How
Successful Dieters Keep Weight Off
Meal plan examples
Click Here
People who lose large
amounts of weight and keep it off for a long time have four things in
common: They follow a high-carbohydrate, low-fat diet, eat breakfast
just about every day, monitor their weight closely and get a lot of
exercise. So says James Hill,
Ph.D., co-director of a long-term study of 3,000 people in a database
called the National Weight Control Registry. Members of the group have
lost an average of 60 pounds and kept it off for an average of five
years.
The people in the study
originally lost their weight — anywhere from 30 to more than 100 pounds
— using "every way known to man," Hill says. "The similarity is in how
they maintain it. I think we need to give more attention to how to help
people maintain weight loss." Hill, a
physiologist and director of the Center for Human Nutrition, University
of Colorado Health Sciences Center in Denver, pressed that message
during a news conference on trends in obesity research sponsored by the
American Medical Association.
In an interview, Hill
said the research he described had been published in medical journals,
most recently in the Annual Review of Nutrition 2001. The authors were
Hill and co-director Rena Wing, Ph.D., a behavioral psychologist at
Brown University. The National Weight
Control Registry was founded in 1993 in an attempt to discover what
makes some people successful in keeping off the weight they lose, Hill
says. "We're trying to say, 'What can we learn from these people that
can help other people to be successful?'"
Surveys show that in any
given year, about half of U.S. adults are trying to lose weight. But if
they are successful, most of them don't keep the weight off. According
to the National Institutes of Health, more than half of adult Americans
are overweight, and about one in four adults is obese, or at least 20
percent overweight. Obesity substantially increases the risk of death
from coronary heart disease, stroke, diabetes and several forms of
cancer.
Harold S. Solomon, M.D.,
director of the Weight Loss and Lifestyle Enhancement program at Beth
Israel Deaconess Medical Center in Boston, says this research shows that
people can keep weight off and points to how to accomplish it. For many people who have
been successful, "it's almost like they've had a religious conversion,"
says Dr. Solomon, an associate professor of clinical medicine at Harvard
Medical School.They become almost obsessive about it," he says. "Those
are successes, but is that what you have to do? Are there people who can
be successful with a little less exercise and a little less rigidity?
What (Hill and Wing) have not done is to define the minimum required to
maintain a 50-pound weight loss. Many of my successful patients seem to
have made minor, but permanent, changes in their lives."
To be enrolled in the
registry, a person must have maintained at least a 30-pound weight loss
for at least one year. Some people on the list simply meet the minimum
requirements. "We have people on the other end who have maintained a
100-pound loss for 40 or 50 years," Hill says. About half lost weight on
their own and half used some sort of formal program, Hill says. According to
questionnaires, most members of the registry have these habits in
common:
High-carbohydrate,
low-fat diet: This is not necessarily the diet they followed to lose the
weight, but it is their long-term eating plan. Although some
low-carbohydrate, high-protein diets are popular, "we looked for people
who were eating a low-carbohydrate diet in this group, and we couldn't
find any," Hill says. Self-monitoring:
"They weigh themselves a lot and they record what they eat on a regular
basis," Hill says. This is important because it allows people to catch
weight fluctuations early and act to correct them. Breakfast: "They
eat breakfast, so they're spreading out their calories over the day."
Hill says researchers are just starting to gather data on what the
participants actually eat.
Exercise: "They
get a lot of physical activity. I think this is the most important,"
Hill says. The average participant burns up about 2,700 calories a week
in physical activity, the equivalent of about one hour of moderately
intense activity every day — for example, five miles of walking. The
National Institutes of Health recommends at least 30 minutes of moderate
activity at least five times a week, but surveys show only 22 percent of
U.S. adults get that much exercise. Most of those in the weight registry
walk a lot, but many do weight lifting, cycling and other activities,
Hill says. Although people in the
study have lost a great deal of weight, the average participant
currently has a body mass index of about 25, the borderline number for
overweight. But Hill says the average BMI before weight loss was 35,
well into the obese range. "That's a huge amount of weight loss."
Based on his years of
experience with patients, Dr. Solomon says he thinks the key to
long-term weight loss is to set up rules for yourself about eating and
exercise, and to internalize those rules so they become second nature,
like brushing your teeth every day. He gives the example of
someone who eats a salad every day for lunch, but still thinks about a
cheeseburger. At some point, he or she will give up and eat the
cheeseburger. In contrast, people who have permanently lost weight often
say they do nothing in particular to keep it off, because they have
internalized their rules, and that is a permanent change, he says. "They have sort of
drummed the cheeseburger out of their minds," he says. "They have a new
reality."
If you are starting on a
weight-loss program, Dr. Solomon advises making rules for yourself based
on knowledge of good nutrition and your own eating style. There is no
right way, he says, only a way that works for you. Dr. Solomon advocates
weighing yourself daily, as most people in the weight-control registry
do, to keep track of how you are doing and to help you stay focused.
by Lisa
Ellis InteliHealth News Service
Back to top
