Good News for “Yo-Yo” Dieters

By Dr. Madelyn Fernstrom

If you’ve lost and gained the same 20 (or 30, 40, 50+ pounds) for years and believe that you’ve “wrecked” your metabolism and can’t maintain successful long term weight loss, there’s very good news for you!

A recent article in the scientific journal Metabolism followed more than 400 women for one year. About 40% of the participants classified themselves as “weight cyclers,” defined as losing (and regaining) at least 10 to 20 pounds at least three times. Participants were assigned to one of four treatment groups: (1) reduced calorie diet only; (2) reduced calorie diet plus exercise plan; (3) exercise plan alone; (4) no intervention, served as the comparison group. 

Now here’s the good news! There was no significant difference for the total amount of weight lost between women who were yo-yo dieters and those who weren’t. That’s a reassuring message for the millions of women (and men) who feel their efforts are sabotaged by their past weight cycling history.

If you’re trying to avoid the problem of yo-yo dieting altogether, start with setting modest, realistic goals for yourself. Slow and steady wins the weight loss race. Small short-term goals add up to long-term success. 

Is Obesity the New Normal?

There’s an old joke that goes something like this: “If you want to feel thinner, hang around with heavier people.” Maybe that’s not so funny anymore. With two-thirds of the U.S. population overweight or obese, the “look” of Americans has changed. We’re sizing ourselves up not by personal health, but by how we look compared to others. In discussing their weight, people often tell me they’re a lot slimmer than most of the people they know — as if this removes personal responsibility for their own weight concerns. It’s a defensive posture, implying things could be a lot worse. While often true, it doesn’t make the individual’s weight less important as a personal health risk.

And that view is not limited only to body size perception. As a nation, we’ve changed our view of what a single serving looks like and what “family size” servings mean. What was perfectly acceptable as a single serving a decade or two ago, now looks puny in comparison to the “new” scale of serving size. And a family sized package for four servings, often becomes a meal for two. This is glaringly apparent when we look at federal guidelines (developed years ago) for what “counts” as a serving size. Most of us laugh when we hear about a serving of protein the size of a computer mouse, or palm or your hand. How could anyone fill up with that, many people ask?

We are living in a different world, where our eyes are now accustomed to viewing larger people and larger servings as the new normal. To me, this updated — but skewed — way of looking at the world can only lead to a future with increasing weight-related health problems.

 Do you agree?

Stop "Grazing" to Lose Weight

By Dr. Madelyn Fernstrom

I’m not sure when this change first occurred, but we’ve gone from a nation of structured “three square meals a day” to grazing all day with small, frequent meals. We do this all in the name of good health and weight control. Does this idea of “fueling” throughout the day really work? Not for most people! 

While it is well-documented that skipping meals leads to overeating later in the day, eating more often doesn’t really help to control calorie intake any better than eating three meals a day. In fact, eating less often can help cut calories. 

The more often you eat, the more likely you are to consume extra calories. And extra calories, healthy or not, contribute to extra weight. It’s also harder to keep track of daily calories when you eat more often — your six smaller meals can easily become six bigger meals.

When you eat three times a day (meals and a small snack if you prefer), you support the regulation of true hunger and fullness. With four to five hours between meals, it is much easier to recognize true hunger, eat a meal, and then sense contentment (fullness). When you’re eating every two hours, with smaller amounts of food, you’re never really hungry and you’re never quite full. That can cause mind-body confusion and lead to overeating.

So if your goal is to trim calories for slow and steady weight loss, I’d suggest starting with trimming how often you eat every day. Stay hydrated between meals with loads of water (flavored with a slice of fruit or splash of juice), herbal teas, or your choice of low-calorie beverage.

These suggestions should work well for healthy people. If you have diabetes or another chronic illness, or if you take prescription medications, always talk to your doctor or a registered dietitian for advice on how often you need to eat to support your personal health. 

Has this strategy worked for you? Let me know!

Want to Lose Weight? Count Calories

By Dr. Madelyn Fernstrom

Years of debate continue about the best eating strategies to lose weight. Who hasn’t heard about the advantages of a high-fat diet – or is that a low-fat diet? Cut the carbs – no wait, keep the carbs? Was that load up on protein or cut back?

Now a new study from the Journal of the American Medical Association has really set the record straight. This excellent research study has documented what most of us already suspect: It’s the calories we consume that affect weight, and not the combination of carbohydrates, fats, and protein in our daily eating.

While this sounds like a fundamental concept, it’s loaded with confusion for most people. Now, we can all take a step forward in identifying what type of eating plan is most compatible with long-term engagement and compliance. Success comes from following your personal preferences to create a plan that is unique for you. You can lose weight if you’re a meat-lover, as well as if you are partial to pasta. Eating fat doesn’t make you fat – extra calories do!

The first step to long-term weight loss is an effective eating plan. And the great news is that this eating plan can take many different forms. Start the year by structuring an eating plan that connects with you. If you need help, it’s worth a visit to a nutritionist for additional help.

Have you found the perfect plan for you? Please share your thoughts!

The 5 Ds of Dieting

By Dr. Madelyn Fernstrom

Do you struggle with food cravings? 

This is a giant barrier to weight loss success. It sets up a negative cycle of initially “battling” the craving, giving in, overindulging, feeling like a failure, and giving up. Sound familiar? 

I’d like you to try my easy “5 Ds” to help manage your food cravings. They really work! 

DELAY – DISTRACT – DISTANCE – DETERMINE – DECIDE.

Delay: Postpone eating for 10-15 minutes when you feel an urge. You’re not saying “no” – just stopping to think before you eat. You’re not ignoring the thought but dealing with it. While you’re delaying your decision, the next D makes it easier…

Distract: Try a non-food activity to give you something to do (so you don’t watch the clock for 10 minutes!). Often the wave of desire to eat disappears in a few minutes when you keep your hands busy without food. Clean out a drawer, call a friend, brush your teeth, surf the web, or even learn to knit!

Distance: It’s important to keep your eating environment at arm’s length – maintaining a distance. Keep food out of sight, not on counters; “out of sight, out of mind” can help. Stay out of the kitchen when a craving strikes. And use the kitchen only for food preparation and meal consumption. Avoid it as a place to hang out.

Determine: After waiting 10-15 minutes, determine whether you are physically hungry or just thirsty; these two are often confused. Also consider whether you might have emotional/boredom hunger, what I call “head hunger.” And avoid getting over-hungry, a main consequence of meal skipping. All of these situations can be helped with a structured eating schedule and pre-planned meals and snacks.

Decide: If you’ve made it through the first 4 Ds, it’s time to make a smart choice. Think before you eat and pre-plan what you are really looking for – sweet, creamy, salty, chewy – before you make a choice. Look for single-serving packaged items for built-in portion control. You also get the satisfaction of “eating the whole thing.” Aim for a snack between 100-200 calories.

How do you manage your own food cravings? Please share your thoughts!

Weight Loss: One Size Does Not Fit All

By Dr. Madelyn Fernstrom

If losing weight is your New Year's resolution, read on! This month, I'm going to share some of my favorite strategies to help you build your own weight loss tool box. I call it a BEAM box – and it's based on the four pillars of weight loss: Behavior, Eating, Activity, and Medical care. And no tool is too small to be included. It all starts with what you're both WILLING and ABLE to do. These are not the same thing, and when you think about the "able" part, you can set more realistic and practical goals.

One important question I hear all the time belongs with the eating tools: What about meal replacements? Good or bad?

Meal replacements can be a great help, since they make automatic portion control much easier. There's no guesswork in tallying your daily calories (studies continue to show that we all underestimate how many calories we eat). Meal replacements can be a great way to jump-start a reduced-calorie eating plan. This can be as easy as a complete bar or shake (along with a fruit), a large skim milk latte for breakfast, or a frozen calorie-controlled meal. You also might want to try a few weeks of a complete meal replacement plan, like Jenny Craig or Nutrsystems; some people find this the most helpful of all. 

Just one or two meal replacements a day can make the difference between weight maintenance and weight loss. It's a good way to enter the world of structured eating: a must-do for long-term weight loss success.

Whether you purchase a meal replacement, or create your own, these provide the security of easy food choices to both boost your confidence and help turn your attention to the flip side of eating less – being more physical active.