Week 4 has come to an end and Esther has lost another 2 pounds! Her weight is now 142. She even made it through her family’s Greek BBQ with flying colors. She was carefully watched by her family who is aware of her weight loss attempts.

Interview with Esther:
Martha: Did you encounter any barriers this week when it came to your weight loss plan?
Esther: Several things. I had PMS -which makes me really tired and crave sweets. Getting to the gym was a struggle on some days (but I still did it!). In addition, you’ll see on my food log that I gave in to my sweets craving several times. I had a couple nights where I ate out. Eating out is always difficult for me.  I felt like I handled them quite well.

Martha: So how did you handle the BBQ? Did my tips help you at all?
Esther: Your tips definitely helped. I enlisted the support of  my family. My cousin Esther is also watching her weight so we watched each other. (Martha - the two “dieting Esthers”!) I started to waiver when the fresh apple pie came out with three different kinds of ice cream. It got to the point that I was staring at my cousin Robert’s 2 mini marshmallows left on his plate from his Rocky Road ice cream. He did me the favor an ate them before I could!!  My brother then got firm and told me to stop obessing ( I was staring at the pie considering trying to take the uneven piece staring at me). My cousin Steve came to the rescue and took me for a walk down the block !!!  (Pic is of Esther at the BBQ)

Martha: Do you see any potentional problem situations for the upcoming week?
Esther: I’m going to the Hamptons with a friend, Nadine,  from Wed night until Friday night.
We are going to bring healthy food and are only going to dinner one night so that will be the one cheat. I am also having lunch with my family at a Greek Restaurant on Sunday so will have to stay away from some of my favorites or only get tastes and eat a healthy course.

Did Esther meet her goals from last week?:

Four days from Esther’s food records:

Friday June 13 (out with friends)
Breakfast
coffee
raisin bread w/ tsp peanut butter tsp fresh jam
Lunch:
Special K cereal 140 cal
bare naked cereal 180 cal
fresh berries
skim milk
Dinner:
2 glasses white wine
fresh carrots, radishes
olives (plain sm green)
1/2 pita bread w/ cheese
salad with very little dressing
1 1/2 stuffed grape leaves 
1 lamb skewer grilled 
2 oreo cookies 
2 snackwell cookies 

Sunday, June 14 (at BBQ)
Breakfast:
iced coffee
half a bialy with nova and a tbspoon of cream cheese
one small cheese w/ egg greek thing ( no breading )
some fruit salad !
BBQ
perrier with lime ( NO ALCOHOL)
3 pieces of cheese
4 Israeli pickles
mixed salad w/ oil & vinegar
2 lamb shish kebob skewers
one spoon pasta salad ( sm spoon)
one spoon orzo salad ( sm spoon)
one piece greek meats ( inards ) grilled
plate of fruit salad

Monday June 9
Breakfast
coffee   
2% cottage cheese 4 oz   
1/2 banana   
Lunch:
cucumber, tomato olive oil & vinegar   
3 pieces turkey
Dinner:   
homemade coleslaw, light mayo, white vinegar   
1/4 roasted chicken   
watermelon   

Wednesday June 11  
Breakfast
iced coffee    
2% cottage cheese 4 oz  
Lunch  
homemade coleslaw lite mayo, white vinegar    
1 piece chicken thigh + drumstick    
water   
Dinner: 
1/2 portion seaweed salad    
4 pieces sashimi    
1 piece eel sushi    
1 piece spicy scallop sushi, 1 piece sp tuna sashimi    
6 pieces sashimi roll w/cucumber
1 oreo cookie    PMS
1 snackwells cookie PMS
3 prunes
130 calories of part skim milk

My comments on Esther’s food records:
1. It was difficult to estimate some of your calories as I am not sure of the portion sizes nor am I aware of the ingredients. But I would estimate that you averaged 1500-1600 calories.
2. I noticed that you had several really low calorie days (~ 700 calories). While I generally don’t recommend really low calorie days, it is a way to help offset those days where you eat a little too much. However you don’t want to get in the habit of feasting and then starving. But I think what you did this week was fine. Check out my previous post on recovery days.
3. I see that you had PMS cravings as you had more sweets this week. But to your credit, you kept your portion sizes of sweets really small. Good job! Check out my previous post on PMS cravings.
4. I didn’t see too many healthy afternoon snacks…
5. That diet coleslaw you made is a great idea - low cal and filling!

Esthers goals for this week:
1. Once again, aim for 1300 - 1400 calories
2. 2 personal training sessions, one pilates, 3 cardio and as much walking as possible
3. 2 alcoholic beverages this week
4. Continue to be very careful with eating out
5. Plan healthy afternoon snacks
6. You have identified 2 potentional problem situations for the upcoming week. Continue to enlist your family’s support for the Sunday brunch. It sounds like you and your friend Nadine already have a good plan for the Hamptons.

Keep up the great work!

Related posts

• Esther’s Weight Loss Journey: Progress Report #3 (3)
• Esther’s Weight Loss Journey Progress Report #5 (0)
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• Esther’s Weight Loss Journey:Progress Report #7 (0)

“I am too busy to eat right”. I hear this all the time. Trying to fit in work, family, exercise, dating, spending time with friends, etc., can be a daunting task. While a hectic schedule can make eating healthy more difficult, it can be done with a little know how and planning.

Top 6 Tips for Healthy Eating on the Run

• Start your day off with a good breakfast. It may be the one meal of the day that you have total control over. The ideal breakfast is one that contains protein and fiber rich carbs. This will provide your body with the nutrients it needs.
  Examples of quick healthy breakfasts:
  -Whole grain cereal with non fat or 1% milk
  -Oatmeal (instant is ok) with fruit
  -Cottage cheese and fruit
  -Yogurt, fresh fruit and ½ whole grain cereal  (better to make    your own than buy the premade parfaits)
  -PB on whole wheat toast
  -Deli: egg whites or egg on whole wheat bread

• Keep your environment stocked with easy to prepare meals and snacks. Stock your office or home  with healthy foods in case you  do not have time for a real meal or need an afternoon  pick-me-up. 
  Suggestions: nuts, nut butter, whole grain crackers and bread, whole grain cold cereal and packs of instant oatmeal, dried and fresh fruit, yogurt, string cheese, laughing cow cheese, cottage cheese. You may also be less likely to grab a chocolate from your co-workers desk if you know you have a healthy snack waiting for you (or maybe not….)

• Plan ahead. Your best bet is to bring lunch from home so you can control the ingredients.  If that is not an option, you will need to make an effort to find places that have healthy take out foods for lunch and dinner. Since the average person tends to frequent the same few restaurants on most days, find those that have healthy options.
  Suggestions for lunch:
  -Turkey or grilled chicken on whole grain bread
  -Salad with lean protein and low fat dressing
  - ½ sandwich and small broth based soup
  - 2 sushi rolls

• Do not go too long without eating. This will lead to low blood  sugar, decreased energy levels, cravings and decreased motivation to watch what you eat. When you are REALLY hungry, what do you crave – the apple sitting on your desk or junk from the vending machine? Most of us crave junk when we get low blood sugar. Keep healthy snacks on hand. Try not to let more than 4 hours go by without a little snack.

• Keep a large water bottle on your desk. Tell yourself you have to drink at least 48 oz. by the end of the day. Most of us do not drink enough fluid. Having a hectic schedule makes it even harder to remember to drink. Being dehydrated can lead to headaches, low energy levels, “false hunger” (we think we are hungry but we are really dehydrated) and poor energy levels for our workouts.

• No time to cook dinner….find healthy alternatives
  Most city girls (and guys) I know have little time to cook. “Dialing for dinner” becomes routine. Take-out food can be loaded with calories and fat.
  Suggestions for healthy take-out dinners ( I will post more along with the nutritional content within a few weeks):
  -Chinese: steamed chicken, shrimp, tofu or scallops and veggies,
  -Rotissere chicken, ½ baked potato and steamed veggies
  -Japanese: 2 rolls and soup or salad or one roll and 5 sashimi and soup or salad
  -Middle Eastern: chicken kabobs and salad, piece of pita bread
  -Frozen dinner under 350 calories and salad
  -Fresh Direct under 500 calorie meals
  -Salad with grilled chicken (add your own lowfat dressing)

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Polycystic ovarian sydrome (PCOS) is the most common abnormal hormonal condition of women of reproductive age and is the number one cause of infertility. It affects 7-10% of all women. Unfortunately, many women who have it do not know they have it. The diagnosis often slips by physicians as the condition can be tricky to diagnose. I have been specializing in PCOS for the past 8 years and often have the opportunity to help a woman get diagnosed with this condition. This will enable them to get the proper treatment.

Allison was a 30 year old female who came to my office seeking help in losing weight. She had experienced a rapid 30 pound weight gain in college which she has still not been able to lose. Allison reported sugar cravings, mood swings and carbohydrate cravings. She has tried many different diets but none have worked for her.

I obtained Allison’s diet history. Her diet was very low in fat and fairly high in carbs. She indulged her sugar cravings at least once a day. Her caloric intake was approximately 1700 calories a day. She was trying to exercise 2-3 times a week…when she was not too tired.

I frequently ask women who are overweight (especially in the abdominal area) about their menstrual history. It turns out the Allison had irregular periods and was put on the birth control pill in college. I also asked her if she had any symtoms of excessive hair growth - which she did. She said she thought the hair was due to her Italian ethnicity. Irregular periods, rapid weight gain and excessive hair growth (hirsuitism) can be symptoms of PCOS.

Problems:

1. I suspected Allison had PCOS. This could contribute towards her weight gain and difficulty losing weight, carb cravings and mood swings. It can also increase risk of diabetes, heart disease and endometrial cancer if not treated. I had Allison take a PCOS quiz. While this is not a “diagnositic” test, it is a useful tool to suggest a diagnosis of pcos.

2. Allison’s diet was too high in processed carbs and too low in protein and heart healthy fats and fiber.

3. She often went too long without eating. This contributed towards low energy levels, carb cravings and overeating at the next meal.

4. Allison was not exercising on a regular basis.

Solutions:

1. I gave Allison the names of several endocrinologists who specialize in PCOS. She met with one of them and was diagnosed with PCOS. She was relieved to know there was a reason for her difficulty losing weight, excessive hair growth and low energy levels / carb cravings.

2. I provided her with information on PCOS and insulin resistance. I also discussed the importance of a healthy diet in treating PCOS.

3. I explained that she would likely feel better and have more success in losing weight if she moderated her carbohydrate intake, selected lower glycemic index carbs and ate more frequent mini meals that included a high fiber carb, protein and fat. For example, snack on peanut butter and whole grain crackers rather than 2 hundred calorie packs of fat free cookies.

4. Increase her exercise to 4 times a week. In addition, I recommended that she walk to work (2 miles) at least 3 times a week. I explained the benefits of increasing physical activity: burning calories, speeding metabolism, stress management, lowering insulin levels, etc.

5. Keep a food record recording what she ate, the time she ate and how she felt. In additon to helping her keep track of her calories, this also showed her which meals made her feel better.

6. I also stressed the importance of calorie control. I often see people who think they can eat almost unlimited food as long as their carb intake is low. I recommended 1400 calories a day for Allison.

The good news, I have been meeting with Allison for follow-up appointments every 2 weeks. She has been able to lose 8 pounds in 7 weeks. She feels much more energetic and had fewer carb cravings. She has been meeting her exercise goals and says she feels like a new person.

Check out my website for more references on PCOS

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One of the biggest complaints I hear from my clients is ”I do not have time to eat right”. I realize how difficult it is to find the time to plan healthy meals when you are constantly on the run. However, if you want to lose weight and optimize your health,  you will need to make eating right a priority. Make sure your apartment is stocked with healthy foods that can be made into quick meals or snacks. Treat your meals almost like medications and make sure you eat something (mini meal or snack) every few hours. Once you get low blood sugar, it is likely that you will be looking for something sweet or starchy to eat versus the apple you originally planned to eat for a snack.

Sue is one of my new clients who was interesting losing 15 pounds as well as increasing her energy levels. She is a stay at home mom with a hectic schedule. Being the mother of 3 children, she is always on the go. Dropping kids off, picking them up, feeding them, helping with homework, doing housework, she rarely makes time to make herself meals. As a result, Sue does not eat a real lunch and ends up picking at her kids lunch or just snacking during the day. Sue did not think she was eating that much and could not understand why she could not lose weight. I had Sue keep a detailed food record which included what she ate as well as the time she ate. It revealed her diet was very low in protein and veggies and high in processed carbs (ie. pretzels, sugar free cookies). It also showed she often went more than 6 hours between meals.

Here were her problems:

1. She was not eating a balanced lunch that contained protein, fat and carbs. Balanced meals help keep the blood sugar more level. This will improve energy levels as well as help control the urge to snack. In addition, balanced meals will improve the nutritional content of the diet. What you eat for lunch is especially important as it will carry you through the rest of the afternoon. Afternoon is a particularly dangerous time for many “snackers”.

2. She was going too long without eating. This contributed towards low energy levels and a decreased willpower to avoid her kids snacks.

3. The calories from snacks ended up being over 600 calories. This is more calories than a real lunch would be. In addition, most of her snacks were from processed foods (i.e pretzels, cookies)

My suggestions:

1. Plan a balanced lunch that contains adequate protein, fat and carbs. For example, make a sandwich on whole grain bread, open a can of lentil soup, pick up a take-out salad with grilled chicken, veggies and kidney beans.

2. Eat lunch by 1:30. Waiting too long to eat will cause excessive hunger and will likely result in inappropriate food choices later in the afternoon.

3. Stock up on healthy foods that can be made into a quick lunch.

4. Be aware of healthy take-out choices in the neighborhood or on the way home from errands. Healthy take-out can be a good option if you do not have the time or right foods available to make lunch. More on take-out food later….

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