Unintentional Weight Gain

By Jean Kressy, MS, RN, with Margo Woods, DSc, Emily Potts, MSc, and Joan Connors, DMin, RD

When HIV-positive people need to lose weight, they’ve got to follow the same rules as everyone else. Nutrition experts say a good way to begin is by keeping a food diary that includes everything you put into your mouth, the time of day, where you are, and something about your mood. When people write down what they eat, they are more likely to lose weight, especially when they have to show their diary to a nutrition counselor. Also, details about when and where they are, who they’re with, and how they’re feeling can identify when they eat for reasons other than hunger.

Diet

All diets start with food choices. Some diets are lists of what you can or cannot have, or foods that should or shouldn’t be eaten together. Others focus on how much, or little, you are allowed to eat. There are diets that say some fasting is good and others that say eat as much as you like. What’s right?

Nutrition experts agree that the best diets are patterned after a healthful eating plan. And because ‘on a diet’ sounds like it has a beginning and an end, serious “dieters” know the the best plan is the one that teaches them healthful changes they can follow the rest of their lives.

Chances are good that you’ve got some eating habits that need to be broken before you can make progress losing weight. Learn which habits need changing and start working on the ones that you know you can do; they’ll be the easiest to change and have the best chance of staying with you. Changes that are too different from what you are used to are harder to make.

Healthful eaters:

1. Use the food guide pyramid as a blueprint for choosing what to eat. The pyramid emphasizes whole grains, fruits and vegetables, lean meats and low-fat dairy foods. There is plenty of variety; any food can find its place on the pyramid; it’s a matter of how often and how much.
   
   
2. Cook the low-fat way. Start by choosing foods lower in fat and trim fat from meat before cooking. Use low-fat cooking methods, such as steaming, broiling or baking and when using fat in cooking, make do with small, measured amounts.
   
   
3. Know portion size. At first you may need a scale or measuring cup to know what a 3-ounce piece of chicken (the size of a deck of cards!) or a half-cup serving of rice looks like, but eventually you can eyeball it. If it looks a little lonely on the plate, use a smaller plate and spread the food out.
   
   
4. Eat from plates, not packages such as bags of chips or cartons of ice cream, which make it easier to eat more.
   
   
5. Go easy on alcohol. Besides the calories (more than carbohydrate, less than fat), alcohol can stimulate the appetite and make you eat more.
   
   
6. Know how to manage when eating out. Become expert at low-fat menu reading, and ask for sauces or dressings on the side. Bring home leftovers.
   
   
7. Plan meals and snacks ahead and have regular eating times—haphazard eating tends to be high-calorie eating.
   
   
8. Never go shopping when hungry and always take a list to avoid spur-of-the moment decisions.
   
   
9. Know when to change food-driven routines. If the doughnut shop is too hard to let pass on the way to work, change the route.
   
   
10. Sit at the table when eating. Eat slowly so that your brain knows when you’ve had enough, and don’t read or watch television or do anything but eat. When you get up from the table, you know the meal is over and don’t go into the kitchen to eat leftovers.

Exercise

Dietary tinkering, without exercising, is never going to help you lose weight and keep it off. Just ask the yo-yo dieter whose scale is worn out from years of going up and down. Because exercise develops muscle and increases basal metabolism rate (how fast calories are burned,) it’s considered the key to successful weight loss. Muscle tissue, even when you’re resting, requires more calories to maintain than fat.

Smart exercisers know:

1. Exercise gives you a psychological lift and makes you feel better. Furthermore, regular and moderate exercise can even reduce appetite.
   
   
2. The best exercise plan works on endurance, strength, and flexibility. In addition, it calls for activities that use a variety of muscles.
   
   
3. People who have been inactive should ease their way into an exercise routine. They should choose something they enjoy and keep in mind that exercise includes everything from walking the dog to Ironman competition. Moving is what counts!

Food and the Inner You

People eat for lots of reasons that don’t necessarily involve hunger. If you can identify why and when you eat when you’re not hungry (called triggers), it can be a first step to losing weight. People sometimes eat because they’re:

1. Bored: when you think there’s nothing else to do, you eat. Make a list of non-food activities you like, such as walking, shopping or reading, and substitute them for food when you’re bored.
   
   
2. Depressed or lonely: turning to food when you’re feeling down is not a good way to manage emotions. A quick-fix change of scenery may be all you need to feel better; if the problem is more complicated, professional counseling may be helpful.
   
   
3. Socializing: a buffet table or holiday party may be all you need to eat more than you should. Learn your triggers and how to manage them. For example, eat less on the day of a party so you have more calories to play with when you get there. Once you arrive, make only one trip to the buffet and do your socializing in another part of the room.

The Weight Loss Thinker

Anyone who thinks he can lose 30 pounds in 30 days by eating steak and grapefruit is only kidding himself. In fact, to lose weight and keep it off, you may need to change the way you think about what it takes to make it happen.

Weight loss thinkers:

1. Are more concerned about health than weight.
   
   
2. Set realistic goals that will work. Don’t use words like “always,” “never” and “must” because they get in the way of progress. Don’t say, “I’ll never eat another potato chip, or take the elevator when I can walk.” When you slip, get back on track and don’t dwell on it.
   
   
3. Have specific goals. Instead of “cutting down on fat,” “switch to 1% low-fat milk.” Instead of “doing more exercise,” “walk for 45 minutes every day before breakfast.” When goals are specific, it’s easy to know when they’re reached.