GW MFA Internist Marijane Hynes, MD, Discusses Holiday Weight Gain

Marijane Hynes, MD

Between Thanksgiving feasts and holiday parties, weight gain feels inevitable. Most people, however, only put on a few pounds (even if it feels like more). Here, Marijane Hynes, MD, clinical professor of medicine and founder of the Weight Loss Clinic at the George Washington University (GW) Medical Faculty Associates (MFA), tells us how we can maintain a healthy weight during cookie and pie season.

How typical is it for people to put on a little bit of weight during the holidays?

Hynes: Well, it’s very typical. The average winter weight gain is around two to three pounds during the winter. In general, a lot of people slow down a bit over the holidays, eat more, and don’t exercise as much. The problem is that because of the unusual weight gain with the pandemic, people are much more aware now of what they are eating and want to avoid more weight gain.

What can people do to maintain a healthy weight during this time?

Hynes: One thing is keeping up an exercise routine during the holidays. I think that is particularly important. A lot of that routine often falls by the wayside because people get busy. We know that when people exercise more, they tend to eat healthier and they get less hungry, which sounds counterintuitive, but it is real.

Research, which is mostly done on obese people, used to say that exercise was not as important as what goes in your mouth, but we are finding out that you must keep moving at least a half hour to hour per day to really maintain a healthy weight. Sitting for extended periods promotes weight gain.

What impact does physical exercise have on weight management? If you wanted to burn calories after Thanksgiving, for instance, would jogging a few miles or taking an aerobic exercise class make a difference?

Hynes: So, there are 3,500 calories (about 4.5 hours of running) in one pound. Most people do not realize that. If you, let’s say, had a holiday 3,500-calorie dinner, then you are not going to lose a pound by exercising the next day. But if you exercise consistently, you are going to eat less at that meal.

What people tend to do is skip lunch and then go to a holiday dinner, and that is not a good thing. You may not have a big lunch, but you do not want to skip meals in anticipation of a bigger meal because people tend to eat more when they skip meals. You could have a regular breakfast, a little bit lighter lunch but still have something, and then you will not go to a huge dinner hungry. You also should not go thirsty because people will tend to drink more alcohol when they are just thirsty. Alcohol is also an appetite stimulant, so people tend to eat and drink more when they drink alcohol.

What techniques would you recommend for people who find themselves snacking a lot during the day?

Hynes: I always ask my patients who snack a lot, “What's going on while you’re snacking? Are you hungry? Are you bored?” Boredom contributes an awful lot to people snacking inadvertently. I try to make my patients more aware of what they are doing when they are just snacking. It can be helpful to think, “Am I really hungry?”

You should not have a lot of snack food in the house. We always tell our patients to get rid of any food you cannot handle. Even if it is healthy, like grapes, if you know you are going to eat a whole bag of grapes, you should not be buying it. If you have a [craving] for some potato chips, for example, I tell people to get a small bag and eat them outside of the house. If they are in your house, they are in your belly. It is just a matter of time.

I also make sure that they get enough protein at all meals, so they are less hungry. When there is lots of food around, like pizza and fatty food, a lot of people cannot control their snacking. If it is out of sight, it really is, for a lot of people, out of mind.

Do you recommend eating three larger meals a day or mixing it up and eating smaller meals more frequently?

Hynes: It has not been researched as much as it should be, but people who have six small, frequent meals tend to eat more at each meal. They do not tend to lose weight, and in fact, they tend to gain weight. People do not have six small meals; they often have six regular-sized meals, which leads to weight gain.

I am a proponent of people having breakfast. If you look at the at the National Weight Control Registry, people who have lost more than 40 pounds and kept it off for several years traditionally eat breakfast and have some protein at breakfast. Most of those people have three meals a day. I think people do better when they have something for breakfast; it doesn’t have to be a lot, just something like yogurt with berries, with a high-protein cereal or walnuts sprinkled on top of it.

The worst thing you can do is not eat all day. That is just a recipe for disaster. I do have patients who do that; they have a latte in the morning, for instance, hardly eat all day, and then they find themselves in a takeout line at 5 p.m., and that is because they are hungry.

You should really push yourself not to eat a lot of processed foods. There’s a new study at the National Institutes of Health showing that with processed foods, which could even be a bagel with cream cheese and some bacon, you’re much more likely to gain weight than if you had whole grain oatmeal, because real food increases the hormones that make you feel full.

I also push people to avoid eating out. I think that is what happened with the pandemic; people ordered takeout all the time. Takeout foods, even from “healthy places,” are more caloric. Anytime you walk in a restaurant or get takeout, you are talking 200 to 400 more calories than if you ate at home.

How can the GW MFA help people with weight management?

Hynes: We have dieticians who can work with patients, and we have a weight management team, with the goal of helping patients adopt a healthy lifestyle. Our team at the GW MFA Weight Loss Clinic does medical weight management. That is different from surgical weight management, which is bariatric surgery. We have an expert on plant-based diets who works with patients and a psychiatrist who helps our patient with issues related to mental health and obesity, mostly depression and anxiety.

We also have an obesity clinic that is working to help residents learn about weight management. We are trying to create a culture where the internist can really work with the patients as well, so patients will not have to just go to an obesity specialist. The GW Culinary Medicine Program teaches residents and students how to make fresh and healthy meals, which they can translate to their patients. We have a lot going on to push for healthier diets, and that's important.

To make an appointment, visit the GW MFA Weight Loss Clinic or call 202-741-2222.

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