Lots of diets promise quick and easy weight loss. But what do you do afterward? Instead of rapid weight loss, focus on slow changes that result in sustainable weight management
By John Casey
WebMD Weight Loss Clinic - Feature
Reviewed By Gary Vogin, MD
Perhaps uppermost among all the unpleasant parts of weight loss is the fact that it is so easy to fall off the diet wagon and gain weight back.
"You really, really work at dieting and drop all these pounds, then you want to eat something and just enjoy it without worrying about how many grams of fat it has or how many calories," says Catherine Gush, 43, a medical assistant in a doctor's office in Craig, Colo.
It's that moment when all the hard work, irritability, and delayed gratification come up against the pleasure of the pint of gourmet ice cream in the freezer and the strip of fast-food joints along the highway.
"You see the food, and you ask yourself, 'What's the point?'" says Walt Stock, 39, an automotive repair technician in Latrobe, Pa. "At least if I eat the food I know I'll feel better for a while, and I'll eat it sooner or later, so it might as well be sooner."
This is what some dietitians and doctors call "diet dropout." And it is often a result of dieters' unrealistic goals.
Even when under medical treatment for weight problems, "patients tend to hit a plateau after about three to six months of treatment or when they've lost about 5 to 15 percent of body weight," says Louis Aronne, MD, associate professor of medicine at Cornell University's Weill Medical College who specializes in the study of obesity. "They stop losing weight, and their appetites return. It causes a lot of frustration, even for patients who are very motivated."
Fantasy Scuttles Weight Loss
"A lot of weight-loss programs out there direct people in the action phase of weight loss only," says Leslie Bonci, RD, a spokesperson for the American Dietetic Association and director of the sports medicine nutrition program at the University of Pittsburgh in Pennsylvania. "These programs take an all-or-nothing approach that is not conducive to long-term weight management."
Some of these unrealistic goals are the result of heavy advertising for products that claim to help people lose weight. Many of these advertisements play into people's fantasies about weight loss.
"If you see an ad that says something will give you quick and easy weight loss, you can be sure that is a fantasy," says Aronne. "Weight loss is all about slowly changing lifestyle by eating better food and getting more exercise."
Talk to your doctor before you start your diet to give yourself a better chance of long-term success, Bonci says, adding that a registered dietitian can be an enormous help for many people who want to drop weight.
"A dietitian can design a diet that fits your needs and provides an appropriate calorie level," she says. "One of the best ways to start is to keep a food diary for a few days to identify your dieting weak spots and start setting realistic goals, such as trying to cut just 250 calories per day from your usual diet."
Simple dietary changes, coupled with exercise and realistic expectations, says Bonci, can easily result in a weight loss of one-half pound per week for most of us.
The Ugly Truth
Really, no one wants to hear the old "eat better and get more exercise" advice. But the ugly truth is that the body allows for only that recipe for weight loss, unless you include liposuction and stomach-shrinking surgery.
"Vegetables have high water and fiber content," says Bonci. "They are crunchy, and they give your mouth something to do. Don't deny yourself some of what you want to eat when you want to eat it, but consider adding a piece of fruit or a vegetable before you eat the cookie. Eat an apple and two cookies instead of five or six cookies."
Not only will this approach help you lose weight, it is also easier to maintain these kinds of simple lifestyle changes over the long haul. This approach is also recommended by the American Heart Association (AHA). Their heart-healthy guidelines are a good place to start if you are concerned about your weight and want to do something that is more likely to help your long-term health than are radical diets and strange devices sold on television infomercials.
"We are emphasizing the positive message of what people should eat -- for example, more plant-based foods," says Ron Krauss, MD, who was the lead author of the AHA guidelines for diet and exercise. Krauss is a senior scientist at the Lawrence Berkeley National Laboratory at the University of California. "In the past we have focused rather heavily on the percent of calories as fat and amounts of cholesterol. These are still important considerations, but the emphasis has shifted to allow consumers to understand the importance of an overall eating plan."
The focus should be on simple, slow changes that will result in sustainable weight loss, says Bonci.
"We do a lot of sitting around being passive, watching television," she says. "We are continually bombarded by food messages. It's no wonder we've got an epidemic of obesity in this country. But these are the kinds of things we can do to turn that around."
Published July 29, 2002.
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