By Dr. Kasia Ostrzenska
Five years ago, I was like a lot of Americans — inactive, overweight, tired and frustrated.
Even as a graduate of medical school, I didn't know how to shed the extra pounds and get healthy.
I heard conflicting advice from nutritionists and other health care professionals, some of whom were also fighting the bulge. My own medical practice was based more on writing prescriptions than prevention.
I was only 37, but at 5 feet 2 and 170 pounds, I knew that I, too, was heading toward poor health and a medicine cabinet full of drugs if I didn't make major changes.
I needed information: Why are we overweight? Why is it so hard to shed those pounds? Why can't we seem to keep weight off once we lose it? What is the real role of exercise?
So I started doing research, and putting what I learned into practice on myself.
Today, I'm 45 pounds lighter, have maintained my new weight for nearly five years, and have transformed my medical practice to help others follow the same path. In that time, my patients have lost more than 6,900 pounds.
Here are the main lessons I've learned, and now teach my patients:
• Change your mind, change your weight. Most people who go on diets have a short-term goal in mind. We decide what we should weigh, then we cut calories and increase activity. But our actions are not sustainable for life, and once we lose the weight we resume our previous habits — and weight.
Making it worse, most dieters lose more muscle and water than fat. Even though you may have reached your scale goal, you are in fact way off in your fat-loss success. Through multiple attempts of crash dieting we essentially eat up our muscles, slow down our metabolism and become even fatter.
We need to strive for long-term health, strength and vitality, not a number on a scale.
And we need to be 100 percent dedicated to this battle. Think of it as food rehab — just as if you were fighting alcohol or drug abuse. Once a foodaholic, always a foodaholic.
• Eat to target fat loss, don't starve yourself into weight loss. You must feed your metabolic engine as you lose fat. Through my research and experience, I am convinced that protein is essential for fat loss. I prescribe generous amounts of lean protein, particularly fish and vegetable-based proteins such as soy supplements.
In addition, specific carbohydrates such as leafy green vegetables are essential to reshaping your body. White flour, sugar and starchy foods like potatoes increase your body's need to produce insulin. This hormone manages blood sugar levels, plays a role in fat production and makes you hungry. Cut out the simple sugars completely, emphasize proteins and low-glycemic carbs, and see what happens to your appetite.
To paraphrase Hippocrates, let your food be your medicine for a leaner you. Go for natural foods instead of processed foods that stimulate appetite and cravings. Think of it this way: Have you ever craved a bushel of apples? Probably not. But what about a large bag of potato chips?
• Exercise, but be smart about it. "Eat less, move more'' has become a mantra in the weight-loss industry. I love exercise now — I lead my patients in Zumba/aerobic and toning classes at my office three days a week.
But I don't prescribe exercise for all my patients right away. For many obese people who have been sedentary, working out may be physically difficult. And it can stimulate appetite — just what you don't need when embarking on a new eating program.
For initial fat loss, diet is key. Consider that you need to burn 3,600 calories to lose a pound of fat, and a typical workout burns only a few hundred calories.
That's why I counsel patients who aren't accustomed to exercise to lose some fat first. After getting used to their new program, they're feeling strong, they're burning fat, and they're ready to tackle a new challenge.
But if you want to keep losing weight, you have to understand that exercise is not a license to eat more. It is, however, vital to cardiovascular fitness, firm muscles, stress relief and an overall feeling of well-being.
By the time you have completed your transformation and fat-loss goal, exercise should not only be a regular part of your life but also an enjoyable and even fun part of your day that will help you maintain your new lean body for the long-term.
Katarzyna "Kasia'' Ostrzenska, M.D., is medical director of Bay Medical Center in St. Petersburg. She is board certified in internal medicine and holds free seminars on healthy lifestyle changes. She can be reached at (727) 343-6606 or www.baymedical.com.