Lifestyle Changes and Psychosocial Treatments
Even modest weight loss can reduce the risk factors for heart disease and diabetes. The simplest (but still difficult) approach to weight loss is reducing calories and exercising at least 150 minutes a week. Behavioral and mental changes in eating habits, physical activity, and attitudes about food and weight are also essential to weight management. Studies show that people who lost at least 10% of their body weight and kept the weight off for more than 1 year share several characteristics, including:
- Exercising for at least 1 hour each day
- Eating a low-fat, low-calorie diet
- Eating breakfast each day
- Weighing themselves regularly and often
- Eating the same diet on weekends as they do on weekdays
Some Tips for Losing Weight. The following are some general suggestions for dieters:
- Start with realistic goals. Diet failure is extremely common, and the odds of significant weight loss are low, particularly in people with the highest weights. People who are able to restrict calories, engage in an exercise program, and get help in making behavioral changes can expect to lose 5 - 10% of their current body weight. That is generally all that is needed to achieve meaningful health changes. Certainly, the distorted image of a super-thin female shape should not be anyone's goal.
- Maintain a regular exercise program, assuming you have no health problems that will stop you. Choose a program that you enjoy. Check with your doctor about any health considerations. [For more information, see In-Depth Report #29: Exercise.]
- Do not use hunger pangs as cues to eat. A stomach that has been stretched by large meals will continue to signal hunger for large amounts of food until its size reduces over time with smaller meals.
- Be honest about how much you eat and start by recording all calories in writing. Many people significantly underestimate their consumption of high-calorie foods and overestimate intake of low-calorie foods. People who do not carefully note everything they eat tend to take in too many calories when they believe they are dieting.
- Observe weekend eating. People tend to eat more on the weekends. If it is difficult to monitor all meals during the week, it be may be useful to at least track eating habits during the weekends.
- Once the pounds are lost, do your best to keep the healthier weight. Make daily, even hourly, conscious decisions about eating and exercising activities. Such thinking, in many cases, can become automatic and not painful.
- Don't give up, even after repeated weight loss failures. Most studies indicate that yo-yo dieting or weight cycling have no bad psychological or physical effects. Repeated dieting also does not harm the body's ability to burn calories efficiently.
- Weight loss, in any case, should not be the only or even the primary goal for people concerned about their health. The success of weight loss efforts should be evaluated according to improvements in disease risk factors or symptoms, and by the adoption of healthy lifestyle habits, not just by the number of pounds lost.
Key Components of a Lifestyle Change Program
Reduce rate of eating.
Keep food records.
Eliminate environmental triggers to eating.
Identify high-risk situations for overeating.
Separate eating from other activities.
Face up to emotional barriers to exercise.
Understand the link between exercise and weight control.
Establish reasonable exercise goals.
Develop a plan for regular activity.
Add increased activity into daily lifestyle.
Develop reasonable weight-loss goals.
Avoid "all or none" thinking.
Focus attention away from the scale and toward behavior.
Uncouple weight from self-esteem.
If you "fall off the wagon," take steps to ensure you do not repeat the situation (recover from lapses with constructive action).
Understand the key role of social support to health.
Identify supportive others.
Match personal style to support-seeking activities.
Be specific in making support requests.
Be assertive but reinforcing in drawing help from others.
Resist the temptation of popular fad diets.
Eat with your health in mind; do not concentrate on what should be "off-limits."
Eat with moderation in mind.
Develop a tailored plan.
From Brownell KD. The LEARN Program for Weight Control. 7th ed. Dallas, Tex: American Health Publishing Company; 1998.
Review Date: 04/14/2010
Reviewed By: A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital (4/14/2010).