Shedding pounds won't be easy

Hopkins physician sees prospects of success with multidisciplinary approach

A Passion For Weight Loss

January 04, 2009|By Liz Atwood | Liz Atwood,liz.atwood@baltsun.com

For many people, the start of the new year means the start of a new diet. But most people will ultimately fail in their efforts to lose weight, says Dr. Lawrence J. Cheskin, founder and director of the Johns Hopkins Weight Management Center.

A New Year's resolution to lose weight is a good step, according to Cheskin, associate professor of international health (human nutrition) at the Johns Hopkins Bloomberg School of Public Health. But it's simply the first step in what must be a life-changing strategy to shed pounds and keep them off.

What is the Johns Hopkins Weight Management Center?

It's a Johns Hopkins Bayview Medical Center facility at Greenspring Station that takes a multidisciplinary approach to weight loss. We have doctors and dietitians who try to individualize the approach so you get the specific aid you need.

Do you see an increase in the number of people coming to your clinic after the holidays?

We do see an uptick. It is partly because of New Year's resolutions. It is also partly because over the winter there is a tendency to gain weight. We are presented with more food opportunities and more social opportunities and less chance to exercise.

Is there something about cold weather that makes us want to eat more?

Eating is more of a behavior that is learned, but our bodies are very good at maintaining the weight or increasing it. In prehistoric times, who made it through the winter? It was those who ate more calories.

What is the first thing you tell patients who come to the clinic seeking to lose weight?

We want them to do a thorough assessment of how they got into trouble. We have a team of experts. As the physician, I look at the medical aspects such as the person's metabolism and health effects of their weight. We have a dietitian to look at specifics of what they are eating and the portions. And we have a behavior psychologist to look at the triggers that cause the eating.

Most of us gain weight not because of excessive hunger, but because we eat when we are bored, or stressed or celebrating.

What are the most common mistakes you see people make as they approach their New Year's resolution to lose weight?

There is an all-or-nothing tendency that can be a problem. An intermediate approach is best. You don't change from being a sinner to being a saint; you're just a smarter sinner.

What is the most effective way to go about losing weight?

There is a science to appetite control. You need to have small snacks throughout the day and choose foods that are inherently more filling so you can fool your body and go with fewer calories. We want to avoid people getting hungry, so it's best to eat foods that are high in fiber and water content, and low in fat and sugars.

Do some diet plans, such as a low-carb plan or a low-fat plan, work better for certain kinds of people?

Yes, and unfortunately you don't know what that is going to be from day one. You have to be flexible. Generally we feel the low-carb approach is a good approach. Vegetables, fruits, foods high in proteins. But it's important to individualize the approach.

Should patients consider weight-loss surgery?

For people who have made a good effort, we say let's try surgery as a tool. It's not going to fix it. You can undermine the surgery if you don't change the underlying habits.

Have you ever had trouble with weight issues yourself?

I have not struggled with weight, but have had medical problems that made dietary changes important. ... I have worked with thousands of people, and think it makes me more flexible in my approach than if I had lost weight myself by a particular method, and believed that was the solution.

Can the downturn in the economy have an effect on people's eating habits?

Yes. The cheapest way to get your calories is with fatty or sugary foods and junk food. You can feed your family on mac and cheese and hamburger more cheaply than on fresh fish, fruits and vegetables.

Do you have any advice for people to help them stick to a diet?

Remind yourself that this is not an easy process. ... Everywhere you turn there are going to be temptations. ... But losing weight has important consequences. It isn't just about looking better in a bathing suit. It's often a major boost to your long-term health, energy level and mood.

For information on the Johns Hopkins Weight Management Center, call 410-583-2860 or go to hopkinsbayview.org/weight.

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