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	James L. Holly, M.D.

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Your Life Your Health - Obesity: Weight Reduction

James L. Holly,M.D.

February 15, 2001

Your Life Your Health - The Examiner

With a few Spring-like days behind us, our minds turn to gardens, outings and inevitably, our desire to improve our health. Few things attract more attention and few things produce more expenditures in America than "easy," "painless" weight reduction gimmicks. Yet, the reality is that the best things in life are free. Unfortunately, we often don't want to hear what is free because while it doesn't cost us money, it costs us in discipline, determination and resolve.

There are seven principles which underlie any successful weight-reduction program:

Admit that you're fat.
No program -- absolutely none -- will be successful which does not include the self-disciplined and intentional reduction in the total caloric intake.
Any successful weight reduction program, must include a reduction in the total fat intake in the diet.
Eat more vegetables and fruits and start eating vegetables which you don't like.
Start a reasonable exercise program which you can and will maintain for at least ten years.
Be a tortoise rather than a hare. Be resolved to continue for as long as it takes.
Tell others what you are doing and invite them to hold you accountable

To successfully lose weight and to keep the weight off, the first step is accepting that you are "fat." We often use euphemisms to soften the impact of self revelation.

I am not "fat," I am portly!
I am not "fat," I am corpulent!
I am not "fat," I am plump!
I am not "fat," I am overweight, or, as Garfield the cat says, "under tall!"

Yet, each of these mental accommodations which we make with reality simply excuse our ignoring of the health implications of "significant" obesity. If you are more than 20% overweight -- 20 pounds for a person whose ideal weight is 100 pounds and 180 pounds for someone whose ideal weight is 150 pounds -- your weight is contributing to the inefficiency of bodily functions and can produce dire health consequences. If you wake up one morning and say to your self in the mirror, "Hi, my name is _______ and I am FAT," you have taken the first step to doing something about it.

Weight Reduction Principle Number One: Admit that you're fat.

The second step is to change something, however small it may seem to be. Some things require radical change. These things typically are those with a one-time fix, such as smoking cessation. The only effective way to stop smoking is to stop! "Slowing down" not only does not help your health -- a few cigarettes a day have been shown to be as bad as two packs -- but it is a sure way to fail. Weight reduction on the other hand, because it is a life-time and a life-style matter, is best done by "slowing down."

No matter what diet you chose, and there is no magical potion which will help you "melt" away the pounds, you must decrease your total caloric intake each day in order to lose weight. Fat is nothing but "stored energy!" When you consume more food than is required for your body to function, the body stores that excess energy in "fat" deposits. Some animals use these fat stores for food during long periods of fasting, such as during hibernation for bears. Human beings do not, and, indeed, cannot go for long periods of time with no food, and therefore, if you regularly and consistently eat more than you require, your fat stores will continue to accumulate.

A pound of fat has about 3,500 calories stored in it. Therefore, in order to get rid of a pound of fat, you must consume 3,500 calories fewer than are required to maintain your current weight. Very active people require about 15 calories per pound of body weight to maintain their weight. Inactive people may require fewer than 12 calories per pound of body weight. If you exercise regularly, you will increase the number of calories which you expend. For instance, if you walk or run a brisk mile, you will expend about 130-150 calories of additional energy, or the equivalent of the calories in a large apple.

Fat is the physical evidence that you are eating more food than you require. Now, it is possible not to "pig out" and still gain weight, if you are inactive. Successful weight reduction will usually be the result of a combination of increased output -- more exercise -- and decreased input -- eating less. And, never forget, if you are not hungry part of the day, you will not lose weight. Furthermore, if you are not willing to "work through" hunger pains, you will never successfully lose weight.

Principle Number Two: No weight reduction program -- absolutely none -- will be successful which does not include the self-disciplined and intentional reduction in the total, daily caloric intake.

The third step is to learn that not only must there be a total decrease in the amount of food consumed on a daily basis, but there must be a change in the kinds of food. Fat is one of the basic food groups and contains 9 calories per gram, while protein contains only 4. It is obvious therefore, that if you eat 10 grams of fat, you are taking in 90 calories, while if you eat 10 grams of protein, you are taking in only 40 calories. This means that you can eat twice as much protein as fat and still not gain weight. In addition, the health consequences of a high-fat diet, besides contributing to weight gain, are dire in that it contributes to hardening of the arteries as well. Remember, in the same way that fat accumulates around the waist, under the skin and in other obvious places, it also accumulates around the heart and in the liver. If you will simply reduce the amount of meat which you eat, you will begin to see improvement in your weight.

Principle Number Three: Any successful weight reduction program, must include a reduction in the total fat intake in the diet.

The fourth step to a successful weight reduction program is to start eating things which you don't like. A diet of meat and bread may be delicious, but it is not healthy. It contributes to:

hardening of the arteries
irregular bowel habits which may contribute to colon cancer
heart disease and aging because of the absence of naturally occurring antioxidants in the phytochemicals (plant chemicals) contained in fruits and vegetables.
weight gain because of the fat content of most meat
inactivity because of the sluggishness produced by heavy meat protein diets.

Fruits and vegetables not only have vitamins which we know we need, they contain many other healthy, naturally occurring chemicals which contribute to health in ways we don't even understand. Fruits and vegetable also contain fiber which is an essential part of controlling cholesterol and creating bowel regularity.

If you are REALLY serious about losing weight and keeping it off, think about the vegetable which you absolutely can't stand. Then begin to eat it twice a day. Make sure you eat all of that food before you allow yourself to eat anything else. Several things will happen:

You will think about what you're eating.
You will begin liking something you previously despised.
You will make a definite change in your eating pattern, because you will change the way you approach and think about food.

All of these are critical aspects to a successful, long-term weight reduction and health-improvement program.

Principle Number Four: Eat more vegetables and fruits and start eating vegetables which you don't like.

Fifth, start to exercise. Remember, like your diet changes, exercise must be something which you can and will maintain for the rest of your life. It must be:

Convenient,
Not cause you potential injury and
Be something you can do even as your body ages.

This means that "power lifting" is not a reasonable exercise regimen for a fifty or sixty year old to undertake. It also means that why running a marathon may be an exciting goal, it is not a life-long exercise regimen which you can maintain. Walking, biking, swimming, even jogging, are life-long exercise regimens which you can maintain over a very long period of time. Start cautiously and remember, it is not how much you do in the first week which makes the difference. It is how much you do in the next ten years that will change your health.

Principle Number Five: Start a reasonable exercise program which you can and will maintain for at least ten years.

Sixth, make sure that you are not starting a program, but that you are changing your habits for life. The story of the tortoise and the hare has many applications, few more appropriate than in changing your habits for health reasons. The hare may get the initial raves and praise, but it is the tortoise who will be successful. Initial success is important for maintaining enthusiasm, but initial success which is not followed by long-term resolution will only result in frustration and failure. Repeated failure will discourage new attempts. As you change your life-style:

Substitute fruit for fats.
Substitute dried fruits such as raisins for candy.
Eliminate high calorie, low food value products such as cold drinks and snack foods from your diet.
Add foods to your diet which are good for you but which you previously avoided because of taste.
If you eat out, eat where you can get vegetables which are not prepared with sugar and fat.
If you eat out, avoid, all-you-can-eat buffets which encourage you to overeat.
Don't go on a three month diet; change your habits for life.

Remember, what Dr. Cooley supposedly once said, "If you put it in your mouth and it tastes good, spit it out; it's not healthy for you." While this is an exaggeration, it has some truth. As you retrain your body, you retrain your taste. Learn to like what you didn't like; learn to eat what you have avoided. If you succeed in eliminating a great deal of meat and fast foods from your diet, you will go a long way toward a life-long successful change in your weight and health.

Principle Number six: Be a tortoise rather than a hare. Be resolved to continue for as long as it takes.

Seventh, with your family, friends and associates, talk about what you are doing. Let them help hold you accountable. The more you talk about your commitment, within reason, the more you internalize it and objectify it so that you are more likely to maintain your commitment.

Principle Number Seven: Tell others what you are doing and invite them to hold you accountable.

Remember, it's your life and it's your health.

Related Articles

	Obesity and Overweight: Summary of National Institutes of Health Report Obesity: Fat and Fit Obesity: Getting Rid of Fat; Why Is It So Hard? Obesity: How to Beat It Obesity: Weight Loss - Medicine, Myths and Magic

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