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Setting Reasonable Goals

Traditionally, weight loss goals were based on reaching an ideal weight, as defined by height-weight charts. More recently, 10% reductions in body weight have been suggested as successful outcomes. There are many factors that support such a change in thinking. Perhaps the most compelling is that many weight-related conditions, such as diabetes and high blood pressure, are significantly improved with weight losses of 5-10%, even if individuals remain considerably overweight. [Please see our article, "The Health Benefits of Modest Weight Loss."] Although the success of a 10% weight loss has been endorsed by expert panels and governmental guidelines, it is unclear whether persons attempting to lose weight agree with this view.

Our Patients’ Perspective

Recently, my colleagues and I at the University of Pennsylvania asked 60 women beginning a weight loss program “What is your goal weight?” We also asked them for a weight that fit the following four descriptions:

Dream Weight: A weight you would choose if you could weigh whatever you wanted.

Happy Weight: This is not as ideal as the dream weight. It is a weight, however, that you would be happy to achieve.

Acceptable Weight: A weight that you would not be particularly happy with, but one that you could accept since it is less than your current weight.

Disappointed Weight: A weight that is less than your current weight, but one that you could not view as successful in any way. You would be disappointed if this were your weight after the program.

We compared our patients’ responses to the new modest weight loss recommendations discussed above. What a difference! Our patients, who weighed an average of 218 pounds, chose an average goal weight of 149 pounds — a 69 pound weight loss! This represented a 32% reduction in body weight, an amount three times greater than the 10% recommendation. Even more surprising was the amount of weight loss that participants felt was necessary for success. A 37 pound weight loss (a 17% reduction) was “disappointing and not successful in any way.” and a 55 pound weight loss (a 25% reduction) was only “acceptable, but not one that I would be happy with.” Given these high expectations, it wasn’t surprising that almost half (47%) of our patients did not even achieve their “Disappointed Weight” after 48 weeks of treatment! The average weight loss that our patients achieved was 35 pounds (a 16% reduction). This study suggests that most people beginning weight loss programs have goals that are unattainable. No treatment, except surgery, produces the weight losses (32% reduction) desired by our study participants.

Consequences of Unrealistic Goals

Unrealistic goals leave many people feeling unsuccessful even after significant weight loss. Rather than feeling proud of their weight loss and developing skills to maintain it, many can only focus on how much more they have to lose. Despite feeling better physically and psychologically, the patients in our study were not satisfied with their weight after treatment. This is an example of a well-known psychological truth: satisfaction with any outcome is determined by the difference between what actually happened and what was expected to happen. Our study found that people’s satisfaction with their weight was more related to how close they came to their goal weight (chosen before the program began) than it was to their actual weight loss. So, people 10 pounds from their goal were more satisfied than those who were 20 pounds from their goal, no matter how much weight they lost. We are concerned that dissatisfaction with weight loss, combined with frustration when unrealistic goals are not achieved, will lead to overly aggressive methods to lose weight, perceived failure, abandonment of weight control efforts, and eventual weight regain.

Snooze and You Might Lose! (Weight)

Can sleeping more help you lose weight? At first, the idea seems counterintuitive. But research shows that sleep deprivation can cause hormonal and metabolic changes that can lead to weight gain. Plus, when you’re feeling sluggish, you’re more likely to crave empty calories like chips or cookies—and less likely to have the energy to hit the gym.

Below, Orfeu Buxton, PhD, an instructor of medicine at Brigham and Women’s Hospital in Boston, and Jana Klauer, MD, a research fellow at the New York Obesity Research Center of St. Luke’s-Roosevelt Hospital, discuss the complex relationship between sleep and body weight.

How can sleeping too little affect body weight?
JANA KLAUER, MD: When we sleep too little, we produce more cortisol, the stress hormone in the body. Cortisol, in turn, causes the release of insulin and higher insulin levels are associated with increased weight because insulin is a hormone that promotes fat storage.

ORFEU BUXTON: Another factor associated with sleep restriction that might lead to increase in weight is increased hunger. It seems as if the body responds to sleep restriction by craving more fuel. Leptin is a molecule secreted by fat cells and conveys a satiety signal that says, “There’s enough fuel on board.” With sleep restriction, even when the level of activity and the amount of calories are constant, the body says, “I need more food.” This is inappropriate and may lead to overeating and potentially to obesity in the long term.

What other effects does sleep restriction have on the body?
ORFEU BUXTON: From sleep restriction experiments it’s clear that, with just a week of sleep loss, sleeping only four hours a night, insulin levels are higher and the ability of blood sugar to be used is dramatically altered. And these changes developed in healthy young adults in just a week of sleep loss. The alterations of blood sugar metabolism are termed “impaired glucose tolerance.” and this is one of the early stages on the way towards full-blown diabetes. Habitual sleep restriction could play a very important role in increasing risk for diabetes later in life, especially if maintained over many years and decades, much like a sedentary lifestyle or poor eating habits. It’s not something that catches up with you in a week or in two weeks, but it’s something that over decades can shorten your life.

How can sleeping too much affect body weight?
ORFEU BUXTON: It’s not clear that sleeping too much has anything to do with increasing body weight. There have been some studies that have associated very long sleep duration (like 10 hours or more) on a regular basis, with obesity or weight gain or even increased mortality. It’s not clear at all that it was the sleep that did that, or if sleep was a symptom of some unknown health problem.

How does sleep loss affect your food choices?
JANA KLAUER, MD: When the body’s rested, you think clearly and you don’t have reduced energy and you’re more apt, under those circumstances, to make wise nutritional choices and to select something that’s healthy for your body. When you’re sleep-deprived, you want to go for an empty calorie energy boost and usually those are carbohydrates that are very low in nutrients and very high in calories.

What is the connection between sleep and exercise?
JANA KLAUER, MD: You might be more tired and you won’t give your workout the intensity that you normally would or maybe you’ll skip your workout. If you’re going to be exercising, you need to rest. When someone switches their sleep pattern to one of increased deep sleep, they wake up renewed. They don’t put off going to the gym; they get out of bed, put on their gym clothes and go out the door and exercise. And exercise will help you to sleep deeper and really get into that deep slow-wave sleep. It is a cycle, and exercise will help them to sleep better that night, so I think each kind of helps the other.

Could poor sleep be another risk factor for obesity?
JANA KLAUER, MD: Sleep is just as important as nutrition and exercise in a healthy diet plan. It’s very important to give yourself adequate sleep. Americans sleep, during the workweek, an average of 6 hours and 54 minutes and, on the weekends, they add about 40 extra minutes per day. So we do go around a little sleep-deprived.

ORFEU BUXTON, MD: Poor sleep or restricted sleep can potentially be seen as a symptom of a stressful or unhealthy lifestyle. Adequate sleep is a sign of a balanced lifestyle along with diet and exercise. It’s been an important recognition that sufficient sleep is important for good health.

The Fat Inside: The Concealed Consequences of Obesity

People who are obese probably already know they’re more likely to develop heart disease and diabetes. But they may not realize they are also heading toward a whole range of gastrointestinal (GI) problems, from acid reflux to fatty liver disease to some GI cancers.

“Having excess body fat means not just having excess fat inside fat tissue, but also having excess fat in organs, particularly the liver.” says Dr. Samuel Klein, director of the Center for Human Nutrition at Washington University in St. Louis. “Having excess fat in the liver causes liver dysfunction and even can lead to serious long-term liver disease. For example, if you’re obese and have diabetes and hypertension, you have about a 75 percent chance of having fatty liver disease.” In fact, fatty liver disease is now the most common cause of abnormal liver tests in the U.S.

Normally, nutrient-rich blood passing from the stomach and intestines through the liver is converted into energy when food is processed. But the metabolism of excess fat, and the subsequent increase in fatty acids, can damage the liver and impair its function. Fat in the liver can lead to non-alcoholic fatty liver disease, which resembles the damage to the liver done by alcohol abuse. It then can progress to cirrhosis of the liver, in which liver cells are replaced by scar tissue. As a result, liver disease due to obesity has become a common cause of liver transplantation in the United States.

Obesity is also a risk factor for gastroesophageal reflux disease, or GERD, which causes chronic heartburn. GERD involves a malfunction in the lower esophageal sphincter, a muscle that acts as valve between the esophagus and stomach. The valve fails to close properly, allowing acid, enzymes and partially digested food in the stomach to slip back up into the esophagus, causing heartburn. Losing weight, especially if people improve their diets in the process, can ease GERD symptoms.

The relationship between weight and gallbladder disease is a more complex one. Gallbladder disease is characterized by the development of gallstones. Gallstones are small masses of solid material —mainly cholesterol in most cases— that form in the gallbladder when it cannot dissolve all of the cholesterol in bile, or when the gallbladder is not emptying properly.

“People who are obese, particularly obese women, have a much higher risk of gallstones than non-obese women.” Klein says. “But losing weight initially increases your risk of having gallstones because weight loss itself changes the composition of bile.” However, gradually losing weight, and then keeping it off, can help lower the risk of developing gallstones.

While obese people are not more likely to get pancreatitis, or inflammation of the pancreas, they are more likely to have a severe form of it. “The reason for that is unknown.” Klein says. “It might be due to excess fat around the pancreas that gets digested by leaky pancreatic enzyme releasing fatty acids and toxic products around the pancreas.” In addition, obese patients with gallstone disease are at risk of developing gallstone pancreatitis. This is thought to result from a temporary blockage of the pancreatic duct as small gallstones pass from the gallbladder into the small intestine.

Obese people may also have a higher risk of colon and rectal cancers than leaner people do, for reasons that are not yet clear. The same is true when it comes to liver cancer, which can arise from cirrhosis related to fatty liver disease.

“I think it’s important to recognize that, in addition to the diseases we associate with obesity—diabetes, hypertension and heart disease—being overweight can also increase risk of GI disease.” Klein says. “These diseases need to be on the radar screen.”

To Keep the Weight Off, Try an Honest Scale

If you are trying to lose some weight and keep it off, stepping on a scale every day may help more than hurt, say researchers.

Although it may not be pleasant to see where that bag of potato chips wound up, a new study found that weighing yourself every day may help you keep minor fluctuations under control. In addition, meeting with a weight-loss counselor, either in person or on the Internet, may help to motivate you to keep the weight off.

“The years immediately following weight loss poses the greatest risk for weight regain.” said Dr. Rena Wing, study author and director of the weight control center at Brown University, “Thus, a major problem is the treatment of obesity is prevention of [gaining back the weight].”

For the study, which was presented at an obesity conference, 291 people who had lost at least 10 percent of their body weight in the last two years were counseled on diet and exercise and divided into three groups.

Two of the groups met either online or in-person with a weight-loss counselor every week for four weeks and then monthly for a total of one-and-a-half years. All of the participants had to submit weekly weight reports and were notified if they had gained five pounds or more. The third group only received monthly newsletters on weight loss.

At the end of the study, the researchers found that 46 percent of participants who had in-person counseling and 55 percent of the participants who had counseling via the Internet had regained at least five pounds. Those who went without counseling fared worse—nearly three-fourths regained a significant amount of weight.

While the power of weight-loss counseling has been known for some time, Dr. Gary Foster, clinical director of the weight and eating disorders program at the University of Pennsylvania, was surprised by how well online support groups worked. “If you can do that well with the Internet, it makes counseling so much more available.” he said.

Wing also found that there was a strong connection between the regular use of a scale and the ability to keep off the lost pounds. In fact, 61 percent of the patients who weighed themselves once a day were able to keep their weight off, while only 32 percent of the less-frequent scale-steppers were able to.

“The scale gives you feedback and allows you to reverse small weight gains before they become big weight gains.” said Foster.

Other means for monitoring weight gain, like trying on a pair of jeans, tend to be more subjective. A person can make excuses, claiming that the jeans were stiff from the wash or that they shrunk, said Foster.

But a scale is undisputable, said Foster. “It is a reality check.”

Face It - Your Kid is Overweight

If your child were overweight, you’d realize, right? Maybe not. A new study reveals that mothers frequently believe their children are at a healthy weight when they aren’t.

Since moms tend to have a large influence over what her kids eat and how much they exercise, the idea that many of them do not recognize that a child has a weight problem reveals a startling discrepancy between perception and reality.

“It is concerning that many mothers did not perceive their overweight children as being overweight,” says Dr. Elena Fuentes-Afflick, study author and associate professor of pediatrics at University of California, San Francisco.

Fuentes-Afflick and colleagues looked at interviews with 194 Latina mothers and their children who were all enrolled in the Latino Health Project. Almost 44 percent of the children in the study were overweight by the time they were three years old.

However, those moms who claimed that their children were in good to excellent health were more likely to have children who fell into the obese group. “A significant number of women believed that their children were normal weight when they were, in fact, overweight,” says Fuentes-Afflick. Indeed, those mothers who thought they were overweight themselves were more likely to have overweight children but have no concerns about their overall health.

In a time when obesity rates are soaring among American adults and children alike, it seems ever more important that parents recognize their children’s unhealthy habits and do what they can to change them. Even though this study only included Latina women, Fuentes-Afflick sees these results as having implications across the Unites States.

“It’s not just Latina parents,” she says. “I believe this is not an ethnic-specific problem.”

Fuentes-Afflick encourages all parents to explicitly ask about their child’s weight at their next pediatrician’s appointment. And if your doctor asks about your child’s habits, be honest. Ask your doctor what he or she would recommend to help your child grow into a healthy adult.

Shrinking Growing Problems
Picture a chubby baby sitting next to a leaner one. Which do you think is cuter? For many mothers, weight implies that their baby is healthy and doing well. That’s OK to a degree for infants, says Fuentes-Afflick, but parents have to learn how to adjust this view as their children get older.

Overweight children seem more likely to become overweight adults if they don’t learn how to control their weight at a very early age. A recent study showed that British children who are obese at the age of 11 are much more likely to remain obese into adulthood than those who have their weight in control at this age. Because of their chronic obesity, these children are at much higher risk for obesity-related diseases, like heart disease and diabetes, later in life.

However, pediatricians often struggle with how to make parents understand the severity of being overweight as a child.

“We have a lot of stigmas around being heavy, and parents don’t want their child to fall into that category,” says Fuentes-Afflick. “It often takes several visits to the pediatrician, communicating the same message, before parents understand that overweight is an important issue for children.”

Additionally, since pediatricians need to consider a child’s weight in light of the fact that they are growing and developing, the lifestyle changes that they may suggest aren’t always easy for parents to implement.

“For kids to lose weight, we need to promote broad-based healthy living,” says Fuentes-Afflick. That means cutting out the juice, soda and fast food and creating family-wide changes like shutting off the television, limiting video game time and getting everyone outside for a walk.

Men Want Steak - Women Want Cake

What’s your ultimate comfort food? A huge ice cream sundae dripping with hot fudge or a juicy, tender T-bone steak?

A new study, published in Physiology and Behavior, confirms the old stereotype: women tend to comfort themselves with sweet-tasting foods when they are feeling down. But it also reveals that men prefer meat as their comfort food. And unlike women, they eat mostly when they are feeling at their best.

“In the past, comfort food was considered primarily as a strategy to alleviate stress, sadness and other negative emotions.” said Dr. Jordan LeBel, associate professor at Cornell University’s School of Hotel Administration. “Ensuring emotional well-being is still the goal, but pleasure and positive emotions can also determine food choice, especially in men.”

What’s your ultimate comfort food? A huge ice cream sundae dripping with hot fudge or a juicy, tender T-bone steak?

A new study, published in Physiology and Behavior, confirms the old stereotype: women tend to comfort themselves with sweet-tasting foods when they are feeling down. But it also reveals that men prefer meat as their comfort food. And unlike women, they eat mostly when they are feeling at their best.

“In the past, comfort food was considered primarily as a strategy to alleviate stress, sadness and other negative emotions.” said Dr. Jordan LeBel, associate professor at Cornell University’s School of Hotel Administration. “Ensuring emotional well-being is still the goal, but pleasure and positive emotions can also determine food choice, especially in men.”

The Right Breakfast Keeps The Weight Down

It seems that your mother was right when she reminded you that “breakfast is the most important meal of the day”—at least when maintaining a healthy weight is on the agenda.

A breakfast that includes a bowl of cereal seems to help girls stay leaner than those who eat other foods for breakfast or skip the meal altogether, say researchers in a study published in the September 2005 issue of the Journal of the American Dietetic Association.

As part of the study, researchers recruited over 2,300 girls between the ages of 9 and 10 and tracked their breakfast patterns during various three days intervals until the girls were 19 years of age. Those who ate cereal at least three mornings a week had a body mass index (BMI) of 25 or lower, within the normal range for their weight and height. However, girls who never ate cereal had an average BMI of 27, a range considered overweight by experts.

The rate of being overweight was even higher for those who skipped breakfast.

“When you have something for breakfast, you’re not going to be starving by lunch.” explained study author Dr. Bruce Barton, president of the Maryland Medical Research Institute in Baltimore.

But before you grab the box of frosted flakes, however, it’s important to realize that cereal consumption itself may not be the key to a lower weight; it may simply be an indication of a person who makes healthier lifestyle choices in general. Those who eat cereal with breakfast, for example, have been shown to consume less fat and cholesterol.

“Some of the girls who didn’t eat cereal, would just raid the fridge in the morning.” said Barton. “One had a breakfast of hot dogs and chocolate milk.”

While skipping breakfast can cause you to be extra hungry for your next meal, cereal seems to have a bigger impact on a healthy weight than other breakfast choices, according to researchers, because many cereals are high in fiber and low in fat. Breakfasts that did not include cereal, contained 60 percent more fat on average than those that included a bowl of cereal.

“Cereal is not very high in calories, but it tends to be absorbed more slowly by the body, keeping you satisfied longer than, say, a bagel.” said Barton.

Barton also suspects that the milk used along with the cereal helps, too. Previous studies have shown that the calcium in milk helps the body regulate fat better.

So, while starting the morning with a whole-grain cereal may be helpful in keeping your weight down, avoiding the donuts and cold pizza for breakfast certainly helps, too.

Five Ways to Feel Full and Eat Less

It’s a common complaint: how can you lose weight if you’re hungry all the time? The solution may be easier than you think. Many acts of overeating, in fact, may have less to do with appetite than the sheer amount of food we have on our plate, says Dr. Barbara Rolls, a nutrition expert at Penn State University and author of The Volumetrics Eating Plan.

If we “super-size” our meals, it only stands to reason we would want to get our money’s worth by cleaning our plates. But this is not how our bodies are meant to work. “Big meals override the cues that tell us we are full and should stop eating.” says Rolls, who has seen this time and time again in various studies. “It’s quite strange.”

Food packaging and commercials may suggest cravings that are not really there; plus there’s depression, anxiety and other outside influences that cause us to eat when we’re not really hungry. Of course, a healthy appetite can make it hard to lose weight, especially if your stomach is grumbling because you’ve cut back on calories to shed a few pounds.

So rather than just eating less, Rolls and others say, there are ways to feel full without giving up all that much. For hunger pains that don’t go away—real or imagined—here’s what the latest studies suggest:

Super-size filling foods
Fruits and vegetables contain a lot of water and fiber, which can quickly fill you up. Better yet, they are low in calories. Ross suggests super-sizing these foods much like you would fast food. “Rather than cutting back, just eat more fruits and vegetables instead.” she says.

Try a variety to a keep your diet interesting. Corn or strawberries may prove more appealing than Brussels sprouts or grapefruit for some, so don’t give up on all of these foods if you don’t care for a few.

Eat your protein
A high-protein, low-carb diet is believed to be unhealthy over the long term, but the latest diet craze has helped reveal a little-appreciated detail: protein-rich foods are possibly more filling. In a recent study, Dr. David Weigle of the University of Washington School of Medicine followed 19 people who kept to a 2,000-calorie diet for several months.

At first, they got 15 percent of calories from protein. Then they upped their protein to 30 percent. The men and women ate the same percentage of carbohydrates throughout, while cutting back on fats. Compared to the weeks they ate less protein, volunteers reported feeling more full when they ate 30 percent of their calories from protein. They also lost more weight.

No one has studied whether a juicy steak is more filling than fruits and vegetables, at least calorie by calorie, says Rolls. But as long as the protein is lean, she says that including such foods in your diet may help you eat less and lose weight.

Limit fatty foods, can the soda
Cakes and other fatty foods pack a lot of calories without adding much substance. A recent study on mice found that high-fat diets seem to override a hormone that tells the body when it’s full. Foods laden with sugar and fat may taste good, but they do little to fill you up.

Indeed, researchers at Tufts University found that nearly two-thirds of adults got more calories from soft drinks than any other specific food. As a whole, they were also more obese than those who stuck to fruit juice and low-fat milk.

Snack “smart”
A little snacking may not only keep your hunger in-check between meals, but may also leave you less tempted to overeat at dinner. Indeed, some research suggests that snacking throughout the day instead of sitting down for regular meals may lead to greater weight loss.

Keep in mind that this does not apply to what we think of as traditional snacks, such as cookies or chips. Nibbling on nuts or cheese, which are high in protein, may leave you fuller than snacking on foods that are high in carbohydrates or calories. To make sure snacking doesn’t become just another big meal, try picking out different foods that are low in calories and keep them handy for when hunger strikes.

Eat until you’re hara hachi bu
Translated from Japanese, this literally means “eat until you’re 80 percent full.” Residents of the Japanese island of Okinawa, who are among the oldest and healthiest people on the planet, have perfected this practice over the years.

In general, Okinawans eat 10 percent to 40 percent fewer calories than Americans. Try eating until you feel mostly full, then wait 20 minutes. Research suggests that many people are satisfied after following the 80 percent rule, even though they eat less.

Why We Over Eat

Fructose, the sugar found in fruit, honey and many common sweeteners, may be one cause of the rising obesity rates in the United States.

In animal studies, researchers from the University of Florida have found that fructose tricks your brain into thinking that you are hungrier than you truly are, causing you to eat more to feel satiated. The researchers of the study, published in Nature Clinical Practice: Nephrology, attempt to explain the pathway that fructose takes to make you hungry. In the future, this finding may offer scientists a new way to help people counter weight problems.

“There may be more than just the common concept that the reason a person gets fat is because they eat too many calories.” said Dr. Richard Johnson, the lead author of the study and professor of nephrology at the University of Florida’s College of Medicine.

Following the Fructose Link
While there is no doubt that overeating high-fat, high-calorie foods and forgoing exercise is a major cause of obesity, Johnson’s team tested fructose consumption in animals, hoping to see if this sugar is an underlying cause of metabolic syndrome, a condition that is linked to type 2 diabetes and obesity.

With the introduction of high fructose corn syrup to soft drinks, jellies, ketchup and other commonly used products, fructose consumption has risen more than 30 percent since the 1970s. During this period, the rate of metabolic syndrome and obesity has doubled in the United States, according to Johnson.

To study the link between fructose, metabolic syndrome and obesity, Johnson and his colleagues fed rats a high-fructose diet for 10 weeks. When compared to rats fed a normal diet, the test group had not only gained weight, but there were higher levels of uric acid in their bloodstream, as well as signs of metabolic syndrome.

Johnson said that high levels of uric acid block the action of insulin, a hormone responsible for the proper use and storage of sugar. And without the adequate amount of sugar going to the cells that need it most, the brain thinks that it needs more food to function properly, sending signals to the body to eat more.

“If you feed fructose to animals, they rapidly become obese, with all the features of metabolic syndrome.” said Johnson. “And a high-fructose intake has been shown to induce certain features of the metabolic syndrome pretty rapidly in people.”

But when the researchers blocked or removed the uric acid in the fructose-fed rats, the symptoms of metabolic syndrome were almost completely reversed. “We were able to significantly reduce weight gain.” said Johnson. “The insulin resistance was less, and the blood pressure fell.”

Other studies have provided some evidence that uric acid is a factor in human metabolic syndrome, too, but Johnson cautions that human bodies may not respond to fructose in the same way as rats. He is now beginning a series of studies on humans to determine if fructose plays the same role in weight gain and metabolic syndrome.

“We cannot definitively state that fructose is driving the obesity epidemic.” he said. “But we can say that there is evidence supporting the possibility that it would have a contributory role, if not a major role.”

Selecting a Weight Loss Program

The New Year comes with resolutions of weight loss. Each year, Americans spend over $30 billion in the weight loss industry. There are hundreds of diet books and programs on the market, and they each seem to have a different twist: low fat, high carbohydrate; high fat, low carbohydrate; high protein; liquid supplements; food combining; eat for your blood type; and many others. Finding a program that is safe, realistic and effective long term is quite a confusing task.

We have all heard the statistics: 95% of people who lose weight subsequently regain it. This is because the majority of the diets are fad diets that promise quick easy results, but unfortunately end up in weight gain. Most programs do not focus on changing behaviors. Therefore once you go “off” the diet, the weight is regained. Most of the diets are also not realistic or even safe to follow on a long-term basis.

As a registered dietitian in private practice, I am frequently asked which is the “best diet” to follow. Before you continue onward to read my suggestions, I would recommend that you ask yourself two questions to assess your readiness to begin any weight control program:

1. Is this a good time for me to start a program? If you are under heavy stress or a hectic travel schedule, etc., you may want to postpone your efforts until the timing is better. You want to be able to give this effort 100%, as changing behaviors is a difficult task.

2. Are you self-motivated to lose weight or are you being pressured to lose weight by a spouse or health professional? You are most likely to be successful in losing weight if you are trying to lose weight for yourself–not to please others.

Once you have determined that you are ready to begin a weight loss program, use the following recommendations to help select a safe, effective program that will hopefully result in permanent weight control.

Look for a diet program that promotes a safe and realistic weight loss of 1 — 2 pounds a week. Many people are still looking for the “quick fix” and gravitate towards diets that promise the most rapid weight loss. However the old saying holds true: the quicker the weight comes off, the quicker it goes back on. Loss of over three pounds a week (or over 1 — 2 pounds for a smaller person) will consist mainly of water loss. Once you return to your normal diet, the weight will return as well. Slow and gradual weight loss is not as appealing as the rapid loss promoted in many of the fad diets, but it is more effective. I would recommend that you steer clear of those diets promoting quick weight loss.

Look for a diet that is not too restrictive in calories. The hazards of a diet too low in calories include:
1. Slowing of the body’s metabolism so that you actually burn less calories, making weight loss very difficult. I have witnessed this phenomenon many times with some of my clients who have put themselves on very restrictive diets. They are unable to lose weight even though they are consuming only 900 calories per day. Once the calories are slowly increased, the metabolism will start to speed up, making weight loss possible.
2. Deprivation from a restrictive diet often leads to bingeing.
3. Muscle will be used for fuel when the calories are too low. Muscle is an active tissue that burns calories. As you lose muscle, your metabolism will slow down.

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