Losing Weight Simple But Not Easy

Published by Contra Costa Times

Posted on Wed., March 31, 2010
By Stephen Daniels, MD

"Oh, Dr. Daniels, how could I have gained weight? I don't eat anything. All I've had for the past two days is water."

Ms. Smith cried she was so discouraged.

"But how about the days before? Did you eat much the days before the past two days?"

She thought for a minute and said: "Well yes, we celebrated my brother's birthday. But not eating for two days should make up for it. Shouldn't it?"

Ms. Smith suffered from a common misconception that a person will lose weight by intermittently starving and eating. I call this "starve, starve eat." Usually you'll gain weight if you do this.

One theory is that even briefly starving the body causes it to prepare for the next period of starvation, and to turn the next meals into fat.

What about other diets, diet pills and weight loss programs? The bottom line is this: many of them work as long as you stay on them.

The problem is that you will regain your weight unless you fundamentally and permanently decrease your calorie intake (eat less) and/or increase the calories you burn (by exercise).

Another frequent weight loss strategy I hear frequently is, "I've cut out red meat." But most (lean) red meat is no more fattening than chicken or fish, and much less fattening than many common foods.

If there's one food a person should give up to try to lose weight, it's probably cheese. Many cheeses have many more calories than most meats.

Another (usually unsuccessful) weight loss strategy is to order salad instead of a meat entree. But if the salad comes with creamy dressing, grated cheese and bread and butter, it may have more calories than the meat, chicken or fish entree.

So what should one do to lose weight and keep it off? The answer is simple but not easy: reduce calorie intake (eat less) and increase calorie usage (exercise).

For most of us this takes constant attention and effort: awareness of our calorie intake, a scale to check our weight changes, and regular exercise. Here are some guidelines that I and others have found effective.

Don't consume "wasted" calories. That is, don't eat sweets, sugary drinks or other foods you don't really enjoy.
Never eat while watching TV or the movies.
When ordering at a restaurant, ask the server for a "to go box" and a saucer (for a coffee or tea cup). Before you eat, put one-half to two-thirds of the meal in the "to go box" and eat what's left.
No food except water or diet drinks after dinner. Evening snacks are a diet killer.
Saucer diet: Never eat more food for any meal than fits on a saucer. Put a small amount of each food type on the saucer to eat, and save the rest.

Fundamentally, our obesity problem comes from food manufacturers and restaurants making foods that are more and more appetizing, and labor-saving devices that allow us to use so little physical energy in our daily lives.

To lose weight, we have to fight our natural instinct to consume foods that taste and look so good, and to exercise more for our health, not because we have to.

Daniels practices family medicine for Contra Costa Health Services, the County Health Department.