Tired of a one-size-fits-all approach to dieting? In “The Real You Diet,” nutrition expert Madelyn Fernstrom helps you come up with a weight-loss plan that works for your unique body and lifestyle. An excerpt.
Chapter 2: Size Yourself Up — How to Create Your BEAM Box The Real You plan is based on knowing what you are both willing and able to do to sustain a long-term commitment to weight control. That’s what building a BEAM Box is all about. Your personal toolbox will be selected from the four-point BEAM foundation, with all points equally essential for real-life weight control. In the four chapters that follow this one, I’ll lay out these tools for you to pick and choose what feels right for you. Don’t expect your combination of tools to be identical to those of your friends, or even of your closest loved ones. You want to find the perfect fit to meet your needs both for now and for the future, when (not if!) you need a change in your plan. Only a personally tailored plan that meets your own needs will give you the confidence and commitment needed to lose weight and keep it off.
Ten Steps to Building Your BEAM Box It all starts with baby steps. I’ve laid out ten basic steps to get you started on building your BEAM Box.
While I suggest a few general time guidelines in some of the steps, there’s no rush or pressure to get through any of them. Many people can complete the ten steps in six to eight weeks, but I want you to rely on your internal timer. Some steps you’ll breeze right through, and others may take more time. What’s most important is following each step until you feel confident that you’ve mastered it, and only then moving on to the next one.
1. Discover the real you. Evaluate yourself by taking all four mini-quizzes in this chapter. Your score will determine what tools you will need and where you need to focus particular effort. Everyone is unique and has a different starting point. You might already have the right tools in one area but need more help with another. You may want a fresh start and need to build a foundation from the ground up.
2. Visit your doctor. If you haven’t seen your primary care doctor (or gynecologist) in the past six months, schedule a visit. No primary care doctor? Talk with your friends and family to find one. Check with your insurance company for a complete listing of physicians in your network.
3. Upgrade your equipment. Purchase a simple pedometer (no talking, calories, or strides required) that just counts steps. Accusplit (www.accusplit.com) is one that meets my three criteria for a pedometer: it’s economical, easy to use, and accurate. If you want to invest more money, go ahead and select a more elaborate model, but it’s not a must-have to track your activity. The most important thing is to wear it every day.
Get a reliable home scale. You’ll want a digital model, one that is economical and only indicates weight. No need to spend extra (unless you want to) for body fat, muscle mass, or other measures that don’t change quickly. These add on a lot of cost, for marginal return. If your scale records all different weights depending on where you have it placed in your bathroom, or you’re squinting to look at a needle on a nondigital scale, it’s definitely time for a new scale.
4. Pick the tools for your BEAM Box. Review all the tools described in each of the four BEAM chapters (or consult the quick list in appendix C) and pick some tools from each group that immediately interest you. Write them down, and review them daily. Scan the list for those that jump out at you as tools you are both willing and able to try. It’s also worthwhile to take a look at the Fernstrom Fundamentals to stay connected for daily inspiration. They are listed briefly at the end of this chapter and explained in more depth in chapter 3.
5. Get started! Chapter 7 lays out a 21-day plan with activity goals and meal plans. A starting to-do list will help you call upon all four points of your BEAM Box foundation. Here is where you will begin to put your tools to work for you.
The first seven days of the Real You plan are meant to help you form new habits, and the next fourteen days are geared toward sustaining those habits. As you implement the 21 days of your Real You eating plan, you will begin to discover which tools are working for you and which ones you might want to change.
6. Form new habits. Evaluate your first seven days on the plan. If you feel you can maintain the changes you’ve made and you like your lifestyle selections, then don’t change anything. Stick with what you have and see if you can maintain these healthy changes for another two weeks. You can get more eating ideas from the next fourteen days of meal plans or simply continue with your choices from the first seven days. That’s three weeks with your BEAM Box — the time it takes to form a new set of habits.
7. Sticking to it. If you have not lost at least 3 pounds by the end of three weeks, don’t panic. Take the quizzes in this chapter again. See if there are any areas where you feel vulnerable, and choose more tools from that specific area. Do a little “reverse calorie counting ” (see chapter 4 ) and trim 200 calories per day from your current eating plan. Keep wearing your pedometer, and aim to increase your total steps by 1,000 every day. Haven’t yet made an appointment with your doctor, or still haven’t found one? Do it now. You may be facing some unknown medical/biological issues that are sabotaging even your best efforts.
8. Keep things interesting. Start bartering and exchanging within the food categories to avoid getting bored or disengaged while staying consistent in your calorie intake, If you’re still happy with your original plan, there’s no need to change until you feel like it.
9. Stay active. Review your physical activity plan. Make sure you are maintaining thirty minutes of “daily living activities.” Aim to add a planned aerobic/cardio activity or strength training at least once a week if you haven’t already done so.
10. Evaluate your success. Take a look at the rate of weight loss you have achieved from using your present BEAM Box. If you haven’t lost at least 5 pounds in the past six weeks, talk to your health provider about possible biological hidden causes of weight gain. Evaluate whether your lifestyle log has been converted to your “mental database.” That’s the point where you feel you’ve mastered the foundation of your lifestyle and you no longer need to keep a daily written log.
Maintain and Sustain for Life Your new eating and activity plan is now a lifestyle. You’ve mentally ingrained your own BEAM Box, and your responses are automatic. From this time on, revisit your BEAM Box every two weeks. Make sure you weigh yourself at least once a week, but not more often than once a day. Check to make sure you are not bored with your food choices and are maintaining structure. Make sure your activity level is consistent and you’re getting at least thirty minutes of daily living activity, with vigorous activity two or more times a week. (“Vigorous” means you’re using enough energy that you can’t talk while doing the activity.)
At the end of eight weeks, or whatever time period you feel comfortable with, you should be reasonably confident that your BEAM Box is filled with the essential tools that work for you. While you can add and switch tools in all categories, you’ve done the hard work to establish the foundation of good health. You have your “workhorse ” tools for every day, and then the tools you pull out now and then. When you feel stalled, or need a change, go back to “boot camp,” where you can revisit and adapt your BEAM Box to reflect your current needs.
When to Consider Using Power Tools While your BEAM Box is the foundation of your healthy lifestyle plan, you may need to think about adding the power tools of prescription medication and/or surgery to support your lifestyle effort. Your first step must always be to accept that these power tools can support, but not replace, the lifestyle effort. Medication and surgery may be the missing tools for your BEAM Box. Months 3 to 6: Interested in prescription medications? Review chapter 8 to see if you meet the medical criteria for medications, and if the action of these medicines meets both your medical needs and your eating style. A visit to your doctor will help you evaluate this next step. (Important note: If you are not a candidate for medication, and your body mass index [BMI] is 40 or over, you can go directly to considering a surgical option for more help. Check out appendix A to learn how to calculate your BMI.)
Months 6 to 12: If you’ve tried a medication and it is not a good support to your lifestyle, you might want to consider obesity surgery. Review chapter 8 to see if you meet the surgical criteria. Start with a visit to your primary care doctor to discuss this option, and get a referral to a Center of Excellence Surgical Program.
The Self-Evaluation Process It’s now time to take a fresh, honest look at yourself, eyes wide open — no squinting — to find the real you.
While we all have strengths we can rattle off when it comes to weight loss, it’s the personal barriers we face that sabotage our lifestyle effort and get us down and discouraged. No one is a perfect eater or exerciser. We all get stressed-out, go off track, and struggle. There is always room for improvement. While it’s important to feel good about the positive changes we make, it’s equally essential to tackle our barriers to success. Honestly sizing yourself up helps you to better start selecting your first set of tools. Chapter 1 explained the four kinds of tools you’ll need to build your BEAM Box. Now it’s time to take the first step and do a self-evaluation of your starting point.
For some of you, this task is easy, a no-brainer. For others, it takes some time and effort to tease out the essential, and missing, tools. With that in mind, I’d like you to take four mini-quizzes to identify your vulnerable areas in each of the BEAM categories. Don’t worry if you need help in all four of them. Most of us do. The number of tools you begin with is unimportant, it ’ s just getting started that counts. These are tools for life, and in the process of building your complete BEAM Box, you’ll continue to add tools at your own pace.
In each of the quizzes that follow, answer the questions with a yes or no. Add up your yes replies.
Your Behavioral Awareness
1. Do you eat when you’re stressed?
2. Do you sneak food when no one is looking?
3. Do you feel guilty when you eat dessert?
4. Do you eat when you’re bored?
5. Do you eat first, and think about your food choices later?
6. Do you sleep less than six hours a night?
7. Do you eat even when you feel physically satisfied?
8. Do you eat more when you’re happy?
If you answered yes to four or more questions, then your behavioral tools are missing or rusty. Check out chapter 3 for more help. You’ll be able to select a variety of tools that provide support and solutions in areas where you need it the most.
Your Eating Awareness
1. Do you jump from plan to plan to lose weight?
2. Do you easily get bored with an eating plan?
3. Are you confused about the basics of healthy eating?
4. Do you skip reading food labels?
5. Do you eat whenever food is around you?
6. Do you think you don’t drink enough fluid during the day?
7. Do you count everything except calories?
8. Do you skip meals?
If you answered yes to four or more questions, your eating tools need some help. In chapter 4 you will learn to make food work for you rather than against you.
Your Activity Awareness
1. Do you feel you are too busy to exercise?
2. Did you used to be more active than you are now?
3. Do you ignore the urge to move when it strikes?
4. Do you save your physical activity for the weekends?
5. Do you think exercise counts less than eating to lose weight?
6. Do you have physical limitations for exercise?
7. Do you feel overwhelmed by the idea of daily exercise?
8. Are you confused about the “best” exercise options?
If you answered yes to four or more questions, you need to give special attention to your physical activity needs discussed in chapter 5 . Here you’ll learn how to add more activity to your daily life in ways that are compatible with your interests and exercise temperament.
Your Medical Awareness
1. Are you embarrassed to go to your doctor?
2. Do you avoid discussing your weight issues with your doctor?
3. Do you have medical illnesses related to your weight?
4. Do you take prescription medications for your medical illnesses?
5. Have you ever been told you have metabolic syndrome?
6. Do you think medicine you take contributes to your weight gain?
7. Are you unsure of your height and weight?
8. Do you think your body is fighting your weight-loss efforts?
If you answered yes to four or more questions, your medical tools need some work. Chapter 6 will tell you how to have an honest and effective discussion with your doctor about your weight.
Hidden Causes of Weight Gain I’d like you to think about the hidden causes of weight gain. This is particularly important for those who feel they’ve tried everything to lose weight and it’s still not coming off. It’s a critical step to understanding important tools you might consider.
If you’ve been struggling with your weight for what seems a lifetime (or actually may be), check out the hidden causes described below and see how fixable they can be, once you have identified them and built the right tools around them. How do these examples apply to you?
Hidden Behavioral Causes of Weight Gain Lack of sleep. Not enough sleep is among the top hidden reasons for weight struggles. With fatigue, many people eat for energy. Being tired leads to lack of focus and to “not caring” about a lifestyle plan. People fall back on between-meal snacking to wake up, when a power nap is really what’s needed.
Poor stress management. Mindless eating comes from lack of focus, and poor coping skills with the stressors in our lives. We eat to soothe ourselves, or to reward ourselves, and we indulge in extra calories — which does work, temporarily — to make us feel better. It’s important to learn to self-soothe and manage stress responses without food.
Lack of consistency. Some general awareness every day is needed to avoid what I call “weight creep.” It takes only 100 calories extra a day to gain 10 pounds in a year. Most often, people “relax” their lifestyle on the weekend, or stay on their plan four or five days a week. That’s enough to promote a pound or two a month of hidden weight gain.
Hidden Eating Causes of Weight Gain Confusing “heart-healthy” or “fat-free” with low-calorie. Reading a food label these days is like reading an encyclopedia; so much information is given, but what really counts? There is a huge amount of confusion about “healthy” versus “lower-calorie” eating. While the first step in any healthy eating plan is to seek out heart-healthy fat, don’t be fooled by product marketing. “Healthy” claims on food packaging don’t automatically translate to calorie savings. Olive oil is great for your heart, but not for your waistline; both olive oil and butter (artery-clogging fat) have the same calories. Nuts are heart-healthy and protein rich — but just a small handful has 100 calories! Trans fat–free doesn’t mean fat-free. Nowadays it’s all about reading labels to avoid falling into this confusing trap of health versus calories. Portion distortion. None of us is very good at eyeballing portion sizes or at estimating the calories in foods. Studies show we’re at least 50 percent too low in our “guesstimates,” even professionals in the field. While we feel we’re doing a reasonable job, the cues to do so — plate size, utensil size, hidden fats, and more — all set us up for failure. In fact, the average dinner plate in Europe is close to what we use for a salad plate. Our dinner plates are like platters. No wonder standard portions look skimpy! We’ve got to learn to downsize our portions.
Skipping meals. Whether it’s to save time or calories, most meal skippers don’t pay attention here and don’t think it matters. The most frequent line I hear is: “I skip meals, but it’s not a problem until I get home for dinner. Then, I’m eating all night.” Here’s the bottom line: If we skip a meal, biology kicks in and makes us overly hungry for the next meal. This strategy is doomed to fail.
Hidden Activity Causes of Weight Gain Too much exercise. How could this backfire? Rigorous exercise actually stimulates hunger. It’s the body’s response to refuel for metabolic balance. In caveman times, this was helpful for survival, but not now, when food is available 24/7 and we are not foraging in the wilderness for food. We can sometimes fool ourselves into thinking our body needs more calories than it does for weight-stable refueling.
Overestimating exercise calories burned. As with food, we don’t estimate the calories we’ve used in exercise very well. We might feel sweaty and think we’ve burned thousands of calories, based on time spent exercising, but it’s best to really know the distance covered. It can take about five minutes to consume 500 calories and nearly two hours for most people to burn it off!
No exercise. Those claiming they are simply too busy for any activity can have a real problem. Even a small drop in daily activity — cutting out a 20-minute walk each day — can add 100 calories a day and 10 pounds in a year. Here’s a perfect example: “I used to park blocks away in a cheaper parking lot. I was promoted, and got a spot in the corporate lot. I’ve gained five pounds in three months.” Small activity changes make a difference.
Hidden Medical Causes of Weight Gain Medications. Some medications can lower the body’s metabolic rate and stimulate hunger as a side effect. These include some antidepressants, antipsychotic medicines, antihistamines, insulin and other blood sugar regulators, and anti-inflammatory medicines. If you’ve started a new medicine and gained 4 pounds or more in a month, this might be a contributor. If you’ve gained weight after months or years on the same medication, it’s unlikely that the medication in question is the cause.
Undiagnosed mood disorders. Depression and anxiety have both biological and behavioral causes. While some people struggling with depression express symptoms including loss of appetite, insomnia, and weight loss, a large subgroup sleeps more, eats more, and gains weight. Plus, thyroid problems, which can alter weight, are often linked to depression.
Thyroid function. The thyroid gland is your body’s “furnace” and sets your thermostat. It is regulated by a signal from the brain to release thyroid hormone into the system, and alterations in this gland can wreak havoc on a weight-management plan. The thyroid is easily tested and treated with a visit to your doctor. There are many causes of thyroid problems, and only a visit to your doctor and a blood test can diagnose them. Elevated blood insulin. Also known as “insulin resistance,” elevated blood insulin is a main symptom of a medical condition known as “metabolic syndrome.” It’s invisible unless you get a blood measurement. The constellation of symptoms that occur with metabolic syndrome includes not only high insulin levels, but central weight gain (belly fat), elevated blood pressure, and high cholesterol. Those with an “apple” shape can be at particular risk. Only your doctor can evaluate this important medical issue.
Fernstrom Fundamentals: Twelve Steps to Long-Term Weight-Loss Success Let’s turn for a minute to some other areas of self-awareness and goal-setting. I’ve taken some of the basic tools and distilled them into an easy set of fundamentals upon which a strong basis for success is established. These are twelve concepts you must embrace for your toolbox to serve you well. Check out chapter 3 for the specifics of how to use this practical set of tools. These fundamentals are at the foundation of all successful BEAM Boxes.
I’ve outlined the basic areas and concepts for you to integrate into your own plan. You should be able to use these to identify previous barriers to weight-loss success and help you think about realistic goal setting.
The Real You Diet: Fernstrom Fundamentals
1. Stay connected.
2. Think before you eat anything.
3. Recognize contentment. Look for Level 2 of fullness.
4. Minimize mindless eating.
5. Agree that there are no bad foods, just bad portions.
6. Learn to barter.
7. Keep your mouth busy with noncalorie items.
8. Buy single servings.
9. Accept your temperament.
10. Remind yourself that daily physical activity is important.
11. Wear a pedometer.
12. Don’t beat yourself up. Learn from your mistakes.
Now, with the first tool of self-awareness, and understanding of your strengths and weaknesses under your belt, let’s take a step-by-step look at how to build your own BEAM Box. Thoroughly read the next four chapters, which describe in detail the tools for each of the four core points of your foundation. In building your BEAM Box, the more tools you understand, the more you will be able to use.
If you are eager to get started right away with an eating plan, you can go directly to chapter 7. There you will find a three-week plan to get you started with structured meals and menu plans, along with some activity guidelines. You might prefer to jump-start your process; just be sure to review all the tools while you are doing it. A list of menus and recipes is not enough without incorporating the tools you need to succeed. The best way to maximize your resources and optimize your success on your weight-loss journey is to build an effective BEAM Box to aid you along the way.
Excerpted with permission from “The Real You Diet: Your Personal Program for Lasting Weight Loss” by Madelyn Fernstrom (Wiley, 2009).