Going on diets can be incredibly frustrating. Most of the time we "cheat" within a few days, and give up until next time. We blame ourselves for poor self-discipline. Sometimes we do lose some weight, but 90-95% of us gain back most or all of the weight we've lost within two years, often much sooner. We get excited about new diet books that explain why all the old diets didn't work, and why this one will. Unfortunately no weight-loss diet has come to the rescue and been proven to have significantly better results over the long term.

There are easier, better ways to manage your weight. This week we'll look at strategies that can help you to slowly lose or maintain your current weight, and help you stay healthy at any weight.

1. Eat less processed food.
   The further from its original plant or animal state a food is, the more processed it is. Not all processing is bad. Frozen fruits and vegetables are healthy substitutes for fresh ones, for instance. But many processed foods are loaded with sugars that make you fat, trans fats that are bad for heart health, salt that can drive up your blood pressure, and preservatives that may cause cancer.
   
   
   • Processed carbohydrates: The biggest culprits are white flour, sugar, corn syrup and white potatoes, and foods made with them. Your body can digest them almost as fast as you eat them, and they send your blood sugar levels soaring. Your pancreas then pumps out insulin to help your cells absorb the sugar and bring your blood sugar back down to normal. The long-term problem with processed carbs is that you can wear out the body's response to high sugar levels and you may end up with insulin resistance, which can lead to diabetes and heart disease. Your body stores any calories you don't use right away as fat. And you'll probably feel hungry again soon. If you eat some satisfying protein instead (meat, cheese, fish, yogurt, nuts, sliced turkey, chili, peanut butter) possibly with a healthy carbohydrate (fruits, vegetables, whole wheat bread or crackers, brown rice, sweet potatoes) you'll be satisfied much longer. Your body will gradually digest these foods so you'll have steady energy for hours.
     
   • Processed fats: Vegetable oil is good for you, but not when it's chemically transformed into a form that stays hard at room temperature. Then it's called trans fat, and eating it in any amount increases your risk of heart disease. Read the nutrition label and avoid foods that contain trans fats. They're in many baked goods.
   • Processed meats: These products (like bacon, sausage, ham, hot dogs and the meat in most tacos and pizzas) are treated with preservatives that may cause cancer. They're high in saturated fats that are bad for your heart. And they're high-calorie, high-salt, and high-fat foods. Save them for special occasions. Try making your own pizza and tacos at home with ground beef and cheese instead.
     
2. Find physical activities you enjoy and schedule them regularly.
   Unless you're training for a marathon, you won't burn very many extra calories with exercise. The "calories burned" readouts on exercise machines are misleading. They don't take into account the fact that your base metabolism would still burn some of those calories if you sat and read a book. But being active is the number one thing you can do to stay healthy at any weight.
   
   Walking is a lovely thing to do with family, friends, or your dog. It gets you outside and away from it all, and can lift your mood, too. When the weather isn't good, the time flies when you're walking on a treadmill in front of a TV. Elliptical trainers are even better, because you use your arms and legs, and the motion works your waistline, too. You may loose inches from strength training (weight lifting) even if you don't lose pounds. Get a trainer to show you how to do it safely the first few times. If your body is in the right positions on machines, you're very unlikely to injure yourself. Your posture will improve and your body will just feel better once you get in the groove. Older people will gain bone and muscle strength and be less likely to fall or break a bone.
   
   
3. Limit your home food choices by shopping wisely.
   If there aren't any potato chips around, you aren't going to eat them. If there's a big bowl of fresh fruit out, you might grab an apple. We "graze" on what's available, so make those healthy foods. Stock the refrigerator with cole slaw, baby carrots, rotisserie chicken, string cheese, hummus dip, low-fat yogurt, and sliced turkey. Keep whole-wheat bread and crackers, canned light tuna fish (which has less mercury than albacore tuna), high-fiber cereals (Raisin Bran, Total, Shredded Wheat), peanut butter, raisins, bananas, apples, canned pineapple, salsa and trans fat-free blue corn tortilla chips on hand. Set out a bowl of nuts or dried fruit now and then along with the fresh fruit.
   
   When you do buy something less healthy like full-fat ice cream, cookies, cake or potato chips, don't go for the economy size. Get just enough for one meal, party, or treat.
   
   
4. Eat at home more, and try packing your lunch and snacks.
   Eat breakfast. You won't get so hungry later, and it's easy to make it a quick healthy meal.
   
   If you usually go out for lunch or hit the vending machines for snacks, consider taking lunch and snacks instead. You'll save money and probably eat healthier fare.
   
   Have dinner at home most nights, too. You're more likely to overeat at a restaurant where servings are large and there are so many choices and flavors to try. That's because of what scientists call sensory-specific satiety. When you've had a certain amount of a food, you don't want any more. You feel full. But if the waiter comes by with a dessert tray, you suddenly find room for more. It's human nature.
   
   
5. Satisfy your eye's need for volume.
   Our eyes aren't really bigger than our stomachs. We eat what looks like the right amount. Scientists who study eating behavior have found out what you already knew. We don't like the looks of small portions, and assume that they won't satisfy us even if they have plenty of calories. One healthy solution is to add low-calorie volume.
   
   
   • Start your meal with a big bowl of soup.
   • Serve sweet potatoes and squash with smaller portions of any high-calorie entrée. They take much longer to digest than white potatoes and help to fill up your plate. Kids love them, too.
   • Find ways to prepare high-bulk vegetables that you and your family really like. One trick is to steam vegetables (try broccoli, cauliflower, green beans, zucchini, onions or carrots), dump out the water, and then melt a pat of butter in the bottom of the steamer. Add the vegetables back in and toss with the butter and just a dash of salt. A topping of melted cheese also makes the veggies go over better.
   • Serve a fruit or vegetable salad with every meal. One reason they're relatively low-calorie is that they contain lots of water. That makes them look big and fill you up.
   • Take the time to stack lettuce and tomato on your sandwich. It'll taste better and look more like a meal.
   Another solution is to trick the eye by usingsmaller plates, bowls, utensils, cups and glassware. It's no-brainer portion control.We've supersized all of these items over the last 50 years, as you'll see if you look at antique sets of plates and glasses. Some nutritionists suggest storing or giving away your larger sets, and using only smaller ones. A plateful of food will automatically be less food. And use tall, skinny glasses instead of short, fat ones. They appear to hold more.
   
   
6. Pay attention when you're eating instead of watching TV, reading, or working.
   When you're eating on automatic pilot, you're likely to eat more and enjoy it less. Try eating with "mindfulness." That just means paying attention to the sight, smells and taste of the food you're eating, and how your tummy feels as you eat it. Slow down if you tend to eat fast. Put your fork down occasionally and take a sip of water. This is a tough practice for busy people, but it can make a big difference because it gives you a chance to feel when you're full. It can take twenty minutes for your body to register the calories you've eaten and feel full. If you wolf down your food, you end up eating past the point of satisfaction.
   
   
7. Drink beverages that don't have added sugars.
   This alone can make a big difference in keeping your weight down. We don't compensate for liquid calories by eating less. Drinking sodas, fruit drinks and sweetened ice tea and other drinks with added sweeteners is linked with obesity.
   
   
8. Pay attention to how your clothes fit and what the scale says.
   Prisoners gain more weight than college freshmen eating in cafeterias do. Some experts think it's because they wear loose orange jumpsuits instead of their normal clothes, so they have no feedback that they're getting fatter. People who maintain their weight tend to stay honest with themselves by weighing themselves at least once a week and noticing how their clothes fit so they notice small weight gains.
   
   
9. Get plenty of sleep.
   You would think that you'd burn more calories awake than asleep. But many studies have found a link between how much people sleep and the chances that they'll grow obese. Experts think tired people may get hungrier than the well rested. They tend to eat more junk food and less healthy food. Other studies indicate that sleep-deprived people may not process sugar as well as normal, so they have high insulin and blood sugar levels. Try to get at least seven hours of shuteye per night; eight is better.
   
   
10. Consider therapy if you overeat because of stress or emotional issues.
    An analysis of 36 studies found that cognitive behavior therapy can help you get better results than diet and exercise alone. It's a type of therapy that's short-term, practical and results-oriented.
    
    

I am determined to lose weight. What's the best weight-loss diet?

It's any diet you can stick with. From eating steaks on the Atkins diet to buying meals from Jenny Craig, nearly all diets work for some determined people. Meal replacement bars and drinks can help people get off their favorite foods. Learning to eat smaller portions with group support and accountability in a program like Weight Watchers makes a lot of sense. Many dieters count fat grams, carbohydrate grams or calories, sometimes using handy free online tools like FitDay.

Low-carbohydrate diets are popular for a reason. People on low-carb diets tend to lose a bit more weight (especially around their waistlines) and stick to their diets better than people on low-fat diets, at least in the short run. (Studies have shown that over the months the results of different diets converge.) That's probably because protein is more satisfying than carbohydrates or fats are, and you get plenty of it on low-carb diets. And your choices are very limited. Low-carb diet seems to help people with diabetes and prediabetes bring down their blood sugar and cholesterol levels, too.

Scientist Brian Wansink, who runs a food lab at Cornell University, suggests that you cut just 100-200 calories a day. If you cut more your metabolism might slow down to conserve energy. That makes it much harder to lose weight. He says that won't happen if you cut back slightly, and you won't feel deprived or hungry. You'll lose about one pound a month.

Weight Watchers tests well in studies. That could be because the program teaches portion control and steers you to foods with low calorie density, or because the group meetings help. If it appeals to you, Weight Watchers is a good bet for a sensible diet with social support. And if you reach your goal weight, you become a "lifetime member." You can go to meetings for free as long as you're within a few pounds of your goal. If you gain more, you pay until you get back down to your goal. Getting help with maintaining weight loss is a huge plus. And studies have found that people do better on programs that have group meetings.

What about using supplements or prescription drugs for weight loss?

Search the Nutrition Wise Archives for our article Dietary Supplements for Weight Loss, and see this week's Nutrition Wise article Weight Loss Medications.

Updated on 10/16/09 by J. Johnson (BA English composition, Northwestern University). Published on 11/09/09.

References:

1. Gilboa SM, et al "Association between prepregnancy body mass index and congenital heart defects" Am J Obstet Gynecol 2009; DOI: 10.1016/j.ajog.2009.08.005.
2. Sun Q, et al "Adiposity and weight change in mid-life in relation to healthy survival after age 70 in women; prospective cohort study" BMJ 2009; 339: b3796.
3. Effect of bite size and oral processing time of a semisolid food on satiation. Zijlstra N, de Wijk RA, Mars M, Stafleu A, de Graaf C. Am J Clin Nutr. 2009 Aug;90(2):269-75
4. Where We Live and Cancer Risk at http://www.aicr.org/site/News2?page=NewsArticle&id=16793&news_iv_ctrl=2302#break 
5. Kelly T, et al., "DXA whole body reference data from the 2008 NHANES data release" ASBMR 2009; Abstract FR0285.
6. Kelly T, et al., "Dual energy x-ray absorptiometry body composition reference values from NHANES" PLoS ONE 2009; DOI: 10.1371/journal.pone.0007038.Is Happiness Catching? At http://www.nytimes.com/2009/09/13/magazine/13contagion-t.html?em 
7. Ternouth A et al "Childhood emotional problems and self-perceptions predict weight gain in a longitudinal regression model" BMC Med 2009.
8. Arble D, et al., "Circadian timing of food intake contributes to weight gain" Obesity 2009; DOI: 10.1038/oby.2009.264.
9. Evolutionary Speculation About Tuberculosis and the Metabolic and Inflammatory Processes of Obesity Jesse Roth, MD JAMA. 2009;301(24):2586-2588.
10. Kajimura S, et al "Initiation of myoblast to brown fat switch by a PRDM16-C/EBP-b transcriptional complex" Nature 2009; DOI:10.1038/nature08262.Obese Americans Spend Far More on Health Care at http://www.nytimes.com/2009/07/28/health/policy/28obesity.html?ref=health 
11. Tossing Out the Diet and Embracing the Fat at http://www.nytimes.com/2009/07/16/health/nutrition/16skin.html?ref=health 
12. Pi-Sunyer FX, et al "Combination therapy with naltrexone + bupropion causes significant weight loss and improves cardiometabolic parameters in obese individuals: a randomized phase 3 study over 56 weeks" ENDO 2009. Abstract OR18-5.
13. Excess Pounds, but Not Too Many, May Lead to Longer Life at http://www.nytimes.com/2009/06/26/health/26weight.html?ref=health 
14. Determining optimal approaches for weight maintenance: a randomized controlled trial. Dale KS et al. CMAJ 2009 May 12; 180:E39
15. Swinburn BA, et al "Increased energy intake alone virtually explains all the increase in body weight in the United States from 1970s to the 2000s" ECO 2009.
16. Mallam K, et al "Impact of physical education on the body composition and metabolic health of primary school children" ECO 2009; Abstract 920.
17. Chen L, et al "Reduction in consumption of sugar-sweetened beverages is associated with weight loss: the PREMIER trial" Am J Clin Nutr 2009; 89: 1299-306.
18. Van Marken Lichtenbelt WD, et al "Cold-Activated Brown Adipose Tissue in Healthy Men" N Engl J Med 2009; 360: 1500-8.
19. Cypess AM, et al "Identification and importance of brown adipose tissue in adult humans" N Engl J Med 2009; 360: 1509-17.
20. Virtanen KA, et al "Functional brown adipose tissue in healthy adults" N Engl J Med 2009; 360: 1518-25.
21. Whitlock G, et al "Body-mass index and cause-specific mortality in 900,000 adults: collaborative analyses of 57 prospective studies" Lancet 2009; DOI: 10.1016/S0140-6736(09)60318-4.
22. Johnson L, et al "Dietary energy density affects fat mass in early adolescence and is not modified by FTO variants," PLoS ONE 2009; DOI:10.1371/journal.pone.0004594.
23. Neovius M, et al "Combined effects of overweight and smoking in late adolescence on subsequent mortality: nationwide cohort study" BMJ 2009; DOI: 10.1136/bmj.b496.
24. A core gut microbiome in obese and lean twins.Turnbaugh Nature. 2009 Jan 22;457(7228):480-4.
25. Leibel R L "Energy in, energy out, and the effects of obesity-related genes" N Engl J Med 2008; 359: 2603-04.
26. Cecil JE et al "An obesity-associated FTO gene variant and increased energy intake in children" N Eng J Med 2008: 359: 2558-66.
27. Pischon, T et al "General and Abdominal Adiposity and Risk of Death in Europe" N Engl J Med 2008; 359: 2105-2120.
28. Astrup A, et al "Effect of tesofensine on bodyweight loss, body composition, and quality of life in obese patients: a randomised, double-blind, placebo-controlled trial" Lancet 2008; DOI: 10.1016/S0140-6736(08)61525-1.
29. Stice E, et al "Relation between obesity and blunted striatal response to food is moderated by TaqIA A1 allele"Science 322: 449-452.
30. Transforming Research Strategies for Understanding and Preventing Obesity Terry T.-K. Huang, PhD, MPH; Thomas A. Glass, PhD JAMA. 2008;300(15):1811-1813.
31. Preventive Health for Women: Screening and Immunizations Medical Clinics of North America — Volume 92, Issue 5 (September 2008) — Copyright © 2008 W. B. Saunders Company
32. Doctor . . . Could It Be My Thyroid? At http://archinte.ama-assn.org/cgi/content/full/168/6/568?etoc 
33. Leptin gene and leptin receptor gene polymorphisms are associated with sweet preference and obesity. Mizuta E, Kokubo Y, Yamanaka I, Miyamoto Y, Okayama A, Yoshimasa Y, Tomoike H, Morisaki H, Morisaki T., 1: Hypertens Res. 2008 Jun;31(6):1069-77.
34. LEPR p.Q223R, beta3-AR p.W64R and LEP c.-2548G>A gene variants in obese Brazilian subjects. Duarte SF, Francischetti EA, Genelhu VA, Cabello PH, Pimentel MM. Genet Mol Res. 2007 Oct 5;6(4):1035-43.

Learn more about healthy living at Blue Health Connection