A cardiologist’s advice on weight loss

Every now and again a patient will ask my recommendations on weight loss. Makes sense, right? Your cardiologist is always harping on you to quit smoking, lose weight, exercise more, get healthier. He should be the one with all the answers.

Well, here’s a little secret: At no point during medical school or training (three years of internal medicine and 3 to 4 years of a cardiology fellowship) do we ever take classes on exercise, nutrition or weight loss. As a matter of fact, during my entire specialty training I remember only one or two hours’ worth of lectures on anything remotely related to health maintenance.

My understanding of exercise comes only from my own experience as a runner and cyclist. This is not to say that other cardiologists are clueless. Some are quite knowledgeable. But our medical training focuses more on disease management than disease prevention.

But here are a few of the common sense recommendations my limited intellect has to offer:

  1. It’s simple math. To lose weight you need to take in fewer calories than you expend. All successful diets come down to the same straightforward principle— either exercise more, eat less or both.
  2. Set reasonable goals. Don’t try one-up The Biggest Loser by dropping 50 pounds in a season. Focus on losing one or two pounds a month. Stick to that goal for two years and you’ll be 25-50 pounds lighter.
  3. Cut out things you know are bad for you. Fried foods, sugary treats, greasy sauces and fatty meats are pretty obvious targets if you want to cut back on calories.
  4. Stay away from sugary drinks. If you absolutely have to consume liquids that are full of calories, try skim milk. It’ll give you protein, calcium and vitamin D. Beer, when it’s more than a can or two a week, has got to go, too.
  5. Don’t eat after 6 p.m. Many people consume half their daily calories in a late meal or late, late snacks. Instead, eat a healthy, early dinner and you won’t go to bed hungry.
  6. Skip the Big Mac. A diet of restaurant food will fatten you up faster than you can say two-all-beef-patties-special-sauce-lettuce-cheese-pickles . . .
  7. Eat more fruits and veggies. It’ll fill up your stomach and provide much needed nutrients.
  8. Pack your lunch. Stay away from the dreaded Workplace Grazing Syndrome (no, it’s not a real medical syndrome, but it should be). To quote Nancy Reagan: just say no.
  9. Exercise daily. You don’t need join a gym, hire a trainer or invest in a $3,000 elliptical machine. Just find a route by your house where you can go for a 30 to 45 minute walk. You’ve got to make it as much of your daily routine as brushing your teeth or using the toilet—it’s got to be habit.
  10. Increase your activity. Park in the back of the lot, take the stairs, spend less time in front of the TV or computer, get your spouse involved, take the dog for more walks.
  11. Stay off the scale for 3 months. Do all the things I describe above, and after three months of cutting back portions and increasing your activity you won’t need a scale to tell you how much better you feel. Even if you don’t lose a pound (which I doubt) you’ll be better off for your efforts, and your heart will be much healthier.
  12. Reward yourself. After a week of good habits, go to your favorite restaurant and order a steak, a bloomin’ onion, cheesecake for dessert, whatever. Just enjoy yourself. It’s impossible to be perfect all the time, but it’s reasonable to be good most of the time.

There you have it. My common sense take on weight loss in twelve short bullet points.

Usually, instead of limiting my patients by dishing out just my opinion, I try to steer them in the direction of people with more knowledge of the subject. A favorite resource of mine is Alegent’s expert dietitian Toni Kuehneman. She’s a staple at the Alegent Heart Healthy Cooking lectures, and I’m sure she could answer any question you could possibly conjure.

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