Making a Change (Part Two)

Editor’s note: This is the second in a series of three stories chronicling Nicole Benge’s weight loss. In this installment, we discover the ways Nicole changed her life- from exercising with her young children, to making time for walks, to fitness programs with a Wii.

ith two sons, ages 4 and 11, and a full-time job, Nicole Benge is a busy mom. But she’s made weight loss a priority, even with a full schedule.

Nicole’s commitment to healthy, sustainable weight loss has had many positive effects on her life, including becoming more active. Where before she’d sit and watch her children play, now she’s hitting the playground with them.

After becoming concerned with her overall health and wellness, Nicole entered St. Vincent Healthcare’s medical weight loss and management program, supervised by Dr. Kathleen Baskett, MD, in May 2009.

Since entering the program, Nicole’s weight loss has totaled more than 70 pounds. The physical toll such weight took on her body came into sharp perspective while playing with her children. She picked up her youngest child, who weights around 50 pounds, and thought, “I can’t believe I carried that weight around.”

Healthy changes

Studies show that regular exercise has a multitude of positive health benefits. Not only does it contribute to healthy, sustainable weight loss and weight management, regular exercise increases strength and muscle mass and can help combat chronic disease.

Before seeking the advice of a doctor, Nicole was already working toward becoming more active and made a routine of walking the family beagle.

These walks are an important component of Nicole’s successful weight loss. People who walk their dogs on average three time a week can get an additional two to three hours of exercise they may not otherwise get. It may not seem like much, but adding even moderate amounts of exercise into the routine can make a big difference if paired with proper diet and nutrition.

Nicole has gradually increased the amount of time she spends walking and averages about an hour and twenty minutes a day. When asked how she finds the time, Nicole said that she walks after the children have finished their homework and gone to bed.

“I’m always out there in the dark,” she said. Nicole loves to read, but there isn’t enough time in the day. “I haven’t read a page. Instead, I download books onto my iPod, and I’ll spend an hour a day listening to a book on iPod and walking the dog.”

At home

While exercise is an important component of weight loss, diet is just as crucial. Nicole can institute a healthy diet into her life, but that change might not stick without support from those around her.

Nicole said her husband makes sure to prepare grilled foods and have vegetables with the family’s meals, and if her family is eating something that isn’t on her plan, she has veggies, fruit, and plenty of protein items like jerky and cottage cheese on-hand.

Though it has taken more preparation and planning at the grocery store to ensure Nicole had the proper foods available, she said the payoff is worth it. Her shopping list nets protein for muscles, complex carbs for energy, and fruits, veggies, and whole grains for overall health.

At work

It wasn’t enough to change her lifestyle at home; Nicole brought her transformation to the office. At first she was quiet about her involvement in a weight-loss program, but discovered other co-workers were also making positive changes in their lives and trying to lose weight.

Nicole has made small adjustments to her routine. When Nicole and her coworkers go out for lunch, they pick places where they can make smart menu choices. She’ll replace mayo with mustard, or cut out the cheese on a sandwich. “We can still go out to eat and enjoy it, it’s just a matter of being smarter about our choices.”

She’s also added more activity at the office, including stretching routines.

Wii fit

With any weight loss program, there comes a point where weight loss plateaus. “My weight loss has slowed,” Nicole said, commenting that in the beginning of her weight loss program she burned more calories, even just sitting. “It takes more to sustain,” she said. “As you lose, it gets harder.”

Nicole doesn’t want to lose muscle mass, so she pairs her cardio routine with weight training that includes ankle and wrist weights. She doesn’t see herself finding time to go to the gym, but that doesn’t mean she doesn’t get a workout. She’s found that the fitness program of Jillian Michaels (a personal trainer featured on the popular television program, The Biggest Loser), available on Nintendo Wii, is a good way to incorporate a personal trainer-style workout without the gym. The game incorporates Jillian’s signature intense boot camp workout, complete with the yelling.

The interactive game allows users to set how many days they would like to workout and the program changes each day, exercising different muscle groups and providing instruction.

Remember, before starting any exercise program, consult with your primary care physician.

Next month: Resolutions not sticking?

Nicole reflects on her life changes and offers tips to stay on track.

Anna Paige is a freelance writer and journalist based in Billings and founder of Pen and Paige, a marketing, editorial and promotional company. Contact her at www.penandpaige.com.

***BONUS WEB CONTENT***

Learn about BMIs, body fat percentages, calorie counting and what it all means to weight loss and overall health.

Fat, essentially, is calories the body stores as energy reserves. When consuming more calories than the body burns, the excess is stored as body fat. When stored in excess, body fat can be a significant impairment of heath.

High body fat percentages have a correlation with diabetes, colon cancer, breast cancer, pancreatic cancer, as well as heart disease, said Dr. Kathleen Baskett, MD, medical director of the St. Vincent Healthcare Weight Management Clinic.

In her book Moving Forward: The Weigh to a Healthier Weight Dr. Baskett, advocates medically supervised weight loss paired with lifestyle change, which she said offers the “greatest opportunity for success.”

If considering a medically supervised weight loss program, Dr. Baskett recommends seeking a medical professional with expertise in bariatric medicine that is also knowledgeable, supportive and caring.

For a patient interested in weight loss, Dr. Baskett’s first steps are to collect his or her medical and weight histories. From there, the doctor can determine the patient’s willingness to proceed and moves forward with a physical exam and lab work (checking the thyroid, screening for diabetes, checking cholesterol levels, liver enzymes and kidney function, etc.). During this time the patient’s body composition and resting metabolic rate are assessed. All this information coalesces into an individualized weight loss plan.

Number crunches

A person’s body composition determines what percentage of body mass is fat tissue and what is lean body mass, measured by a bioelectrical impedance analysis. The device measures the electrical current’s impedance through body fat, resulting in a percentage.

“What percentage of body mass is fat tissue correlates with overall health,” said Dr. Baskett, noting that a healthy body fat percentage ranges from about 19 to 25 percent.

This body composition can determine the amount of excess fat a person carries, and provide weight loss goals on a health management program.

“Ideally when someone is going through weight loss, they want to lose fat. They don’t want to break down muscle, so periodically through the weight loss journey we reassess the body mass composition to ensure a person is burning fat mass and not breaking down muscle,” Dr. Baskett said.

Another measurement that is important to measuring weight loss is the Body Mass Index (BMI), a number that describes how a person’s weight is distributed across his or her body frame. A BMI 30 or greater is consistent with the medical definition of obesity; 40 or greater is consistent with morbid obesity (100 pounds or more above ideal body weight).

An increasing BMI is highly correlated with an increasing risk of developing heart disease, diabetes, high blood pressure, sleep apnea and certain types of cancer, Dr. Baskett said.

Also during a weight loss analysis, the doctor checks a person’s resting metabolic rate. “The resting metabolic rate is in essence how many calories it takes each day to keep the body functioning,” Dr. Baskett said. For example, it’s not unusual for a 40-year-old woman to have a resting metabolic rate of 18/25, meaning it takes 1,825 calories a day to keep body functioning.

From that number, Dr. Baskett can then determine the amount of calories a person can ingest to bring about weight loss. A person will need a calorie deficit per day to bring about weight loss, and Dr. Baskett assigns them a “budget” of calories.

“Weight loss comes down to someone taking in fewer calories then they burn,” Dr. Baskett said.

Budget wisely

Though numbers can make weight loss feel overwhelming, the process can be simplified with a food record. Nicole started watching what she ate by keeping a journal. “You get to know what is in foods, and how many calories they have. You begin to understand what is an acceptable portion.”

Nicole said that dishes she wouldn’t think would be unhealthy at restaurants turned out to have more calories than she imagined. “Part of it is education. You’re paying more attention to what you eat, when you eat, and how much.”

“Initially, people don’t know how many calories are in a food,” Dr. Baskett said. “To know that you have to weigh and measure.”

From the measured food, the patient is able to look up the amount in a resource guide and know the number of calories in that particular serving of food. In addition to books, there are online resources that outline the number of calories in foods. Sites such as www.fitday.com, thedailyplate.com and www.calorieking.com offer online record keeping and food and exercise journals.

“We stress health and nutrition; you make it fit in your budget,” Dr. Baskett said. She also emphasizes the importance of regular meals. “We stress the importance of breakfast, lunch and dinner, as well as mid-morning and mid-afternoon snacks, which help metabolism work more efficiently,” she said. Eating small meals regularly will also improve a person’s energy level.

Dr. Baskett recommends taking weight loss step by step. To become aware of their calorie intake, she asks patients to write down everything they eat and drink throughout the day for two weeks and calculate the calories.

“Most come back astounded because they were not aware of how many calories they were taking in,” she said.