1. Can we know a little more about you, including your professional background as a nutritionist specializing in obesity?
I am Dr Tamarindi Catherine, a nutritionist specializing in the management of obesity.
I studied medicine at the medical faculties of Strasbourg and Nancy. I very quickly moved towards the Nutrition specialty. I graduated from DESC in Nutrition.
I followed various additional training courses with IUDs (Interuniversity diplomas) in Diabetology, Management of overweight and obesity in children and adolescents, Clinical human nutrition and the very last in Bariatric surgery.
I have worked in a private practice for 13 years.
I am part of the Haguenau medical-surgical team which carries out RCPs (Multidisciplinary Consultation Meetings) before bariatric surgeries.
I am a board member of the Anti-Obesity League and other obesity-related societies.
And in 2022, I finished writing my first book
Opération Obésité with Éditions Frison Roche. It is a guide for patients undergoing obesity surgery, a guide that I describe as “nutritional”. There are really in-depth explanations of pre- and post-operative nutritional care.
In my practice today, I work exclusively in private practice. And I meet more and more children and adolescents, who are overweight or obese, pregnant women with gestational diabetes, but also patients with beginning weight problems, requiring nutritional support.
2. What are the main factors that contribute to obesity and how can you help people manage this health problem?
The factors responsible for obesity are numerous. But the first thing we often tend to forget is genetics . Indeed, the ease or speed of gaining weight is genetic. Many families are affected by overweight and obesity. The second factor, the one on which we will be able to act, is the environment : more precisely the way in which patients eat, the quantities, the way of cooking, fast foods, snacking... All these bad habits associated with a sedentary lifestyle or lack of physical exercise are the main causes that lead to obesity.
Our society really favors a sedentary lifestyle, particularly among young people, with a reduction in extracurricular activities, an increase in the use of tablets, consoles, computers, etc.
Treatment by a nutritionist will depend on the grade of obesity and complications. We don't just take care of the weight, but the patient as a whole .
- Initially, the help will be nutritional : re-explain how to eat healthily, with a readjustment of portions, advice on cooking methods... Each advice will be personalized and adapted to the pathologies of each person, their age, their sex...
- Then, the second part is resuming physical activity . If the patient has no particular concerns, he can do it himself. Otherwise, I usually prescribe adapted physical activity with physiotherapists or sports rehabilitators if people are very disabled by being overweight or obese. I work a lot with the Siel Bleu association, with which we have set up sports classes in my town.
- Then, if one element should not be forgotten in the nutritional management of overweight or obesity, it is the psychological part. You cannot help someone struggle with eating disorders, or simply emotional eating with impulses, without also working with psychologists, or even psychiatrists.
I also work in collaboration with SSR centers (follow-up care and rehabilitation) which offer multidisciplinary care , but this time, over three weeks, with nutritional advice, physical activity and the psychological side.
In cases of morbid or severe obesity with comorbidities, obesity surgery may be considered.
3. What is the importance of a global approach in the management of obesity? How do you combine nutrition and other aspects of health to achieve the best results?
Successful weight management requires a global and multidisciplinary approach. Take into account that weight without sport and without the psychological side is doomed to failure. In my opinion, moreover, the first stomach is the brain! It's really like the 3 legs of a stool. All three elements are required for optimal effectiveness.
Often, patients neglect the psychological side because they feel strong, so they believe they do not need it, but the emotional side of eating must be taken into account. Different techniques exist and work: hypnosis, PBA, CBT... I am very open in my way of working to try techniques that have proven results.
Sport will not necessarily promote weight loss, but above all it will avoid the plateaus that we can have recurrently and which can destabilize someone who is losing weight. It will also help improve body distribution, that is to say increase muscle mass and reduce fat mass. At that moment, the weight does not necessarily move, but the centimeters do! The silhouette is prettier and we feel much better.
Nutritional advice obviously remains the basis of care, but it is not everything! You really need to have a network around you of medical and paramedical professionals with whom you are used to working. For my part, I work with a
psychiatrist and a
psychologist whom I know very well and who have the same way of seeing things as me. I work a lot with the
Siel Bleu association and physiotherapists specializing in resuming physical activity. My network of
surgeons is also well established. These are people I trust. The patient remains at the center of this care, he must be aware of this. To succeed in the long term, he must be well supported to be able to change as many of his bad habits as possible.
4. What are some common myths associated with obesity and weight loss that you often encounter in your practice? Could you demystify them?
The ideas of magic diets, miracle pills, fasts... are still circulating a lot! People spend fortunes because their weakness is weight and they want to lose weight at all costs... But nothing works, there is no magic. The treatment that works is that of long-term change, both nutritionally and physically. Know how to accept that the psychological side, the “soft” diet exists and that you need help to move forward.
Surgery too is just a crutch in weight loss, no magic without effort or lifestyle modification. Nothing works without change in the long term.
5. What role does emotional eating play in obesity? How to approach and modify it?
Emotional eating or “soft” eating as I like to call it, is unfortunately one of the causes of obesity. Compulsive snacking causes weight gain.
This element is often underestimated. Restrictive diets and untimely frustrations will favor it. Taking refuge in food when things are not going well is very common, which is why it is often better to restore order in the balanced diet, do sport and not get frustrated. So as not to fall into these excesses. Weight concerns are much more complicated than just calories. Psychological support is a great help in this context.
I usually approach it very quickly in my consultations. We don't go to see a nutritionist just because we've gained weight... We know well that the relationship with food is complicated.
6. Can you share some practical tips to help people with obesity maintain motivation and make lasting lifestyle changes?
The most important thing when deciding to tackle a problem of overweight or obesity is to understand that the
change in eating habits must be
maintained in the long term . This is not a transitional phase, but rather
new reflexes ,
new choices to put in place and
maintain for life . A
balanced diet will obviously be the basis for successfully losing weight in a healthy and balanced way. The second pillar is represented by
physical activity , which will allow the maintenance of this weight loss and, as I said above, the improvement of body distribution with a body richer in muscle mass and less rich in fat mass. . When giving nutritional advice, one of the ideas that is often used is
variety . Weariness and monotony of meals, especially if you are cooking for several people, can also be sources of failure. To always stay motivated, it is important to set
achievable goals that can be maintained over time. Meals must have
flavor , for example using
spices . Above all, you shouldn't get frustrated. If you feel the urge, you can
treat yourself without exaggerating , or even by increasing your physical activity a little!
7. How can nutrition help prevent other obesity-related health problems, such as cardiovascular disease and diabetes?
Obesity is one of the leading causes of mortality in the world due to the complications it causes: increased cardiovascular risk, the risk of certain cancers, the risk of developing diabetes, etc.
Reducing the body mass index (BMI) but especially reducing the waist circumference, which represents the abdominal distribution of fat, helps reduce this risk. Waist circumference is closely linked to cardiovascular risk. Another pathology linked to obesity and especially to the abdominal distribution of fat mass is hepatic steatosis, which corresponds to the accumulation of fat in the liver. This condition, similar to the effect of alcohol, can cause liver cirrhosis or even cancer.
Nutrition, by firstly helping to reduce weight and fat mass, helps to limit the development of these pathologies.
The Mediterranean or Cretan diet has also been shown to reduce this risk, even without necessarily lowering BMI. This is the qualitative side of nutrition: a diet rich in fiber, low in saturated fats, rich in polyunsaturated fatty acids, including vegetables, fish, legumes, oilseeds and coconut oil. olive. This approach helps reduce cardiovascular risk by improving lipid profile in particular, thus reducing the risk of heart attack or stroke.
8. What do you think of the maju bowl and vision? As a nutritionist specializing in obesity, do you see any particular benefits to using bol maju in the context of weight management and improving health?
I discovered the maju bowl thanks to a patient who simply asked me what I thought about it, because she didn't want to weigh her food.
I found the concept very interesting! Because we must not lie to ourselves, to succeed in losing weight, it remains "mathematical", that is to say that the intake must be lower than the expenditure.
Weighing food is an important element, especially at the beginning, to realize quantitative errors. But weighing can quickly become a constraint. The system that you invented is very innovative in this respect, and also very reassuring for people who always want to do well without having the impression of being once again under the control of the food scale.
It also seems to me to be a very good tool after obesity surgery. Indeed, the quantities must also be adapted after the operation, and the fact of not needing to weigh constantly can make things easier.
It is so simple and fun to use !
I very often recommend it to my patients when I feel that weighing food risks being a hindrance, or on the contrary when they need to be reassured by the fact that the quantities they are going to eat are appropriate in the part of their weight loss program.
The maju bowl can very well be integrated into the dietary rebalancing of a person who decides to lose weight or simply someone who decides to eat better to improve their health.
Weight loss goal: preconceived ideas!
Eating for €35 with 2 hours of preparation in the kitchen, for 1 week, it's possible!