Peak Performance
We understand there are many options for weight loss. We have developed a comprehensive program that we believe offers advanced and effective medical treatment for obesity and overweight. The individualized attention, medical testing, frequent follow up, provider access, and medical equipment are costly to provide. We believe the value you will find in our program will be worth the cost to you, and the benefits to your health will be priceless.
Our program does include prescriptions for medications that promote weight loss if they are mutually agreed upon by the client and provider. Some clients may not need or want medications, and others will want or have a great potential benefit from medications. If you have questions about specific medications please ask your provider. Please note, the cost of medications is not included in the program fees and we do not currently provide hormone replacement.
Yes, we offer 10-minute informational calls to help you decide if our program is right for you.
EDUCATION STATION
Exercise and Physical Training
Two words: protein and lifting. We can work with you to determine how much protein you should be getting and setting up a strength training regime that works for you.
Many times, we overcomplicate exercise and take an “all or nothing” mentality. Then, when we don’t have time for the full one-hour workout or to hit the gym five days per week we give up and never start. To incorporate exercise into a challenging schedule, start by looking at your week and find 2-3 times you can get in a workout. Be willing to use cracks of time, like a brisk walk during your kid’s football practice or a short workout on your break at work. Start small and incorporate longer or more frequent workouts over time if you can.
This is a loaded question, with many possible answers because everyone has their own opinions on fitness. There are, however, a few exercise tips that are nearly always true, especially with firefighters and law enforcement officers. First, the best exercise is one you will do regularly. We can give you the best fitness program in the universe but if you quit doing it a few weeks or months into it then it isn’t good enough. Find an exercise you enjoy, or one you at least don’t hate and can do consistently. If you love jazzercise, we won’t judge you and will applaud you if you do it regularly. Whatever you do will always work better than what you intend to do but don’t. Second, for fat burning and building endurance, low to moderate intensity exercise is usually beneficial in a fitness program, so we often emphasize rucking, brisk walking, or light cycling. It’s known for improving depression and anxiety as well. Third, strength is important for physically demanding jobs, and strength training as little as twice per week has been shown to improve weight loss, so we promote incorporating strength programming in your fitness program, either initially or over time. Finally, high intensity cardio improves cardiovascular fitness, metabolism, blood sugar, and stress levels so this type of exercise is beneficial as well. To sum it up, a fitness program that includes varied intensity in cardio and strength training is going to be most beneficial, and we work with clients to build a routine that will work for their goals and preferences.
General Weight Loss and Fitness
Losing weight is possible, but it can be challenging for anyone. First responders have to work meal plans and exercise routines around long and unpredictable shifts. Interrupted sleep often compounds the challenges, along with processed station snacks and treats. Your job also brings stress as you witness traumatic events, and over time unhealthy coping mechanisms can develop. While it’s important to understand and acknowledge these unique challenges, we can also strategize ways to navigate and overcome them.
Obesity and overweight are commonly known to increase risks for occupational injuries, cardiovascular events, cancers, and high-risk conditions such as hypertension and diabetes. Firefighters are already at increased risk for cancers and cardiovascular disease, and the prevalence of overweight and obesity only compound these risks further. Additionally, the physical nature of both law enforcement and firefighting professions naturally brings a risk for injury, which is only compounded by the conditions of overweight and obesity. Basically, public service professionals are at higher risk for injury, cardiovascular events like heart attack and stroke, and cancers if they are overweight than someone of a similar size and body composition in a lower risk profession.
An elevated body fat percentage is associated with an increased risk for conditions such as high blood pressure, diabetes, and many cancers. Studies show even mild to moderately elevated body fat percentage can increase health risks significantly, and that the incidence of elevations in blood pressure and blood glucose often begin prior to the development of “obesity.” Additionally, a higher body fat content disrupts regulation of hormones that control hunger and satiety, so the higher our body fat is, the more likely we are to be hungry and the harder it becomes to lose weight. This compounds the health risks further.
Medically monitored weight loss is a structured approach to achieving and maintaining a healthy weight under the supervision of healthcare professionals and following evidence-based medicine practices. At Peak Performance this includes comprehensive medical evaluation, lab and cardiopulmonary exercise testing, body composition analysis, mental health assessment and monitoring, and regular follow up. Interventions to promote weight loss will include customized nutrition and exercise plans and may include prescription medications.
Although overweight and obesity can be diagnosed using BMI, we prefer to use body fat percentage to make those medical diagnoses. BMI simply represents someone’s size, but can over or underestimate overweight and obesity. Body fat percentage of 25-29.9 in men and 30-39.9 in women are generally classified as overweight, and ≥30 in men or ≥40 in women is classified as obesity.
Mental Health and Motivation
Sleep is when our body naturally restores itself, and shift workers are often sleep deprived. This is one factor that can increase the risk for overweight and obesity. Men who do not get enough sleep, or good quality sleep, often have lower testosterone levels, which can contribute to difficulty building muscle and a propensity for higher body fat percentage. Additionally, poor sleep is associated with decreased mood and increased risk for depression, anxiety, and heightened stress levels. The good news is that many people are successful in losing weight and maintaining a healthy weight despite shift work, but it does take intentional effort and a good plan.
Motivation is always going to wax and wane, and that’s where good habits and discipline have to sometimes take the wheel. However, there are some things that can help us be more motivated. One is to set up a realistic, doable routine. Don’t set yourself up for failure with a workout or nutrition plan that is too restrictive or intense to maintain. If you do, you will inevitably get off track, because you have left yourself no flexibility. Then, you feel like you have failed and get discouraged. To maintain motivation, create a plan that will help you feel like a winner – one that you actually can do and even enjoy.
Stress can increase cortisol, blood glucose levels, and trigger emotional eating or drinking habits. Stress management can be a significant factor in losing or gaining weight. First responders simply have stressful jobs that require them to repeatedly be exposed to a surge of adrenaline and endure the physical responses that follow. While that may not be modifiable, there are things we can do to manage stress during and outside of work. Regular exercise, sufficient sleep, doing activities we enjoy, and not overworking ourselves with overtime and second jobs can reduce the effects of stress on our bodies.
Special Considerations
One of the challenges of weight loss is navigating social situations and events and not allowing them to sabotage your progress. First, one indulgent meal is not going to erase a week of consistently following your plan, but the more we veer off our plan the less weight we will lose. If you want to lose weight you are going to have to limit those indulgences, and here are a few tips:
- Pre-decide what you will eat and what you won’t—and stick to it.
- Don’t attend events overly hungry; have a high-protein snack beforehand.
- Choose the healthiest options available, prioritizing protein, vegetables, fruits, and whole foods.
- Avoid mindless grazing by asking yourself questions like, “Do I really want this?” and “Is this worth it?”
This can definitely be done but takes some flexibility. To lose weight we need to be in a calorie deficit, but we cannot take that deficit too far or we shut down our metabolism and will not lose weight. For those in an active occupation it is important to fuel adequately for your work. Your provider will calculate your caloric needs based on your level of activity, goal weight, and overall size and body composition.
First, eat adequate protein and hydrate well. This stabilizes blood sugar, helps with satiety and hunger, and promotes healing. It’s also important to eat according to your activity. If you usually exercise regularly and are active but your injury is preventing you from moving much you need less calories overall and probably less carbs than you usually have. Then, do let your injury heal and rest as needed, following any instructions from your provider, but don’t use the injury as an excuse not to exercise at all. If you have an upper body injury you can usually walk or even jog and do leg and core strengthening exercises. With a lower body injury you are able to do upper body exercises and you are often able to modify cardio, walking or cycling instead of running for example.
Nutrition and Diet
Have you ever heard the saying “you can lead a horse to water, but you can’t make him drink”? Don’t be like that horse. In order to perform physical work to full capacity we need to be hydrated. Poor hydration can lead to heat intolerance and poor performance, when exercising or doing physically demanding work. Hydration is critical to keeping first responders safe and enabling them to perform well. Being hydrated is also key to weight loss. Thirst is often mistaken for hunger, so adequate hydration actually helps control appetite to some degree. Studies have shown that drinking water prior to a meal can reduce overall food intake and prevent overeating. And the better hydrated we are, the better we generally feel, which can mean higher likelihood we will make the effort to exercise, be active, and cook or eat healthy foods. There is a reason hydration gets all the hype: water is important!
There is no one-size-fits-all-first-responders diet. Generally, we do not recommend a very low or no carbohydrate approach for people who have physically demanding jobs, but we do recommend limiting sugar and moderating carbs. Prioritizing protein to maintain and build muscle mass is also key for nearly all our clients. And it’s always beneficial to fuel with low-sugar and nutrient dense whole foods as much as possible to ensure preparedness for the demands of the job.
Again, plan. We sympathize with those working night shifts who have limited options, or those whose shift has been too busy to prepare a healthy meal. We do not, however, accept the excuse that healthier choices are not possible anytime you are on shift. Have healthy snacks and small meals ready as often as possible, and with fast food look for healthier options. Many menus have calorie and nutritional facts posted and there are options for grilled chicken instead of fried, salads instead of burgers, and a side of fruit or veggies instead of fries. Make a healthier choice most of the time.
One word: plan. For those whose lives are unpredictable we have to prepare. First responders are always prepared to respond to any emergency. From monitors and medications in an ambulance, to tactical vests and body armor on an officer, you have planned to be able to perform the duties of your job. Do the same to fuel yourself. Eat a healthy, high protein meal at the beginning of your shift and bring easy-to-grab meals and snacks to have throughout the shift. Things like fruit, jerky, cheese sticks, protein shakes or bars, and “protein packs” are great options. When on shift a little effort can go a long way. Then, on days off keep nutrition on point as much as possible, planning healthy meals you can use as leftovers for lunch the following day. Don’t let your schedule run you but look at your schedule for the week and plan ahead!
Practical Tools and Strategies
Look for healthy habits you can start, or unhealthy habits you can stop or decrease. For example, start with drinking more water, work your way up to a gallon per day. Make half your dinner plate vegetables every day. Reduce or stop drinking sugary drinks, including alcohol. If we make incremental changes and stick with them, weight loss follows.
At Front Line Mobile Health we have repeatedly seen the effect culture has on a shift or a crew. Some prioritize healthy eating and fitness, and it shows in their labs, body composition, aerobic capacity, and overall health. Others don’t prioritize healthy habits, and it also shows.
If there’s one thing we’ve heard all too often it’s “I eat pretty healthy.” Sure. We all do, or at least we think we do, until we track it all. Wearable fitness trackers and fitness or nutritional apps provide us with real data and they hold us accountable to what we are actually doing, not what we think we are doing. Data and accountability are highly associated with weight loss success, and the data these apps provide give your weight loss provider more insight into how to help you adjust and meet your goals.
