We pop that last holiday cookie into our mouths and tell ourselves, “Last one!”

We may go overboard, exercising too hard, too fast and never allowing ourselves anything “off the diet.”

Then, inevitably, our resolve melts as the stresses of life send us back to the couch and the cookie jar.

How do you start a safe, effective eating and exercise program you can stick with? How can you keep your body healthy as part of a regular routine that — face it — may involve a cookie or two down the road?

Dr. Samuel Blackwell of Peak Nutrition and Weight Loss Center in Apex agreed to provide a few answers. As a board certified doctor of bariatrics, he’s been medically supervising patients, with the help of a staff dietician, at Peak Nutrition since opening it in 2007.

Q. Tell us about your educational background and interest in bariatrics:

A. I have an undergraduate degree in zoology at Duke University and medical degree at the University of Florida College of Medicine. I had my residency in Family Medicine at Duke University. I’m a member of the American Society of Bariatric Physicians, the American Board of Bariatric Medicine, and am board-certified in family practice.

Throughout my professional career in family medicine, I have tried to stress with my patients the importance of maintaining a healthy body weight. However, I would often feel inadequate to assist them with the challenges overweight and obese people face. A few years ago, I decided to pursue greater expertise in this field of endeavor called bariatric medicine, which has culminated in Peak Nutrition and Weight Loss Clinic being established.

Q. What are some of the biggest myths about weight loss?

A. Perhaps the biggest myth about weight loss is to tell people who are overweight or obese, “You’re fat because you eat too much, so simply eat less and you'll lose weight.” In fact, obesity is a chronic disease with many contributing factors, including genetics, biological, psychological and cultural-social components.

A long-term, effective weight loss program must address all these issues.

Another common myth regarding weight loss is that reaching modest weight loss goals doesn’t matter. Indeed, significant improvements in one’s risk of developing certain chronic diseases, such as diabetes and hypertension, as well as increased longevity are achieved with 10 percent weight loss.

Q. What’s most important in keeping a healthy weight?

A. The two most important components in maintaining a healthy weight are proper nutrition (both in terms of quality and quantity of food) and exercise. Our busy lifestyles often cause us to neglect these fundamentals, but developing healthy habits helps to ensure keeping a healthy weight!

Q. What do you think of diet fads? Are there any with scientific veracity, like eating low-carb, etc.?

A. Diet fads generally should be avoided. Some diet fads can potentially be harmful, and they are often ineffective in maintaining long-term weight loss. A person may lose a lot of weight on some extreme diet, but ultimately we must learn to eat the healthiest foods in the proper amounts. Sound nutritional and medical guidance are more likely to result in safe and sustainable weight loss.

Q. Do you have an influx of patients at New Year’s, hoping to stick with a resolution to lose weight and get fit?

A. Many patients choose to come to our weight loss clinic at the beginning of the new year with a personal commitment to lose weight and better their health. We applaud them and do everything we can to channel this enthusiasm into long term success.

Q. How do you know if you’re obese?

A. Obesity refers to an excess of total body fat, which can be assessed by a variety of techniques. The most common technique used is Body Mass Index (BMI), which provides a range from underweight to morbidly obese based on one’s weight and height. Obesity is defined as a BMI of 30 or greater. This measurement takes into account the fact that an acceptable weight for an individual will vary based on how tall or short they are. Two other useful techniques to assess obesity are waist circumference (greater than 35 inches in women and greater than 40 inches in men may suggest a weight problem) and body fat percentage (greater than 25 percent in men and greater than 33 percent in women). As a bariatrician, I utilize all these techniques in evaluating my patients’ weight loss goals.

Q. If you are obese, what are the general guidelines to shed pounds safely and effectively?

A. A reasonable preliminary goal would be to decrease one’s body weight by 10 percent from their baseline. When this goal is achieved (usually within three to six months), further weight loss can then be attempted if indicated. This generally occurs with one to two pounds per week weight loss utilizing a nutritionally balanced, moderate caloric deficit program. We also offer the OPTIFAST full meal replacement program, which can result in 40- to 50-pound weight loss in 12 weeks (1 to 2 percent body weight loss per week on average). When appropriate, appetite suppressant medication can be a helpful tool while patients are working toward their weight loss goals. Regular visits with the physician are included to ensure the patient’s safety during the entire process.

Q. Is there such thing as being a healthy, overweight person?

A. Technically, the definition of “overweight” is defined as a BMI between 25 and 29.9 (remember obesity is 30 or greater). One-third of Americans are overweight and another one third are obese. We clearly have an epidemic on our hands. The risk of developing certain health problems, including respiratory problems, some cancers, sleep apnea, diabetes, cardiovascular disease and depression increases with a BMI greater than 25. Although “healthy” may be a relative term, people should make every possible effort to keep their weight (and their BMI) within the normal range.

Q. Do you think that surgical intervention is being abused?

A. For the appropriate patient, bariatric surgery may be a very acceptable choice. Patients with a BMI of 40 or greater certainly may benefit from this procedure. Surgery does have complications associated with it, however, and should not be viewed as the “quick fix.” Hopefully most patients can address their weight problem before an operation appears to be the only solution left.

Q. How do you personally keep a healthy weight?

A. I stay active with frequent walking, and I eat moderate portions of (usually) healthy foods spaced throughout the day. I am also fortunate that my genetic predisposition does not tend toward obesity. Being aware of what constitutes good versus bad choices nutritionally often helps.

Peak Nutrition is located at 1111 Pemberton Hill Road, Suite 103 in Apex. To find out more, call 589-0990 or visit peaknutritionandweightloss.com.