Creating a Healthy Home Environment: OAC "Your Weight Matters" (#YWM2013) Session Recap

This session was on Friday, August 16th and was lead by Eliza Kingsford, MA, LPC, Clinical Director of Wellspring Health. She's also been featured on Dr. Oz and Dr. Phil (whoa).

First I want to say this session was totally not about what I thought it was about. But...it was awesome.

She started by telling us about the National Weight Control Registry. This effort, started in 1994 by Drs. Rena Wing and James Hill, both of the University of Colorado, is the largest investigation into long-term successful weight maintenance. Check out the website. It's actually pretty cool.

For our purposes, Ms. Kingsford outlined a few habits of people who successfully maintain weight loss (for 2+ years). Like did you know:

• 78% of successful weight loss maintainers eat breakfast every day?
• 75% of them weigh themselves at least once a week?
• 90% exercise at least an hour a day?

Nik interpretation: a successful maintainer is engaged in their health. BUT, Kingsford points out that they also see their process in a very specific way as well. Maintainers:

• tend to think of themselves as living a healthy lifestyle not as being on a diet.
• as such, they accept that stalls are a part of the process. They look at the long-term span of weight loss over day-to-day fluctuations.
• they tended to have started by making just one healthy lifestyle change. Once they got that down, they added another and another.

Nik interpretation: a successful maintainer has realistic expectations and a sustainable plan.

According to Kingsford, some key parts of successful maintenance are:

• self-monitoring (logging your food intake, your exercise)
• positive coping (learning alternate ways to deal with life's ups and downs)
• social support (healthy people who hang with healthy people tend to stay healthier longer)
• and stress management 

To successfully lose and maintain, Kingsford says, you must recognize there is a problem then accept the nature of the problem (Did you gain because you are eating too much? Too much of the wrong things? Other factors?) then develop a plan but, more importantly, develop "stick-to-it-ness." (Or, a sustainable plan that you can stick to and progress from.)

She gave some practical advice on setting yourself up for long-term success. One of the recurring themes throughout the presentation was about setting S.M.A.R.T (Specific, Measurable, Attainable, Realistic and Timely) goals. I want to digress for a moment to emphasize the importance of this! Put your goals against that measure and you'll begin to see why some of your goals simply don't work. For instance, consider the following goal:

Goal: I'm going to become more active.

Ok, how exactly do you measure that? And how do you know you completely got to where you want to be?

Now consider this goal.

Goal: I'm going to walk for 30 minutes three times a week.

That's a S.M.A.R.T. goal. Why is this important? Because we sometimes have a hard time accepting both when we are and when we aren't measuring up to our expectations. Being specific helps you achieve success and success builds upon success. That being said, let's return to Kingsford's tips.

• Have a realistic weight goal. You are NOT the BMI (Body Mass Index). What's the right weight for YOUR body?
• Accept stalls and plateaus. They are a part of the process. If you are living a healthy lifestyle (versus working toward a specific numerical weight loss goal) you will be motivated to keep up your healthy lifestyle in the face of a stall.
• Plan both for success and damage control. That means that, yes, sometimes you will mess up. But you can't let that make you give up or descend into a free-fall of bad decision making. You have to press on!

Lastly I want to leave you with a sage piece of advice she gave. Our relationship with food was learned. That means it can also be un-learned. We can create new habits. But it takes work. And time. And patience. Setting yourself up with unrealistic goals only shoots you in the foot in the long run. So examine your goals and habits. Are you pushing harder than you know you can in the long-term? Do you have an all or nothing attitude. You might want to change that. The National Weight Control Registry shows us evidence that those processes do. Not. WORK!

The Science Behind Will Power - Session Notes from OAC Your Weight Matters (#YWM2013) Convention

Since I decided to give each educational session it's own post AND since the conference is over, technically I can go in any order I want, right?

There's a reason I'm posting this one first. Read until the end to find out why! WARNING: This is a highly condensed summary of what I heard. When the full presentation becomes available, I'm going to try to remember to come back and post the link!

This session was led by Dr. Sean G. Connolly, a psychologist in private practice who is studying the oft misinterpreted concept of will power. Dr. Connelly is based in San Antonio, TX for the past 30 years and for the past 10 has worked with weight-loss patients. He also works with many bariatric practices.

In this session, he gave us an overview of what will power isn't, what it is, how it works and how we can use that knowledge to us it, much the way we use our altered anatomy, as a tool to achieve our goals.

First off...what is will power?

Dr. Connolly says we often think of will power in terms of something we have or don't have. That's the wrong way to go about it. Will power is a muscle of the brain which means that like any other muscle, you can:

• Learn how to use it correctly and effectively
• Strengthen it with exercise
• But when you don't exercise it, it loses its strength

He also cited research that indicates something else that's very interesting. It's so important I need to underline it. As humans, we have a finite amount of will power (finite = set amount). If you use it all up you have to build it up again to be able to use it.

Don't believe me? Consider this. Ever notice that the checkout line at the grocery store is loaded with stuff you should not eat? That's not by accident! Marketers know you've likely exercised a lot of will power in the store (with regards to things like the nutrition of your food choices, the price or quantity) and that by the time you make it to the checkout line some of your will power has been depleted. So when you are in that state you are more susceptible to making bad decisions.

Dr. Connolly also pointed out that will power is a function of the brain that can't be separated from other functions. So that is to say that using will power takes away energy from other brain functions and vice-versa. This does not mean that will power is bad! It just means we should recognize that if our brains are engaged in other processes (dealing with extreme emotion, for example) our will power can be weakened.

Ok...so how exactly does one build up their will power?

Dr. Connolly says to exercise your will power you can try something called "delayed gratification." The concept is not so much about saying "no" as it is about saying "not right now." He cited a study where two groups of children were given marshmallows. One group was told not to eat the marshmallows until the group leader came back and that if they did this, they'd get more marshmallows. The other group was simply told not to eat the marshmallows until the group leader came back.

C'mon...what do YOU think happened? Of course the kids who were promised more marshmallows delayed their gratification so that they could get more. This is powerful evidence that if there is a will, we can exercise will power!

So how do you delay gratification. He suggests starting with some small abstention like staying off social media for a short length of time or not practicing a habit for a day. These acts will help exercise your will power muscle.

So...what happens if my will power muscle gets tired?

According to Dr. Connolly you are more prone to making bad decisions. But your will power being tired can be linked to many other things like:

• Your body being tired - so get more rest!
• Being under exceptional stress
• Being depressed
• Being presented with too many choices at once

His advice is to not put yourself in will power struggles when you are tired or feeling unusually stressed or depressed. It's just a losing set-up. This is NOT to say that you give in to every whim you have. But this would not be the time to intentionally expose yourself to temptation either.

What other factors affect will power?

Dr. Connolly cited other things that affect the will power. This is where my notes get a bit sketchy as my computer got wonky! The one thing I do have noted is that spirituality and beliefs can be a powerful will power catalyst. I can personally attest to that. Every year I do a Lent promise in observance of the season leading up to Easter. I find I am able to abstain from nearly anything (yes, even peanut butter one year!) for that forty days - even things I could not abstain from before.

But it doesn't have to be religious beliefs only. Moral beliefs, any beliefs. One might say that a person who decides to become vegetarian after deciding they don't believe in killing animals is practicing will power by nature of their beliefs. People who boycott companies that make products they like because the company has done things they do not like are practicing will power based on beliefs. Get the picture?

So what this all boils down to...

Will power is a muscle but also a tool. It can wear down and you may have to build it up but, as Dr. Connolly points out, one set back does NOT mean you've lost your will power! It's something that is bound, by its nature, to have high points and low points. Therefore we'd do well to heed the following tips:

• Again, don't put yourself in the position of having to exercise will power when you are tired, stressed or depressed
• If you know your will power will be tested, try using "If/then" visioning to help. That's just a fancy way of saying something like "If I go to Aunt Martha's and she offers me those cookies I've always loved, then I'll pop a piece of gum and politely decline." Like that.
• Recognize that sometimes you'll need to ask for help when your will power is low. That's nothing to be ashamed of.
• Be accountable! That helps you exercise will power when it's hard to do so. Make S.M.A.R.T. goals (Specific, Measureable, Achievable, Realistic, Timely) and share them with friends. Then report back on how you did. It helps!

...now that you're all educated, let's do a challenge!

Since we now know we can exercise our will power muscle to make it stronger, I'd like to challenge you to exercise your will power muscle.

In the comments of this post, tell me one thing you will abstain from doing for a full day next week. You need only commit to abstaining one of the days of next week between Monday and Friday (August 26 - 30, 2013). Don't overdo it! Remember, we're exercising a muscle. Just like you wouldn't lift too much weight at first, neither should we try to exercise drastic will power.

Anyhoo...leave your commitment to abstain in the comments. Then on Saturday (September 1) I'll post asking you to be accountable and say how you did. I want you to pay particular attention to:

• Was abstaining easy or hard?
• How did your thought process/decision-making process change as a result of abstaining?
• Did you have to make any trade-offs to make it work? If so, what were they?
• If you ended up violating your abstention, what were the circumstances? Were you trying to exercise will power in another area of life?

"So, Nik...what's the reward? What's my 'delayed gratification?'"

Good question! To those who take on the challenge and check-in you'll be entered to win some of my OAC swag (and I got a lot of good stuff)! But remember, this exercise is about deciding NOT to do something, not to do something. And since will power is a muscle we're working to develop, try not to make it anything unrealistic (remember: S.M.A.R.T. goals!) So think about it and decide what you're not going to do next week to exercise that will power muscle!

Your All-Access Pass to OAC "Your Weight Matters" (#YWM2013) General Sessions!

I think I've decided I'm going to cover each session I attended as a separate blog post because there's just too much information to try to fit it into daily recaps.

But I wanted to start off to linking you all to the general sessions that were web-casted live during the convention. These were powerful sessions that went into subjects that are on many of our hearts and minds! I'm going to post the video directly with a link to the video on YouTube. In addition, I HIGHLY advise you all to check out the Obesity Action Coalition YouTube Channel for more great stuff!

The Roller Coaster of Life: The Ups & Downs that Can Affect a Woman's Weight
(Running Time: 50 min., 7 sec.)

My big take-away from this session is that there are many forces, that have nothing to do with self-control, that can affect a woman's weight. While none of these are an excuse to "let ourselves go" (as the proverbial phrase reads) they are things we should take into account if we face challenges in our efforts to live a healthier life. We tend to internalize those challenges and blame ourselves, even for things over which we have no control!

View this video directly on YouTube!

Weighing Success Beyond the Scale: Identifying & Maintaining a Healthy Goal Weight

(Running Time: 50 min., 5 sec.)

I think this was an important message because we tend to think of a healthy lifestyle as a means (diet, exercise) to an end (ideal body/body weight). But sometimes our personal goals just aren't that realistic and setting all our hopes on an unrealistic goal can be toxic. Some points that stood out from this one for me were:

• It's a myth that there is a "correct weight for your height." There are many other factors at play.
• People who exercise and eat the same do not lose the same! That is to say you can do everything right and so can the post-op next to you and you can get two different sets of results. Another compelling reason NOT TO COMPARE!

View this video directly on YouTube!

Understanding & Managing Food Addiction

(Running Time: 44 min., 9 sec.)

This was perhaps THE most affirming session for me. I am a food addict. And I don't take that term lightly. Studies show that the very brains of food addicts work differently than those who do not suffer from food addiction. So as much as we all like to say "I am addicted to popsicles" or "I wish I could get addicted to the gym!" addiction is a very serious disease and this session goes over some animal research that gives us a greater glimpse into food/sugar addiction in particular. WARNING: If you identify yourself as a food addict some of this may hit home hard. Watch it in a space where you can react freely.

Watch this video directly on YouTube!

Teaming Up to Tackle Obesity (presentation after opening mix & mingle)
(Running Time: 1 hr., 53 mins., 53 sec.)

Corey Louchiey and James Thornton are both former NFL players who are personally battling obesity. In this session, which also includes their doctors, they talk about the struggles of overcoming obesity (James through bariatric surgery, Corey through traditional diet & exercise). What's amazing to me about these two men is that they report not being particularly close until they started their journeys. Now they support each other through the up's and down's. I love that one method of weight loss was not put above the other. Both are valid choices!

Watch this video directly on YouTube!

Pregnancy & Weight-Loss Surgery: Information from OAC "Your Weight Matters (#YWM2013) Convention"

One of the cool parts about the Obesity Action Coalition's convention was sessions called "Lunch with an Expert." These were table discussions where you could ask an expert in certain fields direct questions about their expertise. Since you guys sent me to this conference, I tried to pick lunches that addressed some of the questions I get from you guys.

The first one I attended, on Friday, was on pregnancy & weight loss surgery. It was led by Dr. Robin Blackstone of Scottsdale Health Care Bariatric Center. She's worked a lot with patients who were preparing to conceive and post-ops who have gone through pregnancies.

She started off where a lot of GYN's start off - by advising about birth control! She said that it's important to be on a good method of birth control, especially in your losing phase. A woman of childbearing age is very fertile during this time because of hormonal changes brought on by rapid weight loss. She also pointed out that during the rapid weight loss, our bodies go into ketosis. Ketosis can affect a fetus. So it's best to get cleared for pregnancy before actively trying to conceive. She did note, however, that in the event of an unplanned pregnancy, don't panic. Just know your pregnancy will probably be deemed riskier and require a bit more medical intervention.

IMPORTANT: She told us that traditional birth-control pills are sugar-coated and thus people who had malabsorptive surgeries might not break them down properly. She said to ask your doctor to prescribe you a pill that is at least 3 mcg (or 0.2 mg), which increases the likelihood of absorption.

From there, we talked about preparing to conceive and she had some great wisdom to share:

• When you are preparing to conceive, it's best to let your bariatric surgeon know about it (or it might be most effective, as she stated, to inform your bariatric nurse coordinator or an equivalent). At the very least, they should know just in case your obstetrician needs to consult with them, however, they may want to request a set of labs before you conceive.
• Dr. Blackstone advised to pay particular attention to thiamine levels. Thiamine deficiencies can cause major birth defects so you need to make sure yours are at a good level going in.
• In general, Dr. Blackstone suggests patients trying to conceive take an extra B-complex vitamin daily.

Then we talked about when you are actually pregnant. There are several situations she's experienced as a doctor and she wanted to make sure patients are prepared to deal with them.

On eating/eating more:

• Barring any special medical condition, it isn't really necessary to take in a lot more food during pregnancy. Instead, she advises patients eat healthy meals more often for stable blood sugar.
• She said this several times, so I think it bears mentioning. The human body is designed to support the baby through this process, therefore the baby will take what it needs from your body. Don't go overboard on anything "for the sake of the baby."
• Make sure to maintain your protein levels at about 60-80g a day (or whatever your nutritionist recommends).
• Unrelated but related: Studies now show that most women need only gain about 20 lbs. during pregnancy (in the case of a singleton pregnancy, multiples would be different).

Medical Tips

• IMPORTANT: People who have had RNY or the Sleeve should NOT get the traditional 2-hour glucose test (where they make you drink the syrup-y stuff). Not only will it likely make you sick, but it doesn't always return an accurate reading. Request a blood glucose test instead!
• IMPORTANT: If you experience any abdominal pain (around the area of your stomach/sleeve/pouch, rib cage, etc.) get it checked out! She told us the story of a doctor in an ER who was stumped by a pregnant woman's severe abdominal pain. She was a Lap-Band patient and her band had slipped pretty severely. They were able to get it out fast before it did any harm, but take that as a warning: ALWAYS take abdominal pain seriously!
• I also want to re-stress the many small meals throughout the day. Dr. Blackstone warned that pregnant women have to work especially hard to keep their bodies out of starvation mode. It shuts down your metabolism and can be counter-productive to your pregnancy)

On freaking out about gaining weight:

• Find a weight-loss surgery specific pregnancy group (online or in person) where you can talk openly about your fears without judgment.
• If you feel extreme anxiety about your weight gain, seek psychological help!
• When seeking psychological help, find someone who has worked with bariatric patients before. 

On exercise after childbirth:

• Do it! Exercise after childbirth has many benefits.
• The baby gets more oxygen when mom exercises.
• Mom has more stamina/energy when she exercises
• Mom's body is better prepared for childbirth when she exercises
• You can do most any exercise form you did before pregnancy, however, some modifications to movements may be necessary. Check with your OB/fitness professional to design a workout that's right for you and your baby!

Whew! That was a lot of information for one hour but Dr. Blackstone really was great. I hope this information is helpful to all my Foodies who are planning families!

OAC "Your Weight Matters" (#YWM2013) Recap - August 15, 2013

Today's recap is not that eventful. I took two planes. I did NOT take Spirit Airlines which means the planes got where they were supposed to go when they were supposed to get there. Yay!

Upon arriving in Arizona, I had three thoughts:

1. Damn, it's hot!
2. This landscape is gorgeous!
3. I am about to be among "my people!"

And I was! The first two people I ran into was my pal Beth, aka "Melting Mama" and fellow Foodie, Nannette!

This is a record year because I've seen her and fellow food blogger Shelly, aka "Eggface" three times this year. Considering Shelly lives in Southern California, Beth in New England and me in the Mid-Atlantic, that's quite a feat!

The main event today (besides registering) was the Meet & Mingle. After registering I took some time to go through my "swag bag" and found this:

They gave us the menus for all planned meals with nutrition information AND a worksheet to calculate how many calories and how much protein we planned to consume at each meal. Kudos, OAC! I like this a lot. 

The Meet & Mingle was a great event as well. They had a decidedly more health conscious menu than other conferences I'd been to this year. There was some stuff of the starchy variety (keeping in mind this conference is not exclusive to weight-loss surgery patients) but there was also this:

A beautiful tray of veggies with some nice dips. I sort of used this reception as dinner (because a Foodie is on a budget!). I sort of missed having meat, but I dealt.

So the main event was the talk, "Teaming Up to Tackle Obesity." This consisted of a panel of two bariatric surgeons, dr. Archie Roberts and Dr. Henry Buchwals and two former NFL football players Corey Louchiey, who lost weight with diet and exercise and James Thornton, who lost weight after having bariatric surgery. I LOVED this panel for several reasons:

1. There was no emphasis on one method being better than the other. Both were treated with equal validity.
2. Both men spoke on their struggles with eating more healthfully and changing their lifestyles. (And many of those struggles were the same!
3. These two men didn't know each other well before they both decided to change their lifestyles but are now good friends who support each other, without judgment or comparison, in healthier lifestyles.

This was so encouraging to hear. I believe WLS is one of many options for gaining control of obesity. The two doctors recognized this and also the fact the people look up to athletes. That admiration has value and they wanted to capitalize on it to be able to capitalize on that to motivate people to change their lives.

Me & James Thornton, former NFL player who is "Teaming Up to Tackle Obesity."

After they talked they took questions and one person asked James Thornton what he'd say to people who told him he took the easy way out. James said that there is no easy way. No magic bullet and that he'd let people know that the reality is that any method of losing weight is hard. 

I have an amendment to that. (Indulge me another soap box moment this week.) After James spoke one of the surgeons made a remark about people not saying the same thing when a person has gall bladder surgery or heart surgery, about "taking the easy way out." This is true but in my opinion there is a reason for that.

When you have gall bladder problems and have to have surgery for it you don't apologize for having gall bladder surgery. When you have heart surgery, even if it was caused by some behavioral pattern, you don't apologize for having heart surgery. And the world doesn't expect you to. But in some way - whether overt or subtle - many WLS patients apologize for having to have WLS. We apologize for not being able to do it with diet and exercise alone. We apologize for not being born with ideal genetics. And in many ways we apologize for being human.

Let's work on that, ok? Because in reality if you look at your so-called "skinny" friends, many of them probably have the same habits you did back in the day. But you might not consider them bad habits because that person did not end up obese as a result. So stop apologizing for being human, for making mistakes and for needing medical treatment for a medical condition that is likely threatening your health and future.

That one simple shift in thinking has the power to do so much. So think about it, ok?

In the meantime to follow what I do on Friday, August 16, you can:

• Follow the hashtag #BFYWM on Twitter. I'll be using it to post updates.
• Stay tuned to the Bariatric Foodie Facebook Page. I'll be posting pictures and quotables there as well.
• Tomorrow night I'll post my Friday recap.

I hope you guys are enjoying my coverage so far. If you have questions about anything I've seen or done, leave a comment. I'm happy to address anything you want to!

Bariatric Foodie goes to the Obesity Action Coalition "Your Weight Matters" Conference!

Don’t worry, I’ve left behind some good recipes to tide you guys over while I’m gone. But then I won’t really be “gone.” I’ll just be busy blogging for you guys at the Obesity Action Coalition “Your Weight Matters” Conference in Phoenix, Arizona!

I wanted to let you all know my (tentative) plan for how I’m going to communicate with you during the conference.

• If you want live, moment-to-moment updates, be sure to follow the hashtag #BFYWM on Twitter (You are following Bariatric Foodie on Twitter, aren't you?)
• If you’d prefer recaps periodically throughout the day be sure to stay tuned to the Bariatric Foodie Facebook Page. I’ll be sharing quotes, notables and photos there.
• If you want an in-depth look at the sessions I’ve attended I’m going to post daily recaps here on Bariatric Foodie. I expect my recaps will go up pretty late at night, especially for my East Coasters, so check back often!

And I want to take one more opportunity to say THANK YOU! I am only able to attend this conference because you guys routed your Amazon, Netrition and Quest Bar orders through Bariatric Foodie and ordered copies of the “Bariatric Foodie Guide to Perfect Protein Shakes” during the month of June! I’m really proud to say that my Foodie Nation came through in this way and I will proudly represent you to everyone I meet in Arizona!

Let’s do this! 

OAC "Your Weight Matters" (#YWM2013) Conference Recap: Friday!

WARNING: There's a lot to cover so this post is going to be LONG. Many of you got the moment-to-moment on Facebook and Twitter, but I wanted to give you a more in-depth look at what I did today!

Meals

Let's start there because that's pretty straight-forward. So far, OAC has been doing an excellent job of giving us healthy options (and with the help of the handy-dandy nutrition guide, I know how to make smart choices!). For breakfast I had an egg white/veggie scramble with cheese, some turkey bacon and a big dollop of Greek yogurt with fruit. Yummy!

I did a "Lunch with the Experts" session. A lot of you ask about pregnancy after WLS so I went to the session that covered that topic! I'm going to post about that in a separate post because there's a lot of information that came out of that one.

We had bagged lunches. I chose the tuna salad bag. The entire bag came with two pita breads, tuna salad, lettuce & tomato, a bag of pita chips, hummus, salsa, an apple and a little piece of dark chocolate. Of that, I ditched the pita breads (broke my heart too, I love them!) and kept the pita chips so I could dip the hummus, ate the tuna naked with the salsa on top. I skipped the apple altogether (apples are like four Thanksgiving dinners in my pouch).

Dinner was at the welcome event which had a Hollywood Beach Movie theme. I didn't do a costume because...well...I just didn't! But there were some good ones there, including my beloved Eggy dressed as seaweed:

The dinner was...enhhh. It had potential. They had a lovely garden salad, some tofu and veggie dish (I did not partake), a quinoa-veggie medley, fruit salad with mint and a Hawaiian-esque chicken dish and Mahi-Mahi were the proteins. This is what I took.

Total eyes bigger than stomach moment but it turned out for the good because I didn't care for the Mahi-Mahi so I nibbled on the chicken and ate some of the salads.

The Sessions

I don't have pics of all the sessions but my plan (so this post doesn't exceed the Iliad) is to describe each session and summarize the key points.

Plenary Session #1

We started with an opening session featuring Heidi Hanna, who is the author of The SHARP Solution: A Brain-based Approach for Optimal Performance. She talked about stress and energy management. We think a lot about managing our stress but not so much about how we manage our energy. Especially us WLSers. I can't tell you how many Foodies I've heard say that they have a hard time saying no when people ask them to do things. Well when you don't refuel your own tank, how can you be there for others?

Hanna suggests that we:

• Think about the commitments we make. Are you investing your energy wisely?
• Don't be afraid to care for yourself first?
• Sleep is important - don't skip it!

Plenary Session #2

The second session was my favorite of the entire day. it was led by Dr. Robert Kushner of Northwestern University and was on the major events that impact a woman's weight. Basically in his work with Northwester, Kushner began asking his women patients to chart life events as they charted their weight. He began to see certain links between spikes in weight and life events. He also noticed that at different periods in a woman's life, different factors effected her weight and that some of those factors could also affect others as well. I learned that:

• Women who give birth as obese women can "imprint" the risk of certain diseases on their fetus, such as obesity and diabetes. He cited studies that found that children born to women after they'd lost weight did not carry the same level of risk.
• That in adolescence many girls experience weight gain because of a variety of factors, including psychological. Teenage girls can be affected by socialization, the media and a host of other factors.
• Stress is a major factor in weight gain for women but not just for the reasons you may think. He relayed that our coping mechanisms have as much to do with resulting weight gain as the stress itself.
• He shared that people who lack sleep tend to gain weight more easily.
• And finally he shared that menopausal women, due to hormonal changes, can experience a change in weight and size. This, coupled with lifestyle changes associated with age (which can include a decrease in physical activity) can lead to significant weight gain.

Northwestern is doing several interventions to help women overcome these factors, including a program that does obesity intervention with pregnant women. I flagged this program to learn more about it because I was so fascinated!

Plenary Session #3

This one was on weight bias. I admit I didn't even have a great conception of how deep weight bias runs until I listened to the presentation from Joe Nadglowski and Ted Kyle, both members of OAC's national board. They pointed out such influences biases as:

• Those in the media. Do you ever notice many times in pictures and videos in the media obese people's chest and stomach are shown but not their faces? Showing someone's face gives them an identity and dignity and I admit even I had become used to those images!
• In the healthcare industry: Studies have shown many doctors don't spend as much time with obese patients and don't offer them as many preventative services. What made me the most sad is that in a poll taken, 24% of nurses reported being repulsed by obese patients.
• In the work place. Obese people can be perceived as lazy, unkempt, unintelligent or "not a good fit" for a job or a promotion. They can experience lower pay and fewer advancement opportunities.
• In education. Obese youth can be considered not as smart or not as great a candidate for college.

The main way to fight weight bias is to communicate clear messages like:

• Obesity is bad. Obese people are not bad.
• Obesity is a disease, not an identity. Reject the label of "being obese." You suffer from the disease of obesity.

After lunch we had three breakout sessions.

Break-out session #1: Home is where health begins: Creating a healthy home environment

This session wasn't exactly what I thought it would be about. It was mostly about the habits of people who have successfully maintained weight loss. There is a national registry of weight control that studies the habits of people who have lost and maintained weight. The habits were nothing new. People who maintain their weight tend to eat breakfast, exercise, weigh themselves routinely. But they also:

• Think of themselves as having a healthy lifestyle, not as being on a diet
• Don't get fazed over plateaus. They persist through them because they are living an overall healthy lifestyle
• Set S.M.A.R.T. (Specific, Measurable, Attainable, Realistic & Timely) goals

One thing that was stressed here was something I say all the time. The only way to replace good habits with bad is to habitually practice the good habit in place of the bad. It will feel strange and out of place at first but eventually the good habit will become second nature.

Breakout session #2: Planning, Shopping & Dining: Practical Tactics for Good Nutrition

I enjoyed the speaker, Dawn Jackson Blatner, very much. She's a registered dietician and author of "The Flexitarian Diet." She taught us that just as we consider a manicure or pedicure or sweets a treat, so should we also look at feeding ourselves healthfully. So she gave the following tips.

• Planning: plan out your meals. She suggested planning just two meals of each kind (breakfast, lunch and dinner) and rotating between those meals or variety. 
• Shopping: She also suggested writing down your list when you go to the grocery store to avoid bad decision purchases and shared that the best time to go grocery shopping to avoid crowds and stress are either during the day on a weekday or later in the evening. She suggested that the ratio of types of products in your shopping cart should mimic how you eat. So for me my shopping cart should be 40% protein products, 35% carbohydrates (and remember carbs are not just starch but fruits/veggies too!) and 25% fat. She also empowered us to remember reasonable condiments like sauces and dips. They can make eating healthy foods more enjoyable!
• Eating: Many people talk about mindful eating and Blatner issued a challenge. You want to eat more mindfully? For 7 days commit to eating every meal at a set table, off a plate with silverware. I know that's not always possible but to the extent that we can do it, I think it's a great idea!

Breakout session #3: Who's Staring Back at you in the Mirror? Improving Self-Perception

This session was led by a very charismatic and dynamic woman named Merrill Littleberry, a psychotherapist. She challenged us to change how we look at ourselves by changing our behavior in relation to others.

• Stop holding onto the negative. Write new "cue cards" for yourself. Instead of focusing on everything you haven't done, focus on what you have done.
• Show Gratitude. When someone compliments you on your progress, learn to say thank you instead devaluing what the person has said. If you practicing gratitude, eventually you may begin to believe those compliments.
• Be careful of the people you surround yourself with. Are they just taking and taking? Healthy relationships are give and take so if people in your life aren't giving it's time to re-examine. Unhealthy relationships can be a drain on your psyche and can further damage your self-perception. 

If you want more information on these sessions, I'm going to post the links to the presentations when they become available to me. For now, I'm going down to today's sessions! There are some sessions that are being live-streamed if you want to watch (and you should because this is good stuff!). Otherwise, I've been posting a lot of the detailed stuff on Facebook and Twitter for discussion. Tune in by following the hashtag #BFYWM or for general insights from all attendees use #YWM2013.

I look forward to sharing another great day with you in the second day of the conference!