Ask The Doctor

Sustained Weight Loss Takes Commitment

by Dr. Steven Garner, M.D.

Dear Dr. Garner,

I watched some of the television coverage of the N.Y.C. Marathon, and I saw how much determination the runners have to achieve their goals.

I know that I am overweight and my goal is to lose weight so that I can live a healthier life, but it seems impossible for me to keep the pounds off. I have been on every different kind of diet, and the story is the same: I lose some weight only to gain it all back in the next few months.

My husband says I lack willpower, but I’m usually focused and can stick to things, no matter how unpleasant they are. Could you tell me what I am doing wrong?

Overweight in Auburndale
Dear Overweight,

Millions of people diet each year only to find that the weight they have lost returns soon after the diet is discontinued.

A study conducted a few years ago demonstrated a strong association between appetite and weight gain with body chemicals known as hormones. Some hormones make you hungry, and others make you feel as though your stomach is full.

In this study, 50 participants were given a strict diet to follow for three months.

The average weight lost was 30 pounds per person. At the end of one year, most of the dieters had gained back a good deal of the weight they had lost. This was in spite of the fact that they were placed on maintenance diets and had appropriate counseling.

Blood tests were analyzed, and it was found that the hormones responsible for making someone feel hunger had risen after the diet. The increased appetite caused weight gain.

These results are interesting and may be helpful in the long-term approach to weight loss.

Beyond Willpower
I think that it is unfair to state that someone has no willpower because he or she can’t maintain weight loss. There clearly are strong factors in our biology that cause us to lose and gain weight. Nevertheless, it doesn’t do us any good to “blame it on the hormones.”

Diet is not rocket science. It is essentially the combination of the calories one takes in with food versus the number of calories that one expends with exercise and bodily functions. If we take in more calories than we expend, we will gain weight. It is as simple as that.

Some strategies to lose weight are as follows:

1. Each person must develop a plan with his or her doctor to determine the best way to lose weight and keep the pounds off. A safe target is one pound a week, which equates to decreasing your calories by 500 a day.

2. Moderation is very important. Studies show that vigorous exercise can lead to an increased appetite and increased weight. Instead of power workouts, do moderate exercise such as walking for 30 minutes about five days a week.

3. Motivation is essential. You are not just losing weight to make yourself look or feel better. It will also help you to live longer and be healthy for your children, family and friends.

Look at diet as a marathon, not a sprint. The commitment to lose weight is not just for weeks or months but should last a lifetime.

Surgical Options
For some, the most appropriate treatment may be weight loss surgery, which is reserved for people 50-100 pounds overweight. This surgery has been shown to be effective for long-term weight loss as well as addressing associated diseases, such as diabetes.

You should talk to your doctor to see what approach and strategies are best for you. I wish you luck and hope that this gives you and your husband some insight into the difficulties that all dieters have.

Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET TV, Tuesdays at 8 p.m. on Time Warner Channel 97, Cablevision Channel 30 and Verizon FiOS on Demand.

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