Archive for the ‘Weight Regain’ Category

Exercise: Anti-Aging and Other Metabolic Benefits

Sunday, March 20th, 2011

At my Diabetic Mediterranean Diet blog, I recently noted that regular physical activity prevented or postponed death.  Onward now to other benefits.

Waist Management

Where does the fat go when you lose weight dieting?  Chemical reactions convert it to energy, water, and carbon dioxide, which weigh less than the fat.  Most of your energy supply is used to fuel basic life-maintaining physiologic processes at rest, referred to as resting or basal metabolism.  Basal metabolic rate (BMR) is expressed as calories per kilogram of body weight per hour.

The major determinants of BMR are age, sex, and the body’s relative proportions of muscle and fat.  Heredity plays a lesser role.  Energy not used for basal metabolism is either stored as fat or converted by the muscles to physical activity.  Most of us use about 70 percent of our energy supply for basal metabolism and 30 percent for physical activity.  Those who exercise regularly and vigorously may expend 40–60 percent of their calorie intake doing physical activity.  Excess energy not used in resting metabolism or physical activity is stored as fat.

Insulin, remember, is the main hormone converting that excess energy into fat; and carbohydrates are the major cause of insulin release by the pancreas.

To some extent, overweight and obesity result from an imbalance between energy intake (food) and expenditure (exercise and basal metabolism).  Excessive carbohydrate consumption in particular drives the imbalance towards overweight, via insulin’s fat-storing properties.

In terms of losing weight, the most important metabolic effect of exercise is that it turns fat into weightless energy.  We see that weekly on TV’s “Biggest Loser” show; participants exercise a huge amount.  Please be aware that conditions set up for the show are totally unrealistic for the vast majority of people.

Physical activity alone as a weight-loss method isn’t very effective.  But there are several other reasons to recommend exercise to those wishing to lose weight.  Exercise counteracts the decrease in basal metabolic rate seen with calorie-restricted diets.  In some folks, exercise temporarily reduces appetite (but others note the opposite effect).  While caloric restriction during dieting can diminish your sense of energy and vitality, exercise typically does the opposite.  Many dieters, especially those on low-calorie poorly designed diets, lose lean tissue (such as muscle and water) in addition to fat.  This isn’t desirable over the long run.  Exercise counteracts the tendency to lose muscle mass while nevertheless modestly facilitating fat loss.

How much does exercise contribute to most successful weight-loss efforts?  Only about 10 percent on average. The other 90 percent is from food restriction.

Fountain of Youth

Regular exercise is a demonstrable “fountain of youth.”  Peak aerobic power (or fitness) naturally diminishes by 50 percent between young adulthood and age 65.  In other words, as age advances even a light physical task becomes fatiguing if it is sustained over time.  By the age of 75 or 80, many of us depend on others for help with the ordinary tasks of daily living, such as housecleaning and grocery shopping.  Regular exercise increases fitness (aerobic power) by 15–20 percent in middle-aged and older men and women, the equivalent of a 10–20 year reduction in biological age!  This prolongation of self-sufficiency improves quality of life.

Heart Health

Exercise helps control multiple cardiac (heart attack) risk factors: obesity, high cholesterol, elevated blood pressure, high triglycerides, and diabetes.  Regular aerobic activity tends to lower LDL cholesterol, the “bad cholesterol.”  Jogging 10 or 12 miles per week, or the equivalent amount of other exercise, increases HDL cholesterol (“good cholesterol”) substantially.  Exercise increases heart muscle efficiency and blood flow to the heart.  For the person who has already had a heart attack, regular physical activity decreases the incidence of fatal recurrence by 20–30 percent and adds an extra two or three years of life, on average.

Effect on Diabetes

Eighty-five percent of type 2 diabetics are overweight or obese.  It’s not just a random association.  Obesity contributes heavily to most cases of type 2 diabetes, particularly in those predisposed by heredity.  Insulin is the key that allows bloodstream sugar (glucose) into cells for utilization as energy, thus keeping blood sugar from reaching dangerously high levels.  Overweight bodies produce plenty of insulin, often more than average.  The problem in overweight diabetics is that the cells are no longer sensitive to insulin’s effect.  Weight loss and exercise independently return insulin sensitivity towards normal.  Many diabetics can improve their condition through sensible exercise and weight management.

Miscellaneous Benefits

In case you need more reasons to start or keep exercising, consider the following additional benefits: 1) enhanced immune function, 2) stronger bones, 3) preservation and improvement of flexibility, 4) lower blood pressure by 8–10 points, 5) diminished premenstrual bloating, breast tenderness, and mood changes, 6) reduced incidence of dementia, 7) less trouble with constipation, 7) better ability to handle stress, 8) less trouble with insomnia, 9) improved self-esteem, 10) enhanced sense of well-being, with less anxiety and depression, 11) higher perceived level of energy, and 12) prevention of weight regain.

People who lose fat weight but regain it cite lack of exercise as one explanation.  One scientific study by S. Kayman and associates looked at people who dropped 20 percent or more of their total weight, and the role of exercise in maintaining that loss.  Two years after the initial weight loss, 90 percent of the successful loss-maintainers reported exercising regularly.  Of those who regained their weight, only 34 percent were exercising.

Stay tuned for my specific exercise recommendations.

Steve Parker, M.D.

The Secret to Prevention of Weight Regain

Monday, June 14th, 2010

Losing excess weight is easier than keeping it off.

Neither is exactly a walk in the park.

Prevention of weight regain is the most problematic area in the field of weight management.  You may have heard that “diets don’t work,” but they do.  Many different weight loss programs work short-term, if “work” is defined as loss of five, 10, or more pounds while you adhere to the program for several weeks or months.  The problem is that the lost pounds usually return.

Why?  You get bored with the diet, or your willpower flags, or the diet simply stops working, or the transition from weight loss to maintenance is unclear, or you just feel too bad to go on, or you lose your commitment, or you take a job as a taste tester for Baskin-Robbins Ice Cream, or whatever. 

Most diets ultimately fail in the long run because people go back to their old habits. 

Read on for the secret to prevention of weight regain.  They apply to a majority of weight-loss methods, although many programs ignore this problem because the cure is a hard pill to swallow. 

Moving Ahead

For purposes of further discussion, I will assume that you have already lost excess weight down to your goal and now we must focus on staying thereabouts from here on out.  Finally down to your goal!  A grand accomplishment!  You’ve got a new wardrobe, or the old clothes fit again.  You have more energy and feel younger.  Maybe you cured or improved some health problems.  Perhaps you’re getting more attention from the opposite sex (ooh la la!). 

Our species’ scientific name is Homo sapiens.  It is from the Latin sapere, which means “to be wise.”  Wisdom is the ability to make correct judgments and decisions.  Undoubtedly, your success at weight loss required correct judgments and decisions.  You are not done yet.  You will need sustained wisdom to avoid weight regain.

Be wise about this especially: you can never again eat all you want, whenever you want, over sustained periods of time.  

Now that you have reached your goal weight, you must restrain yourself on a daily basis.  Think about it.  You became overweight because you didn’t watch what you ate and didn’t exercise enough.  You can’t go back to your old ways.  Reject this advice, and you have a 100 percent chance of regaining your lost weight. 

Have you heard of the Energy Balance Equation?

Calorie Intake minus Calories Burned

         =  Change in Body Fat

You have been able to lose fat weight because you ate less energy (calories) than your body required for metabolism and physical activity.  Your body remedied the energy deficit by converting fat into energy.  A pound of fat contains 3,500 calories of energy.  If you lost a pound per week, your body on average converted 500 calories of fat daily into energy (7 days x 500 calories = 3,500 calories = 1 pound of fat). 

Now that you are at your goal weight and want to stay there, you need to add 500 calories per day back into the equation.  Add the calories by eating more food, exercising less, or a combination of the two. But if you add back more than 500, you will regain weight.

The true measure of a successful weight management program is not simply how much weight is lost, but whether the lost weight stays lost over the long run.  What distinguishes weight losers who keep the weight off from those who gain it back?  Two factors, mostly:

          1.  Restrained eating
          2.  Regular physical activity
.

“Successful losers” apply self-restraint on an almost daily basis, avoiding food that they know will lead to weight regain.  They limit how much they eat.  They consciously choose not to return to their old eating habits, despite urges to the contrary.  The other glaring difference is that, compared to regainers, the successful losers remain physically active.  They exercised while losing weight, and continue to exercise in the maintenance phase of their program.  This is true in at least eight out of 10 cases.  It’s clear that regular exercise is not always needed, but it dramatically increases your chances of long-term success. 

In a nutshell, my maintenance phase prescription for you is: Keep exercising, and eat a little more.  Keep exercising, and eat a little more.

Go out of your way to be physically active for 30 to 45 minutes on at least four days per week, if not all days.  Walking is fine.  The more you exercise, the more you can eat without getting fat again. 

At the end of your weight-loss phase and the beginning of the maintenance phase, it is surprisingly easy to start overeating.  Forewarned is forearmed.  Avoid this landmine any way you can.  It helps to continue monitoring food consumption and exercise on your food diary while eating an additional 200–500 calories per day.  Continue weighing daily.  Keep exercising.  After a month or two of this regimen, you’ll have an intuitive sense of what and how much you should be eating without regaining weight.  Then stop the daily log routine. 

Another option for transition to the maintenance phase: if you have been exercising regularly but loathe it, you could stop exercising and stay on your current calorie level diet.  In other words, don’t start eating more.  See what happens with your weight.  Perhaps you could later eat an extra 100 to 200 daily calories without gaining weight.  Continue recording your daily intake and weight for a couple months.  

Weigh yourself daily during the first two months of your maintenance-of-weight-loss phase. After that, weigh weekly.  Daily weights will remind you how hard you worked to achieve your goal.  When you look now at a brownie, candy bar, or piece of pie, you ask yourself, “Do I really want to walk an extra hour or jog an extra three miles today to burn off those calories?” If so, enjoy. Otherwise, forego the unneeded calories. 

Be aware that you might regain five or 10 pounds of fat now and then.  You probably will.  It’s not the end of the world.  It’s human nature.  You’re not a failure; you’re human.  

But draw the line and get back on your old weight-loss program for one or two months.  Analyze and learn from the episode.  Why did it happen?  Slipping back into your old ways? Slacking off on exercise?  Too many special occasion feasts?  Allowing junk food back into the house?  Learn which food item is your nemesis—the food that consistently torpedoes your resolve to eat right.  For example, I have two—candy, and sweet baked goods such as cookies and muffins.  If I just look at them I add a pound.  Remember an old ad campaign for a potato chip: “Betcha can’t eat just one!”?  Well, I can’t eat just one cookie.  So I don’t get started.  I might eat one if it’s the last one available.  Or I satisfy my sweet craving with fresh fruit or a diet soda.  Just as a recovering alcoholic can’t drink any alcohol, perhaps you should totally abstain from…?  You know your own personal gastronomic Achilles heel.  Or heels.  Experiment with various strategies for vanquishing your nemesis. 

It’s OK to overindulge in food infrequently (10–12 times per year), on special occasions such as birthdays, wedding anniversaries, holidays.  But you must counteract the extra calories by cutting down intake or by exercising more, either before or after the feast.  No big deal.

Click to read additional ideas on prevention of weight regain.

Steve Parker, M.D.

Yo-Yo Dieting In Women Has No Effect On Death Rates

Tuesday, June 9th, 2009

Yo-yo dieting isn’t so bad after all.

Ten years ago there was lots of hand-wringing in the medical community about the potential dire physical consequences of “weight cycling” - also known as yo-yo dieting.  You know, lose a bunch of weight, gain it back, lose it again, gain it back, etc.

Then you didn’t hear so much about it.  It was a bit of a fad.  Like “detoxing,” although certainly more legitimate. 

A recent study in the Archives of Internal Medicine reported on the cardiovascular and mortality effects of yo-yo dieting in women in the massive Nurses’ Health Study.  One in four of these women could be classified as weight cyclers.  The worst ones were defined as those who lost at least 9.1 kg ( 20 pounds) at least three times.

It turns out the weight cyclers had the same rates of death from cardiovascular disease or any cause as the women who didn’t cycle.  They did eventually gain more overall weight as they aged, compared to the non-cyclers. 

Note that this study investigated death rates only.  So there may have been effects on rates of high blood pressure, diabetes, gout, stroke, etc, that we wouldn’t know about. 

Steve Parker, M.D.

Field, Alison, et al.  Weight cycling and mortality among middle-aged or older womenArchives of Internal Medicine, 169 (2009): 881-886.

Prevention of Weight Regain

Thursday, November 20th, 2008

Clinical Diabetes recently published a review article, “Weight Regain Prevention,” summarizing effective strategies for prevention of weight regain after a successful weight-loss program.  The article is not specifically for or about people with diabetes.  You are probably aware that regain of lost weight is a huge problem.

The authors start with a review of various weight-loss strategies, including low-calorie diets, very low-calorie diets, commercial programs such as Weight Watchers, behavior modification therapy, meal replacements, weight-loss drugs, etc.  I recall no mention of bariatric surgery.

To its credit, Weight Watchers is the only commercial program to report data from randomized controlled trials, the gold standard in clinical scientific studies of effectiveness.  [Weight Watchers lost more weight than the self-help control group.]

By way of review, here is the typical pattern of a weight loss effort.  Maximal weight loss occurs in the first six months, at least for people who are compliant and don’t drop out of the program after the first few weeks.  After the initial six months, weight regain starts. By one or two years after start of the effort, most people - but not all - have regained all the lost weight, if not more.

The authors’ recommendations for prevention of weight regain are mostly based on well-designed, published, peer-reviewed, scientific studies.  They identified characteristics of successful weight loss maintainers - what I call “successful losers.”  The idea is that a person will enhance her odds of keeping the lost weight off by incorporating these habits into her lifestyle:

  • Maintain high levels of physical activity.  Consider at least 60 minutes daily of moderate activity.  Ouch!
  • Limit television to less that a few hours a day.
  • Eat a diet low in fat and calories.  [I disagree with the accross-the-board low-fat recommendation.]
  • Maintain a consistent eating pattern throughout the week and year.  Successful losers often report less variety, compared to other people, in all food groups except for fruits.
  • Eat breakfast routinely.
  • Control emotional eating.
  • Weigh frequently, whether daily or weekly.
  • Catch and address weight regain early, before it gets out of hand.
  • Consider sequential medications.  E.g., sibutramine for months, then orlistat for months.
  • Individual and/or group follow-up support.  Even follow-up by phone works.
  • Have realistic expectations.  Most dieters only lose about half the weight they expected in the first place.  The resulting sense of disappointment sabotages efforts to keep the weight off.  Anticipate the universal tendency to regain lost weight.
  • Helpful diet patterns:  eat more than five servings a day of fruits and vegetables, watch portion sizes, self-record food intake, plan meals, limit fast food.
  • “Exercise is central to weight loss maintenance.”  And finally . . .
  • “Exercise is central to weight loss maintenance.”

Steve Parker, M.D.

Reference:  Ulen, Christina, et al.  Weight Regain Prevention.  Clinical Diabetes, 26 (2008): 100-113.  DOI: 10.2337/diaclin.26.3.100

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The Role of Exercise in Maintenance of Weight Loss In Women

Saturday, September 27th, 2008

This news is a bit stale, but I wanted my readers to be sure to see it.

An article in the July 28, 2008, issue of Archives of Internal Medicine teaches us the role of regular physical activity in keeping lost weight from returning to once-overweight women.

Methodology

201 overweight women (body mass index 27-40) aged 21 to 45 wanted to lose excess weight.  They were sedentary at baseline, exercising fewer than three days a week for under 20 minutes.  Sound familiar?  Depending on baseline weight, the participants were assigned to eat either 1200 or 1500 calories per day, and to exercise according to one of four different exercise programs.  Exercise recommendations were to burn a certain number of calories per week (1000 or 2000 calories) at either moderate or vigorous intensity.  There were weekly group meetings for discussion of eating and exercise for the first six months, twice monthly meetings during the next 6 months, and monthly for the next six months.  There was telephone contact for between months  19 to 24.  This is pretty intense contact.  Each participant was given a treadmill to use at home, but my impression is that other forms of exercise were permitted and discussed.

Ten subjects were excluded from follow-up analysis, mostly because they got pregnant.  Nineteen others lost interest and dropped out.

Participants self-reported their physical activity levels.

At 24 months into the study, 170 of the original 201 participants were able to provide objective weight loss data.

Findings

Of the 170 subjects available for full analysis at 24 months, 54 either gained weight or lost none.  Thirty-three lost 0 to 4.9% of initial body weight, 36 lost 5 to 9.9% initial body weight, and 47 (24.6%) lost 10% or more of initial body weight.  [Who says diets don’t work?]

People who lost 10% or more of initial body weight at 24 months reported performing more physical activity - 275 minutes a week - compared with those who lost less than 10% of initial body weight.  This amount of exercise equates to 55 minutes of exercise on five days per week above the baseline level of activity, which was sedentary as you recall.  Whether they were assigned to “moderate” or “vigorous” exercise intensity didn’t seem to matter.  Whether they actually performed at the assigned level is unclear.

These women who sustained a weight loss of 10% or more of initial body weight at 24 months were burning 1835 calories a week in physical activity.

Women who lost less than 10% of initial body weight, or lost no weight, exercised an average of 34 minutes a day on five days a week.

By 24 months, participants on average had regained about half of the weight they had lost during the first six months  [which is typical].

Take-Home Points

After six months of dieting, many people start to regain half of what they lost.  We saw this phenomenon recently in the Israeli study of low-fat vs low-carb vs Mediterranean diet.

If you have a lot of excess fat to lose, you have to wonder if it would make sense to start a different diet program every six months, until you reach your weight goal.  Maybe there’s something about the novelty and excitement of a new diet program that keeps you motivated and disciplined for six months.  Joel Gates is trying a new one every month for a year, with great success.  Read about his experience at DozenDiets.com.

The authors note there are few similar long-term studies examining the amount and intensity of physical activity needed to improve weight loss success.  So this is important new information.

In using exercise to help prevent weight regain, it may not matter whether the exercise is moderate or intense.

The authors write:

…the inability to sustain weight loss appears to mirror the inability to sustain physical activity.

Long-term sustained weight loss is possible for a significant portion of overweight women.  Although most women won’t do it, success is enhanced by exercising for 55 minutes on five days a week.  Most men won’t exercise that much either.  Which camp do you fall into?

[For physical activity instruction and information, visit Shape Up America!, Physical Activity for Everyone, or Growing Stronger: Strength Training for Older Adults.]

Steve Parker, M.D.

Reference:  Jakicic, John M., et al.  Effect of Exercise on 24-Month Weight Loss Maintenance in Overweight Women.  Archives of Internal Medicine, 168 (2008): 1,550-1,559.  

Is Exercise Important as Part of a Weight-Management Program?

Monday, May 12th, 2008
While physical activity alone seldom results in significant and sustained weight loss, maintaining weight loss without physical activity is nearly impossible.

The quote above is from James Early, M.D., Clinical Associate Professor, Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita (Wichita, Kansas), as printed in Clinical Cornerstone, 2007, volume 8, No. 3, page 69.

It’s a simple truth, one that bears repeating, as the truth too often is submerged in a roiling sea of misinformation and trivia.

Exercise is extremely important for the vast majority of people who want to lose weight and keep it off, but it’s encouraging to know that it is possible to be successful if you don’t want to or can’t exercise.

This second quote is from the first edition of Thin For Life: 10 Keys to Success From People Who Have Lost Weight and Kept It Off, by Anne Fletcher, page 20.  Out of the 160 “weight-control masters” studied by Anne, 70% exercised three or more times per week.  Nine percent told her they didn’t exercise at all.

But what kind of exercise helps with weight management?  The most important criterion is that it be pleasant for you.  If not outright fun, it should be often enjoyable and always tolerable.  Your exercise of choice should also be available year-round, affordable, safe, and utilize large muscle groups.  The greater mass and number of muscles used, the more calories you will burn.  Compare tennis playing with sitting in a chair squeezing a tennis ball repetitively.  The tennis player burns calories much faster. Your largest muscles are in your legs, so consider walking, biking, many team sports, ski machines, jogging, treadmill, swimming, water aerobics, stationary cycling, stair-steppers, tennis, volleyball, roller-skating, rowing, jumping rope, yardwork, housework, etc.  What?  You don’t find housework pleasant?  At least try it once with upbeat music blaring in the background.  Walking is “just what the doctor ordered” for many people.  It is readily available, affordable, usually safe, and requires little instruction.  If it’s too hot, too cold, or rainy outside, you can do it in a mall, gymnasium, or health club.

Another option is instructional exercise DVDs and videotapes, featuring either a celebrity or prominent fitness trainer.  Early leaders in this field 20–30 years ago included Richard Simmons, Jane Fonda, and Cindy Crawford.  Many of these programs require only a pair of sneakers and loose clothing.  Others include the option of using inexpensive equipment, such as light hand-held weights.  If exercise videos sound appealing, you can’t go wrong with one of these: Supersweatin’ Party Off the Pounds, by Richard Simmons; Walk Away the Pounds—Walk Strong, by Leslie Sansone; Tighter Assets With Tamilee: Weight Loss & Cardio, by Tamilee Webb; Burn & Firm—Circuit Training, by Karen Voight; Minna Optimizer—Balanced Blend, by Minna Lessig; Personal Training System, by Denise Austin; Timesaver—Lift Weights to Lose Weight (volumes 1 & 2), Super Slimdown Circuit, and Functionally Fit—Peak Fat Burning, by Kathy Smith.  Search for these titles at Amazon.com, where you can read reviews of them by actual users.

Another fun option for high-tech indoor exercise is Dance Dance Revolution by Konami.  Perhaps you have seen a version of this video game in an arcade.  You must use a video game console, such as a PlayStation or Xbox, and the Dance Dance Revolution Controller along with your TV screen.  The controller is a 32 inch by 36 inch floor pad partitioned into several large squares.  The TV screen shows you which squares to step on in sequence as the music plays, and you rack up points for accurate timing and foot placement.  Each supplied tune can be danced at numerous skill levels, from easy to expert. Trust me; it’s more fun than I can describe.  If you enjoy moving to music, time flies as you focus concentration on the TV display.  Some versions of the game have a workout mode that tracks your calories burned.  If you already have a video game console, you pay about $150 for the controller and game disc.  As always, check for compatibility of all components before purchasing.

For additional help with your exercise program, check out Physical Activity for Everyone and Shape Up America!

Steve Parker, M.D., author of The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer   www.AdvancedMediterraneanDiet.com

Keeping Lost Weight From Returning is NOT Impossible

Wednesday, March 12th, 2008

I often hear from the general public, and even my physician colleagues, that losing weight and keeping it off is a hopeless goal.  So, why try?

Because it’s not hopeless.

The March 12, 2008, edition of the Journal of the American Medical Association includes an article from the Weight Loss Maintenance Collaborative Research Group.  Researchers identified a group of 1,032 overweight or obese adults who lost at least 8.8 pounds (4 kg) during a 6-month weight loss program.  These adults had high blood pressure, blood lipid abnormalities, or both.  38% were African American and 63% were women.

Average weight of the group before losing weight was 213 pounds (96.7 kg).  The weight-loss program consisted of 20 weekly group sessions, exercise goal of 180 minutes per week (26 minutes per day, usually walking), reduced caloric intake, and adoption of the Dietary Approaches to Stop Hypertension eating pattern.  The goal rate of weight loss was 1 or 2 pounds per week (0.45 to 0.91 kg per week).  Study subjects were taught how to keep records of their caloric intake and physical activity.

Except for the weekly group sessions, this program is similar to the Advanced Mediterranean Diet.

So each of these folks lost at least 8.8 pounds on this program.  Researchers followed them over the next 30 months to see how much weight would be regained.  Average weight loss for the entire group actually was 19 pounds (8.6 kg).  As expected, many people did regain weight over the next 30 months, between 6 and 9 pounds on average.  Of course, some individuals lost much more weight initially, and didn’t gain any back.  Some regained all of the lost weight, plus extra.

Overall, 42% of participants “maintained at least 4 kg [8.8 pounds] of weight loss compared with entry weight…” over the 30 months of follow-up.  37% remained at least 5% below their initial weight.

The “5%” figure stands out, for me, because we see improvement in obesity-related medical problems with loss of just 5 to 10% of body weight.

The authors cite studies indicating that “each kilogram [2.2 pounds] of weight loss is associated with a decrease in systolic blood pressure of 1.0 to 2.4 mmHg and a reduction of incident diabetes of 16%.”

To summarize the weight changes:  Study participants weighed 213 pounds before the behavioral weight-loss program.  Average weight loss was 19 pounds, down to 194 pounds.  Average weight regain over 30 months was in the range of 6 to 9 pounds.  Participants were still pretty big, but 37% of them probably saw some improvement in their medical status.

A huge amount of effort went into this study, on the part of both researchers and study participants.  Nevertheless, average results are relatively modest.  Keep in mind, however, that the numbers are averages, and you are not average.  I’m sure some of the participants went from 220 pounds down to 150 pounds and stayed there.  That could be you.

Steve Parker, M.D., author of The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer    www.AdvancedMediterraneanDiet.com

Reference: Svetkey, Laura et al.  Comparison of Strategies for Sustaining Weight Loss: The Weigth Loss Maintenance Randomized Controlled Trial.  Journal of the American Medical Association, 299 (2008): 1,139-1,148.

Who Says “Diets Don’t Work”?

Monday, February 4th, 2008

Claims that “diets don’t work” are based on the assumption that any weight lost is simply gained back quickly.

The Endocrine Society met in Toronto in June of 2007.  Experts presented data on maintenance of weight loss by overweight people.  What percentage of people who lost 10% of their weight kept the weight off for one year?  About 20%.  Not great, but better than many would expect.  That’s a 200-pounder losing down to 180 and staying at 180 pounds for a year.  This degree of weight loss will improve many cases of high blood pressure, knee arthritis, and type 2 diabetes mellitus.

The U.S. Centers for Disease Control and Prevention reports even better data.  Almost 60% of 1,310  people in the National Health and Nutrition Examination Survey who lost 10% of body weight maintained 95% of the loss for one year.

How do they keep the weight off?  Characteristics of “successful losers” include a low-calorie diet (probably 1,6oo-1,800 on average), weighing at least once per week, and burning about 2,600 calories per week in physical activity.  [A 150-pound person expends 1260 calories a week by walking 3-4 mph for 30 minutes daily.]

Many successful losers cycle through weight loss and gain several times before determining which combination of diet and physical activity ultimately works for them.

So, don’t give up!

Steve Parker, M.D, author of The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer   www.AdvancedMediterreaneanDiet.com

References:

McGuire, M.T., et al.  International Journal of Obesity, 23[12] (1999): 1,314-1,319.

Weiss, E.C., et al.  American Journal of Preventive Medicine, 33[1] (2007): 34-40.


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