2013-05-19T02:25:50-04:00 Will Aguila, M.D. http://www.huffingtonpost.com/author/index.php?author=will-aguila-md Copyright 2008, HuffingtonPost.com, Inc. HuffingtonPost Blogger Feed for Will Aguila, M.D. Good old fashioned elbow grease. tag:www.huffingtonpost.com,2012:/theblog//3.2272041 2013-02-06T07:04:04-05:00 2013-04-08T05:12:01-04:00

Will Aguila, M.D. http://www.huffingtonpost.com/will-aguila-md/ One study in the Journal of Family Issues found that "men who gained weight were more likely to report marital problems than men who lost weight." What makes matters worse is the guilt that follows because you don't want to admit relationship failure. This guilt builds up and adds to the anxiety that you already have. Eventually you find an escape, which for many of us is food. As we make the wrong food choices in ever increasing quantities, we gain weight and our guilt mounts, thus perpetuating the obesity cycle.

Toxic relationships exist in many forms. Perhaps you have a girlfriend or a boyfriend that is just not compatible with you. Perhaps you are married to someone that is not your ideal match. You may have a difficult relationship with your son or daughter where neither of you understand each other. You may even be in an abusive relationship. Whether it is verbally, mentally or even physically abusive, they all set the stage for a downward spiral.

Generally these toxic relationships that I see in my practice pose a significant impediment to losing weight and keeping it off. Despite all efforts to change eating habits and increase exercise, it just isn't that simple. The key to getting healthy when you're in a bad relationship is to resolve the stressor by either breaking off the relationship or coming to some common ground with your partner. However, if you are not aware that this is root of your weight problem, then you will never completely conquer your weight issues.

I have consistently observed in my practice a different type of toxic relationship; one where one of my gay patients is involved in a heterosexual marriage or relationship because they are unable to "come out" and disclose their true feelings. This situation leads to deep resentment and tension with their heterosexual partner. Guilt and anxiety soon follow, as well as a long-term addiction to highly palatable and calorie-dense foods; for many, this is their release.

I have noticed that this situation happens mostly to gay men; since the underlying caveat is that the affected individual is unable to disclose his gender preferences for fear of reprisal from family, friends and employers. It is unfortunate that our society has created such a stigma when it comes to gender identity that this leads to severe emotional and physical injury in the form of chronic stress and obesity.

I disclose to you that this is only an observation that I have made in my practice, and is difficult to quantify how often this is in play in the greater population. Unfortunately, there is not much data on this particular problem in scientific literature; it has either not been identified as an issue before or there are constraints in obtaining data. Either way, I feel that this may be a problem that is being ignored.

Addressing eating habits without addressing the stressors that caused them in the first place is like pulling weeds from the ground without removing the roots; it will work for the short term but soon the problem will resurface and you will be back to where you started from.

Losing weight and keeping it off is about changing the very "fabric" of your life. Researchers at the Scripps Institute have found that dopamine has been associated with addictive responses to certain foods, much like we see with cocaine or heroin use. Similar associations have been made with serotonin, and are brilliantly described in Dr. Mike Dow's book Diet Rehab.

You need to find other outlets, in place of food, that release the same chemicals in the brain than the tasty, calorie-dense alternatives we pick up at the drive-through windows. These other outlets come in the form of activities that require creativity and intellect. A study published in the journal Nature Neuroscience found that dopamine released during music-listening can cause feelings of euphoria. Other examples might include training for a 5K run, writing a book, running a support group, getting involved in community events. These activities can replace the "high" we get from eating high-calorie foods. Dr. Susan Albers discusses this in her book, 50 Ways to Soothe Yourself Without Food. Treating the overeating, setting up the action plan, and looking for new outlets all have to be done in conjunction.

The cycle of overeating and obesity can be broken. Those trapped in it know what it feels like, but putting our heads in the ground and wishing it would go away will not work -- anybody who has lost weight only to gain it all back and then some knows what I mean. There are at least seven common root causes, maybe more, that lead to using food as an escape; here I describe but one of them. What is important is that they are all treatable.

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Will Aguila, M.D. http://www.huffingtonpost.com/will-aguila-md/
Everything that you need to learn about effort you can learn from having an itch at the center of your back that you can't reach. Think about it. When you get that itch, you just have to take care of it or it will drive you crazy. You first try to reach back with your hands, but you just can't quite get there. Next you try using a pen or a stick, but you can't get the whole area just right. Now you rub against a wall or some other angled object; this helps, but not quite since the wall isn't sharp enough.

Maybe you're lucky and you find your spouse or a friend and ask them to scratch it for you... this works. Or maybe there is no one around so you fashion some type of instrument into a makeshift claw and you get to it. Later, you go out and buy a backscratcher so that you're prepared if it ever happens again.

What you did here is solve a problem by applying the effort and adjusting it to make it work. What prompts effort is the urgency of the matter: "How badly do you want the prize?" Plus, you know that if you apply the effort you will get the results... the itch goes away.

Look at how you solved the problem. You first tried to simply reach for it. We often try the simplest solutions first, and there is nothing wrong with that. In fact, it is a law of nature that everything tries to take the path of least resistance; water is a great example of this. But the problem occurs when we try to take the easiest path and it doesn't work out. This is where determination tends to slip for most people. THIS is the turning point and the spot where I hope you will learn to be different.

If the simplest solution does not work out, then you need to ask yourself "how bad do I want it?" and if the answer is "pretty bad" then you need to get creative. In our back scratch example, you next try to use some sort of instrument. But since this may not be the best instrument for the job, you may solve only part of the problem.

Now, in your quest to reach back scratch nirvana, you find a sharp angled wall or corner and you do the back scratch boogie. This works better, but it's not precise and it's not going to pinpoint the area of concern. Again, you are still making progress.

Luckily you found someone who can scratch your back, and when her or she does so, they get some of the area just right, but they leave the other parts untouched. You see, they can't really tell if they're getting it exactly right, you have to guide them. Also, for some reason the itch always travels when you scratch it leaving the scratcher lagging behind the areas where the scratchee needs it most.

Finally the itch goes away temporarily, but you know someday it will be back with a vengeance. Rather than go through all that effort again, you buy a backscratcher specifically designed to scratch your back in the areas that you need it the most. Now you're in control.

There is a lot to learn from the need to scratch your back. First, understand that how long you persist in your effort depends on how badly you want to achieve the intended result. If you want it bad enough, you will stick with it until you're successful. You need to find the passion in what you want, otherwise you will abandon the fight.

Once you're passionate about achieving your goal, you plan your effort. The key steps are as follows: 1. try the easiest route, 2. use what is available to help you, 3. create something new, 4. ask others for help, 5. prepare yourself to manage future obstacles. These are all the steps that you took above when you had an itch to scratch. These are the same principles that apply to accomplishing any goal; you just have to find the right itch.

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Will Aguila, M.D. http://www.huffingtonpost.com/will-aguila-md/
As I was preparing to interview the legendary Richard Simmons for my radio show, I looked at some interviews he did with Dr. Oz and in one of the interviews he said something that just totally "clicked"; it brought tears to my eyes as it did to him. He said that he learned to keep the weight off because he did not want to experience that feeling of inferiority that he felt when he was overweight. That's it! That was exactly why I was so apprehensive about wearing the weight vest! I too felt vulnerable and exposed when I was obese, and I didn't want to be there again, even if only for an hour. Even though this was all in my subconscious, I dreaded putting the vest on again because it brought me back there! It made me fear that I could fail again.

Those of us who have overcome our battle with weight always tuck away in the back of our minds the fear that it can happen again. It keeps us in check, but it is ever-present. Learning to live with the fear of failure and to control it is essential to maintaining success. However, fear is not what you have to thrive on, otherwise it will eventually wear you down. Scare people into driving better by showing them pictures of gory car wrecks and that will only work briefly. Change their whole state of thinking and it will last for good.

The lesson that I learned from this vest is that no one needs to feel inferior because of his or her weight. The lack of self-esteem that people experience when overweight is key to understanding how to treat them. This needs to be understood by weight loss providers, trainers and physicians that help these people to lose weight. Feelings of failure and guilt are closely tied to this lack of self-esteem and unless we change that negative into a positive, those feelings will sabotage and haunt us even after we've lost the weight.

Now, I don't mean that we need to settle for minimal effort for fear of harming someone's self esteem. On the contrary, encouraging and even expecting appropriate effort is necessary. But by "pushing" someone instead of encouraging them we set them up for failure. As we belittle them, we erode their self- confidence. The one characteristic that all permanent weight loss graduates have in common is that they regained their self-confidence and self-esteem. This should be protected at all costs.

Putting on that vest made me feel vulnerable, exposed, inferior, slow, a failure... none of the things I really am or was, even while I was obese, but it made me feel like that anyway. I know what carrying that weight can do to others, and now I know how important it is to recognize it in those that I am helping through this journey.

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Will Aguila, M.D. http://www.huffingtonpost.com/will-aguila-md/ 12 percent of New Year's resolutions are kept after the one year mark? A resolution to lose weight is by far one of the most common. Early in January, the YMCA and other gyms will be brimming with well-intentioned "resolutionists" working hard on keeping their promise. But by mid-March, the vast number of them will have given up and returned to their previous habits.

Well-ingrained habits are hard to change. We favor the good intentions of restructuring the way we think, but these will give way to comfort and satisfaction. But why is it that we fail to keep our resolutions? Is it lack of motivation? Maybe it is fear of change or lack of determination?

I believe that two main factors are working against each other here. The first is the fear of change. We get comfortable with our daily choices; we may not like the choices, but we feel safe with them. Many times we don't make a substantial change because we feel that we are in a zone that is safe. Why venture out and try your luck?

The other factor is not understanding the importance of determination. Our past experiences with success or failure will reflect on our ability to be determined. According to the Merriam Webster dictionary, determination is "a firm or fixed intention to achieve a desired end." Motivation is basically a "boost or incentive" to do something. So by definition, determination is really the key to achieving success with something; motivation is just the incitement.

Determination, being the driving force behind achieving a task, has to be followed by effort, which is the work necessary to achieve the desired end. This is where a lot of people will stagger. You see, two issues are at play here. The first is that we may correctly or incorrectly see the effort necessary to achieve our goal as gargantuan. We can create and compound our own worst fears. Almost always, this is a false pretension.

Oftentimes we see the effort as insurmountable because of our experience with our past failures and how we handled them. If we failed at our attempts often in the past, we tend to expect much the same outcome that we did before. But what you need to understand is that although the journey may be the same, the path is always changing! Armed with this knowledge is one of the ways that you can change your outcome and avoid predicting failure.

Determination is what allows you to choose the right path and to switch directions, rather than quitting, if it isn't the right path. No one can teach you "determination," but we can plant the seed, water it and watch it grow into a Grand Sequoia.

Success is then a cycle that originates with inspiration and motivation quickly follows. Motivation then is followed by determination, which leads to effort and this in turn leads to accomplishment. If you attain accomplishment, then you reach further inspiration and the cycle continues itself.

You must keep this cycle alive by driving determination, which is the steam engine that keeps it going. Do this by finding the right people and events that keep you motivated and by taking the effort in stages, not trying to set your goals so high that the effort needed to achieve it is unrealistic. Take shorter, simpler steps that lead to accomplishment, then further inspiration, and then more motivation. Make the cycle of success work for you.

And this is what you have to do to keep that New Year's resolution alive, regardless of what your resolution is. Plant your determination and "watch it grow." Understand the cycle of success and how it works so that you keep looking ahead and adjusting your path.]]> tag:www.huffingtonpost.com,2011:/theblog//3.1100287 2011-11-23T08:45:40-05:00 2012-01-23T05:12:01-05:00

Will Aguila, M.D. http://www.huffingtonpost.com/will-aguila-md/
For many people, Thanksgiving is their favorite holiday. Not because it's the time for family or reflection of our blessings; it's because of the food, plain and simple. No other holiday is so embedded with the image of food. Think about it. I say, "Thanksgiving" and your first thought is a large roasted turkey... you know you thought about it just now -- don't try to deny it!

Whether this image has been ingrained in our psyche through media and advertising is irrelevant because we choose to accept it. I'm not saying that the Thanksgiving turkey dinner is a bad thing, but we need to put it in perspective. Perhaps I imagine a Norman Rockwell type of family gathering where everyone is giving thanks around the table.

My point is not to sound political, but to prepare the stage for the habits that I am about to call to your attention. You see, the reason we allow ourselves to develop these habits is because we've made this holiday all about the food. Therefore we give ourselves permission to indulge in these behaviors because it's "only once a year." But, who are we kidding? In reality, these eating habits last throughout the whole holiday season, well into the New Year.

So, here are some of those bad holiday habits. I'm certain they are very familiar to a lot of us. Now be careful, these actions can be merely holiday-related, or they can be warning signs of a future eating disorder. Which are you guilty of?

1. Finishing someone else's plate. By this I don't mean, "Can I try a bite of that?" I mean the proverbial "Are you going to finish that?" Sound familiar? This is one of the most common behaviors that I've seen in people that have, or will have, a weight problem. It starts off innocently enough, but can become a very serious habit, enabling you to eat in excess of 300 to 500 calories or more! It can even be a whole meal, depending on how much your partner eats. Maybe you don't do this, but I bet you will see a lot of people during the holiday who do... if you just watch.

2. Starving yourself all day so that you can eat more at dinnertime. This is justified as "preparation" for the marathon-eating event later in the day. You want to "make room" for the dinner. All this is going to do is give you a voracious appetite so you will overeat and likely do so very quickly. All that preparation and anticipation of Thanksgiving dinner, what good is it if you're only going to inhale the food in 10 to 15 minutes?

3. Going for seconds and even thirds. The faster you eat, the more helpings you will take until, hopefully at some point, you will feel satiety. Unfortunately when you do finally feel like you can't eat another bite... you will be uncomfortably full!

4. Eating until you are uncomfortably full. Unbuckle your pants and loosen your zipper. Congratulations, you have reached nirvana. I know this can happen to the best of us and likely will on Thanksgiving, but beware: This kind of behavior, if it occurs often, can be a warning sign for binge eating disorder.

Don't be dismayed; a little indulgence can happen to anyone during a holiday such as Thanksgiving. But regrets are the result of poor planning. Plan for the holidays and don't set into new habits. Just because it's holiday season doesn't mean that you have to eat with reckless abandon.

So, take some time to reflect on the real reason for the holidays: family and friends. Be thankful for what you have and merciful to those who don't have. We like to show our love to others with our food, but we can show this love more powerfully with words of compassion and kindness. Remember, it's really not about the food!]]> tag:www.huffingtonpost.com,2011:/theblog//3.1030632 2011-10-29T03:10:00-04:00 2011-12-28T05:12:01-05:00

Will Aguila, M.D. http://www.huffingtonpost.com/will-aguila-md/ characteristics:

1. Persistence of use despite problems related to the use of the substance
2. Compulsive and repetitive use
3. Craving
4. Withdrawal

Can we classify food as an addiction? Persistent use despite problems related to the use of the substance... check. Compulsive and repetitive use... check. Cravings... check. Withdrawal? There is certainly withdrawal -- just ask anyone who has tried to change his or her diet cold turkey. This is why it is so difficult to make healthier food choices and cut off the foods that we crave.

The hypothesis that food is an addiction is currently being studied by the Yale Rudd Center for Food Policy and Obesity. Research is showing that there are similarities in the way the brain responds to drugs and highly-palatable foods. Certain neurotransmitters in the brain, including dopamine and serotonin, are released in response to certain drugs, and the same pathways seem to be cross-linked with certain foods.

The addictive nature of foods is important to understand because we are sometimes too eager to blame obesity on lack of willpower or fortitude. Yes, we make choices, we can choose not to smoke, we can choose not to take drugs, but we cannot choose "not to eat." If we are genetically susceptible to addiction and we are given the right trigger, such as an overwhelming stressor in our life that causes us ongoing anxiety, then we will connect certain foods to those pathways in the brain that release those "feel good" neurotransmitters and we have a full-blown addiction.

The thing about food addiction is that, unlike drugs, alcohol or smoking, food addiction is not yet frowned upon by society. It's still "okay" to be addicted to food, plus it's cheap, readily available in large quantities, it's packed with high density carbs and fats, it's promoted all over the media, and it is legal! What an ideal substance to abuse, right?

In my many years of treating people with weight problems and with my own experience as a recovering binge eater, I identified certain recurrent factors that affect overeating. These factors fit together in a specific order to create a cycle that explains why we overeat and why it's so hard to break the habit. If we never manage the triggers, we're bound to repeat this cycle. Even after a "successful" diet, we'll gain the weight back.

The "Cycle of Obesity," as I call it, is a cycle that begins with a life-changing stressor, perhaps the death of a loved one, an unhappy marriage, a job that is highly stressful or a do-it-all mom that never has time for herself, a perfectionist personality, an abusive spouse, physical or sexual abuse as a child, the list goes on. But it is usually one or two major events, and those who have it usually know what it was that started it.

This life-changing event causes severe ongoing anxiety, which eventually may lead to depression. Some method to offset this then follows, usually in the form of food because it's legal and easy to get. We then feel better and start making that connection with certain "feel good foods." We then develop guilt as we gain weight and experience failure and loss of control. The guilt adds to the anxiety that we already have and more depression sets in... we eat more! The cycle is then complete: anxiety, depression, overeating, guilt, anxiety, depression, overeating, guilt...

What I found is that if we just treat the overeating part of this cycle and we do not address the rest of it, we are destined to fail any diet and even surgery; we will find a way to gain the weight back! You have to get to the root of the problem. I know this works, I use it all the time with my patients and I used it with myself to keep my weight off.

Now bear with me here, because I am going to reveal another interesting observation. If you take the cycle of obesity and replace the overeating portion with any other addiction such as alcohol, drugs, gambling, sex, or any others, you will see that this is really a cycle of addiction! Think about it; all the key ingredients are there. All you need to do is change the addictive substance. How do you pick your addiction? Is it just a matter of opportunity, what's available? This may be an explanation, in part, of why we have an obesity epidemic in this country. The substance of opportunity now is different than what it was 20 years ago, people used to turn to cigarettes and alcohol, which was more acceptable back then. Now, it's food that is readily accessible, socially acceptable, and legal.

If you look closely at this cycle of addiction it explains why people gain weight when they quit smoking or become alcoholics when they conquer their obesity. If you don't manage the cycle and treat the root causes, all you do is replace one vice for another! The cycle will continue because it was never broken.

Ignoring the real issues will not lead to long-term results in any case of addiction. It's just like putting a band-aid on a large bleeding gash. Yes, some deep root problems will require counseling and long-term resolutions, but others really don't. You would be surprised how time-management, relaxation, exercise, building up your self-confidence and learning to accept failure can have a profound effect on minimizing or breaking the cycle. You just have to be honest with yourself, find the real emotional cause, then treat it appropriately. Understand the cycle of obesity and use it as a road map to break your own addictions and help others break theirs. ]]> tag:www.huffingtonpost.com,2011:/theblog//3.983653 2011-09-29T08:59:00-04:00 2011-11-29T05:12:01-05:00

Will Aguila, M.D. http://www.huffingtonpost.com/will-aguila-md/
The recipe for a healthy life

• 2 cups of self-confidence


• 1 cup determination


• ½ cup healthier choices


• ¾ cups of increasing activity

Mix until smooth and bake at 350 degrees. Remove from oven and sprinkle with expectations. Serve while still hot and enjoy!

This is a recipe for healthy living. You may vary quantities of the various ingredients, but you need all of them to complete the recipe. I know that many readers will propose even more ingredients to this recipe; but ultimately, if you have the key ingredients above, it will work.

The problem arises because most of the time we lack one or more of the ingredients, and we try to achieve the same results without them. The fact is, every one of these qualities is essential to a healthy lifestyle. You can't have one without the other.

So let's go through this list of ingredients individually. I think that of all the qualities that I mentioned above, self-confidence is the most elusive. Most people do not carry an innate overabundance of self-confidence. This is an "acquired taste." This ingredient depends so much on past experiences -- both successes and failures.

How we were shaped as children plays heavily into our self-confidence. If we are encouraged and celebrated for making our best efforts early on, then we will carry this enthusiasm forward as adults. However, building up your self-confidence as an adult is much more difficult if you were constantly put down as a child. If you tell me that this is all "hogwash," then you probably haven't experienced this kind of upbringing yourself.

Essentially, self-confidence and parenting style are linked hand in hand. As a parent you will help to shape your child for the future, whether you like it or not. The child may spend most of his or her time in school or daycare, but you are still their hero, mentor and best example. Throughout life they will emulate you!

Self-confidence is almost never acquired all at once. Increasing your self-confidence is the key ingredient in successful and sustained weight loss; to keep the weight off for good, you need to feel good about yourself. This is a trait that builds up over time. You will achieve long-term success in weight loss only after you realize that you are "worth the effort." This feeling has to come from deep within you, but if your feelings of self worth were repressed early on in life, then you will struggle with this ingredient.

The good news is that you can win back your self-confidence by helping others achieve theirs. Strange as this may seem, I have found that if you use your talents to help others succeed, you will gain that self-respect and self-confidence for yourself as well. It will take time, but it will happen. Do it and you'll see the results. Success builds upon success!

How about determination? It's true that you can have an innate desire to succeed, improve and triumph at all cost. But even with this determination, it can become a life long struggle to achieve if you lack the other basic ingredients. Self doubt and fear of failure will permeate your efforts. Yes, you can overcome these, but it will take that much more "sweat equity" to do so.

Having that burning desire inside to succeed is crucial. Work on it, and let it flourish. This is the engine that is driving your ship. Don't allow anyone to extinguish it!

Don't expect to succeed every time. Some of the most successful people in the world failed multiple times, but they had determination. They continued to try, and learned from their mistakes. Not achieving your goals when you try is not failure. Failure is not doing something about it. Expect failure ... achieve success!

Now you need to make healthier choices. Don't be extreme and try to quit smoking, lose weight and start training for your triathlon all at the same time. If you try to do it all at once, you are more likely to fail. Take small steps, and always inch forward. Start with something as simple as not finishing your spouses or children's plate. Drink one or two glasses of water more a day. Or how about limiting your soda intake to lunchtime only? These small steps add up to big changes over time.

Do you think that you're not making progress if you start only with small steps? Think again. You will see improvement in your weight and your attitude very quickly. This improvement will allow you to build up your self-confidence, which in turn, will allow your determination to flourish. Notice how all the ingredients are starting to come together?

Next, increase your activity. I don't mean exercise; I mean activity. Whether it is gardening, washing the car by hand every Saturday ("wax on, wax off") or playing with your kid outside, increasing activity is easy and can be your first step to wellness. Make it a habit of increasing activity in everything that you do ... be creative. Remember, we want small steps that count.

Now our recipe is almost complete. Don't forget to sprinkle with expectations. How we perceive our future and ourselves is extremely important to our well-being. We have to feel that we are worth the effort. These key ingredients will enhance our lives and open us up to new horizons that we previously thought to be unattainable. Don't be afraid to follow a new recipe and enjoy the outcome.
]]> tag:www.huffingtonpost.com,2011:/theblog//3.958950 2011-09-12T16:23:37-04:00 2011-11-12T05:12:02-05:00

Will Aguila, M.D. http://www.huffingtonpost.com/will-aguila-md/
For many people, the benefits of working out are not instantly felt at the start of a new exercise program. In fact, when you first begin to exercise, it hurts! You get shortness of breath, your joints hurt, your muscles will ache for days, and you can even feel depressed and uninspired. You might also experience feelings of failure because you have such a hard time performing the workouts at the beginning. So at first, food comforts us, while exercise doesn't! The truth is, in order to get the benefits of exercise, you have to keep at it for a while. You have to get through the "hump" of pain in order to accept and actually enjoy it. You'll have a better chance of sticking with a new exercise program if you take some steps to prepare both your body and your mind for the harsh reality you may face at the outset.

Slowly integrating exercise into your daily activities is the key. Even better, concentrate on increasing activity on a daily basis. Walk a little more and climb the stairs more often, even if you do it slowly. Work in the yard and in the winter, walk in the mall. Wash your car and carry grocery bags a little further in the parking lot. By looking at it as increasing your daily activities rather than structuring an exercise routine, you are more likely to get started and more likely to be more successful. Even something as simple as mopping the floor in the kitchen will count!

Next, lose some weight without exercising first. Losing just five percent of your excess weight prior to beginning an exercise program will allow you to have more energy, feel less winded and lighter, plus, your joints will hurt less. This change alone may turn an "undesirable" exercise experience into a lifelong and enjoyable habit.

When you feel comfortable with increasing your daily activities, then you'll be ready to move on. Here is where taking small, but consistent, steps in the right direction are important. Don't set your standards too high. Do not set yourself up for failure.

Setting the proper goals is very important. We all want to have "rock hard abs" or a fitness magazine body. We are an "abs versus flab" society; it's either one extreme or the other. But we have to set realistic goals and shoot for being fit. Believe me, if you shoot for being fit, the rest will follow. Here is where starting with a professional trainer is very beneficial, as they can help you set an appropriate and safe exercise routine. Also, be sure to always check with your doctor before beginning an exercise program.

If you can't afford a trainer all the time, then try to use one for just the first three to four sessions so that you at least learn the basics. A local YMCA is an excellent resource. There, you can even sign up for a family program and involve your child in different sports while you exercise at their gym or pool. A family plan is affordable and is a much better alternative than signing up your child for a sport and sitting on the bleachers talking to other parents every day while your child practices. Using the YMCA in this way also allows you to exercise as a family and connect with each other; you arrive there together and you leave together! You get a chance to get your kids out of the house and make them active. It is easy to make this a habit.

Remember, that you want to make exercise an enjoyable and positive experience so that you stick with it for life. Exercise is not about willpower! You shouldn't have to fight yourself to keep going. Willpower will only get you so far. Exercise is about resolve.

As a final note, I know that it's often difficult when you're overweight or obese to join a public gym because you may feel self-conscious about your looks. No doubt that some gyms are part social club, part fitness club, but try not to let this stop you from getting the best experience out of your routine that you can.

If you feel intimidated in your gym, you can join together with a group that is physically similar to you. By doing this you will dissipate some of the negative feelings and at the same time, inspire yourself to do better because you are now part of a group. There is sometimes "safety in numbers" at a gym so to speak. Besides, if you create a big enough workout group, you will "own the place!"

Remember that the struggle with obesity is not an obscure dark tunnel, but a predictable journey that offers many side roads and avenues that lead to your success. You call the shots; you make the rules. A bright horizon is in your hands!
]]> tag:www.huffingtonpost.com,2011:/theblog//3.935289 2011-08-26T15:25:02-04:00 2011-10-26T05:12:01-04:00

Will Aguila, M.D. http://www.huffingtonpost.com/will-aguila-md/
The "Bento Box Attitude" thinks that if you can't sustain weight loss by these two principles alone then you must be lazy and lack discipline. Any ideas that fall outside of this box are not considered valid and we don't need -- or want -- to deal with them. If it's really that easy, why is permanent weight loss still so elusive? Is it because we want to fit obesity into this little bento box? What happens when we realize that it doesn't quite fit?

Unfortunately, obesity is not meant to be tucked neatly into a compartmentalized box. It's not as easy as "eat less and exercise more." The cravings come from somewhere and there are reasons why they exist. So much of the problem of obesity is above the stomach. It really has everything to do with the heart and the brain. We cherish our foods so much that we choose to shut down the brain temporarily so that we can soothe our heart. This form of temporary amnesia is what we call denial.

Denial is a difficult concept to understand because those who have never been obese sometimes cannot comprehend why anyone could "let themselves go." And many of those who are obese don't want to believe that they are. Putting our heads in the sand will not make this denial go away. We need to understand the problem in order to solve it.

Do we wish for a utopian society where food does not exist and everyone takes a pill for nutrition once a day? Where food is no longer an intricate part of our culture? Such a society, as described by Laura Riley, Food Critic for the St. Petersburg Times, as utopian as it may seem, would not offer us a reprieve from the daily temptation of choosing food to medicate our sorrows.

While exercising and eating better are important, they are but one spoke of the weight loss wheel. I believe that obesity is really a cycle that begins when we learn to medicate our anxiety and depression with food. This overeating eventually leads to guilt as we gain weight and start to experience feelings of failure. The guilt in turn adds to the anxiety that we already have and plunges us deeper into depression, which we comfort with what else? Food. We then find ourselves stuck in the "Cycle of Obesity."

By using this Cycle of Obesity as a roadmap, we can see that if we just treat the overeating portion of the cycle (diet and exercise) we may lose weight, but we are bound to gain it back because we never resolved the emotional triggers that may have made us eat in the first place. Therefore, in order to beat obesity and keep the weight off, we must fix every part of this cycle -- not just the diet and exercise parts.

What causes your stress, anxiety and depression? What guilt do you carry? Some of these issues may have even been cradled since childhood. Ignore these and you are destined to repeat the Cycle of Obesity. Once more, every time you repeat the cycle, your guilt increases as your feelings of failure cause you to overeat even more. I believe that this is why people often gain the weight back and "then some" after going on a diet.

Learning what these triggers are seems like a difficult challenge, but anyone suffering from severe weight problems -- who is not in denial -- knows what his or her triggers are. These triggers are major life stressors such as the loss of a loved one, a very stressful job that leaves no room for personal time, loneliness, an unhappy marriage, a lifelong lack of self-worth and/or extreme perfectionism. Other common causes include childhood sexual, physical and/or mental abuse. By being honest with yourself you can identify the triggers and work out a formula to defeat them.

The Cycle of Obesity offers a good explanation for emotional eating. It also explains why, when you feel like using food for comfort, simply taking a walk, exercising, reading a book, drinking water or other immediate remedies, will have minimal or short-term effects. You have to get to the root of the matter and only by doing something to treat the triggers will you completely break the cycle and conquer your emotional eating.

Here are four things that you can do right now to get started in breaking the Cycle of Obesity:

1. Write down and identify the major stressors that are causing you to eat. Be completely honest with yourself. Seek appropriate professional counseling if necessary.

1. Learn to accept failure. If you fall, get yourself up and try again. Do not expect success on your first attempts at anything. Find out what caused you to fail so you don't repeat the same mistake again.

1. Recruit someone you trust completely to help you with your journey.

1. Set shorter, more attainable goals for yourself. As you accomplish one goal, move on to the next one. Success builds upon success.

You cannot tuck your weight loss problem neatly into a little box and wonder why it does not go away. To conquer obesity you must understand its root causes and deal with them. Breaking the Cycle of Obesity is definitely possible and it allows you to live the authentic life that you desire. Just remember, the solution is not "one size fits all" and it certainly can't be found in a Bento Box.
]]> tag:www.huffingtonpost.com,2011:/theblog//3.923372 2011-08-15T08:16:21-04:00 2011-10-15T05:12:02-04:00

Will Aguila, M.D. http://www.huffingtonpost.com/will-aguila-md/
When we take a closer look at how weight gain and obesity work, we start to understand why the "Facebook Diet" may not be such a great idea. Obesity is a cycle that occurs when we allow ourselves to medicate our feelings of anxiety and depression with food. We learn to overeat to soothe our emotions and eventually, a certain degree of guilt develops -- especially if we are gaining weight. As this guilt increases, it adds to the anxiety and depression that we already experience and makes us overeat even more; creating a cycle. The cycle starts with anxiety, but the steam engine that keeps it running is guilt.

Now consider the pressure that you put yourself under by broadcasting your goals to hundreds of your Facebook friends. If your progress is less than stellar, you may feel that the "eyes of the world are looking upon you." This feeling -- whether it's substantiated or not -- increases your feelings of failure. It will fuel the obesity cycle by maximizing your stress, anxiety and guilt, which will in-turn, lead back to overeating.

So instead of creating a healthy measure of accountability for yourself, you've actually made matters worse. With every rotation of the cycle the guilt increases more and more. You're now in danger of spiraling out of control. This is an example of why, when people fail a diet, they gain back all the weight they lost and then some!

Now, consider the possibility of sabotage. Sabotage in weight loss occurs in many forms and the fact that you wish to have others hold you accountable for your own weight loss is a reflection of your past experiences with self-sabotage.

Another form of sabotage which can be just as harmful is "friendly fire." Friendly fire can occur by well-intentioned family members or friends who believe you may be losing too much weight or that you're not eating enough. Such sabotage is not intentional and should not be viewed as deliberate, but it may harm you nonetheless. Critique from beloved family members and friends -- especially if consistent -- can lead to an inevitable downfall if you're not prepared for this type of disparagement.

Now, consider the flip side of that coin, the "hostile takeover." This type of attack comes from so-called friends and co-workers that may take a certain amount of delight in your downfall. They may be totally upfront about their attack, criticizing you openly in the social media platform. Or, they may be ninja about it, not making any mention whatsoever of your progress, even when it is undeniably obvious. Such tactics may be meant to crumble the foundations of your efforts for their own amusement -- and Facebook puts it all on display.

Therefore, posting a regular journal via social media may cause your weight loss struggle to become a "gladiator sport" and the whole Facebook nation is sitting in the Coliseum cheering your success or hoping for your failure.

I suggest that rather than commit to your friends, you commit to yourself, because after all, this is for you. Minimizing stress, anxiety and guilt breaks the cycle of obesity. If you want to avoid criticism and sabotage so that you can optimize your chances for success, keep your daily diet details out of the public spotlight. Let the results speak for themselves.

It's your body and no one else's. The contract that you make with yourself is more valid than anything that you can promise to others. You have what it takes in you to do this! I know, I did it myself. Listen to your inner voice and trust it. If you need to share your plans with someone, then share them only with the people who are closest to you and who will be champions for your cause.

Do what it takes, but don't be disappointed if you fall. Get up and try again. But above all, beat the cycle!]]> tag:www.huffingtonpost.com,2011:/theblog//3.917601 2011-08-07T00:04:21-04:00 2011-10-06T05:12:01-04:00

Will Aguila, M.D. http://www.huffingtonpost.com/will-aguila-md/ U.S. Centers for Disease Control and Prevention. These startling obesity numbers show no signs of slowing down, making it crucial to understand why it's happening to you or to someone you love.

My personal struggle with obesity began in 1991. I started a new job, moved to a new city and got married at the same time. Can you imagine the stress? I began to "medicate" myself with food and the expected weight gain soon followed. I tried all sorts of diets, but I failed miserably. Believe it or not, I actually gained weight on Slim Fast!

What was causing my diet plan to fail over and over again? Surprisingly enough, it was my perfectionism. What made me fail was my inability to accept my own faults. I was trying too hard to have everything in my life "perfect." Just like most people who set out on a diet, I had very high standards for weight loss and when I didn't meet those goals, I lapsed into anxiety and depression and turned to food for comfort. It was time to try a different approach. Instead of relying on my perfectionism to help me lose weight, I needed to abandon it.

As as a medical doctor and surgeon, I've found the majority of my patients suffering from obesity are actually perfectionists too. We're not the lazy, procrastinating, passive-aggressive people that many think we are. We set very high, sometimes unreachable, standards for ourselves. I recently did a study of 101 patients and found more than 73 percent of them showed above average levels of perfectionism! Most of the perfectionism was the self-imposed type -- meaning they expect to be perfect.

Nobody likes to fail, but perfectionists despise it. Overweight perfectionists think in "all or nothing" terms; either we do something very well or we don't do it at all. There is no middle ground. When we find we cannot achieve our goals, we stop trying because we fear failure. What's often interpreted as a "lazy" or a "quitter" mentality, is in fact, a protective mechanism to save us from facing failure.

Diet detours and frustrations happen to just about everyone -- the hard part is not letting these setbacks destroy your progress. With perfectionism in mind, here are three tips to help you break the struggle with weight loss:

1. Set shorter, more attainable goals for yourself. The goals should be realistic so if you fall short, you're more likely to recover and try again. If the goals are too difficult you will think, "I'll never be able to do this." You'll indulge your extreme thinking tendency and the show is over! Weight loss professionals and exercise trainers need to understand this concept too so they don't facilitate your failure. Set out to lose one to two pounds per week rather than 10 pounds. Don't attempt to run a 5K if you can't even walk a block. If you're honest with yourself by setting realistic goals, you WILL get there.

2. Don't weigh yourself every day. I recommend weighing yourself only on Fridays. Why? Because if you weigh yourself on Monday and you had a "bad" weekend, you might think, "What's the point, I blew it anyway." Thus, you'll quit the rest of the week. If you weigh yourself on Friday, you will know how you did throughout the week and prepare yourself accordingly for the weekend.

3. Work on thinking "in the middle." Here's an exercise to help you get away from extreme thinking. Think about your current goals and draw three columns on a piece of paper. On the right side, write the absolute best possible outcomes for your goals. On the left side, write down the worst possible scenarios. In the middle, write down possible outcomes that you would be willing to accept. Finally, rank the middle column in order from first to last and shoot for the middle three choices. This helps you to accept less than perfect outcomes. Refer to this list every day, and it will change your life for the better!

My own 10-year bout with binge eating and inflexible perfectionism led me to understand the need to moderate my thinking. When I understood the root cause of my obesity, I was able to treat the triggers and eliminate my cravings for comfort foods. Since then, I've kept the weight off for seven years and counting! By understanding this perfectionist tendency in obesity, we can do a much better job at helping people conquer their struggle with weight. Remember, the secret to success is knowing why you failed and doing something about it.
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