Dear Sue:

I really need to lose some weight, but I don't know where to begin. I was just diagnosed with high blood pressure, and I'm "very overweight" (215 pounds). The doctor said I should think about losing some weight and start to exercise. I've had seven back surgeries since 1990, though, so the days I feel up to exercising are limited. How do I start a life program of exercising and eating better? What is a safe way to go about this? Thank you,
Deborah

Dear Deborah:

First of all, congratulate yourself on your resolve to begin a better way of eating and exercise for life. That is a major first step, and taking the initiative to research a healthy approach is the best way to do it. Here are some suggestions that may help.

• You will need to begin with a hefty dose of patience and realism. Since you want to make a change in lifestyle, you will need to do it gradually, slowly breaking old habits and learning new ones.
• A dietitian you can work with can be an invaluable asset. She or he can help design a diet and exercise program tailored specifically to you and can provide feedback, suggesting midcourse adjustments. Your doctor should be able to recommend one to you in the area that specializes in weight loss and weight management. Also, the American Dietetic Association has a Website (http://www.eatright.org) where you can search for a dietitian in your area. Just click on Find a Dietitian.
• In order to find an good exercise program that will be helpful to you without harming your back, you may want to speak to a trainer at a local health and fitness club, or perhaps talk to a physical therapist.
• There is one book I highly recommend that is not based on fad diets, special foods or gimmicks. It is designed to help you change your eating behaviors and exercise habits by behavior modification. It is Habits Not Diets: The Secret to Lifetime Weight Control by Dr. James Ferguson and Cassandra Ferguson. It is a combination guidebook and workbook with food diaries, activity and behavior charts and more.
• Another good book that focuses on healthy behavior modification and on intuitively getting to know your appetites is Full & Fulfilled by Nan Allison, MS, RD, and Carol Beck, MS.

Best of luck to you in finding an approach that works for a lifetime. Many thanks for writing.

Sincerely,
Sue Gilbert, MS, nutritionist