Why is it so difficult to avoid putting those pounds back on?
Biology, environment and the pressures of everyday life all
play a role.
* Biology -- The body's metabolism, programmed for survival
in times of food shortage, works against dieters. Your
metabolism slows down because it is trying to conserve
energy. So you get hungry, your body doesn't expend as many
calories as before, doing the same things, and you have to
reduce calories even more.
* Environment -- It's tougher to lose weight and keep weight
off now than it was 20 years ago because there are so many
incentives to eat more and move less. The cheapest foods are
often the unhealthiest. Activity is reduced by labor-saving
devices, sit-down entertainment such as computers, lectures,
and the growing number of people in desk jobs.
* Life pressures -- Weight control takes a lot of work, hard
work. If life gets in the way, a spouse gets ill, your child
is going through behavioral problems -- the disposable energy
that you have for any project, including weight control, gets
diverted. So you go back to old habits and you regain
weight.
YOU CAN SUCCEED
Is it possible to lose weight and keep it off for a long
time? Plenty of highly motivated people have succeeded. Now,
research is starting to provide a clearer picture of how they
do it.
Some of the most detailed information comes from a national
long term study. The National Weight Control Registry
contains information on 3,000 people who have lost 30 to 100
pounds (average -- 60 lbs.) and then kept their weight stable
for at least one year (average -- five years).
They lost wieght using many different diets or programs, says
James Hill, Ph.D., co-director of the study, along with Rena
Wing, Ph.D. of Brown university. But those who keep it off
have several things in common, he says.
Exercise
People in the weight-control registry, on the average, burn
up about 2,700 calories a week in physical activity, says
Hill, director of the Center for Human Nutrition at the
University of Colorado Health Sciences Center in Denver.
That's equal to about one hour of moderately intense activity
every day. For example, five miles of walking. "I think this
is the most important factor," Hill says.
It's not clear if people who lose smaller amounts of weight
need to exercise this much. Still, a large body of research
agrees that exercise is essential in counteracting the body's
tendency to regain weight.
Without exercise, the other efforts are simply temporary.
There are very few people who can lose weight and keep it off
without changing the amount of energy they expend.
Guidelines from the National Heart, Lung and Blood Institute,
part of the NIH, make the following recommendations about
exercise to prevent weight gain.
* Consult your doctor and an exercise physiologist and start
slowly to avoid injury.
* If you have been inactive, start with 10 to 30 minutes of
moderately intense activity, such as walking, three days a
week. Build up to 30-45 minutes on most or all days of the
week.
* Reduce sedentary activities. Build more activity into your
day by getting off one stop before your destination, parking
farther away, taking the stairs instead of the elevator,
gardening etc.
* Schedule your physical activity a week in advance, budget
the time to do it, and use a diary to record the amount of
time you spend exercising. Record the type of activity as
well as the intensity.
Self Monitoring
People in the weight control registry are highly disciplined
about this. They weigh themselves a lot and they record what
they eat on a regular basis.
Our experience with patients also shows that self monitoring
is important because it allows you to notice weight
fluctations early and to take action.
This doesn't mean you get crazy about every pound you go up
or down, but it does mean that this is a chronic problem and
when you gain weight, what are you going to do about it? The
way you reverse small weight gains is to have a specific
plan.
Sustainable, Healthy Diet
Although people in the registry originally lost weight using
a variety of diets, the vast majority kept the weight off by
following a low fat, high carbohydrate diet.
Although new research indicates that low carbohydrate regimes
such as the Atkins diet can produce significant weight loss,
very few people in the weight control registry were following
Atkins long term.
Another important rule is to control portion size, and we
still believe that reducing dietary fat is the most efficient
way of reducing calories.
Our own patients who are successful at long term weight
control make rules for themselves about eating. They make
those rules second nature.
For example, someone who eats a salad every day, but longs
for a pizza or shwarma, at some point will give up and
indulge. In contrast, people who permanently lose weight
often say they don't do anything special to keep it off
because they have made a permanent change in how they think
about food.
They have sort of drummed the pizza out of their minds. They
have a new reality.
BREAKFAST
This is another important element for people in the National
Weight Control Registry. They eat breakfast, so they're
spreading out their calories over the day.
This pattern is important to reduce hunger and bingeing. You
have to eat breakfast. You have to spread your calories out
and eat at least three or five times a day.
The Role of Support
It's difficult to keep weight off, but research indicates
that it helps to have some outside support.
We know that frequent contact with a health professional or
some other entity that's looking after them, which would
include a support group, is helpful. We find in our clinic
sessions that people who participate in the most work
out/exercise lose the most weight.
Unfortunately, we don't know cause and effect. If you force
people to go to sessions, would you get the same effect?
Maybe people who are successful are proud, so they show
up.
The form of support you need may depend on your personality.
Our sense is that in an attempt to find out what works, we
generalize too much. Some people are sole dieters and some
like buddies. The most consistent data show that consistent
contact with a professional improves the long term
outcome.
But ultimately, what matters is individual vigilance.
Maintenance is a very active process. If you go with the
tide, you will gain weight.
For a FREE 30 Day BRUNER METHOD Home Fitness/Lifestyle
Program, contact him at POB 1903, Jerusalem, 91314, Israel.
Tel. (02-652-7684. Mobile: 052-865- 8211. Fax; 02-652-7227.
Email dr-brunner@hotmail.com.
