When my brother was teaching me to drive a stick shift, he did a lot of talking. "Okay, bring up your foot," he would say. "Get it to that point where you feel it's about to give. Do you feel it? Okay, slowly, slowly, release the clutch." I kept stalling out.
Then, on one of our driving excursions, we stopped at a crowded tollbooth. I could feel the sweat build on my forehead in anticipation of stalling as I tried to pull away. My brother started to speak. "Shut up," I told him. He had been talking so much about what I should feel as I went from neutral to first gear that I couldn't feel a thing. I was too busy trying to listen. But when he kept quiet, everything fell into place. I smoothly shifted gears, and another stick-shift driver was born.
In many ways, that's how it is with dieting. You can be told how to do it, but in the end you have to feel your own way through it, at least to some degree.
The problem is that that there are so many opinions about what to do to lose weight that nobody can feel his or her way through anything. However, what it takes to lose weight is different for different people.
For me it was giving up sweets for a while. I had always eaten pretty healthful meals, but sugary foods of all kinds were what kept me obese as a grade schooler and overweight throughout my adolescence and university years.
That is why, during my last term in school some 20 years ago, I kept all cakes, cookies, and ice cream out of my off-campus apartment. I also was strict with myself about not having seconds of anything, no matter how much I liked the taste. For instance, I would buy a package of 6 little chicken drumsticks and broil them all at one time, but only have 2 for dinner and use the other 4 for 2 other meals. I bought those tiny boxes of raisins and would use only 1 per bowl of breakfast cereal.
I had 2 things going for me to make dieting work. One was that, living by myself, I was not lured into eating for social reasons. Most of the time, I completely called the shots. Those times that I did eat with others, I was so motivated by my continuing success that I was able to control whatever urges I had to stray from the diet.
The second thing in my favor was that I knew what a meal was. I knew how to get a protein, a starch, a green vegetable, and a salad on the plate. Meals were not fancy, but they did the trick.
The result: between September and December of 1978, I dropped from about 160 pounds to 135—a notable difference on a guy who is 5 feet 5 inches with a wiry frame.
But mine is only one story. Even in my own circle, there is a lot of variation. My friend Fay dropped from a high of 200 pounds at age 12 to 115-120 pounds using a variety of methods at different times in her life. The first 40 pounds came off with Stillman's, a precursor to today's high-protein diets that allowed her only beef and chicken and loads of water—no bread, vegetables, or fruits—although she did allow herself ketchup. Then, she gained back about 15 pounds and kept trying to go back on Stillman's, but recounts that "it didn't work for me."
After that, she tried a combination of "starving as much as possible," as she puts it, Weight Watchers, and other plans and "got into the 130s." Then, after she gave birth to my godson, she went with the flow of the extra calorie burning that occurs during breastfeeding and lost another 20 pounds.
At 5 feet 5 inches, she weighs a decidedly svelte 115-120 pounds. One of her most important strategies, she says, is eating more food earlier in the day. "I don't starve all day like I used to," she comments. "I also exercise a lot more—spinning, running, weight training."
For my brother's friend, Wayne, weight loss began with exercise. In 1987, he says, "somebody recommended Nordic Track to me. I bought it, started using it, realizing what bad shape I was in. As I exercised, I felt better. As I felt better, I started eating better." Part of his new eating style was having more fruits and vegetables. "That was a big thing," he comments. "That really made a difference."
The lowest weight Wayne got down to was 168, from a high of 225 on a 5-foot 8-inch frame. "I stayed there for 4 or 5 years," he says. "Now I'm probably about 190."
Okay, so those are 3 people's stories. Open it out to the wider world and there are more—many more. And no 2 stories are exactly alike.
Perhaps nowhere is that made clearer than in a databank of information called the Weight Control Registry. Compiled by researchers, it is an ever-growing list of people who have lost at least 30 pounds and have kept it off for at least 1 year. The registry has thousands of enrollees, and many of them have lost well over 60 pounds—and kept the weight off for years and years. How?
Some used a formal program such as Weight Watchers, or professional assistance, like individual sessions with a psychologist or a registered dietitian. Some did it on their own. Some, like me, restricted certain types of foods. Some ate all the foods they always had but in limited quantities. Some counted calories; some, fat grams. Others followed what is referred to as an exchange diet, often used by people with diabetes. Still others used liquid formulas, at least during part of their effort. In other words, each had found a way that was right for him or her alone.
That does not mean that some generalizations can't be. A number of approaches to weight loss are shared among many. For instance, people who are successful at keeping off lost weight do not appear to follow regimens that eliminate whole food groups or advise unusual combinations of food.
Many people who lost weight came to the realization that the only way it was going to work was for them to eat less food. Yes, it is possible to eat a greater volume of food than you have been eating and still lose weight. Whole books have been written about it, but it entails eating loads of vegetables and fruits and what many would consider painfully small portions of protein-rich foods like meat and starch-rich items like bread and pasta. Most people, it appears, worked it out by eating less food all around—not huge amounts of one thing and tiny portions of another.
Other generalities about losing weight:
You have to be able to deal with at least a little hunger—at least at first. Most weight-loss books sell themselves on the notion that you do not have to endure any hunger to shed pounds, but that does not describe people's experiences.
Marion Nestle, someone who lost 10 pounds when her physician told her she had high cholesterol, recalls that the first weekend was "really rough." I, too, struggled at first with the hunger from meal to meal. It took a little while for my body to adjust.
Anne Fletcher, a dietitian who surveyed more than 200 people who lost weight and kept it off for her "Thin for Life" book series, concludes that dealing with hunger is a matter of "learning to trade off momentary pleasure for long-term satisfaction." She says people learn to tell themselves, "'I can wait another hour until supper time."
It helps to feel psyched. Many successful weight losers seem to devote a great deal of mental energy to staying with the program. I remember when I was losing weight that there was no budging me from my plan; I was really "pumped."
Mary Lou Klem, a project director for the Weight Control Registry, says the registry's enrollees were not asked specifically about how psyched they felt. But the registry does say they reported that they were "more committed to make changes, more committed to losing weight."
It is important to keep on top of it. Losing weight is not something people can do without devoting considerable attention to it. It does not just happen. Rather, it takes a certain mindfulness, or even hypervigilance. Weight Control Registry members report having used "more intensive approaches…on the successful attempt," note the registry keepers in an article in a study.
The Marine-like toughness does not necessarily have to last forever. I suspect that what happens with a lot of people who lose weight is what happened with me. At first, you have got to be super-vigilant and firm with yourself. But then, as you lose weight and your body requires fewer calories to support its smaller size—and you get back in better touch with your physiologic appetite—you can go a little easier on yourself.
Weight Control Registrants corroborate my experience by reporting that they find keeping off their weight easier than losing it in the first place.
That said, however, it should be noted that not everybody's body responds to strict dieting. It is in part for that reason, in fact, that my sister-in-law, Tricia, a large woman who comes from a family where people put on weight easily, decided not to try to slim down. "If I were a size 12," she comments, "I would be thrilled. But I'm not, and that's okay. My priority is to stay healthy."
And she does. At her last physical, her cholesterol levels, blood pressure, and other vital signs were all within the normal range.
Eating regular meals is the way to go. Eating patterns reported by Weight Control Registrants suggest a habit of having regular meals. That is not to say they do not snack; they eat an average of about 5 times a day. But very few eat less than, say, twice a day. An average of 3 meals a week are eaten at restaurants.
Exercising will help—up to a point. Exercise is an important piece to weight loss, but it takes more than exercising. Consider that when a National Institutes of Health (NIH) Task Force set guidelines for losing weight a few of years ago, it said that people wanting to shed pounds should create a calorie deficit of 500-1,000 calories a day. Walking with moderately intensity for 30-45 minutes can expend about 100-200 calories. However, the bulk of the calorie deficit comes from eating less food.
While exercise alone does not just melt off the pounds the way many people assume, it is important to note that vigorous physical activity is a great motivator in a weight-control effort. It is also great at helping to keep the weight off after you have lost it.
During the first 6 months after my weight loss, I gained back 9 pounds—twice. It was very hard losing them both times. I had to go into that super-mindful small-portions, no-sweets mode again, and knew I didn't want to sustain that kind of vigilance for the rest of my life.
Then, my brother got me into jogging. I felt ridiculous running around outside in a pair of gym shorts, but I soon became hooked. I had never been active in my life, and I found I enjoyed challenging my body. Today, I jog 3 miles several days a week, take a brisk, hour-long walk at lunchtime, and play an occasional game of tennis with my neighbor Tom. Because I've become active, I can enjoy some cake without having to worry too much about the needle inching up on the scale.
Those in the Weight Control Registry maintain their losses by exercising, too.
It pays to monitor yourself. I weigh myself once a week. Apparently, so do many in the Weight Control Registry. Doing so helps keep them stay true to their weight loss goals.
Eat Right—Academy of Nutrition and Dietetics
National Weight Control Registry
Dietitians of Canada
NWCR facts. The National Weight Control Registry website. Available at: http://www.nwcr.ws/Research/default.htm. Accessed April 6, 2017.
Wing RR, Phalen SS. Long term weight loss maintenance. Am J Clin Nutr. 2005;82(1 Suppl):222S-225S.
Last reviewed April 2017 by Michael Woods, MD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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