A Weight Loss Journey

How will we plan our journey, or know how far we’ve travelled if we don’t know where we are now?  We need to determine initial measurements for several basic health indicators.  Of course, the easiest, and most expensive, way to do this is to make an appointment with your primary care physician.  Confess to her that you are embarking on a weight loss journey and that you intend to do it in the safest, healthiest, most effective way possible.  After the cheering subsides, ask for lab orders to get your serum cholesterol tested.  The nurse will probably already have taken your pulse, blood pressure and weight.  Write those down, throw in what you remember about how tall you are, calculate your BMI, and you’ll be on your way.

Now, if you plan to do this on your own as much as is practical, there are other ways to get some of the data.  It’s still a good idea to talk with your doc about starting any new diet/exercise program because you want to be aware of any safety precautions you should be taking that are related to your age or physical condition.  However, if you prefer not to invest the required time and money, you could make a few calls and talk with other professionals.  You could try the ask-a-nurse hotline in your local area.  Then, take the following measurements.  You will still need a doctor’s order to get the blood lab work done.

 How to Measure your Heart Rate:

 At rest (sitting or lying down), take your first two fingers and locate the radial pulse. This artery is found on the thumb side of your wrist on the underneath part of the arm (near where you would wear your watch).  Make sure you are using only the first two fingers and not the thumb, as the thumb can have its own inherent pulse. Also, don’t press too hard or you could actually block the artery and you won’t feel anything at all. After finding the pulse, look at your watch (or use a stop watch) and count the number of beats in one minute. This number represents your resting heart rate. You could also just count the number of beats in 30 seconds and multiply by 2. The best time to get a true resting heart rate is immediately upon waking up in the morning prior to getting out of bed.

 How to Measure your Height:

 Stand up straight, next to a wall, put a ruler horizontally on your head and stick a piece of colored adhesive tape at the point where the ruler reaches the wall.  Then measure the distance from the floor to the adhesive tape with a tape measure.

 How to Measure your Weight:

Most people’s weight varies across the day based on what they eat and eliminate. Just drinking a couple glasses of water can make the numbers on the scale go up. To minimize time of day problems, pick a particular time of day when you will weigh yourself and stick to it. Early morning, before breakfast, is usually the best time of day to weigh.  Weigh yourself frequently for a few days to understand your average baseline weight. After the initial assessment period, weigh only about once a week at the same time as your baseline measure.

 How to Measure your Blood Pressure:

To measure your blood pressure at home, you can use either an aneroid monitor or a digital monitor which can be found in most pharmacies. The aneroid monitor has a dial gauge that is read by looking at a pointer. The cuff is inflated by hand, by squeezing a rubber bulb.  The blood pressure reading flashes on a small screen.

Because the digital monitor is automatic, it is the most popular blood-pressure measuring device. The blood pressure measurement is easy to read, because the numbers are shown on a screen.

            How to use a digital monitor?

1. Put the cuff around your arm. Turn the power on, and start the machine.
2. The cuff will inflate by itself with a push of a button on the automatic models. After the cuff is inflated, the automatic mechanism will slowly reduce the cuff pressure.
3. Look at the display window to see your blood pressure reading. The machine will show your systolic and diastolic blood pressures on the screen. Write down your blood pressure, putting the systolic pressure before the diastolic pressure, e.g., 120/80.
4. Press the exhaust button to release all of the air from the cuff.
5. If you want to repeat the measurement, wait 2 to 3 minutes.

Record Your Weight Loss Baseline:

• Date:                                                  
• Heart Rate:                                       
• Height:                                              
• Weight:                                             
• BMI:                                                  
• Blood Pressure:                             
• Blood Lipids:
  • Serum Cholesterol (SC)             
  • HDL Cholesterol (HDL)             
  • LDL                                          
  • SC/HDL Ratio                           

Eventually, we will transfer this information to a journal where we can record daily, weekly, and monthly measurements along with observations and modifications to the program.

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Basic Health Indicators

Heart Rate:  The number of heart beats per minute.  The heart rate is based on the number of contractions of the lower chambers of the heart. The pulse is a bulge of an artery from the wave of blood coursing through the blood vessel as a result of the heart beat. The pulse is often taken at the wrist to estimate the heart rate.

Body Mass Index:  A key index for relating a person’s body weight to their height. The body mass index (BMI) is a person’s weight in kilograms (kg) divided by their height in meters (m) squared.
 

Metabolic Syndrome Factors

Insulin Resistance:  Insulin is an important hormone that has many actions within the body. Most of the actions of insulin are directed at control of sugars and starches, fats, and proteins.  Insulin also is important in regulating the cells of the body including their growth.  Insulin resistance is a condition in which the cells of the body become resistant to the effects of insulin, i.e., the normal response to a given amount of insulin is reduced.  As a result, higher levels of insulin are needed in order for insulin to have its effects.

High Blood Pressure:  High blood pressure (hypertension) means high pressure in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called “pre-hypertension”, and a blood pressure of 140/90 or above is considered high.

Cholesterol Abnormalities:  Cholesterol is a fatty substance (a lipid) that is an important part of the outer lining of the body’s cells.  Cholesterol is also found in the blood circulation of humans. LDL cholesterol is called “bad” cholesterol, because elevated levels of LDL cholesterol are associated with an increased risk of coronary heart disease.  HDL cholesterol is called the “good cholesterol” because HDL cholesterol particles prevent atherosclerosis by extracting cholesterol from the artery walls and disposing of them through the liver.  Thus, high levels of LDL cholesterol and low levels of HDL cholesterol (high LDL/HDL ratios) are risk factors for atherosclerosis, while low levels of LDL cholesterol and high level of HDL cholesterol (low LDL/HDL ratios) are desirable.

LDL cholesterol (mg/dl)
   <100 Optimal
   100-129 near or above optimal
   130-159 Borderline high
   160-189 High
   > 190 Very high

HDL cholesterol (mg/dl)
   <40 Low (undesirable)
   >60 High (desirable)

What gets measured, gets managed.  Our weight loss journey must start with a baseline measurement of each of these factors.  Suggested techniques for simple, inexpensive testing to follow.

·         Heart rate

·         Height

·         Weight

·         Blood Pressure

·         Blood Lipids

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