You don’t have to be skinny to be healthy. In fact, one of the most dreaded “chief complaints” that a doctor can hear is that their patient is inexplicably losing weight. To waste away has as ominous a connotation now as it did in pioneer times. But excess body mass can cause health problems by markedly increasing risk of heart disease, lung disease, and diabetes. It also erodes quality of life by increasing osteoarthritis and fatigue (it is tiring to lug around extra weight). To feel better now and stay that way well into the future, most of us have some pounds to lose. Don’t take it personally! The rising average weight of Americans is a product of technological advances made over the last century; now we need to adjust our habits so that our caloric intake is closer to our reduced “modern” utilization.
The first rule of reasonable and sustained weight loss: don’t hate you self for being heavy! Even if you have been labeled as morbidly obese (I don’t think we doctors realize how rude we can seem) — meaning you are at least 20% over your ideal body weight—your body is still a miraculous entity made up of wondrously complex and efficient organ systems. It is something to be cherished; something to nurture so that it lasts as long as it possibly can. Weight loss is a way to be good to yourself—it helps your body be more energetic, resilient and enjoyable! Making the effort to drop pounds is a gift to yourself and your future self; turning it into an act of deprivation or sacrifice will make the job much more difficult. Truly embracing the positive aspect of trimming down however, will make the mournful call of your stomach for another cookie easier to ignore.
Rule number two: Don’t get bogged down by details. Setting rigid weight loss schedules and goals undermines things by provoking discouragement and a sense of hopelessness. People reap health benefits from dietary improvements even with very modest weight loss, so for many folks chances of succeeding are improved by initially creating a more realistic/achievable goal. Aim for dropping 7-10 pounds by summer!  As for detailed monitoring of polyunsaturated fats and grams of protein and the like, Weight Watchers has an excellent program that can result in meaningful pound reduction. (Their website program is super, too). But if that is not your style, feel free to custom make your nutritional program! The essential issue is to decrease your daily caloric intake—in general, say less than 1600 calories per day for women, less than 1850 calories for men. Virtually all foods are labeled now, so it is not too onerous to keep track. And there certainly is an app for that! Or simply keep breakfast and lunch each about 400 calories; dinner can then be a hearty 800 calories (950 for the men).
Rule number three: DO NOT STARVE YOURSELF—not only will this make you miserable, scientists now believe that food deprivation can trigger one’s metabolism into a dramatic “save mode” (saved calories = fat). In fact, some of the most successful diet plans promote eating a low calorie, hi bulk, nutritious snack such as a bowl of shredded wheat with skim milk or a crisp apple plus a glass of water before every meal! This tends to markedly reduce the intake of high calorie foods without forcing one to leave the table hungry. This same concept applies to snacks— it is advisable to reach for something filling and low cal, and top it off with a large glass of water. As for sweets, it is better to indulge in portion-control candy, such as Thin Mints or M&Ms, than the goodies that have an extra portion of carbs added in, such as muffins and cookies. And every dieter is urged to limit foods with artificial sweeteners, for these chemical are also suspected to trick the body into starvation mode—which means no energy, extra pounds!
Rule number four: Exercise! While the objective is for everyone to exercise vigorously for at least 30 minutes three times a week, that might not be a manageable goal for a markedly overweight or de-conditioned individual. Doing something as simple as walking on the treadmill for several minutes daily IS a significant activity—it will promote better metabolism plus improve the overall feeling of well-being so that more exercise becomes desirable. Seeking out fun things that can be anticipated with pleasure, like walking with friends or dancing, hiking, or rollerblading—is important!  Regular activity has been shown not only to help lose weight, but to improve joint health by promoting auto-repair of cartilage. As the old- time farmers sagely state: “It’s the rust, not the wear that retires a tractor.”
If we are fortunate, life is a marathon, not a 100 yard dash. It is essential to maintain robust self-respect, while setting a reasonable weight goal and developing a workable dietary and exercise strategy. Habits need to be adjusted and readjusted so that a reasonable amount of calories is consumed without provoking the detrimental sensation of starvation. Overly-detailed diet plans are optional, not mandatory.
Finally, movement is a key ingredient to this recipe for better health. Following these simple rules will yield an improved sense of well-being in short order, and substantial weight loss by the end of the year.
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