Weight Loss
Weight Loss: The No-Diet Approach
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
Diet and Women
Medical Author: Carolyn Janet Crandall, MD, MS, FACP
Medical Editors: Melissa Conrad Stöppler, MD and William C. Shiel Jr., MD, FACP,
FACR
Ms.
W. J., a 55 year-old woman, comes to her doctor saying, "Doctor, I have never
been this heavy in my life, even after I had my kids. I am trying to diet, but it's not working.
I'm so frustrated. Is it due to my hormone pills?
It seems like it's worse since my mother passed on last year."
This type of encounter occurs every day across the U.S. Over half of all Americans are overweight, meaning they are at a weight that is
associated with increased health risks. Even
though Ms. W. J. has worked hard at trying to lose weight, she needs to know some of the possible reasons
why she hasn't been successful. Her situation
brings up four major issues, including menopause, hormones, personal loss, and
diet failure.
Menopause and hormones
Women
have more body fat throughout their lives as compared to men. After
menopause, women generally gain weight. Research is still conflicting as to whether this is
due solely to menopause or solely to age (because men also typically gain weight as
they become older), or perhaps a combination of age and menopause.
When women
are taking hormone replacement therapy, they are
just as likely to gain weight as women taking a sugar pill (placebo).
This means that the hormones are not causing the weight gain but
rather that menopause itself, in conjunction with age, is likely to be responsible. It is not Ms. W. J.'s imagination that she is heavier than she has ever been
during this menopause period. This
is very common.
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Introduction to weight loss
Whether you are trying to lose 5 pounds or more than
50, the same simple laws of physics determine whether or not you will lose weight and how fast your weight loss will occur. Remembering these simple guidelines and putting them into practice can lead to weight loss without the aid of any special diet plans,
books, or medications.
Our weight is determined by the amount of energy that we take in as food and the amount of energy we expend in the activities of our day. Energy is measured in calories. If your weight
remains constant, you are probably taking in the same amount of calories you burn each day. If you're slowly gaining weight over
time, it is likely that your caloric intake is greater than the number of calories you burn through your daily activities.
Everyone is in control of the amount of food he or she consumes each day, so
our intake of calories is something we can control. To a major degree, we can
also control our output of energy, or the number of calories we burn each day.
The number of calories we burn each day is dependent upon
- our basal metabolic rate (BMR), the number of calories we burn per hour simply by being alive and maintaining body functions and
- our level of physical activity.
For some people, due to genetic (inherited) factors or other conditions, the resting metabolic rate
(BMR) can be slightly higher or lower than average. Our weight also plays a role in determining how many calories we burn at rest -- more calories
are required to maintain your body in its present state, the greater your body weight. A 100-pound person requires less energy (food) to maintain body weight than a person who weighs 200 pounds.
Lifestyle and work habits partially determine how many
calories we need each day. Someone whose job involves heavy physical labor will naturally burn more calories in a day than someone who sits at a desk most of the day (a sedentary job). For people who do not have jobs that require intense physical activity, exercise or increased physical activity can increase the number of calories burned.
As a rough estimate, an average woman 31-50 years of age who leads a sedentary lifestyle needs about 1,800 calories per day to maintain a normal weight. A man of the same age requires about 2,200 calories. Participating in a moderate level of physical activity (exercising
three to five days per week) requires about 200
additional calories per day.
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