Carb crazy? Consider this: Refined carbohydrates, such as bread, potatoes and rice, create a surge in insulin that in turn drives down your resting metabolic rate, explains Aronne. "It's important to keep carbohydrates in your diet, but really focus on fruits, vegetables and whole grains, which have less of an effect on insulin levels," he explains. And when buying whole-grain breads and cereals, make sure the first ingredient listed is whole wheat, whole oat or cracked wheat.
Shaping is a behavioral technique in which you select a series of short-term goals that get closer and closer to the ultimate goal (e.g., an initial reduction of fat intake from 40 percent of calories to 35 percent of calories, and later to 30 percent). It is based on the concept that "nothing succeeds like success." Shaping uses two important behavioral principles: (1) consecutive goals that move you ahead in small steps are the best way to reach a distant point; and (2) consecutive rewards keep the overall effort invigorated.
The Core Plan is based on the science of energy density. Energy density refers to the amount of calories in a given weight of food. Foods that are considered low energy dense foods have a small amount of calories for a large volume of food (for example, vegetable soups, vegetables, and fruit). High energy dense foods provide a lot of calories for a small amount of food (for example, oils, butter, cream sauce). The Core Plan provides a "balanced diet by centering on a list of healthy foods that keep you full longer."
Over the past few years it has become clear that weight is an important health issue. Some people who need to lose weight for their health don't recognize it, while others who don't need to lose weight want to get thinner for cosmetic reasons. We understand that in some ways your weight is different from, for example, your cholesterol level or your blood pressure, because you can't see what these are by looking at someone. Many patients have had health care providers who approached their weight in a less-than-sensitive or helpful manner. Some patients may have had health care encounters in which they felt blamed, but not helped. Successful weight management is a long-term challenge.
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