All of us want to be a better version of our self, so as the calendar turns over another year, it is the occasion to declare a fresh start. Most of us pick goals that have personal meaning, often connected to how our bodies look and feel. My friends are working out more, de-toxing, exercising, eating organic and losing weight. Health clubs get a surge of new member in January and Weight Watcher’s sessions are full.

So why is it that by spring 90% of  New Year’s resolutions have been abandoned? It is human nature to lose our resolve and return to old habits. So how do we convert to that healthy lifestyle and make it stick? Here are a few suggestions:

1. Start simple and concrete. Resolutions that are too broad, too big, or too drastic are doomed to fail. Think big, but start small.
2. Write down the change you plan to make and post it several places. The act of writing it makes the commitment more engrained. Posting a reminder in several places re-enforces the plan. 

You may choose to stop drinking soda or other high calorie drinks. Reminders on the refrigerator or near your bathroom scales can keep it fresh in your mind. Outlook or smart phones can be good to keep you on track. Try emailing yourself daily.

1. Give a commitment of 21 days, rather than forever. It takes 21 days to form a habit and the short time frame will help you avoid discouragement.
2. Re-evaluate at three weeks. If you could not reach this goal, try to identify the challenges and come up with solutions. Write down your revised strategy to re-new your commitment. If you did succeed, try adding a new habit to change.
3. Don’t procrastinate. The next time you start you will wish you had done it sooner. No time like the present. Just do it.

Once you change a small habit you can keep it for a lifetime. Being a better version of ourselves is an accessible goal!

A survey sent to 600 liposuction patients looked at their long term satisfaction, asking a long list of questions, such as:

• How would you rate your appearance after liposuction?  87.3% rated “good or better.”
• Are you more productive in your work?  Better productivity reported in 27%, no change in 71%.
• Would you have the procedure again? 79% said yes.
• Would you recommend the procedure to family and friends?  86% said yes.

The vast majority reported favorably to each of these questions. However, it was found that those who ate a healthy diet, exercised regularly, and maintained a stable body weight were 2x more likely to have increased productivity, 15x more likely to have dropped in clothing size, 2.5x more likely to have a high self appearance score, and 3x more likely to have improved health. Those who took active control of their health were far happier.  

The authors concluded that there are four elements to having a good long term result from your liposuction procedure.  The first is having a good surgeon performing a well executed procedure, but the other three are controlled by you, the patient. Healthy eating habits, regular exercise, and commitment to a positive lifestyle are huge determinants of satisfaction with the choice. So, real satisfaction involves team work with your doctor. The authors developed a map of how to tell what factors affected your happiness with the choice.

PRS Vol.114, No.7, p.1945 

www.PRSJournal.com The_Key_to_Long_Term_Success_in_Liposuction__A.40

During the 2008 presidential campaign period Michelle Obama reintroduced the sleeveless sheath dress (a la Jackie Kennedy) as a new fashion statement. So the cut of the upper arm became important for style. This worked well with her “let’s move” campaign for diet and exercise.

So how does one get Michelle Obama arms?

Well, upper body workouts are a good start. Women are not as likely to develop their arm muscles as men, but it is an important part of feeling good, staying strong, and looking fit.  

However, lots of women may have good muscle tone with other factors the interfere with the shape of their upper arms.

Some carry fat selectively in their upper arms. This is common for an overly enthusiastic fat collection in the triceps region, leaving a hanging weight of extra tissue. LIPOSUCTION can be a valuable way to contour the upper arms with minimal scarring. Its success is somewhat dependent on the elasticity of the skin. The best results occur when the skin retracts to its former shape after the fat is removed. This may take three to six months to occur.

If you have too much skin, or skin that has been irreversibly stretched out, the extra skin needs to be removed with an ARM LIFT. There is a large array of variations on an arm lift (known as a BRACHIOPLASTY). A minimal scar armlift can confine the scar to the armpit. If there is more excess skin the scar may need to extend down the inner arm or over the triceps region to achieve a better contour. As in most areas of plastic surgery, the choice needs to be individualized for the best outcome.  

If your upper arm is one that you hate to show in sleeveless dresses, a consultation may help define a good solution for you.

In the United States one third of adults are Obese (BMI >30). OBESITY brings a burden of increased medical problems and risk of premature death. Excess body mass significantly decreases energy, activity and sense of well being, not to mention body image. Many resources, public and private are being devoted to combating this epidemic. MICHELLE OBAMA has made anti-obesity her signature issue in the “Let’s Move” campaign.

The Nov 24, 2011 NEW ENGLAND JOURNAL of MEDICINE published a randomized controlled study in 415 obese people to compare two different approaches to supporting WEIGHT LOSS. All patients were followed by their doctors for a two year period. One group of subjects had weight loss coaches that provided in-person support with both group and individual sessions. A second group had its counseling provided remotely by e-mail, phone or web site. The third group was entirely self directed without supplemental advise or support.  

The self directed (non-supported) control group had a mean weight loss of .8 kg, not much change at two years. The two groups that received support both were able to maintain a 5% weight reduction. This modest weight loss is a good start on decreasing cardiovascular and diabetic risk even if it is still a far distance from being at ideal body weight. The group with face-to face coaching did slightly better than those who received their support on line, but support was critical.

The take home lesson is that lifestyle changes are hard to maintain especially when attempted all by yourself.  Education and encouragement make a difference in being able to sustain change in habits. You may lack both time and money for one on one coaching, but taking advantage of on line support systems may be a very good method to reinforce behavioral modifications. Most health clubs offer a supervised program to track diet and exercise. There are multiple web sites for monitoring calorie intake and exercise to track progress in those key behaviors. Here are a few you might find helpful:

www.healthdiscovery.net – Weight Watcher’s Support Network

win.niddk.nih.gov/ – Weight-Control Information Network

www.obesityhelp.com – Web site with resources for surgical weight loss

www.overeatersanonymous.org – Successful group based on the 12 Steps model

Don’t forget to keep moving!