“I have GOT to lose weight.”
“I don’t even recognize myself in those photos”
The above is just a couple of the thoughts that have gone through my mind in the last 6 months. Given that the weight loss industry in the United States is estimated to be worth $66 billion, I doubt my above thoughts are very unique. Currently, the CDC estimates that 7 out of 10 people are overweight (BMI>=25) or obese (BMI >=30). The remaining 3 people may have BMIs creeping upwards (I know I do!) and weight is still a concern. I must disclose that I am not a registered dietitian nor am I pretending to be an expert in diet or exercise; I am simply an interested and inquisitive doc!
So let’s ignore the gimmicky infomercials and annoying fads and delve in!
Do I need to eat less?
YES. Portion control is key. Don’t feel bad: everyone struggles with this. The fact that many restaurants serve you double to triple the serving size has only served to confuse your stomachs and brains over the years.
Get in the habit of only eating one plate of food per meal. That’s right — no seconds. If you’re a seconds lover/scrape-the-pan kinda gal, this is your ticket to real and sustained weight loss.
A. Try switching on your favorite television show AFTER a meal. Oftentimes, a 30 minute food free interval is all you need to realize you’re actually full. Do NOT, however, watch TV WHILE eating. Studies have shown that you end up eating more if you eat while watching TV because you’re not paying attention and/or appreciating your food as much as it deserves.
B. Try drinking a big bottle of water during and another after dinner. Our brain can get hunger and thirst confused and sometimes what we perceive as continued hunger is just thirst!
C. Try brushing your teeth after meals to get the taste of food out of your mouth or using mouth wash or floss to get your mind to understand that meal time is over!
Can I keep drinking soda?
Soda needs to go! Or at least be severely limited! As a recovering coke zero addict myself, no one understands your pain more than I. Soda is incredibly high in calories and sugar with no nutritional benefits. What about “diet” sodas? Studies have shown that a diet soda actually increases your hunger and, when coupled with dinner (versus plain water), can actually increase your total caloric intake. More and more studies are showing the harm of artificial sweeteners as well.
The simplest solution? Swap out your soda for sparking water. Don’t like the taste of sparkling water? Just stick with plain water then! Sick of the flavor of plain water: try squeezing or leaving a piece of fruit in your water. Or try adding some texture with chia seeds. You know yourself best, so whatever modification to water you need to make yourself drink it – do it! It’s recommended you drink two liters a day—so start drinking!
Do I have to work out?
YES. Working out is strongly linked to physical fitness and cardiovascular health. The National Weight Control Registry (NWCR) was established in 1994 and is the largest prospective investigation of long term successful weight loss maintenance. This registry is currently tracking the behaviors of over 10,000 people who have successfully lost 30 or more pounds and kept it off for at least a year. It’s the largest registry of its kind, and it’s amazing because it is comprised of people who have not only lost weight— but kept it off! The successful people! 90% of the NWCR participants reported doing approximately 1 hour of physical fitness a day, but interestingly the most common type of exercise was walking! Working out is an important part of a healthy lifestyle and weight loss. So even if it isn’t vigorous- get MOVING!
Do I need to join a program or gym?
While 55% of participants of NWCR (National Weight Control Registry) achieved their weight loss through a structured program, a significant 45% of participants accomplished their goals through no formal program at all. So don’t feel like an expensive gym membership is necessary to reach your weight loss goals. However, studies have shown that having a work-out buddy or being part of a team/community/online program is helpful in reaching your fitness goals!
Should I check my weight regularly?
YES. 75% of NWCR participants weighed in regularly (at least once a week), and most said they would modify their behavior (less intake, more working out, etc) with a new finding of weight gain. The concept of weight loss is generally out of sight, out of mind—and regular weigh-ins help you keep your eye on the prize!
Do I have to change my diet?
YES! 98% of participants of the NWCR reported that they modified their food intake in some way to lose weight. What particular diet did they choose? Here comes the rub: they chose all kinds! Paleo, vegan, ketogenic, you name it, they tried it! But what did their diets have in common? You guessed it— low calories (boo!). What did the fastest growing diets of 2017 (intermittent fasting, vegan, paleo) also have in common in other studies? LOW CALORIES. I myself do not believe all calories are created equal, but it’s hard to argue with the evidence. So there it is: there are likely some people who will reach a reduction in calories through a paleo diet and others who can reach it through intermittent fasting and still others who will reach it through portion reduction. There are many diets and many paths, but the evidence from the majority of studies show that the majority of successful weight losers are restricting their calories in some form or fashion.
Bottom line: There is not a perfect diet for every single person. A diet which works for your friend or sister will likely not work for you! This is probably because weight loss is a rich composition of genetic, physiologic, and psychologic which are hard to generalize across a diverse group of people. So try to make sensible food choices and try to work these into your routine. Focus on your strengths- if you like the way vegetables taste then eat more of them! Because vegetables are generally high in fiber, they give you a full feeling often times without many calories at all! And they help you poop so who doesn’t like that? If you like sweets, try to substitute fruits for rich processed high calorie desserts. Even though it is not seen as a dessert commonly in the United States, in many cultures around the world, fruit is the preferred way to end an evening. Making fruits, veggies, and lean protein the mainstay of your diet is the key!
Can I be good during the week and reward myself on the weekends? “CHEAT DAYS”
The NWCR participants reported that they roughly ate the same on the weekdays and weekends. This is probably because real sustained weight loss has to come from true lifestyle changes, not just cyclic yo-yoing from good days to cheat days. This being said, it’s important to realize you’re human and to not be too hard on yourself—its not sustainable. Try to make small changes that are doable versus stark changes to your current behavior. Instead of salads all week and pizzas all weekend, try to limit to one slice of pizza with a side salad instead!
So in the words of Aristotle: “We are what we repeatedly do. Excellence, then, is not an act but a habit.”
Hope this article helps both you and me develop some good habits!