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The statistics are clear: too many Americans weigh too much. Over one-third of adults are overweight, and over two-thirds are overweight or obese. That means you are more likely than not to find yourself in the group of overweight or obese Americans. Even if not, you may be interested in weight loss to hit a goal that you have for yourself.
Why Lose Weight?
There are all kinds of reasons to get rid of extra pounds. They raise health risks and can interfere with your emotional well-being, too. Losing weight can:
Lower blood pressure, blood cholesterol, and blood sugar.
Increase insulin sensitivity.
Lower risk for heart disease, type 2 diabetes, stroke, and Alzheimer's disease.
Reduce joint pain.
Improve self-confidence and self-image.
You do not need to lose a lot of weight to get a lot of benefits. You can expect improvements in health with a loss of 5 to 10% of your total body weight, or 10 to 20 lb. if you weigh 200 lb.
How Can I Lose Weight?
If you are among the millions of Americans who want to lose weight, you need accurate information to learn about your options. Different strategies can work better for different people, so it is vital that you consider your individual preferences and situation as you narrow your options. The main choices are:
Increasing physical activity.
Weight loss surgery.
The way to lose weight is to shift your calorie balance. The calories you take in through food and beverages need to be fewer than the calories you expend from daily living and exercise. That is, you need to burn more than you eat.
Diets for Weight Loss
Changing what you eat is the biggest factor in weight loss for most people. There are many different diets you can choose from, and many of them have a seemingly different focus, such as nixing carbs or adding protein, but all weight loss diets that work have something in common: they reduce calories in some way.
The number of diets to choose from can be nearly overwhelming, but you can work towards selecting the right one for you by considering certain factors. You might try asking yourself, and/or a healthcare provider, these questions as you sift through your choices.
Does it work? Do people who follow the diet lose weight?
Does it include foods you love? You are unlikely to be able to follow the diet long-term if you do not enjoy the foods on it. If you live for cheese and meat, for example, you may not be able to tolerate a plant-based diet for long.
Does it allow for special treats? Life happens. Does the diet allow you to work in holiday parties, restaurant meals, and the occasional craving?
Is it safe? "Safety first" applies here. Be sure the diet provides enough calories to keep you going; a minimum of 1,200 calories per day is a good rule of thumb. Another benchmark for safety is to lose no more than 2 lb. per week.
Is it nutritionally adequate? The diet should have a range of foods to provide the vitamins and minerals you need. Weight loss should not lead to malnutrition!
Is it healthy? Does the diet improve health markers, such as lowering blood pressure and blood sugar, and reduce risk for chronic diseases such as heart disease? If you do not want to dig into the scientific research on the diet you are looking at, you can take a look at the foods and nutrients on the diet to get a good idea of its healthiness. There are no tricks here – common sense dictates that you opt for more vegetables and fiber, and less sugar and processed foods, for starters.
These are some of the most popular and top-ranked diets and strategies you can follow.
You can shift the calorie balance by making small changes to your regular diet. This can be the best choice for you if you love the foods you already eat, and do not want to change your habits much. Each little change saves calories, and those saved calories add up. For example‚Ä¶
Have a cup of puffed cereal instead of a cup of granola, and save 300 calories.
Drink water instead of a 12-oz. soda, and save 250 calories.
Use 4 egg whites instead of 2 whole eggs, and save 80 calories.
Order half of a turkey and avocado BLT sandwich instead of a full one, and save 300 calories.
Serve 1/2 cup of rice and a side salad instead of 1 cup of rice, and save 150 calories.
Serve strawberries with 2 tablespoons of whipped topping instead of sugar, and save 70 calories.
These changes take little effort, since you are still eating your typical foods. You can shop the same aisles of the supermarket, cook the same recipes you always do, and order your usual choices at restaurants.
The principle: Starches and sugars are carbohydrates that provide 4 calories per gram. The Department of Agriculture (USDA) has found that these carbohydrates contribute about 50% of calories to the average American diet. Furthermore, carbohydrates serve very little purpose besides providing energy, or calories. So, cutting out some carbs can help you cut calories and lose weight.
Most low-carbohydrate diets limit or exclude high- carbohydrate foods, such as some or all of the following:
Grains, such as wheat (including couscous and farro), barley, rice, and oats.
Grain products, such as bread, crackers, pasta, and breakfast cereal.
Flour-containing baked goods, such as cookies, cake, and pie.
Starchy vegetables, such as sweet potatoes, potatoes, and corn.
Sugary foods, such as desserts, candies, and processed foods with sugar, such as certain types of yogurt and sweetened cereal.
Juices, and sugar-sweetened beverages, such as soft drinks, energy drinks, and sports drinks.
Fruit, especially dried fruit and higher-sugar types.
Beans, peas, and lentils.
Your reduced-carb diet is likely to include:
Meat, fish, poultry, and eggs.
Nuts and seeds.
Fats, such as avocados and olive oil.
Lower-sugar fruits, such as strawberries.
There are many diet plans that reduce carbohydrates. Some are stricter and minimize carbohydrates. Others emphasize a controlled intake of nutritious carbohydrates. These are some popular approaches.
South Beach. This diet starts only low-carbohydrate foods, but progresses to include nutritious carbs, such as whole grains and fruit.
Atkins. This diet starts with severe carbohydrate restriction, and you gradually reintroduce carbohydrates as you lose and then maintain weight.
Ketogenic diet. Your carbohydrate intake is so severely restricted (to 30 grams or less per day) that your body must use fat or protein for fuel.
These diets can help you lose weight and improve health factors, such as:
Lowering heart disease risk factors, such as blood pressure and triglycerides.
It is important to choose healthy fats, such as olive oil and avocados, instead of butter, shortening, and lard. Saturated fats, such as those in fatty meats and poultry skin, can raise your levels of small dense LDL particles, which are related to heart disease.
A paleo diet is based on a caveman's way of eating. It includes foods that people ate in the Stone Age, with meat, poultry, and fish making up the majority of the diet. You can also have eggs, vegetables, fruit, nuts, seeds, and oils. The diet excludes grains, dairy products, added sugars, added salt, legumes (beans, peas, lentils, and soy products), and processed foods.
How healthy is a paleo diet? The theory behind the diet is that cavemen did not suffer from chronic diseases, so eating the way they did can help you prevent these conditions. The diet can help you lose weight, since it excludes so many foods, but it can cause nutrient deficiencies. It is hard to follow long-term, and it excludes certain foods, such as whole grains and legumes, that are linked to lower risk for many diseases.
A vegetarian diet excludes meat, poultry, and fish, a vegan or strict plant-based diet also excludes dairy products and eggs. The diet has some potential benefits.
It help reduce hunger while you lose weight because it can be high in fiber from vegetables, fruit, whole grains, beans, and nuts.
A high-fiber diet can help lower blood sugar and blood cholesterol levels.
It can help lower harmful small, dense, LDL particles because you do not get saturated fat from meat, butter, or other animal products.
Still, a plant-based diet is not automatically healthy or good for weight loss. For the most benefits, remember that:
Sugar is vegan, but not healthy! It adds extra calories without nutrients.
Whole grains are healthier and better for weight loss than refined grain products, such as white bread, pasta, and rice, refined cereals, and white crackers.
French fries and doughnuts can be vegan, but they are high in unhealthy fats and refined starches.
You can get two filling nutrients – protein and fiber – from beans, peas, and lentils.
Commercial Diets: Prepared Meals and Meal Replacements
If you have trouble figuring out what to eat, or you dislike grocery shopping and cooking, you might look into a diet plan that delivers prepared meals. Nutrisystem is a popular example, but there are many other companies that offer meal delivery, with or without nutritional support. You are likely to get up to 3 meals and 2 snacks per day on a reduced-calorie plan that may also let you specify preferences such as low-carbohydrate or vegetarian.
There are several potential benefits to meal delivery services.
You can lose weight if you follow them.
Your A1C, a measure of your long-term blood sugar control, can drop within to 6 months.
They are often customized so you can choose from options such as vegetarian or reduced-carbohydrate.
There are drawbacks, too. For example:
In many cases, you still need to go grocery shopping to supplement your diet with fresh, healthy foods such as fruits and vegetables, yogurt, cheese, and nuts.
You might get bored with the variety of meals offered and the program may beunsustainable for your lifestyle.
You may not learn the skills you need to keep the weight off after you stop using the program.
The meals can be expensive, and you may have to pay for coaching if that is part of the plan, such as with Jenny Craig.
The meals are for an individual (you), and your family will still need to eat‚Ä¶something.
As long as you do stay on the plan, you will probably lose weight because you will be restricting calories and so you will probably lose weight and get the health benefits associated with weight loss. In one research study, people with a high blood sugar level who used Nutrisystem for 3 to 6 months were able to lower their A1C levels by up to 1%. This shows that they had better blood sugar control
Meal Replacement Programs
The theory behind meal replacements sounds good: replace 1, 2, or 3 daily meals with a bar, shake, or even a special cookie, and you will lose weight. It is true that cutting calories will help you lose weight, but it is usually best to be wary of these programs.
It is hard to stick to them. A bar, shake, or cookie may not fill you up, so to satisfy hunger, you might add foods that are not on the plan.
They may not be nutritionally adequate or optimal. Even if you do get your essential vitamins and minerals, you might miss out on important "extras" such as antioxidants and fiber found in plant-based foods.
They can be boring. A few weeks of shakes and bars may be tolerable, but it could take months or over a year to hit your weight loss goal.
It can be hard to keep the weight off. Once you stop following the plan, you might go back to your old eating habits since you did not learn new, healthy habits while on the plan.
Slim-Fast and the Cookie Diet are examples of meal replacement diets. Each day on the Slim-Fast program, you replace two meals with a bar or shake, have one meal that contains nutritious foods, and have 3 small snacks. On the Cookie Diet, you eat special cookies and one meal per day.
You can lose weight from reducing calories; one study found an average loss of 2.7 kg (5.9 lb.) after 6 months on the diet. Average blood pressure dropped by 2.7/2.5 mm Hg (systolic/diastolic), blood sugar decreased 3.4 mg/dl, and total cholesterol decreased 13.5 mg/dl on average.
A Mediterranean Diet Pattern
A Mediterranean diet pattern is just that: a pattern, rather than a strict diet. It describes the traditional pattern of eating found in countries around the Mediterranean Sea, such as Italy, Greece, and Spain. You would eat:
Plenty of plant-based foods: vegetables, whole grains, nuts, and legumes.
Oils, especially olive oil, instead of butter.
Poultry and fish at least twice a week.
Red meat only a few times a month.
More spices and less salt.
Red wine, in moderation, if you want.
A review found that people who followed a Mediterranean diet for a year lost, on average, 4.1 to 10.1 kg. (9 to 22.2 lb.). The diet can help you lose weight because it includes satisfying foods, and it limits processed, high-calorie foods such as sweets. It has many potential health benefits, likely related to the monounsaturated fats in olive oil and the nutrients in plant-based foods and fish. The diet has been linked to:
Lower total and "bad" LDL cholesterol levels, and higher "good" HDL cholesterol.
Lower blood pressure.
Lower blood sugar levels and increased insulin sensitivity.
The DASH Diet
The Dietary Approaches to Stop Hypertension, or DASH, diet was designed to lower blood pressure. Compared to the average American diet, it is higher in fiber, vegetables, fruit, and low-fat dairy products, and lower in saturated fat, red meat, snacks, and sweets.
The diet includes:
4-5 servings of vegetables per day.
4-5 servings of fruit per day.
6 servings of grains per day, with emphasis on whole grains.
2-3 low-fat dairy products per day.
Up to 6 oz. of lean meat, poultry, or fish per day.
4 servings of nuts, beans, and seeds per day.
2 to 3 servings of oils per day.
The DASH diet can help you lose weight by limiting high-calorie foods such as fatty meats and sugar-sweetened foods. Also, it helps reduce hunger by increasing low calorie-dense foods such as vegetables, low-fat dairy products and lean proteins, and high-fiber foods such as vegetables and whole grains.
Research on DASH found:
Individuals who followed DASH as part of a weight management program with cognitive-behavioral counseling plus exercise lost an average of 8.4 kilograms over 4 months.
Blood pressure dropped by 5 points systolic and 3 points diastolic among individuals with pre-hypertension on a DASH diet, and the drop can increase with a low-sodium DASH diet.
A DASH diet can lower total cholesterol by 13.7 mg/dl and "bad" LDL cholesterol by 10.7 mg/dl.
A DASH diet can lower blood sugar when combined with exercise.
Fat is a calorie-dense nutrient. Each gram provides 9 calories, compared to 4 calories from a gram of carbohydrates or protein. So, you can potentially lose weight by cutting back on fats and fatty foods, such as the following:
Fatty processed foods, such as creamy and cheesy dips and soups.
Fatty meats and full-fat dairy products.
High-fat baked goods, chips, and ice cream.
Excess added fats, such as butter, used in cooking and in spreads.
Fried foods, such as French fries, fried chicken, onion rings, and doughnuts.
The diet can help you lose weight by steering you to lower-calorie foods, such as vegetables and fish. Still, a very low-fat diet has not been shown to work long-term, and a moderate-fat diet may be healthier if you choose healthier, unsaturated fats, instead of saturated ones. The diet can be good for health if you stick to nutritious foods, but bad for health if you choose sugary and starchy foods in place of fatty ones.
Exercise for Weight Loss
You may already know that exercise burns calories, and that can help you lose weight.
However, the calorie-burning boost to weight loss may not be the greatest benefit of exercise for weight loss and health. Research suggests that what you eat is far more important for weight loss than how much you work out. However, exercising regularly appears to be important in keeping off the weight successfully. It may because exercise:
Is a reminder of how hard you are working to control your weight.
Helps your body directly feel the benefits of being good to yourself.
Improves your confidence in your own ability to treat yourself right.
Exercise has benefits way beyond weight loss. It improves health and quality of life. Consider these effects.
Exercise can lower blood pressure, total cholesterol, and blood sugar, and raise "good" HDL cholesterol.
Exercise lowers risk for heart disease, stroke, type 2 diabetes, dementia, and hypertension.
Exercise helps you sleep better.
Exercise increases energy.
Exercise can improve mood.
So how much exercise should you do, and what is the best type? Along with stretching to increase flexibility and lower injury risk, experts suggest doing cardio and strength training regularly.
"Cardio," or aerobic activity, burns calories and has the health benefits mentioned above. The Centers for Disease Control and Prevention, or CDC, suggest getting at least 150 minutes of moderate-intensity aerobic activity per week, or at least 30 minutes at least 5 days a week. You can add up bouts of 10 minutes at a time to hit your 30 minutes.
These are examples of moderate-intensity activities. They burn about 150 to 200 calories per half-hour for someone who weighs 150 to 200 lb.
You can also hit your recommendations by getting at least 75 minutes per week, or 15 minutes 5 days a week, of vigorous-intensity aerobic activity. You might burn 125 to 175 calories in 15 minutes doing these activities.
Swimming laps quickly.
Exercise can help with weight control, but stay aware of two common traps. One is that exercise makes you hungrier, so some people eat more when they exercise. They may eat enough to outweigh the weight loss benefits of their exercise – that is, they eat more extra calories than they burned.
The other trap to avoid is exercise extra to burn more calories so you can eat more. Most people overestimate the calories they burn, and underestimate the calories they eat, so it is likely that you will lose out if you try to match extra eating with extra exercise. The other problem is that calories from food add up faster – the cookie may have 300 calories and take a minute to eat, while it might take you an hour of exercise to burn that off.
The CDC suggests strength training your major muscle groups at least 2 times per week. You can use weight machines, weights such as dumbbells or barbells, resistance bands, or body weight. Strength training tones your muscles, but does not need to bulk you up. Instead, it:
Improves bone health.
Increases insulin sensitivity.
Weight Loss Supplements
Weight loss supplements, or diet pills, can work in various ways. They can help reduce hunger, increase metabolism to burn more calories, and block carbohydrate or fat absorption. Most have little effect, according to the Office of Dietary Supplements at the National Institutes of Health.
These are some ingredients that you might find in weight loss pills, along with their possible effects.
African mango – reduces fat cell production.
Beta-glucans – reduces hunger.
Bitter orange – increases metabolism and reduces appetite.
Caffeine – increases metabolism.
Capsaicin – increases metabolism.
Carnitine – increases fat burning.
Garcinia cambogia – reduces fat cell production and appetite.
Guar gum – reduces hunger.
Hoodia – reduces appetite.
White kidney bean – reduces carbohydrate (starch) absorption.
Weight loss supplements carry many risks.
They are regulated as dietary supplements, not drugs. That means that the manufacturer, and not the Food and Drug Administration, or FDA, is responsible for insuring safety and effectiveness.
While some are relatively safe, others have side effects such as headaches, gastrointestinal distress, insomnia, nausea, muscle weakness, and nutrient deficiencies.
More serious complications can include hives, heart palpitations, liver damage, and high blood pressure.
If you choose to use weight loss drugs, be sure to do so only with the approval of your doctor, and under supervision. At the same time, you can work towards long-term success by changing your dietary habits.
Weight Loss Surgery
Weight loss surgery, or bariatric surgery, is a more extreme option for higher-weight individuals who have not found long-term success controlling weight with dietary changes. You may qualify for bariatric surgery if:
You have extreme obesity, or a BMI over over 40 kg/m2, OR
You have Class II obesity, or a BMI between 35 and 40 kg/m2, and an obesity-related comorbidity such as sleep apnea, type 2 diabetes, osteoarthritis, or hypertension, AND
You have tried diets in the past and they have not worked for you to lose weight and keep it off.
Bariatric Surgery Basics
There are a few different types of weight loss surgery procedures. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), the most common are:
Gastric sleeve – 58% of procedures. The surgeon removes your stomach pouch and creates a vertical "sleeve" for food to pass through.
Gastric bypass – 19% of procedures. A small stomach pouch is created and attached to your lower small intestine, so much of your digestive system is "bypassed."
Gastric band – 3% of procedures. A small band is placed around the upper portion of your stomach, so the pouch where food goes during a meal is smaller.
All of the approaches are restrictive; they restrict the amount food you can eat by making your stomach smaller. The gastric bypass is also malabsorptive; it reduces the absorption of food, so you get fewer calories, but also fewer nutrients.
After surgery, you must follow a strict diet. It progresses over the course of weeks or a couple of months from liquids, to pureed foods, to semi-soft foods, to solid foods. As you continue to lose weight, you continue to emphasize a low-calorie, high-protein diet.
Bariatric Surgery Benefits and Success
Bariatric surgery can be the most effective way to lose a lot of weight and keep it off. It can also lower your risk for obesity-related conditions, and improve them if you have them.
You can improve your chances of success by:
Choosing a surgeon with a history of safe and effective procedures.
Making sure your team includes a nutritionist, exercise specialist, and mental health professional with experience in bariatric patient care.
Going to all of your support group meetings and any follow-up appointments.
Above all, following your instructions for the post-op and long-term diet and exercise program.
Barriers to Weight Loss Surgery
About 8% (1 out of 13) adults have extreme obesity, with a BMI, but only 1% of patients who are eligible for weight loss surgery get it. Barriers can include social stigma, lack of information, and, frequently, lack of coverage or difficulty getting approval from health insurance plans – a procedure can cost $15,000 to $25,000 out of pocket. There are also concerns such as:
Risks of side effects and complications, such as nutritional deficiencies, gastrointestinal discomfort, and food intolerances.
Long-term commitment – your eating patterns will need to change for life to maintain your weight loss.
Fitting in "real life," such as social engagements and vacations, on your restricted diet.
Lark helps you eat better, move more, stress less, and improve your overall wellness. Lark’s digital coach is available 24/7 on your smartphone to give you personalized tips, recommendations, and motivation to lose weight and prevent chronic conditions like diabetes.