The importance of multiple measures – keeping track of getting healthy

Weight loss can be an extremely difficult thing.

I was reminded of that this morning when one of my long-term weight loss clients came in and got particularly frustrated that the scale hadn’t budged since our last meeting.  After chatting for a few minutes it became clear to me what a stranglehold the number on the scale had on her emotions, so I asked “Before you weighed in here today, did you feel that your month had been successful?” to which she said that yes, it had – she had found a way to work in exercise around a busy schedule of classes and full time work, and she had dealt with the Easter holiday in a very sensible manner. She had been successful, even if she didn’t feel that way this morning.

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When trying to lose weight, there are so many factors that go into success. The end goal – weight loss – is a compilation of a million different things: knowing what foods are good, choosing those foods, finding new ways to prepare them, learning new forms of physical activity, finding an activity that appeals to you, rearranging your schedule to fit that in…the list goes on and on and on.  It’s important that we measure success in as many different ways as we can.  My patient was so fixated on one measurement that it erased the successes that she had in different areas.

The following is a list of ways to measure weight loss success, in order of descending importance.  The ranking is only my opinion, but I feel strongly about it.

Food log – This is a simple yes or no: did you fill out your food log? Tracking food and exercise is the single most important behavior when it comes to successful weight loss.  The simple act of writing down on paper (or typing into your phone or computer) what you’ve eaten forces you to think about the foods that you put into your body.  This can be done as low-tech as a pen and a sticky note or you can use an app on your phone – which leads me to:

Daily calories – My Fitness Pal is my all-time favorite for tracking calories. I have suggested this app (available for both apple and android devices) to almost 100% of my weight loss patients, and even to those trying to gain weight. Most of the time they’ve already heard of it by the time they get to me! The reason I like it so much is because the food database is so extensive that it’s tough to find a product that someone hasn’t already loaded. Additionally, you can store recipes (this does take some effort) and it remembers frequently eaten foods. The calorie recommendations are trustworthy, so you can be confident that the app isn’t going to underfeed you. I do suggest that people measure their portions for the first few weeks to ensure accuracy. HOWEVER keeping tabs on calories can get all-consuming for some people and effectively take over their lives. If you are someone who experiences this, and tracking calories affects the way that you interact with others or makes you irritable to a point where your relationships and/or psychological state are suffering, don’t do it.

Weight – That’s right, weight tracking is not as important as keeping a food log and using an app to track daily calories, IMO. There has been research lately that daily weighing has a huge impact on overall weight loss, and perhaps it does for some people. I would prefer my patients weigh once or twice weekly, on the same days and at the same times; and focus their energy on tracking food diligently. The correlation between the foods you choose to eat and the calories you ingest is 100% –  you don’t get more calories than you put in. In contrast, your weight is affected a TON by things like hydration status and GI function. This can get discouraging for people.

Daily steps – I wear my UP24 band from Jawbone religiously and have the tan line to prove it (not cute). Incidental activity – all that moving we do when we weren’t purposely “exercising” – is consistently correlated with lower BMIs in the literature. Focusing on the number of daily steps taken can be an effective way to increase calorie expenditure outside of planned exercise.  Additionally, it’s been shown that the amount of time you spend sitting (aka not walking) is positively correlated with mortality REGARDLESS of whether you exercise regularly.  In plain English that means the more you sit the sooner you die, even if you ran for an hour this morning. I guess I should stand up, eh? On top of ALL THAT, a simple walk can reduce stress, increase insulin sensitivity and provide an alternate route for cells to take up blood sugar thereby reducing risk of type 2 diabetes (or helping to control it), and all sorts of other good stuff. More steps is simply more healthy.

Fitness tests – There are many different fitness tests: VO2 Max testing, simple step tests, the mile time trial you were forced to do in gym class, and even simple things like the number of dumbbell curls you can do or the weight you can squat. Keeping track of your physical fitness is especially important when you’re using exercise to help you reach the ultimate weight loss goal. There are times when the number on the scale isn’t moving but you’ve gained muscle and physical abilities to go along with it. These things cannot be discredited, as they are HUGE for your health.

Inches – Along with fitness tests, inches can be a testament to the work being done when exercising. Muscle weighs more than fat and can therefore skew the number on the scale but it takes up less space which will show in your inches. Measure waist, hips, mid upper-arm circumference, chest (for the ladies), thigh, neck, calf – whatever it is you want to track!  My favorites are the first 5.

Body fat % – BF% can be calculated with circumferences, with skinfold calipers, underwater weighing techniques that use water displacement, air displacement “bod pods”, or using bioelectrical impedence handhelds or scales. Typically when people are trying to lose weight, they want to lose fat versus lean mass. Tracking this percentage over time is a helpful way to make sure that you’re not compromising your muscles.  However, this is often a pain in the ass to figure out so don’t kill yourself trying to find someone with a perfectly calibrated pair of skinfold calipers.

***OF NOTE*** I did not list any blood tests on here because it’s unrealistic to do on a daily, weekly, or even monthly basis for anyone who doesn’t have a medical reason to have labs run regularly. I used to work in insurance and BELIEVE ME, shit’s expensive. However, it is important to get a lipid panel at your annual checkup and keep track of your total cholesterol, LDL, HDL, Triglycerides, Glucose, and A1c. I’ll talk about all of these at another time, but your doc will give you a heads up if something is wrong with these labs (all of which should improve with weight loss).

My best advice? Pick a few measures that work for you. If you become too fixated on one, try focusing on another. The goal here is health, not obsession, so celebrate ALL successes and let the setbacks be motivation!

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One response to “The importance of multiple measures – keeping track of getting healthy

  1. Pingback: 8 New Years resolutions (and modifications) that are actually worth your time | How to Eat, R.D.·

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