Weight loss

VOL 115 / NO 4 / APRIL 2004 / POSTGRADUATE MEDICINE

Download this Patient Note in PDF format (62K file)

Whether you are carrying extra pounds because overweight runs in your family or because you have learned unhealthful eating and exercise habits, it's difficult to lose weight and maintain the weight loss in our high-stress, fast-food culture. More than 60% of US adults are overweight or obese and are therefore at risk for heart disease, high blood pressure, arthritis, high cholesterol levels, diabetes, psychological problems, and certain types of cancer.

Is it possible to lose weight and keep it off?
It is possible to lose weight by eating a more well-balanced, lower-calorie diet and exercising regularly. But even if you don't lose as many pounds as you'd like, it's important to remember that you are improving your health. To maintain your new weight, you'll have to continue to exercise and not overeat.

What is the best approach to weight loss?
The best approach combines a healthful diet with daily exercise. Choose foods that are low in saturated fat and high in "good" fat, such as monounsaturated and polyunsaturated fat. This involves eating a variety of whole-grain products, nuts, vegetables, and fruits and avoiding red meat and processed foods. Another way to evaluate foods is to ask yourself whether they are "whole" or as close to their natural state as possible.

Be realistic in your goals and in making dietary and exercise changes to your lifestyle. Slow, steady weight loss and lifestyle changes are easiest to keep up. Shoot for losing 1 or 2 pounds a week and doing 30 minutes of aerobic exercise and strength training a day. If you haven't exercised recently, you may need to start with 10 minutes a day.

Should I follow a low-carbohydrate diet?
Low-carbohydrate diets (for example, the Atkins diet, the South Beach diet) may help you lose weight faster than traditional low-calorie diets in the short term, but they are no better in the long run. Until further research is done on the long-term health effects of low-carbohydrate diets, it's best to stick with a traditional low-calorie diet.

What are some other tips for maintaining a healthy weight?

• Eat breakfast to avoid becoming overly hungry later.
• In the grocery store, stick with your list and stay away from soft drinks and high-fat foods that will tempt you.
• Keep healthful snacks available, such as fresh fruit and vegetables, almonds, low-fat yogurt, whole-grain crackers, and reduced-fat cheese.
• When you eat at a restaurant, choose steamed or broiled foods over fried foods.
• Train yourself to eat only when you're hungry rather than when you're bored, tired, or depressed.
• Be as active as possible, even if this just means taking the stairs instead of the elevator and parking in the spot farthest from the entrance to your work or the businesses you go to often.
• Some people find that joining a weight-loss group or hiring a dietitian or a personal trainer helps keep them motivated.

What about weight-loss medications?
Over-the-counter diet pills aren't recommended as part of a weight-loss program because they're not effective--and can be dangerous. But some prescription medications can help some people lose weight when used as directed. Your doctor may recommend that you try one of these drugs.

Could surgery help me?
Different types of gastric and intestinal bypass surgery, which was sometimes called stomach stapling, can help some severely obese people lose weight. However, a bypass operation is serious, has risks, and requires a lifetime commitment to healthful eating and important lifestyle changes. Therefore, only people who are at risk for serious health consequences as a result of their obesity and who have tried every other option are allowed to have it. If you think you may be one of these people, talk to your doctor.

What if I have a setback?
Commitment to your new healthful lifestyle is the key to success. If you occasionally overeat or skip a day of exercise, get right back on track. When you're feeling discouraged, remember all the benefits of keeping in shape.

For more information on weight loss American Obesity Association 1250 24th St NW Suite 300 Washington, DC 20037 202-776-7711 http://www.obesity.org The Weight-control Information Network 1 WIN Way Bethesda, MD 20892-3665 877-946-4627 http://www.niddk.nih.gov/health/nutrit/win.shtml

This information is not a substitute for medical treatment.

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