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Weight control and diet

Description

An in-depth report on losing and managing weight safely for health benefits.

Alternative Names

Dieting; Obesity; Weight loss

Weight Loss and Maintenance

Even modest weight loss can reduce the risk factors for heart disease and diabetes. The simplest (but still difficult) approach to weight loss is reducing calories and exercising at least 150 minutes a week. Behavioral and mental changes in eating habits, physical activity, and attitudes about food and weight are also essential to weight management. For people who are very overweight and cannot lose weight using lifestyle measures, a number of effective weight-loss medications are available. And for those with severe obesity, surgical procedures are proving to be very beneficial.

Some Tips for Losing Weight. The following offer some general suggestions for dieters:

• Start with realistic goals. Diet failure is extremely common and the odds of significant weight loss are low, particularly in people with the highest weights. People who are able to restrict calories, engage in an exercise program, and obtain help in making behavioral changes can expect to lose between 5 -10% of their current body weight--which is generally all that is needed to achieve meaningful health changes. Certainly, the unwholesome and distorted image of a super-thin female shape should not be anyone's goal.
• Maintain a regular exercise program, assuming no precluding health problems. Choose one that is enjoyable. Check with a physician about any health considerations. [See In-Depth Report #29 Exercise .]
• Do not use hunger pangs as cues to eat. A stomach that has been stretched by large meals will continue to signal hunger for large amounts of food until its size reduces over time with smaller meals.
• Be honest about how much you eat and start by recording all calories in writing. Studies suggest that when many people report their own calories intake they significantly underestimate their consumption of high-calorie and over-estimate the low-calorie foods. People who do not carefully note everything they eat tend to take in excessive calories when they believe they are dieting.
• Observe weekend eating. People tend to eat more on the weekends. If it is difficult to monitor all meals during the week, it be may be useful to at least track eating habits during these days.
• Once the pound are lost, strive to maintain the healthier weight. Make daily, even hourly, conscious decisions about eating and exercising activities. Such thinking, in many cases, can become automatic and not painful.
• Don't give up, even after repeated weight loss failure. Most studies indicate that yo-yo dieting or weight cycling has no adverse psychological or physical effects. Repeated dieting also does not impair the body's ability to burn calories efficiently.
• Weight loss, in any case, should not be the only or even the primary goal for people concerned about their health. The success of weight reduction efforts should be evaluated according to improvements in chronic disease risk factors or symptoms and by the adoption of healthy lifestyle habits, not by just the number of pounds lost.

Key Components of a Lifestyle Change Program
Lifestyle	Reduce rate of eating. Keep food records. Eliminate environmental triggers to eating. Identify high-risk situations for overeating. Uncouple eating from other activities.
Exercise	Confront psychological barriers to exercise. Understand mechanisms linking exercise to weight control. Establish reasonable exercise goals. Develop a plan for regular activity. Integrate increased activity into daily lifestyle.
Attitudes	Develop reasonable weight-loss goals. Avoid "all or none" thinking. Focus attention away from the scale and toward behavior. Uncouple weight from self-esteem. Recover from lapses with constructive action (relapse prevention).
Relationships	Understand the key role of social support to health. Identify supportive others. Match personal style to support-seeking activities. Be specific in making support requests. Be assertive but reinforcing in drawing help from others.
Nutrition	Resist the lure of popular fad diets. Develop pro-health rather than restriction mentality about eating. Eat with moderation in mind. Maximize fiber. Develop a tailored plan.
From Brownell KD. The LEARN Program for Weight Control. 7th ed. Dallas, Tex: American Health Publishing Company; 1998.

• Review Date: 3/29/2006
• Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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