Question: My pulmonary doctor encouraged me to try to lose weight saying that it would likely help me breathe better. But, I get short of breath when I try to increase my activity, and I don’t think that I eat too many calories because I don’t eat large meals. I am 55 years old, female, 5’3” tall and weigh 170 pounds. Is it even possible for me to lose the excess weight?
Answer: Yes, it is possible to lose weight even with limited activity. You should expect that it will require a major and long-term commitment to an appropriate plan. But, it is certainly worth the effort to lose even 10 percent of your current body weight. The benefits of doing so would likely be improved ability to exercise and to breathe. You will also decrease your risk for other health problems.
For everyone, the only way to lose weight is to eat fewer calories than the body needs. Stored calories from excess body fat is then used to provide the shortage of necessary energy the body needs daily.
There are three steps common to achieving successful weight loss and maintenance — which will be implemented differently by each individual:
The first step is making a commitment to change. This is much more than wanting to lose weight. Lots of people want to lose weight, but few are successful, especially in the long-term. I encourage people to not even begin trying to lose weight until they have thoroughly analyzed what habits contributed to their excess weight gain; what realistic behaviors are necessary to support weight loss; and what obstacles can be expected to be encountered and how to deal with them.
For example, you should expect to be hungry at times. But, how will you deal with that? What sacrifices are you willing to make? Are you willing to eat in such a way to support the primary goals of weight loss and nourishment instead of eating for pleasure or to celebrate?
The second step is determining an appropriate plan that will work best for you. No two plans will be exactly the same, because no two people are the same. You know yourself best and probably have an idea of what will and will not work for you. You know your lifestyle, challenges, support system, environment, food and activity preferences and capabilities. Consider sharing your plans and challenges with someone you can trust to have your best interests in mind — as well as with your PH health care team.
Registered dietitians can also help provide the resources and support to follow through. They are the best equipped to help you evaluate the safety and practicality of your strategy while considering your medical issues. What you don’t want to do is to try something that is short term or is unrealistic. If a plan is not appropriate, and you therefore fail to lose or maintain any weight loss, the experience of failure has the potential of sabotaging future efforts. It is worth it to take the time to figure out what is credible and likely to work for you.
The first two steps foster the necessary motivation, confidence and insight to begin a weight loss plan. The third step is to practice your plan.
- How you will track your progress, food intake or activity?
- Will you be accountable to someone?
- What resources best support your efforts as you live out your new lifestyle?
- When and how will you reward your efforts and successes?
Anticipate that you will need to improve and refine your plan and activities as you determine what you need and what works and doesn’t work for you. There will be unexpected challenges: deal with them with the long-term goal in mind as opposed to giving up. This is not a sprint, but a marathon to be run with the endurance that will ideally result in behaviors to support better health for the rest of your life.
YES, you can lose weight, even with a lung condition such as pulmonary hypertension. But, to do so successfully requires an intentional approach that includes commitment, an appropriate plan and the support to practice healthy behaviors for a lifetime.
If you would like more information or additional resources, I recommend visiting the following websites:
Finding a registered dietitian: www.eatright.org/find-an-expert
Weight management guidelines: https://www.nhlbi.nih.gov/health/educational/lose_wt
Food tracker: https://www.choosemyplate.gov/tools-supertracker
Katherine Beich is a registered dietitian nutritionist at the Center for Advanced Heart and Lung Disease at Baylor University Medical Center in Dallas. She received a Bachelor of Science in nutrition from New Mexico State University and a master’s degree in nutrition at Texas Women’s University. She has worked in multiple positions at Baylor Scott and White Health and is currently employed in an outpatient clinic. She is dedicated to assisting others by identifying the nutrition and lifestyle changes they are willing to make and providing them with the support to be successful. In her spare time, Katherine enjoys cooking, water aerobics and “living life” with friends and family.
This article first appeared in the Spring 2017 issue of Pathlight magazine. Become a member of PHA to receive this quarterly publication full of patient profiles, medical information and tips for living with pulmonary hypertension.
By Katherine Beich, M.S., R.D.N., L.D., Baylor University Medical Center, Dallas