Fad diets tend to have lots of very restrictive or complex rules, which give the impression that they carry scientific heft, when, in reality, the reason they often work (at least in the short term) is that they simply eliminate entire food groups, so you automatically cut out calories. Moreover, the rules are almost always hard to stick to and, when you stop, you regain the lost weight.
Rather than rely on such gimmicks, here we present 18 evidence-based keys for successful weight management. You don’t have to follow all of them, but the more of them you incorporate into your daily life, the more likely you will be successful at losing weight and – more important – keeping the weight off long term. Consider adding a new step or two every week or so, but keep in mind that not all these suggestions work for everyone. That is, you should pick and choose those that feel right for you to customize your own weight-control plan. Note also that this is not a “diet” per se and that there are no forbidden foods.
1. Start with a healthful diet that’s rich in vegetables, fruits, whole grains, sugary foods and saturated and trans fats (see tinyurl.com/healthydietWL). You can include fish, poultry and other lean meats, and dairy foods (low-fat or nonfat sources are preferable to save calories.) Aim for 20 to 35 grams of fiber a day from plant foods, since fiber helps fill you up and slows absorption of carbohydrates. A good visual aid to use is the USDA’s MyPlate (www.choosemyplate.gov), which recommends filling half your plate with vegetables and fruits. Grains (preferably whole grains) and protein foods should each take up about a quarter of the plate.
2. Keep an eye on portions. You can eat all the broccoli and spinach you want, but for higher-calorie foods, portion control is the key. Check serving sizes on food labels – some relatively small packages contain more than one serving, so you have to double or triple the calories, fat and sugar if you plan to eat the whole thing. Popular “100-calorie” food packages do the portion controlling for you (though they won’t help much if you eat several packages at once).
3. Eat Mindfully. This involves increasing your awareness about when and how much to eat using internal (rather than visual or other external) cues to guide you. Eating mindfully means giving full attention to what you eat, savoring each bite, acknowledging what you like and don’t like and not eating when distracted (such as while watching TV, working on the computer and driving). Such an approach will help you eat less overall, while you enjoy your food more. Research suggests that the more mindful you are, the less likely you are to overeat in response to external cues, such as food ads, 24/7 food availability and super-sized portions.
4. Eat Slowly, chew well. A component of mindful eating, this allows more time for satiety signals to reach the brain (it takes about 20 minutes), so slow eaters tend to feel more full and eat less. The process of chewing itself may also stimulate satiety signals. In addition, eating slowly makes you more aware of the smell, taste and texture of the foods, which can lead to greater satisfaction with fewer calories. Keep in mind also that the most pleasure often comes from the first few bites of a food; after that, it’s the law of diminishing returns. Thus, you should focus on those first few tastes of chocolate, cake, or other indulgences as this may be enough to satisfy. For gadget lovers, the HAPIfork ($99) is an electronic fork that vibrates if you don’t pause long enough between bites.
5. Don’t rely on willpower. Instead, control your “food environment” so that you don’t unconsciously overfill your plate and eat when you’re not hungry. That means, for example, not having junk foods at home or a least keeping them out of sight (such as on a top shelf or in the back of the fridge) – and changing your routines so you don’t regularly encounter temptations (such as avoiding the office pantry between meals if it has enticing foods and driving a route that doesn’t take you past your favorite food places). Use smaller plates, bowls, cups and utensils – you may even want to invest in portion-controlled plates (that delineate what reasonable serving sizes are) or portion-control devices (that allow you to measure your food directly on the plate); many different kinds are available online. Portion out snacks into small bowls or bags; don’t eat from large bags or boxes. You may not have control over everything in your food environment, but being aware of hidden food triggers and traps may be enough to keep you from overeating.
6. Identify any emotional triggers that may be making you overeat, such as eating when you are stressed, depressed, upset, angry, lonely or even happy and excited. To distinguish between real hunger and emotional eating, rate your hunger/fullness levels before, during, and after eating – on a scale of 1 to 10, with 1 being “beyond hungry” or “starving” (with associated headaches, lightheadedness and weakness) and 10 being “beyond full” (as in after-Thanksgiving-meal stuffed). Ideally you should eat when you are at level 3 (hungry but not yet uncomfortable) and stop at 7 (full and satisfied). An example of the scale can be found at tinyurl.com/hunger-fullness-scale. If you often eat for reasons other than hunger, find pleasurable non-food-related activities that you can do instead, such as going for a brisk walk or run.
The “Right” Diet
There’s no single diet that’s right for everyone. Where do you fit in?
- Carbs vs. protien vs. fat? Various popular eating plans – such as the Zone, Dukan, Atkins, Pritikin, and Ornish – are based on wildly different ratios of carbohydrates, protein and fat. Some people lose weight more easily on low-carb/high-protien diets, while others do well by eating more carbs and less fat, partly due to genetic reasons. Experiment to find which balance works best for you. Whatever the fat/carb/protein ratio of your diet, opt for “good” carbs (in vegetables, fruits, beans, whole grains), “good” fats (in fish, nuts, seeds, vegetable oils), and healthy protein (in legumes, white-meatn chicken, low-fat or non-fat dairy). And remember that the total number of calories you eat matters more for weight control than what proportionof them comes from each macronutrient.
- Calorie-counting vs. mindful eating? Just as some people like to count calories or use some point system or portion-controlled foods, others will prefer a more mindful approach (as discussed in tip #3), which helps them naturally cut down on calories whiout having to keep track.
- Solo vs. Group? Many people do well by having a diet and exercise partner, joining a structured weight-loss program such as Weight Watchers, or consulting a dietitian who can set up an individualized lifestyle plan and monitor progress. Others may be more successful on their own.
- Most important is to find an eating plan that you can stick with over the long term, since the relatively easy part is losing weight; more difficult is keeping the weight off.
7. Go for volume (low-energy-dense foods). Eating foods low in energy density – that is, with fewer calories relative to their weight and volume – increases satiety, so you are likely to fill up on fewer calories. This well-tested concept was first developed by Barbara Rolls, Ph.D., at Pennsylvania State University in her well-regarded Volumetrics eating plan. In general, the best way to lower the energy density of your diet is to eat more foods that have a high water and high fiber content (notably fruits, vegetables, broth-based soups, and cooked whole grains) in place of low-moisture or high-fat foods (such as cheese, crackers, cookies and fried potatoes). Incorporate more of these foods in recipes – add more vegetables to soups, stews and pasta dishes, for example; fill sandwiches and wraps with lots of lettuce, chopped cucumbers and grated carrots; top whole-grain pizzas with more vegetables and less cheese. Snack on popcorn and grapes instead of raisins (for the same 120 calories, you can eat more than a cup of grapes compared to only 1/4 cup of raisins).
8. Get adequate protein (and include some with all meals). There’s evidence that protein increases satiety more than carbohydrates do. Protein also helps limit muscle loss during weight loss. Look for sources of lean protein (such as beans and other legumes, white-meat poultry, and low-fat or non-fat dairy) or those also rich in healthy fats (such as fish, nuts, and soy foods). Some research suggests that distributing your protein throughout the day also helps in weight loss, rather than eating the bulk of it at, say, dinnertime. According to a 2015 paper in the American Journal of Clinical Nutrition, higher-protein diets that include at least 5 grams of protein at each meal may reduce appetite and thus body weight compared with lower-protein diets. However, people with or at high risk for kidney disease – and that includes many older people – should be careful not to consume excessive amounts of protein.
9. Eat Regularly (don’t skip meals) and choose healthful low-calorie snacks. Many people find that going longer than a few hours without food makes them more likely to overeat later (often on high-calorie treats). Find a meal-timing pattern that works best for you. If you eat between meals, plan ahead for healthful “mini snacks” (100 to 200 calories), such as a small container of low-fat yogurt with a handful of berries; two tablespoons of hummus with a cup of baby carrots or sliced bell peppers; a slice of cheese or two thin slices of turkey on half a whole-grain pita; an ounce (small handful) of nuts; a tablespoon of peanut butter and a banana.
Supplements: Slim Pickings
Hundreds of formulas are marketed for weight loss – touted to burn fat, boost metabolism, control sugar cravings, or help people overcome a genetic predisposition to obesity. But like all supplements, they are not subject to FDA reveiw for effectiveness or safety.
Among the mind-numbing list of ingredients used are CLA, hoodia, capsaicin, hydroxycitric acid, and chitosan. Some, such as guarana, green tea extract and yerba mate, are caffeine-like central nervous system stimulants that can increase blood pressure. Others such as cascara and senna are potentially dangerous herbal laxatives that can result in temporary weight loss by hastening the exit of waste from the intestines, while herbal diuretics like buchu and uva ursi can cause temporary water loss.
A few ingredients have been tested in controlled studies, with inconsistent results or modest effects at best. But most have no convincing cientific support behind them or have not been tested at all. And none are “clinically proven” for significant weight loss, no matter what their labels say. Save your money. For more on diet supplements, go to tinyurl.com/dietsuppsWL
10. Limit variety at meals. Variety in your overall diet is important to ensure that you get a range of nutrients and other substances that contribute to good health. But having too many choices at once can lead to overconsumption (the “smorgasbord effect”) because foods with different flavors and sensory qualities whet the appetite, even if you are physically satiated – which is why there always seems to be “room for dessert”. It’s also easier to overfill your plate when you have a large number of choices. On the other hand, you’re likely to eat less if you have less variety, since foods similar in taste and texture dull the palate ( a phenomenon called sensation-specific satiety). Be especially careful at all-you-can-eat buffets and parties. Scan the whole array of foods before making your selection, choose nor more than three or four items that most appeal to you, and make only one trip. Using smaller plates also helps limit your choices.
11. Don’t drink your calories. Beverages are not as satiating as solid foods, and people usually do not compensate for liquid calories by eating less food. It’s okay to drink milk but otherwise stick with water or other noncaloric beverages like tea and coffee (watch the cream and sugar). Choose whole fruits over juice. The jury is still out on whether they help with weight loss. The proposed 2015 U.S. Dietary Guidelines do not recommend sugar substitutes, citing a lack of evidence that they help in long-term weight loss. To liven up water, try a squeeze of lemon or lime or other fruit essence. If you drink alcoholic beverages, be aware of their calories (more than you may think) and that alcohol can have a disinhibiting effect on eating control.
12. Cook at home often. That allows you to eat more whole foods and control how much oil, sugar and other high calorie ingredients you use. Studies have shown that people tend to eat more when they eat out – though you must still be careful to limit portion sizes at home. If cooking from recipes, look for healthy lower-calorie ones that include nutrition analyses – and stick to the serving sizes. Be aware also that just as restaurant portions have ballooned in recent years, recipe serving sizes have also been on the increase.
Exercise: The Other Half of the Equation
Studies comparing the roles of calorie reduction and exercise in weight loss have generally found that the greater benefit comes from the dieting. But combining exercise and diet is usually best. Exercise not only burns calories and makes you trimmer and fitter, it also helps prevent the loss of muscle mass and the drop in matabolic rate that usually accompanies dieting. And once you’re at your desired weight, exercise is an effective way to prevent or minimize future weight gain.
For overall good health, the U.S. Dietary guidelines recommend that adults do at least 150 minutes a week of moderate intensity exercise (such as 30 minutes, five days a week) or 75 minutes a week of vigorous aerobic exercise. To lose weight and maintain weight loss, aim higher: 300 minutes a week at moderate intensity or 150 minutes at high intensity. To meet the goals more easily, you can break up your exercise – even into periods as short as 10 minutes.
You should also aim to be more active all around – taking the stairs instead of the elevator, parking farther away from your destination (or, better yet, walking instead of driving for shorter distances), and avoiding too much TV or other “couch potato” time. Find activities and sports you enjoy so you will be more likely to stick with them (working out Shouldn’t feel like “work” after all). Using some type of fitness tracking device or smartphone app can be motivating.
Another perk of exercise: It can help ease snack cravings, some research has found. In a 2015 study in PLOS ONE, for example, overweight people reported reduced cravings for high-calorie sugary snacks after a brisk 15-minute walk. And in a 2011 study in Appetite, people who walked and then did computer work ate half as much chocolate from a bowl at hand as those who rested before the task. Breif bouts of exercise may help elevate mood, similar to what chocolate and sugary foods do. Any kind of physical activity may do the trick.
Doesn’t exercise make you hungrier, though, so you may end up eating more calories than you’ve burned off? Most studies suggest that when people exercise moderately, they tend to eat only slightly more than when they don’t work out. But it’s hard to generalize, since appetite regulation is a complex process, involving blood sugar levels, a variety of hormones and other chemicals, and psychological factors. Exercise’s effect on your appetite may also depend on your gender, body weight, fitness level, as well as on thge frequency, duration and intensity of your workouts. And the effect is likely to be different once exercise becomes habitual, because of the body’s adaptation processes during a long-term exercise regimen. However your appetite is affected by exercise, watch how much you eat afterwards, and don’t use food as a reward for your workout efforts.
13. When eating out, follow these simple rules. Take advantage of calorie listings on menus (or online beforehand) to find lower-calorie options, don’t order anything that’s been super-sized, and consider sharing entrees (or asking for half to be wrapped to take home before you start eating). Or have an appetizer or salad as your main dish. Reading over the whole menu before you order and asking questions of your server or the chef can help steer you toward more healthful, lower-calories options. Request that dishes be prepared with no or minimal butter, oil or other high-fat ingredients, and ask for salad dressings on the side so you can control how much you use. For getting around menu “tricks” that restaurants use to boost sales – often of the cheaper and less-healthful foods – go to tinyurl.com/menusWL.
14. Allow for (controlled) indulgences. Most people find foods high in fat and sugar pleasurable, since they activate the body’s “reward system” (which releases chemicals in the nervous system relating to pleasure). Overly restricting such foods (or any other types of food you crave) can be counterproductive since it can increase your desire for them and lead to bingeing. An occasional treat is fine, as long as it doesn’t tip the scale with calories. You might, for instance, have a small treat daily or save up for some treats on weekends. On the other hand, some people can’t eat just a little and may be better off avoiding hard-to-resist foods altogether.
15. Keep a food diary. Studies, including one in the Journal of the Academy of Nutrition and Dietetics in 2012, have found that dieters who regularly record what they eat lose more weight than those who don’t. It doesn’t matter how you do it – in a notebook, on the computer, or with an app on your phone – as long as you record your intake consistently and honestly (including even condiments and tastings you may take while cooking). this simple act makes you more accountable for what you eat and helps you see patterns in your eating habits that may be contributing to weight gain.
If you are obese and have failed all other weight-loss attempts, you can ask your doctor about prescription diet medication and possibly bariatric surgery.
- Five diet drugs (plus one OTC drug) are now available for long-term use, but their drawbacks and risks usually out-weight their modest benefits. We’ll discuss these drugs in an upcoming issue.
- Bariatric surgical procedures, including gastric bypass surgery and placement of a band in the stomach, work by restricting the amount of food the stomach can hold and/or by affecting how food is digested. Bariatric surgery has proven long-term benefits, but it doesn’t work for everyone and carries its own risks.
16. Get enough sleep. As discussed earlier, an often-overlooked factor in body weight may be your sleep habits. Though the optimal amount of sleep varies from person to person, too little sleep (fewer than six hours a night in one study) has been linked to weight gain because it may affect appetite hormones and lead to increased hunger and food intake, decreased calorie burning and increased fat storage.
Lost Weight? Now for the Hard(er) Part…
The weight-loss industry tends to focus on strategies needed to shed pounds – but these may be different from what you need to maintain your new, lower weight.
For instance, as a study in the American Journal of Preventive Medicine found, people who succeeded at losing weight and keeping it off shared some common practices: they ate lots of fruits and vegetables, controlled their portions, planned what they would be buying before shopping, an dread nutrition labels. But the successful weight maintainers and other tactics in their arsenal too: they were more likely to follow a consistent exercise routine, eat higher amounts of lean protein, reward themselves for sticking to their diet or exercise plan, and remind themselves why they need to control their weight.
Meanwhile, the national Weight Control Registry has found that successful weight-loss maintainers tend to be conscious of calories, have a less-varied diet, weight themselves regularly, keep food diaries, watch less TV and exercise a lot among other winning strategies.
Why the need for some new strategies?
Weight control is a process in which you fine-tune what works for you as you go. You may find, for example, that limiting calories works initially, but that you feel better and can more easily keep your calories down by eating a higher proportion of protein. You may also need a variety of exercise before you find a routine that works best for you. And you may have high motivation to lose weight in the beginning, but then find that over time, as enthusiasm wanes, you need to remind yourself of your goals more often, and reward yourself more often for staying on course.
Don’t get discouraged: Most people fail several times before they “get it right”. It may take a few rounds before you succeed at keeping the weight off. The good news is that if you can keep the weight off for two years, chances are you’ll keep it off over the long term, according to the National Weight Control Registry. You may still have to work at it every day, but you gain more confidence in your ability, which goes a long way towards lasting success.
17. Consider weighing yourself regularly – at least once a week. This increases self-awareness and can provide encouragement if the numbers are going in the right direction – or it can motivate you to get back on track if you detect an upward trend. A 2014 study in PLOS ONE of 40 overweight people found that more frequent self weigh-ins were associated with greater weight loss and that going more than a week without stepping on the scale was associated with greater weight loss and that going more than a week without stepping on the scale was associated with weight gain. Regular self-weighing is a particularly effective strategy for maintaining long-term weight loss, according to the National Weight Control Registry, which tracks people who have successfully lost and kept weight off (see box above). Whether you weight yourself and how frequently is a personal decision however. Some people get discouraged by small fluctuations that occur over the course of a day or several days (which reflect normal shifts in fluid levels, rather than changes in body fat). Keep in mind also that weight is not everything: Another good – and sometimes better – gauge of weight-loss success is to measure your waist and other body areas, such as your hips and thighs.
18. Set realistic goals and have a realistic body image. Just as weight tends to creep up over time, shedding excess pounds takes time. Don’t expect to be able to lose 10 pounds a week (any diet that says you can is counting on water losses, not fat loss). Small and steady losses – about one to two pounds a week – usually win the race for the long term. For most people, losing just 5 to 10 percent of body weight will provide health benefits. Also keep in mind that, depending on your body type and genetics, you may never be able to get back to your high school or college weight. And if you and your family members tend to have a certain body shape (like a pear, for example), weight loss will result in overall slimming but won’t reshape your body.