I Just Need to Lose Weight! – Updated Cancer Exercise Guidelines, and more.

Dear Fellow Traveler,

As we are heading into the holiday season, many of my patients are dreading the temptation of being surrounded by lots of food (cookies!) and the resulting weight gain. When concerned about health outcomes, weight is an easy culprit – blame it on the weight! Recently while discussing new health issues, one of my patients told me — surprisingly calmly considering this has been a priority for this patient for years already — “I just need to lose weight”. I sensed the defeat and helplessness.

Weight is a topic that is central in many people’s lives. It can be viewed statically (as the number on our scale, our perception of our weight) or dynamically (losing weight or gaining weight too fast and/or unintentionally). Weight is associated with many negative feelings, such as defeat, helplessness, shame, guilt, frustration, embarrassment, judgment, sadness, and stress. These feelings can contribute to unhealthy eating patterns and the vicious cycle of emotional/stress eating, or even yo-yo dieting. Almost every patient asks me about their weight. What can they do to get it and keep it down? What should their weight goal and speed of weight loss be? Which weight loss methods are the best?

The misconception often goes that if one is more disciplined, one will have better weight control. But weight control cannot be simply reduced to only two factors, food intake and energy expenditure. There are many unknowns about which factors control and stabilize one’s weight. This makes it hard to determine the best interventions for losing weight. Many different homeostasis models have been proposed by the scientific community, such as the set-point theory. Beyond that, in regard to improving cancer outcomes, we do not yet fully understand which factors matter most – e.g. weight in normal range, weight loss, physical fitness, redistribution of fat deposits.

There is not a magic solution. There are many resources out there to guide weight loss, most of which manipulate what/when you eat and how active you are, but most have not been studied or compared with robust scientific methods. Everyone has to find the approach that fits with their belief system, personality, and lifestyle. Here are a few general pointers that you may find helpful:

Any change is hard. Start low and go slow. This will allow you to solidly integrate a new habit it in your life.
Multiple small interventions may be more sustainable and wholesome than a one-prong approach. E.g. Swap out your current breakfast for oatmeal or call your friend while walking around the block.
Rather than pursuing diets that omit certain food groups or ask you to fast for a prolonged period of time, it may help to pursue a diet as nature intended: a wholesome, plant-enriched diet of moderation and variety, while minimizing processed foods.
Please allow yourself a treat every now and then since eating also allows you to socialize and enjoy life.

If ever the cancer should recur, then I hope you will not blame yourself, since there are more factors associated with cancer outcomes than lifestyle. You can only do your best with the resources and the physical/emotional abilities available to you, and you likely will fall off the wagon once or even several times along the journey. The point is that you keep trying in ways that fit where you are in life!

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Learn and Think:

A near decade-old guideline update has been released, issued jointly by the American College of Sports Medicine, the American Cancer Society and 15 other international organizations, with new advice about physical activity for cancer survivors. More precise and practical details are still needed from future studies, however. As always – any exercise is better than nothing!