In part one of my question and answer session with Susan Harrow Rago, MS, RD, LDN, much of the discussion was on nutritional counseling for weight loss. In this second segment of our Q&A, Susan Rago shares her weight loss tips on eating healthy to lose weight in the real world where time, money, and competing priorities are constant obstacles. Susan’s weight loss tips and guidance help her clients attain and maintain health and wellness. I hope they help you, as well.
Susan Rago puts most of her energy into weight loss tips and treatment that help 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 heart 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 past-president of the Southern District New Jersey Dietetic Association.
Read Susan Rago’s bio in our first Q&A article, Susan Rago Counsels Clients to Lose Weight.
Here are Susan’s weight loss tips from the second part of our interview:
Susan Rago’s Weight Loss Tips
My Bariatric Life: Do you classify obesity as a disease? If so, is it a physical or psychological-based disease?
Susan Rago: I don’t think it really matters whether we classify obesity as a disease or not, except for insurance reimbursement purposes. And I do think that insurance should cover, at least in part, coverage for the treatment of obesity, especially nutrition counseling by registered dietitian nutritionists [Find an RDN/LDN]. The important thing is that millions of people are struggling with obesity. There are most likely both physical and psychological manifestations, many of which are not well understood, which is why treatment of obesity is so frustrating for all involved.
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.
My Bariatric Life recommends Hunger: A Memoir of (My) Body from the New York Times best-selling author Roxane Gay, a searingly honest memoir of food, weight, self-image, and learning how to feed your hunger while taking care of yourself.
My Bariatric Life: How do you teach a person to thwart head hunger and break the cycle of emotional eating?
Susan Rago: 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 [Find Treatment].
My Bariatric Life also recommends our articles:
- What to Do About Emotional Eating
- Steer Clear of Emotional Eating
- And the book, Counseling Overweight Adults: The Lifestyle Patterns and Approach Toolkit by Dr. Robert Kushner.
My Bariatric Life: Is it more complicated for the person whose overeating is linked to depression?
Susan Rago: 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.
Sugar, Fat, Cholesterol and Calories
My Bariatric Life: 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 Rago: 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.
My Bariatric Life: 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 Rago: 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.
My Bariatric Life: 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 Rago: 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 intake of trans fat.
My Bariatric Life: Will eating more than the recommended daily allowances for fat and cholesterol cause weight gain? Is there a link between dietary cholesterol and blood cholesterol?
Susan Rago: 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.
My Bariatric Life: How important is diet relative to exercise in this case?
Susan Rago: 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.
Weight Loss Tips for Overcoming Obstacles
My Bariatric Life: What weight loss tips do you have for the average working family with children to find the time to prepare healthy meals from scratch, as well as exercise?
Susan Rago: 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.
My Bariatric Life’s favorite appliances for easy meal preparation:
- Electric pressure cooker (InstantPot etc)
- Ceramic wok pan for stir-fry
- Slow cooker crock pot
- Portable gas grill
My Bariatric Life: What weight loss tips do you have for morbidly obese people who have so much weight to lose that they feel their situation is hopeless?
Susan Rago: 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 weight 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.
Get more weight loss tips and a few really good tools (free) in our first Q&A article, Susan Rago Counsels Clients to Lose Weight. And be sure to follow Susan on Facebook and visit her website Transcend Health.
Living larger than ever,
My Bariatric Life