Weight Management

Weight Management
Americans are obsessed with both food and dieting. As a nation, we love to
eat. We eat out often, when meals are often higher in fat and calories than
meals eaten at home; we eat larger portions; and we indulge in dozens of
delicious “new” food products found on our grocery store shelves every
year.
But we also spend billions of dollars a year on commercial weight-loss
products and services hoping for a quick fix to our weight problem. And
what a problem: with all that eating, the Centers for Disease Control and
Prevention (CDC) reports that 68 percent of the nation is overweight or
obese. What’s more, dieting is failure-prone, and the statistics are even
worse when it comes to those who can keep the weight off.
The answer to this weight loss/weight gain cycle lies in how you manage
your weight on a day-in, day-out basis. Your diet—the way you eat—is
ingrained in your lifestyle. To change your weight—whether you want to
lose a few pounds, or more, and keep them off—or to ensure you don’t
succumb to the expanding-waistline syndrome, you must permanently
adopt a healthy lifestyle.
Unfortunately, it’s not just all that tempting food that stands in the way of
your efforts to achieve or maintain a healthy weight. Technology has
altered Americans’ lifestyle. Most of us, most of the time can be found
sitting—in front of a computer or TV, in a car, at a restaurant. About a
quarter of adults—and an even greater percentage of women—report they
are sedentary and engage in no physical activity during leisure time, and
less than half exercise regularly. And as women age, their tendency to be
sedentary steadily increases.
Being overweight increases your risk for many diseases. If you are
overweight, you are more likely to develop heart disease and stroke, the
leading causes of death for both men and women in the United States.
Overweight people are more likely to have high blood pressure, a major
risk factor for heart disease and stroke, and high cholesterol, also a risk
factor. They’re twice as likely to develop type 2 diabetes—a major cause of
death, heart disease, kidney disease, stroke, amputation and blindness—
as those not overweight.
Additionally, several types of cancer are associated with being overweight.
In women, these include cancer of the uterus, gallbladder, cervix, ovary,
breast and colon. Being overweight can also cause problems such as gout
(a joint disease caused by excessuric acid), gallbladder disease or
gallstones, sleep apnea (interrupted breathing during sleep), and

osteoarthritis, or wearing away of the joints. Anyone with risk factors for
health problems must be concerned about extra weight.
It all seems so simple: eat less, exercise, lose weight. But few people
succeed in losing more than a few pounds on diets and even fewer
succeed in maintaining that weight loss.An estimated 90 percent of dieters
regain the weight in five years. One reason is that many factors other than
overeating can play a part in weight, including your genetic makeup,
cultural influences and natural hormonal and neurologic regulators.
Extreme dieting programs can sometimes be harmful and are rarely
successful over the long term. Thus, weight loss should not be your only or
even your primary goal if you are concerned about your health. Instead, the
success ofyour weight-management efforts should be evaluated not just by
the number of pounds you lose, but by improvements in your chronic
disease risk factors,such as reduced blood pressure,cholesteroland blood
sugar levels, as well as by new, healthy lifestyle habits. In fact, some
experts believe that weight is not the sole cause of the diseases associated
with being overweight, but that the accompanying unhealthy foods and
sedentary lifestyles also contribute to these diseases.
On the flip side, some women are underweight, despite having tried to
achieve or maintain a “normal” weight. Having a metabolism that burns too
many calories can be as dangerous as being overweight. Underweight
women are susceptible to vitamin and mineral deficiencies, resulting in a
loss of bone density and muscle tissue.
A Word About Teens
Teenage girls today feel a lot of pressure from the media, friends and
sometimes their own parents to be very slim. This pressure can create a
distorted body image, making them see themselves as fat when they are
not fat, or they see themselves as fatter than they really are.
According to the National Eating Disorders Association(NEDA), 40 percent
of newly identified cases of anorexia are in girls ages 15 to 19, and over
half of teenage girls use unhealthy weight-control behaviors, such as
skipping meals, fasting, smoking cigarettes, taking laxatives and vomiting.
Fad dieting can keep teenagers from getting the calories and nutrients they
need to grow properly. Stringent dieting may cause girls to stop
menstruating and prevent girls from developing adequate muscle tone. If
the diet doesn’t provide enough calcium or vitamin D, bones may not lay
down enough calcium, which may increase the risk ofosteoporosis later in
life.
The flip side to teenagers feeling pressured to be thin is that some may
have legitimate concerns about their weight that adults dismiss.Adolescent

obesitycan carry serious lifelong health consequences. The best advice to
teenage girls: Instead of dieting because everyone is doing it or because
you are not as thin as you want to be, first find out from a health care
professional or dietitian whether you carry too much body fat for your age
and height. If you need to lose weight, follow the sensible guidelines laid
out here. Depending on your age, your health care professional may
recommend you eat more low-fat dairy products than is recommended for
adults because of your heightened need for calcium.
Treatment
The key to weight management is incorporating three strategies into
lifelong practices—eating healthfully, exercising regularly and, for some
women, changing your relationship with food. Unfortunately, of the millions
of American women who are trying to lose weight, a minority use this
method.
The most important key to success is to approach any changes in diet and
exercise not as punishment, but as a plan to implementpleasurable healthy
substitutes for unhealthy overeating and sedentary behavior.
Eating for Weight Management
Keeping in mind the biological reason we eat—to provide our bodies the
energy and nutrients it needs to carry out the tasks we ask of it—is a good
way to think about food.
Since an estimated 90 percent of dieters who lose weight regain all or part
of it within five years indicates that “dieting” is not the answer to weight
management. The best “diet” is a way of life that you can follow for the rest
of your life. Therefore, it should consist of a balance of a variety of foods.
You can ask a nutritionist or registered dietitian for guidance on the number
of calories you should eat to reach and maintain your goal weight. But as a
rule of thumb, you should take in about 250 calories per day less than is
needed to maintain your current weight and add an exercise regime that
burns an additional 250 calories a day if you want to lose weight. This
regimen should help you safely lose about a pound per week.
Your basal metabolic rate (BMR) is the number of calories your body needs
to maintain its basic functions. Several factors go into the calculation of
your BMR, including your height, weight and age. To get an idea of your
BMR, go to www.bmi-calculator.net/bmr-calculator. You need additional
calories to provide energy for daily activities; the more active you are, the
more calories you need.

A more accurate method is to keep a detailed food diary over a few days to
a week during which you maintain your weight. Determine exactly how
many calories you eat on an average day—several books and websites
provide calorie counts for thousands of foods—and use that figure as a
starting place for weight maintenance or weight loss.
After you’ve determined how many calories per day you should eat, plan
daily menus. A registered dietitian or nutritionist can help you plan menus
that include the types and amounts of food you should eat which, in most
cases, should be based on the sensible guidelines set forth by the federal
government in its 2010 Dietary Guidelines for Americans. The guidelines,
available at www.healthierus.gov/dietaryguidelines, aim to help Americans
lose weight in an effort to reduce the risk of obesity-related chronic
diseases. The guidelines recommend balancing calories with physical
activity and encourage Americans to eat more healthful foods, such as
vegetables, fruits, whole grains, fat-free and low-fat dairy products and
seafood, and to consume less sodium, saturated fats, trans fats, added
sugars and refined grains.
The easiest advice to follow is to divide your plate into sections. Half your
plate at main meals should consist of colorful vegetables, one quarter of
grain products such as whole-grain bread, pasta, whole-grain rice and
cereals, and one quarter of lean meat, fish or poultry. Several times a
week, you should substitute dishes made from dried beans or peas as your
main course.You should also eat plenty of fruits and get three cups of low-
fat milk products like yogurt or cheese daily.
These guidelines will help reduce your calories and fat and increase the
fiber in your diet, all of which have been shown to decrease the risk for
heart disease. While you should try to cut back on fats and sugars, allow
for an occasionaltreat. As soon as you label a food as “off limits,” chances
are you will crave and perhaps even binge on it. A few simple ways to cut
back on calories include:
Hold the sauce. Dishes that include high-fat sauces, mayonnaise and
regular salad dressings should be consumed only occasionally and only in
small portions.
Drink more water. And steer clear of calories hidden in drinks like juice
drinks, alcoholic beverages,fancy coffee concoctions and smoothies.Avoid
excessive fruit juice consumption.
Eat high-volume foods.High-volume, low-calorie foods, like most fruits and
vegetables, are high in water and fiber, helping you feel fuller longer. Up
your intake of vegetables and cut back on fats and sweets.

Focus on nutrient-dense foods. The 2010 Dietary Guidelines suggest
replacing foods that contain sodium, solid fats, added sugars and refined
grains with nutrient-dense foods and beverages. These foods include
vegetables, fruits, whole grains, fat-free or low-fat milk and milk products,
seafood, lean meats, poultry, eggs, beans and nuts and seeds.
Health care professionals recommend women have moderate fat
consumption, between 20 to 35 percent or less of your total calorie intake.
Most fats should come from polyunsaturated fats and monounsaturated
fats, which are found in vegetable sources. The Dietary Guidelines for
Americans 2010 recommend consuming less than 10 percent of calories
from saturated fats and restricting trans fats (also known as trans fatty
acids) as much as possible. The guidelines also recommend limiting
cholesterol to less than 300 milligrams per day.
Strategies for reducing saturated fat and cholesterol include:
Get 10 percent of less of your fat from saturated fat sources such as red
meats, processed meats, organ meats or high-fat dairy products.
Choose low saturated-fat protein sources, such as fish, turkey, chicken,
legumes (dried peas and beans), nuts and seeds.
Use lean cuts of meat and trim excess fat.
Substitute skim and low-fat milk for high-fat dairy foods.
Broil, bake or boil foods instead of frying.
Increase your consumption of fruits, vegetables and whole grains.
You’ve probably heard of “good” fats and “bad” fats. These labels refer to
the effects various types of fat have on your body and health. Saturated
fats are commonly found in animal-based food products, as well as in palm
and coconut oils. They are solid at room temperature. Excess amounts of
saturated fat are considered unhealthy because they can contribute to fatty
deposits in the arteries, clogging them and leading to heart disease.
Unsaturated fats are liquid at room temperature and are known as oil. Two
types of unsaturated fats are monounsaturated and polyunsaturated, both
of which are thought to help lower cholesterol. Examples of these fats are
olive and canola oils. Monounsaturated fats also are found in avocados,
nuts and olives.
Trans fats are actually unsaturated fats that have been chemically
modified. Manufacturers add hydrogen to vegetable oil in a process called
hydrogenation. This increases the shelf life and the flavor stability of foods
containing these fats. Trans fats can be found in vegetable shortenings,
some margarines, crackers, cookies, snack foods and other foods made
with or fried in partially hydrogenated oils. Like saturated fat and dietary

cholesterol, they raise LDL cholesterol and increase your risk for
cardiovascular disease.
Essential fatty acids are a category of fatty acids found in polyunsaturated
fats your body needs but cannot manufacture itself. Good sources of
polyunsaturated fatty acids include soybean, corn and cottonseed oils.
When an unsaturated fat is solidified—into margarine, for example—the
process turns it into partially hydrogenated oils, which contains trans fatty
acids.
The Skinny On Fad Diets
Despite the ads that claim miracle weight-loss for some products, there
simply is no magic formula for losing weight. Fad diets, like those based on
cabbage soup, grapefruit or protein, may help you lose some pounds in the
short run, but they don’t work in the long term because they’re impossible
and unhealthy to maintain. The truth is permanent weight loss takes time
and requires a permanent change in eating and exercise habits.
Extreme diets of less than 1,000 calories per day carry health risks and
could trigger excessive overeating following the period of extreme caloric
restriction. Such diets usually provide insufficient vitamins and minerals as
well. Severe dieting also has unpleasant side effects, including fatigue,
intolerance to cold, hair loss, gallstone formation and menstrual
irregularities. Most of the initial weight loss is in fluids; later, fat is lost, but
so is muscle.
It is very dangerous to be on severe diets longer than 16 weeks or to fast
for more than two or three days. There have been rare reports of death
from heart arrhythmia when liquid formulas didn’t have sufficient nutrients.
High-protein, low-carbohydrate diets are still used by some people for
weight loss. Although a high-protein diet will lead to quick weight loss, its
long-term health and safety benefits are uncertain. One byproduct of this
type of diet is the release of substances called ketone bodies, which can
lead to a condition called ketosis and cause nausea and lightheadedness
because you are restricting your body’s source of fuel. Such high-protein
diets may also be high in saturated fat and low in fiber-rich and healthful
whole grains, fresh fruits and vegetables.
Carbohydrates provide your body with its main source of fuel and energy,
namely, a form of glucose called glycogen. This complex carbohydrate is
stored in liver and skeletal muscle. Simple carbohydrates (sucrose) offer
quick energy boosts, while complex carbohydrates provide the body with
fuel for several hours.
Examples of simple carbohydrates include fruit sugars (fructose) found in
fruits, milk sugars (lactose) found in milk products,and other forms of sugar

(sucrose) found in sweeteners such as corn syrup, honey, dextrose, high-
fructose corn syrup and fruit juice concentrates. Complex carbohydrates
are found in whole grains, rice, peas and dried beans, such as lentils and
black, kidney and pinto beans.
Carbohydrates stored in the body are packed with water. That’s why
introducing a low-carbohydrate diet leads to rapid weight loss as the body
turns to stored carbohydrates for energy, eliminating large amounts of fluid
from your body. After the stored carbohydrates are gone, your body turns
to fat and lean body tissue for fuel, inducing further weight loss.
Many people on low-carbohydrate diets eat less but feel fuller due to the
high-protein, high-fat foods they consume. However, this creates more
work for your kidneys, which have to process the high amounts of protein.
This is especially dangerous for people with diabetes. Additionally, excess
protein excretion can cause valuable calcium to be excreted.
Many health care professionals believe that rather than adhere to a low-
carbohydrate diet, it’s healthier to consume healthy carbohydrates in
reasonable amounts. This means focusing on complex carbohydrates like
beans, whole grains and vegetables, as well as simple carbohydrates that
pack plenty of fiber, such as fruits.
Choosing A Diet Plan
With all of the fad diets circulating these days, you need to do your
homework before embarking on a new weight-loss plan. The following
questions will help you determine if a diet is healthy and legitimate or just a
scam:
Does the plan promise dramatic and rapid weight loss? If a program is
promising results that sound too good to be true, they probably are. A 10-
pound loss in two weeks is unrealistic and may harm your overall health. A
weight-loss goal of one to two pounds per week is a safe and effective rate
for long-lasting results.
Does the plan exclude entire groups of foods? If a weight-loss plan
excludes an entire group of foods such as grains, fruits, vegetables, dairy
or protein, you risk missing out on essential vitamins and minerals.
Does the plan require extremely low calorie levels? Most experts agree that
we need to consume at least 1,200 calories each day to maintain a healthy
body. This is a minimum; most people actually need more. If a weight-loss
plan restricts calories below this level, it’s not nutritionally adequate, and
you’ll be in danger of nutrient deficiencies.
Are you required to buy special foods or supplements to follow the
program? Weight-loss programs that rely on special foods or supplements
tend to be money-making schemes to benefit the seller. These types of

programs will drain your wallet without teaching you about nutrition and
healthy eating habits.
Does the plan address lifestyle changes, such as increased exercise and
improved eating habits? Realistic weight-loss plans should focus on the
causes of your weight gain and on long-term lifestyle changes, not just on
short-term losses.
Can you continue this way of eating for the rest of your life? Weight loss is
difficult, but maintaining that weight loss is even harder. Any plan that
allows you to lose weight should also be a plan you can continue
indefinitely to maintain that weight.
The following claims and promotions should alert you to the probability of a
bogus weight-loss scheme:
The plan is touted as requiring no sacrifice—no exercise or no change in
your eating habits.
No reliable evidence or scientific proof is offered to back up claims that the
plan is safe and effective.
Testimonialsand case histories of people who have supposedly been
successful on the plan are offered as “proof” of its effectiveness. A few
successes don’t prove the plan will work for everyone.
The plan is described in sensational articles, or worse, advertisements
made to look like articles, in tabloids and weight-loss magazines.
The plan is promoted as “cleansing” the body of “toxins” to let the body’s
“natural” curative powers help in your weight loss efforts.
Today’s most popular weight-loss programs vary greatly. No single diet is
appropriate for everyone, so you’ll want to weigh factors that vary by plan,
such as types of food you can eat, reliance on supplements or drugs,
calorie levels allotted and support offered.
Popular Weight-Loss Plans
Mediterranean-Style DietThe Mediterranean diet is really a way of eating,
rather than a particular diet. Some large studies point to the Mediterranean
style of eating as a good alternative to low-fat dietary approaches as a way
to reduce weight and, consequently, reduce your risk of heart disease and
diabetes. Like the low-fat diets, the Mediterranean eating pattern focuses
on fruits, vegetables, whole grains, nuts and seeds, but it also includes
olive oil as a significant source of monounsaturated fat and wine in low to
moderate amounts. The major protein sources are dairy, fish and poultry,
with minimal red meat.The Mediterranean eating style allows a higher
percentage of calories from fat than the low-fat diets typically endorsed by
health organizations, but several recent major studies have shown that the

diet is an alternative to low-fat diets, especially for lowering risk of diabetes
and heart attacks, often related to weight.
Weight WatchersThis diet program, one of the most popular among health
care professionals,has helped millions of people worldwide lose unwanted
pounds since it was founded in 1963. In general, the plan is healthy—long
on fruits and vegetables and short on fat, protein and sugar. Weight
Watchers provides two options—weekly in-person meetings or Weight
Watchers Online. Weight Watchers meetings offer member support. (Your
weight is kept private.) Meeting leaders have achieved their own weight
loss goals with Weight Watchers and have been able to maintain their goal
weight. The discussionscan be helpful because they focus on the common
challenges you face when trying to lose weight—what to do about eating in
restaurants or at a wedding, for example. They also let members exchange
dietary advice on tasty alternatives or ideas for trimming calories. Weight
Watchers Online offers members comprehensive guides to help them learn
how to follow the Weight Watchers approach and food plan, including
interactive tools and customized sites for men and women. Exercise is
stressed as part of the program.In the past, Weight Watchers used a
system that assigned point values to each food. Dieters were allowed to
consume a specific number of points per day based on their weight, and
members weren’t given much direction about how to divide those points
between the various food groups. As a result, a dieter on this program
could eat too much of a single, and perhaps unhealthy, type of food.
However, with the Points Plus program launched in 2010, dieters get more
direction on how to make healthy food choices. The program still focuses
on calorie restriction, but it encourages members to choose healthful foods
that are high in nutrients and low in sugar and fat.
NutriSystemThis diet is based mostly on NutriSystem’s prepackaged foods
and involves reducing participants’ calorie intake to an average minimum of
1,200 calories per day for women and 1,500 for men. The NutriSystem
program is now completely at-home—participants have the option to go
online to chat with one of their weight loss counselors about diet and
exercise. While the program was developed by registered dietitians and
health educators with input from physicians, there have been some
complaints in the media that the counselors are not highly trained. If you
are concerned about this, you may want to ask about credentials at your
center, and always discuss any diet plan with your health care
professional.Because clients eat prepackaged meals, they have few food
decisions to make. Thus they’re not learning how to make choices in the

real world or change their lifestyles. The program also sells vitamin and
mineral supplements.
Jenny CraigThis program also relies on its own brand of prepackaged
foods, plus some additional supermarket foods, and provides calorie
recommendations depending on your gender and current weight. Clients
can attend weekly lifestyle classes and receive one-on-one counseling or
choose an at-home program that allows for consultations via phone. As
their comfortlevel grows, clients are given the option to transition to regular
foods.Jenny Craig emphasizes increased physical activity, changing
ingrained eating habits and learning how to balance meals and food
choices. The program was developed by registered dietitians and
psychologists with input from physicians.Relying on prepackaged foods
makes dining out and socializing difficult and de-emphasizes behavior
modification and lifestyle change that are very important to long-term
weight loss. Also,Jenny Craig makes “weight-loss supplements” an integral
part of the system. While vitamin and mineral supplements may be helpful
to overall health, no herbal or enzymatic supplements should be relied
upon for weight loss.
Liquid Fasting Programs (Optifast, HMR and New Directions)These
programs consist of a highly structured dieting approach that combines
medical, behavioral and nutritional knowledge and skills to support weight
loss. The medical team (physician, registered nurse, dietitian or
psychologist) provides medical supervision for the dieter in an out-patient
medical setting. The diets use vitamin-fortified liquid-meal replacements or
prepackaged foods to achieve a reduced calorie intake. Part of the
structure includes mandatory weekly group sessions that support the
weight-loss efforts and promote positive eating behaviors. In some settings,
one-on-one counseling is available.The programs emphasize changes in
lifestyle behaviors to support weight loss including daily physical activity
and menu planning. Once the diet is completed,the patient transitions back
to a recommended, healthy eating plan. In many locations, exercise
physiologists are available to help design personal exercise plans.During
the weight-loss phase of the programs, dieters use only the meal
replacement products. Because of this, some dieters find it difficult to
transition from liquid to regular food. The support of the trained program
staff is essential to this transition. Most programs emphasize that the
maintenance phase of these programs is the key to success with long-term
weight maintenance.
Due to the close contact with medical professionals, these programs are
beneficial for individuals with significant weight to lose or for those with

serious health problems associated with their weight. Participation involves
the approval of your health care professional. Some locations may also
offer the opportunity to utilize prescription weight-loss medications.
Low-Carb DietsThese trendy diets, including the Atkins, Sugar Busters and
Protein Power plans, claim that carbohydrates—and not fat or an
overindulgence in calories—are what make people gain weight. They go
against the recommendations of the U.S. Department of Agriculture
(USDA), the American Heart Association, the American Dietetic
Association and the American Diabetes Association.Fat and protein intake
are unlimited in some of these plans, more limited in others. The higher fat
and protein level of the Atkins Diet can provide more fullness with meals
and snacks. Foods containing simple carbohydrates are restricted, so
blood sugar surges after a high-carbohydrate meal doesn’t occur, helping
control appetite. This also prevents blood sugar levels from rapidly
plummeting, which contributes to hunger.These diets rebel against the past
decade’s message for healthy eating—moderate fat; increased whole
grains, fruits and vegetables; and moderate amounts of protein. These
recommendations are based on scientific evidence that eating a well-
balanced diet will decrease risks of chronic disease and increase health.
While high-fiber diets rich in fruits and vegetables are shown consistently to
decrease chronic diseases, diets high in animal protein continue to raise
concern of possible increased risks for certain cancers.
Several recent studies found that high-protein diets have no proven
effectiveness in long-term weight reduction and may damage health of
those who stay on them for a long time.
Note: Because prolonged ketosis (a side effect of high-protein diets) can
lead to kidney damage, people with a family history of renal disease or who
have renal problems should avoid high-protein diets.
The ZoneThis diet relates excess weight to both overeating and/or to
unbalanced consumption of calories from the carbohydrate, fat and protein
groups. In the Zone, your diet is exactly one-third lean protein, two-thirds
fruits and vegetables and a dash of monounsaturated fat. The diet claims
that this is “the metabolic state in which the body works at peak efficiency.”
The diet consists of one gram of fat for every two grams of protein and
three grams of carbohydrates.Compared to many other low-carb regimens,
this diet promotes a higher percentage of low-fat protein foods. This diet is
most likely successful because it restricts caloric intake enough to lose
weight. The average person eating in the Zone consumes no more than
800 to 1,200 calories a day. Some critics consider this a strict, controlled

eating regimen, requiring significant effort to adhere to a complex set of
rules, charts and tables.
South Beach DietThe South Beach Diet is sometimes lumped in with low-
carb diets like Atkins, but it differs in some significant ways. It focuses on
replacing “bad carbs” with “good carbs” and “bad fats” with “good fats.” It
restricts simple carbohydrates, such as refined sugar and enriched grains,
but permits complex, fiber-rich carbohydrates such as whole-grain bread
and brown rice. It also allows more vegetables and focuses on the
“glycemic index,” which relates to how quickly the body digests foods.
Simple carbs digest quickly and cause spikes in blood sugar. It recognizes
that while foods rich in “bad fats” may help control the hunger cycle, they
also contribute to high cholesterol and heart disease. So the South Beach
Diet replaces them with foods rich in unsaturated fats and omega-3 fatty
acids, such as lean meats, nuts and fish. The three-phase diet ends with a
maintenance phase to help you learn how to maintain a healthy weight.
Flat Belly DietThe Flat Belly Diet follows many of the same principles as the
Mediterranean diet but also emphasizes how much and how often you
should eat. It starts with a four-day “jump start” and then has a four-week
plan that focuses on: eating an unsaturated fat at every meal; limiting
meals to 400 calories per meal; and eating every four hours during the day.
It teaches you how to eat a balanced diet with proper portions of
vegetables, fruits, whole grains, nuts and seeds, low-fat dairy products and
low-fat proteins, such as fish, poultry and beans. It also includes an
exercise plan to help you manage your weight.
Single-Food DietsDiets that push grapefruit or eggs, cabbage soup or
oranges have surfaced over the years. These diets are dangerous because
they’re unbalanced nutritionally and rely on too few calories.
Liquid Meal Replacement DietsThese liquid meal replacements, such as
Slim-Fast, are milk-based products that have added vitamins and minerals.
If “balanced” is defined as containing adequate amounts of the nutrients the
government has established as the Reference Daily Intakes (RDIs), then
Slim-Fast meets the requirements. Slim-Fast users get a daily menu of
three snacks, two shakes or meal bars and one balanced meal, customized
to their tastes.Recent research shows that meal-replacement diet plans
such as Slim-Fast work. A landmark 10-year study demonstrated that the
Slim-Fast Meal Replacement Plan helped individuals lose weight and
maintain body weight long-term. Participants weighed an average of 33
pounds less after 10 years than a matched group.After analyzing studies
comparing several types of restricted-calorie diets, the American Dietetic
Association issued a practice guideline concluding that structured meal-

replacement plans could be at least as effective for losing weight as
reduced-calorie diets and sometimes more effective. The guidelines also
suggest that for overweight and obese adults who struggle with food
selection and portion control, one or two daily meal replacements fortified
with vitamins and minerals and supplemented with self-selected meals and
snacks may be a successful weight loss and maintenance strategy.
Using Medication to Lose Weight
Women with increased medical risk from their obesity may benefit from
adding a weight-loss medication to their nutritional and exercise regimen.
Most research-based and professional associations recommend lifestyle
therapy for at least six months before embarking on a weight-loss plan
using physician-prescribed drug therapy. Even then, it must be used only
as part of a comprehensive weight-loss program that includes dietary
therapy and physical activity. Currently available prescription medications
include:
phentermine (Adipex-P, Fastin, Ionamin, Obenix, Oby-Cap, Teramine,
Zantryl)
diethylpropion (Tenuate, Tepanil)
phendimetrazine (Adipost, Bontril, Melfiat, Obezine, Phendiet, Plegine,
Prelu-2)
orlistat (Xenical)
Most prescription weight-loss drugs are FDA-approved for short-term use
only, usually less than 12 weeks. Orlistat (Xenical) is the only drug
approved for long-term use. Orlistat also is now available over the counter
under the brand name Alli in 60 mg pills, half the strength of the
prescription dosage in Xenical, making it the first FDA-approved over-the-
counter weight loss drug. Like Xenical, Alli blocks digestion of about 25
percent of the fat eaten at a meal. Orlistat has been found to be safe and
effective in combination with a low-fat (less than 30 percent fat), low-calorie
diet and can help people lose 50 percent more weight than dieting alone.
Safety is an issue with some weight-loss medications. The drug
sibutramine (Meridia) was removed from the market in 2010 because
studies showed an increased risk for heart problems, including non-fatal
heart attack and stroke. The FDA is also reviewing reports of serious liver
injury in people taking orlistat. No definite association has been
established, but people taking orlistat should watch out for any symptoms
of liver injury, such as weakness, fatigue, fever, jaundice or brown urine
and report these signs to their doctors.
Most of these drugs decrease appetite by affecting levels of certain brain
neurotransmitters that affect appetite. Orlistat does not act directly on the

central nervous system but instead blocks an enzyme essential to fat
digestion so your body doesn’t absorb fat. In general, combining weight
loss medications with an increase in activity level and a decrease in
calories can help you lose 10 pounds more than what you might lose with
nondrug obesity treatments.
If you are, may be or could become pregnant or are nursing, be sure to tell
your health care professional. The effects of most of these drugs have not
been tested on unborn babies; however, medications similar to some of the
short-term appetite suppressants have been shown to cause birth defects
when taken in high doses. Also, diethylpropion and benzphetamine pass
into breast milk.
Before you take any product for weight loss, be sure to discuss it with your
health care professional first. There are numerous potentially dangerous
over-the-counter drugs and herbs that claim to help you lose weight. These
over-the-counter drugs, except for Alli, and herbs have not been approved
by the FDA and may cause significant health complications and even
death.
Surgery
For clinically severe obesity, your health care provider may recommend
surgery for weight loss. Many people, including some health care
professionals, wrongly believe that obese people merely need to stop
eating so much to lose weight. In reality, extreme obesity is a potentially
deadly disease that sometimes requires a treatment as dramatic as
surgery. Surgery is an option for carefully selected patients under the care
of a health care professional.The surgery, called bariatric surgery, reduces
the size of your stomach, limiting the amount of food it can hold. Most
physicians consider people for the surgery who:
have tried other methods of weight loss (changes in eating behavior,
increased physical activity and/or drug therapy) and are still severely obese
have a BMI of at least 40 (or 35 in addition to other medicalconditions such
as diabetes, hypertension and heart failure)
understand the procedure, risks of surgery and effects after surgery
are motivated to make a lifelong behavioral commitment that includes well-
balanced eating and physical activity needed to achieve—and maintain—
desired results
There are several types of bariatric surgery:
Roux-en-Y gastric bypass (RYGB). In this procedure, sometimes referred
to as “stomach stapling,” the stomach is reduced to the size of a golf ball.
The stomach is divided into a large portion and a small portion. The small
portion is sewn or stapled together to make a small pouch, which holds

only about a cup of food. The small pouch is then disconnected from the
upper portion of the digestive tract and reconnected to a lower portion of
the intestine. Not only do you eat fewer calories, but your body absorbs
fewer calories because part of the intestine, the duodenum, has been
bypassed.
Adjustable gastric band. This procedure is performed laparoscopically,
through a small incision in the abdomen. The surgeon wraps a saline-filled
silicone band around the top of the stomach to create a small pouch about
the size of a thumb. The size of the pouch can be altered by increasing or
decreasing the amount of saline (salt water) in the pouch. You eat less
because you feel full sooner.
Other less common procedures include:
Biliopancreatic bypass with duodenal switch (BPDS). In this procedure,
much of the stomach is removed, leaving only a “gastric sleeve” that is
attached to the small intestine, completely bypassing the duodenum and
upper small intestine.
Biliopancreatic diversion with duodenal switch is a similar procedure, but a
smaller portion of the stomach is removed, and the remaining stomach
(gastric sleeve) remains attached to the duodenum. The duodenum is
connected to the lower part of the small intestine. As with the gastric
bypass procedure, you absorb fewer calories with both of these
procedures.You also eat less because your stomach is smaller. Removing
part of the stomach is also thought to reduce production of an appetite-
related hormone called grehlin. This procedure is generally used for people
who have a body mass index of 50 or more.
All procedures can lead to complete remission of diabetes, sleep apnea,
hypertension, kidney failure and other weight-related medical conditions.
While bariatric surgery is extremely safe, the greatest risks come after the
surgery. Some occur soon after the operation, such as hemorrhage,
obstruction, infection, hernias, pulmonary embolisms (blood clots in the
lung) and leaks between the areas where tissue was sewn together.
Long-term complications include nutritional deficiencies, including
malabsorption of vitamin B12, iron and calcium; and hypoglycemia, or low
blood sugar, which can lead to various medical conditions, including
neuropathy.
Most people undergoing bariatric surgery have rapid and extreme weight
loss. It often helps patients lose as much as 50 percent of their excess
body weight. Just over half of people who undergo weight loss surgery
have kept the weight off five years after the procedure.

After surgery, you have to learn to eat smaller amounts of food at one time,
to chew food well and to eat slowly. If you don’t adjust your eating habits,
you won’t lose as much weight. Additionally, especially in the first three
months after surgery, you must be sure to eat the proper amounts of
protein, calories, minerals and vitamins as recommended by your health
care professional and you will likely need nutritional supplements for the
rest of your life.
Trying To Gain Weight?
For the underweight woman who needs to gain weight, either for health
reasons or appearance’s sake, the journey can be difficult. Weight gain can
be more difficult than weight loss. The underweight woman may have a
higher metabolism, fewer fat cells or a genetic tendency to be leaner. She
may also be taller, or just not care about food.
Winning at weight gain comes down to pairing a balanced eating pattern
with regular physical activity—like any healthy lifestyle. The trick is to make
sure you eat more calories than you burn. But you shouldn’t give up
exercise because it has many health benefits! Consider adding a weight
training program because building muscle will increase your weight. Here
are some more tips that can help:
Plan ahead for extra meals and snacks. Instead of the traditional three
square meals a day, add two or three substantial snacks between three
moderate-size meals. By spreading out your food choices during the day,
you’ll be more likely to enjoy your meals and snacks without feeling stuffed.
Concentrate on calories. Tip the scales toward weight gain by choosing
foods that are calorie-dense, or high in calories. While rich desserts and
fried foods quickly come to mind, the emphasis should be on foods that
pack other nutrients, such as protein, vitamins and minerals, in addition to
calories. These include dairy foods, nuts, peanut butter or avocados. Aim
for the higher end of the recommended number of servings from each
group in the Food Pyramid. And watch your use of added sugars and
saturated and trans fats.
Let snacks work in your favor. Smart snacking plays an important role in
gaining weight. Choose snacks that add calories, vitamins and minerals,
such as powdered milk added to a yogurt or ice cream-based shake with
fruit and fruit juice, nuts and seeds.Dip crackers, chips and fresh vegetable
relishes into high-calorie dips made with low-fat cheese, low-fat sour
cream, mashed beans or salad dressings made with mono- or unsaturated
oils. Space out snacks during the day so you don’t spoil your appetite for
later meals.
Physical Activity is Key to Weight Management

Daily physical activity is essential to weight management. Exercise not only
burns calories, it also tempers your appetite, boosts metabolism, improves
sleep and provides psychological benefits, such as an increased feeling of
control and self-esteem, as well as reducing stress.
If you are over 40, have been inactive for some time, suffer from shortness
of breath or weakness that interferes with daily activities, or have a chronic
health condition, consult a health care professional before increasing your
physical activity. Notify your health care professional about any chest pain,
faintness or dizziness, or bone or joint pain you’re experiencing and any
medications you’re taking.
Physical activity is defined as any bodily movement produced by skeletal
muscles resulting in energy expenditure. The best kinds of exercises for
burning calories are moderate- to vigorous-intensity physical activities. The
calories burned per hour are listed for a 140-pound healthy woman.
Moderate-intensity activities include:
hiking (386 calories)
light gardening/yard work (302 calories)
dancing (319 calories)
golf, walking and carrying the clubs (244 calories)
bicycling, less than 10 mph (370 calories)
tennis, singles (386 calories)
walking, 3.5 mph (370 calories)
yoga (336 calories)
Vigorous-intensity physical activities include:
aerobics, high-impact (445 calories)
calisthenics (512 calories)
running/jogging, 5 mph (580 calories)
swimming (580 calories)
bicycling, 12-14 mph (554 calories)
racquetball, casual (445 calories)
skiing, downhill (554 calories)
weight lifting, vigorous (400 calories)
While you and your health care professional should set up a detailed
exercise plan based on your individual health status, the 2010 Dietary
Guidelines recommend that for substantial health benefits, healthy women
engage in at least150 minutes of moderate-intensity aerobic exercise or at
least 75 minutes of vigorous aerobic exercise per week while not exceeding
caloric intake requirements. For additional and more extensive health
benefits, the guidelines recommend at least 300 minutes of moderate-
intensity aerobic exercise or at least150 minutes of vigorous-intensity

aerobic exercise per week. The guidelines also recommend muscle-
strengthening activities that involve all major muscle groups on two or more
days per week.
If you have beeninactive, you need to work up slowly to this amount so you
don’t get injured or overly fatigued and then become discouraged. Start
with five or 10 minutes (or whatever you’re comfortable with) every other
day, adding one minute every other session. Low- to moderate-intensity
physical activity, like housework, gardening and walking the dog provide a
great deal of general health benefits,but for weight loss,you need to up the
ante and exercise at a higher intensity with more vigorous activities like
brisk walking or jogging, singles tennis or other racquet sports, aerobics
classes, ice or roller skating, swimming or cycling.
Because the goal of moderate to vigorous physical activity is to work your
heart muscle, your exercise needs to increase your heart rate. One way to
determine if you are exercising intensely enough is to measure your heart
rate. After warming up and sustaining an aerobic activity for about five
minutes, take your pulse by placing two fingers on the carotid artery on the
side of your neck, just under your jaw line and about one to two inches in
front of your ear. Count the beats for 10 seconds.
Your heart rate should be about 50 to 85 percent of its maximum, which is
your age subtracted from 220.
If you’re out of shape or older than 60, aim for an intensity at the lower end
of the 50 to 85 percent range of your maximum heart rate. To determine
what your heart rate should be during exercise,subtract your age from 220;
divide that number by six for a 10-second heart rate count, then multiply
that number by 0.5 for the lower end of the range and 0.85 for the higher
end. For example, if you’re 70:
220 – 70 = 150 (this would be your maximum heart rate for one minute)
150 / 6 = 25 (this would be your maximum heart rate for 10 seconds)
25 x 0.50 = 12.5 (this would be 50 percent of your maximum, or the lower
end of where your 10-second heart rate should be when you’re exercising)
25 x 0.85 = 21.25 (this would be 85 percent of your maximum, or the higher
end of where your 10-second heart rate should be when you’re exercising).
The following chart illustrates recommended heart rate counts based on
your age. (These are rates per minute; use the instructions above to
convert your 10-second count to heart beats per minute.)
20 years 100-170 beats per minute 200 beats per minute

An easier way to judge intensity is the “talk test.” You shouldn’t be
exercising so hard that you can’t talk with a friend or recite a poem. If you
can’t talk without gasping for breath, slow down. On the other hand, if your
exercise is easy enough that you can sing a song out loud, you probably
need to increase your intensity.
Another type of exercise has received much attention over the past several
years for its contribution to weight loss efforts. Strength training, which
includes weight lifting and isometrics, or using your own body weight as
resistance, not only improves muscular strength and endurance but raises
metabolism, enabling you to burn more calories.
Make sure you take a few minutes to warm up before doing any kind of
exercise and stretch when you finish.
It’s best to incorporate a combination of both types of exercise into your
lifestyle— moderate to vigorous physical activities to burn fat and strength
training to build muscle. Neither is as effective alone.
At the same time, you need to reduce the amount of television you watch,
since TV watching is independently associated with weight gain.
Some Techniques May Not Live Up to Expectations
Spot exercising, or training particular areas of your body, won’t reduce
body fat in specific locations because exercise draws on fat stores
throughout your body. Gimmicky devices such as bust developers, vacuum
pants and exercise belts do absolutely nothing to reduce fat in specific
locations or, in the case of the bust developer, to add bulk. Electrical pads
wrapped around the waist, arms or thighs have been reported to cause
burns and fires. Similarly, cellulite-removal creams have been shown in
several studies to be ineffective.Their apparent effect on fat may simply be
from constricting blood vessels and forcing water from the skin, which could
potentially be dangerous for people with circulation problems.
Liposuction is an increasingly popular technique to reduce fat in specific
areas on the body. Liposuction, also called lipoplasty or suction lipectomy,
is a surgical procedure that vacuums out fat from beneath the skin’s
surface to reduce fullness in areas such as the abdomen, hips, thighs,
knees, buttocks, upper arms, chin, cheeks and neck. But depending on

how much fat is removed, liposuction may not lead to weight loss, and it
definitely won’t change any behaviors associated with weight gain. It is also
not an appropriate strategy for everyone, as age and skin tone can play a
role in how successful the technique will be.
Get Your Mind In Gear
Another key to successfulweight loss is incorporating behavioral strategies
into your new eating and exercise activities. These include learning about
nutrition, planning what to eat and making sure you eat regularly to end
impulsive and thoughtless eating.
Some specific and helpful behavioral strategies include:
Set the right goals. Your goals should focus on specific dietary and
exercise changes, such as, “I will eat five servings of fruits and vegetables
every day this week,” or, “I will work up to being able to walk briskly for 30
minutes at a time,” rather than just on weight loss.Selecttwo or three goals
at a time to incorporate into your lifestyle rather than trying to change
everything at once. Effective goals are specific, attainable and forgiving,
which means that you don’t have to be absolutely perfect. Remember, too,
in setting your goals, that losing more than one to two pounds per week
can be unhealthy and greatly increases the chances of regaining the
weight.
Reward success. To encourage yourself to attain your goals, reward
yourself for successes. An effective reward is something that is desirable
and timely such as attending the cinema or taking an hour for yourself.
Don’t use food as a reward!
Keep a food and exercise diary. Many behavioral psychologists believe it’s
necessaryto track your daily food consumptionto achieve long-term weight
loss. From a simple pad of paper to a computerized program that provides
reports and analyses of your progress, the best tool is the one you use
every day. Incorporate your goals, such as eating five servings of fruits or
vegetables each day, into your self-monitoring efforts.
Monitor your weight sensibly. Keep track of your weight, but don’t weigh too
often. One day’s diet and exercise patterns won’t have a measurable effect
on the scale the next day, and your body’s water weight can change from
day to day, which may frustrate you and derail your efforts.
Join a support group. Weekly meetings with a nearby support group or
even over the Internet can help in a variety of ways. They provide
accountability, helpful ideas, emotional support, an outlet for sharing
frustrations and a variety of other psychological benefits.

Use positive self-talk. Take responsibility and see yourself as in control,
able to talk yourself into exercising every day rather than being angry,
hopeless or in denial.
Find ways other than food to respond to stress and other situations in your
life. Certain cues, from stress to watching television, may stimulate
unhealthy eating. In some cases,you can avoid those cues;don’t go to that
Mexican restaurant where you always eat too many chips, for example. For
situations that can’t be avoided, however, such as the business lunch or an
argument with your spouse, relearn new ways to respond. If you track the
situations surrounding your overeating in your food diary, you can more
easily determine the cues you need to be aware of.
Change the way you go about eating. There are a variety of tricks—from
using a smaller plate to eating more slowly—that can help you eat less.
Setting an eating schedule, starting meals with a broth-based soup, only
buying foods on a pre-planned menu and other similar efforts can all help.
When eating out, don’t feel compelled to finish your entire meal if portion
sizes are too large. The steady growth of food portion sizes served both in
restaurants and at home has encouraged the overeating that is fueling the
obesityepidemic in the United States, according to survey by the American
Institute for Cancer Research.
Appropriate portion size is very important. When dining out, for instance, try
to take home at least half of your dish. You can ask the waiter to box up
half of it before you start eating. When eating at home, serve your plate and
leave the remaining food in the kitchen; do not place it on the table. Half
your plate should be filled with vegetables, one quarter with a protein and
one quarter with grain products such as whole-grain bread, pasta, whole-
grain rice and cereals. Never, ever, supersize any kind of fast food or
takeout meal.
Prevention
It’s best to use weight management techniques before you become
overweight, to prevent weight gain in the first place. The federal
government issues helpful dietary guidelines, spelling out how much and
which food you should eat and how much you should exercise to stay
healthy. The guidelines, which are revised every five years (most recently
updated in 2010), are widely used by health care professionals, food
makers and educators, and also form the basis of the well-known U.S.
Department of Agriculture (USDA) Food Pyramid used to teach healthy
eating habits based on food groups such as grains, vegetables and fats.

The 2010 Dietary Guidelines recommend:
Addressing the obesity epidemic in the United States by reducing calorie
intake and increasing physical exercise
Be physically active most days of the week
Letting the Food Pyramid guide your food choices
Eating a variety of grains daily, especially whole grains
Eating a variety of fruits and vegetables daily
Keeping food safe from foodborne illness
Choosing beverages and foods that limit intake of sugars
Choosing and preparing foods with less salt
Drinking alcoholic beverages in moderation
Choosing a diet low in saturated fat, trans fatty acids and cholesterol, and
moderate in total fat
Specifically, the 2010 Dietary Guidelines recommend the following for adult
women; to find the amounts that are right for you (exact amounts vary
based on your age), visit the Food Pyramid Web site at
www.MyPyramid.gov:
Meats and beans (Protein)
Eat five ounces of protein every day (five and a half ounces if you are
between the ages of 19 and 30) .Vary your choices of meats, poultry, fish,
beans, peas, nuts and seeds).
Fruits, vegetables and milk
Eat at least one and a half cups a day of fruit (two cups if you are between
the ages of 19 and 30) and two-and-a-half cups a day of vegetables (two
cups if you are age 51 or older).
Eat a variety of fruits and vegetables every day and choose from all of the
five vegetable subgroups (dark green, orange, legumes,starchy vegetables
and other vegetables) several times per week. You may consume fresh,
frozen, canned or dried; go light on fruit juices.
Drink three cups per day of either fat-free or low-fat milk or equivalent milk
products such as yogurt and cheese.
Carbohydrates
Eat six servings (five servings if you are 51 or older) of grains (cereal,
breads, crackers, rice or pasta) a day. At least three ounces should be
whole grain, and the other three enriched or whole grain. One ounce
equals about one slice of bread, one cup of cereal or one-half cup of
cooked rice, cereal or pasta.
Eat fruits and vegetables that are high in fiber and choose whole grains
Try to avoid adding sugar or sweeteners to foods and beverages
Sodium and Potassium

Do not consume more than 2,300 mg (approximately 1 teaspoon) of
sodium per day. Reduce sodium intake to 1,500 mg per day if you are 51 or
older, are African American, or have hypertension, diabetes or chronic
kidney disease.
Use little or no salt when preparing foods
Eat fruits and vegetables high in potassium such as potatoes, sweet
potatoes, soybeans, bananas and spinach.
Facts to Know
About 68 percent of the nation is overweight or obese.
According to the CDC, there has been a dramatic increase in obesity in the
United States over the past 20 years. In 2009, only the District of Columbia
and Colorado had a prevalence of obesity less than 20 percent.
According to the National Eating Disorders Association(NEDA), 40 percent
of newly identified cases of anorexia are in girls ages 15 to 19, and over
half of teenage girls use unhealthy weight control behaviors, such as
skipping meals, fasting, smoking cigarettes, taking laxatives and vomiting.
Obesity rates for children are 12.4 percent in those ages 2 to 5, 17 percent
in those ages 6 to 11 and 17.6 percent in those ages 12 to 19.
Children and teens who are overweight often have a lifelong struggle with
their weight and are at high risk for developing diabetes, high blood
pressure, diseased arteries, damaged hearts and liver damage.
If a woman’s waist circumference divided by her hip measurement is
greater than 0.8, she is considered to have a high amount of visceral fat,
which is the type of fat that surrounds the internal organs. This is especially
true if her waist measurement is more than 35 inches. This type of fat is
associated with higher risk of certain diseases and conditions like diabetes
and heart disease.
If you eat 250 calories per day fewer than needed to maintain your weight
and exercise enough to burn an additional 250 calories a day, you will lose
about a pound per week.
Your basal metabolic rate (BMR) is the number of calories your body needs
just to maintain its basic functions. You need additional calories to provide
energy for daily activities; the more active you are, the more calories you
need. Several factors go into the calculation of your BMR, including your
age, height, weight and gender. To get an idea of your BMR, go to
http://www.bmi-calculator.net/bmr-calculator.

The CDC reports that compared with whites, African Americans have a 51
percent higher prevalence of obesity, and Hispanics have a 21 percent
higher prevalence.
Despite the ads that claim miracle weight-loss for some products, there
simply is no magic formula for losing weight. The truth is, permanent weight
loss takes time and requires a permanent change in eating and exercise
habits.
Key Q&A
How do I know if I’m overweight, underweight, or if my weight is
normal?One measure of overweight and obesity is your body mass index
(BMI), which can be determined by dividing your weight in pounds by your
height in inches squared and then multiplying by 703. For example, a
woman who is 5 feet 6 inches and weighs 140 would have a BMI of 22.6,
as follows:
5 feet 6 inches = 66 inches
66 squared = 4,356
140 divided by 4,356 = 0.0321
0.0321 x 703 = 22.6
If a woman’s BMI is under 18.5, she is considered underweight; between
18.5 and 24.9, she is considered of normal weight; between 25 and 29.9,
overweight; 30 or greater, obese. However, if she has more muscle mass
than normal, these numbers won’t apply, and her health care professional
should measure her body composition to determine her degree of
overweight. BMI is also adjusted for age, as well as gender, for people
under age 18.
My health care professional says I need to lose 10 pounds. Why should I
bother with such a small amount?Being overweight, even by 10 pounds,
can be bad for your health. If you are overweight, you are more likely to
develop health problems including heart disease and stroke, type 2
diabetes, some forms of cancer, gout, gallbladder disease, sleep apnea
and osteoarthritis.
As hard as I try, I just can’t lose that 10 pounds. Shouldn’t I just give
up?No, because your weight management efforts may be paying dividends,
even if you aren’t losing pounds. Eating more healthfully and adding
physical activity to your day have health benefits of their own, including
improvements in your chronic disease risk factors such as blood pressure,
blood sugar levels and cholesterol.

I need to lose 10 pounds. Are weight-loss drugs appropriate for
me?Weight-loss medications may be appropriate for carefully selected
patients who are at significant medical risk because of their obesity. They
are not recommended for use by people who are only mildly overweight
unless they have health problems that are made worse by their weight.
These prescription drugs should be used only with the careful supervision
of a health care professional.When they are used, these medications must
also be combined with physical activity and improved diet.
My health care professional says my weight is normal, but I need to
exercise more. Why should I exercise if I don’t need to lose
weight?Exercise not only improves your cardiovascular health and
conditioning, but it can help ward off illnesses like cancer, diabetes and
osteoporosis. Plus, it has psychological benefits and helps reduce stress.
My health care professional says I’m underweight. What’s so bad about
that?Underweight women are susceptible to vitamin and mineral
deficiencies, resulting in a loss of bone density and muscle tissue.
What sort of health care professional can help me set and achieve weight
management goals?A physician may be the best place to start for a full
health assessment and referral. An endocrinologist is a physician who
specializes in metabolic conditions including obesity. A registered dietitian
can evaluate your diet and suggest ways of fighting various health
problems or simply becoming healthier by modifying your diet. A personal
trainer provides one-on-one goal setting and professional expertise, most
often in the area of fitness and exercise.
Is liposuctionan effective way to lose fat?Liposuctiondoes,indeed,remove
fat from specific regions of your body. But if you haven’t learned to eat
healthfully and incorporate physical activity into your lifestyle, you will
regain any lost weight (although your new fat deposits may develop in
different sites on your body). In addition, liposuction surgery has side
effects and can have serious complications. You should talk to an unbiased
health care professional, such as your primary care physician, before
making any decisions about liposuction.
What is a healthy diet?Half your plate at main meals should consist of
colorful vegetables, one quarter should consist of grain products such as
whole-grain bread, pasta, whole-grain rice and cereals and one quarter
should consist of meat, fish or poultry. Several times a week, substitute
dishes made from dried beans or peas as your main course. Eat plenty of
fruits. Eat three cups of low-fat milk products like yogurt each day. These
proportions will help lower your saturated fat intake and increase the
amount of fiber in your diet, both of which have been shown to decrease

risk for heart disease. While you should try to cut back on fats and sugars,
allow for an occasional treat. Also, most of your fat consumption should
come from monounsaturated or polyunsaturated fats with saturated fats
accounting for less than 10 percent of your fat intake.
How much should I exercise?The “Dietary Guidelines for Americans 2010”
recommend that for substantial health benefits, healthy women engage in
at least150 minutes of moderate-intensity aerobic exercise or at least 75
minutes of vigorous aerobic exercise per week while not exceeding caloric
intake requirements. For additional and more extensive health benefits, the
guidelines recommend at least 300 minutes of moderate-intensity aerobic
exercise or at least150 minutes of vigorous-intensity aerobic exercise per
week. The guidelines also recommend muscle-strengthening activities that
involve all major muscle groups on two or more days per week.
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