By Karen Asp
If you were to poll your clients, one goal would no doubt unite the majority: weight loss. In fact, three in 10 Americans—25 percent of men and 32 percent of women—are trying to lose weight, according to a recent Gallup study of more than 1,000 adults.
The same study also found that 52 percent of respondents had lost weight at least once in their lives. How’d they do it? The majority, 47 percent, opted for diet and exercise while 32 percent reported dieting only; another 19 percent said exercise alone did the trick (Saad, 2011).
Seems like a no-brainer, right? After all, everybody knows that eating less and exercising more lead to weight loss. Not so fast, though. If it were truly that easy to lose weight, obesity rates wouldn’t be skyrocketing, and being normal weight would be, well, the norm.
So how can your clients shed pounds? Leading experts weigh in below, offering 11 of the most effective strategies to help your clients dump those pounds for good.
When it comes to committing to healthy habits, everybody has obstacles. Yet here’s the difference between successful losers and people who struggle with weight loss: Those losers have found ways to surmount their obstacles.
To do that, though, your clients first need to figure out what’s holding them back. Encourage them to reflect on past weight-loss attempts and identify what’s stopped them from sticking with their plans, says John P. Foreyt, Ph.D., director of the behavioral medicine research center at Baylor College of Medicine in Houston, Texas.
Once they’ve identified those barriers, ask them to create simple strategies to overcome those barriers. “Strategies need to be tailored to each individual,” Foreyt says. “Although personal trainers can offer helpful suggestions, each person is different and knows better what will work for them than somebody who doesn’t know them as well.”
Who doesn’t want to lose 10, even 20, pounds in a week? Trouble is, quick fixes like this only lead to failure. “People who lose weight this quickly tend to regain it rapidly,” Foreyt says. Because they haven’t learned new patterns of behavior, people in this situation often revert back to old habits after losing weight so quickly.
While this may not be music to your clients’ ears, safe, long-term weight loss happens at a rate of 1 to 2 pounds per week. At that rate, your clients can make slow, gradual changes—for instance, cutting 250 calories a day from the diet or burning 250 more calories a day—they can sustain for the long haul.
Adopting new habits is like cleaning closets for the first time in years: Do too much at once and you’ll be so overwhelmed that you quit. That’s why it’s best to make only one lifestyle change at a time, says J. Graham Thomas, Ph.D., assistant professor at Brown Medical School in Providence, R.I., and co-investigator of the National Weight Control Registry (NWCR), a database of individuals who have lost at least 30 pounds and kept it off for a minimum of a year.
Yet that begs an interesting question: If you’re trying to lose weight, should you focus on diet or exercise first? Diet, Thomas says. “It’s not that physical activity has no role,” he says. “But physical activity seems to have more importance for weight maintenance than weight loss.”
That’s why Thomas starts clients with small dietary changes—for example, using reduced-calorie versions of food they eat regularly (such as light or whipped cream cheese) or loading sandwiches with more veggies and less meat—and gradually integrates physical activity into their programs. Over time, that physical activity is stepped up so that by the time people hit their goal weight, they’re doing a reasonable, but sustainable amount of physical activity.
You’ve probably preached the virtues of tracking progress via exercise logs, but there’s good reason to continue making this a staple practice among your clients. “If you want to lose weight, you have to become aware of your exercise and eating behaviors, which means observing, recording and getting feedback,” Foreyt says.
Studies have shown that, on average, people trying to lose weight underestimate calories by as much as 50 percent, which is why a journal can be beneficial. “You might then think twice about what you’re eating,” Thomas says.
Fortunately, though, your clients aren’t stuck using paper and pen, which can be cumbersome. Instead, high-tech options like smartphone apps, body-monitoring devices and Web sites promise to be more convenient and perhaps even more motivational. “Many of these technology-based interventions also help you set goals and connect you to other people with similar goals,” Thomas says. Because support is often a key ingredient in weight loss, these technologies could give your clients an extra edge in sloughing off the weight.
The scale might be the last thing your clients want to face, especially if they’ve only recently begun their journey toward slimming down. Yet like food and exercise logs, the scale will help keep them accountable. “The information from the scale can help determine if what you’re doing is working and motivate you to continue healthy behaviors,” says Thomas, who recommends weighing daily. “You can also adjust habits as necessary.”
And there’s proof in the pudding, so to speak. Stepping on the scale is a trick that has worked for NWCR members: 75 percent weigh in at least weekly, while 38 percent weigh themselves daily (Graham et al., 2011).
Just make sure your clients understand the need for realistic goals when they step on the scale. “Otherwise, they’ll be disappointed with the number they see,” Thomas says.
Also, let them know that they don’t need to lose large amounts of weight to benefit. “Losing just 10 percent of body weight is associated with significant health improvements,” Thomas says.
If you have clients who fear the scale, Thomas has two suggestions. First, remind them that the number on the scale isn’t a commentary about them as a person. Also, let them know that as they become more comfortable weighing in, their anxiety will lessen.
Everybody knows that if you want to slim down, calories count. Yet many of your clients may not know that foods have something called energy density. “By eating foods with lower energy density, you can fill up on fewer calories,” explains Barbara Rolls, Ph.D., professor of nutritional sciences at The Pennsylvania State University in University Park, Penn., and author of The Ultimate Volumetrics Diet (HarperCollins, 2012). “You’ll feel full and satisfied, rather than hungry and deprived.”
Foods with a low energy density generally have a high water content, which explains why they help fill you up. These include fruits, vegetables, beans, legumes, cooked grains, low-fat meats and skim milk. On the other hand, foods with a high energy density, such as crackers, chips, candies, cookies, nuts and butter, provide a lot of calories in a small amount of food.
Keep in mind, however, that this doesn’t mean your clients should only eat foods that are low in energy density. Otherwise, they’d be eating mainly fruits, vegetables, soups and salads, which wouldn’t be satisfying or nutritionally adequate and may be too low in calories, Rolls says.
Instead, Rolls recommends using guidelines from MyPlate to help balance the energy density of foods. In general, advise your clients to fill half their plate with vegetables and fruits, one quarter with lean protein and the remaining quarter with whole grains.
It goes without saying that exercise needs to be part of the weight-loss equation, but here’s the million-dollar question: How much exercise does it take to shed pounds?
In 2008, new government guidelines suggested that adults log at least 150 minutes per week of moderate-intensity aerobic exercise (or 75 minutes of vigorous-intensity aerobic activity or a mix of the two intensities) and muscle-strengthening exercises two or more days a week for health benefits (Centers for Disease Control and Prevention, 2008). Yet when it comes to weight loss, some individuals may need more.
In one study of more than 34,000 middle-aged women, participants who averaged 60 minutes a day of moderate-intensity exercise gained less than about 5 pounds and maintained a normal weight over a 13-year period (Lee et al., 2010). Another telling sign that points to greater amounts of exercise for weight loss: More than half of NWCR members burn more than 2,000 calories per week, or the equivalent of 200 minutes each week of moderate-intensity exercise, through physical activity (Graham et al., 2011).
Of course, getting first-time exercisers to commit to 60 minutes of daily exercise can be challenging, which is why you should offer a compromise. “If people can exercise for at least 30 minutes, seven days a week, they’ll see results,” says Mickey Harpaz, Ph.D., exercise physiologist and nutritionist in New York City and Fairfield County, Conn., and author of Menopause Reset! (Rodale, 2011). Once they meet that 30-minute goal, they may naturally want to do more.
For many Americans, sleep has sunk to the bottom of their to-do lists. More than a third of adults log fewer than seven hours a night, according to a study of more than 74,000 adults by the Centers for Disease Control and Prevention (2011). Yet sleep may have as much impact on weight as do diet and exercise, which is why your clients need to make sleep a bigger priority.
Take, for instance, a study from the journal Sleep Breath in which researchers analyzed data from annual check-ups of 21,000 apparently healthy adults. Compared to people who slept seven hours a night, people who logged five or fewer hours a night were more likely to gain weight and become obese during the three-year study period (Kobayashi, 2011). Yet another study found that people who snoozed five or fewer hours a night gained significantly more abdominal fat than people who slept for six to seven hours (Hairston et al., 2010)
What’s the connection between lack of sleep and weight? For starters, when you’re sleep deprived, you’re cranky and agitated and want to medicate yourself with every sleep skipper’s drug of choice: food. Even worse? “You don’t have good restraint when you’re sleep deprived,” says David Katz, M.D., M.P.H., director of the Yale University Prevention Research Center in New Haven, Conn., explaining why cookies, donuts and chips are so irresistible when you’re low on sleep.
Plus, when you mess up your sleep schedule, you disrupt circadian rhythms that normally regulate sleep and wake cycles. As a result, you cause cortisol and insulin levels to rise, making you hungry all of the time, Katz says.
To avoid weight gain, seven to eight hours of sleep a night seems to be the sweet spot. Just don’t let clients think that racking up more sleep will earn them extra points. “Studies also show that if you sleep too much, you can gain weight,” Katz says.
Although Americans today are more sedentary than ever, lack of physical activity is only one factor contributing to the country’s obesity epidemic. Perhaps a bigger cause? Increasing portions.
When researchers looked at portion sizes, they found an interesting relationship to the average size of Americans. “As portions increased starting in the 1970s, the average body weight of Americans began to rise, and they’ve continued to rise in conjunction with each other,” Lisa R. Young, Ph.D., R.D., adjunct professor of nutrition at New York University in New York City and author of The Portion Teller Plan (Broadway, 2006).
Of course, portion control is critical for anybody trying to lose weight, as “big portions contain more calories than small portions and encourage people to overeat,” Young says. Here are some simple ways your clients can control portions:
- Keep a food diary to gauge how much they’re eating.
- Weigh foods when eating at home.
- Use visuals in identifying correct portion sizes (for instance, a cup of pasta is a fist or baseball and a 3-ounce portion of meat is a deck of cards or palm).
- Use smaller plates.
- Fill half that plate with fruits and veggies.
From the plethora of food ads that dominate television to high-fat snack items placed near check-out counters in the most unusual places, today’s society is packed with cues to eat. As a result, your clients may have lost touch with true hunger cues, instead letting habit rule what they put in their mouths.
Yet while you can certainly teach clients to recognize when they’re hungry, there may be an even better approach: Teaching fullness. Why the shift away from hunger cues? “Hunger is both emotional and physical, and it’s difficult to tease the two apart,” says Madelyn Fernstrom, Ph.D., C.N.S., founding director of the Weight Management Center at the University of Pittsburgh Medical Center and author of The Real You Diet (John Wiley, 2010). “Fullness, however, is much easier to recognize.”
To determine fullness, Fernstrom recommends using a three-point scale. At one, you’re actively hungry and your stomach is grumbling. Two means you’re content and satisfied, even though you could eat more. Three is when you’re completely stuffed. The goal? “Think about being satisfied as the end goal, stopping when you reach that second level,” she says.
Your clients know that being stressed can jeopardize their health. Yet they may not know that stress can impact their waistlines, packing on pounds.
In a nine-year study published in the American Journal of Epidemiology, individuals with higher body mass index gained weight under stress (Block, 2009). “Stress may lead to comfort eating, which for some people lowers anxiety,” says Jason Block, M.D., lead author and nutrition and obesity researcher at Harvard Medical School in Boston. In certain individuals, stress also increases cortisol levels, which makes them more likely to gain weight.
The upshot? Stress reduction should always be a part of weight-loss interventions. “People first need to recognize that stress can possibly lead to weight gain, especially if they have a propensity to eat while stressed,” Block says. Once they do that, they can build stress-coping mechanisms into their daily routine, which will vary from one individual to another, and break the cycle of comfort eating.
References
Block, J.P. et al. (2009). Psychosocial stress and change in weight among U.S. adults. American Journal of Epidemiology, 170, 2, 181-192.
Centers for Disease Control and Prevention (2011). Unhealthy sleep-related behaviors. Morbidity and Mortality Weekly Report, 60, 8, 233-238.
Centers for Disease Control and Prevention (2008). How much physical activity do adults need?
Graham, T.J. et al. (2011). The National Weight Control Registry: A study of “successful losers.” ACSM’s Health & Fitness Journal, 15, 2, 8-12.
Hairston, K.G. et al. (2010). Sleep duration and five-year abdominal fat accumulation in a minority cohort: The IRAS family study. Sleep, 33, 3, 289-295.
Kobayashi, D. et al. (2011). Association between weight gain, obesity and sleep duration: A large-scale 3-year cohort study. Sleep Breath, September 3, 2011 [Epub ahead of print]
Lee, I.M. et al. (2010). Physical activity and weight gain prevention. Journal of the American Medical Association, 303, 12, 1173-1179.
Saad, L. (2011). To lose weight, Americans rely more on dieting than exercise. Gallup Wellbeing, November 28, 2011.
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Karen Asp is a freelance journalist, ACE-certified Fitness Professional, a contributing editor for Woman’s Day and the Fit Travel columnist for AOL. She also writes regularly for numerous other publications, including Self, Fitness, Women’s Health, Better Homes and Gardens, Real Simple, Prevention, Runner’s World, Redbook and Men’s Fitness.