[music playing] Announcer: Production of Being Well is made possible in part by: Sarah Bush Lincoln Health System, supporting healthy lifestyles.

Eating a heart healthy diet, staying active, managing stress, and regular check-ups are ways of reducing your health risks.

Proper health is important to all at Sarah Bush Lincoln Health System.

Information available at sarahbush.org.

(singing) Our patient care and investments in medical technology show our ongoing commitment to the communities of East Central Illinois.

Paris Community Hospital Family Medical Center.

HSHS St. Anthony's Memorial Hospital, delivering compassionate care close to home.

From advanced surgical techniques and testing, to convenient care for your family we promise to make a healthy difference each and every day.

St. Anthony's, together we are better.

Ke'an: Thank you for watching this episode of Being Well.

I'm your host Ke'an Armstrong and today we're talking about weight loss management and a diet called the HMR diet.

Joining me today is Kristina Adams.

She is with Sarah Bush Lincoln Health Center and she's a registered dietitian and the director of Weight Management and Wellness.

Kristina: Thank you.

Ke'an: Yeah, thanks for being here today.

Kristina: It s exciting.

Ke'an: It is exciting.

And it's exciting to learn about how do I control my weight and how do I lose weight.

Let's start off by talking about what is HMR.

Kristina: It's actually a program called Health Management Resources is what the acronym HMR stands for.

It's a company that is based out of Boston.

They've been around since 1983 so over 30 years of experience in the weight loss industry.

It's definitely an ongoing concern in our society today with the obesity epidemic not only with adults but also children, so it's definitely a hot topic and something of concern, so HMR is definitely in the forefront to help with those.

Ke'an: Yeah, I mean it's always a struggle when it comes to weight loss management and figuring out what do I need to do because it's an ongoing struggle for a lot of people and then when you do mention children, same thing there.

You've got to think about that when you're young, right?

Kristina: Yes, for sure.

HMR's traditionally catered towards 17 and older, so we do attract more of an adult population.

When we look at pediatric population we have to be more of a family approach so it's definitely more of a dynamic that's challenging.

But we feel like if we can get mom and dad on the healthy track, then hopefully the kids will be on the healthy track too.

So when we target that adult population, that's a lot of the discussions that we have with them too, as you know it's a family affair.

Ke'an: All right.

So tell me about this diet, what makes this different?

Kristina: HMR's traditionally been a medical monitored diet, which means there's more to it than just following a simple meal plan.

I mean there's medical monitoring that goes into it, a lot of patients come to us that are really needing to lose 50 pounds or more, but over the years it had developed into more of a moderate level healthy eating plan, so we do have folks wanting to lose 20, 30 pounds and be able to manage that weight loss too.

We have a wide variety of programs for patients to follow.

The medical monitoring is more of a clinic-based program, so that requires regular attendance, meeting with medical providers in the office as well.

We also have an at home program so patients that aren't able to do the clinic-based model or don't want to do that model or don't need the medical monitoring can do more of a slower pace but at home type of diet where they are doing it more on their terms a little bit, but actually having a meal plan to follow that gives them guidance.

Ke'an: You mentioned medical monitoring.

Explain that to me a little bit.

Do they need to go to the regular doctor for that or- Kristina: Great question- Ke'an: how does that start?

Kristina: We actually have our own medical staff, so that's a little bit of what sets us apart from other programs because we have a medical director, we have nurse practitioner, we have registered dietitians, we have exercise specialists, so we have quite a range of background with the programs for our staffing, and also a lot of longevity with the program.

We have only HMR having 30 years experience, but locally we have anywhere from five to 17 years of experience with this, so definitely a lot of credentialing I guess for our program.

Medical monitoring means that they would see one of those providers at least weekly or every other week possibly.

There's typically some lab work involved just to monitor certain electrolyte levels or liver enzyme functions.

When we talk medical monitoring, the diet itself tends to be very low calorie diet, so it does promote a little faster weight loss than conventional dieting, so that's the need for the medical monitoring piece as well.

A lot of our patients come to us with medications that they re on, a lot of health problems that we need to monitor, so both of those in itself also are part of the medical monitoring that they would do.

Ke'an: Do they get the medical monitoring whether it's the at home version as well?

Kristina: Good question.

It s just the clinic model.

If they come to us and are interested in medical monitoring it is the class because they do need to be seen, if not weekly, every other week and typically monthly we do some kind of blood work or checks on them to check everything to make sure everything's going the way we want it to be going and making sure they re doing okay with the weigh loss plan as well.

The at home plan isn t the same diet, so it s not considered a very low calorie diet.

It s more moderate level, more using the grocery store food, as well as conventional dieting, as well with the meal replacements that we use with the HMR program too.

It s a little bit moderate range and they are able to just contact their primary care providers if they have any concerns or medications or health problems.

Ke'an: Now you ve mentioned meal replacements a couple of times.

What is a meal replacement?

Kristina: That s a good question because it can be pretty much anything.

If you go to the grocery store ever there s a lot of prepackaged foods that are nice little containers and they have a certain calorie amounting to them.

A lot of products that we see in the supermarket every day are meal replacement, so they re nothing new to dieting, but when using the right amounts it can really promote weight loss and help to maintain that weight loss.

With what we use with HMR, they re very nutritionally balanced, they re a good source of protein, they tend to be lower in sodium, so they re a little bit more of a healthier model if you will than maybe what you re finding in the grocery store, because it can be a little deceiving because we know labels on our food products in the grocery store are a little hard to read sometimes.

We can be a little misled as well, so we want to be careful with some of the meal replacements that we see in the grocery stores.

Ours tend to well biased maybe tend to fall into more of a nutritionally balanced category.

Ke'an: Now you ve brought some samples here today.

What would you like to start out with?

Kristina: Well we do have what most patients may think of a meal replacement, they may think of an entree.

That s probably the one that we think of the least as a clinician that we re looking at because the entrees are one of that we use not as part of the very low calorie diet necessarily.

We do more of a protein drink with that one.

The entrees when we think of meal replacement maybe what comes to mind for most people because they think of a true meal, so in essence an entree is something that comes to mind.

With our entrees, they re all under 300 calories, they re anywhere from 10 to 15 grams of protein on average.

We do have some that are upwards of 18 to 20 grams of protein.

So they really do pack a lot of nutritional value in a small amount.

We tend to find with our patients that we work with and the obesity epidemic, they re over eaters, so it s very kind of deceiving when they see this smaller package because they do like the volume.

They do get a high fiber content, protein content, which is more fulfilling to them even though it s a smaller volume.

We do have options on the entrees depending on what meal plan they follow, that they can add more volume to that using vegetables.

That gives them a little bit more to work with.

Ke'an: That s what we were talking about earlier, was is this is all I get to eat, because that s a lot of People are like, Am I going to be hungry?

Kristina: Yes, we get that a lot.

And then patients are surprised.

They think it s one of those things they really have to finally just dive in and do it, and really see for themselves like, Oh, I can be full on less amount, and realizing that it s a big difference in the nutrient density of the foods that they re choosing.

We have many patients that come to us that regardless of their weight, they tend to be malnourished because of the lack of nutrients that they may be getting because they re overcompensating in certain areas and not getting enough of another area.

Ke'an: Right, not eating the right things.

Kristina: Correct.

Ke'an: Not eating your colors.

Kristina: That s right.

You ve been listening.

Ke'an: Yeah.

This says no refrigeration needed and ready in one minute.

That s different because- Kristina: That is a really key selling point for a lot of patients because they are on the go, depending on their office space they may not have refrigeration close by or even freezer space so they are prepackaged meals that are ready to go, they re cooked and they re just vacuumed sealed, so they re not an MRE, they re not dehydrated by any means, but they could be in a room temperature if needed.

We don t know if we want encouraging one to do that, but they can be if needed, but most the time it is something you would be able to heat up very short amount of time and they re really portable for that reason.

People can travel with them.

They can have them at your desk and their work area.

They don t have to worry about getting up and going places.

A lot of times the break room can be a challenging area to go at a workplace, not knowing what s in there, so it s nice to just be able to go in there, take your entree, heat it up, and then go back to your work space.

Ke'an: Yeah, absolutely, anything to simplify the process helps people along.

What else do we have here?

Kristina: Well, we can go to the meal replacement protein drinks that we talk about, because that predominately is what we use with our medical monitoring piece as well.

It comes in a little different packaging.

We have our protein drinks that actually are individual packets that can be used.

Then we also have a protein drink that s more of a powder in a canister that can be used too.

Depending on which meal plan you follow, there s a protocol that we use for your prescription of which plan and which product you would use.

Ke'an: So you don t have to figure it out on your own?

There s people there to help you along the way.

Kristina: Yeah.

And that s the great thing about HMR.

They ve got over 30 years experience in this area, so it really is right there for us to use.

We don t have to recreate the wheel.

They ve got a lot of great experience.

They use the research from what patients are successfully doing to lose weight and keep it off and share that with us, so we re able to kind of be able to share that with the patients at the same time going, Hey, you know, this is what we re seeing successfully happening with patients keeping their weight off.

Ke'an: We ve got a couple of other things back here.

Let s see what else we ve got.

Kristina: Well we know sometimes everybody has a sweet tooth, so we do have a hot cereal and a hot soup.

I talk about meal replacements.

These may not come to mind for a lot of people.

It may just be an entree or a protein drink, but these are good options because it does give you a little bit different flavors.

I m not real sweet tooth.

I like more of the salty crunchy kind of food so the chicken soup is a nice alternative because it s not all a sweet drink.

A lot of the protein drinks are cold so sometimes if you don t want something cold all the time, the hot chicken soup is a nice alternative as well as the cereal.

The cereal is a little bit more hardy texture, something you don t have to drink, so you are eating this, and once again, it s not as sweet as our shakes too.

Ke'an: It s funny that you mentioned that.

I was talking with a friend, a colleague earlier about weight loss and eating different things and getting tired of drinking something.

Like you want to eat something, you want to crunch on something.

So coming into play there, eating something with a spoon or a fork does come in helpful too.

Kristina: Yes, the hot cereal has been a big hit since it came out.

Ke'an: Good, okay.

Then you ve got these bars down here that look like candy bars but I m sure they re not.

Kristina: Yeah, there are lots of protein bards in the market out there, so it s really nice that these are a nice alternative to a shake or an entree or even a cereal, because these are a lot more portable.

Let s face it.

We can throw these in our bag, in our car, just keep them at our desk and have those available.

A lot of patients that they travel, they work great on the plane because then they have something that they can pull out even in an airport or an airplane that they can have too.

They re really helpful.

They re a great source of protein.

I mean they re 10 grams of protein so they re really going to give you once again that nutritional punch that you want to help keep you full until you can get to that next meal or grab some fruits and vegetables or ways of planning your following or even in maintenance these are a great tool to use too because they do keep you in check.

Ke'an: Well, that s some good examples of what the food looks like and tastes like and so forth.

You mentioned earlier with the medical monitoring the exercise and the physical aspect of this too.

So how does that play in to the meal replacements?

Kristina: Yeah, great question because we get that a lot because sometimes we focus on the diet part of it where we realize that the other equation still counts that we need to be focusing on being physically active, because we want to definitely make sure patients are keeping up metabolic rates, so the only way naturally to do that is to exercise.

We really work with patients on what they are able to do for activity and what they have resources to do activities with, to make sure that we can get them a game plan going so that they do have something in mind to exercise.

Sometimes our patients aren t able to do much because of their weight so we do have to kind of work slowly with them as they re getting weight off working with that.

We do have our center for healthy living that really focuses on getting patients maybe used to working out because it may be a whole new concept to them to actually, I ve never been on a treadmill, or, What s an effective way to use a treadmill, those kind of things, or just whatever they have around the house, we re realizing that, Hey, a water bottle is typically about a one pound weight, so you ve got exercise equipment right at your finger tips, and may have not known that.

Ke'an: Learning some different life skills there.

Now you have some examples here that you brought in that I wanted to talk about when we re talking about physical activity as well.

Tell me about these pieces of examples here, because this one here kind of got me like- Kristina: Intimidating.

They re great tools with weight loss.

We see our patients a lot of times be frustrated if they see, I only lost a pound.

Thought I was going to lose more.

They go down that road.

But when they can see like, this is a pound, it makes a difference.

Ke'an: Yeah, my goodness.

Kristina: The challenge is we don t lose it in a section like that.

We lose it all over so if we don t really notice it necessarily unless we re stepping on the scale and seeing that pound weight loss, so when you can visually kind of get your mind wrapped around, Oh, that s a pound, that s what I lost, and this is five pounds, that s what I ve lost.

Ke'an: Five pounds versus a pound right there, that s what you can measure as how much you re losing.

This is the fat and that s the muscle.

Kristina: These are the muscle model.

You can see just comparing them side by side that the muscle s much more sleek, much more contained if you will, compact.

When we talk about gaining muscle losing fat, that s what we re talking about because as you re losing weight and focusing on the activity level at the same time, we want to see patients gaining more muscle, gaining more strength, more endurance, more flexibility, range of motion, just all over being more productive, and a lot of that is because they re building muscle and losing the fat that s kind of bringing us down.

Ke'an: And getting healthier along the way.

So yes, I would much rather have this than this.

Kristina: Exactly.

Ke'an: Talk to me about who would make a good candidate for this type of approach.

Kristina: Great question, because it s really ideal for anybody, and I think sometimes when we talk about medical monitoring that s the first thing that comes to mind, maybe when someone thinks of losing weight or even thinks of the HMR diet, but it s a lot more than that.

So I encourage anyone to just look at everything that s available to them and what might be their best option or even to call and talk with us because we can certainly help direct them, if they have certain weight loss goals that they re looking at, then yeah, one might be better than another, but that doesn t mean it s going to work for them.

Sometimes the whole slow and steady wins the race is a good way to go too because we do have a lot of patients that have quite a history of weight loss successes and failures so they really have had that yo-yo dieting that we re trying to get them out of that cycle when with our program we focus a lot just lifestyle change, behavior modification, so it may be focusing on this diet to get their weight off, but we don t expect them to do that for ever.

It really is what are you going to do after you get to those weight loss goals to keep it off.

Ke'an: Don t want immediate results, say, I want 10 pounds off by the end of the week and then I can go back and eat the stuff that I really want to eat.

Kristina: Exactly, trying to get out of that mindset.

We have a lot of history coming to the table with some bad habits probably that aren t so healthy and we re trying to change that around, so it s going to take some practice and some experience having healthy behaviors in place to get rid of those old habits.

Ke'an: What is the shelf life for this type of food?

Kristina: Most of it it s anywhere from 18 months to two years.

It is vacuum-sealed and prepackaged, but they do have expirations on them, so you do need to be mindful of that.

One other quality with the products is temperature, if the entrees, even though they re shelf stable, you wouldn t want to keep them in a hot car every day all day long kind of thing.

The shake products are all dairy based.

We do have a lactose free formula too.

They re fined packaged and stored pretty much anywhere, but if you do mix one of them up then it becomes more unstable as far as being a dairy product and needing to be refrigerated so you want to be cautious of those things.

Ke'an: Now do you have anything for people who are vegetarian?

Kristina: We do have some vegetarian entrees that I think there s about four of them.

I m trying to think how many we have.

But all of the products do have either dairy or egg based to them, so the products depending on their version are vegetarian if they re complete vegan or not, how they would be able to manage with that type of a diet.

Ke'an: Then speaking of what people can t eat and can eat, what about food allergies?

How does that come into play?

Kristina: Great question.

I m glad you brought that up because that s one of the other pluses for our entrees because they re vacuum sealed.

You can probably just take a quick glance at the ingredients, but you can pronounce everything.

Since they re vacuum sealed, they don t have all those crazy ingredients in them that really are put in to products because of the preservation of them.

The vacuum sealing helps with that, so it really is helpful for people with food allergies because of that reason, because the MSG is probably the most common that I can think of that people have an allergic reaction to, so a lot of our products are very low sodium and are free of a lot of the preservatives and additives because of the vacuum sealing when it comes to the entrees.

Gluten intolerance, gluten free or Celiac, those kind of things, some of our products do fall into the gluten free category, so we do have these labeled as well for patients that are looking for that kind of information.

Ke'an: Now with the meal replacement, physical activity, we hear a lot you really need to stay hydrated, you need to drink a lot of fluids.

What s your recommendation with this approach?

Kristina: Same thing.

Yeah, definitely the same thing, especially with weight loss.

When you re focusing on low calorie eating to promote weight loss, and you ve got high amount of activity going, hydration is very important.

There s a lot of processes going on that you really need that fluid balance for, so we really push for non-chloric sources and predominantly water is the best source, but sometimes we need electrolyte replacement so low sugar and no calorie, sports drinks would be a good option too that would help bring the electrolyte levels up and help with any fluid replacement or fluid balance.

Ke'an: Now speaking of low sugar, which you just mentioned, what about people who have diabetes?

Kristina: Great, great question too.

Most of our patients are diabetic.

Unfortunately it just kind of goes with the obesity epidemic.

A lot of patients do develop some stage of diabetes that they maybe can able to get off medication or reduce medication, so it s definitely a safe program for them, and that s once again, part of the medical monitoring that we look at.

Ke'an: And then women who have had children, a lot of times what s on their minds is, I need to lose weight.

I need to get my body back.

What if they re breastfeeding?

Kristina: Typically we tell them to wait because there are artificial sweeteners in the products, so we don t want them utilizing those while they re breastfeeding because of that reason.

They do need to keep their calorie requirements up for the breast milk production too, so we re not necessarily encouraging too much of a low calorie plan with those, so anyone who comes to us postpartum we do kind of assess where they re at with their postpartum, lactation, and just kind of go from there on what their needs are.

Ke'an: Then also speaking of other medical conditions in people who may have heart conditions and have to stay away from caffeine.

You may have mentioned that earlier, but do these, any of this food, the drinks, anything, have caffeine?

Kristina: No, and that s the one thing I really liked about it, and I ve worked in the weight loss industry almost 17 years, and I really like the products are nutritionally balanced and you can pronounce everything that s in them and it doesn't have high amounts of the things that we re not sure of what it's going on with them.

There s no secret ingredient to that for losing weight and it doesn't have anything that s really going to raise a heart rate artificially that we re looking at too.

So I really encourage patients to give them a try because I think they re very nutritionally balanced and they can help with the right variety of health problems as well and getting folks healthy and getting off medications and helping them improve those things.

Ke'an: Now you have some success stories with this program, and I know a couple of the success stories have to do with a couple of EIU alumn that have gone through the program, and we re actually, part of our program here at Weiu, so talk to me about the success stories.

Kristina: The success stories are always kind of the heart and goal of the program.

It really helps to work with patients and see their success from day to day, week to week, year to year, and seeing them be able to not only get the weight goals but ultimately we want to see patients keep that weight off.

Then we always tell them, You know, the weight loss is the easy part.

It s keeping it off that s the hard part.

When we see them time after time, and they re still keeping weight off, that s really the shinning light that we re like, Okay, they re walking the talk, they re practicing this new lifestyle, and they re able to manage that weight.

Not to say they don t have bumps in the road like we all do, but they know where to come to get help, they know how to get back on track, or they know the tools that we ve talked about and worked with them through the program are able to utilize that, so those success stories are very helpful.

Ke'an: If people want more information about this program where would they turn?

Kristina: They can give us a call.

Our phone number is 238-4774, and our website of course has everything out there on it, the Sarah Bush Lincoln website, so it s sarabush.org website that you can find information and go to the Weight Management page on there.

Ke'an: Are there other resources as well that folks can learn from?

Kristina: There s the HMR website itself they could find information.

Anyone can join our program.

There s no doctoral referral needed, so they can definitely look out, look for information out there as well.

Ke'an: Well, this has been very informative, lots of different options out there for different people.

Weight loss is something that folks struggle with I think for a lifetime.

I think this has been very educational for viewers out there.

If you have enjoyed this program, we thank you for watching and learning about this new approach to weight loss management and getting healthy and living a well balanced diet life.

We thank you for watching and we ll see you next time.

Announcer: Production of Being Well is made possible in part by: HSHS St. Anthony's Memorial Hospital, delivering compassionate care close to home.

From advanced surgical techniques and testing, to convenient care for your family we promise to make a healthy difference each and every day.

St. Anthony's, together we are better.

Sarah Bush Lincoln Health System, supporting healthy lifestyles.

Eating a heart healthy diet, staying active, managing stress, and regular check-ups are ways of reducing your health risks.

Proper health is important to all at Sarah Bush Lincoln Health System.

Information available at sarahbush.org.

(singing) Our patient care and investments in medical technology show our ongoing commitment to the communities of East Central Illinois.

Paris Community Hospital Family Medical Center.

[music playing]