Getting Started: Take These Four Simple Steps
In reading along so far, you might think what you've just learned is too hard to tackle, so you decide, as many people do, just to give up. Hold on! Hang in there. One size does not fit all when it comes to weight management. Fortunately for us in the Pittsburgh region, we have so many choices - from free weight-management support groups and self-pay treatment groups to insurance-covered medical programs.
But how do you get started? As the Nike commercial says, "Just do it." Here are my four steps to weight loss that can get you on the winning path to a healthy weight:
- Find a Plan That Works for You: I'm always asked about the "best" diet plan or diet book. My answer is always the same: The best plan is one that is compatible with what you're both willing and able to commit to. Beware of any plan that talks about "good" and "bad" foods and eliminates whole food categories, such as carbohydrates or fats. Balance is the key. While most plans vary a bit, choose one containing about 40 percent carbohydrates, 30 percent proteins and 30 percent fats. (See the sidebar above for some basics about effective weight-management eating.)
Don't forget to count your calories. Weight loss is based on calories in and calories out. But don't confuse terms such as heart-healthy, trans-fat free, reduced fat, 100 percent whole grain and naturally fat-free with low calorie. They often don't go together. In addition, keep a food log. Nothing fancy, but if you bite it, write it. That way, you become more accountable for what you've eaten each day. - Identify What Physical Activities You Are Willing and Able to Do: You don't have to run a marathon to exercise, and you don't even have to "exercise" to get some exercise. What you do need is to be more physically active. The first step in this process is to increase what I call "activity of daily living." This means to get more steps in your day: parking farther away in a parking lot from your destination, taking the stairs for a flight or two, getting up off the couch, walking around while on the phone - there are dozens of easy ways to incorporate healthy activities in your daily living.
The bottom line is to have at least 20 to 30 minutes a day of moderate walking. This strategy alone - without any other changes - will help you drop about 10 pounds in a year. Consistency is key here, and purchasing a pedometer to monitor your steps can be a big help. While the "gold standard" is 10,000 steps a day for weight loss, don't aim for that at the start. Work up to 5,000 steps a day, and within a month, get to 10,000. It's a habit you can form. - Set Realistic Goals and Keep Motivated: I often think weight loss is more about our "heads" than our "stomachs." We eat for so many reasons that are unrelated to physical hunger, including happiness, sadness, stress, anxiety, boredom and habit. (Anyone for Raisinettes and popcorn at the movies after a big dinner?)
Behaviors relating to lifestyle are very tough to change, but with so many ways to do it, change is quite manageable - if you start with a plan. The first word here is "realistic," and I encourage you to set some realistic and specific goals for yourself. A slow and steady set of changes becomes a habit for a lifetime after about two to three weeks. Here's one example: Instead of saying, "My goal is to lose 30 pounds," say, "I'm aiming to lose a pound a week for the next three months, with a goal of at least 10 pounds."
It's also important to address how well you're able to cope with daily stress. If it's a struggle to manage stress on your own, seek the advice of a friend, support group or private therapist. - Talk to Your Doctor and Identify Options: Have trouble talking to your doctor about your weight? You are not alone. Many people do, feeling embarrassed or judged. However, your doctor is not a mind-reader, and he or she needs to know that you want to have a dialogue about weight loss. Where your doctor can help is not as a sole source of support for all of the diets you've tried but as a professional who can help you evaluate possible medical causes for weight gain. A doctor also can open a realistic discussion about where to locate the right kind of support for your weight-loss needs. Your doctor can be your partner in figuring out the biological issues relating to weight gain but cannot always be the right contact for behavioral issues, which might need further referrals.
If you've made a consistent lifestyle change and find that you're not making progress (review the 13 Hidden Causes of Weight Gain) or your point of intervention is beyond what lifestyle alone can do, talk with your doctor about prescription medications or obesity surgery. These can support, but not replace, the lifestyle effort.
Although prescription medications are limited in utility (it's hard to turn off appetite without many side effects) and often are an out-of-pocket charge, talk to your doctor about this option. If you are considered severely obese (termed Class 3, meaning a BMI of 40 or more) or moderately obese (termed Class 2 with significant medical illness), you might consider a surgical option. Try to set up a separate consultation with your doctor, not when you're visiting for a specific ailment, which often could be related to your weight.
Keeping the Weight Off: How to Stay Weight-Stable
What is successful weight management? It's identifying a healthy weight that you can maintain with moderate - not heroic - effort. Your empowerment comes with acceptance that keeping weight off (not weight loss!) over the long term is success, and that requires choosing a realistic, not ideal, weight. Pittsburghers, like all Americans, are great at losing weight but not so great at keeping it off. The difference in weight loss and weight maintenance is quite small and sometimes is just a matter of cutting out 100 calories or adding a 20-minute walk.
So, what are we to do? For long-term success, consider these final tips:
- Consider a Diet Buddy: Seek out a friend or relative, join a support group or connect online. "Going it alone" is tough when it comes to staying on track. Some people like group support, while others prefer the personal touch of a one-on-one connection. Be realistic and search out what works best for you.
- Maintain Structure: When you have a daily structure to support your effort, you're automatically in control. Weigh yourself weekly or even daily, keep a food journal and take a walk every day.
- Stay Consistent: Lifestyle changes are difficult and must be learned over time or relearned when necessary. Focused effort is important to stay on track, and daily accountability to your eating and activity plan is a must. It's the small changes done daily that add up to consistent calorie savings. You can turn some small changes into a lifelong habit - in a matter of two or three weeks.
- Learn From Your Mistakes: A lapse is normal, but avoid a total collapse. We're all human, and we can only put forth our best effort, not a perfect effort. There will be times we get off track. It's important to recognize these small lapses as a learning experience and then change behaviors to avoid them in the future. Don't despair and figure, "What's the use?" Keep going. Practice. Eventually you'll find your effort really works!
Pittsburgh magazine health editor Dr. Madelyn H. Fernstrom, Ph.D., C.N.S., is the founder and director of UPMC's Weight Management Center. She is the diet and nutrition editor for NBC's "Today Show" and is the author of The Runner's Diet. Also, visit "Health Journal with Dr. Madelyn Fernstrom," a health and wellness blog at iVillage.com.