"Eat Everything on Your Plate and Stop Fidgeting" - WRONG by Dr. Paul O'Brien

Remember what your mother used to say. She did not want you to waste food nor to waste energy. That was good advice when we didn’t have enough food. Fidgeting was a non-productive activity. It achieves nothing apart from using up energy. If we have limited energy intake we mustn’t waste our energy output.

We are now in different times. We have enough food, too much in fact, and we try to eat away at this mountain of excess. At the same time, we do too little. Activity has become optional. Who among us now spend their day picking corn, shoveling gravel, building roads, scrubbing floors, washing clothes by hand, walking into town to do the shopping? We are much more likely to be sitting rather than standing, standing rather than walking, inside rather than outside, comfortable rather than huffing and puffing. When was the last time you broke into a sweat because of hard work?

We need to do more, more physical work, more exercise and be more active throughout the day. But we also need to fidget more, to burn up more energy with useless activity which will make up for the lack of productive activities in our typical day. Already, when we overeat, we do increase our fidgeting subconsciously. I would like to encourage you to look for it and to go for it.

It is worth knowing what happens to all the energy we take in as food. Let’s suppose you eat 2000 calories in a day. The major part of it goes into just keeping the body ticking. Even if you lie perfectly still all day and do not lift a finger, you will use up between 1200 and 1400 calories in maintaining the systems of the body – keeping the heart pumping, the body temperature up, the tone in the muscles, the liver making proteins, and numerous other internal needs. This is the basal metabolic rate (BMR) and it uses up 60 to 70% of our normal energy intake. Just to metabolize food also takes energy and that uses about 160 calories or 8% of the intake. This is why the dieticians tell you that you must eat to “turn on your metabolism”. It is not correct or logical or accurate but we can return to that at a later time.

The rest of the 2000 calories (between 400 and 600) is used for all the activities of daily living. Some of these are productive – walking, physical work, exercise, and some are non-productive – moving around rather than standing, standing rather than sitting, moving rather than being quiet and fidgeting rather than being still. If you are eating the correct number of calories each day, these tend to be in balance and your weight is steady. There are no excess calories to store as fat. But what happens when you eat more than you need?

Let me tell you about an experiment done by Dr. James Levine at the Mayo Clinic. He took a group of 16 healthy non-obese volunteers and, for 8 weeks, he had them to eat 1000 calories more per day than they usually had. Not surprisingly, they put on weight. However they did not store all the excess as fat. They did not put on as much weight as we might have expected. And, most importantly, some put on more weight than others. On average they gained about 10 lbs. One person gained 17 lbs and another gained only 3.5 lbs.

Dr. Levine could show that some of his 16 subjects were “easy gainers” – a little bit of extra food and the weight goes on. You are most likely to be in the easy-gainer group. Others were “hard-gainers” – they could resist the effects of the extra food. They “burned” it up. And he showed the reason for the major difference among the 16 people and their weight gain with overfeeding was what he called their NEAT – their Non-Exercise Activity Thermogenesis. The people just move around more and so burn up energy to generate heat. The more NEAT you generate, the less of the excess is stored as fat and so the less the food impacts on your weight.

These 16 people eating 1000 calories per day too much all increased their NEAT. The increase in NEAT used up about one third of the extra calories (33%). A little more than a third was stored as fat (39%). And the remaining third was used to digest and absorb the extra food (13%), increase in their BMR (8%) and build more muscle (4%). The “hard-gainers” increased their NEAT by nearly 70% and so had almost no fat increase with all of the overeating. The “easy-gainers” had just a small increase in NEAT and increased their fat stores by over 9 lbs. There was no relationship between the change in the BMR or the TEF and the gain of fat. It was driven almost fully by the NEAT.

What does this tell us about getting an optimal outcome from the Lap Band? It tells us to be active. Moving around is one of the discretionary parts of weight-loss. It is a part that we can control and Dr. Levine’s study shows us that it does make a difference.

So get moving. Always be doing something active, always moving. Build it into your day. Make it a habit. Always be looking for something to do. Regard sitting down as a wasted opportunity. It doesn’t really matter what you are doing. Just do it.

Eat Less: The Key to Success After Lap Band

The Lap Band really does work. It enables you to lose weight. As you lose weight, your health improves, you are physically better, socially more confident and you will have an improved quality of life. Also, as a special bonus, you are likely to live longer. It is an outcome you wish for and an outcome that we want to achieve for you.

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