Dieting Dilemma: Keeping Weight Off (cont.)

Consider this: "If you make subtle changes in your routine, you'll see subtle changes in your body," he explains. "Dramatic lifestyle changes bring dramatic changes in your body." Temporary lifestyle changes -- well, you get the picture.

"Staying lean requires constant vigilance," says Zelman. "People say to me, 'Oh, you're so thin. I say, 'Give me break, you think I eat everything I want?' It's rarely about genetics. It's usually that your metabolism slows down 10% every decade. You need to be cutting back on calories, or they will catch up with you."

Small changes work. "You can have that piece of cake -- but you have to figure out how you can," she tells WebMD. "It's about portion control, cutting a little bit here and there."

For some people, meal replacement bars or shakes help. "It takes care of your appetite and takes all the decision-making out of the process -- so you're not tempted," says Zelman. "It helps control one meal at a reasonable calorie level."

Eating breakfast also helps. "Breakfast gets your metabolism going, so it revs up your engine," she advises. "When you wake up, your basal metabolic rate is low. When you put food in your system, it gets your blood glucose going. You have to make sure you have protein in that breakfast so you're not starving two hours later. It makes you less hungry in other meals, helps you control what you eat."

Keeping a journal keeps you honest. "You have to have some checks and balances," says Zelman. "If you have to write down 'I ate a whole cheesecake,' you acknowledge that you did it. That will keep you from eating so much the next time."

The Exercise Side of the Equation

Sticking with an exercise program is just as crucial, Hewitt tells WebMD. "I'm not sure you can lose weight permanently without exercise."

"Strength training helps rebuild your muscles, helps rev up your metabolism. That means lifting weights. Nothing too grueling -- just enough to wake up your muscles."

When most people are on a weight loss diet, they lose muscle mass -- which slows metabolism, he explains. Your age compounds the problem; every decade, our metabolism slows down by 10%. The result is weight gain.

Strength training helps rebuild your muscles, helps rev up your metabolism. That means lifting weights. Nothing too grueling -- just enough to wake up your muscles.

There's one caveat: Severely obese women have developed good muscles to carry that weight, so they may have all the lean body mass they need, says Hewitt. Those women should focus on getting more aerobic exercise like walking.

A trainer or exercise physiologist can help greatly in outlining a good exercise program based on your lean body and fat ratio. But do-it-yourself works, too.

"To get started, ask yourself: What am I doing now that I can do better? Then do that," says Hewitt. "When that becomes a habit, do a little more. Anything of value requires effort. If you want good health, if you want a great shape, it you want to be trim and agile, it takes effort."

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