By Maria Fleet
When it comes to weight management, if we want to be successful, we can’t wing it or improvise on our own. Dr. Dawn Smiley-Byrd, an endocrinologist who practices in and around Atlanta, GA, says it’s important to have a solid plan – one worked out with a doctor, and revised as time goes on. That can help when life’s distractions pull us away from our weight loss goals. Even our own bodies, she says, can interfere with these goals.
Dr. Smiley-Byrd’s specialty puts hormones at the center of her work with patients and their weight loss objectives. Hormones are key in understanding how our bodies use calories. Unfortunately, when we try to lose weight, our bodies actually rebel against us, in a way. Through complex biological mechanisms that doctors are understanding better and better, our bodies try to hold on to the weight. Dr Smiley-Byrd says her patients sometimes experience weight regain as a lack of their own willpower. They don’t realize what’s happening has a scientific explanation. “There’s a true physiologic mechanism underlying this. Every time we lose weight, our body is working against us to regain that set weight,” Dr. Smiley-Byrd explains.
There are three important things going on in the background as soon as we start cutting back on food. An appetite-stimulating hormone, ghrelin, starts to increase, and at the same time, other hormones that suppress appetite gradually decline. “Ghrelin is a very powerful hormone, and that’s going to cause us to snack more, to feel hungry.” Third, our metabolism slows down when we restrict calories. These are powerful methods the body has to try to keep itself alive at a time when it detects food may be in short supply. Dr. Smiley-Byrd says when she explains these mechanisms to her patients, they’re stunned. “It’s not just a sigh of relief. It’s a shock. They’re like, ‘Wow, I didn’t know that that was happening in the backdrop,’” she says.
She recommends a robust plan to go up against these biological forces competing against us. To help her patients devise a plan to counteract this unyielding bit of biology, Dr. Smiley-Byrd quizzes her patients about what they are doing, and what has worked for them before, and even what hasn’t worked. She asks about what medications they take, and what supplements they use. She recommends that they keep a food journal and share it with her, because that’s how she can really zero in on where changes can be made. “You’d be surprised at the amount of sugar we could cut just by taking out a soda pop or two,” she says. Another hidden source of extra sugar is fruit juice, which ”has a lot of calories and a lot of sugar,” she reminds her patients. A better substitute is to eat the whole fruit, which includes fiber and slows the rate at which the sugar is absorbed.
Just as weight gain didn’t happen overnight, weight loss won’t either – but our decisions throughout the day can make a difference, if we set an intention in advance. Parking a little further away from our destination will help us get in some extra steps. Taking the stairs instead of the elevator will give us a short aerobic workout. Getting up from our desks every so often – or even using a standing desk – can keep us moving more during the day. These are all small things, but if we can maintain them, eventually they become automatically woven into our lifestyle in a way that becomes permanent.
The strongest partner in figuring out a plan to get around the biological obstacles that we KNOW are coming is, in fact, our doctor. “When we look at data over the years, we know that patients are certainly more successful when they partner with their health care provider. So that would be the first step,” says Dr. Smiley-Bird. For some people, talking to their doctor can be an obstacle in itself. Dr. Smiley-Byrd understands that it can be intimidating to bring up our weight at the doctor’s office. Here again – planning in advance will make a difference. “One of the things that you can do is get in front of the mirror and practice, practice those things that you really want to ask,” she says.
Another thing she recommends is to set up an appointment specifically to address questions about managing weight. Her prescription: “Make an appointment for just this conversation alone, with nothing else involved, so that you can have a one-on-one conversation about your weight, the journey that you’ve been on and where you’d like to go.” Knowing that managing excess weight is the focus of the appointment, the doctor will also be prepared to discuss all the options available – from meal planning, to exercise, to medication and surgery, if warranted.
The most important thing that Dr. Smiley-Byrd wants people reading this to know about managing their weight is that it’s achievable. Doctors now have a better understanding of how our bodies respond to changes in our lifestyle and diet, and they can help patients prepare for, and handle, setbacks. “At the end of the day, it is hard work, but I want people to be encouraged and know that this is doable,” she emphasizes. Partnering up with a doctor and forging a plan together can make all the difference.
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