Weight Loss For LifeWho should lose weight?Health experts generally agree that adults can benefit from weight loss if they are moderately to severely overweight. Health experts also agree that adults who are overweight and have weight-related medical problems or a family history of such problems can benefit from weight loss. Some weight-related health problems include diabetes, heart disease, high blood pressure, high cholesterol levels, or high blood sugar levels. Even a small weight loss of 10 to 20 pounds can improve your health, for example by lowering your blood pressure and cholesterol levels. You do not need to lose weight if your weight is within the healthy range on the weight-for-height chart, you have gained less than 10 pounds since you reached your adult height, and you are otherwise healthy. How We Lose WeightYour body weight is controlled by the number of calories you eat and the number of calories you use each day. So, to lose weight you need to take in fewer calories than you use. You can do this by becoming more physically active or by eating less. Following a weight-loss program that helps you to become more physically active and decrease the amount of calories that you eat is most likely to lead to successful weight loss. The weight-loss program should also help you keep the weight off by making changes in your physical activity and eating habits that you will be able to follow for the rest of your life. To lose weight and keep it off, you should be aware of the different types of programs available and the important parts of a good program. Knowing this information should help you select or design a weight-loss program that will work for you. The three types of weight-loss programs include: do-it-yourself programs, non-clinical programs, and clinical programs. Do-it-yourself programsAny effort to lose weight by yourself or with a group of like-minded others through support groups, worksite or community-based programs fits in the "do-it-yourself" category. Individuals using a do-it-yourself program rely on their own judgment, group support, and products such as diet books for advice (Note: Not all diet books are reliable sources of weight-loss information). Non-clinical programsThese programs may or may not be commercially operated, such as through a privately-owned, weight-loss chain. They often use books and pamphlets that are prepared by health-care providers. These programs use counselors (who usually are not health-care providers and may or may not have training) to provide services to you. Some programs require participants to use the program's food or supplements.Clinical programsThis type of program may or may not be commercially owned. Services are provided in a health-care setting, such as a hospital, by licensed health professionals, such as physicians, nurses, dietitians, and/or psychologists. In some clinical programs, a health professional works alone; in others, a group of health professionals works together to provide services to patients. Clinical programs may offer you services such as nutrition education, medical care, behavior change therapy, and physical activity. Clinical programs may also use other weight-loss methods, such as very low-calorie diets, prescription weight-loss drugs, and surgery, to treat severely overweight patients. These treatments are described below:
If you are considering a weight-loss program and you have medical problems, or if you are severely overweight, programs run by trained health professionals may be best for you. These professionals are more likely to monitor you for possible side effects of weight loss and to talk to your doctor when necessary. Whether you decide to use the do-it-yourself, non-clinical, or clinical approach, the program should help you lose weight and keep it off by teaching you healthy eating and physical activity habits that you will be able to follow for the rest of your life. DietThe word "diet" probably brings to mind meals of lettuce and cottage cheese. By definition, "diet" refers to what a person eats or drinks during the course of a day. A diet that limits portions to a very small size or that excludes certain foods entirely to promote weight loss may not be effective over the long term. Rather, you are likely to miss certain foods and find it difficult to follow this type of diet for a long time. Instead, it is often helpful to gradually change the types and amounts of food you eat and maintain these changes for the rest of your life. The ideal diet is one that takes into account your likes and dislikes and includes a wide variety of foods with enough calories and nutrients for good health. How much you eat and what you eat play a major role in how much you weigh. So, when planning your diet, you should consider: What calorie level is appropriate? Is the diet you are considering nutritionally balanced? Will the diet be practical and easy to follow? Will you be able to maintain this eating plan for the rest of your life? The following information will help you answer these questions. Calorie levelLow-calorie diets. Most weight-loss diets provide 1,000 to 1,500 calories per day. However, the number of calories that is right for you depends on your weight and activity level. At these calorie levels, diets are referred to as low-calorie diets. Self-help diet books and clinical and non-clinical weight-loss programs often include low-calorie diet plans.The calorie level of your diet should allow for a weight loss of no more than 1 pound per week (after the first week or two when weight loss may be more rapid because of initial water loss). If you can estimate how many calories you eat in a day, you can design a diet plan that will help you lose no more than 1 pound per week. You may need to work with a trained health professional, such as a registered dietitian. Or, you can use a standardized low-calorie diet plan with a fixed calorie level. The selected calorie level, however, may not produce the recommended rate of weight loss, and you may need to eat more or less. Good nutritionMake sure that your diet contains all the essential nutrients for good health. Using the Food Guide Pyramid and the Nutrition Facts Label that is found on most processed food products can help you choose a healthful diet. The Pyramid shows you the kinds and amounts of food that you need each day for good health. The Nutrition Facts Label will help you select foods that meet your daily nutritional needs. A healthful diet should include:
These nutrients should come from a variety of low-calorie, nutrient-rich foods. One way to get variety and with it, an enjoyable and nutritious diet is to choose foods each day from the Food Guide Pyramid (see Figure 2). Types of dietsFixed-menu diet. A fixed-menu diet provides a list of all the foods you will eat. This kind of
diet can be easy to follow because the foods are selected for you. But, you get very few
different food choices which may make the diet boring and hard to follow away from home.
In addition, fixed-menu diets do not teach the food selection skills necessary for keeping
weight off. If you start with a fixed-menu diet, you should switch eventually to a plan that helps
you learn to make meal choices on your own, such as an exchange-type diet.
Exchange-type diet. An exchange-type diet is a meal plan with a set number of servings from each of several food groups. Within each group, foods are about equal in calories and can be interchanged as you wish. For example, the "starch" category could include one slice of bread or 1/2 cup of oatmeal; each is about equal in nutritional value and calories. If your meal plan calls for two starch choices at breakfast, you could choose to eat two slices of bread, or one slice of bread and 1/2 cup of oatmeal. With the exchange-type diet plans, you have more day-to-day variety and you can easily follow the diet away from home. The most important advantage is that exchange-type diet plans teach the food selection skills you need to keep your weight off. Prepackaged-meal diet. These diets require you to buy prepackaged meals. Such meals may help you learn appropriate portion sizes. However, they can be costly. Before beginning this type of program, find out whether you will need to buy the meals and how much the meals cost. You should also find out whether the program will teach you how to select and prepare food, skills that are needed to sustain weight loss. Formula diet. Formula diets are weight-loss plans that replace one or more meals with a liquid formula. Most formula diets are balanced diets containing a mix of protein, carbohydrate, and usually a small amount of fat. Formula diets are usually sold as liquid or a powder to be mixed with liquid. Although formula diets are easy to use and do promote short-term weight loss, most people regain the weight as soon as they stop using the formula. In addition, formula diets do not teach you how to make healthy food choices, a necessary skill for keeping your weight off. Questionable diets. You should avoid any diet that suggests you eat a certain nutrient, food, or combination of foods to promote easy weight loss. Some of these diets may work in the short term because they are low in calories. However, they are often not well balanced and may cause nutrient deficiencies. In addition, they do not teach eating habits that are important for long-term weight management. Flexible diets. Some programs or books suggest monitoring fat only, calories only, or a combination of the two, with the individual making the choice of both the type and amount of food eaten. This flexible type of approach works well for many people, and teaches them how to control what they eat. One drawback of flexible diets is that some don't consider the total diet. For example, programs that monitor fat only often allow people to take in unlimited amounts of excess calories from sugars, and therefore don't lead to weight loss. It is important to choose an eating plan that you can live with. The plan should also teach you how to select and prepare healthy foods, as well as how to maintain your new weight. Remember that many people tend to regain lost weight. Eating a healthful and nutritious diet to maintain your new weight, combined with regular physical activity, helps to prevent weight regain. Physical ActivityRegular physical activity is important to help you lose weight and build an overall healthy lifestyle. Physical activity increases the number of calories your body uses and promotes the loss of body fat instead of muscle and other nonfat tissue. Research shows that people who include physical activity in their weight-loss programs are more likely to keep their weight off than people who only change their diet. In addition to promoting weight control, physical activity improves your strength and flexibility, lowers your risk of heart disease, helps control blood pressure and diabetes, can promote a sense of well-being, and can decrease stress. Any type of physical activity you choose to do vigorous activities such as running or aerobic dancing or moderate-intensity activities such as walking or household work will increase the number of calories your body uses. The key to successful weight control and improved overall health is making physical activity a part of your daily life. For the greatest overall health benefits, experts recommend that you do 20 to 30
minutes of vigorous physical activity (see the following Activities Chart) three or more times a
week and some type of muscle strengthening activity, such as weight resistance, and stretching
at least twice a week. However, if you are unable to do this level of activity, you can
improve your health by performing 30 minutes or more of moderate-intensity physical activity (see
the Activities Chart) over the course of a day, at least five times a week. When including
physical activity in your weight-loss program, you should choose a variety of activities that can be
done regularly and are enjoyable for you. Also, if you have not been physically active, you should
see your doctor before you start, especially if you are older than 40 years of age, very
overweight, or have medical problems. A fact sheet on physical activity and weight control is
available from WIN.
Behavior ChangeBehavior change focuses on learning eating and physical activity behaviors that will help you lose weight and keep it off. The first step is to look at your eating and physical activity habits, thus uncovering behaviors (such as television watching) that lead you to overeat or be inactive. Next you'll need to learn how to change those behaviors. Getting support from others is a good way to help you maintain your new eating and physical activity habits. Changing your eating and physical activity behaviors increases your chances of losing weight and keeping it off. For additional information on behavior change, you may wish to ask a weight-loss counselor or refer to books on this topic, which are available in local libraries. What Works For You?A variety of options exist to help you lose weight and keep it off. The key to successful weight loss is making changes in your eating and physical activity habits that you will be able to maintain for the rest of your life.Additional ReadingFact sheets offering related information from the Weight-control Information Network (WIN) are listed below. Active at Any Size describes the benefits of being physically active no matter what a person's size, and presents a variety of activities that large people can enjoy safely. Choosing a Safe and Successful Weight-loss Program provides a list of things to look for when choosing a safe and effective weight-loss program, as well as a list of questions to ask program providers. Gastrointestinal Surgery for Severe Obesity describes the different types of surgery available to treat severe obesity. It explains how gastrointestinal surgery promotes weight loss and the benefits and risks of each procedure. Just Enough for You describes the difference between a portion the amount of food a person chooses to eat and a measured serving. It offers tips for judging portion sizes and for controlling portions at home and when eating out. Prescription Medications for the Treatment of Obesity presents information on medications that suppress appetite or reduce the body's ability to absorb dietary fat. The types of medications and the risks and benefits of each are described. Walking A Step in the Right Direction offers tips for getting started on a walking program and illustrates warm-up stretching exercises. It also includes a sample walking program. Weight and Waist Measurement explains two simple measures body mass index (BMI) and waist circumference to help people determine if their weight and/or body fat distribution are putting their health at risk. Other ResourcesU.S. Department of Agriculture Center for Nutrition Policy and Promotion. The Food Guide Pyramid. Home and Garden Bulletin No. 252. October 1996. Phone (202) 606-8000. www.usda.gov/cnpp/pyrabklt.pdf. U.S. Food and Drug Administration Center for Food Safety and Applied Nutrition. Guidance on How to Understand and Use the Nutrition Facts Label. June 2000. www.cfsan.fda.gov/~dms/foodlab.html. Blair SN, Dunn AL, Marcus BH, Carpenter RA, Jaret P. Active Living Every Day: 20 Weeks to Lifelong Vitality. Champaign, IL: Human Kinetics; 2001. Available from www.humankinetics.com, or your local or on-line bookstore. |