Waist Management

Staying slim in Pittsburgh may be more challenging than in other cities. But it's no excuse. Here are 13 hidden causes of weight gain and advice to get you on a winning path to a healthy weight.

Story by By Madelyn Fernstrom, Health Editor

What's the No. 1 health issue facing Pittsburghers?

It's an easy one to identify but a tough one to solve: our weight. Two-thirds of us are overweight or obese. One survey ranks us in the top 15 cities of greatest inactivity.

It's easy to cringe when we face the "battle of the bulge" because so many of us feel we're losing the fight. So, what to do about this issue? If you think slimming down is all about diet shakes and foot races in mini-shorts, read on. No matter what size package you're in right now, it is possible to manage your weight and promote your health with some easy-to-make changes you can use every day.

While we have some unique challenges in Pittsburgh when it comes to weight loss, there is a whole host of positive things we can do to get energized, feel better and improve not only our waistlines but also our general health.

Why It's Hard to Stay Slim In Pittsburgh

We face some special challenges in our region when it comes to managing our weight. These are not excuses but part of who we are. Once these issues are recognized, it's easier to work around them.

1. Weather: We love our seasons, but the weather can be a big deterrent to getting outside. We don't have a year-round sunny and warm climate as in Florida or California, where it's easy to be outdoors most of the time.
2. Terrain: We have a beautiful, hilly terrain, but it can be tough to navigate those hills on foot or on a bike. We don't have a flat grid like New York or Washington, D.C., where people pride themselves on walking long distances.
3. Family Affairs: Pittsburghers are family-oriented in so many great ways, and food is an important part of this mix. Family gatherings often focus on a variety of favorite foods - but not on all the calories.
4. "Pittsburgh Portions": Not only here but all across America there is the problem of "portion distortion." Often, a "single" serving in a favorite restaurant is enough for two or three people.

Taken together, these are all parts of a lifestyle that can be better managed. While it's sometimes tough to know where to begin in addressing weight management, some basic knowledge will empower you to make some changes.

Weighing in on a Healthy Body

There's a lot of confusion about what your "ideal weight" should be. The term "ideal" doesn't have a lot of meaning until you put the pieces of the puzzle together. An easy way to start is to find out your Body Mass Index. Go to pittsburghmagazine.com for the chart. This number accounts for both height and weight, gender, frame size and muscle mass (unless you are a super-hero!). It's the best all-around number to know in identifying where you are in the healthy weight-range continuum.

You may wonder how much weight you need to lose for better health. There's no perfect answer, but consider common sense. Whether you are overweight by medical guidelines or even moderately to severely obese, there are effective strategies you can take to trim down, particularly if you have an illness, such as high blood pressure or diabetes, affected by your weight.

If you're at a stable weight and have no health-related problems, consider staying at that weight. You may want to lose a few pounds simply for aesthetic reasons; keep in mind that the BMI chart is composed from information based on thousands of people, and you cannot always use population data to make the best choice for you.

Once you've sized yourself up, it's time to take a closer look at what you are both willing and able to do for a trimmer waistline. At first glance, many people say, "I'll do anything to lose weight," but often, that's not true. What you need is a combination of realistic goals, efforts and expectations.

Beware the 13 Hidden Causes of Weight Gain

If you're thinking, "I've been there, done that, and I'm not losing weight," look at some of these hidden causes of weight gain that could be obstacles in your quest for a healthier you.

1. Confusing "Heart-Healthy Fat" or "Fat Free" With "Low Calorie": Label-reading these days is like reading an encyclopedia - so much information, but what really counts? There is a lot of confusion about "healthy" versus "lower-calorie" eating. While the first step in any healthy-eating plan is to seek out heart-healthy fat, don't be fooled by product marketing. Olive oil is great for your heart but not for your waistline; both olive oil and butter have the same calories. Nuts are heart-healthy and protein-rich - but just a small handful has 100 calories! Trans-fat-free doesn't mean fat-free. Nowadays, you need to read labels for the calorie count.
2. Portion Distortion: Few of us are good at "eyeballing" portion sizes or estimating calories in foods. Studies show we're at least 50 percent too low in our "guesstimates." (Even professionals in the field miscalculate!) Our measuring cues - including plate size, utensil size and hidden fats - are deceiving us. In fact, the average dinner plate in Europe is close to the size of our salad plate, and our dinner plates are like their platters. No wonder standard portions look skimpy!
3. Skipping Meals: Whether it's to save time or calories, most meal- skippers think, "I skip meals, but it's not a problem until I get home for dinner. Then I'm eating all night." Here's the bottom line: If we skip a meal, biology kicks in and makes us even hungrier for the next meal. This is a strategy doomed to fail.
4. Getting Too Much Exercise: This may sound contradictory, but rigorous exercise actually stimulates hunger. It's the body's response to "refuel" for metabolic balance. In caveman times, this was helpful for survival, but not now, when food is easily available 24/7.
5. Overestimating Exercise Calories: We often don't correctly estimate the calories we lose in exercise. We might feel sweaty and think we've burned thousands of calories, but the truth is it takes about five minutes to consume 500 calories and nearly two hours for most people to burn them off!
6. Not Exercising Enough: Those claiming they are simply too busy for any activity can have a real problem. Even a small drop in the activity of daily living - cutting out a 20-minute walk - can add 100 calories a day, which would be 10 pounds in a year. Here's a typical comment: "I used to park blocks away in a cheaper lot. I got promoted and now use the corporate lot. I've gained 5 pounds in three months."
7. Lack of sleep. Not getting enough sleep is among the top hidden reasons for weight struggles. As a result, people become fatigued and eat for energy. Being tired can lead to apathy and a lack of focus when it comes to a healthy lifestyle plan. Many of us eat between meals to "wake up" when what we really need is a power nap.
8. Poor Stress Management: Mindless eating can come from poor coping skills with stressors in life. We eat to soothe and reward ourselves, which does work - temporarily - to make us feel better. It's important to learn to self-soothe and manage stress without food.
9. Weight Creep: Some general awareness every day is needed to avoid what I call "weight creep." It takes only a few extra calories a day to gain extra pounds a year. Most often, people "relax" their healthy lifestyle on the weekend, or they stay on their eating plan four or five days a week. That's enough to promote a pound or two a month of hidden weight gain.
10. Medication Side Effects: Some medications can lower your metabolic rate and stimulate hunger as a side effect. These include some antidepressants, antipsychotics, antihistamines, insulin and other blood-sugar regulators, and anti-inflammatory medications. If you've started a new medicine and gained 4 pounds or more in a month, check with your doctor.
11. Undiagnosed Mood Disorders: Depression and anxiety have both biological and behavioral causes. While some people experience loss of appetite, insomnia and weight loss, a large subgroup sleeps and eats more. Also, thyroid problems, which alter weight, are often tied to depression.
12. Thyroid Function: The thyroid gland is your body's "thermostat," which sets the "furnace." Alterations in the thyroid gland, which is regulated by a signal from the brain to release thyroid hormone into the system, can wreak havoc on a weight-management plan. Thyroid problems can be easily tested and treated with a visit to your doctor.
13. Elevated Blood Insulin: Also known as metabolic syndrome, elevated blood insulin levels are invisible unless you get a blood measurement. Symptoms include not only high insulin levels but also central weight gain (a bulging belly, for example), elevated blood pressure and higher blood fats. Those with an "apple" shape can be at particular risk. Only your doctor can evaluate this measure.

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