[Elizabeth Cohen, Cnn:] Good morning, and welcome to HOUSE CALL. I'm Elizabeth Cohen, sitting in for Dr. Sanjay Gupta. Now, we're so pleased to be with you on this special weekend, the first weekend of the New Year, because we know that you have plans. You probably plan on losing weight or eating better or cutting back on stress. Maybe you're planning on having a few cosmetic procedures this year. Well, we want to help you with all of that. It's a New Year, and we want to be part of your plan.
[Cohen:] We're only a few days into 2010, and if you've resolved that this will finally be the year that you're going to get fit or eat healthier or stop smoking or join the gym, then this half hour will give you the tools you need to achieve your goals. That's where our guest comes in. His name is Dr. Jeffrey Gardere. He's a clinical psychologist in private practice in New York. Now, Jeff, you're going to tell us everything we need to start out right starting today. What is your number one tip, Jeff?
[Jeffrey Gardere, Ph.d., Psychologist:] I think the number one suggestion that I always make is instead of just talking about what your New Year's resolutions are, actually write them down. This is a contract that you make with yourself. You memorialize it, and it is there on paper. And, you can look at it any time you need a reminder, you can put it on your bathroom wall. You can put it on your refrigerator. It is there for you to remember what it is that you set out to do.
[Cohen:] OK. Now, I can see myself tearing it off the refrigerator like February 1st, you know? If I'm lucky to last that long. What is the key to actually keeping these resolutions once you've made them and written them down?
[Gardere:] Well, I think, first of all, you have to put together a plan. A lot of us like to use the GPS system. A lot of us like to follow maps. Well, why not follow a road map for the New Year's resolutions that you've set out. Make a simple step-by-step incremental plan that you can write down whatever your results happen to be, whether positive or negative, and that you can build rewards into. But this is something that you can refer to every day that'll give you the guidance that you need. Now, once you do that, the other very important thing is to let the world know about it. Yes. Be able to talk to your friends, to family, to co-workers, and let them know what your New Year's resolutions are. It commits you to doing it because now, it's not just in your home or your head, but it's out there in the world. You put it out there, number one. And number two, you will get their support so that if you run into some problems here and there, they'll give you that, you know, "you go girl" or "you go boy" that's needed, that reinforcement that you need to keep things going. And, of course, if they have similar New Year's resolutions, well, you all can do it together. It becomes a group effort and you become a support for one another.
[Cohen:] Jeff, you said something that makes a lot of sense to me, but I don't know exactly how to do it. Give me an example. For example, if I want to lose weight, that's my aim for the New Year, what's the map? What do you set out a map for losing weight? What do you mean by that?
[Gardere:] Well, for example, you have to be very specific as to the amount of weight you want to lose. And something that's realistic, which is another good tip, too. But what you would do is you would sit down with a piece of paper or in front of your computer and you would write what your goal is, that I want to lose weight. Next, write down how much weight you want to lose. What really works for you? Let's say you want to lose two or three pounds. Well, put down 2.5 pounds or three pounds and a time a frame that you want to do it in, which would be, say, for example, in a month or a month and a half. Now, part of this road...
[Cohen:] All right. So set parameters, that's what you're trying to say? Set the parameters.
[Gardere:] Set the parameters.
[Cohen:] OK. My producer found a tip. I'd just had to get this in there because it's so funny.
[Gardere:] Yes.
[Cohen:] She saw something that said, "When you start to keep a resolution, expect to feel lousy when you begin." Is that good advice, do you think?
[Gardere:] Well, I think I think it's realistic advice because a lot of people have to go outside of their comfort zone in order to reach these New Year's resolutions, in order to make the major changes in their lives. So, of course, you're going to be uncomfortable at first. But, again, if you follow that road map, then you will see that eventually you have documented those things that you've done, and now, you actually have a history of making that change, and you will feel better about it. The point I was going to make about yes, the point I was going to make about the road map and so on is that just do your best to write down what your plan is and just follow it. Keep it simple.
[Cohen:] That's right. Keep it simple. I think that's a great piece of advice. Now, Jeff, stay with us, because you've got some great advice for us on reducing stress and how that can be a life-saver. But first, the most common resolution is getting fit. So I'm sitting down with trainer Laura Cozik, she tells me 20 minutes of exercise four days a week is all we really need to get fit. Welcome back to HOUSE CALL, on this very special New Year's weekend show. Since it's the beginning of a New Year, we all want to know how can we get motivated to make a real difference in 2010. Many of us have made a commitment to be more fit this year and that's why I've invited Laura Cozik to be on the show with us. Welcome, Laura.
[Laura Cozik, Fit Nation Trainer:] Thank you so much.
[Cohen:] I am so glad you're here, because I know this year, I made a personal commitment to try to work out more, to be bit a healthier than I have been in the past. But I'll tell you, my biggest obstacles is I have long hours, I come in here early in the morning, I have four children, I have a husband. Where am I going to find the time to work out? And I think that's probably a big challenge for a lot of people.
[Cozik:] It's definitely a big challenge. And people, I think, make the mistake of thinking they have to devote hours and hours of training every week or they have to go to the gym every single day. So, I would say to you, write down on a piece of paper maybe three 20-minute segments of time that you can give to me in the next week. So you pick realistic time for you, whether it's morning, afternoon, evening something that's doable and achievable. Write those down and then commit to them.
[Cohen:] Now, if I swim or run for 20 minutes, does that really do anything?
[Cozik:] Absolutely.
[Cohen:] Really?
[Cozik:] Absolutely, especially if it's new to you. Especially if it's something you haven't done in the past. It's new to your body. It's a challenge to your body. It tricks the body into challenging, trying something it hasn't done before. So, yes, absolutely. And it depends on what you're working. There's no one answer to every question let me just say that. So, there's no one length of time that works the magic number or one activity. It's just being active. So, if someone's just starting out, you can do three 20-minute segments for the first month each week and then grow from there. You can burn a lot of calories in the 20 minutes. It depends how hard you work.
[Cohen:] Right. That's true.
[Cozik:] Yes.
[Cohen:] I guess you should really you should be able to push yourself. Right. We have e-mails from some of our viewers who have questions for you.
[Cozik:] OK.
[Cohen:] Let's see, this one is from Indira in Rockaway, New Jersey. And she says, "I'm 5'4" and 145 pounds. I eat healthy. I use the treadmill 30 minutes twice a week and I also walk in Manhattan for 20 minutes every day, yet I still do not lose any weight." Oh, boy, what can she do?
[Cozik:] Something else.
[Cohen:] Something else. There you go. Right, if it's not working. Right, try something.
[Cozik:] That's the basic answer, yes.
[Cohen:] But she's I mean, she says she eats well. So if she just, for example, added 30 minutes of swimming to her regimen...
[Cozik:] She could do that. Or she could change the workout on the treadmill. If she's walking or jogging on the treadmill at a steady state effort for, whatever it is, for her 30 minutes at a time, probably she should change that up. Steady state is not the best way to go. Interval training is awesome when you have less time. So, I would say to her, do a one-minute hill followed by two minutes of recovery and do that 10 times. Or do a one-minute fast run on the treadmill, followed by two minutes of recovery. Something to change the pace, change the effort, change the heart rate, change the incline on the treadmill.
[Cohen:] So, those little things could help her lose weight.
[Cozik:] Absolutely.
[Cohen:] She doesn't necessarily have to devote more time. All right. Here's another e-mail from a viewer named Brenda in Jupiter, Florida. And she wants to know, "When trying to build muscle mass to firm up, but not bulk up, is it better to use heavier weights and fewer repetitions or lighter weights and more repetitions?"
[Cozik:] This is an age-old question. Really, yes. My answer is always going to be and because it's my philosophy, to work heavier with less repetitions. If you're women are not going to put on bulk unless, you know they're taking some kind of steroid. So...
[Cohen:] Really, you're not recommending, right?
[Cozik:] No, we're not recommending that. No, not at all. But women don't tend to build huge muscles on their body. I have a lot of clients that don't want to lift a weight over five pounds. And I say to them, well, how much does your pocketbook weigh? You know, if your pocketbook weighs about 10 tons but you only willing to workout with a five-pound weight.
[Cohen:] Right.
[Cozik:] Yes. You really do have to challenge yourself. So, my guideline is eight to 12 repetitions to failure. And that's another thing that I think a lot of women, especially, don't do is work to failure.
[Cohen:] What does that mean, to work to failure?
[Cozik:] You see men doing it all the time in the gym where they have someone spot them for their last repetition because they can barely complete the exercise. So, they're hitting their limits. And a lot of women work below their limit. They stop before they're actually exhausted. But we do want to get fit and you have to reach your current limitations and then pass them a little bit in order to get higher on the scale of strength, fitness, cardio.
[Cohen:] That makes sense, I think.
[Cozik:] Yes.
[Cohen:] Well, Laura Cozik, thank you. You've given me a lot of great ideas for starting out the New Year. I really appreciate it.
[Cozik:] Great. Thank you so much.
[Cohen:] Great. And as I mentioned, Laura is the trainer for our Fit Nation program. Five people have committed to running triathlons for the very first time. And Laura's going to be there to help them out. Now, if you want to follow the progress of our Fit Nation folks, you want to go to CNN.comFitNation or Facebook.comCNNFitNation. Now, our economy may be struggling, but that doesn't mean you have to. I'm going to help you get yourself back on track to a healthy life. And we all have too much stress in our lives, myself included. Learn how to relax and take it easy. It can save your life. And perhaps you've been thinking about having plastic surgery this New Year. We have your solution on how to beat the clock. We're in a tough economy. And that might mean cutting back on a trainer or a gym membership. And that's OK. You don't need them to get fit. You just need the basics. Here's Dr. Sanjay Gupta.
[Dr. Sanjay Gupta, Cnn Chief Medical Correspondent:] If it's a fit body you're after, don't worry. Money matters don't have to derail your plans.
[Jennifer Cohen, Author, "no Gym Required":] I really don't believe that the every day average person needs to rely on a personal trainer to kind of motivate them and get them in shape.
[Gupta:] Jennifer Cohen, a fitness trainer by trade, says you don't even need her or even a gym membership. You just need a few basics to get started.
[Cohen:] Using your own body weight is a great way to tone your body.
[Gupta:] And if you have just a little bit of money to spare, she says, invest in some exercise tools.
[Cohen:] A few hand weights, a couple of resistance bands, a medicine ball.
[Gupta:] So, you want to get started today, just remember: start small.
[Cohen:] A squat using a ball on a wall to doing a push-up and then doing a triceps dip and doing that circuit three or four times. You can do increments of 10 minutes in the morning, 10 minutes at night.
[Gupta:] Try to integrate some cardio drills like running in place, make sure to stretch and talk to your doctor before starting any workout. Dr. Sanjay Gupta, CNN, reporting.
[Cohen:] Some of the same strategies that apply to your workouts can also help you save money on food. Keep it simple and look for options that work for you. When it comes to eating, cutting costs doesn't have to mean cutting nutrition. Nutrition is, Julie Schwartz says, just with your finances, a little bit of planning and some smart picks can help stretch your dollars.
[Julie Schwartz, Registered Dietitian, Emory Univ:] It's really shopping wise. It's looking at circulars, what's on sale this week.
[Cohen:] And if it's lean meats you're looking for, you can save some cash by choosing meats in their least process form. Also, try to incorporate lots of fruits and veggies into your diet. Buying in season and at a local farmer's market is often less expensive. And if fresh veggies are still too costly, there's always frozen or canned options. If you can only afford the staples like rice, pasta, or beans?
[Schwartz:] A bag of beans will take you a long way. You know, a bag of rice with that beans, you've got a complete protein. It's filling and it can really help out.
[Cohen:] That is great advice. So, you're on your way to eating right while saving money. You're on your way to getting fit. So now, what about your stress level? Discover how to bust stress through simple tricks that you can do at your own desk. This is HOUSE CALL. We're giving you the tools you need to reach your health goals in 2010. And if your goal is to reduce stress, that's a good one because stress, over the long run, can put you at risk for heart disease, depression, sleep problems, and much more. New York clinical psychologist Jeffrey Gardere is back. And, Jeff, people, I think, sometimes, get a little bit confused between two things. There's chronic stress and there's acute stress. Can you, quickly, give me an example of each one of those?
[Gardere:] Sure. Acute stress is something that happens to you not very often but in a very big way. For example, if you're in a car accident and you survive that car accident, but, of course, that is something that is a major stress on your mind and your body. It's that one-time event, and that's the end of it. And you go through some of the emotions and physical problems with that. Whereas, chronic stress is something that is a constant in your life. You can say that it might be school or it might be work or it might be a marriage, and what we see with the chronic stress is, Elizabeth, over time, we become used to it so we think, but it is slowly, but surely, wearing us down emotionally. It wears us down physically...
[Cohen:] So, what do you about the chronic stress?
[Gardere:] ... where you have what you talked about.
[Cohen:] Right. What do you do about the chronic stress? If you've got a terrible job or a terrible marriage or your mom is chronically ill, I mean, what can you do about that?
[Gardere:] Well, one of the things that sometimes you can't do is get rid of what that's that stressor is. I know some people would like to get rid of a marriage but you can't always do that in this economy. But most often, if we're talking about work or school, that's something that, in fact, is a constant in your life. Really, the key here, Elizabeth, is how you perceive the stress, that stressor, how you accept that stressor, and what your attitude is about it. If you can just what I like to say flip the script and trick the devil and view that stressor in a different way, then your body and your mind will respond in a different, and hopefully, much more positive way.
[Cohen:] Can you think of a time that you've had to do that, Jeff, where you've had something stressful in your life and you've flipped it around? What did you do?
[Gardere:] Well, I remember, from many years when I had an employer before I started a private practice, I was actually very stressed out by the kind of work that I was doing. So, what I ended up doing was changing my attitude. Instead of seeing it as a burden, I was very actually grateful that I had the job, but then I did specific things, Elizabeth. Instead of staying at my desk all day, I would take frequent breaks where I would take a breath, you know, walk around the particular place. So, that was a way of disconnecting from that stress. But most importantly, what I did was that I learned to exercise. And I would do that before I came to work or sometimes after work, and that would be a good way of getting out a lot of the tension.
[Cohen:] Now, sometimes, I think the most stressful things are things about which we have zero control. For example, if you lost your job and you still got to pay your mortgage and you still got to raise your kids, what in the world do you do about that kind of stress?
[Gardere:] Well, what you need to do is, instead of becoming a victim to that stress, you need to become much more empowered so that you can manage that stress. You don't want that stress managing you. So, what I tell people all the time is if you are about to lose your job well, get a Plan A and Plan B together so that you can be the master of your fate, be able to in some ways map out, once again, what your options are so that you are not a victim to that particular situation.
[Cohen:] Hey, you know, Jeff, I think that's a great point. That even when you think you don't have options, you often do. So, thanks, Jeff, for coming here and talking to us about how to get rid of some of the stress in your life. I appreciate it.
[Gardere:] My pleasure. Thank you, Elizabeth.
[Cohen:] Well, have a great New Year's weekend. And now, we want to talk about people, again, being stressed over the economy. But that doesn't seem to be stopping them from getting a little nip and tuck. Next up, experts tell us how to get the biggest bang for your buck based on your age. Is this the year you've decided to finally do a little nip and tuck? Well, if so, we've got a rundown of the most popular procedures and how old you should be when you get them. At every age, the battle to beat the clock is most often fought in the face. You can't fight your genes, the number one factor that dictates aging, but there are things you can do even at age 30 to slow down the aging process. Avoid the sun and use sunscreen, don't smoke, eat a healthy diet, drink a lot of water, and use face creams with antioxidants. But some people want more than that. And a new trend is to start getting anti-aging treatments young. Some plastic surgeons are actually suggesting Botox at 30. Dr. Marc Yune says Botox can keep you from getting wrinkles in the first place.
[Dr. Marc Yune, Facial Plastic Surgeon:] With Botox, we're actually relaxing the muscles of the facial expression to prevent wrinkling.
[Cohen:] Some other procedures plastic surgeons recommend in your 30s...
[Yune:] Some skin treatments such as microdermabrasion and light chemical peels.
[Cohen:] And once some women start, they have a hard time stopping. In their 40s, many women start getting more invasive treatments.
[Yune:] The first sought after procedure in facial work is eyelid surgery. That's because it's the first part that ages on the face noticeably.
[Cohen:] And as women approach their 50s and menopause, the aging process accelerates. So, some women decide it's time for more surgery.
[Yune:] We call one of the most common aging face procedures, upper and lower blepharoplasty, face-lift, lift and smile lines, that's just how the face ages.
[Cohen:] But even plastic surgeons admit there are risks and side affects for all of these procedures, and you don't need any of them.
[Yune:] Nobody needs me. If they come in to see me, it's simply because they want to address something.
[Cohen:] You could just decide to age naturally. Sometimes people think cosmetic procedures are no big deal. That it's almost like going to spa for the day. But doctors tell me, that is not true. As one put it, "We cut you, and you bleed." So, you should be very careful choosing that person who's going to cut you. We have some guidelines now for people when they're trying to choose a surgeon for plastic surgery. First of all, you should ask the question: is your office accredited with the procedure, since most plastic surgery procedures are done actually in doctors' offices not in hospitals. But you still want to ask if the doctor has hospital privileges to do the procedure you're having. If a hospital doesn't trust them enough to do it, you don't want to have that procedure with that person. Also ask: how many procedures have you done? Then go to other doctors and compare numbers. Now, there are a couple of plastic surgery no no's that we'd like to go over. Don't try to have too much work done at one time. Sometimes people try fit a bunch of different procedures in one surgery. That can cause real problems. Also, try not to remain immobile for very long after your surgery. That can lead to blood clots. Also, shop around and find that surgeon who's board certified. That's not a no no, actually, that's a yes-yes. You want to shop around. You want to find someone who is board- certified. Now, if you miss any part of today's show, be sure to check out the podcast on CNN.compodcasting. Remember, this is the place for the answers to all your medical questions. Thanks for watching and Happy New Year. I'm Elizabeth Cohen. More news on CNN starts right now.