What is the National Weight Control Registry?

What is the Nation Weight Control Registry?

The National Weight Control Registry (NWCR) is the largest prospective investigation of long-term successful weight loss maintenance and was established in 1994 with the purpose of allowing people to register online if they have lost thirty pounds and maintained their weight loss for one year.  Registered users are given detailed questionnaires and annual follow-up surveys are conducted to examine the behavioral and psychological characteristics of participants, as well as the strategies they use to maintain their weight loss. The NCWR follows, observes, and records the data of over ten-thousand individuals and from this information we can see the consistency of the people who have maintained their weight loss and replicate the same methods in our patients.

National Weight Control Registry Facts

  • 80% of registered participants are women and 20% are men.
  • The average age of women was 45 years of age and the average age of men was 49 years of age.
  • The average weight of women was 145 pounds and the average weight of men was 190 pounds.
  • The average weight loss was 66 pounds with a diverse range between the 30 pound minimum to 300 pounds.
  • Duration of successful weight loss ranges from 1 year to 66 years.
  • 45% of participants lost weight on their own without enrolling in a weight loss program or professional consultation.
  • 98% of Registry participants report that they modified their food intake in some way to lose weight.
  • 94% increased their physical activity, with the most frequently reported form of activity being walking.
  • There is variety in how NWCR members keep the weight off. Most report continuing to maintain a low calorie, low fat diet and doing high levels of activity.
  • 78% eat breakfast every day.
  • 75% weigh themselves at least once a week.
  • 62% watch less than 10 hours of TV per week.
  • 90% exercise, on average, about 1 hour per day.

How do you help patients to keep the weight off once they’ve reached their goal?

Dr. Khani, it seems very easy to lose weight as such but have you experienced that patients regain back weight quickly? If so, how do you address that issue?

Once a patient has lost weight and can maintain the same methods and attitude, they can control their weight. It is true that it can be very difficult to maintain lost weight because between six months to a year, patients will experience changes to their body. Such changes include a return of ghrelin hormones which cause feelings of hunger and the decline of their metabolic rate due to lower calorie intake. Patients whom are unaware of these changes are likely to experience what is called a fat attack which causes weight gain.  We explain to our patients from day one that fat attacks will occur and plan accordingly to prepare for this with what we call a Fat Attack Action Plan.

A Fat Attack Action Plan serves as a contract, detailing how the patient will maintain and control their weight. The plan is broken into three zones; green, yellow, and red. Each zone corresponds with the weight of the patient and depending on the current zone their weight places them in, different actions are to be taken in correlation with their condition. The green zone can be considered the safe or controlled zone in which a patient’s goal is to continue without deviations from their current techniques and methods to maintain their weight unless changes occur. The yellow zone is the cautious zone, in which a patient’s goal is to revert back to the green zone due to an increase in weight. Methods to return to the green zone from the yellow zone may include an increase in physical activity, a change in diet, lower calorie intake, a detox program, meditation, use of a flex belt to strengthen core muscles, and increased attendance in the support groups. The red zone is the panic zone, patients who find themselves in the red zone are recommended to make an appointment for treatment and consultation.

Different institutions have different definitions of what is considered good weight management. The National Institute of Health (NIH) considers ten percent weight loss and maintenance for a year successful weight loss. Another institute, the National Weight Control Registry (NWCR), the largest prospectors study in the last ten years, considers thirty pound weight loss maintained for a year successful weight loss. Suppose we have a test patient we can observe named John whom currently weights two-hundred pounds and previously weighted two-hundred and fifty pounds at the start of his weight loss program. John has reached his weight goal but now he wants to maintain this weight so we prepare his Fat Attack Action Plan which is similar to the asthma action plan that asthma patients use so that they are prepared for any complications and in John’s case, he will know what to do if his weight goes up. Weight fluctuates on a daily basis and with this taken into consideration, John will be considered to have maintained his weight or be in the green zone if it does not rise above two-hundred and four pounds. If John’s weight were to be between two-hundred and five pounds to two-hundred and nine pounds, he would be considered to be in the yellow zone which would require John to be more alert, cautious, and increase his physical activity to revert to the green zone. Lack of awareness could cause John to also fall into the red zone, placed between two-hundred and ten pounds and above.

How does learning to forgive help in losing weight?

How does forgiving yourself and forgiving others help in the weight loss program?

During the weight loss program, when we discuss the mantra of forgiveness, it suggests that you learn to let go. Grudges and prejudices in your conscious and subconscious mind create a heavy weight that does not allow your spirit and mind to fly. Every day we negatively judge others and ourselves and as we’ve discussed, negative thoughts, feelings, and emotions can hold us back so it is very important to forgive not only others but ourselves as well.

It is important to realize that we live two lives in two universes; one universe is on the outside and the other is the universe inside our mind. We spend five percent of our time in the outside universe and the other ninety-five percent of the time in our mind’s universe. Our mind’s universe contains our personal past, faiths, beliefs, experiences, grudges, prejudices, etc. When you think and act in the other outside universe you live in, what you do will reflect your mind’s universe. From your mind’s perspective, your thoughts and actions are right. This is also true for others and from their point of view what they do is also right based on their own personal experiences. Once you realize this, from a higher perspective you understand that from their perspective what they do is right even if it is not for you and this makes forgiving others much easier. When you forgive, understand that you will get the most benefit because grudges and prejudices are more harmful than what those whom we hold those grudges or prejudices can.

We live in a very diverse society in which we can hold prejudices and grudges against others for their different communities, cultures, religions, nationalities, ethnicities, economical differences, etc. When we ask patients directly if they have a problem forgiving other people or themselves and when they answer yes, they have a more difficult time losing weight. Once you realize that weight management is not only counting calories, medicine, and exercise but as well as your psychological state of mind and well being, you will become happier and weight loss will just happen on its own. Live freely of grudges, prejudices, understand others and you will see how it may change your life.

How does creating peace in life, help to lose weight?

You suggest that you create peace in their lives. How does that help to lose weight?

It is very important to create positive emotions to have positive experiences in the present moment. We try to explain to patients that they are living in this moment in the universe; there is no past or future. You have already learned how to live in the present moment so now your mind is here rather than in the past or the future but this life suggestion may make you restless because now you can only live in this universe. This restlessness is caused by not wanting to live in the present or enjoying this moment and your mind will try to escape this by thinking of the future. This can cause anxiety, stress, and fear which is not healthy for you physical body because it is experiencing these negative emotions as if they were happening right now. Emotions affect the state of the body and the initial negative emotions may lead to increasingly negative feelings as per quantum physics because you are tuning into a negative frequency.

The first step to achieve peace is to simply accept the present life situation in this moment in the universe. This is the best solution and as soon as you do that you will begin to feel peace. You have to learn to tell yourself, “It is what it is.” This means that you are accepting the situation but don’t just say it for the sake of saying it, create the feeling that you are okay and fine with the situation to stop fighting with the negative energy. For example, suppose that in the morning you are driving and get a flat tire while you are already late for work. What do you do? You start to think more negatively and create negative emotions but if you accept the situation you can begin to find a solution and avoid negative emotions while working towards positive ones. When we say that the power of surrender is powerful, the surrender here does not mean that we are giving up but that we are surrendering ourselves to the situation and accepting it. The power of surrendering and acceptance bring peace, quietness, and relaxation in the present moment to begin solving our problems.

We like to propose to patients a scenario involving two children and one piece of candy you have to give to either one. One child is joyous and would be very happy to receive the candy but he will not be unhappy if he does not receive it. The other child is restless, frustrated will become unhappy if he does not receive the candy. Naturally, you would like to give the candy to the joyous child because he is already happy and his happiness will touch your heart while bringing positive energy to your mind and aura. God sees things in a similar manner. When you are frustrated and display negative emotions while casting blame on others, God will ignore you until you become like the joyous child and when you become like the joyous child he will bring you more happiness. Always remember that you want to be like the joyous child, not just to get things but to bring happiness into other people’s lives as well.

How does living in the present moment help with the weight loss?

During the weight loss program, first consultation and in the subsequent visits, we really enforce sincerely suggest living in the present moment. We discussed earlier how the mind functions and how it focuses on the past or future and how our present suffers because of that. Understand that the present moment is the only moment that you have right now, that you have to experience happiness, unhappiness or anything else and that is why you have to value this moment because the universe only exists at this time. Whatever the current time is, the few hours ago in the past do not exist anymore and neither do the next few. The universe only exists in this moment; you are here in this moment, and if your mind goes to the past or future, they do not exist. Sometimes when I go back to India and when I go to the city where I grew up, I feel and realize that there is nothing like in the past because the whole city has changed. In my memory everything is clear but only in memory and that is the only place where I see there was a past but the past never existed, it was a present moment. It is the same thing with what we call future moments, they will only come to you as present moments and as soon as they come, they become the past.

To help you better understand; let me ask you this question, which I ask everyone. Do you have any kind of problem right now? You may answer that you don’t but what happens as soon as finish reading this? Your mind will start to think when you are alone and when this happens your mind will take you to the past or future. Understand that a thinking mind means it is not here in the present. We have already discussed that as soon as you start thinking of something or try to avoid thinking of something, that you make an image of it in your mind. You start thinking about past problems or future worries and as soon as that happens your body reacts as if those things are happening right now. Your body reacts to this by releasing stress hormones which suppress your immunity, affect your sleep and in a matter of seconds you begin to suffer. This suffering is naturally created by your mind. You allow this to happen because you can control your mind to stop thinking and worrying about the past or future.

The mind has two functions. One is the thinking mode and the other is the action mode. The action mode is when the mind is occupied by whatever actions you are doing. Knowing this will help you understand how we can live in the present moment and stop suffering. So where does that suffering come from? From the thinking mind. To live in the present moment we must understand that our body is always in the present moment, it cannot fly into the past or the future. If we can anchor and embrace our mind with our body, we can begin to live in the present moment. The techniques and exercises we give to patients involve visualizing the mind touching the body from head to toe every half hour or so, so that they may slowdown and come back to the present moment. Another method is to count your breathes so your mind can stop thinking and focus on what the body is doing. Understanding your body in the present moment with your five senses also brings your mind into the present so focus and pay attention to the things you touch, taste, hear, and see. While reading this your mind has probably thought about what you are reading, attempting to understand It and attempting to relate to this. This critical thinking serves a practical purpose.

If we want to understand how to fix our problems with distracting thoughts of the future, you must realize that at this point, in this life that you have certain goals and methods to achieve your goals. You live in the present moment, understand the goal but do not think of the goal, think of the journey and your steps to your goal. As soon as your mind focuses on your goal you will be on the right path to reach it.

How do you teach patients to make good food choices?

The most important aspect of weight management is to make healthy food choices. Not just while participating in the weight loss program but throughout your whole life. We try to train patients from the start to use their mind and to help them believe that they can do it, become healthier and make good food choices. An important thing we tell patients is that they use the power of allowance. For example, if they see unhealthy, indulgent foods and think to themselves, “I cannot have this.” It means that subconsciously they still want it but can’t have it, that they have not changed their way of thought. We advise you now that instead of thinking, “I cannot have this”, say clearly in your mind, “I can have this, I don’t want this.” So what is the difference here? “Cannot” means you are not allowing yourself and “I don’t want this” is an exercise of free will and free will is the most powerful thing over the mind. When you feel that you have allowed yourself to have something rather than depriving yourself of something that sensation of deprivation goes away. When many people begin a weight loss program, that deprivation creates pressure that can make them quit the program quickly. Always say, “I can eat anything but I choose to eat healthy food.” This says you are allowing yourself to make choices and exercising your free will. Now you can focus on healthy food and as we have previously discussed, what you focus on with your mind becomes your life experience.

The second thing we advise is to eat food before going out. A good choice would be nuts because they secrete hormones in the gut that suppresses your appetite. Something to be aware of is that if you consume food too quickly, you may overeat before your body can tell your brain that you are full so we advise to eat slowly. Another suggestion we make is to always have in mind what you will order at a restaurant to avoid cravings from seeing and visualizing the items on the menu. When grocery shopping, many stores keep their fresh fruits, vegetables, and meats on the outer parameter of the aisles. Most food within the aisles is processed and while they may be low fat or low calorie, they may also be high in sugar or sodium.

The last and most important thing to keep in mind is that it is that you will likely make mistakes. These mistakes may make you feel guilty and attract negative feelings. These negative emotions may make you commit more mistakes and it is important to forgive yourself so you can stay in the moment, in the present and focus on your goals. If you know that for whatever reason that you know are going to indulge yourself in unhealthy foods or drinks that you allow yourself to consciously make that mistake. It is important to understand that unhealthy foods will only give you pleasure and not long lasting happiness. The difference between pleasure and happiness is that pleasures are short lived and that sensation of pleasure happens because we are indulging our senses. The senses work only with change in their threshold, so even if you eat your favorite foods every day, after a while you will not enjoy it anymore because your senses work with and enjoy change.

How does the use of ‘Visualization Technique’ help in the weight loss?

Visualization techniques are very powerful techniques to achieve any goals that you have and that is the power of imagination of the mind. We talk about the mind and how we can use it differently and this uses the power of imagination. For example, right now I’ll tell you to please avoid thinking for the next few seconds of the white colored lion sitting in the backseat of your car, in the parking lot. Now the lion is looking for you so he comes out of the car, crosses the parking lot, walks into the clinic, into the waiting room and now he’s in the corridor, about to knock down this door over. Don’t think about it.
So now tell me what happened. I told you to not think about the white lion but you saw the white lion in spite of me telling you to not see it. So do you realize what happened? Whenever we tell someone what not to do, their mind still needs to think of what not to do. Now if somebody is sitting here in this room with us whom does not understand English and only understands French, do you think he would have seen the white lion if I told him the same thing in English? No, because he did not create the lion in his mind, because he did not interpret the words in a language he understood thus his mind did not create the image but because you were the one creating it, you experienced the white lion as if it were real.

The point here is that we experience everything in life with what we create in our mind. It doesn’t necessarily have to happen and that’s where the problem starts, that whatever you’re thinking, each thought creates an image and now you can add feeling onto it as well and that image becomes true for you. Now the body sees this image the mind has created as happening in that moment because the body cannot perceive time. For example, if you think of something that will happen after four days, that you worries you, your mind sees those images and your body will perceive them as happening in that moment.
Now, when you keep saying “I don’t want to be fat, I can’t lose weight” and put your frustrated feelings behind not only the thought and the image you have created, you experience that negative image in a similar way to how you experienced the white lion. This creates a wall in your mind that allows this thought to come in your life and that does not allow you to see things differently. However, we can use this same process to our advantage. We can see things differently with our mind and then the body will perceive things differently.

In science, quantum physics and the Laws of Attraction show us that everything in the universe from our thoughts to our feelings, every atom and every molecule has a frequency. Whatever frequency you tune into will affect your life in that moment so you have to make sure that you are in a positive frequency and visualizing yourself healthier.

An exercise I suggest you do is to buy clothing that would fit a thinner version of yourself. For example, if your weight was two-hundred and fifty pounds, you may try to purchase clothing that would fit you if you were fifty pounds thinner. You may say to yourself that you do not want to go out of your way to buy clothing because it is an expense you are not willing to pay. That is your subconscious blocking your progress already and this exercise serves as a small test to gauge your commitment to your weight loss. The article of clothing that you purchase will serve as a tool on your path to weight loss. Next, visualize yourself as your thinner version in a beautiful place surrounded by the person or persons you would like to be with, in the clothing you purchased for the exercise. Think of how you would enjoy being with them as your thinner self, the compliments they would say about your new self. When you think of thoughts such as this in the evening when your subconscious overtakes your conscious mind, ideas and images enter your subconscious faster while bridging these concepts in your mind with your body, helping you to become thinner faster. The reason again is that what the mind visualizes, the body experiences as if it is already happening. This visualization exercise is a very powerful technique that can be utilized in many ways such as images and audio.

I try to tell my patients that whatever they have received in life so far, that they have either consciously or subconsciously thought of it. You are sitting here because you have planned to come here and sit here. You can use this technique for anything you want in your life such as relationships, careers, studies, sports, etc. It will help you to enrich your life in any aspect that you want it to but you need to believe that it will happen. This belief that is almost like a belief in faith is the fundamental aspect of this technique.

How do you help patient change their thought process to be successful?

The mind is the place where everything begins and everything ends. When enlightened consciousness is in our mind we are free to do conscious thinking and make choices to determine our way. Compare this to the digestive system where food is digested and the circulation system where the heart pumps blood. We do not say we are digesting food or pumping blood because these two things happen automatically, subconsciously. Compared to these two systems, the mind gives us the choice to think consciously however ninety-five percent of the time thinking happens subconsciously, out of our control.

What you perceive with your mind is your reality, if you go to sleep and do not dream, your mind is shutdown and the world does not really exist for you. For people whom were once living and no longer here, for them this world does not exist. The point is that whatever we keep focused in our mind, that that is our life experience. Life is a moment to moment experience but unfortunately we are not aware of some of these experiences because subconscious thinking does not let us directly experience what is happening around us. For example, when we get up in the morning, we automatically go to the bathroom. We do not think, “Here we are, what do we do now?” consciously. Our conscious mind is somewhere else thinking of the past or future. Throughout our normal morning routines, our subconscious mind guides us for the most part while the conscious mind occasionally becomes active for practical purposes and critical thinking. Once we are ready and have made our way to work, we think about home or any number of things besides work. When it is the morning, we think of the evening. When it is the evening, we think about work. Throughout the weekdays we think of the weekend and when it becomes the weekend we thinking of the weekdays. This anticipation of future events and re-experiencing of past events is called subconscious or unconscious living.

In contrast to subconscious living, conscious living is when the mind can focus on what is currently happening without distraction from thoughts of the past or future. The most important aspect of conscious living is that the universe exists only in this moment, it does not exist in the past anymore or in the future. When the mind is either in the past or future, our mind does not receive the energy flow of the universe and people who live in the past or future feel tired and fatigue because of the separation of their mind, spirit, and body. This is the issue we try to focus on and we try to explain to patients that they are not their mind, that instead they can control their mind with their conscious. When they are living subconsciously, their mind is controlling them and life is not in their control.

The main point for patients is that when they see the universal flow of energy and live in this moment, their mind and body embraced together, that they can now enjoy the moment. The past is gone and living in the past makes you lose sight of the present. Thinking of the future distracts you from what you can do in the present. This knowledge is not as important as the self-realization and deep awareness of the problem and what is happening so that we can learn how to live consciously, in this moment.

Frequently Asked Questions

Frequently Asked Questions

Bhranti: Hey, Yoely! During this weight loss program, every ten days the patient comes in for clinical monitoring. What do you do in this time?

Yoely : Bhranti, during the weight loss program, the patient is required to come every ten days. During that process the patient is weighted, we take their blood pressure and ask the patient a series of questions. We ask how they are doing with the diet, if they have had any problems with the medication, their dietary intake and exercise. They should be exercising, if not we recommend a program. Most importantly we ask about their attitude towards the program. That will determine how the patient is doing or how he/she shall succeed.
Bhranti: You said exercises. For instance, do you have anything in mind for them to do?

Yoely : We do offer resistance bands available in the office. The price is ten dollars. Depending on how strong or how flexible the patient is, we may recommend a medium to maybe a large size resistance band. This one is a red, heavy resistance band. The patient doesn’t have to be going to the gym to do exercise; they can do this at home. This is one of the exercises and it’s pretty easy. You just put it over your head and kind of do this and feel it in your back and your arms. We also give them a package of exercises on how to use the resistance bands if the patient is interested.

Bhranti: I have no insurance. Do you have a plan for a person with no insurance?

Yoely : We offer package plans that range from 250 to 550, depending on what a patient would like to do. That includes the doctor’s visits, three clinical visits and the medication. It also includes any EKG which is basically checking your heart and a body composition. What the body composition is, it tells you your fat percentage, metabolic rate, water and muscle mass.

Bhranti: What is the Secret Box?

Yoely : The secret box basically contains quotes that keep you positive or motivated through the program. It also contains recipes that you can use during the program if you don’t cook for instance. So you can just use that little guide and cook something from there.

Brahnti: I don’t have money right away. Do you have any payment plans available at your clinic?

Yoely : We do offer payment plans for non-insured patients. You do not have to pay anything up front. As long as you pay the fee within six months, it is zero interest.