Showing posts with label weight loss. Show all posts
Showing posts with label weight loss. Show all posts
Thursday, June 3, 2010
660 seconds (11 mins) of minimal resistance training = a HUGE difference for fat burning
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We know pretty unequivocally that the biggest part of a fat loss program is nutrition. That's first. BUT we also know that exercise can really help with keeping that program going. If we look at work on obesity and the role of exercise, we're looking at 5 hours of exercise a week (along with diet and expert support).
5 hours may be a good and healthy norm, but do you know any geeks who will say ya you bet i can get that 270-300 mins a week in. You bet. Not.
So a question might be, what's the minimal amount someone - especially someone at risk of being obese - can do in terms of working out to achieve a metabolic difference - where that metabilic change is to a boost start burning more calories in a day, and in particular burning more fat calories.
Researchers in 2009 took a look at just this question. The answer is - we're not entirely sure, but here's something that looks really promising:
Just to be clear about what the program included:
So not what anyone would call a super arduous program or one that folks without mobility/pain issues could perform as these moves are all done on machines. Some of us might have chosen different moves - like only compound moves without machines - but let's leave that aside. These have the advantage of also being seated, which for an inactive overweight population may be a good thing.
Main Pluses. The main thing is that after 6 months, the folks doing this very simple, every-other-day program had significantly greater fat free mass (FFM) - or lean mass (eg, muscle) than the Control group. That's nice. But what is associated with this in terms of potential fat loss support? An upped metabolism, as measured by various metabolic resting rate measures. Faster metabolism is a known associated outcome with exercise; that means more fuel will get used more quickly. For example, 24hr energy expenditure went up from 13091 kJ's a day to 13618. That's a big deal.
And one more finding - the RQ measure - checking expiration gasses - showed that the (resistiance training) RT group seemed to have an upped "fat oxidation" level - that is, burning more fat for fuel, as opposed to carbs. That's what we want from exercise: more fat burning.
Reality Check. Working out alone doesn't cut it for fat loss. In the results, both groups over six months had their weight go up and their BMI go up. That's not good. BUT the fat mass increase in the RT was "non-significant" at 3.3% but definitely significant in the C group at 8.8%. Note, there was no specified dietary intervention in the study; the only mandated change was the exercise program:
Take Aways. So what are the possible take aways from this study? One the authors suggest is that 11 mins. of resitance trainging might pose an interesting alternative to cardio/aerobics. As the authors state "the positive influence of even a small amount of RT on fat oxidation suggests an important role of RT on body mass management."
So imagine the benefit of combining a minimum 11mins of resistance training with some simple non-calorie-counting nutrition habits (like those found in precision nutrition) and who knows how the world might change?
Simple Program for fat loss? workout: 11mins of resistance, 3 days a week + nurtition: Change one thing a month with say the PN habits (download), and suddenly persistence of simplicity carries the day.
If you try this approach or know someone who will, pleaes let me know how it goes.
Citations
We know pretty unequivocally that the biggest part of a fat loss program is nutrition. That's first. BUT we also know that exercise can really help with keeping that program going. If we look at work on obesity and the role of exercise, we're looking at 5 hours of exercise a week (along with diet and expert support).5 hours may be a good and healthy norm, but do you know any geeks who will say ya you bet i can get that 270-300 mins a week in. You bet. Not.
So a question might be, what's the minimal amount someone - especially someone at risk of being obese - can do in terms of working out to achieve a metabolic difference - where that metabilic change is to a boost start burning more calories in a day, and in particular burning more fat calories.
Researchers in 2009 took a look at just this question. The answer is - we're not entirely sure, but here's something that looks really promising:
Long-term resistance training (RT) may result in a chronic increase in 24-h energy expenditure (EE) and fat oxidation to a level sufficient to assist in maintaining energy balance and preventing weight gain. However, the impact of a minimal RT program on these parameters in an overweight college-aged population, a group at high risk for developing obesity, is unknown. PURPOSE: We aimed to evaluate the effect of 6 months of supervised minimal RT in previously sedentary, overweight (mean +/- SEM, BMI = 27.7 +/- 0.5 kg x m(-2)) young adults (21.0 +/- 0.5 yr) on 24-h EE, resting metabolic rate (RMR), sleep metabolic rate (SMR), and substrate oxidation using whole-room indirect calorimetry 72 h after the last RT session. METHODS: Participants were randomized to RT (one set, 3 d x wk(-1), three to six repetition maximums, nine exercises; N = 22) or control (C, N = 17) groups and completed all assessments at baseline and at 6 months. RESULTS: There was a significant (P < 0.05) increase in 24-h EE in the RT (527 +/- 220 kJ x d(-1)) and C (270 +/- 168 kJ x d(-1)) groups; however, the difference between groups was not significant (P = 0.30). Twenty-four hours of fat oxidation (g x d(-1)) was not altered after RT; however, reductions in RT assessed during both rest (P < 0.05) and sleep (P < 0.05) suggested increased fat oxidation in RT compared with C during these periods. SMR (8.4 +/- 8.6%) and RMR (7.4 +/- 8.7%) increased significantly in RT (P < 0.001) but not in C, resulting in significant (P < 0.001) between-group differences for SMR with a trend for significant (P = 0.07) between-group differences for RMR. CONCLUSION: A minimal RT program that required little time to complete (11min per session) resulted in a chronic increase in energy expenditure. This adaptation in energy expenditure may have a favorable impact on energy balance and fat oxidation sufficient to assist with the prevention of obesity in sedentary, overweight young adults, a group at high risk for developing obesity.
Just to be clear about what the program included:Participants performed 1 set of 9 exercises designed to train all major muscle groups (chest press, back extension, lat pull down, triceps extension, shoulder press, leg press, calf raise, leg curl, and abdominal crunch) using a resistance of 3–6 1RM, approximately equal to 85–90% of 1RM.
So not what anyone would call a super arduous program or one that folks without mobility/pain issues could perform as these moves are all done on machines. Some of us might have chosen different moves - like only compound moves without machines - but let's leave that aside. These have the advantage of also being seated, which for an inactive overweight population may be a good thing. Main Pluses. The main thing is that after 6 months, the folks doing this very simple, every-other-day program had significantly greater fat free mass (FFM) - or lean mass (eg, muscle) than the Control group. That's nice. But what is associated with this in terms of potential fat loss support? An upped metabolism, as measured by various metabolic resting rate measures. Faster metabolism is a known associated outcome with exercise; that means more fuel will get used more quickly. For example, 24hr energy expenditure went up from 13091 kJ's a day to 13618. That's a big deal.
And one more finding - the RQ measure - checking expiration gasses - showed that the (resistiance training) RT group seemed to have an upped "fat oxidation" level - that is, burning more fat for fuel, as opposed to carbs. That's what we want from exercise: more fat burning.
Reality Check. Working out alone doesn't cut it for fat loss. In the results, both groups over six months had their weight go up and their BMI go up. That's not good. BUT the fat mass increase in the RT was "non-significant" at 3.3% but definitely significant in the C group at 8.8%. Note, there was no specified dietary intervention in the study; the only mandated change was the exercise program:
Differences in reported dietary intake (total energy, carbohydrate, fat, protein) were not significant between the baseline and intervention periods for either RT or C, or between the 2 groups during the intervention. The mean intakes for total energy, and percent of dietary carbohydrate, fat and protein were 9538 kJ/day, 50%, 34%, and 16%, respectively. There was no difference for either group at baseline and 6 months between energy and macronutrient intake during the three days of standardized food prior to or during the calorimeter stay.In other words, eating habits didn't change BUT over six months, these folks gained lean mass, had there metabolic rates go up, and instead of losing fat free mass as in control, had their fat free mass go up.
Take Aways. So what are the possible take aways from this study? One the authors suggest is that 11 mins. of resitance trainging might pose an interesting alternative to cardio/aerobics. As the authors state "the positive influence of even a small amount of RT on fat oxidation suggests an important role of RT on body mass management."
So imagine the benefit of combining a minimum 11mins of resistance training with some simple non-calorie-counting nutrition habits (like those found in precision nutrition) and who knows how the world might change?
Simple Program for fat loss? workout: 11mins of resistance, 3 days a week + nurtition: Change one thing a month with say the PN habits (download), and suddenly persistence of simplicity carries the day.
If you try this approach or know someone who will, pleaes let me know how it goes.
Citations
KIRK, E., DONNELLY, J., SMITH, B., HONAS, J., LeCHEMINANT, J., BAILEY, B., JACOBSEN, D., & WASHBURN, R. (2009). Minimal Resistance Training Improves Daily Energy Expenditure and Fat Oxidation Medicine & Science in Sports & Exercise, 41 (5), 1122-1129 DOI: 10.1249/MSS.0b013e318193c64eTweet Follow @begin2dig
Miller, W., Koceja, D., & Hamilton, E. (1997). A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention International Journal of Obesity, 21 (10), 941-947 DOI: 10.1038/sj.ijo.0800499
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Friday, August 14, 2009
Brown Fat: New Improved Single Factor Thinking
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Let me predict it here first, folks: Brown Fat will be the Next Big Thing in the Drive for a Single Factor Big Pill Solution to Obesity.
Put "brown fat" into google today and you'll see all sorts of clever people and magazines referencing this new study on how "brown fat" (used a lot for generating body heat in mamals and neonatals) can be used to help burn the evil "white fat" - our abundant adipose tissue.
Yes evil, says the article, in contrast to the "good fat" story from early last week i was telling. The article commences powerfully:
Electron micrographs of brown fat cells reveal one of their hallmarks: an extraordinary number of mitochondria, which, as described below, are involved in heat generation.
The mitochonria are typically round, with cristae across their entire width.
My favorite quote by one of the researchers from this story exemplifies single factor thinking:
Here, we have a head of a medical group, reminiscent of Barbie, saying gee, working out every day is hard; wouldn't it be great if i had a pill to lose weight for me?"
THis is the height of medical research? Wouldn't it be great to have a pill? Maybe that is the height of medical research: it's not about health, well being, quality of life, but about how far can we push this single thing for that effect.
If medicine were about well being perhaps the kinds of questions it would ask would be What are the issues around such weight gain? how does behaviour (neurology) interact with physical being (physiology)? what's the forensic differences between the Lean minority and the increasingly Fat majority? whether lean or fat what are the complex beneficial interactions of eating and movement and rest/sleep on a whole range of homeostatic factors that impact well being? do they have even greater impact on any level for those who are obese? doing things like improving insulin sensitivity, bone mineral density, cardio vascular fitness, ant-aging, balance, vision, awareness, focus? Knowing these complex interplays of systems to create a myriad of positive effects, is another drug or surgical intervention a good idea?
No? so what's on offer? A pill? and if not a pill how about an invasive procedure?
It's single factor thinking because it gets excited about saying "gee, if we could just tweak this one thing, wouldn't that be great if life were that simple...ok there may be side effects but look at that fat go...ok maybe nothing's happening with bone mineral density or strength, but look at that fat go." And some side effects like anti-anti-aging, are acknowledged:
Enthusiasm for the potential is unquenched. Here's another quote from the same article:
You know this may be exciting science and the source of many future publications and god knows how many dead rats in the process of Losing Weight, but it feels (a) arrogant and (b) taking the easy way out.
By analogy in Europe, there's laws against the sale of foods produced from GMO - genetically modified crops. Many farmers and People generally don't trust scientific manipulations in the food supply at such a vast level messing with what is perceived as Nature. There's concern that Something could go Horribly Wrong. To allude to another ancient trope for margarine commercials "It's not nice to fool Mother Nature"
Likewise the arrogance here is that we can find a Single Solution that will work in a Complex System (like us) and not think there'll be significant consequences. The taking the easy way out feels just ignorant. And in no small part disrespectful. We are complex organisms. Worse, we have psychologically reinforced habits wired up to physiological, homeostatically defined responses: we have behaviours wired into us for a non-fuel-abundant environment. And now we have abundant access to personal fuel. No wonder we're getting fatter.
Saying that, i'll say it again, it takes work and skills and practice and support to know how to change habits, to keep them changed and, initially, work against what are bodies are telling us to do: eat! The formula might be easy: eat less/move more, but the implementation is not simple, and sure as heck isn't saying gee let's just change this biological function. I bet that will be great! i won't have to work out. And we'll make lots of money to help other people not have to learn how to cook and move and learn habits of lean eating.
That sound cynical? Afterall these scientists are keen; they want to help solve an epidemic. And at least one of them is motivated to get off the eliptical. And i say Good For You - get off the elliptical and get something healthy like a kettlebell or a water rower.
But that's not what this anti exercise head of a diabetes research group is thinking - at least not as portrayed in this article. He thinks swap activity for pill. One Single Thing (workout: hard) for some Other Single Thing (pill: easy).
But we know that exercise is not a Single Thing - depending on how hard, how long, how frequently etc etc there are all sorts of effects going on inside that are good for us, hitting an abundance of systems: visual, vestibular, proprioceptive, mechanical, chemical, biological.
By comparison what does taking a pill do? We go from rich multi-factor interactions when we move to a far narrower set of internal interactions in ingesting a pill. And this from someone who should Know Better, don't you think?
-------
Thanks to Xafier for pointing out this article to me,
and let me cite Eric Cobb again for framing the notion of single factor thinking, covered in the 9S:sustenance cert. Tweet Follow @begin2dig
Put "brown fat" into google today and you'll see all sorts of clever people and magazines referencing this new study on how "brown fat" (used a lot for generating body heat in mamals and neonatals) can be used to help burn the evil "white fat" - our abundant adipose tissue.
Yes evil, says the article, in contrast to the "good fat" story from early last week i was telling. The article commences powerfully:
IN THE war on our waistlines, fat is the enemy. It is fat, or adipose tissue, that gives us our beer bellies and our love handles, our man boobs and our muffin tops. And when plastic surgeons sculpt people into slenderness, it is fat tissue they suck up and throw out with the clinical waste.
Electron micrographs of brown fat cells reveal one of their hallmarks: an extraordinary number of mitochondria, which, as described below, are involved in heat generation.The mitochonria are typically round, with cristae across their entire width.
"I exercise on an elliptical trainer and it's pretty hard for me to burn up 500 calories," says Ronald Kahn, head of obesity research at Harvard Medical School's Joslin Diabetes Center. "If I could do it without working and do it every day, it would be pretty great."Wow, where to begin here? Nigh on 20 years back there was a furor that was kicked off with Matel's "Math is hard" Barbie. What that was saying to kids - young girls especially?
Here, we have a head of a medical group, reminiscent of Barbie, saying gee, working out every day is hard; wouldn't it be great if i had a pill to lose weight for me?"
THis is the height of medical research? Wouldn't it be great to have a pill? Maybe that is the height of medical research: it's not about health, well being, quality of life, but about how far can we push this single thing for that effect.
If medicine were about well being perhaps the kinds of questions it would ask would be What are the issues around such weight gain? how does behaviour (neurology) interact with physical being (physiology)? what's the forensic differences between the Lean minority and the increasingly Fat majority? whether lean or fat what are the complex beneficial interactions of eating and movement and rest/sleep on a whole range of homeostatic factors that impact well being? do they have even greater impact on any level for those who are obese? doing things like improving insulin sensitivity, bone mineral density, cardio vascular fitness, ant-aging, balance, vision, awareness, focus? Knowing these complex interplays of systems to create a myriad of positive effects, is another drug or surgical intervention a good idea?
No? so what's on offer? A pill? and if not a pill how about an invasive procedure?
Researchers are experimenting with various ways to increase the amount or activity of our brown fat, either pharmaceutically or even surgically, by extracting ordinary white fat through liposuction, transforming it into brown fat and re-implanting it. A mere 50 grams of brown fat - well within the range of what some of us already have - could dissipate around 500 calories a dayand why is this single factor thinking?
It's single factor thinking because it gets excited about saying "gee, if we could just tweak this one thing, wouldn't that be great if life were that simple...ok there may be side effects but look at that fat go...ok maybe nothing's happening with bone mineral density or strength, but look at that fat go." And some side effects like anti-anti-aging, are acknowledged:
Manipulating brown fat, whether by drugs or surgery, may not be risk-free, however. By increasing energy expenditure you generate a high-flux metabolic state, points out Celi. This could increase our exposure to potentially harmful free radicals generated by the metabolism, which could conceivably cause cancer or even hasten ageing.But what if there's a reason that we have fewer brown fat cells as we age; maybe it helps us age better?
Enthusiasm for the potential is unquenched. Here's another quote from the same article:
Right, well is that statement true? Increasingly, most obesity appears now in kids. The rate is growing almost exponentially, right? (remember the piece a few weeks about about resistance workouts and obese kids - and how they lost no adipose tissue?) and kids apparently have way more brown fat cells than middle age folks apparently. So, maybe obesity isn't age related, or about just brown fat cell ratios.Nedergaard believes the focus should be on preventing the decline in brown fat as people get older. "Most obesity appears in middle age and onwards, and this is when it seems brown fat activity starts to disappear," he says. It might be possible to identify the cause of this decline and then reverse it, perhaps by replacing a lost hormone. What this hormone might be, though, remains a mystery.
You know this may be exciting science and the source of many future publications and god knows how many dead rats in the process of Losing Weight, but it feels (a) arrogant and (b) taking the easy way out.
By analogy in Europe, there's laws against the sale of foods produced from GMO - genetically modified crops. Many farmers and People generally don't trust scientific manipulations in the food supply at such a vast level messing with what is perceived as Nature. There's concern that Something could go Horribly Wrong. To allude to another ancient trope for margarine commercials "It's not nice to fool Mother Nature"
Likewise the arrogance here is that we can find a Single Solution that will work in a Complex System (like us) and not think there'll be significant consequences. The taking the easy way out feels just ignorant. And in no small part disrespectful. We are complex organisms. Worse, we have psychologically reinforced habits wired up to physiological, homeostatically defined responses: we have behaviours wired into us for a non-fuel-abundant environment. And now we have abundant access to personal fuel. No wonder we're getting fatter.
Saying that, i'll say it again, it takes work and skills and practice and support to know how to change habits, to keep them changed and, initially, work against what are bodies are telling us to do: eat! The formula might be easy: eat less/move more, but the implementation is not simple, and sure as heck isn't saying gee let's just change this biological function. I bet that will be great! i won't have to work out. And we'll make lots of money to help other people not have to learn how to cook and move and learn habits of lean eating.
That sound cynical? Afterall these scientists are keen; they want to help solve an epidemic. And at least one of them is motivated to get off the eliptical. And i say Good For You - get off the elliptical and get something healthy like a kettlebell or a water rower.
But that's not what this anti exercise head of a diabetes research group is thinking - at least not as portrayed in this article. He thinks swap activity for pill. One Single Thing (workout: hard) for some Other Single Thing (pill: easy).
But we know that exercise is not a Single Thing - depending on how hard, how long, how frequently etc etc there are all sorts of effects going on inside that are good for us, hitting an abundance of systems: visual, vestibular, proprioceptive, mechanical, chemical, biological.
By comparison what does taking a pill do? We go from rich multi-factor interactions when we move to a far narrower set of internal interactions in ingesting a pill. And this from someone who should Know Better, don't you think?
-------
Thanks to Xafier for pointing out this article to me,
and let me cite Eric Cobb again for framing the notion of single factor thinking, covered in the 9S:sustenance cert. Tweet Follow @begin2dig
Tuesday, July 14, 2009
Lean Eating: Rewiring our Instincts for Sure Fire Fat Loss, Guarenteed
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IF we all know that to lose fat we need to eat less (fewer calories in than energy needed out equals fat loss), then why aren't all of us lean?
Some really cool recent thinking suggests that we are wired at a pretty basic level to respond to an environment that no longer really exists: an environment when food was way way less available - even as recently as 20 years ago (you know, the late 80's?) we were leaner people. We are raising the first generation in a hundred years where parents are predicted to start out living their children in increasing numbers.
What's happened?
If you accept that we're wired to ensure we have the fuel we need to survive, going after food is pretty natural. We have tons of chemical signals telling us we need food. There's one that tells us we're hungry and need carbs; one that tells us we need fat.
The cool thing is, these homeostatic signals can be trained, especially by hedonic controls. And in fact the most important part of getting lean seems to be getting habits around eating practices that plug into these Hedonic responses like what some have called instincts. Hunger in this framework is instinctual: our stomach grumbles, we go looking for food.
Likewise, when given a choice, going for the calorically rich foods (pizza vs salad), as is going for the familiar (pizza rather than some strange concoction we've never seen or smelled before), as is going for variety (if there are three types of cheese pizza, we go for a slice of each - eating more - in a response to get in a variety of food types).
So you can see that if we have instinctual behaviours saying EAT, EAT HIGH CAL FOODS, EAT FAMILIAR HIGH CAL FOODS, EAT MANY KINDS OF FAMILIAR HIGH CAL FOODS, if food is abundant, we're going to Obey Our Thirst (or hunger).
So, if we accept these ideas (and i'll find the sources - they're currently locked in a cargo hold) about our Hedonic Responses to Food, then staying lean means working with our instincts and training them, largely to relax - to know that we're safe, there's loads of food close by, we don't HAVE to eat right now for fear of starvation (personally i think there is a Starving Student/Starving Musician gene, and some of us have both - such that even now, when i see a buffet at an event i have to consciously remind myself that those days have passed - i do know, pretty much where my next meal is coming from and when; i do not have to find a way not only to eat lots but horde stuff to take home/back to the bus/to the dorm)
The super cool thing is, there are many many many approaches to working with our let's call them "instincts" - as a metaphor if nothing else - to be able to learn to control our very real, our very "looking out for us" wiring that is only thinking of the best for us and our survival.
So over at iamgeekfit, the blog i have for grad student geeks who largely do not move or eat well, i've proposed "mc's Change Only One Thing Sure Fire Diet"
Let me know what you think. And heh, especially if it works for you - it will take time - habits take time to develop - just like getting a swing down takes time to move from conscious effort to reflex (mine's still not "owned" to that degree), it takes time. BUT another cool thing? we start to make progress the SECOND we bring our attention to our practice. And as long as we continue to bring our attention to our practice, where our goal is to achieve the perfect rep, in diet as in swings, then guaranteed we will arrive.
If you have a loved one who needs to lose weight, i'd be delighted to know if you think the proposed approach might help make it safe to move to fat freedom and what Beck calls "thinner peace" Tweet Follow @begin2dig
Some really cool recent thinking suggests that we are wired at a pretty basic level to respond to an environment that no longer really exists: an environment when food was way way less available - even as recently as 20 years ago (you know, the late 80's?) we were leaner people. We are raising the first generation in a hundred years where parents are predicted to start out living their children in increasing numbers.
What's happened?
If you accept that we're wired to ensure we have the fuel we need to survive, going after food is pretty natural. We have tons of chemical signals telling us we need food. There's one that tells us we're hungry and need carbs; one that tells us we need fat.The cool thing is, these homeostatic signals can be trained, especially by hedonic controls. And in fact the most important part of getting lean seems to be getting habits around eating practices that plug into these Hedonic responses like what some have called instincts. Hunger in this framework is instinctual: our stomach grumbles, we go looking for food.
Likewise, when given a choice, going for the calorically rich foods (pizza vs salad), as is going for the familiar (pizza rather than some strange concoction we've never seen or smelled before), as is going for variety (if there are three types of cheese pizza, we go for a slice of each - eating more - in a response to get in a variety of food types).
So you can see that if we have instinctual behaviours saying EAT, EAT HIGH CAL FOODS, EAT FAMILIAR HIGH CAL FOODS, EAT MANY KINDS OF FAMILIAR HIGH CAL FOODS, if food is abundant, we're going to Obey Our Thirst (or hunger).
So, if we accept these ideas (and i'll find the sources - they're currently locked in a cargo hold) about our Hedonic Responses to Food, then staying lean means working with our instincts and training them, largely to relax - to know that we're safe, there's loads of food close by, we don't HAVE to eat right now for fear of starvation (personally i think there is a Starving Student/Starving Musician gene, and some of us have both - such that even now, when i see a buffet at an event i have to consciously remind myself that those days have passed - i do know, pretty much where my next meal is coming from and when; i do not have to find a way not only to eat lots but horde stuff to take home/back to the bus/to the dorm)
The super cool thing is, there are many many many approaches to working with our let's call them "instincts" - as a metaphor if nothing else - to be able to learn to control our very real, our very "looking out for us" wiring that is only thinking of the best for us and our survival.
So over at iamgeekfit, the blog i have for grad student geeks who largely do not move or eat well, i've proposed "mc's Change Only One Thing Sure Fire Diet"
Let me know what you think. And heh, especially if it works for you - it will take time - habits take time to develop - just like getting a swing down takes time to move from conscious effort to reflex (mine's still not "owned" to that degree), it takes time. BUT another cool thing? we start to make progress the SECOND we bring our attention to our practice. And as long as we continue to bring our attention to our practice, where our goal is to achieve the perfect rep, in diet as in swings, then guaranteed we will arrive.
If you have a loved one who needs to lose weight, i'd be delighted to know if you think the proposed approach might help make it safe to move to fat freedom and what Beck calls "thinner peace" Tweet Follow @begin2dig
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