How to Really Lose Weight, Q&A with Susan Harrow Rago MS, RD, LDN
Susan Rago, MS, RD, LDN
In part one of my question and answer session with Susan Rago, MS, RD, LDN, much of the focus was on nutritional counseling. In the second segment of our question and answer exchange, Susan will share her thoughts on eating well to attain and maintain good health. In addition, she will discuss other subject matter about what will help people be the best and most healthy they can be.
Susan puts most of her energy into helping adults make the necessary lifestyle changes to reduce the risk for type 2 diabetes, kidney disease, and cardiovascular disease. To realize this, her clinical focus is on obesity, pre-diabetes and type 2 diabetes, chronic kidney disease, and risk reduction for cardiovascular disease.
Susan has been a volunteer with the American Heart Association and the American Diabetes Association, a member of the Academy of Nutrition and Dietetics and American Association of Diabetes Educators, and president of the Southern District New Jersey Dietetic Association. Here is what Susan had to say during the second part of our interview:
My Bariatric Life: How do you teach a person to train her body to recognize satiety and real hunger?
Susan Rago: Many people don't feel they are full or satisfied unless they are stuffed. I warn clients that when they cut down on the volume of food, they will experience hunger, at least until their appetite adjusts to a smaller volume of food., which seems to take about two weeks. We talk about how to deal with the short-termed hunger related to decreasing food volume. The satiety issue sometimes has deep-seated emotional roots and sometimes takes a little more time to resolve.
MBL: How do you teach a person to thwart head hunger and break the cycle of emotional eating?
Susan: This is probably one of the most difficult issues to manage. Often we'll discuss making a list of other satisfying activities to refer to when in the midst of a potential emotional eating episode. Limiting exposure by not keeping trigger foods in the house and accessible is also a tactic. However, if this is a serious problem for a client, I would recommend that he/she seek additional counseling from a mental health professional.
MBL: Is it more complicated for the person whose overeating is linked to her condition of depression? What if antidepressants or other medications are causing weight gain, how do you compensate for that?
Susan: That is a difficult situation and it depends on how successfully the depression is being treated. The same principles would apply. I actually have a few clients who are in this situation currently. Their goals are to focus on maintaining their weight and not gaining rather than weight loss at this point.
MBL: How can the average working family with children find the time to prepare healthy meals from scratch, as well as exercise?
Susan: Rotisserie chicken! No, seriously, the problem is much deeper. Many young people do not know the basics of food preparation. But the good news is there are so many resources available online with healthy, easy recipes. Crock pot recipes are extremely easy. Although a little more expensive, many grocery stores have produce that's already cleaned and ready to just microwave or steam. Fruit is easy to buy and eat. In fact, many grocery stores have registered dietitian nutritionists who can be great resources to families. Grilling is also quick and easy. As far as exercise, it's helpful to plan family activities that include some form of exercise e.g., biking, swimming, walking, dancing.
MBL: We read a lot about Americans consuming too much added sugar and its link to obesity. But what about natural sugars found in fruits, vegetables, and dairy, are there limits on what men and women should consume per day?
Susan: My personal opinion is that it's doubtful the obesity problem is caused by people consuming too much sugar from fruit and dairy. And I really don't think anyone's got an obesity problem from eating too many vegetables! Most likely people are getting too much sugar from soda and other sweetened beverages, candy, pies, cakes, cookies, ice cream, doughnuts, etc.
MBL: Will consuming too much natural sugar cause weight gain? Are natural sugars extracted from fruit and plants and used as sweeteners a healthy choice?
Susan: I personally don't care for artificial sweeteners. A teaspoon of sugar has 16 calories. If you need a little sugar, use a teaspoon of sugar. But don't use 16 teaspoons! Consuming too many calories from any source will cause weight gain.
MBL: How many grams of total fat should men and women have per day? And what percentages of that would be for saturated fat, polyunsaturated fat, mono saturated fat, and trans fat?
Susan: There’s lots of controversy about this right now. Fat is a very concentrated source of calories but it also provides satiety value so it plays an important role in the diet. The total grams of fat per day would depend on a person's total daily calorie requirement as well as any other co-morbid conditions present. We probably all can agree that it's a good idea to limit I take of trans fat.
MBL: What are the recommended daily limits for cholesterol and how is it related to fat in the foods we eat? Will eating more than the recommended daily allowances for fat and cholesterol cause weight gain?
Susan: Again, eating too many calories from any source will cause weight gain. It's doubtful that dietary cholesterol has any effect on an individual's blood cholesterol.
MBL: What are the key factors that are needed for permanent significant weight loss? How important is diet relative to exercise in this case?
Susan: Exercise is so important for good health for so many reasons. But to lose weight, a person needs to cut down on the amount of calories. And this change needs to be permanent.
MBL: What do you say to morbidly obese people who have so much weight to lose that they feel their situation is hopeless?
Susan: Focus on short term changes and on making lifestyle changes. It's a marathon not a sprint. Event if you don't reach your desired goal weight, a loss of 20-30 pounds can make a big difference to your health. And if you stick with the changes, the weight will come off.
You also may enjoy my series of interviews with Lori Rosenthal, MS, RD, CDN, a bariatric dietitian. Read more:** Keep the Weight Off for Life**