Dear Sue:

My mother was told by the doctor that she was overweight (215 pounds, 5'4"). She was in a car accident and has a difficult time walking and exercising. What do you recommend for folks to lose weight when they can't follow your recommendation to exercise? Thank you for your help,
Mary

Dear Mary:

Although it is more difficult, it is not impossible to lose weight with limited movement. By understanding metabolism and appetite, you can help make the appropriate adjustments.

1. Keep your metabolism burning. Follow a low-fat, low-calorie diet that focuses on:
   • vegetables
   • fruits
   • whole grains
   • low-fat dairy products
   • lean meats, poultry and fish
   However, our bodies adapt to low calorie intake by reducing our basal metabolic rate, so to help prevent slowing down the internal engines, don't reduce calories below 1,200 a day.
2. Focus on those foods that have the highest level of satiety -- the ones that make you feel most full after eating. Studies have found that the best way to control your appetite is with a food that is high in bulk and low in calories. For example, eat a large salad and drink a glass of water before your main meal. The most satisfying foods are those high in fiber, particularly fruits. Calorie for calorie, apples and oranges were more filling than bananas. Potatoes topped the list. Other highly filling foods were whole grains and high-protein foods such as fish. The least satisfying foods (for the calories) were bakery products, especially white bread, doughnuts and cakes. Popcorn was the best snack food for satiety. The best way to control and to satisfy your appetite is with foods high in fiber and low in fat.
3. Visit with a physical therapist to get an evaluation and professional help for safe ways to incorporate some form of movement and exercise into your daily or weekly routine. I think you will be pleasantly surprised to find that there are ways your mom can get moving that are adapted to her limitations. For example, it may be that a form of water aerobics would be comfortable. The activity will not only help keep her calorie-burning engines going, it will improve her mental outlook as well. The therapist may also help find some weight-training exercises she can perform that will help increase her muscle tone -- also a great way to help burn calories and lose weight.

Good luck!

Sue Gilbert, M.S., nutritionist