TORONTO - She has treated more than 5,000 people over the last decade who have struggled with obesity, but wrestling since childhood with personal weight issues, Dr. Ali Zentner became her own first patient.
She saw her first nutritionist at age nine when she tipped the scales at 120 pounds, and described herself as the biggest kid in all of her grade school classes. An admitted emotional eater, Zentner would turn to ice cream to soothe her sorrows following social or academic failures or a bad day at work.
By age 31, she was pre-diabetic with high blood pressure — and in the worst shape of her life.
Zentner's personal struggles are laid bare in her new book "The Weight-Loss Prescription" (Penguin). She also outlines strategies to help individuals break the cycle of poor eating habits and physical inactivity and encourage healthier relationships with food.
The Vancouver-based obesity specialist who practises internal medicine says she felt it "absolutely necessary" to share her own story and those of her patients in the book.
"Unfortunately, in today's society, obesity is still very much viewed as a social condition and not a disease, and we very much blame the patient," the 41-year-old said during a recent visit to Toronto.
"I wanted a book that wasn't just a how-to, but also to teach a component of empathy. I wanted there to be stories where people wouldn't just adopt a healthier lifestyle, but that they would identify with others in their struggle. And if it wasn't their struggle, I want them to develop a sense of empathy."
Zentner recalls in the book barely being able to walk five minutes on the elliptical when she first started. Over time, that number gradually rose in small increments until she was spending an hour a day on the trainer.
She and her husband eliminated their twice-weekly Chinese food takeout habit and she stopped "eating candies by the bagful," opting for fruit at dinner rather than ice cream.
Zentner would go on to lose 40 pounds within six months, and has dropped more than 175 in total.
She commutes to work by bike and has gone on to complete feats of endurance that would have once seemed impossible, from recently running a marathon in Honolulu to climbing Mount Kilimanjaro.
"As I say to patients, this disease isn't your fault but it is your responsibility," says Zentner, medical correspondent for Global National.
"I wanted people to know that if I could take the responsibility and still keep at it a decade later and be more enthusiastic about it and more passionate about it a decade in than I was when I first started ... then maybe they could too."
Zentner said she makes the assumption in the book that it's not the startup of a new diet that's the issue but "the mid-game," along with the lack of a cohesive plan to maintain the regimen long-term.
So, rather than adopting a one size fits all model, she encourages individuals to follow a structure for improved eating habits in keeping with their existing behaviour patterns.
Zentner defines and offers specific tips for those who fall under various eating personalities: the emotional eater, the calorie drinker, the fast-food junkie, the all-or-nothing dieter, the portion distorter and the sitting duck.
Whether using old-fashioned pen and paper or a digital app, she also emphasizes the value of keeping a food diary to discern eating patterns and look at where individuals may be falling short in meeting their targets.
"Part of maintaining (your lifestyle change) is looking at who you are and what your behaviour patterns are now instead of `That's what I want,'" says Zentner, who was the medical expert on CBC reality series "Village on a Diet."
"You have to see what your capabilities are and what the map looks like before you can even imagine getting to the destination. But I think we often — especially in this weight-loss world — we focus so much on the destination, this elusive kind of number."
Zentner says it's also incredibly important for individuals not to "diet in silence."
In addition to stating their intentions towards healthier living, she says people should draw on outside support to help them along their journey — one they don't have to embark on alone.
She points to one example in the book of a female patient who is married with three young boys and would typically order three pizzas, cheesy bread and chicken wings four nights a week.
They now order in just one night a week, trade cheesy bread for salad, nix the chicken wings entirely and eliminate leftovers by opting for an extra-large pizza. A second evening is devoted to homemade pizzas made from whole wheat pitas which Zentner says has become "the best night in the house."
"You make health the norm and everything else is a deviation."
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Get Your Head In The Game
What's the real reason behind your weight loss goals? Do you want to look great in your wedding dress or just have more energy throughout the day? "You have to find a meaningful reason for finally wanting to lose weight," Bauer says. Writing your goals down or finding an online community support group are the first steps to develop healthy weight loss patterns, Bauer adds.
Track Your Progress
"It's also important to give yourself a pat on the back because you will hit plateaus," Bauer says. She recommends weighing in regularly (if you're up for it) and using a measuring tape to track the state of your abdominals, legs, arms or other areas you're working on. You can also try free graphing sites like <a href="http://www.skinnyr.com/">Skinnyr</a> or <a href="http://www.fridgegraph.com/">Fridge Graph</a> to track your progress every month — or <a href="http://www.livestrong.com/article/76905-create-weight-loss-graph/">just stick to Excel</a>.
Exercise...Every Single Day
"Exercise every single day for at least 30 minutes like it's a prescription," Bauer says. Bauer recommends multitasking to make exercising go by faster. Try going on the treadmill with your iPad or a book or holding on to some weights during your morning commute to work.
Eliminate The Extras
How many times do you take a piece of someone's cookie or take a sip on someone's drink? Bauer says everything adds up. To stop yourself from adding extra calories to your diet, she recommends putting all those extra bits and pieces of food into a plastic bag and not in your mouth.
Use A Support System
Grab a co-worker, friend or even your kid and go for a walk. "This is an easy way to enjoy success together. "Work out with someone or start a walking club in your neighbourhood," Bauer says.
Lose Liquid Calories
"Generally sugary soda products have about 17 teaspoons of sugar and up to 250 calories. The worst part is these drinks don't fill you up and you often crash," Bauer says. She suggests drinking little to no pop over time and limiting wines or champagnes to one glass per day. What you should be drinking? Plain old H20.
Be Comfortable In The Kitchen
It's time to skip takeout and put on a chef's hat, Bauer says. "How much do you eat when you go out? A cheeseburger and fries at a restaurant can add up to 1,400 calories," she says, adding that eating sweet potato fries with low fat spaghetti and meatballs at home, for example, can cut the fat in half. If you're looking for recipe ideas, check out <a href="http://www.huffingtonpost.com/taste/">Huffington Post Taste.</a>
Avoid Trigger Foods
"Keep that junk out of your house. Don't fool yourself into thinking you're only going to have one," Bauer says. Trigger foods are those addictive go-to foods that everyone has in their cupboards or fridges. It could be ice cream, chocolate or chips. Give your kitchen a clean sweep and remove all of the junk food. (It will also benefit your kids).
"When you take a trek on the dark side, don't let it set you back," Bauer says. If you're an emotional eater, don't give up on your goals or feel bad about yourself, she adds. "This is the hardest thing. Most successful dieters have conquered this and if you can master it, you will lose whatever you want and keep it off."
Set Both Short-Term And Long-Term Goals
It doesn't matter if you want to lose 10 pounds or 100 pounds, both short-term and long-term goals should be set for weight loss, Bauer says. She recommends having small goals like skipping fatty foods and trying new recipes, and not using the vending machine at work as a long-term goal.