What You Should Know Before You Start A Weight-loss Plan

You may want to lose weight for personal reasons. Or you may need to lose weight to improve your health. It can reduce your risk of certain conditions, such heart disease and type 2 diabetes. It can lower your blood pressure and total cholesterol level. It also can relieve symptoms and prevent injuries related to being overweight.

There are several factors that can affect your efforts to lose weight. These include making changes to your diet, exercise, and lifestyle. There are tools and tips to keep you on track. In addition, you should know what not to do. Talk to your doctor before you begin a new plan. They can help you customize a program and safely monitor your progress. Even small changes can make a big difference in your health.

Path to improved health

There are other things you should do before you start. Commit to the weight-loss plan. Consider telling people close to you. They can help monitor your progress and provide support. This can hold you accountable.

There are 3 important facts about weight loss. The first is your weight. The second is your body mass index (BMI). Your BMI is based on your weight and height. Doctors consider BMI to be the best measure of your health risk. In fact, the medical terms “overweight” and “obesity” are based on the BMI scale. A BMI of between 25 and 30 is considered overweight. Someone with a BMI of more than 30 is considered to have obesity. The higher your BMI, the greater your risk of a weight-related illness. This includes type 2 diabetes and heart disease. Your doctor can help get your BMI, or you can use a BMI calculator. The BMI chart is the same for male and female adults. There is a separate chart for girls and boys under 20 years of age. There is also a separate BMI calculator for Asian patients.

The third fact to know for weight loss is waist circumference. Body fat often collects in your stomach area. This is more of a health risk than body fat that builds up in your thighs or buttocks. For this reason, your waist circumference is a valuable tool. To begin, place one end of a tape measure on top of your hipbone. Wrap the other end around your stomach, making sure it’s straight. The tape shouldn’t be too tight or too loose.

Doctors consider greater than 40 inches to be unhealthy for men and greater than 35 inches to be unhealthy for women. A high waist circumference is known as abdominal obesity. It can be a sign of metabolic syndrome. This is a group of conditions that increases your risk of a weight-related illness. It can lead to type 2 diabetes or heart disease. Your doctor will diagnose the syndrome if you have at least 3 of the 5 conditions listed below.

Metabolic syndrome condition	Treatment	Recommendations
Abdominal obesity (measured by waist circumference) Men: greater than 40 in. Women: greater than 35 in.	Lose weight Increase physical activity	Cut 250 calories a day to lose a ½ pound a week. Aim to lose around 20 pounds a year. Get at least 30 minutes of moderate activity 5 days a week.
High blood pressure 130/85 mm Hg or greater	Lose weight Reduce salt intake Eat more fruits and vegetables, and low-fat dairy products	Aim to lose around 20 pounds a year. Keep the saltshaker off the table and don’t use salt when cooking. Avoid high-sodium (salt) foods. Check food and drink labels for sodium content. Get at least 5 servings of fruits and vegetables a day. Get 3 glasses of skim milk, low-fat yogurt, or cheese a day.
Low HDL (good) cholesterol Men: less than 40 mg/dL Women: less than 50 mg/dL	Lose weight Increase physical activity Eat less carbs and more monounsaturated fats Stop smoking	Aim to lose around 20 pounds a year. Get at least 30 minutes of moderate activity 5 days a week. Replace cookies, candy, and cakes with unsalted almonds, walnuts, and peanuts. Eat nuts in moderation. Get help to quit smoking.
High triglycerides level 150 mg/dL or greater	Lose weight Eat less simple carbohydrates Limit alcohol intake	Aim to lose around 20 pounds a year. Increase amount of omega-3 fatty acids by eating fish 2 times a week. Replace juice and soda with water, seltzer, or diet soda. Consume less than 2 alcoholic drinks a day for men, and 1 drink a day for women.
High blood sugar (measured after fasting) 110 mg/dL or greater	Lose weight Eat more fiber	Aim to lose around 20 pounds a year. Replace white bread with brown bread, whole grains, and cereals.

Once you have measurements, set safe and practical goals. Your doctor also can help. Your goals should be specific. Be prepared for setbacks, but don’t give up. Reward yourself with something healthy when you hit a goal. For example, you could try a new activity, get a massage, or buy a new outfit. These efforts will help you keep going. 

Nutrition

In general, eat fewer calories than your body uses in order to lose weight. Calories come from the foods you eat and drink. Some foods have more calories than others. For example, foods that are high in fat and sugar are high in calories, too. Some foods are made up of “empty calories.” These add a lot of calories to your diet without providing nutritional value.

If you eat more calories than your body uses, your body stores them as fat. One pound of fat is about 3,500 calories. To lose 1 pound of fat in a week, you have to eat 3,500 fewer calories. That divides out to 500 fewer calories a day. One thing you can do is remove regular soda from your diet. This alone cuts over 350 calories per day. You also can burn off 3,500 more calories a week. You can do this by exercising or being more active. Most people do a combination of the two. If you do this for 7 days, you can lose 1 pound of fat in a week.

Most experts believe that you should not lose more than 2 pounds per week. This can mean that you are losing water weight and lean muscle mass instead of stored fat. It can leave you with less energy and cause you to gain the weight back.

Try taking a food habits survey. It will tell you where you need to make changes to your diet. It also can identify what nutrients you lack. Tips for improving your diet include:

• Only eat when you are hungry. This could mean 3 meals and 1 snack every day. Or it may mean 5 to 6 small meals throughout the day. If you aren’t hungry, don’t eat.
• Don’t skip meals. Skipping meals on purpose does not lead to weight loss. It can make you feel hungrier later on. It could cause you to overeat or make poor food choices.
• Wait 15 minutes before getting a second helping of food. It can take this long for your body to process whether it’s still hungry.
• Try to eat a variety of whole foods. This includes lean meats, whole grains, and dairy. When choosing fruits and vegetables, eat the rainbow.
• Avoid processed foods and foods high in fat or sugar.
• Drink plenty of fluids. Choose no- or low-calorie drinks, like water or unsweetened tea.

In some cases, your doctor may refer you to a nutrition specialist. They can help you with grocery shopping and recipes that fit your needs.

Exercise

Both adults and children should get regular physical activity. It is important for losing weight and maintaining good health. Below are ways to increase your activity and burn calories.

• Add 10 minutes a day to your current exercise routine.
• Challenge yourself. Move from moderate to intense activities. (See chart below.)
• Take the stairs instead of the elevator.
• If safe, park further away or walk to your destination instead of driving.
• Do more household chores, such as dusting, vacuuming, or weeding.
• Go for a walk or run with your dog and/or kids.
• Exercise at home while watching TV.
• Be active on your vacations. Try going for a hike or bike ride.
• Buy a pedometer or activity tracker. This measures how many steps you take each day. Try to increase your daily number of steps over time. (You can buy pedometers at sporting goods stores.) Some experts recommend walking at least 10,000 steps a day.
• Limit time spent online, watching TV, and playing video games. This should equal less than 2 hours total per day.

Moderate activity	Approximate calories per 30 minutes*
Stretching	90
Light weight lifting	110
Walking (3.5 miles per hour, or mph)	140
Bicycling (less than 10 mph)	145
Light yard work or gardening	165
Golf	165
Dancing	165
Hiking	185
Intense activity	Approximate calories per 30 minutes*
Heavy weight lifting	220
Heavy yard work	220
Basketball	220
Walking (4.5 mph)	230
Aerobics	240
Swimming (freestyle laps)	255
Running or jogging (5 mph, or 12 minutes/mile)	295
Bicycling (more than 10 mph)	295

Adapted from Dietary Guidelines for Americans 2005.
*Average calories burned for a person who weighs 154 pounds. If you weigh more, you will burn more calories. If you weigh less, you will burn fewer calories.

Lifestyle

You may have to alter your schedule to make changes to your diet and exercise. This could mean waking up early to work out or packing your lunch so you don’t eat fast food. Along with diet and exercise, you should make other lifestyle changes. Getting enough sleep can help you lose weight. Sleep affects your body’s hormones. This includes the hormones that tell your body if it is hungry or full. You also should try to reduce your stress level. A lot of people relate stress to weight gain.

Things to consider

When you start a weight loss plan, there are things to keep in mind. You may have an obstacle that makes it hard to lose weight. Or it could have led to weight gain in the first place. You also need to be careful of where you get advice. Your weight loss plan should be safe and successful.

Medical conditions that contribute to obesity

For some people, weight gain can be related to genetics. Others may have a medical condition that makes it hard to lose weight. Examples of this include:

• Hormonal disorders
  • Cushing’s disease
  • Diabetes
  • Hypothyroidism
  • Polycystic ovarian syndrome (PCOS)

• Sleep disorders
  • Obstructive sleep apnea
  • Upper airway respiratory syndrome

• Eating disorders
  • Bulimia
  • Carbohydrate craving syndrome.

Certain medicines also can interfere with your weight loss efforts. This includes:

• Antihistamines for allergies
• Alpha or beta blockers for high blood pressure
• Insulin or sulfonylureas for diabetes
• Progestins for birth control
• Tricyclic antidepressants for depression
• Lithium for manic depression
• Valproate for epilepsy
• Neuroleptics for schizophrenia

Talk to your doctor about how to manage your weight despite these obstacles. Lifestyle changes, treatment, or surgery can help. You also may benefit from a support group or counseling.

Diet pills, supplements, and fad diets

Some companies and people claim diet pills make you lose weight. This may be true at first, but pills don’t help you keep the weight off. They don’t teach you how to make lifestyle changes. The U.S. Food and Drug Administration (FDA) does not test most diet pills. Many of them can have harmful side effects. Talk to your doctor if you think you need a supplement. They can recommend one that doesn’t interact with your medicines or conditions.

Fad diets also are not proven to be safe or help you lose weight. They often offer short-term changes, but don’t help you keep the weight off. People who promote fad diets are famous or get paid to make claims. This does not make them correct or trustworthy.

There is no one magic diet that helps every person lose weight. The idea of “going on a diet” implies that you will “go off the diet” one day. Do not rely on a fad diet to do the work for you. Instead, find a healthy, balanced eating plan that can become a practical lifestyle.

Weight-loss management

There are tools you can use throughout your weight loss plan. They help to track your progress and reach your goals. These include:

• A pedometer to count your steps (some brands: Fitbit, Garmin)
• A food diary, or journal
• Smartphone apps to record diet and exercise (some apps: MyFitnessPal, Lose It!)
• A measuring tape or scale
• A BMI calculator

Continue to talk with your doctor while on your weight loss plan. Think about the big picture. Setbacks are bound to happen, but you should concentrate on the small goals and changes. These are what will get you to the finish line.

Questions to ask your doctor

• Are there any risks to a weight loss plan?
• What weight loss goals should I make?
• What BMI should I aim for?
• What happens if I lose more than the recommended 2 lbs. per week?
• What should I do if I have a food craving?
• Should I take any supplements as part of my weight loss plan?
• Can you recommend a dietician?
• Can you suggest a support group for people who are losing weight?
• Once I meet my weight loss goals, how do I maintain my weight?

Resources

American Academy of Family Physicians: Food Habits Survey

American Academy of Family Physicians: Nutrition for Weight Loss

American Academy of Family Physicians: Nutrition: How to Make Healthier Food Choices

American Academy of Family Physicians: Nutrition: Keeping a Food Diary

Centers for Disease Control and Prevention: Adult BMI

Centers for Disease Control and Prevention: Losing Weight

National Institute of Diabetes and Digestive and Kidney Diseases: Choosing a Safe and Successful Weight-loss Program

U.S. Department of Agriculture: MyPlate.gov