Weight loss advice is constantly coming at youwhether you ask for it or not. You might hear about it via the latest wacky plan some influencer tweets out, a buzzy bestselling book, or your judgey sister-in-law who has been eyeballing your body at every family gathering since your brother first brought her home. There is certainly no shortage of tips on how best to slim down.
The problem is, of course, that most of them are (low-fat) baloney, and wont result in long-term, lasting weight loss. Research shows that almost half of all Americans have tried to lose weight within the last year, according to the Centers for Disease Control and Prevention, and many succeed. Its keeping it off thats a heck of a lot harder: A meta-analysis of 29 long-term studies showed that more than half the weight people lost had been regained at the two year mark, and by five years, folks had put 80% back on, according to a 2018 article in Medical Clinics of North America.
So Prevention asked 10 top weight loss and obesity clinicians from around the countrypeople who are up on the latest science and whose main motivation is to help their patients be healthier, if not radically sveltefor their perspectives. Heres what they would like you to know.
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1"Know your why."
People who have a good reason to lose weight are more likely to get it off and keep it off. For example, if someone wants to look great for her daughter's wedding, she is very likely to be successfulbut to regain the weight after the wedding. If a person wants to lose in order to have less knee pain or better control over their diabetes, these reasons will persist after weight loss, and support keeping the weight off permanently. Ethan Lazarus, M.D., FOMA, obesity medicine physician at Clinical Nutrition Center in Greenwood Village, CO, and president-elect of the Obesity Medicine Association
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2"You are not a number."
People always ask me, 'What should I weigh?? As if we could just program ourselves like robots! The answer depends on what you want. If thats improved health, less pain, prevention of diabetes and other diseases, theres strong evidence that quite small weight loss5-10% or sois often sufficient, even if you end up nowhere near what the ideal weight tables suggest. Many people think they need 10 times more weight lossbut once they make some small changes and lose a few pounds, they often feel so much better than they expected. Scott Kahan, M.D., M.P.H., director of the National Center for Weight and Wellness. He also serves on the faculties of the Johns Hopkins Bloomberg School of Public Health, the George Washington University School of Medicine, and the George Washington University School of Public Health and Health Services.
3"Pick a routine you can stick with."
Determine an eating routine of planned portions of plants and protein every three to four hours. Pick a routine you can stick with 80% of the time. Angela Fitch, M.D., FACP, FOMA, associate director of the Massachusetts General Hospital Weight Center and an assistant professor of medicine at the Harvard Medical School; She is also Vice President of the Obesity Medicine Association.
4"One size does not fit all."
Know yourself. One size does not fit all when it comes to a weight loss plan. Ive developed a short quiz that people can take to quickly identify which lifestyle factors have been tripping them up and getting in the way of successful weight loss, which includes questions about when you tend to eat, how much you exercise and the role food and body image plays in your life. Knowing what to focus on can make changing the way you approach weight loss feel less overwhelming. Robert Kushner, M.D., medical director of the Center for Lifestyle Medicine at Northwestern Medicine in Chicago, and Professor of Medicine, Northwestern University Feinberg School of Medicine. His new book is Six Factors to Fit: Weight Loss that Works for You!.
5"Movement is everything."
The best predictor of successful weight loss maintenance is the amount of physical activity you are doing. Long-term successful weight loss maintainers are doing LOTS of physical activity...about one hour of moderate activity, 6 days a week. Donna H. Ryan, M.D., professor emeritus at Pennington Biomedical Research Center in Baton Rouge, LA. She served as associate executive director at Pennington Biomedical for 34 years where she was active in research, teaching, and administration.
6"Start before it becomes a disease."
Start working on it immediately when you begin gaining weightbuilding muscle through strength training, doing cardio, and stop eating processed foods, which we think is causing inflammation. You want to reduce inflammation by healthy eating and exercise so that the disease of obesity wont take hold In your bodyonce it becomes a disease, diet and exercise alone wont work. Caroline Apovian, M.D., professor of medicine and pediatrics in the Section of Endocrinology, Diabetes, and Nutrition at Boston University School of Medicine. She is also director of the Center for Nutrition and Weight Management at Boston Medical Center.
7"Obesity is complicated."
I'm often asked, I dont eat that much, so why am I not losing weight? I tell patients that obesity is a complex disease and typically there is not a simple solution. It may not be the quantity of the food you eat, rather it may be the quality. In addition, it may be more related to other lifestyle factors, like sleep or stress. These may directly or indirectly influence eating behaviors and food intake. Some people are on medications that promote weight gain and impair their ability to lose weight. In the end, its important for clinical providers to understand the multitude of potential contributors in order to assist patients in treating their obesity. W. Scott Butsch, M.D., director of obesity medicine in the Bariatric and Metabolic Institute at the Cleveland Clinic.
8"A plateau is normal."
I wish everyone understood that all weight loss efforts end with a plateauno one should be disappointed or surprised if the treatment plan results in limited or no weight loss at some point. That is the natural adaptation of the body to the changes you've made. Rather than throwing in the towel and feeling resigned that your plan is not working, people can choose to work on maintaining the weight lost or modify the treatment plan if more weight loss is desired. This is especially important if your goal is to lose more than 10% of your initial weight. Jamy Ard, M.D., associate professor in the Department of Epidemiology and Prevention and the Department of Medicine at Wake Forest University Baptist Medical Center. He is also co-director of the Wake Forest Baptist Health Weight Management Center.
9"Adherence is more important than speed."
The most common question I am asked by new patients is What should I expect my rate of weight loss to be? There is no right answer to this question, and there are many factors that determine the answer. The key concept is to be focused on adherence to your plan. And dont compare yourself to others. Be content with your results, whatever they are, knowing that you are doing all you can do to lose weight. Wickham Simonds, M.D., FOMA, founder of Dr. Simonds Metabolics & Weight Loss in Raleigh and Durham, NC, and a trustee of the Obesity Medicine Association
10"You need a backup plan."
The body fights back against weight lossit does this in many ways that were very productive 150+ years ago when food was scarce, but which are maladaptive today. You have to plan for this to happen and have a backup plan when it does. See an obesity medicine trained provider who can help you determine the best ways to deal with this challengethe the provider has medicines, diets and counseling, techniques and tools that you do not have access to by just reading a book or using an app. Remember, we are all a bit different so that what works for one person may not work for you. Craig Primack, M.D., president of the Obesity Medicine Association and co-founder of the Scottsdale Weight Loss Center in Scottsdale, AZ..
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