January, 2008

Creating & Sustaining Motivation

Jan Remer-Osborn, PhD  Behavioral Health Services
Advocate Good Samaritan Hospital

My philosophy of life is that if we make up our mind what we are going to make of our lives, then work hard toward that goal, we never lose - somehow we win out."
Ronald Reagan

Think of a time you accomplished a goal.  How did it feel?  What steps did you take to reach it?  Were there any bumps in the road?

The Core of Motivation:  Acknowledging your own value.  You are worthy and deserving.  Aligning with your “better” self.  Belief you can follow through.  Creating a vision of a healthier, more satisfying life.

Understanding Motivation Incentive, drive, Motivation is simply the reason for an action that gives purpose and direction to behavior.  MOTIVATION IS YOUR ”WHY”
Motivation is “WHAT drives you” to behave in a certain way or to take a particular action.  It is your WHY.  Your WHY is the strong reason for you to desire something.

It is not what you desire, but the strong reason you desire it. Let me give an example. If you want to stop working and go into business for yourself here are some possible explanations: Your desire – to have your own business.  Your WHY – to be independent, to have more time for your family, to have more time to pursue your dreams.

Creating Motivation  Your WHY often goes beyond the physical objectives themselves.  Your why often satisfies a psychological need. If your reason for doing something is just material or extrinsic (e.g. to own a Mercedes or have a huge house), it is unlikely to see you through the difficult times to achieving your dreams. Your WHY has to look beyond the physical. It has to be from deep within.  That way when the going gets tough, your WHY will see you through it because it is a strong, burning reason.  It is a reason that will stand strong in the face of opposition.

Creating and Sustaining Motivation  It is a reason that will stand strong in the face of opposition If YOUR “WHY” IS BIG ENOUGH, THE HOW DOESN’T MATTER.  If your reason for wanting something is strong enough, even if at the time you don’t know how to achieve it, pursue it.

Step One – decide what you want.  Never mind how you are going to get it – decide what you want. Be as clear as possible on what you want. There will be more on this in a later section on setting goals. Write it down. You must have a definition of motivation that is personal to you.

Goals that are not written down are just wishes.“  Anonymous

Step Two – Think about WHY you want it. Remember these have to be strong reasons. Write them down. By carrying out these two steps you will have sorted out your personal definition of motivation. Your WHY is your personal definition of motivation.

•The most powerful motivation is a one that looks at permanent, life-type benefits, not short-term incentive or loss. In other words, if you lose weight for a cruise or because you had a heart attack, you may not stay with the plan.  But if you lose weight in order to be able to dance at your grand children's weddings, or to stay out of a nursing home, you have a REAL long-term reason for doing what you're doing.

Motivation Assassins  The motivation assassins live inside of life and they spring on us without us even recognizing it!  We all come equipped with a deep well of motivation.  We just need someone to help us tap into it.  If we identify and know how to handle the motivation assassins, we CAN achieve our goals!! Now what could be an assassin? Easy one! What causes you to hit the couch with lethargy or run for the cookies? The 2^nd goal of this talk is to help you identify these motivation-assassins and stop them dead in their tracks!!  There are only Seven Motivation Assassinators. Discover which most often come after you.

Keeping your Vision Focus on the Prize Do you start out with a goal, a picture in your excited about achieving it, and then after three days you just don’t think about it again?  This motivation assassinator is known as too little focus. Many times this one keeps the others from ever being able to come after you at all.  Put up inspirational quotes in areas that you frequent to keep you on target with your goals.  One example is to place notes or pictures on the refrigerator when you may go for a snack to remind you of healthy choices.
Negative Belief System  Do you find the words “This is just too hard, I can’t do this,” or, “I don’t want to do this” going through your mind or even coming out of your mouth?  That MA is known as your negative belief system.  This one comes against people and much of the time they don’t even realize it’s happening.  The negative belief system is the biggest liar. That one is not true, but we’re convinced in our mind that it is.
Habit  Can you think of opportunities where you could have exercised but simply chose not to?  You chose to watch television or work on the computer or take a nap or whatever?  Can you think of times where you knew you should have chosen water or juice, but did what you’d always done and had soda pop or beer instead?  That motivation assassinator is known as habit. Habit is the sneakiest of all the MAs. 
Emotional Vampire  Have you ever found yourself in an argument with your spouse?   It gets tense, it gets heated, and when you see it’s not going your way, you run for the brownies. That one is an emotional reaction, and it’s the most common.
Social Pressure  Have you attended an event not planning to eat, then ate because everyone else was eating? That MA is your social influence.
Time Management  Have you found yourself without a minute to spare for exercise or for making wise food choices? This MA is the most common in the 21st Century, and it’s known as time management.
Relapse/Failure  “If at first you don't succeed, you're running about average."  M.H. Alderson
This ties for one of the most lethal assassins.  If we slip up, we can be tempted to let go and slide all the way down.  We can give up and stop caring. Prepare for slip-ups.  Do not expect perfection.  Look at the big picture, at your successes and get back on track.

“Success is not final, failure is not fatal: it is the courage to continue that counts." Winston Churchill
Maintaining the Short Race  •"Perseverance is not a long race; it is many short races one after another." Walter Elliott

Affirm your Belief Believe in yourself.  Stop buying into the lie that you can’t succeed.  Pay absolutely no attention to those that say it’s ‘ok’ if you can’t do it and even less attention to those who insinuate that you’re not good enough.   It was said of Michael Jordan, when he first made the NBA, that his greatest weakness was shooting.  SHOOTING... MICHAEL JORDAN’S GREATEST WEAKNESS WAS SHOOTING! Needless to say, he dominated that world!  He believed he could do it and worked to get his ability to where his belief was.  Life will be infinitely easier on us when we’re a little bit tougher on ourselves.

If one advances confidently in the direction of his own dreams and endeavors to live the life which he has imagined, he will meet with a success unexpected in common hours.

Henry David Thoreau

December 6, 2007 LWB Holiday party see the Album for pictures.

September 6, 2007 

Exercising For the Seasons

Presented by Joey Bonavota, MS 

As Weather changes throughout the seasons, you have to be able to make adjustments not only physically , but also fundamnetally. Intentsities of exercise need to be adapted based upon the environment or weather elements. First and foremost, regardless of whether you perform your exercises indoors, outdoors, warm weather, or cold weather, you have to make sure that you perform warm up and cool down sessions before and after exercise.  Warming up comes at the beginning of your exercise. It helps get the heart ready for exercise and loosens up the muscles for physical activity. It usually consists of 3-5 minutes before exercise and entails some stretching to take place as well.  Getting the heart and muscles ready for exercise is a good indicator of having a better or improved exercise session. Some benefits for warming up include the following: 1. Helps make muscles more elastic, therefore, easier to stretch. 2. Reduces the risk of muscular injuries such as a possible tear or pull of the muscle itself. 3. Peform daily tasks at home easier. 4. Helps improve lean body mass at a quicker rate.  Cooling down is the same as warming up with the only exception being, instead of coming at the beginning of your exercise, it concludes your work out; allows your heart rate from peak levels , to come back down to where it was before you started exercising. You should also perform some brief stretches to maintain elasticity of the muscle. Some benefits of cooling down include; 1. Blood to pool back to the heart. 2. minimizes dizziniess and light headedness after workouts. 3. Allows the muscles to stay warm throughout the day.

During hot weather workouts, you have to be able to change your exercise patterns. Choose to exercise either in the early part of the day or later when the sun sets to avoid high humidity weather which can be detrimental to your health. You should also adjust intensity levels because higher temperatures will cause you to sweat more excessively which can cause you to become extremely dehydrated. Dehydration can lead to heat stroke so be sure to know the warning signs. Make sure you drink plenty of fluids in higher temperature weather. Drinking the normal 64 oz of water will not be enough because your body is losing alot more fluids than normal. Last, make sure that you wear appropriate clothing. You should wear something very loose, light and multicolored. The brighter the colors, the better. Dark clothing attracts heat so stay away from it.

For cold weather work outs, again change your exercise routine. Choose early afternoon for exercise since that's going to be the warmest part of the day. You should also wear layers of clothing. In the beginning of exercise, your body is cold but gets progressively warm throughout the duration of your work out so be sure you wear layers so you can easily remove a layer or two. Also take into consideration the wind speed. Re route your exercise by going with the wind and not against it. Going against the windchill can feel like a slap in the face when the speed gets faster and bitter cold get lower. Take longer to warm up. You will have to make your warm up and cool down sessions longer siimply because it will take longer for the muscles to warm up in that type of climate. Lastly, wear polypropylne, which is a synthetic fiber type material that keeps sweat away from the body. Do not wear cotton underneath because cotton abosorbs sweat and when it turns cold from being outside, it can cause you to get pneumonia. Keep head and hands covered to help keep heat from escaping.

You might want to look into getting a health memebership or purchasing home equipment during the brutal months of winter to help maintain exercise consistentcy.

June, 2007

 The ANT-less Picnic

A tremendous turnout for the picnic.  All patients that could not make this event there is always next year.  We will post the games that we played and below are some of the pictures from the antless event.  Thank you to all that helped in preparing food and making this a great event.

  Nothing like fun at the picnic.

 What a conversation no one is moving.

 Do they work here? Of course Joey and Barbie.

 Were some people cheating? No way......

  Still working on the games.

 We have time from the quiz to look up and say hello.

  Look who was late and then had to get a small? meal.

  Yes Barb and Briana were there as well.

May, 2007

Clothing Selection as You Change was presented by R Arent

 
We are awaiting the script to place here.

4/5/2007 Top Ten Fitness Myths

Discover the truths behind the myths…………………..

Presented by Joey Bonavota, MS 

Separate Fact, from Fiction. 

There are many misconceptions regarding fitness.  People are misinformed via various media outlets: Radio, TV, Magazines, Friends, Newspapers, Internet and others sources.  The fitness world promotes plenty of fads.  Please follow with us the top ten myths of the fitness world.

# 10: “Muscle turns to fat”
Muscle and Fat are two different tissues.  Muscle cannot turn into fat and fat cannot turn into muscle.  Muscle is made up of protein and water and fat is…FAT, or adipose tissue and water.  Muscle will atrophy or “shrink” when not used regularly, not turn into other tissues.  Extra calories consumed are stored as fat that surrounds the weakened muscle.

#9: “Excessive sweating during exercise means you’re out of shape”
Just the opposite is true.  The better shape you’re in, the more you sweat.  Fit people are more efficient at regulating their body temperature and sweating is the body’s ability to cool itself down as one’s body temperature increases, such as in exercise.  One must be careful that dehydration does not occur during this process.  Keep taking fluids during exercise.

#8: “Don’t start weight training until after you’ve lost the weight”
Strength training promotes weight loss.  Building muscle increases your body’s metabolism.  Muscle burns calories, fat does not.  Weight training helps to improve the number of inches you will lose.  Muscle takes up 20-25% less space than fat and muscle is more dense or weighs more than fat.

#7: “The best time to exercise is in the morning”
The best time to exercise is whenever you can fit it in your day or night.  We are all not morning people.  Exercising in the evening can be just as effective in the morning.

#6: “If you exercise, you can eat whatever you want”
Not True!  Eating more calories than you burn off will lead to weight gain.  You are what you eat.  Healthy eating and exercise are essential to maintaining your preferred weight.  You need to place equal emphasis on both diet and exercise to be successful in weight loss and maintenance of your weight.  We live in a balance if we cannot exercise enough to burn off the calories we take in then we must adjust our calories downward.

#5: “Low intensity exercise causes you to lose more fat”
Low intensity exercise burns fewer calories than higher intensity exercises.  Moderate intensity exercise burns more calories and elevates resting metabolism.  Resting metabolism is our ability to burn calories even when not exercising during the rest of the day.  Your metabolism stays elevated several hours after a moderate-intensity workout and therefore burns more total calories.

#4: “Spot reduction is possible”
You cant spot reduce fatty areas of your body.  You cannot control where fat is removed from your body by doing exercises targeting that area.  Abdominal exercises can not flatten your stomach alone- you have to burn the fat to see the “six pack”!

#3: “No pain, No gain”
When starting a new program, initial soreness is to be expected for the first few days.  Extreme Soreness can be a sign of overtraining or overextending your body.  Delayed Onset Muscle Soreness (DOMS) can occur and has a peak at 24-48 hours after exercise.  DOMS results from inflammation and elastic tissue tears in the muscle.

 #2: “Women who weight train will bulk up”
This is physiologically impossible.  Women don’t have the genetic potential for this type of muscle growth.  Testosterone promotes muscle growth.  Women naturally have low levels of testosterone.  Women body builders usually take steroids or other performance enhancing drugs to develop the look they have.  Estrogen inhibits growth of bulky muscle.

#1: “There is a quick fix out there somewhere”
If it sounds too good to be true…..it is!  Be wary of gimmicks and fads.  There is no magic pill or miracle-working exercise device will help you with your fitness goals.  Claims are based on marketing strategy, personal bias or results of research studies that have a conflict of interest as they are usually sponsored by the manufacturer of the product.  Hearing it on TV/Radio doesn’t make it true.  This goes for the internet/newspaper and word of mouth.

March, 2007

Making Restaurant Selections
Briana Hanson, RD, LDN   

Item Description:

Resources

  n      Rate Your Restaurant Diet
    q     www.cspinet.org/nah/quiz/index.html

n      National Restaurant Association
q     www.restaurant.org

n      Illinois Restaurant Association
q     www.illinoisrestaurants.org

n      American Dietetic Association
q     www.eatright.org

n      American Heart Association
q     www.americanheart.org

  n      Lowfat Lifestyle
            q     www.lowfatliving.com

2/01/2007  Addiction Transfer by Dr. Greg Malo

Addiction transfer occurs when we switch one behavior, such as overeating, with another behavior. This is often subconsciously done to numb emotions or to fill an inner void.

By giving up food quantities with weight loss surgery, we know 5 to more than 30% of the patients may transfer their addiction for food to other addictions. These addictions include: food, drugs, alcohol, smoking, sexual activity, gambling, shopping, and others. Addiction transfers may develop about one year after weight loss surgery.

Why do these addictions occur? Dr. Malo explained that certain chemicals affect the brain and its functioning. One chemical that is secreted in the brain is Dopamine. We love Dopamine, it makes us feel good. Dopamine is called the “Pleasure” transmitter of the brain. He also stated that the ability to notice the Dopamine by the brain cells is decreased in obese patients. We do not know if this decreased absorptive ability occurs before the obesity or if obesity causes less Dopamine receptors. Levels of the Pleasure chemical is elevated with foods, sex, drugs, alcohol and smoking. Therefore, the need to experience the pleasure comes from deep within the middle of the brain and our ability to control this behavior is in our subconscious. We may not be able to resist the need for the pleasure unless we have developed other addictions to produce the same response.

Stress occurring from changes in our life may have been dealt with by food consumption in the past. Now the stress is being diffused by other methods: Drugs, Alcohol, Sex and gambling. For some this may take on other methods that we will discuss that are safe for you and your brain.

We think we live in equilibrium, everything is in balance. The truth is that we are on average balanced and the rest of the time we have opposing forces always fighting each other. The good versus evil conflict, except our battle is with hormones and other chemicals in our bodies. We have conditioned responses that cause increases in chemicals such as Dopamine. These conditioned responses are very strong and have been learned over a long period of time. Some examples include an increase in Dopamine by just smelling or seeing food, not just eating the food.

Our brains are hard wired to “Gorge.” Why, you may ask? Our genetics have instilled in them the ability to absorb the majority of what we eat as stored energy. In cave dwelling days we needed this because we didn’t know when our next meal would occur. Therefore the people who stored more calories could be stronger if the next kill was in a long time period. Today, our society influences our balance of too many calories by: decreasing our exercise with our use of cars; we eat more calories in larger portions of food; and appealing food is readily available and heavily marketed. Unfortunately, we still can absorb and store our calories very efficiently. This is the Calories in minus calories out equation. If more in than out then we gain weight.

How do we make changes? First and foremost we need to elevate our Dopamine levels. The NUMBER ONE safest way to increase Dopamine levels is…………EXERCISE. Does this give the punch of a really good piece of favorite food, maybe not? However, the effect from exercise may last longer and in regular lifestyle changes over a long period of time, years, this may replace the other triggers for a high Dopamine surge. We suggested that people use the support group meetings and for some therapy to try and help these subconscious addictions. Addictions are difficult to control if you remain isolated. Educate yourself about addictions, identify your additions and the extent they are ruling your life.

Suggestions for further reading:

Katherine, Ann. Anatomy of a Food Addiction: The Brain Chemistry of Overeating: An Effective Program to Overcome Compulsive Eating (3rd edition)

Jay, Katie. “Addiction Tip Sheet – Addiction and Weight Loss Surgery: a Social Worker’s Perspective.” www.helpstartshere.org.

Jay, Katie. Dying to Change: My Really Heavy Life Story, How Weight-loss Surgery Gave me Hope for Living.

Rosik, Christopher. “Psychiatric Symptoms among Prospective Bariatric Surgery Patients: Rates of Prevalence and their Relation to JScoial Desirability, Pursuit of Surgery, and Follow-up Attendence.” Obesity Surgery 15 (May 2005): 677-683.

Pinel, John P. J., Assanand, Sunaina, and Lehman, Darrin R. “Hunger, Eating, and Ill Health.” American Psychologist 55 (October 2000): 1105-1115.

1/04/2007   Question and Answers

Question and Answer session mostly concerning LWB and our previous patients and help with long term follow up.  We explained that LWB is here to provide education and a team approach to weight loss surgery in a holistic manner.  We will continue to emphasize preoperative teaching, in hospital education and even more emphasis on post operative care and the long term struggle to maintain LIFESTYLE CHANGES.  We explored what new topics people are interested in hearing during our support group meetings.