Kaela Pittman

FSCN 3612
October 22, 2013

Nutrition Make Over Ben Zweiban

Ben Zweiban is a sophomore at the University of Minnesota Twin Cities. He moved to
Minnesota before his freshman year of college, leaving his family in West Palm Beach, Florida.
Throughout Bens whole life he struggled with being slightly overweight. Growing up, Ben lived
with his father who owned a chain of sandwich shops in Florida, called Jon Smith Subs, which
uses high quality ingredients and full flavors to draw in customers. At an early age Ben learned
that fat gave his favorite foods the flavors he loved. Because his mother moved out when Ben
was a child, Bens father would bring home takeout after work most nights of the week because
it was more convenient in his busy life than having to cook a full meal after a long day at work.
When Ben came to college he fell into many unhealthy behaviors including, over consuming
high fat, unhealthy foods, drinking many empty calorie beverages and going long periods of time
without eating. Ben does, however, enjoy a variety of vegetables, took time to cook meals at
home when he could and consumed a daily vitamin to get his basic nutrients. After a year in
college, Ben realized he was gaining a lot of unwanted weight and started to feel depressed, had
very little energy and stopped going out to do the active things he used to love, like playing
racquetball and Frisbee. He weighed 250 pounds and had a BMI of about 34 (which would
classify him as obese). Coming into sophomore year Ben was determined to lose weight so that
he could feel comfortable in his own body again.
During the first week of sophomore year (Fall 2013) Ben and I sat down to have a serious
talk about his eating behaviors and overall lifestyle and Ben agreed to be part of my Nutrition
Make-Over project. During this first meeting I listened to Bens concerns and practiced
motivational interviewing skills to carry out the discussion. Motivational interviewing is a form

of therapy that enhances intrinsic motivation and promotes confidence in peoples ability to
make behavior changes toward good health and has been shown to be effective with those who
desire to lose weight (Walpole). With each concern we came up with a plan to change that
specific food behavior. First of all, we noticed that Ben had to get on a normal eating schedule.
Ben works overnight multiple times a week which threw off his normal sleeping cycle and then
he would go almost a full day without eating, skipping breakfast and lunch, and having a snack
and one large meal at night. I explained to him that having a regular meal schedule maintains his
blood sugar so that he would not get irritable and run out of energy early in the day. Also that
eating breakfast is very important for maintaining his metabolism, keeping insulin receptive to
glucose in his diet and decreasing lipids in his blood (Farshchi). I also explained that and that
skipping breakfast has actually been linked to gaining weight because it is harder to control
hunger later in the day and that he would most likely end up eating more, which he was very
surprised about (Van Der Heijden)! We came up with a initial plan for him to commit to eating
breakfast at a regular time (about 8:30 am) either before he went to class or after getting off of
his overnight shift. Because Ben never felt like he was never really hungry for breakfast, most
likely because he felt sick from eating so much for a late dinner the night before, we had him try
making a simple milk and protein powder shake quickly before he went off to class.
The next concern about Bens diet that we talked about was his obsession with full fat
and sugar foods. Growing up in his fathers sub shop, Ben learned to pick out and appreciate the
taste of high quality ingredients and full fat and sugar recipes. It is very hard for him to choose
healthier options when he enjoyed the taste of these products so much. When trying to help him
understand why a diet too heavy fat in is not healthy, I explained that fat is a very concentrated
form of energy, what happens to fat after it is digested and absorbed and how eating more fat

than he needs will result in greater adipose tissue storage and therefore more weight gain and
also affects his blood lipid level, insulin sensitivity and cholesterol (Flatt). While stressing that
fat is still a important and essential nutrient, Ben and I came up with a few exchanges he could
make in his diet to lower fat and calories including drinking skim milk instead of 2% milk, using
low fat dressings instead of blue cheese dressing, choosing lean meats, and comparing food
labels to choose products with lower amounts of saturated and trans fat. Ben also had many
sources of added sugar in his diet and consumed sugar-sweetened sodas too frequently; there was
absolutely no way Ben would consider calorie and sugar free sodas because he was disgusted by
their taste compared to a nice, sweet, full sugar soda. After talking about Bens enjoyment of
soda, I explained that sodas were empty calorie products and did not deliver any essential
nutrients but an abundance of calories. We discussed the topic of nutrient density and I pointed
out the difference between many nutrient dense foods and empty calorie products. We also
discussed how liquid calories are absorbed very quickly in your body and that they delay satiety
signals from getting to the brain, where the appetite is controlled, and although they fill him with
energy, he would remain hungry and end up eating more (Almiron-Roig). As an action plan for
this food behavior, we discussed him using soda as a treat a few times a week instead of a
constant daily indulgence. We also found one no calorie, sugar free, carbonated beverage he
ended up liking for an option to drink! With these exchanges and changes, Ben had a more
balanced diet and initiated healthier behaviors in relation to food.
After a month and a half (about half way through the fall semester of Bens sophomore
year) Ben has lost about 20 pounds, has a BMI of 31, is playing racquetball 2-3 times a week, is
going out to parties and events more frequently and feels much better about his health and his
body. Ben has gotten in the habit of drinking a protein shake for breakfast and started adding

other components to his shake to increase the nutrient density. He also started taking regular
snacks with him to his full days of classes and has started planning his meals in advance. Ben has
also gotten used to many of the low fat and low sugar options to limit calorie intake. Recently,
however, he has become very restrictive with what he eats and has started listening to the media
for nutrition advice and is trying to pick up a low carbohydrate, high protein diet. While this may
be better than Bens previous diet, I believe more stress is needed on the idea that all foods can
fit into a balanced diet and the basics of the Dietary Guidelines and MyPlate should be
introduced to make sure he has a healthy diet. Throughout the rest of the semester Ben remains
determined to achieve a healthy weight and hopes to stay on track to be 200 pounds by the end of
the school year before he goes home to visit his family after spring semester in May 2014.

References
Almiron-Roig, E. "Liquid Calories and the Failure of Satiety: How Good Is the Evidence?"
Obesity Reviews 4.4 (2003): n. pag. Onlinelibrary.wiley.com. 5 Nov. 2003. Web. 22 Oct.
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Farshchi, H. R., M. A. Taylor, and I. A. Macdonald. "Regular Meal Frequency Creates More
Appropriate Insulin Sensitivity and Lipid Profiles Compared with Irregular Meal
Frequency in Healthy Lean Women." European Journal of Clinical Nutrition 58.7
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<www.nature.com.ezp3.lib.umn.edu/ejcn/journal/v58/n7/full/1601935a.html>.
Flatt, Jean-Pierre. "Use and Storage of Carbohydrate and Fat." The American Journal of CLinical
Nutrition (1995): 952S-59S. Print.
Van Der Heijden, Amber A.W.A., Frank B. Hu, Eric B. Rimm, and Rob M. Van Dam. "A
Prospective Study of Breakfast Consumption and Weight Gain among U.S. Men**."
Obesity 15.10 (2007): 2463-469. Onlinelibrary.wiley.com. 6 Sept. 2012. Web. 22 Oct.
2013. <http://onlinelibrary.wiley.com/doi/10.1038/oby.2007.292/full>.
Walpole, Beverly. "Motivational Interviewing as an Intervention to Increase Adolescent Selfefficacy and Promote Weight Loss: Methodology and Design." BMC Public Health 11
(2011): n. pag. Biomedcentral.com. 11 June 2011. Web. 22 Oct. 2013