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Ultimate Guide to Weight Loss: Making healthy choices

How do I lose weight?

Probably one of the most common questions I get asked and one of the most difficult to answer. But this is more than just about the number on the scale, it is about your overall state of health.

Obesity affects more than 90 million Americans. Being overweight is bad for you for multiple reasons. This fact has been understood by doctors for centuries.

Let’s go over some of the commonly used terms used to describe body weight and ignore the negative social terms some use about weight and body habitus. The term overweight refers to a weight above the "normal" range.

But what is considered normal?

This is determined by calculating the body mass index.

The body mass index (BMI) is defined as the weight in kilograms divided by height in meters squared.

Overweight is defined as a BMI of 25 to 29.9 kg/m2. Once this threshold is exceeded and the BMI is ≥30 kg/m2 it is called obesity and this is when weight starts to have a serious negative impact on your health. Severe obesity is defined as a BMI ≥40 kg/m2.

Another useful measure is the waist circumference. It is a measure of the girth of the abdomen. A waist circumference of ≥40 inches (102 cm) for men and ≥35 inches (88 cm) for women is considered elevated and is a potential threat to your health.

Obesity is not a single disease and carries with it various other diseases, such as type 2 diabetes, high blood pressure, sleep apnea and more. These conditions have a negative impact on a person’s quality of life AND overall health.

Weight Loss is Very Difficult

Have you ever heard someone say "just eat less" or "you should just exercise more"?

If only it was that simple. These statements are not helpful and show a complete lack of understanding about weight loss and the challenge facing those who struggle to lose weight.

If you are overweight or obese and are motivated to start losing weight and improving your health, you have taken the first step by reading this blog and learning more about the options available.

There are many options to address weight loss, here we will discuss one of the most important aspects of a successful weight loss strategy. Obviously there are many components to this.

Why is weight loss important?

Being overweight and obese is associated with a higher risk of dying. Sounds terrible because it is. But don't worry, this isn't a doom and gloom article. Instead, we are going to provide actionable ideas to help.

As mentioned above, there are many medical problems seen with obesity such type 2 diabetes, hypertension, dyslipidemia, and heart disease. The higher the BMI, the greater the risk of morbidity and mortality.

The relationship between obesity and death does not discriminate and is similar for all races and ethnicities.

It is well established that weight loss reduces the risk to your heart and improves your overall quality of life.

What is the best approach to weight loss?

The ultimate goal is to prevent, treat, or reverse the complications of obesity and as a result, improve one’s quality of life.

Even losing a small amount of weight, such as just 5% of total body weight will improve your overall health.

In order to be successful it is important to set REALISTIC goals.

Setting realistic goals increases you chances of success, and as the pounds come off, you feel better and the work becomes easier. It's a snowball effect of positive reinforcement.

Trying to lose 30% or more of total body weight as the initial goal is doomed for disappointment and failure.

It is not unreasonable to lose nearly 10% of your total body weight with lifestyle modifications that don’t rely on surgery or medications for weight loss.

It is also important to realize that everyone is different and realistic and achievable weight loss goals should be individualized.

What can you do if you don’t want surgery or medications?

Many are quick to suggest surgical weight loss as the first option. I disagree. And even if you are going down that treatment path, behavior modification is of paramount importance for successful weight loss.

The goal is to change bad habits and make long term changes in eating behavior.

This is done by changing your approach to eating while increasing your physical activity. No fad diets or crazy exercise routines. Those don't work long term. There is no quick fix.

The reason this is so important is because behavior plays a significant role in weight management. Changing behaviors that contributed to developing obesity is one of the most important ways to treat the disease with long term success.

What behavior modifications are needed to lose weight successfully?

Monitor what you eat. Don't start immediately counting calories. Just pay attention to what you eat and when you eat. This gives you insight about where you can improve and change bad habits.

Losing weight is a very complex process. It is more complicated than just counting calories. Having said that, it is important to take personal responsibility and track how many calories you take in and how active you are. But it's not healthy to perseverate on this.

Self monitoring is a very important component of successful lifestyle changes that will lead to losing weight and keeping it off. But it's the lifestyle changes that lead to long term success.

What is self monitoring?

It means pay attention to what you eat and drink. Pay attention to how much physical activity you are doing daily.

Once you have self awareness, you can begin the journey of correcting the behaviors and changing bad habits.

You can start “food diaries” or “exercise logs” as well as keeping yourself accountable by weighing yourself once or maybe twice a month. But DO NOT get hung up on the number on the scale, instead pay attention to your overall health. Are you feeling a little better everyday? If so good, you are on the right path to success.

These techniques identify problem behaviors and help you optimize your weight-loss. The goal is to focus on making the healthy choices part of your lifestyle. Developing good habits is the goal.

Physical Activity

Before starting any type of exercise program, you should make an appointment with your primary care doctor and make sure you are safe to proceed.

Increasing your activity levels is a great way to make you feel better and if you make exercise part of your daily routine it will not only help you lose weight but will also lower the risk of heart attacks as well.

Exercise alone is not enough to lose weight. It is a big component of the plan and helps with weight loss and maintenance of that weight loss if combined with better eating habits.

How much exercise you need varies from person to person. The Centers for Disease Control (CDC) recommends 150 minutes of moderate aerobic activity, 75 minutes of vigorous activity or an equivalent mix of the two each week.

This is just a recommendation and may not apply to everyone.

The key point is that physical activity is an adjunct to a weight loss program that also includes reduced calorie intake.

Physical activity does not have to be strenuous to be beneficial. If you are just starting with an exercise program just walking a few minutes per day is a good start.

With diet and exercise it is important to set realistic goals!

The goals should be specific, measurable, attainable, realistic and timely.

Now, let us look at how to put these two principles together and start a plan. Here are some examples of simple and realistic goals:

- Going for a 15 minute walk (or jog) on Monday, Wednesday and Friday.

- Make a journal of food intake for breakfast, lunch and dinner for one week.

- Get on the scale to weigh yourself every Monday and record it.

You want the goals you set to be simple. Understand this is a big commitment and there will be good days and bad days. But if the goal is simple and realistic, you will be more likely to succeed.

Achieving your goals

As mentioned above, if your goal is to lose weight and increase your overall health you must be willing to make a commitment.

I can’t emphasize enough that when setting your goals for weight loss, exercise, eating healthy etc, it is important to keep them realistic.

To be pragmatic, once you have a better understanding of your eating habits, make appropriate changes and start an exercise program, you should aim to lose about one pound per week. This is a safe way to approach weight loss and will provide lasting results. There are no quick fixes here. It takes work. This is a marathon, not a sprint. There are no short cuts. In your journey you will have good days and bad days. Keep pushing through. I know you can do it!

Please remember that medical information provided by us must be considered an educational service only. This blog should not be relied upon as medical judgement and does not replace your physician’s independent judgement. This is NOT medical advice. Please seek the advice of your physician.

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