Walking Man – An ER Doctor’s Journey to a Healthy Lifestyle

by Jaime Collins

“What happened to me happens to many people. My story is in many ways every person’s story,” says Mark Bogner, MD.

He’s talking about the weight gain so many of us experience in our middle years. We start having families and spending more time at work. We start eating things our bodies decide should be stored as fat. We put on extra pounds, and our energy declines along the way. The timing and circumstances differ between people, but Dr. Bogner’s experience is, indeed, a common one.

“All of a sudden, we’re not burning the calories we used to,” says the Southwest Health Emergency Medicine Physician. “And the food we’re surrounded with is just plain bad for us. There’s a tug of war, and before long we start losing ground.”

For many, it’s a slow motion slide that feels like it can’t be stopped. When those around you are going through it, too, it may appear to us as the inevitable next stage of life. Ever the scientist who seeks a factual and well proven explanation, Dr. Bogner wasn’t going to accept his blooming weight as fate.

Having poured through the studies and completed a healthy examination of the proven facts, he set out to carve a new and healthier path. Eighteen months later, Dr. Bogner had lost 60 pounds of fat and gained 15 pounds of muscle. And perhaps most importantly, he’s kept the weight off for a full two years.

Recently, he took time to share not just how he did it but how his love of science helped him succeed.

“People see me walking all the time now. They’ve seen the change in my energy and body shape over the last year and a half, and they often want to know how I do it.” Losing weight and eating healthy are both fraught with challenges. Indeed, the how is something many people want to know. Who better to learn from an expert in how the human body works, someone who has taken a deep dive into the raw research on this topic, and someone who has also achieved real life weight loss goals?

 

A Reference Point

Let’s start with a brief look at something called Basal Metabolic Rate (BMR). You may have heard about BMI (Body Mass Index). This is different.

Our bodies use energy no matter what we’re doing, even when sleeping. Your BMR is the number of calories you would burn if you stayed in bed resting all day. You can quickly calculate your BMR by plugging a few numbers into an online tool. Your age, gender, height, and weight are all you need.

Dr. Bogner’s BMR is about 1,800 calories per day, so if he does nothing all day, that’s the upper limit of calories he could eat without gaining any weight. If he ate fewer calories, he would actually lose weight. Plus, there’s the calories he burns going about his normal day. The more calories he burns during his day, the more calories he can eat each day without gaining weight.

If you’ve noticed that every year, it becomes harder to eat whatever you want and stay slim, you’ve learned that your BMR decreases as you age. BMR is also generally lower for women than for men, a fact that doesn’t surprise most women.

Although Dr. Bogner uses BMR as a tool to guide his decision making on food and exercise, he doesn’t rely on counting calories. That’s because he knows it’s not all that simple.

“For a very long time, we have all been taught that losing weight is simple math. We’ve been spoon fed the idea that all you have to do is eat fewer calories than you burn.” There are a great many caveats to the calories in and calories out equation. The human body is magnificently complex, and variation between individuals, including our genetic make-up may push one’s BMR up or pull it down. Dr. Bogner concedes his own BMR is not entirely accurate, yet he also knows he’s living proof that BMR can be a tool to help regulate one’s diet and lose weight. “Inaccuracies are no reason to ignore your BMR. Both your calorie intake and your level of exercise directly affect not only weight but also your general health and wellness as well.”

The same research that informed Dr. Bogner’s tactics for losing weight and increasing his energy is now changing the views of diet and exercise experts around the country, too. For one, it’s become clear that exercising more or doing it harder is not by itself an effective path to weight loss or to overall healthy living. To be successful, one has to change eating habits.

Similarly, eating better is always a step in the right direction, yet not a stand alone solution. Adding exercise to one’s daily life burns calories while also offering the added benefits of increasing and toning lean muscle, boosting energy and endurance, and helping one sleep.

One source of research, articles, and recipes is Blue Zones.

What Is Good Food?

“The food we’re all used to, the food everyone around us is eating every day, and the food so widely available and so effectively marketed to us is almost entirely highly processed, high carb junk,” says Dr. Bogner.

Burgers, fries, pizza, wings, fried this and that washed down with beer, and the sugar added to nearly every item in a package all contribute to unhealthy diets. “The fact is, I’m not perfect, and no one is going to be perfect either,” says Dr. Bogner. “Eating those things once a week compared to eating them four or five or more times a week makes a giant difference. If you’re eating well and staying active, the difference is night and day.”

What’s on Dr. Bogner’s do not eat list? Nearly everything that’s pre-packaged, fast food, sugars in all its forms, and other carbohydrates, such as bread and white pasta (even whole grains should be kept to a minimum). Potatoes in any form should be limited and virtually everything that’s fried should be avoided. Not all fats are bad, but he warns fats should come from healthy foods and oils, eggs, nuts, olives, and healthy lean meats.

The body needs carbs for energy, but healthy carbs come from fruits and vegetables, mostly veggies as too much fruit will give you too much sugar and lead to insulin spikes and fat building.

Need a snack? Grab a handful of nuts or berries or a piece of fresh fruit – instead of chips, candy or that leftover pizza floating around.

And drink water. Lots of water.” Take your body weight and divide it by two,” says Dr. Bogner. “That’s how many ounces of water you should be drinking every day when exercising and trying to drop pounds.” So if you weigh 160 pounds, that’s 80 ounces or 10 glasses of water per day!

Dr. Bogner began his journey with Weight Watchers, a healthy diet program now known as WW which he credits for getting him on track. Though he no longer needs the program, he recognizes the WW point system helps one kick the habit of daily poor choices and forge new habits with healthier foods. So while it may not be a long term solution, it was helpful for Dr. Bogner to get him moving in the right direction.

Dr. Bogner before starting his journey to a healthier lifestyle.

Is there an overarching theme to success in choosing what foods to eat and how much you should eat? “Change your thinking about food,” says Dr. Bogner. “I’ve learned not to think of food as a reward for hard work or healthy living. Food is simply fuel for my body and my brain, so I can do the things I want to do in life.” He insists there are far better ways to reward yourself for working out, working hard, sticking to your plan, losing weight, or just enjoying your day. Instead, each day you stay on track put a little money aside for something you really want. Go to a show. Try a new activity, hobby, or art, or learn something new. If you really want to reward yourself, refuse to do it with something that sabotages what you’re trying to achieve.

Your Secret Weapon

Fad diets are largely disproven as a reliable method to lose weight. They’re really hard to stick to and typically not based on healthy eating. Despite the common belief they don’t work at all, some people do meet with initial success. Nevertheless, there are better, healthier ways! A highly effective alternative to dieting is intermittent fasting. Dr. Bogner has not only researched it, he’s shown it works in his own life. Though he didn’t start out his journey to healthier living with this technique, it wasn’t long before diet boredom took hold and forced a change. Using intermittent fasting at least two weeks out of every month and other times simply sticking to healthy food choices and controlling portion sizes, he makes an impact on his weight while reducing the fatigue of always doing the same old thing.

“It makes a huge difference,” he says. “Intermittent fasting does not mean starving yourself, and there’s strong science behind it that proves its many benefits on top of losing body fat weight.”

Some people fast once a week, all day. Dr. Bogner has a different method for more consistent results. He eats all his daily calories inside an eight hour window, usually from 11 am to 7 pm. The other 16 hours he sticks to water, coffee and other zero calorie drinks. The magic is in not taking in calories during those 16 hours. It fires up your metabolism, burns fat, and provides some impressive additional effects on your overall health. Best of all, with intermittent fasting, the plan is easier to stick to because you can always have a great tasting, healthy lunch and dinner. Here’s a short list of those additional benefits you’ll be racking up:

  • Reduce insulin resistance and lower blood sugar
  • Reducing blood pressure and blood cholesterol levels
  • Boost metabolism for fat loss
  • Reduce inflammation in body tissues
  • Protect against neurodegenerative diseases, heart disease and stroke, and diabetes

 

The evidence on intermittent fasting shows the old adage about breakfast being the most important meal of the day isn’t always true. In fact, it can be the most important meal not to have.

Of course, for those who feel the need for a little boost in the morning, you simply eat breakfast a little later and still get fasting benefits.

So What about Exercise?

“What you choose to do for exercise is far less important than choosing to do it in the first place,” says Dr. Bogner. “Ideally though, I want to see people choose something they want to do. That way you’re more likely to stick to it.”

A great goal is to start walking. “Not occasionally,” he insists. “Every day. At least 12,000 steps. More if you can. My goal is 14,000 a day averaged over a week, and at least 10,000 every single day.” He says since your schedule may vary, a 12,000 step-a-day running average over every week also works well. You might walk more one day and a little less another when you’re short on time. Your phone is a reliable step tracking device, too. Keep it with you, and pay attention to it each day. It will help you move more.

Throw in a few sets of stairs, and you’ll also find yourself building muscle and conditioning your heart.

In addition to his personal goal of 14,000 steps a day average, Dr. Bogner gets at least 30 minutes of moderately intense (or very intense) cardio type exercise every day. Examples would be cycling, running up and down stairs, using a stairmaster or similar exercise equipment, jogging, or high intensity circuit training with weights. Again, Dr. Bogner recommends doing this virtually every day.

And two to three times a week, be sure to include some form of strength or resistance training. If it’s not weights, yoga is a great alterative. Body weight and core exercises, like push-ups, sit-ups, squats, and “mountain climbers” are also very effective and come with the added benefit of not requiring any equipment or gym memberships.

Success Killers

Life often has a way of sabotaging even your best laid plans. However, you can forge an easier path to success if you reduce or eliminate Dr. Bogner’s list of defeating obstacles:

  1. Negative people and experiences. In many ways, you are the sum of the people and places you spend the most time with.
  2. Weighing yourself too frequently. Your weight varies day to day. Weighing in more than twice a week will only serve to discourage you. You’re interested in long term trends, not today versus yesterday. And, weigh yourself the same time of the day. Best is first thing in the morning after your shower.
  3. Vitamin D deficiency. You need Vitamin D, men even more than women for adequate testosterone production as we age. Modern day lifestyles have made this harder. The best way to get Vitamin D is sunlight. Get outside whenever you can.
  4. Not drinking enough water.
  5. Cheating on your calories.
  6. Rewarding yourself with junk food.
  7. Unreasonable goals and time frames. Every step you ever take toward being healthy you take in the present moment. In the here and now. Setting time sensitive goals for the future can add to your enthusiasm if they’re realistic. Aiming for losing 1 pound a week on average is perfect. Some weeks you will do better and feel great. Other times you will hit plateaus, but if you track trends over time and stick to your plan, you will still see the weight come off. Setting goals too high will only discourage you (i.e. 20 pounds in six weeks is foolish). Set reasonable, healthy goals, and find joy in reaching them over and over again!
  8. A focus on dieting. Focus instead on achieving a healthy LIFE. Aim for fitness, and discover a leaner you with more energy. Eat a healthier diet for life, rather than “dieting” for a set period with the sole purpose of losing weight. The real goal is a sustainable lifestyle, not just dropping a few pounds in the short term.

 

We All Respond Differently

“Our bodies are biologically programmed to store more fat than we need,” says Dr. Bogner. “Because your body doesn’t know what future calorie needs it will have, it’s trying to be efficient with calorie burning, and it will naturally store calories for times when they’re scarce. As a result, the most genetically gifted of us may pack on more pounds automatically.”

“Fortunately though, the human body is highly adaptive. If we make the right changes, we will see results.”

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