Mary wrote:

Dennis' Story:

Shape Up America! responds:

Although it is possible that Dennis reported his weight loss inaccurately, we think it is plausible that his numbers are correct for two reasons: (1) He was extremely overweight, weighing 290 pounds at the start of his lifestyle change, and (2) He reported that he "drank too much" and then stopped drinking completely.

In extremely overweight people, when dietary change is initiated that involves a large reduction in calorie intake, the weight loss over the first several weeks is usually greater than 2 pounds per week. For people who are seriously overweight like Dennis, an initial period of very large weekly weight loss, lasting for several weeks, is quite common. This early very large weight loss is due to a diuresis — a water loss that accompanies the fat loss. There is also some initial protein loss which contributes further to the water loss.

The changes in weight and the composition of weight loss in the early weight loss period are described in a 1976 study conducted in the laboratory of Theodore B. Van Itallie, one of the preeminent obesity researchers (now retired).¹ This study of six individuals (ages 19-58) with an average initial weight of 308 pounds (close to Dennis' initial weight) is considered a classic. The rate of weight loss averaged from 4.3 pounds per week on a mixed diet to 7.2 pounds per week on a ketogenic (carbohydrate restricted) Atkins-type diet. The two types of diet were identical in calories. Since these were averages, some people lost more weight than this each week. Indeed in our experience, weight loss is sometimes three times greater than these averages as a result of diuresis, and this water loss is sustained for several weeks.

The water loss (but not the fat loss) differed greatly, depending on the diet. Water loss accounted for 37.1% (on a mixed diet) to 61.2% (on a ketogenic, that is a carbohydrate restricted or Atkins-type diet) of the lost weight during the initial 10-day weight loss period. We know that eventually the water loss slows and the rate of weight loss slows considerably after this initial period.

Because Dennis reported that he "drank too much" and stopped drinking, in addition to reforming his diet and significantly changing his exercise habits, the above explanation seems quite likely. It is well known that heavy drinking can damage the liver and other organs. Eventually this damage leads to edema — the retention of water. When drinking stops, the liver is resilient and mends itself, and the edematous condition can be corrected. We speculate that this is another factor that contributed to his larger than normal weight loss over the five-month period.

We congratulate Dennis for overhauling his entire lifestyle in a positive way. We thank him for contributing his story that, we hope, will help others realize that lifestyle change is possible. We also continue to believe that after the initial weight loss period, a rate of weight loss of no more than 2 pounds per week is desirable, especially because rates of more rapid weight loss are associated with gall bladder disease and other health problems.

One school-based program of high importance is the intramural program. Intramurals are athletic and recreational activities for students that are an extension of the physical education class. Students have the opportunity to select activities they prefer and participate in as many seasons as they like throughout the year. The National Association for Sport and Physical Education (NASPE) issued a position statement in May 2008 on Comprehensive School Physical Activity Programs. This position statement includes the recommendation for intramural programs in schools. In addition, NASPE's position statement on Guidelines for After School Physical Activity and Intramural Sports Programs provides schools with goals, rationale and recommendations for developing an intramural or physical activity program in a school.

NASPE recommends that the intramural or co-curricular programs:

• feature a diverse selection of competitive and noncompetitive activities
• include structured and unstructured moderate and vigorous physical activity
• consider the needs and interests of the wide range of student abilities, particularly those with limited interest or skills in traditional sport activities
• emphasize participation, safety and enjoyment without pressure to excel or perform
• be accessible to all students

Unlike interscholastic sports, which are costly and also limiting in the number of participating students, intramural programs provide increased physical activity opportunities that serve a greater number of students in a school. Intramural programs, and other extracurricular physical activity programs, are the best opportunities for increasing physical activity of students in a school setting. These programs provide opportunities to:

• improve physical fitness
• develop and reinforce positive personal and social behaviors
• provide positive interactions with other students
• increase self-confidence and self-efficacy
• apply lessons learned in physical education class
• establish the habit of participation in physical activity on a regular basis
• support academic achievement

Today's physical education programs offer a wide variety of activities ideal for intramural programs. Early bird weight-training classes, lunchtime rollerblade clubs or basketball league play, and after school wall-climbing clubs are just a few of the varied and innovative offerings that can be easily implemented during the school day. Parents can become involved in the organizational process, serve as volunteers to assist with facilitating activities or raising funds for equipment, and support the school's efforts in expanding physical activity offerings. Parents with specialized expertise can offer to provide instruction within the intramural program.

Intramurals can be a vehicle for instructing students in activities offered within the community but off school grounds, such as golf, tennis, or triathlon. This increases the likelihood that students would participate in these activities outside of school hours. Many students who might not otherwise have the opportunity to explore these types of activities can experience broad exposure to some exciting activity opportunities through a well-developed intramural program. There is potential for the entire school community to get involved!

In order to create an exciting intramural program, schools need to invest time in developing an intramural program that would peak student interest and engage the students in meaningful, well organized physical activity. The following steps can be taken by the school administration to get the process started:

1. Select an experienced program director from the school staff.
2. Design and provide students with a survey of their interests.
3. Be sure the appropriate equipment is available to meet the students' selections.
4. Allow time either before school, during an extended lunch, or after school for the intramural program to take place.
5. Provide for festivity, i.e., tournaments or championships that get many groups within the school and parents involved.
6. Communicate with parents about the purpose of the program and how they can support the educational benefits of sport programs.
7. Help all involved remember that sports are for the kids to help them learn and grow, to get fit for life, to be with peers, and most of all, to have fun!

In order to support our youth in finding their personal physical activity favorites, schools need to provide a "physical activity friendly" culture. By providing a variety of quality physical activity programs, schools will help young people learn and enjoy a variety of activities that hopefully will support a lifelong physically active, healthy lifestyle.

I've found three sources of information (other than your site) beneficial to my recent weight loss of over 12 pounds. I lost the weight slowly over the course of 10 weeks, but am still losing. I eat normal healthy food and exercise as often as possible (3-4 times per week). My goal is to lose 22 pounds total and to maintain that indefinitely. I found the cable TV program, "I Can Make You Thin" to be quite helpful, providing tips I never heard before; but they work! Also, I read "The Secret" and "A New Earth," both of which helped me calm my mind and become more confident about my starting weight and my ability to lose it. Your Web site is also a great help, and I like the RMR calculator and suggestions provided. Thanks for making it easier.

Shape Up America! wants to hear about you! If you would like to share your personal success story and be an inspiration to others who desire to lose weight, simply use our story submission system on the SUA Web site.

Spinach Pesto Pasta
Makes 8 servings (about 1 cup each)

INGREDIENTS:

• 16 oz. whole-wheat linguini pasta
• 4 cups fresh baby spinach, loosely packed
• 2 Tbsp. pine nuts or slivered almonds
• 3 garlic cloves, peeled
• Small handful of basil leaves, without stems
• 1 tsp. dried Italian seasoning
• 3 Tbsp. Parmesan cheese, grated
• Salt and freshly ground black pepper, to taste
• 1/8 cup fat-free, reduced-sodium chicken broth (or vegetable broth)
• 1/4 cup extra virgin olive oil
• 2 Tbsp. lemon juice
• 2 plum tomatoes, diced

DIRECTIONS:

1. Cook pasta according to package directions. Drain, place in a large serving bowl, cover to maintain warmth and set aside.
2. Meanwhile, place spinach, nuts and garlic in a food processor or blender. Pulse until chopped. Add basil, Italian seasoning, cheese, salt and pepper. Pulse to mix. Slowly add broth, olive oil and lemon juice. Process until well blended.
3. Add pesto to warm pasta and toss gently to coat. Top with tomatoes and serve.

Nutritional analysis per serving: 310 calories, 11 grams total fat, 1.5 grams saturated fat, 45 grams carbohydrate, 9 grams protein, 6 grams dietary fiber, 260 milligrams sodium.

Source: American Institute for Cancer Research