospitals or clinics, as weekly monitoring is required.  The HMR Healthy Solutions Diet is another option for people who want to lose a significant amount of weight without the need for medical supervision.  (Medical monitoring may still be required for people with serious medical conditions or for those taking medications for diabetes.)  This program is fairly similar with the exception of adding fruits and vegetables during Phase I.  Participants of this program lose an average of 35-40 pounds.       

If you do not live anywhere near one of the participating clinics but still want to participate in an HMR weight loss program, don't fret!  HMR offers an At Home program.  The diet kit and food get delivered to your door, every other week.  I am not sure what the statistics of weight loss are for the At Home program.  However, I do know that no matter what program people choose (HMR Clinic Program, At Home Program, Weight Watchers, etc.), if you are so motivated, you CAN and WILL lose weight!  I highly encourage anyone who participates in the At Home program to take advantage of the supports and behavioral components.

That is about all I have for now, as I have to move on with my day's agenda.  In a future blog, I will discuss some of the research out there about the importance of social and behavioral supports.    

Enjoy your Saturday! 

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Sunday, October 21, 2012

Day 14: Not So Deprived,...

Nothing says "diet" like Cheesecake Mousse (lol)!  

I found this one in the HMR Recipe book.  The ingredients call for one packet of HMR 800 Vanilla protein shake mix, 6-8 oz water, 8 ice cubes, and 6 tsp of sugar-free cheesecake pudding mix.  I don't have a food processor so I chopped up the ice as much as I could in the blender with a little water.  Then I added the rest of the ingredients.  This was a bit of a decadent treat as far as diet food is concerned.  

Yesterday evening I tried a new entree I hadn't tasted yet,...
Pasta Fagioli!  At only 210 calories, this "traditional hearty mix of penne pasta, beans, carrots, and tomatoes in a savory brown sauce" made a delicious dinner with just the right mix of textures and flavors!

So I am feeling less in a funk than I was a couple of days ago.  I allowed myself to eat more when I was hungry and reached out for support when feeling like I wanted to throw in the towel.  Today I am once again feeling pretty positive about this program, and about making healthy choices for myself.

I wanted to share a few inspirational videos from YouTube re: testimonials:

Karen Johnson, a nurse at Bellin Hospital (WI), lost 73 lbs and cut her cholesterol numbers in about half! 

She no longer takes cholesterol medicines.  Her advice to others: "You have to take care of yourself.  Put yourself forward and in the front.  The more you're able to take care of yourself, the more everything else falls into place." 

Nat, age 42 years, had a heart attack at 38 years of age.  He lost a total of 70 lbs on the HMR program over the course of 4 months, and successfully avoided weight loss surgery.



Michelle also lost 73 pounds:


Teenager, Kyle, lost over 80 pounds:


Finally, Tim lost 186 pounds in 14 months.  He is no longer borderline diabetic and no longer has to use his sleep apnea machine:


I hope these videos are inspirational for anyone considering the program.  (They inspired me!)  Well, I am off to have some lunch and then get some physical activity points in.  It looks like a beautiful 70 degree day in the Central Valley area and I am going to take advantage of this weather!

Have a peaceful Sunday! 
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Friday, October 19, 2012

Day 12: Weigh-In & Research

According to yesterday's weigh-in, I lost another 1.8 lbs, for a grand 11 day weight loss total of 4.7 lbs.  So I should, by all accounts, be happy that the scale is moving in the right direction.  However, I find that I am in a Day-Twelve Funk.  I know that I need to look at the results on a larger scale than a week-by-week numbers game, especially knowing that there will be natural times during the month when the weight will not come off as fast, and in fact may plateau or even show a gain.  This is a normal part of the process.  Even so, I find myself thinking "I should be losing more than 1.8 lbs in a week on this plan.  I could lose that amount on my own".  I am just not as jazzed today about the program as I was days ago.  Ironically, my friend who is also doing this plan went through something very similar on day twelve.  It is really a gift to have a friend going through the same program.  She can relate to what I am going through and has been a good support.  We support each other.  My friend had the courage to reach out and seek support when she went through a rough day.  That gave me permission to do the same.  The benefits of the buddy-system should not be underestimated!           

So this is my plan of action: I need to eat more if I feel hungry.  I encounter a real fear of doing so.  At the same time, if I don't, my body's metabolism might start to slow down and my behavior of restricting will actually work against me.  I have plenty of options.  I just need to follow through on the behavior. 
(Plenty of options.)
Yesterday's meeting went well.  The homework is as follows: 1.) Sample an HMR chicken soup mixed with an entree on my most challenging day.  I wrote in my food journal that I will do this on Sunday.  The nutritionist passed out samples of one of the entrees (Chicken Creole, I believe) blended with the chicken soup mix and served as a hearty soup.  It really was rich and filling - quite good.  I might try that on Sunday.

Every week the group leader discusses some related research.  For example, last night we discussed a brief overview of a study published in the American Journal of Clinical Nutrition (1999) in which 24 women, between the ages of 20-45, ate breakfast, lunch, and dinner in a laboratory one day per week for a month.  The gist of the results: Those that ate soup before lunch consumed less calories overall.  I looked up the actual journal article online to review the methodology, results, and discussion sections.  Participants were divided into 4 different groups: A control group that did not eat a snack before lunch, and 3 other groups that ate  "pre-load" snacks of the same calorie content before lunch.
  • Control Group: No snack pre-load
  • Snack Group 1: Chicken Rice Casserole
  • Snack Group 2: Chicken Rice Casserole and a glass of water
  • Snack Group 3: Chicken Rice Casserole made as a soup
As expected, individuals in the control group ate more at lunch than those in any of the three snack groups.  What was a bit more surprising was that those individuals who ate the chicken rice casserole made into a soup ate 446 fewer calories at lunch, on average, than did their peers in the other two snack groups. Subjects did not compensate at dinner for this reduction in lunch intake.  While the sample size was low, the results were still interesting and notable.

The authors concluded that "consuming foods with a high water content more effectively reduced subsequent energy intake than did drinking water with food".  The authors discussed how food mixed with water appears to increase the level of satiety as opposed to water served with the food (but not as part of the food).  They suggest that it is possible that the water added to the food changes the weight & volume of the food, and therefore the dispersion of nutrient content; this might somehow activate mechanisms involved in hunger.  Water alone may tend to activate thirst mechanisms.  The full research article, titled "Water incorporated into a food but not served with a food decreases energy intake in lean women" can be located here

The second homework assignment was to "sample 2 bouts of physical activity (PA) for at least 10 minutes each" in one day.  Those people who are already getting in 2 different types of activity per day were asked to either add to the time, or add a 3rd activity.

Well, I'm starting to feel my groove coming back.  I have to run as a friend is going to stop by and bring my bicycle to the shop to be repaired.  Looking forward to getting back on the bike trails!

Keep the momentum and have a healthy, happy Friday!  


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Thursday, October 18, 2012

Week 2 Continued: Most Effective Interventions,...

 I always love the dramatic sunsets that liven up my drive home from work!

Days 2 & 3 of week two have been uneventful.  I am starting to feel like the HMR program is just part of my usual routine already.  I am building confidence that I can incorporate phase I of this program into my life for 14 (now 13) weeks.  But I do maintain a dose of skepticism: Will I feel the same way at week 4?  Week 8?  Week 10?

Tomorrow evening is my second official meeting at the clinic.  I am actually looking forward to the weekly meeting, nurse consult, and weigh in, believe it or not.  I am not yet used to the Monday morning call in, which is required before 10:30am.  I had early morning meetings and forgot to fit it in, so I ended up checking in late via phone and email that day.  Aside from the nutritional component, this program utilizes a comprehensive behavioral approach to weight loss.  In fact, it incorporates the 2012 recommendations of the U.S. Preventative Services Task Force (USPSTF) for the effective treatment of obesity: 
"The USPSTF found that the most effective interventions were comprehensive and were of high intensity (12 to 26 sessions in a year). Although the USPSTF could not determine the effectiveness of other specific intervention components, most of the higher-intensity behavioral interventions included multiple behavioral management activities, such as group sessions, individual sessions, setting weight-loss goals, improving diet or nutrition, physical activity sessions, addressing barriers to change, active use of self-monitoring, and strategizing how to maintain lifestyle changes.Weight-loss outcomes improved when interventions involved more sessions (12 to 26 sessions in the first year)." (Retrieved October 17, 2012 from http://www.uspreventiveservicestaskforce.org/uspstf11/obeseadult/obesers.htm.)
As much as I may not want to go meetings on a regular basis or pick up that phone on Monday to check in, I know, as a psychologist, that I, too, need to give in and comply with treatment if I want this intervention to be successful.  I am very motivated to do so right now.
 Well, it's late and appears to be "tuck time", according to my crew.  Time to call it a day.

May you have a restful sleep and a morning full of pep!     

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