Dieting Dilemma: Keeping Weight Off

A lifestyle overhaul works better than dieting

By Jeanie Lerche Davis
WebMD Weight Loss Clinic - Feature

Reviewed By Michael Smith, MD

If you're losing weight, celebrate! A manicure, a massage, three or four M&Ms -- live it up. For every goal you meet, you deserve a reward. Weight loss is not easy.

At the Canyon Ranch health resort in Tucson, Ariz., Michael Hewitt, PhD, research director for exercise science, knows the power of positive strokes.

In fact, the Canyon Ranch philosophy is that "your body today is absolutely perfect," Hewitt tells WebMD. "I'm not saying you're as lean as you could be. But within your genetic potential -- which you can't escape -- your body has adapted perfectly to your patterns of eating, exercise, to the way you've been living your life."

Translation: I'm OK, you're OK. But we're sure not perfect. An overall lifestyle change is necessary to get slim and stay that way.

"You must find the balance -- in diet, in exercise -- that maintains your new weight, without having extra weight creep back on," says Kathleen M. Zelman, MPH, MD/LD, director of nutrition for the WebMD Weight Loss Clinic.

Your mission: "If you can keep the weight off for one full year, you've gone through every birthday, every holiday," Zelman tells WebMD. "You have figured out how to do it and proven you can keep it off."

Meditate on This

Maintaining weight loss begins in your brain. "Visualize who you want to be," advises Hewitt. "Then decide what you have to do to get there. To maintain a leaner, lighter you, how will you have to live your life?"

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."

The Guidelines

While there's no sure-fire formula, there are basic guidelines. Check with your doctor first to make sure this routine is safe for you.

Aerobic workout:

  • To maintain good health, get 20 minutes of aerobic exercise three times a week -- like walking fast enough that you're slightly out of breath.
  • For weight loss, get 40 minutes of aerobic exercise four or more times per week.

Strength training:

  • Lift weights a minimum of twice each week, ideally every other day. (Once a week is not enough; you will lose what you gain, says Hewitt.)
  • Do two or three sets each time; there's little benefit in doing more.
  • Use weights that provide "muscular challenge" -- if you can't do eight arm curls, they're too heavy; if you can do 13 curls, you're ready for the next heavier weight.
  • Note: If you can lift your own luggage, five-pound weights are much too light for most exercises.
  • Do the "key three" exercises: wall squats, chest presses, and the single arm row.

Wall squats: Stand with your back against a smooth wall, feet shoulder-width apart and 1-1/2 foot-lengths from the wall. Maintain slight bend in knees and hang arms freely at sides. Hold a dumbbell in each hand. Slowly slide down wall until knees approach but do not exceed 90 degrees. Press upward until legs are nearly straight. Repeat.

Chest presses: Lie bent-knee on back with arms extended so that hands are above your chest. With a dumbbell in each hand, slowly press hands toward ceiling, bringing weights together. Lower slowly and repeat.

Single arm row: Place one hand and same-side knee on bench or edge of chair with other foot on floor. Keep back flat and parallel to floor. Let a hand weight hang directly below shoulder. Slowly raise weight to just under shoulder, keeping elbow close to side. Lower slowly and repeat. Reverse position to work opposite side of body.

Love You

If you've tried and tried, but work or family must take priority, make self-acceptance your goal, says Hewitt.

"Stop beating yourself up that you're not a supermodel," he says. "Work toward being healthy enough that you have the energy you need to enjoy your life. If you're doing the best you can, accept that this is a good weight for me."

It's healthy to have priorities besides weight loss.

Published March 22, 2004.


SOURCES: Michael Hewitt, PhD, research director for exercise science, Canyon Ranch, Tucson, Ariz. Kathleen M. Zelman, MPH, MD/LD, director of nutrition, WebMD Weight Loss Clinic.


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