Category: Weight Loss

Weight loss is a simple mathematical concept: consume fewer calories than you burn on a daily basis.  This equation can be manipulated on either end: by reducing intake and/or increase expenditures.  None of this is new, special, or revolutionary.  The trick is how to motivate yourself to do this, how to be consistent in your efforts, and how to deal with the inevitable challenges to your plans that occur in day-to-day life.

Dr. Judith Beck, Ph.D has a novel and effective approach to this problem.  By utilizing Cognitive Behavioral Therapy principles, she instructs the reader how to change their thoughts and change their behaviors leading to a healthy approach to food and exercise that is for life.  In her most recent book, The Complete Beck Diet for Life, a follow-up to her How to Think Like a Thin Person, Dr. Beck expands on her tools for dieting success by suggesting options for healthy eating.

Dr. Beck’s CBT approach has been an effective tool, when employed, for dealing with the “sabotaging thoughts” than can occur while dieting: Permissive-thinking, “All-or-None” thinking and others.  When combined with accountability, support, and appropriate (non-food) rewards/motivations, weight loss success can be realized.

  • Plan your meals and record everything that is consumed.  Use a digital food scale to weigh or measure food.  Lose it is a free iPhone app (or is available through their website) to log calories consumed.  Websites such as and provide wonderful information on calories of various food including foods from restaurants when available.
  • Exercise is not optional. Although some weight loss can be realized by calorie restriction, our bodies were created to move.  There are multiple health benefits of exercise including reduction of depression and improvement in blood sugars.  Some exercise is better than none…get moving!
  • Your body is not a trashcan. Excess food is wasted whether you put in on your waist or throw it in the trash.  Do not eat unplanned food & count every bite.
  • Give yourself credit.  By recognizing what you have done right or well, you give yourself a basis to improve from.  We act on what we believe and we believe what we tell ourselves.  Believe that you can be successful!
  • Find your motivation.  Write out your reasons for losing weight and review them often.  Set incremental goals and reward yourself along the way with non-food rewards.

These are some of the tips and resources I use.  How about you?  What have you found to be helpful or not? I would love to hear what has worked or not worked for you.  Please feel free to comment and join in the conversation.



Psychiatric patients are at high risk of becoming obese—with rates up to 63% in schizophrenia and 68% in bipolar disorder. Moreover, weight gain from psychotropics is associated with medication non-adherence.


The 8 behaviors described below can help individuals become more active and take steps toward a healthier lifestyle.


1.  Keep a food diary. Keep a written record of everything you eat or drink in a day. Learn about healthy foods and look up the calories of common foods using food packaging, pocket books listing calorie counts, and online sources.


2.  Start walking. Pedometers could motivate individuals to exercise regularly and reach goals of taking a certain number of steps each day. A physically healthy individual should walk approximately 10,000 steps per day. Scheduling daily walks also provides structure and increases the likelihood of compliance.


3.  Plan meals and eat mindfully. Schedule meals and eat mindfully. This means keeping your full attention on eating by noticing the smell, taste, and texture of food. Eat slowly, enjoy every bite, and avoid eating while watching television or when occupied by another activity.


4.  Have a healthy snack before a meal. Eating a serving of boiled vegetables or a piece of fruit such as an apple before a meal can satisfy hunger and reduce food intake.


5.  Increase fluid intake. Feeling hungry might be a signal that the body needs more fluid.  Drink water, avoid beverages that contain sugar, and limit fruit juice to 4 to 8 ounces per day.


6.  Obtain support from family and friends. Loved ones can reinforce a patient’s weight loss efforts by not eating high-calorie food in front of the patient and buying only healthy snacks such as fruits and vegetables.


7.  Improve nutrition.   Specifically:

* eat at least 3 meals and 2 to 3 healthy snacks per day

*  choose lean meats and whole grains

*  eat 5 servings of fruits and vegetables daily

*  avoid eating after 7 Pm or 3 to 4 hours before bedtime.

8.  Monitor weight regularly. Digital scales give more precise measurements, which can prompt individuals to reduce food intake when they notice weight gain. Frequent feedback can help facilitate behavior changes necessary for weight loss.  Weigh-ins should occur between once-a-day and once-a-week.  

People often need help setting appropriate weight loss goals because achieving their ideal weight may not be possible. Losing 10% of body weight usually is a realistic goal that can improve their health.

(Summarized from Current Psychiatry, Vol 7, No. 9: article by Imran S. Khawaja, MBBS)

Fad Diet De Jour

As I was reading the Sunday paper, I notice an article entitled “Clinic Takes Advantage of New Weight loss Discovery”.  Turns out, this was not an article, rather a paid advertisement, and in no way a “new discovery”.  I am personally and professionally interested in weight management so I decided to do some investigation. 


This local, family practice physician is promoting hCG Therapy for weight loss.  The ad includes the statement, “If you can’t lose weight, it may be because your body’s signals that used to come from brain areas like the amygdala, hypothalamus, and pituitary gland have stopped sending hormones to your stored fat, telling it to move.  HCG Therapy replaces this process.”  I have had two different patients try this program, in their words, “out of desperation”.  They were charged $2500 (paid up-front) for 6 weeks worth of injections of hCG.  Neither patient lost weight, but more shocking, neither patient was told that this was NOT FDA approved.  Stephen Barrett, M.D. talks about this “therapy” on his website: . I found more information about this “discovery” on the Dr. Weil’s website as well:


The acronym hCG stands for human chorionic gonadotropin, a hormone produced during pregnancy. It is made by cells in the placenta and is believed to mobilize abdominal fat to help nourish the fetus. The notion that daily injections of hCG combined with a severely limited caloric intake of only 500 calories per day would prove an effective weight loss method goes back to 1954 when a British physician, A.T.W. Simeons, proposed it. The idea is that if the hormone can convert fat to calories during pregnancy for use by the baby and, in the process, speed the mother’s metabolism, it can do the same thing when injected into people who want to lose weight.


The trouble is, it doesn’t work. Over the years, a number of clinical trials have tested the diet both in Europe and the United States, and none has found that hCG has any positive effect. Sure, you can lose weight on this diet – but that’s because you consume only 500 calories per day, not because you inject yourself with hCG. A study published in the American Journal of Clinical Nutrition in 1976 found no statistically significant difference in weight loss, percent of weight loss, hip and waist circumference, weight loss per injections, or hunger ratings among patients who were on a 500-calorie-per-day diet combined with hCG injections and those who were on the diet and received placebo injections. Taking hCG doesn’t appear to be particularly unsafe, but there is no scientific proof that it does any good. ( )


Such programs “takes advantage”…of individuals’ desire for an “easy fix” and belief that “if it is from a doctor, it must be real treatment.”  I am saddened that there are members of the medical profession engaging in such seemingly profiteering practices.  While I understand the desperation and frustration of failed weight loss efforts, why not promote increasing exercise and a healthier diet (nutritious, balanced)?  Even if individuals did lose some weight from the ultra-low calorie diet, what is the likelihood that they would be able to maintain that weight loss?  Extremely low, especially if the thoughts and behaviors that led to the weight gain were not addressed.  Sometimes there are no shortcuts.  As they say, “If it sounds too good to be true…”