Practical Advice for Lifelong Weight Loss

| Posted On Jun 21, 2018 | By:

african american woman smiling and holding a scaleThere are plenty of fad diets and products on the market that promise quick and easy weight loss results. I wish that weight loss could be that easy, but with some determination and guidance, it is very possible to achieve your weight loss goals.

It’s so important to maintain a healthy weight, defined as a Body Mass Index (BMI) between 18.5 and 24.9. The most recent statistics from the Centers for Disease Control (CDC) indicate that 70.7% of Americans aged 20 and over are overweight with 38% falling into the obese category. Being overweight or obese comes with many risk factors such as heart disease, stroke, high blood pressure, diabetes, and some forms of cancer. But studies show that losing just 5-10% of your starting body weight can help minimize these risks and put you on the path to better health.

One of the first steps I like to take with my patients is to determine why they became overweight in the first place. I’ve discovered that there are usually several factors including:

Most people fall into more than one category, so coming up with a treatment plan typically involves a number of approaches. It may include an evaluation with a sleep specialist to screen for sleep apnea, a referral to a nutritionist to learn about adequate and appropriate nutrition, and/or a referral to a behavioral health specialist to treat undiagnosed anxiety or depression.

Nutrition

Having a good understanding of proper nutrition is really important for anyone who is trying to lose weight. There are an endless number of “crash” or “fad” diets like the cabbage soup, cookie or cleanse diets, and I tell my patients to avoid them all. It’s impossible to eat that way indefinitely, and as soon as you go off one of those diets, you’ll regain the weight and then some. Also, any diet that severely restricts the number of calories you can eat per day triggers your metabolism to go into starvation mode. Your metabolism slows to accommodate the low caloric intake and that continues even after you stop the diet.

To be successful in weight loss really requires a lifelong lifestyle change, and change takes time. Losing weight can seem overwhelming, but by setting small but specific goals you can achieve success. Focus on making one small change at a time such as eating at least one piece of fruit and one serving of vegetables per day. Once you master that change, set another goal and add that to your routine.

I think it’s important that you find ways to continue to enjoy your favorite foods, just in moderation. Deprivation doesn’t work so I tell my patients, “If you love movie theater popcorn with butter, have a small serving of popcorn, but then go back to your healthy eating habits.” What happens frequently is that people eat something unhealthy and it leads to a circle of negative thinking, “I’ll be fat forever” “It’s just not worth it” “I’m never going to get ahold of this.” The next thing you know, you’re back to eating the way you ate before. The key is to change your mindset. Have that movie theater popcorn and think, “Wow, I really enjoyed that. That was really good.” and then go back to eating healthy meals and snacks. By changing your negative self-talk and giving yourself permission to indulge a little bit, you can still enjoy your favorite foods in moderation but on the whole, eat healthier.

If you are eating out of habit and convenience as opposed to eating truly out of hunger, you’re going to gain weight. Your body will tell you what to do, so listen to its signals and stop eating when you’re full. It’s our lifestyles that override our internal cues of hunger and satiety. This article on mindful eating by nutritionist Marlene O’Donnell has some great suggestions to help you develop a healthier relationship with food.

Another problem I find is that people tend to gain weight with age because they don’t change what they eat. As we age, our metabolisms slow down – that’s normal. With each decade, you require fewer calories to maintain your current weight. When you were 20, maybe you needed 2,000 calories to maintain your weight while at age 50 you may only need 1,400 calories. The number of calories you should consume each day depends on several factors including age, height, current weight, activity levels, and metabolic health. Your primary care provider or a nutritionist can help you determine how many calories you should be eating depending on whether you want to lose weight or maintain your current weight.

Pre-packaged frozen meals can be an effective tool for portion control as long as you’re getting adequate nutrition and eating an appropriate amount of calories each day. While they can help get you started on seeing and experiencing the right portion sizes, most people can’t eat frozen meals forever. You’ll be more successful with long-term weight loss if you use those meals as a supplement to healthy, balanced meals that you prepare yourself. Not certain what foods and ingredients you should shop for? Nutritionist Linda Germaine-Miller spoke with her fellow nutritionists and came up with a wonderful shopping list including several helpful tips and simple meal ideas.

Physical Activity

Physical activity is critical for overall health, well-being, and fitness, but I recommend that my patients think about and choose forms of exercise that they like and that fit their lifestyle. For example, a working mom with two kids under age 10 may not have time to get to a gym, but she could get a used piece of exercise equipment such as a treadmill that she could use at her convenience. One way to get motivated to exercise is to download a series off Netflix and only allow yourself to watch it when you’re exercising.

When you begin an exercise program, pick a goal that is so small that you know you can do it, like getting on the treadmill for five minutes a day. Whatever your goal is, make it something you can actually do and that fits into your lifestyle. It starts by adding some form of physical activity to your daily routine and then building on it.

Exercise can also help suppress appetite and it’s a great way to use your brain and energy. When you’re restless and you feel like diving into a bag of potato chips, go take a 15-minute walk and you probably won’t care about those chips anymore.

While there are so many benefits to exercise, exercise by itself won’t result in weight loss. In order to lose one pound, you have to have a deficit of 3,500 calories in your diet. To put that in perspective, an hour of aerobic walking burns about 300 calories. My patients often tell me that they’re really sweating it out at the gym or they’re jogging for a half hour three days a week and they want to know why they haven’t lost any weight. The reason is that they’re not burning enough calories. Weight loss requires changing your caloric intake along with regular exercise.

Medications

For some of my patients who have tried everything and are still not able to lose weight, I discuss the use of prescription medications that aid in weight loss. These medications have their own side effects that can interfere with some health conditions, so I work very closely with my patients to ensure their safety. The use of prescription medication for weight loss is a very individual and specialized approach that requires close supervision and some trial and error to see what works best.

Each person’s weight loss journey is unique and it’s important to get to the root cause of your weight gain, addressing any underlying medical or mental health issues along the way. If you’re ready to lose weight, consult with your primary care provider to identify a healthy treatment plan that will work for you.

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About Dr. Erica Frank

Dr. Erica Frank joined Atrius Health in 2016 and practices internal medicine at our Harvard Vanguard Needham location. She received her medical degree from Tufts University School of Medicine and completed both her internship and residency at Lahey Clinic in Burlington. She has clinical expertise in medically-based weight management.

Comments

  1. If basic claims in Jason Fung’s (book “The Obesity Code”) are correct then the advice given here is not likely to help people lose weight permanently. What’s missing is the need to change the body weight SET POINT by means of periodic fasting. ( WHEN one eats matters almost as much as WHAT one eats.) Otherwise the body will simply fight its way back to one’s usual weight.
    Exercise is great for the health but even though I
    exercise tremendously it didn’t help me lose the weight I needed to.

    Comment by Daniel Broks on July 19, 2018 at 3:31 pm

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