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Weight Loss For Life
Who should lose weight? Health experts generally agree that adults
can benefit from weight loss if they are moderately to severely
overweight (see the following weight-for-height chart below). Health
experts also agree that adults who are overweight and have
weight-related medical problems or a family history of such problems
can benefit from weight loss. Some weight-related health problems
include diabetes, heart disease, high blood pressure, high
cholesterol levels, or high blood sugar levels. Even a small weight
loss of 10 to 20 pounds can improve your health, for example by
lowering your blood pressure and cholesterol levels. You do not need
to lose weight if your weight is within the healthy range on the
weight-for-height chart, you have gained less than 10 pounds since
you reached your adult height, and you are otherwise healthy.
Find
your weight on the bottom of the graph. Go straight up from that
point until you come to the line that matches your height. Then look
to find your weight group.
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How we lose weight
Your body weight is controlled by the number of calories you
eat and the number of calories you use each day. So, to lose
weight you need to take in fewer calories than you use. You
can do this by becoming more physically active or by eating
less. Following a weight-loss program that helps you to become
more physically active and decrease the amount of calories
that you eat is most likely to lead to successful weight loss.
The weight-loss program should also help you keep the weight
off by making changes in your physical activity and eating
habits that you will be able to follow for the rest of your
life.
Types of weight-loss programs
To lose weight and keep it off, you should be aware of the
different types of programs available and the important parts
of a good program. Knowing this information should help you
select or design a weight-loss program that will work for you.
The three types of weight-loss programs include:
do-it-yourself programs, non-clinical programs, and clinical
programs.
Do-it-yourself programs
Any effort to lose weight by yourself or with a group of
like-minded others through support groups, worksite or
community-based programs fits in the "do-it-yourself"
category. Individuals using a do-it-yourself program rely on
their own judgment, group support, and products such as diet
books for advice (Note: Not all diet books are reliable
sources of weight-loss information).
Non-clinical programs
These programs may or may not be commercially operated, such
as through a privately-owned, weight-loss chain. They often
use books and pamphlets that are prepared by health-care
providers. These programs use counselors (who usually are not
health-care providers and may or may not have training) to
provide services to you. Some programs require participants to
use the program's food or supplements.
Clinical programs
This type of program may or may not be commercially owned.
Services are provided in a health-care setting, such as a
hospital, by licensed health professionals, such as
physicians, nurses, dietitians, and/or psychologists. In some
clinical programs, a health professional works alone; in
others, a group of health professionals works together to
provide services to patients. Clinical programs may offer you
services such as nutrition education, medical care, behavior
change therapy, and physical activity.
Clinical programs may also use other weight-loss methods, such
as very low-calorie diets, prescription weight-loss drugs, and
surgery, to treat severely overweight patients. These
treatments are described below:
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Very low-calorie diets (VLCDs)
are commercially prepared formulas that provide no more than
800 calories per day and replace all usual food intake.
VLCDs help individuals lose weight more quickly than is
usually possible with low-calorie diets. Because VLCDs can
cause side effects, obesity experts recommend that only
people who are severely overweight (see
weight-for-height chart) use these diets, and only with
proper medical care. A fact sheet on VLCDs is available from
the Weight-control Information Network (WIN).
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Prescribed weight-loss drugs
should be used only if you are likely to have health
problems caused by your weight. You should not use drugs to
improve your appearance. Prescribed weight-loss drugs, when
combined with a healthy diet and regular physical activity,
may help some obese adults lose weight. However, before
these medications can be widely recommended, more research
is needed to determine their long-term safety and
effectiveness. Whatever the results, prescription
weight-loss drugs should be used only as part of an overall
program that includes long-term changes in your eating and
physical activity habits. A fact sheet on prescription
medications for the treatment of obesity is available from
WIN.
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You may consider
gastric surgery
to promote weight loss if you are more than 80 pounds
overweight. The surgery, sometimes called bariatric surgery,
causes weight loss in one of two ways: 1) by limiting the
amount of food your stomach can hold by closing off or
removing parts of the stomach or 2) by causing food to be
poorly digested by bypassing the stomach or part of the
intestines. After surgery, patients usually lose weight
quickly. While some weight is often regained, many patients
are successful in keeping off most of their weight. In some
cases, the surgery can lead to problems that require
follow-up operations. Surgery may also reduce the amount of
vitamins and minerals in your body and cause gallstones. For
additional information, a fact sheet on gastric surgery is
available from WIN. |
If you are considering a weight-loss program and you have
medical problems, or if you are severely overweight, programs
run by trained health professionals may be best for you. These
professionals are more likely to monitor you for possible side
effects of weight loss and to talk to your doctor when
necessary.
Whether you decide to use the do-it-yourself, non-clinical, or
clinical approach, the program should help you lose weight and
keep it off by teaching you healthy eating and physical
activity habits that you will be able to follow for the rest
of your life.
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Diet
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The word "diet" probably brings to mind meals of lettuce and
cottage cheese. By definition, "diet" refers to what a person
eats or drinks during the course of a day. A diet that limits
portions to a very small size or that excludes certain foods
entirely to promote weight loss may not be effective over the
long term. Rather, you are likely to miss certain foods and find
it difficult to follow this type of diet for a long time.
Instead, it is often helpful to gradually change the types and
amounts of food you eat and maintain these changes for the rest
of your life. The ideal diet is one that takes into account your
likes and dislikes and includes a wide variety of foods with
enough calories and nutrients for good health.
How much you eat and what you eat play a major role in how much
you weigh. So, when planning your diet, you should consider:
What calorie level is appropriate? Is the diet you are
considering nutritionally balanced? Will the diet be practical
and easy to follow? Will you be able to maintain this eating
plan for the rest of your life? The following information will
help you answer these questions.
Calorie level
Low-calorie Diets.
Most weight-loss diets provide 1,000 to 1,500 calories per day.
However, the number of calories that is right for you depends on
your weight and activity level. At these calorie levels, diets
are referred to as low-calorie diets. Self-help diet books and
clinical and non-clinical weight-loss programs often include
low-calorie diet plans.
The calorie level of your diet should allow for a weight loss of
no more than 1 pound per week (after the first week or two when
weight loss may be more rapid because of initial water loss). If
you can estimate how many calories you eat in a day, you can
design a diet plan that will help you lose no more than 1 pound
per week. You may need to work with a trained health
professional, such as a registered dietitian. Or, you can use a
standardized low-calorie diet plan with a fixed calorie level.
The selected calorie level, however, may not produce the
recommended rate of weight loss, and you may need to eat more or
less.
Good nutrition
Make sure that your diet contains all the essential nutrients
for good health. Using the Food Guide Pyramid
and the Nutrition Facts Label that is found on most processed
food products can help you choose a healthful diet. The Pyramid
shows you the kinds and amounts of food that you need each day
for good health. The Nutrition Facts Label will help you select
foods that meet your daily nutritional needs. A healthful diet
should include:
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Adequate vitamins and minerals.
Eating a wide variety of foods from all the food groups on the
Food Guide Pyramid will help you get the vitamins and minerals
you need. If you eat less than 1,200 calories per day, you may
benefit from taking a daily vitamin and mineral supplement.
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Adequate protein.
The average woman 25 years of age and older should get 50
grams of protein each day, and the average man 25 years of age
and older should get 63 grams of protein each day. Adequate
protein is important because it prevents muscle tissue from
breaking down and repairs all body tissues such as skin and
teeth. To get adequate protein in your diet, make sure you eat
2-3 servings (see Figure 2) from the
Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts Group on the
Food Guide Pyramid every day. These foods are all good sources
of protein. |
Source: U.S. Department of Agriculture / U.S. Department of
Health and Human Services
Note: A range of servings is given for each food group. The
smaller number is for people who consume about 1,600 calories a
day, such as sedentary women. The larger number is for those who
consume about 2,800 calories a day, such as active men.
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Adequate carbohydrates.
At least 100 grams of carbohydrates per day are needed to
prevent fatigue and dangerous fluid imbalances. To make sure
you get enough carbohydrates, eat 6-11 servings (see
Figure 2) from the Bread, Cereal, Rice,
and Pasta Group on the Food Guide Pyramid every day.
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A daily fiber intake of 20 to 30 grams.
Adequate fiber helps with proper bowel function. If you were
to eat 1 cup of bran cereal, 1/2 cup of carrots, 1/2 cup of
kidney beans, a medium-sized pear, and a medium-sized apple
together in 1 day, you would get about 30 grams of fiber. |
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No more than 30 percent of calories,
on average, from fat per day,
with less than 10 percent of calories from saturated fat (such
as fat from meat, butter, and eggs). Limiting fat to these
levels reduces your risk for heart disease and may help you
lose weight. In addition, you should limit the amount of
cholesterol in your diet. Cholesterol is a fat-like substance
found in animal products such as meat and eggs. Your diet
should include no more than 300 milligrams of cholesterol per
day (one egg contains about 215 milligrams of cholesterol, and
3.5 ounces of cooked hamburger contain 100 milligrams of
cholesterol). |
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At least 8 to 10 glasses,
8 ounces each, of water
or water-based beverages, per day. You need more water if you
exercise a lot. |
These nutrients should come from a variety of low-calorie,
nutrient-rich foods. One way to get variety — and with it, an
enjoyable and nutritious diet is to choose foods each day from
the Food Guide Pyramid (see Figure 1).
Types of diets
Fixed-menu diet.
A fixed-menu diet provides a list of all the foods you will eat.
This kind of diet can be easy to follow because the foods are
selected for you. But, you get very few different food choices
which may make the diet boring and hard to follow away from
home. In addition, fixed-menu diets do not teach the food
selection skills necessary for keeping weight off. If you start
with a fixed-menu diet, you should switch eventually to a plan
that helps you learn to make meal choices on your own, such as
an exchange-type diet.
Exchange-type diet.
An
exchange-type diet is a meal plan with a set number of servings
from each of several food groups. Within each group, foods are
about equal in calories and can be interchanged as you wish. For
example, the "starch" category could include one slice of bread
or 1/2 cup of oatmeal; each is about equal in nutritional value
and calories. If your meal plan calls for two starch choices at
breakfast, you could choose to eat two slices of bread, or one
slice of bread and 1/2 cup of oatmeal. With the exchange-type
diet plans, you have more day-to-day variety and you can easily
follow the diet away from home. The most important advantage is
that exchange-type diet plans teach the food selection skills
you need to keep your weight off.
Prepackaged-meal diet. These
diets require you to buy prepackaged meals. Such meals may help
you learn appropriate portion sizes. However, they can be
costly. Before beginning this type of program, find out whether
you will need to buy the meals and how much the meals cost. You
should also find out whether the program will teach you how to
select and prepare food, skills that are needed to sustain
weight loss.
Formula diet.
Formula diets
are weight-loss plans that replace one or more meals with a
liquid formula. Most formula diets are balanced diets containing
a mix of protein, carbohydrate, and usually a small amount of
fat. Formula diets are usually sold as liquid or a powder to be
mixed with liquid. Although formula diets are easy to use and do
promote short-term weight loss, most people regain the weight as
soon as they stop using the formula. In addition, formula diets
do not teach you how to make healthy food choices, a necessary
skill for keeping your weight off.
Questionable diets.
You
should avoid any diet that suggests you eat a certain nutrient,
food, or combination of foods to promote easy weight loss. Some
of these diets may work in the short term because they are low
in calories. However, they are often not well balanced and may
cause nutrient deficiencies. In addition, they do not teach
eating habits that are important for long-term weight
management.
Flexible diets.
Some
programs or books suggest monitoring fat only, calories only, or
a combination of the two, with the individual making the choice
of both the type and amount of food eaten. This flexible type of
approach works well for many people, and teaches them how to
control what they eat. One drawback of flexible diets is that
some don't consider the total diet. For example, programs that
monitor fat only often allow people to take in unlimited amounts
of excess calories from sugars, and therefore don't lead to
weight loss.
It is important to choose an eating plan that you can live with.
The plan should also teach you how to select and prepare healthy
foods, as well as how to maintain your new weight. Remember that
many people tend to regain lost weight. Eating a healthful and
nutritious diet to maintain your new weight, combined with
regular physical activity, helps to prevent weight regain.
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Physical activity
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Regular physical activity is important to help you lose weight
and build an overall healthy lifestyle. Physical activity
increases the number of calories your body uses and promotes the
loss of body fat instead of muscle and other nonfat tissue.
Research shows that people who include physical activity in
their weight-loss programs are more likely to keep their weight
off than people who only change their diet. In addition to
promoting weight control, physical activity improves your
strength and flexibility, lowers your risk of heart disease,
helps control blood pressure and diabetes, can promote a sense
of well-being, and can decrease stress.
Any type of physical activity you choose to do — vigorous
activities such as running or aerobic dancing or
moderate-intensity activities such as walking or household work
— will increase the number of calories your body uses. The key
to successful weight control and improved overall health is
making physical activity a part of your daily life.
For the greatest overall health benefits, experts recommend that
you do 20 to 30 minutes of vigorous physical activity (see the
following Activities Chart) three or
more times a week and some type of muscle strengthening
activity, such as weight resistance, and stretching at least
twice a week. However, if you are unable to do this level of
activity, you can improve your health by performing 30 minutes
or more of moderate-intensity physical activity (see the
Activities Chart) over the course of a
day, at least five times a week. When including physical
activity in your weight-loss program, you should choose a
variety of activities that can be done regularly and are
enjoyable for you. Also, if you have not been physically active,
you should see your doctor before you start, especially if you
are older than 40 years of age, very overweight, or have medical
problems. A fact sheet on physical activity and weight control
is available from WIN.
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Vigorous activities
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aerobic dancing |
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running |
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brisk walking |
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cycling |
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swimming |
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Moderate-intensity activities
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walking up the stairs instead of taking the elevator |
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walking part or all of the way to work |
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using a push mower to cut the grass |
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playing actively with children |
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Behavior change
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Behavior change focuses on learning eating and physical activity
behaviors that will help you lose weight and keep it off. The
first step is to look at your eating and physical activity
habits, thus uncovering behaviors (such as television watching)
that lead you to overeat or be inactive. Next you'll need to
learn how to change those behaviors.
Getting support from others is a good way to help you maintain
your new eating and physical activity habits. Changing your
eating and physical activity behaviors increases your chances of
losing weight and keeping it off. For additional information on
behavior change, you may wish to ask a weight-loss counselor or
refer to books on this topic, which are available in local
libraries.
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What works for you?
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A variety of options exist to help you lose weight and keep it
off. The key to successful weight loss is making changes in your
eating and physical activity habits that you will be able to
maintain for the rest of your life.
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Additional reading
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Binge Eating Disorder.
NIH Publication No. 99-3589. This fact sheet describes the
symptoms, causes, complications, and treatment of binge eating
disorder, along with a profile of those at risk for the
disorder. 2001. Available from WIN.
Dieting and Gallstones.
NIH Publication No. 02-3677. This fact sheet describes what
gallstones are, how weight loss may cause them, and how to
lessen the risk of developing them. 2002. Available from WIN.
Gastric Surgery for Severe Obesity.
NIH Publication No.01-4006. This fact sheet describes the
different types of surgery available to treat severe obesity. It
explains how gastric surgery promotes weight loss and the
benefits and risks of each procedure. 2001. Available from WIN.
Physical Activity and Weight
Control. NIH Publication No. 96-4031. This
booklet explains how physical activity helps promote weight
control and other ways it benefits one's health. It also
describes the different types of physical activity and provides
tips on how to become more physically active. Revised 1996.
Available from WIN.
Prescription Medications for the
Treatment of Obesity. NIH Publication No.
97-4191. This fact sheet presents information on appetite
suppressant medications. These medications may help some obese
patients lose more weight than with non-drug treatments. The
types of medications and the risks and benefits associated with
the use of these medications are described. Revised 2001.
Available from WIN.
Very Low-Calorie Diets.
NIH Publication No. 95-3894. Information on who should use a
very low-calorie diet (VLCD) and the health benefits and
possible adverse effects of VLCDs is provided in this fact
sheet. 1995. Available from WIN.
Weight Cycling.
NIH
Publication No. 01-3901. Based on research, this fact sheet
describes the health effects of weight cycling, also known as
"yo-yo" dieting, and how it affects obese individuals' future
weight-loss efforts. 2001. Available from WIN.
"Losing Weight: What Works. What
Doesn't" and "Rating the Diets." Consumer Reports.
June 1993, pp. 347-57. These articles report on a survey
of readers' experiences with weight-loss diets, discuss research
related to weight control, and outline pros and cons of
different diet programs. Available in public libraries.
"The Facts About Weight-Loss
Products and Programs." DHHS Publication No.
(FDA) 92-1189. This pamphlet provides basic facts about the
weight-loss industry and what the consumer should expect from a
diet program and/or product. Available from the Food and Drug
Administration, Office of Consumer Affairs, HFE-88, Rockville,
MD 20857.
"Nutrition and Your Health: Dietary
Guidelines for Americans, Fifth Edition." Home
and Garden Bulletin No. 232. 1995. This booklet answers some of
the basic questions about healthy eating and the link between
poor nutrition and disease. It stresses the importance of a
balanced diet and a healthy lifestyle. Available from WIN.
A Report of the Surgeon General:
Physical Activity and Health. 1996. Produced by
the Centers for Disease Control and Prevention, this report
compiles decades of research concerning physical activity and
health. It addresses the nationwide health problems associated
with physical inactivity and outlines the benefits of becoming
more physically active. Available for $19.00 from the U.S.
Government Printing Office, Superintendent of Documents,
Washington, DC 20402; (202) 512-1800. Stock Number
017-023-00196-5.
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Weight-control Information Network
1 WIN WAY
BETHESDA, MD 20892-3665
Phone: (202) 828-1025
FAX: (202) 828-1028
Internet:
www.niddk.nih.gov/health/nutrit/nutrit.htm
Toll-free number: 1-877-946-4627
E-mail:
win@info.niddk.nih.gov
The Weight-control Information Network (WIN) is a service of the
National Institute of Diabetes and Digestive and Kidney Diseases
of the National Institutes of Health, which is the Department of
Health and Human Services' lead agency responsible for
biomedical research on nutrition and obesity. Authorized by
Congress (Public Law 103-43), WIN provides the general public,
health professionals, the media, and Congress with up-to-date,
science-based health information on weight control, obesity,
physical activity, and related nutritional issues.
WIN answers inquiries, develops and distributes publications,
and works closely with professional and patient organizations
and Government agencies to coordinate resources about weight
control and related issues.
This e-text is not copyrighted. WIN encourages users of this
e-pub to duplicate and distribute as many copies as desired.
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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIH Publication No. 98-3700
January 1998
This e-text updated: December 2002
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Source:
http://www.niddk.nih.gov/health/nutrit/pubs/wtloss/wtloss.htm
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