TIPS AND TOOLS FOR WEIGHT MANAGEMENT

THE COMMUNITY CARE STEPS OF HOPE WELLNESS PROGRAM

I was built like an athlete when I was a teenager and in my twenties. If anyone ever mentioned anything about me getting fat I would always tell them, “I am never going to get fat. I have good genes!” Both my dad and my grandfather were thin. However, when I got a job and didn’t have time to run up and down the basketball court all day, I began gaining weight. I couldn’t believe it, or should I say I didn’t want to admit it. That was just the beginning of my weight problem. Two years ago, my doctor told me that because my mom is diabetic and my dad’s sister has diabetes too, plus being an African-American male, I was at “high-risk” for adult-onset diabetes if I didn’t get my weight under control. I started to think about how much I want to see my daughter graduate and get married and teach my grandkids how to play basketball. So I talked to my doctor. Together we made a plan that includes healthy eating and exercise. And except for the occasional Girl Scout cookie, I’ve been able to stick with it. I lost almost 85 pounds and I’m not done yet. My daughter helps me - we’ve started riding bikes and taking hikes together. She’s eating better and getting in shape with me. I’m learning to manage my weight. I’m still tempted by those Girl Scout cookies but I limit myself to two. I want to be healthy way more than I want to eat a whole box of Tag-alongs!

TABLE OF CONTENTS

Pages

Are you at a healthy weight for your height?

4

Losing Weight: Getting Started

5-6

How much do you really eat?

7-8



Nutrition Facts Labels Are Your Friends 9 Keeping Track is Key

10-11

Food Diary

12-13

Do you have diabetes?

14

of steps

hope © 2010 Community Care Behavioral Health

Are you at a healthy weight for your height? Body Mass Index (BMI) is a number that is often used to determine if a person’s weight is “healthy” or “unhealthy.” Your doctor may use this term. The BMI is a ratio of a person’s weight to height. Use the table below to estimate your BMI. Find your height in inches and then move across to your right until you are in the column with the number nearest your weight. Your estimated BMI is at the bottom of that column. For example, if you are 5’8” tall and weigh 150 pounds, your BMI is 23.

Height

Weight in pounds

4’10” (58”)

91

96

100

105

110

115

119

124

129

134

138

143

148

153

158

162

167

4”11” (59”)

94

99

104

109

114

119

124

128

133

138

143

148

153

158

163

168

173

5” (60”)

97

102

107

112

118

123

128

133

138

143

148

153

158

163

168

174

179

5”1” (61”)

100

106

111

116

122

127

132

137

143

148

153

158

164

169

174

180

185

5’2” (62”)

104

109

115

120

126

131

136

142

147

153

158

164

169

175

180

186

191

5’3” (63”)

107

113

118

124

130

135

141

146

152

158

163

169

175

180

186

191

197

5’4” (64”)

110

116

122

128

134

140

145

151

157

163

169

174

180

186

192

197

204

5’5” (65”)

114

120

126

132

138

144

150

156

162

168

174

180

186

192

198

204

210

5’6” (66”)

118

124

130

136

142

148

155

161

167

173

179

186

192

198

204

210

216

5’7” (67”)

121

127

134

140

146

153

159

166

172

178

185

191

198

204

211

217

223

5’8” (68”)

125

131

138

144

151

158

164

171

177

184

190

197

203

210

216

223

230

5’9” (69”)

128

135

142

149

155

162

169

176

182

189

196

203

209

216

223

230

236

5’10” (70”)

132

139

146

153

160

167

174

181

188

195

202

209

216

222

229

236

243

5’11” (71”)

136

143

150

157

165

172

179

186

193

200

208

215

222

229

236

243

250

6’ (72”)

140

147

154

162

169

177

184

191

199

206

213

221

228

235

242

250

258

6’1” (73”)

144

151

159

166

174

182

189

197

204

212

219

227

235

242

250

257

265

6’2” (74”)

148

155

163

171

179

186

194

202

210

218

225

233

241

249

256

264

272

6’3” (75”)

152

160

168

176

184

192

200

208

216

224

232

240

248

256

264

272

279

BMI

19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35

Source: Evidence Report of Clinical Guideline on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, 1998. NIH/National Heart, Lung, and Blood Institute (NHLBI)

Page -4-

Losing Weight: Getting Started How much weight should I try to lose? Aim to lose 7% of your starting weight. That amount has many health rewards. It is do-able for most people. Do you want to lose more than that? Aim to lose 7% first. Then, if you’re still overweight, set a new weight goal. Here’s how to figure out your weight goal: 1. Multiply your starting weight by .07 Starting weight ____ pounds x .07 = ____ (This number is the number of pounds to lose) 2. Subtract the number of pounds to lose from your starting weight Starting weight ____ pounds - ____ Number of pounds to lose = ____ YOUR GOAL WEIGHT Keep a log or graph of what you weigh. Weigh yourself on the same day of the week and at the same time of day. For example: Weigh yourself every Monday at 8 a.m. What is the best way to lose weight? Many things affect adult body weight, such as: • Age and family background • Eating and activity habits as a child • Eating and activity habits now You can’t change your age or your family background. You can’t change your childhood. But you can change your eating and activity habits now. When you change your eating and activity, you change your “energy balance.” Energy balance works like a see-saw. The energy you take in by eating is on one side. The energy you use up by being active is on the other. Both types of energy are measured in calories. If one or both change, the see-saw will tip. • What if you don’t change your eating or activity? Your weight will stay the same. • What if you eat more calories and/or are less active? You will gain weight. • What if you eat fewer calories and/or are more active? You will lose weight. To lose weight, it’s best to change both sides of the balance. That is, eat fewer calories and be more active. Start by cutting calories. Then add in more activity.

Page -5-

How many fewer calories should I eat? Aim to eat 500 to 1000 fewer calories per day. That will help you lose about 1 to 2 pounds per week. Slow, steady weight loss is safe. It also makes it easier to keep the weight off. Focus on fat first. Fat contains more than twice as many calories as the same amount of protein, sugar, or starch. Cut down on fat to save calories. Eating less fat is also better for your heart. Do your best to stay at or under the daily calorie goal below. A calorie is a measure of energy. If your Starting Weight is:

Your Daily Calorie Goal should be:

174 pounds or less

1200

175-219 pounds

1500

220 pounds or more

1800

Over time, you can adjust these goals based on how much weight you lose. What if I lose less than 1-2 pounds per week on average? • Lower your daily calorie. Don’t go below 1,000 calories per day unless you talk with your doctor. • Add more minutes of walking or other physical activity. What if I lose more than 1-2 pounds per week on average? • Raise your daily calorie goal a little. How can I stay at my calorie goal? Use one of the three methods below. All three have been proven to help people lose weight. • Keep track of the calories in everything you eat and drink every day. Stop eating when you reach your goals. • Follow a healthy meal plan based on your goal. • Use meal replacements to replace one or two of your meals. For the other meal(s), keep track of calories. Stop eating when you reach your goal.

Page -6-

How much do you really eat? What does a teaspoon of margarine look like? How about a half-cup of pasta? Health experts consider those amounts to be one “serving” of those foods. But most Americans don’t know what those amounts look like. Most of us eat more than we think we do. What’s the best way to know how much you really eat? Weigh and measure your food. Over time, you will learn what different amounts look like. Another way is to compare food servings to everyday items. This is shown below. Seven Ways to Size Your Servings Look at the chart below. One serving is in the left column. What it looks like is in the right column. One Serving

Looks Like

3 ounces of cooked meat or poultry, without skin or bones

A deck of playing cards

3 ounces of cooked fish

A checkbook

A medium apple, orange, or peach 1 cup (1 ounce) of ready-to-eat cereal (amount varies by brand) 1 cup of salad greens

A baseball or tennis ball

½ cup of cooked rice or pasta ½ cup of chopped fresh or canned fruit ½ cup of cooked vegetables or dried beans ½ cup of ice cream

½ baseball or ½ tennis ball or a computer mouse

2 tablespoons of salad dressing 2 tablespoons of peanut butter

A ping-pong ball or golf ball

1 ½ ounces of cheese

4 stacked dice A 9-volt battery

1 teaspoon of margarine

A postage stamp the thickness of your finger

Page -7-

It’s All In Your Hands Another “handy” way to judge how much you eat is to use your hand. Measure the foods below in the amounts given. Use measuring cups, measuring spoons, and a food scale. • 1 teaspoon of soft margarine • 1 tablespoon of salad dressing • 1 ounce of nuts (use a food scale) • 1 ounce of chips or pretzels (use a food scale) • ½ cup of chopped fresh fruit or vegetables • ½ cup of cooked cereal, rice, or pasta • 1 cup of ready-to-eat cereal • 3 ounces of cooked fish, poultry, or meat (remove skin, bones, and visible fat) (use a food scale) Compare the amounts above with the parts of your hand below. Fill in the blanks. • My thumb tip (from the knuckle to the end) is the size of ___ teaspoon(s). • My entire thumb is the size of ___ tablespoon(s). • My cupped hand holds: • ____ ounce(s) of nuts • ____ ounce(s) of chips or pretzels • ____ cup(s) of chopped fruit or vegetables • ____ cup(s) of ready-to-eat cereal • My clenched fist is the size of ___cup(s). • My palm (not including fingers) is the size of ____ ounces of cooked fish, poultry (no skin or bones), or meat (no bones). Source: Information provided by the University of Pittsburgh Obesity and Nutrition Research Center (grant DK046204 from the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases).

I know that I’m never going to be a size 2 and I’m OK with that. I just want to get to a healthy weight for my age and height - and maintain it. I want to have enough energy to keep up with my kids. Eating better and exercising has helped me feel better about myself. I look forward to a long and happy life with my family.

Page -8-

Nutrition Facts Labels Are Your Friends Nutrition Facts labels can help you lose weight. Choose foods with less fat and fewer calories. Here’s how to read a Nutrition Facts label: Look at the Serving Size. This is considered one serving. This may or may not be how much you ate. Look at the Servings Per Container. Did you eat the whole container? If so, you ate that many servings. Look at the Calories. A calorie is a measure of energy. The label gives the calories in one serving.

How much did you eat? Did you eat more than one serving? If so, you ate more calories than the numbers shown on the label per serving. Did you eat less than one serving? If so, you ate fewer calories than the numbers shown on the label per serving. Use the Nutrition Facts label to the right to answer these questions. (The answers are below.) 1. If you ate 8 ounces of this food, how many calories did you eat? _____________ 2. If you ate the whole container, how many calories did you eat? _____________ Answers: 1. 560 calories, 2. 1,120 calories Source: Information provided by the University of Pittsburgh Obesity and Nutrition Research Center (grant DK046204 from the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases).

Page -9-

Keeping Track is Key Keeping track of calories has been proven to help people lose weight. Keeping track is like using a checkbook. You write down the calories you “spend” every time you eat. Your goal is like a budget. Here’s how to keep track of the calories you eat: 1. Write down everything you eat and drink every day. Do this as soon as you can after eating each item using a Food Diary. • Use one line for each food and drink. • Spelling is not important. What is important is to: • Be correct about amounts. At first, weigh and measure everything. See the back of this sheet for details. Over time, you will learn what food amounts look like. • Be complete, include everything. Don’t forget what you add to foods. Examples: margarine on toast and sugar in coffee. • Be honest. 2. Write down the calories in each item. • Look up the foods in a Calorie Counter, which lists the calories in foods. Some Counters are books. Others are found on the Internet. Two are: • The Calorie King® Calorie, Fat, and Carbohydrate Counter • http://www.myfoodapedia.gov/ • Compare how much you ate with how much is in the Counter. For example, you ate 2 cups of cereal. The Counter lists 1 cup of cereal. So, you ate twice as many calories as listed. • Record the number of calories you ate. 3. During the day, subtotal the calories. Adjust what you eat and drink the rest of the day to stay within your goal. 4. At the end of each day, add up the calories. Did you stay at your goal? If not, look at your record. What could you have done differently to stay at your goal? Plan to use tomorrow what you have learned today. Weighing and Measuring Foods How much do you really eat? To be sure, weigh and measure each item. You can find the tools you need in most large food or discount stores.

Page -10-

Solid foods: • Use metal or plastic measuring cups and spoons. • Level the food before you record the amount. Liquids: • Use a glass measuring cup. • Read the amount at eye level. Meat, poultry, fish, and cheese: • Use a food scale that weighs in ounces. • Before weighing, cook the food and remove any parts you won’t eat (such as skin and bones). Four ounces of raw meat, poultry, or fish equals 3 ounces cooked. Three ounces of cooked meat, poultry, or fish is about the size of a deck of cards. Try to complete the sample Food Diary below. Look up each food in a counter. Write down the calories for the amounts given. Total the calories. Compare your total with the ones at the bottom of the page. Time

Food

8 a.m. Fried eggs made with butter

Serving Size 2 large

Bacon

2 thin slices

White toast

2 slices

Butter

2 pats

Hash browns

1 cup

Orange juice

Small glass (4 oz.)

Calories

Comments Ate at the diner

TOTAL CALORIES Do you have questions about keeping track of the calories you eat? Talk with your health coach.

Total Calories: 964. Note: Your answer may vary depending on the Counter you use. Source: Information provided by the University of Pittsburgh Obesity and Nutrition Research Center (grant DK046204 from the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases).

Page -11-

Food Diary Name: ________________________________________ Date: _____/______/______ Time

Food

Serving Size

Calories

Comments

TOTAL CALORIES Source: Information provided by the University of Pittsburgh Obesity and Nutrition Research Center (grant DK046204 from the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases).

Page -12-

Food Diary Name: ________________________________________ Date: _____/______/______ Time

Food

Serving Size

Calories

Comments

TOTAL CALORIES Source: Information provided by the University of Pittsburgh Obesity and Nutrition Research Center (grant DK046204 from the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases).

Page -13-

Do you have diabetes? If your answer is “yes,” you may still take part in the Steps of Hope Weight Management Program. However, it will be important for you to talk to your doctor who prescribes your diabetes treatment plan (medicine, diet restrictions, etc.) about the program. People with diabetes have to maintain a special balance between weight, diet, and activity (exercise) with their diabetes medicine. In other words, changes in your food intake may require a change in your medicine or activity level. Changes to your activity level (exercise) may also require a change in your medicine or food intake. Changes to your weight may also require changes. It is important for you to talk to your doctor about the number of calories or carbohydrates you should eat when trying to manage your weight. The diet information we send to members is on counting calories. If your doctor prefers you to be on a carbohydrate count diet, please let us know. We will send you information on this type of diet. It is also important for you to discuss your exercise plan with your doctor. We recommend walking. If you are not able to walk, please let us know and we will send you other suggestions for exercise.

Page -14-

Community Care Steps of Hope Program 339 Sixth Avenue, Suite 1300 Pittsburgh, PA 15222