Weight loss for nurses

Party_of_five, BSN · Mar 21, 2017

I am a huge fan of the 21 Day Fix. It is a workout and nutrition plan. It's not a quick fix like the name implies but rather it teaches you how to eat the right foods in the right portions and you do a daily 30 minute workout. There are 7 different workouts (cardio, yoga, pilates, weight training ect) so you don't get bored. It really works too. Google it.

dirtyhippiegirl, BSN, RN · Mar 21, 2017

You're making this unreasonably difficult.
Close approximations of calories will suffice. For example, in a consistent diet the effect of being 200 calories over each day will have little impact in the grand scheme of exercising, sleeping well, reducing stress, changing food beliefs and habits, reducing calories in, increasing calories out, having a support system, and so on. And losing weight and keeping it off is just that: a complex, long term, consistent act.

Purely from a mathematical perspective, you're going to gain weight as long as you eat more calories than your body needs to maintain weight. Reducing stress, sleeping well, having a support system, etc probably help with the mental component of keeping weight off but 200 x 365 = 73,000 extra calories a year which if you aren't somehow burning them off unintentionally, adds up to about 20 lbs in weight a year.

I know plenty of skinny people who don't rigidly count calories, for what it's worth. If they eat a large lunch out, they'll eat a small dinner. If they go on vacation and eat whatever for a week, they cut back on what they eat for the next few weeks. There does need to be an in/out balance.

Spine_CRNA, BSN, RN · Mar 21, 2017

Purely from a mathematical perspective, you're going to gain weight as long as you eat more calories than your body needs to maintain weight. Reducing stress, sleeping well, having a support system, etc probably help with the mental component of keeping weight off but 200 x 365 = 73,000 extra calories a year which if you aren't somehow burning them off unintentionally, adds up to about 20 lbs in weight a year...

I should have clarified. ..."being 200 calories over each day..." (over what you planned for that day; not over the amount of calories you lost). Yes, calories in need to be less than calories out.

rfmeyer · Mar 22, 2017

The calories in/calories out idea is great, except it is completely false except in extreme conditions. There are vast studies looking at increase and decrease in calories leading to small changes, and then system compensation for homeostasis. I used to believe this same idea until I really became educated on nutrition/DM/obesity. Take a look at the work of Dr Jason Fung on youtube....

R

eatenbylocusts · Mar 22, 2017

It is not the only effective way for losing and keeping off weight, but it is the fastest. I work on the surgical floor so we get all of the bariatric patients unless they have to go to SDU or ICU. I believe there is definitely a place for bariatric surgery, especially with co-morbidities that really need to be treated asap, but I have seen the downsides. Even though there is supposed to be psychological screening done, it sometimes misses a few; like the guy who somehow got a peanut butter sandwich in his room. I think he died. Some seem to think this will keep them from overeating for the long term and it doesn't. Once they recover if they continually overeat, they will stretch their pouch and regain weight. It's been a while since we have had someone who developed a fistula, but we have had about 5 who did and lived on our floor over a year because of a fistula that could not be cared for at home.

I've been working with these patients for 13 years and the surgical outcome has gotten better, but it was just a few years ago when a patient coded at the end of surgery and could not be revived. We have had a few who have come to our floor and then hours to days later need to go to step down. Some of those have passed. And then there were others who lost too much, too fast for too long or continue to have nausea who need to have PPN and a PICC.

My own cousin did well for years after a bypass, but has gained quite a bit back. As with hysterectomies and other medical interventions, it can be taken much too lightly. The emotional reasons and habits really need to be addressed.

bellme1800 · Mar 23, 2017

For me keeping exercise as a routine (many flights of stairs at the hospital if I can't get in a run), a sustainable 12-step approach to avoiding compulsive food behaviors, and the "blessing" of allergies to some common foods have worked to keep off ~50 lb.

-It's counterintuitive that the physical stress of exercise would relieve the psychological stresses of nursing, but it works.

-I'll never be a size 10, but I can buy clothes in a regular store and don't worry about fitting in a chair or breaking it anymore.

-I plan my food and bring it with me, but will swap out my planned starches for an occasional social carb serving at work.

-Made the changes, lost weight slowly for 2-3 years, maintaining for ~3 years so far.

eatenbylocusts · Mar 23, 2017

I remember late night studying and self medicating with M&M's to stay awake. I don't even know how much I weighed, but I saw our group grad picture a while back and was in awe seeing how big I was. I lost some weight just by being done with the stress of school. Fast forward a few years and despite being on thyroid and doing some exercise I am still overweight and have been having some elevated blood pressure readings (150-160 systolic). After some CE s or something I become concerned about this consistent elevation and picked up the phone to call my Dr for BP medication. I then hung up with the thought that I don't want that on my medical record. My friend had been talking about WW and one of my co workers was also. I went home and researched then joined. I was a poster child and lost 45 pounds and my mom rejoined and lost 25. I was amazed that it actually worked. I did the shopping and most of the cooking. I was hungry for the first week, but after that I got into a groove and enjoyed the journey. I researched before eating out and read labels. I was actually eating a bowl of my healthy granola after coming home from my first meeting and was shocked at how many points my healthy snack cost me. I would also use frozen meals often for work. They continue to offer new stuff that is healthier so I wouldn't rule out using some for a quick meal to take to work.

I reached goal and gradually stopped going to meetings and writing down my food. That is key for me and probably others. I am at my heaviest I have been since WW; 14 pounds less than my initial weigh in and that has concerned. I haven't been denying myself of anything since pumpkin everything came out in October and it shows. Some scrub pants are tight and I have sciatica acting up along with other aches.

My church is getting ready for 3 weeks of some kind of fasting so my husband and I will be going vegan/no added sugar as we have the last two years. I plan on taking note of any lessening of joint pain.

POPCORN! This saved me during my return to school for my BSN. I air popped popcorn and sprayed with butter spray and drank diet soda which I rarely ever do now. I haven't been eating the popcorn and I need to!

I have a gym membership and a few years back someone encouraged me to try zumba. Then I tried a different class. I love them and rarely do anything else. In a class or with a video it's easier to keep going and keep the intensity up. But it's quite easy to eat up those exercise calories if one isn't careful.

One of my issues is being married for almost 7 years now and not having the control over the food. I have had the success and know it's possible to do it again and possible for others. Occasionally I use myfitnesspal since I am a recent convert to a smartphone.

How about a support blog. Now I'm thinking about what I should eat to clean out the house by Sunday.

JackNikon · Mar 23, 2017

I don't know much about your workout routine right now, but I work out 6 days a week (yes, even on the nights I work) and, with a few exceptions, I haven't met many nurses who genuinely can't fit a workout into their daily schedule. I work nights exclusively, and I chose night shifts partially to have a few hours of daylight each day to go running. I just get up at 3:30 instead of 4 or 5pm, eat, and hit the gym/trails. Can you change your schedule if need be? Do you have a gym that's convenient or somewhere outdoors that you can walk or run? I have also found that I stay much more motivated if fitness and not weight loss is my goal. I'm much more excited when my daily run feels effortless than when I see the scale move down 2 lbs.

Everyone has already said this, but don't eat junk food. Just don't do it. Cut up veggies and fruit ahead of time and bring that with you, don't buy your meals in the cafeteria (I find that when I'm hungry I'll buy all the junk food at 1am that I told myself at 5pm I wouldn't touch). Bring food that can be broken up into many small meals so you don't get too hungry/don't get that food coma that comes from overeating.

Weight loss/fitness takes discipline. It takes time and effort. You made it through nursing school, you clearly already know how to exercise self discipline and take pride in the slow but steady advancement towards your goals. Apply that to fitness and you'll see results.

Here.I.Stand, BSN, RN · Mar 23, 2017

Regarding bariatric surgery, come on people. You want to change your anatomy because you can't lose weight through diet and exercise. This is an extreme solution. If someone loses 100 lbs through bariatric surgery, they are getting the same weight loss benefit of someone losing 9 lbs per month for a year.

I hope you meant that in a sense that bariatric surgery is not without risks, and that you are advocating a non-invasive strategy out of concern for the health of those who choose this option. (And it does carry significant risks, hence the nursing colloquial "GBGB," as in gastric bypass gone bad.

If you meant it in the sense of one is lazy and taking the easy way, I hope you're not this judgmental of patients. :eek:

Here.I.Stand, BSN, RN · Mar 23, 2017

OP, first of all don't worry too much about credibility with your patients. Considering the current state of health care with high patient-to-nurse ratios, shorter hospitalizations, and core measures or the hospital's requirements which take up a lot of your already limited teaching time... you likely won't be spending much (if any) time teaching about weight loss or other lifestyle issues (for example, a stroke center is required to provide stroke education, or risk losing that certification). If you do get to weight loss discussions, if that patient is ready to make lifestyle changes, they won't use their nurse's appearance as an excuse. Conversely if they do disregard information due to your appearance, that is a sign that they are not ready. Truthful information is just as accurate whether it comes from an obese person or an Iron Man triathlete.

Your own health and wellbeing however, is an extremely important consideration. I'm not considered overweight but am working on a loss of 20-30 lbs. I'm doing the ketogenic thing, although I know other people are successful with simple portion control. But for me, 1) results are a huge motivator, 2) because of the fat I feel satiated instead of deprived, and 3) other benefits of limited carbs. I'm at increased risk of developing DM2, having been diagnosed with gestational diabetes with my youngest child. I do count calories though, because if I simply ate whatever high-fat low-carb foods sound good at the time, I could easily eat 3000+ calories a day. Right now I'm staying around 1500 cal per day.

I use a kitchen scale and use one of those online calculators. For homemade multi-ingredient foods like soup or casseroles, I simply plug in my ingredients as I go, tally for the whole pot, figure out a portion size and divide the total. I have a notebook to keep track of these. For example, the other day I made a pot of soup like Olive Garden's Zuppa Toscana. So I noted the nutritional info for 1 lb sausage, canned chicken broth, cream, etc; I also noted how many cups of anything I put into the pot. I think the total was 8 cups of ingredients, and 1 cup is a decent size serving of soup. So I divided the total calories, fat grams, carb grams, and protein grams by 8 -- that's the macronutrient content per cup of soup. That info is all in my notebook, so next time I make it I don't have to do any math. Obviously that isn't 100% accurate, as one cup may have more sausage than another, but a close enough estimate.

For breakfast this morning I had some salmon patties with 1/2 Tbs of condiment; and a low-carb chocolate mug cake with stevia-sweetened whipped cream and 2 Tbs raspberries. Total 529 calories, 37g fat, 4g CHO, and 35g protein. I'm full. I could have fairly easily reduced the size of the meal to cut calories more.

Ice cream is my kryptonite; I'm accumulating a collection of homemade sugar free ice cream recipes, many of which are

I will occasionally pre-plan a "cheat" day and give myself permission to eat homemade white bread or lefse or pasta or other foods that can't be decarbinated. :cheeky:

I've been doing this less than a month. I don't have a scale but definitely have a flatter tummy and feel a difference in how my clothes fit!

NurseLauraM · Mar 23, 2017

I'm for whatever woks with the least amount of side effects. The calories in/out approach sounds nice because it sounds so simple, but it's really not for everyone. I think that approach is especially difficult for those who are extremely obese, because there are so many other factors involved than just self-control that make weight loss very challenging. After all, you have to have a great deal of self control to succeed after bariatric surgery. If obese individuals all lacked self-control then bariatric surgery would not work for them either, and would likely be dangerous. I do not believe bariatric surgery is the easy way out. But I have to wonder why, even if it was "easy", people have a problem with that. I mean, if there were an easy way to lose weight (and I don't think that there is at this point), why would it be so bad to use it? Why punish people who are overweight unnecessarily?

Do any of you have any personal experience with the pharmaceutical approach? Contrave seems pretty promising, with few side effects.

mmc51264, BSN, MSN, RN · Mar 24, 2017

Most of the weight loss medications that I have seen are some sort of combination with an SSRI/SNRI of which I am intolerant of. I tried several times. gave me heart palpitations and hypoglycemic events.

I wish they had worked. I was one that has gastric sleeve and I have zero regrets. I did a LOT of research and have been been able to follow my instructions/restrictions, etc. As I am supposed to. I know there are many that are non-compliant. Just as there are with some of my ortho pts that walk around with their external fixators on and wonder why they end up with amputations.

There are people who "get it" and those that don't. I wish I could make the pts that I see frequently for non-unions, infections, etc to QUIT SMOKING. Worst thing, I think, that contributes to poor health.