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Thu, Mar-11-04, 09:26
March 11, 2004, 9:19AM
MAKING CALORIES COUNT
Old fashioned diet is key to Methodist plan
By DEBORAH MANN LAKE
Special to the Chronicle
http://www.chron.com/cs/CDA/ssistory.mpl/metropolitan/2443549
The Atkins diet says you can eat unlimited amounts of protein. So Steve Shelton ate an entire chicken. Needless to say, Atkins didn't work for him.
But what did take 150 pounds off the 44-year-old is the doctor-monitored Medical Weight Management Program at The Methodist Hospital, which teaches dieters to evaluate why they eat and educates them about the old-fashioned notion of counting calories.
"The eye-opener is when we do the food laboratories and buy food and take it apart. You can have 1,000 calories in a sandwich meal," said Karen Brewton, one of the program's dieticians. "People are just not aware of how many calories they're eating."
Most adults should consume somewhere between 1,800 and 2,000 calories a day, depending on their height, age and activity level.
But Brewton took what someone might eat in a typical day -- a fast-food breakfast, sandwich lunch and take-out Chinese dinner -- and added them up to a whopping 2,895 calories.
Brewton said people don't realize that a single large bagel can equal four slices of bread while a seemingly innocuous muffin can contain 800 calories -- nearly half of a person's daily total.
The body will use what it needs and the leftover calories are stored as fat.
"The body has a precise calculator and it knows exactly how many calories you need to function and how many you are taking in. It's a very good accountant," Brewton said.
Calorie requirements decline as people age, Brewton said, because the metabolic rate slows down and the body loses muscle mass, which burns more calories.
In the first phase of the Methodist diet, which lasts 12 weeks or longer depending on the amount of weight that needs to be lost, the dieter drinks four high-protein, low-carbohydrate beverages a day -- for 800 calories. The beverages include all the necessary vitamins and nutrients, and dieters take a fiber supplement. Also allowed per day are one pickle, diet Jello-O and decaffeinated, sugar-free beverages. Participants are encouraged to exercise for 30 minutes three days a week.
"The approach is high protein and low carbohydrates but we restrict the protein and calories, unlike the popular diets such as Atkins and South Beach," said Dr. Peter Jones, medical director of the weight program. "But like them, we try to avoid the swings you get with too many carbs."
Meeting in group and private sessions with a behaviorist, patients in Phase I are given the tools to determine what triggers their eating and how to avoid them.
"We really want people to look at their lifestyle and become a different person," Brewton said.
The mental part of the diet is addressed by a behaviorist.
"The biggest issue is emotional eating -- coping with different emotions that make them uncomfortable by using food," said behaviorist Brian Hunter.
The dieters map out their eating patterns by linking thoughts and emotions with eating. Then they are challenged to find 30 ways to cope with emotions without food and how to reward themselves without food.
It was an eye-opener for Shelton, who said he had tried everything, from the cabbage diet to Atkins.
"My problem is that I've never been able to learn the underlying reasons for my eating and coping mechanisms," Shelton said. "It's not only dealing with the nutritional stuff, but also the psychological, the emotional. I ate when I was angry, lonely, tired or happy."
Nir Eshet, who had tried every kind of weight loss program including having his stomach stapled at age 17 in his native Israel, also said learning his eating triggers was key.
"Food had become my refuge from different things. Once I realized that it was about changing behavior, it became easy," Eshet said.
Eshet, 37, who started the program at 473, has lost 208 pounds and has 65 more to go.
In the second phase, which lasts 12 weeks, Shelton and Eshet learned to measure and calculate calories in the food lab while slowly adding solid food back into their diet.
In the third phase, dieters develop an eating plan that will keep them on course, and practice the behavior changes while keeping food records.
"I was at a point a couple of weeks ago where I wasn't losing any weight and they kept telling me to keep my food records," Shelton said. "I started keeping food records again and found out I was eating closer to 1,800 calories a day instead of the 1,200 I should be eating to lose 20 more pounds."
Jones said the third phase, which lasts four months, is where patients learn to maintain their weight -- often the most difficult part.
"My perception is that the shorter the time a person spends in maintenance, the worst the prognosis will be for keeping the weight off," Jones said.
The end result of the program, which can cost $2,000 to $3,000 depending on how much weight needs to be lost, is a healthier and hopefully happier person.
"Most patients reduce their medications or no longer need their medications. Weight loss has a huge impact on health," Brewton said.
MAKING CALORIES COUNT
Old fashioned diet is key to Methodist plan
By DEBORAH MANN LAKE
Special to the Chronicle
http://www.chron.com/cs/CDA/ssistory.mpl/metropolitan/2443549
The Atkins diet says you can eat unlimited amounts of protein. So Steve Shelton ate an entire chicken. Needless to say, Atkins didn't work for him.
But what did take 150 pounds off the 44-year-old is the doctor-monitored Medical Weight Management Program at The Methodist Hospital, which teaches dieters to evaluate why they eat and educates them about the old-fashioned notion of counting calories.
"The eye-opener is when we do the food laboratories and buy food and take it apart. You can have 1,000 calories in a sandwich meal," said Karen Brewton, one of the program's dieticians. "People are just not aware of how many calories they're eating."
Most adults should consume somewhere between 1,800 and 2,000 calories a day, depending on their height, age and activity level.
But Brewton took what someone might eat in a typical day -- a fast-food breakfast, sandwich lunch and take-out Chinese dinner -- and added them up to a whopping 2,895 calories.
Brewton said people don't realize that a single large bagel can equal four slices of bread while a seemingly innocuous muffin can contain 800 calories -- nearly half of a person's daily total.
The body will use what it needs and the leftover calories are stored as fat.
"The body has a precise calculator and it knows exactly how many calories you need to function and how many you are taking in. It's a very good accountant," Brewton said.
Calorie requirements decline as people age, Brewton said, because the metabolic rate slows down and the body loses muscle mass, which burns more calories.
In the first phase of the Methodist diet, which lasts 12 weeks or longer depending on the amount of weight that needs to be lost, the dieter drinks four high-protein, low-carbohydrate beverages a day -- for 800 calories. The beverages include all the necessary vitamins and nutrients, and dieters take a fiber supplement. Also allowed per day are one pickle, diet Jello-O and decaffeinated, sugar-free beverages. Participants are encouraged to exercise for 30 minutes three days a week.
"The approach is high protein and low carbohydrates but we restrict the protein and calories, unlike the popular diets such as Atkins and South Beach," said Dr. Peter Jones, medical director of the weight program. "But like them, we try to avoid the swings you get with too many carbs."
Meeting in group and private sessions with a behaviorist, patients in Phase I are given the tools to determine what triggers their eating and how to avoid them.
"We really want people to look at their lifestyle and become a different person," Brewton said.
The mental part of the diet is addressed by a behaviorist.
"The biggest issue is emotional eating -- coping with different emotions that make them uncomfortable by using food," said behaviorist Brian Hunter.
The dieters map out their eating patterns by linking thoughts and emotions with eating. Then they are challenged to find 30 ways to cope with emotions without food and how to reward themselves without food.
It was an eye-opener for Shelton, who said he had tried everything, from the cabbage diet to Atkins.
"My problem is that I've never been able to learn the underlying reasons for my eating and coping mechanisms," Shelton said. "It's not only dealing with the nutritional stuff, but also the psychological, the emotional. I ate when I was angry, lonely, tired or happy."
Nir Eshet, who had tried every kind of weight loss program including having his stomach stapled at age 17 in his native Israel, also said learning his eating triggers was key.
"Food had become my refuge from different things. Once I realized that it was about changing behavior, it became easy," Eshet said.
Eshet, 37, who started the program at 473, has lost 208 pounds and has 65 more to go.
In the second phase, which lasts 12 weeks, Shelton and Eshet learned to measure and calculate calories in the food lab while slowly adding solid food back into their diet.
In the third phase, dieters develop an eating plan that will keep them on course, and practice the behavior changes while keeping food records.
"I was at a point a couple of weeks ago where I wasn't losing any weight and they kept telling me to keep my food records," Shelton said. "I started keeping food records again and found out I was eating closer to 1,800 calories a day instead of the 1,200 I should be eating to lose 20 more pounds."
Jones said the third phase, which lasts four months, is where patients learn to maintain their weight -- often the most difficult part.
"My perception is that the shorter the time a person spends in maintenance, the worst the prognosis will be for keeping the weight off," Jones said.
The end result of the program, which can cost $2,000 to $3,000 depending on how much weight needs to be lost, is a healthier and hopefully happier person.
"Most patients reduce their medications or no longer need their medications. Weight loss has a huge impact on health," Brewton said.