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Who should lose weight?
Health experts generally agree that adults can
benefit from weight loss if they are moderately to severely overweight
(see the following weight-for-height chart below). Health experts also
agree that adults who are overweight and have weight-related medical
problems or a family history of such problems can benefit from weight
loss. Some weight-related health problems include diabetes, heart
disease, high blood pressure, high cholesterol levels, or high blood
sugar levels. Even a small weight loss of 10 to 20 pounds can improve
your health, for example by lowering your blood pressure and cholesterol
levels. You do not need to lose weight if your weight is within the healthy
range on the weight-for-height chart, you have gained less than 10
pounds since you reached your adult height, and you are otherwise
healthy.
How We Lose Weight
Your body weight is controlled by the number of calories you eat and the
number of calories you use each day. So, to lose weight you need to take in
fewer calories than you use. You can do this by becoming more physically
active or by eating less. Following a weight-loss program that helps you to
become more physically active and decrease the amount of calories that you
eat is most likely to lead to successful weight loss. The weight-loss program
should also help you keep the weight off by making changes in your physical
activity and eating habits that you will be able to follow for the rest of your life.
Types of Weight-Loss Programs
To lose weight and keep it off, you should be aware of the different types of
programs available and the important parts of a good program. Knowing this
information should help you select or design a weight-loss program that will
work for you. The three types of weight-loss programs include: do-it-yourself
programs, non-clinical programs, and clinical programs.
Do-It-Yourself Programs
Any effort to lose weight by yourself or with a group of like-minded others
through support groups, worksite or community-based programs fits in the
"do-it-yourself" category. Individuals using a do-it-yourself program rely on
their own judgment, group support, and products such as diet books for
advice (Note: Not all diet books are reliable sources of weight-loss
information).
Non-Clinical Programs
These programs may or may not be commercially operated, such as through a
privately-owned, weight-loss chain. They often use books and pamphlets that
are prepared by health-care providers. These programs use counselors (who
usually are not health-care providers and may or may not have training) to
provide services to you. Some programs require participants to use the
program's food or supplements.
Clinical Programs
This type of program may or may not be commercially owned. Services are
provided in a health-care setting, such as a hospital, by licensed health
professionals, such as physicians, nurses, dietitians, and/or psychologists. In
some clinical programs, a health professional works alone; in others, a group of
health professionals works together to provide services to patients. Clinical
programs may offer you services such as nutrition education, medical care,
behavior change therapy, and physical activity.
Clinical programs may also use other weight-loss methods, such as very
low-calorie diets, prescription weight-loss drugs, and surgery, to treat severely
overweight patients. These treatments are described below:
Very low-calorie diets (VLCDs) are commercially prepared formulas that
provide no more than 800 calories per day and replace all usual food
intake. VLCDs help individuals lose weight more quickly than is usually
possible with low-calorie diets. Because VLCDs can cause side effects,
obesity experts recommend that only people who are severely
overweight (see weight-for-height chart) use these diets, and only with
proper medical care. A fact sheet on VLCDs is available from the
Weight-control Information Network (WIN).
Prescribed weight-loss drugs should be used only if you are likely to
have health problems caused by your weight. You should not use
drugs to improve your appearance. Prescribed weight-loss drugs, when
combined with a healthy diet and regular physical activity, may help
some obese adults lose weight. However, before these medications can
be widely recommended, more research is needed to determine their
long-term safety and effectiveness. Whatever the results, prescription
weight-loss drugs should be used only as part of an overall program
that includes long-term changes in your eating and physical activity
habits. A fact sheet on prescription medications for the treatment of
obesity is available from WIN.
You may consider gastric surgery to promote weight loss if you are
more than 80 pounds overweight. The surgery, sometimes called
bariatric surgery, causes weight loss in one of two ways: 1) by limiting
the amount of food your stomach can hold by closing off or removing
parts of the stomach or 2) by causing food to be poorly digested by
bypassing the stomach or part of the intestines. After surgery, patients
usually lose weight quickly. While some weight is often regained, many
patients are successful in keeping off most of their weight. In some
cases, the surgery can lead to problems that require follow-up
operations. Surgery may also reduce the amount of vitamins and
minerals in your body and cause gallstones.
If you are considering a weight-loss program and you have medical problems,
or if you are severely overweight, programs run by trained health professionals
may be best for you. These professionals are more likely to monitor you for
possible side effects of weight loss and to talk to your doctor when necessary.
Whether you decide to use the do-it-yourself, non-clinical, or clinical
approach, the program should help you lose weight and keep it off by teaching
you healthy eating and physical activity habits that you will be able to follow
for the rest of your life.
Diet
The word "diet" probably brings to mind meals of lettuce and cottage cheese.
By definition, "diet" refers to what a person eats or drinks during the course of
a day. A diet that limits portions to a very small size or that excludes certain
foods entirely to promote weight loss may not be effective over the long term.
Rather, you are likely to miss certain foods and find it difficult to follow this
type of diet for a long time. Instead, it is often helpful to gradually change the
types and amounts of food you eat and maintain these changes for the rest of
your life. The ideal diet is one that takes into account your likes and dislikes
and includes a wide variety of foods with enough calories and nutrients for
good health.
How much you eat and what you eat play a major role in how much you weigh.
So, when planning your diet, you should consider: What calorie level is
appropriate? Is the diet you are considering nutritionally balanced? Will the
diet be practical and easy to follow? Will you be able to maintain this eating
plan for the rest of your life? The following information will help you answer
these questions.
Calorie Level
Low-calorie Diets. Most weight-loss diets provide 1,000 to 1,500 calories per
day. However, the number of calories that is right for you depends on your
weight and activity level. At these calorie levels, diets are referred to as
low-calorie diets. Self-help diet books and clinical and non-clinical weight-loss
programs often include low-calorie diet plans.
The calorie level of your diet should allow for a weight loss of no more than 1
pound per week (after the first week or two when weight loss may be more
rapid because of initial water loss). If you can estimate how many calories you
eat in a day, you can design a diet plan that will help you lose no more than 1
pound per week. You may need to work with a trained health professional,
such as a registered dietitian. Or, you can use a standardized low-calorie diet
plan with a fixed calorie level.
The selected calorie level, however, may not produce the recommended rate of
weight loss, and you may need to eat more or less.
Good Nutrition
Make sure that your diet contains all the essential nutrients for good health.
Using the Food Guide Pyramid and the Nutrition Facts Label that is found on
most processed food products can help you choose a healthful diet. The
Pyramid shows you the kinds and amounts of food that you need each day for
good health. The Nutrition Facts Label will help you select foods that meet
your daily nutritional needs. A healthful diet should include:
Adequate vitamins and minerals. Eating a wide variety of foods from
all the food groups on the Food Guide Pyramid will help you get the
vitamins and minerals you need. If you eat less than 1,200 calories per
day, you may benefit from taking a daily vitamin and mineral
supplement.
Adequate protein. The average woman 25 years of age and older
should get 50 grams of protein each day, and the average man 25 years
of age and older should get 63 grams of protein each day. Adequate
protein is important because it prevents muscle tissue from breaking
down and repairs all body tissues such as skin and teeth. To get
adequate protein in your diet, make sure you eat 2-3 servings (see
Figure 2) from the Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts
Group on the Food Guide Pyramid every day. These foods are all good
sources of protein.
Source: U.S. Department of Agriculture / U.S. Department of Health and Human Services
Note: A range of servings is given for each food group. The smaller number is for people
who consume about 1,600 calories a day, such as sedentary women. The larger number is
for those who consume about 2,800 calories a day, such as active men.
Adequate carbohydrates. At least 100 grams of carbohydrates per
day are needed to prevent fatigue and dangerous fluid imbalances. To
make sure you get enough carbohydrates, eat 6-11 servings (see Figure
2) from the Bread, Cereal, Rice, and Pasta Group on the Food Guide
Pyramid every day.
A daily fiber intake of 20 to 30 grams. Adequate fiber helps with
proper bowel function. If you were to eat 1 cup of bran cereal, 1/2 cup
of carrots, 1/2 cup of kidney beans, a medium-sized pear, and a
medium-sized apple together in 1 day, you would get about 30 grams of
fiber.
No more than 30 percent of calories, on average, from fat per day,
with less than 10 percent of calories from saturated fat (such as fat from
meat, butter, and eggs). Limiting fat to these levels reduces your risk
for heart disease and may help you lose weight. In addition, you
should limit the amount of cholesterol in your diet. Cholesterol is a
fat-like substance found in animal products such as meat and eggs.
Your diet should include no more than 300 milligrams of cholesterol per
day (one egg contains about 215 milligrams of cholesterol, and 3.5
ounces of cooked hamburger contain 100 milligrams of cholesterol).
At least 8 to 10 glasses, 8 ounces each, of water or water-based
beverages, per day. You need more water if you exercise a lot.
These nutrients should come from a variety of low-calorie, nutrient-rich foods.
One way to get variety -- and with it, an enjoyable and nutritious diet -- is to
choose foods each day from the Food Guide Pyramid (see Figure 2).
Types of Diets
Fixed-menu diet. A fixed-menu diet provides a list of all the foods you
will eat. This kind of diet can be easy to follow because the foods are
selected for you. But, you get very few different food choices which
may make the diet boring and hard to follow away from home. In
addition, fixed-menu diets do not teach the food selection skills
necessary for keeping weight off. If you start with a fixed-menu diet,
you should switch eventually to a plan that helps you learn to make
meal choices on your own, such as an exchange-type diet.
Exchange-type diet. An exchange-type diet is a meal plan with a set
number of servings from each of several food groups. Within each
group, foods are about equal in calories and can be interchanged as
you wish. For example, the "starch" category could include one slice of
bread or 1/2 cup of oatmeal; each is about equal in nutritional value and
calories. If your meal plan calls for two starch choices at breakfast, you
could choose to eat two slices of bread, or one slice of bread and 1/2
cup of oatmeal. With the exchange-type diet plans, you have more
day-to-day variety and you can easily follow the diet away from home.
The most important advantage is that exchange-type diet plans teach
the food selection skills you need to keep your weight off.
Prepackaged-meal diet. These diets require you to buy prepackaged
meals. Such meals may help you learn appropriate portion sizes.
However, they can be costly. Before beginning this type of program,
find out whether you will need to buy the meals and how much the
meals cost. You should also find out whether the program will teach
you how to select and prepare food, skills that are needed to sustain
weight loss.
Formula diet. Formula diets are weight-loss plans that replace one or
more meals with a liquid formula. Most formula diets are balanced diets
containing a mix of protein, carbohydrate, and usually a small amount
of fat. Formula diets are usually sold as liquid or a powder to be mixed
with liquid. Although formula diets are easy to use and do promote
short-term weight loss, most people regain the weight as soon as they
stop using the formula. In addition, formula diets do not teach you how
to make healthy food choices, a necessary skill for keeping your weight
off.
Questionable diets. You should avoid any diet that suggests you eat
a certain nutrient, food, or combination of foods to promote easy
weight loss. Some of these diets may work in the short term because
they are low in calories. However, they are often not well balanced and
may cause nutrient deficiencies. In addition, they do not teach eating
habits that are important for long-term weight management.
Flexible diets. Some programs or books suggest monitoring fat only,
calories only, or a combination of the two, with the individual making
the choice of both the type and amount of food eaten. This flexible
type of approach works well for many people, and teaches them how to
control what they eat. One drawback of flexible diets is that some don't
consider the total diet. For example, programs that monitor fat only
often allow people to take in unlimited amounts of excess calories from
sugars, and therefore don't lead to weight loss.
It is important to choose an eating plan that you can live with. The plan should
also teach you how to select and prepare healthy foods, as well as how to
maintain your new weight. Remember that many people tend to regain lost
weight. Eating a healthful and nutritious diet to maintain your new weight,
combined with regular physical activity, helps to prevent weight regain.
Physical Activity
Regular physical activity is important to help you lose weight and build an
overall healthy lifestyle. Physical activity increases the number of calories your
body uses and promotes the loss of body fat instead of muscle and other
nonfat tissue. Research shows that people who include physical activity in
their weight-loss programs are more likely to keep their weight off than people
who only change their diet. In addition to promoting weight control, physical
activity improves your strength and flexibility, lowers your risk of heart
disease, helps control blood pressure and diabetes, can promote a sense of
well-being, and can decrease stress.
Any type of physical activity you choose to do -- vigorous activities such as
running or aerobic dancing or moderate-intensity activities such as walking or
household work -- will increase the number of calories your body uses. The
key to successful weight control and improved overall health is making
physical activity a part of your daily life.
For the greatest overall health benefits, experts recommend that you do 20 to
30 minutes of vigorous physical activity (see the following Activities Chart)
three or more times a week and some type of muscle strengthening activity,
such as weight resistance, and stretching at least twice a week. However, if
you are unable to do this level of activity, you can improve your health by
performing 30 minutes or more of moderate-intensity physical activity (see the
Activities Chart) over the course of a day, at least five times a week. When
including physical activity in your weight-loss program, you should choose a
variety of activities that can be done regularly and are enjoyable for you. Also,
if you have not been physically active, you should see your doctor before you
start, especially if you are older than 40 years of age, very overweight, or have
medical problems. A fact sheet on physical activity and weight control is
available from WIN.
Behavior Change
Behavior change focuses on learning eating and physical activity behaviors
that will help you lose weight and keep it off. The first step is to look at your
eating and physical activity habits, thus uncovering behaviors (such as
television watching) that lead you to overeat or be inactive. Next you'll need to
learn how to change those behaviors.
Getting support from others is a good way to help you maintain your new
eating and physical activity habits. Changing your eating and physical activity
behaviors increases your chances of losing weight and keeping it off. For
additional information on behavior change, you may wish to ask a weight-loss
counselor or refer to books on this topic, which are available in local libraries.
What Works for You?
A variety of options exist to help you lose weight and keep it off. The key to
successful weight loss is making changes in your eating and physical activity
habits that you will be able to maintain for the rest of your life.
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