The Weigh to Show Gratitude

OK, so I'm playing with words here. I'm trying to help you connect your current weight management issues with the power of gratitude. Why? The holiday season is now in full sway, and it's a good time to sit down and be grateful for all that you have, as well as the opportunities that await you to do even better. So many folks out there may be stirring up the usual holiday anxiety about weight gain, loss of control over one's time and the usual over commitments and obligations. Stop, and take a deep breath. You'll be fine. Let's show you the weigh.

First, adjust your expectations about holiday goals and self care. Travel, family events and work can make it difficult to commit to the usual amount of time for exercise and planning for healthy nutrition. The answer lies in adapting and adjusting by doing what you can and moving on. Avoid perfectionism and being extreme or rigid. Second, don't fall into the abyss of feeling helpless, hopeless and defeated because your self care schedule is different. Make a new goal. You could do what I like to call "tread weight" during the holidays. You'll do what it takes to hold your own weight during the holiday season, correcting for any backsliding. Be grateful that by the end of the 24/7 running around, you're the same weight. When things calm down, you can regroup and aim for more progress.

Being grateful puts you in a self supportive mood, one of self love and nurturing. This calm can help drown out the voices of self criticism that plague so many of you as you try to eat well and stay as active as you can. So what if you couldn't get to the gym? Try to walk more throughout the day and bump up your activities of daily living. Be grateful you have a body that works well enough to do this in the first place. There's that gratitude again.

Want to exercise those gratitude muscles to keep you mentally centered all day? If you do, you'll be more likely to stay mindful of what you eat and how you move your body. Hey, it's great for relieving anxiety and thus reducing the risk of stress overeating. Take these simple steps:

1. Focus on what's right in your life and quit obsessing about what you think is wrong. Go back to your list of gratitude.


2. Say just one thing at any meal time for which you are grateful. If you're eating with others, get everyone on board to do the same. Doing so creates a magical moment for all.


3. Tell people in your life "thank you" as often as you can. The return on your investment is feeling terrific, which helps you stay on track with your self care.


4. Draw upon your gratitude during times when people you know and love are annoying and irritating. It keeps things in perspective so that you don't keep heading for the fridge to numb your frustrations.


5. Watch out so you don't lose yourself in others through envy or jealousy. Don't keep saying how much you want to look like someone else. Concentrate on and be grateful for your unique talents and strengths.


6. Be thankful you're still alert and vertical! Hey, so your thighs are larger than you like. Well, be happy your legs can still support you as you take a joyful walk. Celebrate a mind that can still be mindful of every bite you take to nourish yourself.


7. Find the lesson when challenges hit you. Be grateful for the opportunity to continue to learn something new and grow from a life challenge.

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Blast Your Back Fat: Part Two

Two weeks ago I wrote the Blast Your Back Fat blog post and heard back from lots of you. Many of you wanted to know more about the role of exercise in getting rid of your fat. For instance, does spot reducing work? In my original post, I made it clear that in order to drop those love handles, you needed to activate my three M's: Mind (get that stress under control so you don't stress overeat), Mouth (rein in the calories and eat smaller meals of high quality foods more frequently throughout the day), and Muscle (combine intensity intervals of cardio along with weight training, and don't forget cross training). It takes an integrative approach to minimize fat anywhere on your body.

So, do spot reducing exercises work? No, they don't. It's hard not to look at one part of your body that's stubbornly holding onto extra fat, and not to want to hammer on it endlessly. But that doesn't work. Spot reduction is a myth. You can't work a specific muscle group and hope to drop the fat around it. You'll strengthen the muscle, but the exercises will result in removing fat throughout the body. Look around the gym at guys and gals crunching away on ab balls, but they never seem to drop weight there. Well, it's because they're probably going home and overeating. The great news is that underneath their belly fat, their abs are strong. You just can't see them. As the abs go, so goes the back.

Are there any exercises you can do to tone and shape your back muscles so that as you adhere to a better nutritional program and remove fat, you can look more firm and fit? There sure are. Here are a few of my favorites. You can look in my book Body for Life for Women for specifics for many of these, which you can do at home as well as the gym. For instance, I use tubing (inexpensive and you can buy at any sports goods store) for home and travel workouts. Give them a whirl while also remembering to do your cardio no less than 5 x week, trying to burn 400 caloriess (you can accrue over the day), and using intervals of intensity (see my blog post on Vitamin I - Intensity).

1. Seated Rows:
   
   Gym machine: Sitting on the apparatus with back straight and holding a handle from the cable in each hand. Slowly bend forward keeping the back straight and let the weight of the cable pull you forward, and then draw back to a straight back sitting position. It's like using both hands to row a boat.
   
   Home: Or, take your tubing and wrap it around the leg of a table, bed or heavy sturdy object. Sit on the floor far enough away from the leg so that there is plenty of tension on the tubing, and grab one handle in each hand. Again, with a straight back, allow the tension to pull you forward and then pull back to a full upright sitting position. You should feel a stretch throughout your back. 10-12 reps in 3 sets.


2. One-Arm Rows:
   
   Gym: using a workout bench, place one hand on the bench and the other hand is holding a moderately heavy (you should feel fatigue around the 8-10th rep) hand weight, letting the arm hang straight down. Bend forward at your hips, suck in your stomach, while your back and head are parallel to the floor. Now, retracting your shoulder blade, bend your elbow and pull the weight up until you feel your hand touch your body midway between your breast and pelvic bone. Hold, and then slowly lower your arm down. Repeat 10-12 times, then switch sides. Do this for three sets.
   
   Home: If you don't have a bench, you can do all of this simply using a sturdy chair, whereby you put your free hand on the seat of the chair for stability. It helps to have a mirror so that you can watch alignment.


3. Rear Delt Fly:
   
   Home or gym: Sitting on the edge of a chair or bench, grab a lighter weight in each hand and position hand behind each leg. Now, lean forward from the hips with your back flat. Tuck your chin into your chest. Raise your arms to the sides, gradually bending your elbows as they come up. Squeeze your shoulder blades together. Pause at the top of the extension and then slowly lower your arms. In my book I call this the Prone Fly, which can be done lying on your stomach on a bench with arms hanging to each side. Gym: Many gyms have a rear delt machine that's easy to use.


4. Opposite Arm and Leg Rises:
   
   Home or gym:Lie flat on your stomach with your arms extended over your head and your legs straight. Either rest your forehead on the floor or turn your head to one side. Slowly and simultaneously raise your right arm and left leg until it's difficult to keep your pelvis and chest flat on the floor. Lower and repeat with the opposite arm and leg combination. Don't twist or rock your body to make this easier. Stop if you feel pain.

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Shake Up Your Fat Cells at Any Age with "Vitamin I"

I just returned from Arizona where I led a women's health and fitness retreat. Most of the participants were frustrated and wanted to know why, despite regular exercise and healthy nutrition; they weren't seeing their body fat change. After observing them work out, I concluded that they were "Vitamin I" deficient. What does that mean? I made it up when I wrote Body for Life for Women. Vitamin I is intensity. Without using intervals of intensity on a regular basis, those feminine fat cells won't give up that fat fuel and let you slip into a smaller pair of jeans.

Intensity:

1. Helps you burn calories more efficiently during and after your workout;


2. Increases the fun of exercise while cutting the boredom of endless hours on workout equipment at the same slower pace;


3. Increases your aerobic capacity and endurance while promoting fat loss;


4. Reshapes your body, redistributing fat and toning muscle for the fittest look;


5. Results in more fat loss in a shorter workout time than women who maintained the same moderate exercise level;


6. Applies to both cardio as well as weight training.

Research has shown that women who train with intensity look like it. They've got more toned muscle and less fat, resulting in a leaner, fit-looking body. Intensity also helps override the powerful innate programming in a woman's body to store fat that is so specific to a woman's body. Adrenalin and growth hormone help to stimulate fat release. As women age, fat cell breakdown is more of a challenge. Intervals of intensity will get the fat release ball rolling.

Here's what you need to know to start to incorporate intensity intervals into your training. First, here are the precautions:

1. Anyone who is over the age of 40 and/or has any medical condition that may be affected by intensity (e.g. heart, lung, muscle/joint injury, etc) must first clear any such training through their physician. Moderate levels of exercise are perfectly fine and yield terrific results for health and wellness. Sometimes higher levels of intensity simply cannot be used.


2. It is absolutely imperative and required that everyone who engages in interval training must first warm up at a low and then moderate intensity for no less than 10 minutes prior to starting an intensity interval.


3. For people who are presently unfit (e.g. not regular exercisers and/or overweight or obese), it is essential that you begin very gradually. This means you engage in low and moderate levels of intensity for no less than 6-8 weeks prior to initiating intensity intervals. A fitness professional will help get you started.


4. Intensity intervals in weight lifting must be initially supervised by a fitness professional. I will not address high intensity weight training techniques as this should always be created and guided by a professional.


5. The elliptical trainer and stationary bike are the safest ways to practice intensity intervals. The treadmill requires more pounding and stress on weight bearing joints and the back, but is fine is the individual is already trained and comfortable with brisk walking and running.

Actual high intensity interval training used by athletes is pretty grueling. It involves first the warm up, then going all out at 100% of effort for 30 seconds, then resting at a low level of intensity for 4 minutes, repeating this cycle 4-8 times. I do my own adaptation of this which involves a much more gradual increase in intensity suited for beginners and non-athletes.

1. Do a 10 minute warm up gradually moving from a baseline of lower intensity to moderate intensity;


2. For the first interval, increase the intensity one level up by increasing the speed, resistance, or incline for 30-60 seconds;


3. Bring down to your baseline moderate level of intensity for 3 minutes;


4. Repeat the intensity interval and rest period again;


5. If you feel that the increase of one level up doesn't feel hard enough to cause you to sweat, increase one more level up (now you're up 2 levels of intensity);


6. Repeat this 3:1 interval cycle just twice for starters. Add another cycle every week or so until you're comfortable with between 4-8 cycles.

You need to do cardio no less than five times per week. Try the interval training once per week as a start, working up to doing it three to four times per week. You may notice that over time, your baseline warm up levels may increase and your intensity levels will be higher. That means you're achieving the training effect and improving strength and endurance. Take body size measurements before you begin your intensity interval training and watch the reshaping and toning take place. Get your body fat percentage measured and pay attention to that number, not just your weight. We're talking about changing the quality of your body, not just the quantity.

Start today and reap the rewards of shaking up your fat cells with Vitamin I.

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Why Fat Doesn't Disappear Where You Want It To

Go figure. You're working diligently to achieve a healthier weight, and the fat you want to keep (e.g. your breasts) is the first to disappear, and the fat you want to shed (fill in body part here: stomach, thigh, butt, arm, chest, back) is the hardest to remove. From a recent posting on my weight management message board, dmarchi says,

"Hi, I'm 23 and for the past year I have been dieting and exercising on a regular basis. I try to work out 3-4 times a week. This includes spin classes, running, and step classes. I try to keep my calories at or below 1500 calories a day. I do not count carbs, but I am thinking I might have to. I have lost about 25lbs so far. The problem is I haven't dropped a pant size! It seems like the weight I have lost has come off of places other than my stomach and hips. This is the area I am really wanting to lose weight from. I don't know what to do anymore, I am becoming discouraged and on top of it, I have hit a plateau. Does anyone have any recommendations on how or what I can try doing to improve my weight loss around the stomach and hip area? I would love to lose at least 10 more pounds. I am not sure if I need to change my diet or exercise. Thanks!"

Sound familiar? Let's demystify what goes on with your body fat when you're dropping that excess fat. Here are some rules of the "where the fat's going" road:

1. Genetics. Look at the other people in your family. Your body shape will often appear similar to someone in your family line. Sometimes the similarities are striking - - apple or pear shaped with nuances involving short/long legs, tiny waist or no waist line at all. J Lo can try all she wants to drop weight, but she will always have that famous behind. The same applies to Beyonce's behind and thighs. Your job is to optimize your body shape as best you can, and then live with what genetics endowed.


2. Age and Gender. Throughout their life, men tend to store fat in the abdominal area and they'll note that any excess body fat in their extremities will shed first and the belly is last to go. Most women (there are exceptions) tend to store most of their fat in the hips, thighs and buttocks prior to age 40. Weight reduction classically decreases waist and breasts first, followed by the lower half of the body. After 40, due to declining levels of sex hormones, it is easier to store fat in the belly area as well. In addition, other hard to reduce fat deposits appear in the back, upper abdomen under the breasts, as well as arm pit areas. Weight reduction after 40 often results in removal of fat in the breasts and lower part of the body, followed by the waist and the back - - the exact opposite of the pre-40 years. Again, there's wide variation and we're talking about general patterns.


3. Medical Conditions. Things happen in people's lives. Pregnancy is one example. Many women develop the postpartum "jelly belly" which can be a challenge to manage. The more pregnancies, the tougher it is to shed all of subcutaneous fat that has accumulated. Again, the goal is to minimize this fat, as it's impossible to completely eliminate it in most cases. Polycystic ovarian syndrome (PCOS) can give rise to an increase in belly fat at any age in women. Treatment of the syndrome can help manage this problem. The long term use of prednisone related medications make it difficult to remove abdominal fat. These are a few examples of conditions and medications that can complicate the weight management experience.


4. Plastic Surgery. Many people have gone under the knife and had liposuction, body sculpting and abdominal skin tightening. If weight is gained after liposuction, you may note that fat accumulates in other locations not touched by the procedure and sometimes these regions (back) can be tough to reduce. That's fair warning for those who are considering lipo. If you do it, stick with the program and don't gain weight.


5. Lifestyle Program. A balance of good nutrition and physical activity are the foundation upon which all healthy weight management is based. Cardio and weight training are essential to minimize fat and optimize body shape and muscular tone.

Let's look at dmarchi's comments. She's young and has done a great job removing 25 pounds of fat using a balance of exercise and good nutrition. She's dropped the weight in other places and is frustrated with her hips and stomach. She's also complaining about the plateau in her weight. I'd recommend getting a body composition analysis and finding out what her current body fat percentage is. She's looking to be somewhere between 20-25%, unless she's very athletic. She needs to look at her own genetic pool and she'll probably find that women in her family line have relatively speaking heavier hips and thicker waistlines. Her goal is to optimize her body composition and see where she settles.

To shake things up, I'd recommend introducing more cross training and lots of intensity intervals. She should change up cardio routines every six weeks. I notice she said nothing about weight training. Of all the thing she could do to reshape her body, lifting weight 2-3 times per week will enhance muscularity and minimize body fat.

And finally, she needs to take a patience pill. If indeed she really needs to drop that "last 10 pounds", it's always the slowest to go. Consistency in lifestyle habits is key. When each of us reaches a point where we have done all we can reasonably do to optimize our lifestyle, we'll smile and simply learn to be proud and content with our marvelous, amazing and fit bodies.

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Diet Program Dilemmas

Let's just say you've been thinking about shedding your extra pounds. Then, one day you decide to finally take action. But, suddenly you're confronted with the dilemma of which way to turn. You do a little homework, whip through some magazines, watch TV commercials and call a few friends. Somehow you make your decision and then wonder if you did the right thing. Read what Detwaa sent me on my weight management board recently:

"I just signed up for a weight loss program where you have to follow a routine diet, drink and eat certain foods they offer, exercise, and check in several times per week to see progress. Is that something you'd advice, is it effective? The shakes are incredibly expensive and I'm supposedly required to have them in order to lose 60 pounds in 15 weeks. Did I make a big mistake? Was this something I could have done simply on my own? I have an option to buy the shakes one at a time as I go, or buy them all at once for a discounted price, and I just want to know if I can still lose weight if I don't drink them. This is a healthy low fat, hight protein, calorie restrictive diet."

I'll bet a few folks out there can relate to her angst. The good news is that there is a terrific book written by the Institute of Medicine called Weighing the Options: Criteria for Evaluating Weight Management Programs. The book is unbiased and written by academic experts who prioritize the consumer's health and welfare above any commercial interests. I'd highly recommend this to anyone considering a program. Meanwhile, here are a few helpful tips.

Beware programs that:

1. Promise you the moon. Watch out for programs that guarantee big weight reductions in a short period of time. Most people can safely remove up to 2 pounds per week on a healthy weight management program. Detwaa's program is promising to deliver double that number.


2. Cost you an arm and a leg. I'm not happy when I read "incredibly expensive shakes". Heck, you can buy cheap whey protein powder, add water or skim milk and perhaps fresh or frozen fruit and make your own for pennies. Commercial programs make their money by selling products (e.g. shakes, meals, supplements). Watch out for programs that require you to purchase these products.


3. Are run by people with questionable backgrounds. How long as the organization been around? Always ask many questions about who owns and runs a program. What certifications and qualifications in the field of weight management do these people have? What are the staff qualifications? What is included in your initial assessment? It should be comprehensive and ideally this group would be teaming with your own doctor to achieve optimal results. Did your doctor refer you to this program? What about success rates, and comments and references from other clients? Programs should be supervised by physicians and medical professionals who can answer questions related to each person's unique medical status, as that would change over time with appropriate weight reduction. Also be on red alert for programs offering pills, potions and injections for weight reduction. You absolutely must be fully informed about the professionals and staff involved as well as study thoroughly any materials related to these services and products. Programs operated by hospitals, medical centers, researchers and academics in the field (e.g. University of Colorado's "Colorado Weigh Program") can usually be counted on to deliver the most updated, credible and comprehensive programs.


4. Stress weight loss and not maintenance. The best programs have a strong emphasis on both phases, and provide an excellent maintenance element. Watch out for programs that spend 90 percent of their efforts on shedding weight, and offer only a cursory coverage of any long term maintenance.

The best program for weight reduction involves an interplay between my favorite three elements: Mind, Mouth and Muscle.

1. Mind: Research has clearly shown that when you have a strong mental health component, you'll achieve your best program success. That means there should be a qualified counselor for ongoing help and guidance in person, on the phone and/or through email communications. People need coaching and encouragement as well as answers to ongoing questions involving how to navigate life's stresses while also maintaining an optimal nutrition and exercise program. These experts help people learn behavior skills that will assure not just weight reduction, but maintenance for life.


2. Mouth: It's necessary to have qualified registered dietitians to supervise any program and to customize plans for people's unique needs. In the best of worlds, you're eating whole foods, an appropriate number of calories in balanced meals and snacks, as well as a minimum of commercial (and especially processed) products.


3. Muscle: All programs need to have a reasonable and appropriate physical activity component. It should be based upon established standards like those of the American College of Sports Medicine. Many offer a network of health club facilities as well as fitness professionals who will help guide you as you become more physically active.

So, for Detwaa and other men and women seeking weight management program advice, get serious and do a thorough job of studying your options. Your reward will be a safe and credible path towards sustainable weight reduction and a lifetime of optimal wellness.

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It's Not Just About the Scale

Lee Carson /
CC BY-SA 2.0

While filming the National Body Challenge series for Discovery Health TV, I recall the humorous antics that occurred while I was being taped weighing each of the show's participants. The scale I used was actually a body composition analyzer. In addition to body fat and muscle mass, it also showed overall weight. That was enough to strike fear in the hearts of the women, but not the men. Fully clothed, guys would merrily hop up on the equipment, chuckle at the numbers (which weren't pretty), and high five each other laughing about who had the highest body fat.

By contrast, the women would start to peel every bit of clothing they could get away with on a family rated show, tossing off sweat shirts, rings, watches, bracelets and even earrings, before tentatively stepping on the analyzer. Several pleaded with us for a moment to hit the women's room and empty that bladder. Once on the apparatus, some women would squeeze their eyes shut and not look, a few just looked straight ahead never peering down to check out the numbers, and one even stepped on backwards to avoid looking at anything. No doubt about it. This is Scale Scare at its worst. Many people have lived a life of fearing the number that could mean the difference between having a great day, or the moody blues.

I'd like to help you by setting the record straight. Scale weight alone tells you nothing about what's really happening in your body or your health. Instead, you need to pay attention to other factors: body composition, Body Mass Index (BMI) and waistline measurement.

Scale weight is made up of the interplay between your basic body composition elements (bone, muscle, fat). Since bone doesn't change dramatically in the short term, your weight is all about the relationship between muscle and fat. The more muscle you have and the less fat, the smaller your size.Body composition is about not just the quantity but quality of your body. Also, don't confuse body fat with Body Mass Index (BMI). Your BMI is your weight divided by your height in meter squared and is a number that is used by doctors to assess your risk for medical conditions like heart disease and diabetes.

Also, don't forget your waistline! It's not just how fat you are, it's where the fat is at. If you have too much fat inside your abdomen, you're at high risk for disease. Measure your girth crossing your belly button. Guys need to keep that number below 40 inches, and women below 35 inches.

So you have four main numbers to keep in mind:

• Scale Weight = Bone + Muscle + Fat


• Body Mass Index = Weight/Height m2


• Body Fat Percentage = Total Fat/Total Weight x 100


• Waist size = tape measurement across belly button

Here's a great recent posting from Saginovi30 on my weight management board that makes the point about body composition:

"I'm 5'8", wear a size 4 jeans, but I weigh 145 lbs. Usually women my height and pants size weigh 120 or less. I exercise regularly, but I don't understand why on the outside I look 120 pounds, but in reality, I weigh 25 pounds more. Is it true that muscle weighs more than fat?"

My answer to her is that I can have five women who are all the same age, height and weight, and I will show you five different dress sizes, from a 4 to a 12. That's because the total amount of fat you carry on your body will determine your dress size. Fat occupies more space than muscle. When you're trying to zip up those jeans, that ain't muscle getting in the way! In this woman's case, there is no doubt that she has a low body fat (below 20%) and a higher muscle mass. This is the result of genetics and exercise.

The bottom line is please toss your scale and go out and get a body fat analyzer. They range from simple, inexpensive models that will provide just your weight and body fat percentage, to fancier scales that will show you how many pounds of muscle and fat you carry. To achieve your optimal body composition, it is absolutely necessary to do regular physical activity. If you simply starve yourself all the time to achieve some mythical scale weight, your muscle mass will fall and you'll actually end up with a higher body fat percentage. Instead, your goal is to maximize your muscle and minimize your body fat.

Here are some guidelines for average (non elite athletes or naturally thin people) height men and women:

1. Average adult men need to keep their body fat percentage between 18-25% for their lifetime.


2. Average women should aim to keep their body fat percentage about 20-25% until age 45-50, when the range can increase to 28%, and after the age of 65, up to 32% due to the age related decline in muscle mass after the seventh decade of life.


3. Aim for a BMI below 25.


4. Waist measurements should be less than 40 inches for men, and less than 35 inches for women.

I hope by now you see that scale weight alone is just one element of a more complex picture of your body and overall health.

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Blast Your Back Fat

Back fat, muffin top, love handles, fat roll or spare tire - call it what you want, but it all adds up to that rather not-so-lovely vision of extra rolls of fat popping up all over your back, from your bra line to your belt line. It's the kind of fat that makes you rethink buying a skimpy top where the whole world can revel in your rolls. Have a look in the mirror at your back while wearing a form fitting blouse or sweater. There's that back fat poking out along your bra strap lines. And how about the rolls at your armpits, and the back fat shelf line above your waist? Not a pretty picture. And, as opposed to the menopot which is seen primarily after age 40 (see my blog post "Minimize Your Menopot"), back fat can occur at any age in men and women, but is worse after the age of 40. So where does it come from?

Back fat is an accumulation of excess fat that occurs due to one or any combination of factors including:

1. Being overweight or obese at any age (over eating and lack of physical activity);


2. Genetics in which even some slender people tend to distribute more of their fat to the back area;


3. Ethnicity plays a roll (pun intended) in which some groups tend to pack on back fat more than others;


4. Lack of weight training to bring down body fat and increase muscle tone;


5. Being over the age of 40 in which the decline of sex hormones affects distribution of fat throughout the body.

So what can you do about Back Fat? Plenty. Here are the "Rules of the Roll" to blast your back fat:

1. Make an Action Plan. Sit down and write out your goals. Take measurements throughout your body so you know where you're starting. Take pictures for the visual impact. Create realistic goals and expectations (dropping ½-2 pounds per week is the normal range). The heavier you are to start, the more excess fat you'll be removing. Write down your commitment to change. Journal your progress. Develop a support system to help guide you - like our wonderful weight management board on WebMD.


2. Be patient. Back fat is often one of those stubborn places that sometimes takes longer to reduce. Be persistent.


3. Get real. If you're over the age of 40, you may not be able to completely eliminate all of your back fat, but, like the menopot, your mission is to minimize back fat.


4. Hide it while you remove it. Let's not invite trouble in the form of super tight spandex tops. While you're shedding pounds and getting more fit, try to wear looser, comfortable clothes and toss the muffin topping skinny jeans. There are also great elasticized undergarments that help smooth out the rolls.


5. You must do both weight training and cardio to blast back fat. Don't think you can do this with cardio alone. You'll drop some weight, but you need to reshape and redistribute fat and only a combination of weight training and cardio will do that. Lift 2-3 x week and concentrate on building strength and perhaps boosting your muscle mass a bit. Check out my MUSCLE section in Body for Life for Women for easy ways to do this at home gym-free. Check out the WebMD fitness sites for creative ways to strengthen and tone.


6. Eat a back fat blasting diet. Physical activity is key, and equally so is what you put in your mouth. There is no one food or beverage that will magically remove Back Fat. Instead it's all about eating a variety of healthy foods every day. Quality: whole foods and lean proteins build the foundation for removing Back Fat. Quantity: watch your portion size. Almost everyone out there is eating too much relative to their age and gender. If you eat too much, you wear it. Read the USDA label and know what a serving size looks like. Frequency: eat every 3-4 hours from breakfast through dinner. Stop eating 2 hours before going to bed. Try to eat your dinner no later than 8-8:30 PM, and keep it lean (veggies, lean protein). Wake up in the morning feeling truly hungry. Check out my MOUTH section in Body for Life for Women for healthy, easy nutrition options. Scroll onto WebMD's wonderful nutrition sites for endless suggestions and recipes.


7. Get creative and cross train. No one specific exercise is the ultimate back fat cure. You need to draw from a variety of back strengthening and toning modalities. Mix and change it up every 6 weeks to keep it fresh and challenging. Have some fun and get adventuresome. Take up belly dancing, hip hop or twirl around a ballroom. Ballet is a terrific way to pinpoint back flexibility and strength. Don't forget martial arts, yoga and Pilates. Each uniquely singles out the back for a fat blaster workout.


8. Enjoy a win - win. The stronger the back the stronger the abs, and vice versa. You're working the core of the body and what you do for one, helps the other.

Back fat is a fact of life. Don't waste another moment fretting about it. Take action. And remember, here at WebMD, we've got your back!

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This Is Not A Diet

Whenever I read the postings on my weight management board, inevitably there's one from someone who has had an awakening and is desperately seeking help to reverse obesity. Here's one I received recently from offby40:

"I HAVE JUST SIGNED UP FOR THIS IN HOPES OF FINDING SUPPORT IN STARTING A NEW DIET. I HAVE TRIED MANY DIETS BUT I HAVE A PROBLEM WITH COMPLETING THE DIETS. NOW I AM GOING TO FOCUS ON CALORIE INTAKE AND EXERCISE. I AM 300 LBS AND ABOUT 5FT9 AND MY BMI IS REGISTERING AT SEVERELY OBESE. IS THERE ANYONE THAT CAN GIVE ME SOME POINTERS ON HOW TO GET STARTED, AND HOW TO KEEP IT GOING. I REALLY NEED HELP."

First, I congratulate her for taking herself on to begin the journey to achieve health and wellness. Second, I want to set the record straight for everyone. Throughout this posting, the theme seemed to be "diet"- starting one, failed diets. This is not a diet! Instead, I suggest you say "I'm going to clean up my lifestyle, get healthy and become more mentally and physically fit." This is about healthy living, and developing better lifestyle habits. When you do, you'll find it so much easier to shed excess body fat, feel energized and increase your sense of self esteem. You want to be fit to live your life to the fullest. That's why I called my most recent book Fit to Live.

I'll bet many of you are in the same place as the person who posted this on the board. OK, here's how you start out. First, remember that WebMD has so many wonderful resources throughout our lifestyle channel to help with calorie counting, fitness tips and recipe suggestions. Next, if you're going to change lifestyle habits, that means everything from mental and nutritional behaviors, to financial (is health a priority in your spending), physical activity and environmental (clutter, lack of organization, getting outdoors) components. No need to feel overwhelmed. In my book, I address the key pillars of lifestyle: Mind, Mouth, Muscle, Money and Macrocosm (the environment).

Always start with low hanging fruit- the simplest, smallest steps you can take to get the ball rolling. Before beginning any program, please consult your physician and medical team. Know what your baseline health status is and if there are any restrictions on your program. Here are tips and tools to get started:

MIND: Get a clear vision of why you want to change your lifestyle. It has to be powerful enough to get you through challenging times when you're tempted to revert to old habits. Being fit enough to play with your kids or grandkids? Healthy and attractive enough to get out there and find a partner in life or new friends? Becoming a runner, biker, hiker and hanging out with like-minded folks? Want to prevent or reverse medical conditions that plague you? Anything goes here. Sit down and really think this out. Come up with a mantra to remind you why you need to stay on track- "Sick and tired versus Fit and Fab." Say to yourself "I choose fit and fab." This is a conscious, mindful, deliberate choice. Finally, create realistic expectations. Progress, not perfection, will get you there.

MOUTH: Quality, quantity and frequency are key. Whole foods, lean proteins, and whole grains become the staple of your nutrition. Read the USDA labels on all foods to know what a true serving size is. When in doubt at restaurants, eat ½ of what's in front of you. Eat smaller meals and snacks every 3-4 hours beginning with breakfast and ending with dinner. Remember to include protein and fiber throughout the day, as that combo will curb carb cravings as well as increase your sense of fullness. Try to finish dinner no later than 8:00 - 8:30 PM and leave 2 hours without eating before you sleep.

MUSCLE: Get up and move more throughout the day. Buy a pedometer and crank out 10,000 steps (roughly 4 miles) per day walking. Work up to this goal. Be creative about finding ways to move more. At 300 pounds, you need to protect your knees so avoid any jumping, running, squats or lunges.

MONEY: Invest in a great pair of sneakers with plenty of cushion. Get socks that do the same. If you're a gym type, scope out a good deal on a membership where you can cross train on different cardio equipment (ellipticals are knee friendly and burn calories efficiently) and where you can learn to begin safe and guided weight training, stretching and core work.

MACROCOSM: Look around at your living and working spaces. Does it look like a bomb went off? How can you develop a new healthier lifestyle when you're buried under miles of piles? You need to clean up your environment and get organized. You can't take a walk if you can't find your sneakers and you can't pay for that jazzersize class if you can't locate your checkbook. Be patient, and schedule an hour here and there over time to get this done. Also, get outdoors more. Walking, biking, and hiking in nature are such wonderful, healing experiences. Do it alone, with a friend or in a group. Just do it.

Whip out a journal and keep track of your daily progress. You don't have to write the great American novel. Just monitor what counts- your baseline lifestyle elements, challenges and triumphs. You'll need your starting status: medical issues (what you want to change like blood pressure, blood sugar, any medical conditions); make a note of overall weight, body fat percentage, BMI and waist size (across the belly button); and, clothing size including jeans, pants, dress, belt.

Finally, don't forget to create a support system. This could be your mother, best friend, a mentor, or your dog. It includes keeping up with us on the WebMD weight management board for online support, as well as any helpful books or DVD's that resonate with you. You're assembling your "A" team to help you through thick and thin (ahem!).

OK, there's your foundation. Now hop to it and don't call this a diet!

Genetics May Load the Obesity Gun, but Environment Pulls the Trigger

Ever wonder how powerful genetics are when it comes to your chance of becoming obese? Take a moment and look at your own family tree. Going back as far as you can, think about the people in your family who might have been obese. You're obese if you have a Body Mass Index (your weight relative to your height) of 30 or more. BMI is closely correlated with body fat, with the following two exceptions: 1) a true very muscular athlete where body fat is overestimated; and, 2) the elderly where body fat is underestimated due to their loss of muscle. Check out the WebMD BMI calculator to see what your BMI is.

Many people can see some clear patterns of obesity in the family. Does it appear obesity is your genetic destiny? As it turns out, the answer is more hopeful than you might have originally thought. There is indeed a well known obesity gene, the FTO gene that is associated with increased intake of food, especially fat. It's been thought that people who carry the gene just don't feel as full and satisfied after eating normal portions of fat. There seems to be a fat-satiety disconnect. If you carry double copies of this obesity gene (one from each of your parents) your risk of becoming obese is 2.5 times higher than someone who doesn't. 17 percent of the general population has double obesity genes, and another 40 percent have a single copy. Don't despair. Your genetics will only activate if you give them a comfortable environment to do so - like eating a high fat diet and being sedentary. That's the perfect recipe for the obesity genes to emerge and wreak havoc with your body as well as your life.

New research has shown that a low fat diet can keep the obesity gene under control. Physical activity seals the deal. So, the deal breaker here is not your genetic legacy, but what you eat. The researchers compiled comprehensive data on the eating habits of people who do have the double gene copies. Only when the men and women were eating a high fat diet did you see the expected obesity. How much fat is acceptable? It's higher than you think. The actual number was 41% fat in the diet. Obesity was less common in those who ate less than that. It's recommended that you try to keep your fat intake in the range of 20-30% for optimal nutrition.

Whether you carry this gene or not, all of you - from over-eaters of fat to sugaraholics - need to pay attention to what you're eating. This medical study provides an important and a very positive and hopeful lesson. You don't have to be a prisoner of your own genes. Create a lifestyle of healthy eating and activity, and you'll keep harmful genes at bay. I've always said that genetics may load the gun, but environment pulls the trigger. Take a moment and study your own living and working places. What can you do right now to clean up and reorganize these spaces so that everything - from the food you keep in your fridge and cabinets to your walking or running shoes you keep by the front door - is all there to support your healthy lifestyle and keep you out of harm's way? Get rid of the junk food and choose the produce section of your grocery store over the pastry aisle. Hang out with like-minded people as well. Doing all of this will guarantee you'll be pulling that lifestyle trigger your way.

Related Topics:

• Weight Loss & Fitness with Pamela Peeke, MD, MPH, FACP
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Believe, Achieve and Succeed

This week I watched with fascination as a 5'6" Georgia teen, ranked 70th in the world, triumphed over her six foot Russian opponent at the US Open Tennis event. That was the fourth top seeded Russian she's summarily dismissed since her debut at Wimbledon this year. Known as the Georgia "spark plug", Melanie Oudin is a wonder to watch. But what caught my eye were her shoes. It wasn't the neon rainbow colors, but the area on the side of her shoe at her heel that grabbed my attention. On each shoe, she had one word printed like a billboard of motivation -"Believe". When questioned about it, she simply declared, "I know I can succeed because I really believe it." Observing her is a lesson in what it takes to succeed. She's not perfect and actually capitalizes on that. Actually, her other title is "the comeback kid". She will often lose fairly miserably in the first set, and then come storming back. She notes the first set gives her time to learn the feel of her opponent. She appears impervious to any emotion of defeat or frustration. She learns, adapts, adjusts and moves on to success.

How does this apply to all of you who are seriously trying to improve your lifestyle habits? Here's the lesson - all success starts with the mind. Not some diet craze or exercise boot camp. This laser focus mindset is something I call The Power Mind, which I describe in detail in Body for Life for Women and Fit to Live. One of the biggest mistakes I have observed when men and women embark on their journey to shed excess fat and get more fit, is that without really thinking about it, they hop onto the next "diet" or fitness craze thinking they've found the answer to their girth control problems. You know the drill. It's always short lived and then you're either back to square one or you really blow it and end up in worse shape.

The problem is that you can't just approach your eating and exercise as though you're a robot implementing technical commands. Your mind drives you. You need your head screwed on right to start with. So many people just launch into their well intentioned programs without being very clear about why they need to do this in the first place. Getting to the bottom of that "why" is often tougher than you think. Saying you just want to be "healthy" doesn't work. Go deep and get personal about what drives you. You need to have a very clear vision, passion, strategy, accountability and measurable outcomes. Once you identify the meaning behind your desire to change, then you work on believing you can achieve your healthy lifestyle goal.

The great Olympic sprinter Florence Joyner ("Flo Jo") once noted she used three words to power her through grueling training and competition: "Believe. Achieve. Succeed". Watching Oudin I can see that put into action. How about you? I love those three words and regularly use them in my writing and teaching. If you believe then you lay down the path to be able to achieve and thus succeed. Stop right now and say to yourself "I believe I can patiently and persistently create a healthier lifestyle". Write it down and keep copies of that one line commitment everywhere to get you through tough and challenging times. Be your own best coach and say it to yourself throughout the day. You can do this. Believe it!

Related Topics:

• Weight Loss & Fitness with Pamela Peeke, MD, MPH, FACP
• Get the Weight Loss Wisdom and Fitness newsletters in your inbox weekly!

The Post Workout Burn

I'll bet most of you have heard about the "post workout burn". These are calories you keep on burning even though you're done with the workout. I got to thinking about it again when I got this email from "afdw" on my weight management message board:

"Firstly, if you work out does it increase your metabolism for the upcoming hours? Then since sleep slows down metabolism, will it ruin your metabolism increase? Because now I wonder if I should workout in the morning or at 9pm. I normally workout at 9pm-9.30pm then I sleep at around 11-12. I am curious if this will slow down my metabolism and will I not get the optimal results I should have if I sleep a few hours after my workout. If i do workout in the morning, will it benefit me more? Please give me advice."

Alright, we'll start with the timing issue. What time is best to work out and how do you schedule that relative to your sleep? My easy answer for the workout time is any time that works for you.

First, at the very least, try to stay as active as possible throughout your day by increasing your activities of daily living. Every calorie you burn counts and also stokes your metabolic fire.

Second, do your deliberate workout at a time of day when you know you will have the least chance of being interrupted. If you're a mother, you work around the kids' schedules. And since most people work, it's about being creative and flexible with the nuances of work schedules as well. Hopefully your workout times coincide with your natural biorhythm - some of you are larks (early risers) and others are owls (late to bed). Also, about 50% of people can sleep perfectly fine after an evening bout of exercise. You won't know if you're one of those until you've experimented, so give it a whirl.

Finally, as you try to integrate physical activity into your busy schedule, it's so important to remember those two words I keep repeating: adapt and adjust. If Plan A doesn't work, get going on Plan B. Keep workin' it until you get a baseline schedule of exercise that works for you. Those who do, look, feel and live like it.

Now, onto the issue of the post workout burn. The calories that you expend after you finish up your exercise are known as the "after-burn". Exercise scientists call it EPOC, or excess post-exercise oxygen consumption. After you've worked out, especially if you did an intense workout, your body spends time getting your oxygen, body temperature and blood circulation back to its normal state. Muscles are repairing themselves and restocking their glucose fuel. You may notice your heart and respiratory rate are elevated for a while, and your nervous system remains somewhat activated as adrenalin and cortisol (stress hormone) levels slowly settle down to pre-exercise levels.

This adjustment period can take anywhere from 15 minutes to 48 hours. A rule of thumb is that during this period, your body will continue to burn between 10-15 calories for every 100 calories you burned during your workout. The more intense the workout, the more calories you burn. For instance, in studies comparing low and high intensity workouts in which the same number of calories was burned (500 calories), the high intensity EPOC burned 45 vs 24 calories for the low intensity exercise following each workout. Long, low intense exercise (1.5-2 hours) also raises EPOC to optimal levels. Think of hiking or walking.

New science has shown that if you're looking for a maximal EPOC, don't forget to do both weight lifting as well as cardio. Colorado State researchers compared moderately intense weight lifting and aerobic exercise (cardio) to see if there was a difference in EPOC. It took the weight lifters 100 minutes of lifting versus 60 minutes of cycling to achieve the same 600 calories of exercise expended during exercise. The strength training produced an extra 24 calories of after-burn (total EPOC 51 calories) compared to the same level of intense aerobic exercise, cycling (total EPOC 27 calories). Let's do a little math. The EPOC from cardio done 5 x week would equate to an extra 7000 calories per year above and beyond the calories already spent during the exercise sessions. The EPOC from weight lifting 2 x week would be equal to 5000 calories of extra calorie burn per year. Combining the two, that's a grand total of 12, 000 calories or (dividing by 3,500 calories/pound) almost 3.5 pounds of fat removed as a benefit of the after-burn. Not bad for after-burn!

The bottom line is it doesn't matter when you work out, but what counts is the intensity. If you haven't yet tried intervals of intensity, gradually increase speed and resistance under the supervision of an expert. Ask a fitness professional at your gym or community center for direction, and check out WebMD's fitness resources to get started safely. Start racking up those bonus calories today!

Related Topics:

• WebMD Slideshow: The 30-Minute Workout
• Weight Loss & Fitness with Pamela Peeke, MD, MPH, FACP
• Get the Weight Loss Wisdom and Fitness newsletters in your inbox weekly!

Exercise Does Help You Shed Your Weight

I couldn't believe my eyes. I'd just gotten my current issue of Time magazine and after reading the cover, my jaw dropped - actually clanked on the floor. The cover story read "The Myth of Exercise: Why Exercise Won't Make You Thin". The cover photo portrayed a young woman running on a treadmill and dangling in front of her was the real reason she was sweating - her mental fantasy of a cup cake. Trying to be objective, I methodically read the article. It's written by a good writer who typically doesn't work with this kind of subject matter. His premise was that exercise, especially intense activity, increases your appetite and you end up eating more and actually gaining weight. Further, he noted that people want a food reward - their favorite treat - after every workout session. He also shared his own struggle - he's not obese - with that male gut issue. But there's a cynical, biased edge to his writing, as though to say "Why should I work out if my gut's not disappearing?" I've got a news flash for Mr. Cloud. An over 40-year-old man has decreasing male sex hormones that directly contribute to more fat distributed to his belly. He's not as metabolically efficient at burning fat. Relative to his age, he's eating too much, thus the gut.

Who said that the main reason we work out is so we can chow down on pastries? I asked my good friend and gym mate Newsweek's Eleanor Clift what she thought of this and she posted on her blog:

"...exercise has kept my blood pressure down near astronaut levels, and the endorphins released during exercise help keep me sane...I happen to believe that exercise is the closest thing we've got to a fountain of youth."

I loved this quote because it stresses that activity is a mind and body experience. Heck, so many of my patients over the years have said to me that they began doing more activity to drop weight, but actually continued it because it was so good for their heads - calmed them down, reduced their anxiety and depression, and helped them to cope with the stresses of life so much better. There's also the pride in performing better, from sports to activities of daily living. Doing more activity and watching what you eat does allows you to be able to metabolize that occasional treat without weight gain. I don't know anyone who workouts out so they can plow through a box of doughnuts afterward. There are people out there who fool themselves into thinking exercise will somehow cancel out indiscretions like that, but after jumping on the scale a few times post over eating, reality sets in.

And what about that roaring increase in appetite sending us all racing to a post workout Crispy Crème binge? Read the research. A recent study from University of Pittsburgh found that overweight and obese women didn't need any more calories when exercising regularly than when they were sedentary. So let's set the record straight. Of course you're going to have a greater appetite if you engage in intense exercise. So, you just make sure to keep healthy foods (especially fruits and veggies) around and be mindful of your calories. The basic energy balance equation says that to maintain your current overall weight, you need to take in the same amount of fuel (food) and you burn each day. Ideally, to drop weight you reduce the total number of calories you take in, and you increase the calories your burn.

So, I put it out there on my weight management message board to see what all of you thought about the exercise-weight loss connection. Here are your voices:

"I wondered what research was used for such headlines. I am 60 years old and have never lost weight with a calorie restrictive diet. I cannot starve myself enough. Yet when I added aerobic exercise my entire body improved and I lost 5 dress sizes. I begin in May of 2002 and didn't really notice much the first two months as muscle does weigh more than fat; but by the time school began in the Fall I needed an entirely new wardrobe. From August to November that year I lost one size per month before reaching a plateau. It is not until I hit a bit of depression six years later and stopped exercising that I needed to buy larger sized clothing. I begin my exercise program with a stationary bike and 20 minutes. Eventually I worked up to 70 minutes a day on the elliptical. I ate a healthy diet at that time using WebMD's food intake program (before it got all of the bells and whistles) - I was never hungry or deprived of my favorite foods. With "diets" having such a rebound issue of regaining the lost weight plus 5 to 10 pounds, I just can't believe that diet alone is the key. Exercise improves multiple body functions keeping your metabolism up much better than the loss of muscle associated with weight-loss alone." 1949Rose

"Weight loss is a simple equation: you either decrease the calories you take in by diet modification, increase the calories you burn by exercise, or DO BOTH! Personally, I have had great success with the third option (down over 93 pounds
in 2-1/2 years)." Dukeof Earle

"There is probably some truth that you can lose weight without exercise, I lost several pounds without exercise when I first started. The problem I have is that this article will further convince people that they don't need exercise which I firmly believe to be false! I have no doubt I could have lost a decent amount of weight without exercise but I also know that I could not have dropped the 90 pounds I have lost and kept off without exercise! Exercise is responsible for firming up my muscles, it is responsible for giving my body the shape it had lost but even more than that, exercise has given me more self-confidence then I ever had before - enough so that I trained for a ran a 25k race. My body does require more fuel because I exercise 7 days a week (no not everyone needs to exercise that much but I enjoy my workouts) but the food I eat is healthy and I count my calories so I am not in the position to gain weight. I guess the bottom line for me is exercise is not only good for the body but the mind and soul as well." Redwingfan

Finally, I'm going to put on my hat as the American College of Sports Medicine's spokesperson for their global Exercise IS Medicine campaign. Here are the facts.

• Physical activity is one of the most important behavioral factors in weight maintenance and improving long-term weight loss outcomes. In fact, participation in an exercise program has proven to be the very best predictor of maintaining weight that was lost.
• Exercise and physical activity have been proven to help prevent chronic conditions such as heart disease, osteoporosis, anxiety, depression, obesity and diabetes.
• Studies show that when students are more active (through physical education, classroom activity, play, etc.) they improve test scores and attendance and experience fewer discipline problems and sick days.
• Simple activities like walking, accumulated in 10-minute bouts, can have significant benefits.

So, get on out there and live in balance. Pay attention to your eating and your moving. They're both life giving vital signs.

Related Topics:

• The Incredible Benefits of Regular Exercise
• Weight Loss & Fitness with Pamela Peeke, MD, MPH, FACP
• Get the Weight Loss Wisdom newsletter in your inbox weekly