Lose Weight…and Keep it Off

Our board of experts “weighs in” with the latest on what works for weight loss, and for preventing weight (re)gain.

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Weight is about more than appearance. Being overweight and obese is associated with a lower quality of life (especially as we age) and higher risk for a wide range of diseases (from diabetes and cardiovascular disease to cancer and viral infections). The good news is, losing even five to ten percent of excess weight can have a dramatic impact on health. But what is the best way to lose weight? And how do we get it to stay off?

Tufts University is home to the Friedman School of Nutrition Science and Policy, one of the world’s leading nutrition graduate programs, as well as the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA), where researchers study the intersection of diet and health every day. Here, the stellar researchers and professors who serve on the advisory board of this newsletter offer their up-to-the-minute expert advice on achieving and maintaining a healthy weight.

Cutting Calories/Preventing Regain

Jeanne Goldberg, PhD, is an Advisory Board member and professor emerita of Nutrition Interventions, Communications, and Behavior Change at the Friedman School. Dr. Goldberg has worked on obesity and chronic disease prevention interventions since 1995.

“If there were a ‘magic bullet’ for losing weight and keeping it off, we’d all be our ideal weight. At the end of the day, it is the ratio of ‘calories in’ to ‘calories out’ that determines weight loss. There is no shortage of literature guaranteeing success to anyone who follows the (you fill in the blank) Diet. Some of these diets are well-balanced and sensible. Others lack those healthful attributes. Some are downright extreme. But history has shown if the user burns more calories than they consume, they will lose weight.” (See page 6 for a review of popular diet plans.)

“The critical question is what happens after the weight is lost. While not perfect, a project called the National Weight Registry provided some valuable guidance on maintenance of weight loss. Behaviors associated with successful maintenance included regular weighing, careful monitoring of the amount of food consumed, and regular physical activity (quite a bit of it—as much as two-and-a-half hours a day.) In fact, while it is unlikely that exercise itself (without restricting caloric intake) will lead to weight loss, exercise is critical to maintaining weight loss.”

Quality is More Important than Calories

Editor-in-chief of Tufts Health & Nutrition Letter, Dariush Mozaffarian, MD, DrPH, is dean of the Friedman School. Dr. Mozaffarian has authored more than 400 scientific publications on dietary priorities for obesity, diabetes, and cardiovascular disease.

“For long-term success, focus on overall food quality, rather than specific nutrients or counting total calories. One priority is to eliminate ‘fast carb’ foods rich in refined grains, starches, and sugars: foods like white bread, rice, most crackers, salty snacks, and granola bars, as well as sugary foods like soda, energy drinks, store-sweetened teas/coffees, and candy (which have low nutritional quality). In their place, eat minimally processed, phytonutrient-rich foods like fruits, nuts, seeds, beans, veggies, plant oils, plain yogurt, and fish. Chicken and eggs are fine on occasion, and unprocessed red meat once or twice per week. Higher intakes of healthy fats from plants and plant oils are helpful.”

Naturally Fiber-Rich Foods Control Hunger

Nicola McKeown, PhD, is an associate professor at the Friedman School and a scientist in the Nutritional Epidemiology Team at the HNRCA. Dr. McKeown is internationally renowned for her research examining the role of whole grains in promoting health.

“For most people, trying to control hunger between meals is a challenge! Naturally fiber-rich plant-based foods such as fruits, vegetables, whole grains, nuts, and beans are high quality choices that can actually help control hunger. Fiber slows food intake, stomach emptying, and intestinal transit time, all of which help keep you feeling full and satisfied—so make sure you eat naturally fiber-rich foods throughout the day.”

Slow and Steady Wins the Race

Robin B. Kanarek, PhD, is the John Wade Professor of psychology, emerita, at the Friedman School of Nutrition Science and Policy. Dr. Kanarek’s career has focused on the behavioral neuroscience of nutrition.

“Like the hare in Aesop’s fable who believed speed alone could win a race, many in today’s society believe that there must be a quick way to lose weight and keep it off. This belief has led every year to new diets and other methods of weight loss. Unfortunately, most of these methods do not produce the desired results. In contrast, following the tortoise’s approach of a ‘slow but steady’ pace can lead to successful weight loss which is maintained over time. Be realistic, it probably took years to gain the weight, so don’t expect to lose it rapidly.”

Behavior Change is Key

Alice H. Lichtenstein, DSc, executive editor of Tufts Health & Nutrition Letter, is senior scientist and director of the Cardiovascular Nutrition Laboratory at the HNRCA. Dr. Lichtenstein has been involved in the development of many dietary recommendations, including vice-chairing the 2015-2020 Dietary Guidelines for Americans Committee.

“Successful weight loss and maintenance depend on making behavior changes that develop into new habits. Start by identifying a small number of modifiable behaviors, and then configure your environment to support those changes. For example: if you decide to cut down on certain foods or beverages, don’t have them available in the house. Restock the shelves, fridge, and freezer and rework your shopping list to emphasize the high-quality foods you have decided to include in your healthy dietary pattern. It’s okay to identify a few foods you really enjoy, and—at appropriate times and in appropriate portions—enjoy them guilt-free. Purchase particularly tempting foods in portioned packs (such as small squares of dark chocolate) or divide them out into single servings when they enter the house—and keep them out of sight. Reaching for one should be a conscious, rather than passive, decision. When your initial changes begin to feel natural, move on to your next, small, achievable goal.”

The Motivating “Why”

Joel B. Mason, MD, is senior scientist and leader of the Vitamins and Carcinogenesis Team at the HNRCA. He studies how obesity and other factors alter the risk of cancer formation.

“Understanding the true health impact of excess weight can be motivating. My expertise provides insight into one of the very important adverse health outcomes of being obese—the risk of cancer.

“There is now compelling evidence that obesity (and, to a lesser degree, being overweight) increases the risk of developing over ten types of cancer, and the enhancement of risk is quite substantial for several of these cancers. Obesity increases the risk of developing cancers of the kidney, liver, and uterus as much as two- to four-fold, for example.

“So, although I cannot advise with authority about the best way to lose weight I can, with confidence, underscore the importance of losing weight and keeping it off.”  

Take Charge

Here is a list of science-backed tips and tricks for healthy, lasting weight loss from our experts:

  • Have a plan: Decide what dietary and behavior changes make the most sense for you, and set realistic, achievable, time-bound goals to move towards those changes.
  • Don’t bite off more than you can chew: Make small changes in behavior which fit within your lifestyle and can be maintained over time. Make one change at a time. When that one goal is reached, set another.
  • Take it slow: Gradual weight loss is a key to long-term success. Aim to lose about one-half to one pound a week. Rapid, massive weight loss should not be the goal.
  • Be mindful: Notice what you are eating and how much, but also where, when, and why (for example: eating at night; mindlessly munching in front of the TV; eating in response to stress, sadness, or loneliness), and address the factors that influence your eating behaviors.
  • Don’t drink your calories: Sugary beverages are bad for health and simply add extra calories to your diet, which leads to unwanted weight gain.
  • Cook at home: Prepare food at home as much as possible, rather than ordering out. Preparing food at home gives you more control over what (and how much) food you put in your body.
  • Set yourself up for success: Stock the pantry, fridge, and freezer with healthy choices; use smaller plates and glasses; pre-portion high-calorie items.
  • Get rid of guilt: Eating is one of life’s pleasures. Don’t beat yourself up for a bad day— just go back to reaching for your goals. Eat your favorite treats, occasionally, in reasonable amounts. Work to establish a positive relationship with food.    

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