So, You Want to Lose Weight and Keep It Off

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Thanks to trusted experts and peer-reviewed research, we have some advice for sustainable weight loss.

There’s no sugar-coating it: Losing weight and keeping it off is difficult. A lot of times, diets fail; even among people who “successfully” lose the weight, two-thirds of them gain it all back—and then some—within a handful of years, according to research from the University of California at Los Angeles.

There’s more: According to a 2017 review that looked at and analyzed more than 70 studies of over one million people, 42 percent of adults reported having tried to lose weight some time in the previous 12 months. So, lots of people are trying to lose weight, and lots of people are gaining it back. But we also all know someone (or several someones) who have lost weight and kept it off. So, what gives?

In reality, a never-ending list of factors—including (yes) food and exercise, but also sleep, stress management, hormone health, self-esteem, past weights, and those pesky genetics—influence weight loss as well as the weight your body naturally gravitates toward at a given time in your life, Abby Langer, R.D., a Toronto-based dietitian and nutrition counselor, tells SELF. Of course, maintaining a caloric deficit drives weight loss, but so much more goes into a successful weight-loss effort than the math of calories in and calories out.

“Women so often feel bad about themselves and think their past inability to lose weight is their fault,” says Langer. “They think this because the weight-loss industry has said, time and time again, that to lose weight, you just need to ‘eat less and move more.’ That’s so insulting. And it’s just not true.”

There’s a lot here. So, to demystify what sustainable weight loss looks like, we not only dug into the research, we also reached out to experts who help people lose weight, exercise, and explore their relationships to food, to ask them what actually works. Here’s what they told us about losing weight in a healthy, effective, and sustainable way.

1. Decide if weight loss is a healthy goal for you.

But before we get into how to go about losing weight, please consider this: Weight loss isn’t a healthy goal for everyone, Susan Albers, Psy.D., a psychologist at the Cleveland Clinic specializing in body image and eating issues, tells SELF. “I work in a medical facility,” she says. “I have access to people’s blood work. You can be healthy or unhealthy at every size.”

In fact, a study published in 2016 in the International Journal of Obesity looked at the metabolic health markers of more than 40,0000 adults and found that nearly half of people who are overweight, and 29 percent of people classified as having obesity, were cardiometabolically healthy. It also found that more than 30 percent of people at so-called “healthy weights” had poor cardiometabolic health—which can include hypertension, high cholesterol, inflammation, and insulin resistance.

And beyond that, weight-loss efforts can take an emotional toll. “It can destroy your relationship with food. It can lead you to feel obsessed and frustrated,” Albers explains. For some people, quitting dieting is better and healthier than continuing to try to lose weight. And whatever a person’s weight-loss goal, the priority should be first and foremost on health. “Eating for health frees you up emotionally and is based on improving your body rather than rejecting your body,” she says.

2. Understand that changing your diet isn’t the only thing that facilitates weight loss. There are other factors involved that we’re less able to control.

When the going gets tough (and it likely will from time to time along any weight loss journey), it’s important to realize that a host of non-food factors can make losing weight difficult, explains board-certified obesity medicine specialist Spencer Nadolsky, D.O., a diplomate of the American Board of Obesity Medicine and author of The Fat Loss Prescription. Hormones, genetics, and, ultimately, metabolism are three big ones, he says.

For example, when it comes to hormones, ghrelin makes you hungry, leptin and other hormones keep you feeling full, Nadolsky says. Thyroid, cortisol, insulin, testosterone, and estrogen all influence how you metabolize and store energy. Meanwhile, genetics have a large influence on both basal metabolic rate (how many calories you burn just to live) and hormone health. While all of these things are impacted by our diet, they’re not only controlled by the way we eat. And, in fact, while sleep, stress management, and, when needed, medication can help regulate other hormone levels such as estrogen and thyroid, our hormones and other physiological processes are often out of our control. And by the way, being able to impact our hormone levels and metabolism with our diet doesn’t always work out in favor of weight loss. As a 2016 review notes, one of the reasons weight loss by way of caloric restriction isn’t efficacious is because “this strategy is countered by the body’s natural physiological response to negative energy balance.” In other words: The body fights back against caloric restriction.

3. Do an emotional inventory of your relationship to food before embarking on a weight-loss diet.

Langer says that unless you understand and address the real reasons you're at a weight you (or a doctor) consider "too high,” all of the calorie and macro guidelines in the world won’t matter.

And some of these factors can go pretty deep. Albers says that people often don’t realize how dramatically past experiences influence our relationships with ourselves and bodies. For example, having to clean your plate as a child, getting sweet treats to “cheer up” after a bad day at school, or being called “fat” when you were 8 years old all likely have an impact. “Comments about your body or being urged to lose weight by a parent can do emotional damage for the rest of your life,” Albers says. Unless you deal with these issues, “many people spin their wheels and don't know why they feel so stuck,” she says. For this reason, Langer often refers clients to psychologists who specialize in food issues, and she won’t work with those clients on the nutrition side of things until they’ve started to unpack these fundamental emotional factors. Understanding your relationship to food is an important step in trying to change it.

4. Figure out your weight-loss “why.”

Ah, the über-popular “know your why” strategy. One Brown University study found that when people are motivated to lose weight for appearance and social reasons, they stick with their weight-loss habits for significantly less time than those who are motivated by their health. After all, these external motivators (like looking a certain way or fitting into a cultural ideal) aren’t going to get you going when you’re feeling down, have had a bad day, or are frustrated with a plateau, Albers says.

“Getting deep down to the root of why you want to lose weight is a very powerful and eye-opening experience,” she says. “I do this exercise with my clients. I give them a piece of paper and they start at the top with the initial reason they want to lose weight. Often, it starts with reasons like ‘I will look better.’ Under that, I ask them why that is important. Sometimes there are some very deep and powerful reasons that are incredibly motivating like ‘I want to lose weight to travel on an airplane with my husband on our second honeymoon’ or ‘to be able to really play with my kids.’”

Identifying these deep-down reasons will help you stay dedicated, even when you aren’t feeling super motivated, she says.

5. Figure out your “best weight”—which may not be the number you have in your head.

“Patients can diet themselves down to any weight they put their minds to, but to maintain that weight, they need to actually enjoy the lifestyle that got them there,” writes Yoni Freedhoff, M.D., the medical director of the Bariatric Medical Institute in Ottawa, Canada, and Arya M. Sharma, M.D., Ph.D., the founder and Scientific Director of the Canadian Obesity Network, in Best Weight, a manual for clinicians who treat patients pursuing weight loss. “A patient’s best weight is therefore whatever weight they achieve while living the healthiest lifestyle they can truly enjoy.”

Good point: Even if a weight or body fat percentage is achievable, at a certain point, the investment required to make it happen or sustain it just isn’t worth it, Moore says. And as Albers explains, the ultimate goals are to have energy, be healthy, be able to lead the life you want, and feel that your healthy habits add to, rather than take away from, the quality of your life.

So how can you figure out what weight is actually ideal for you? Albert explains that keeping an eye on health markers like blood pressure, cholesterol, and fasting blood sugar levels can all help clue you into your healthy weight, but the biggest part is simply considering how you feel, physically, mentally, and emotionally.

“Ask yourself, ‘Could I eat this way every single day for the rest of my life and be happy?’” Albers suggests. “If your initial gut reaction is ‘no,’ then it’s time to rethink your approach and goal weight.”

6. Rid yourself of the idea of going “on” and “off” a diet.

The very notion of going “on” or “off” a diet is self-sabotaging. The key to sustainable weight loss is creating habits that you can (happily) live with pretty much forever, registered dietitian Georgie Fear, R.D., C.S.S.D., author of Lean Habits for Lifelong Weight Loss, tells SELF. And in a previous review from the University of Toronto, after examining 59 scientific weight-loss articles, including 48 randomized control trials, researchers concluded that how easy a diet is for you to stick with may actually be a much better predictor of your weight-loss success than the actual diet you choose.

“Do what works for you,” Langer says. “And if something doesn’t, change it. There’s a million other ways to go about it. There are no absolutes in nutrition.” Case in point: In a 2018 JAMA study, when more 600 adults who were classified as overweight followed a low-fat or low-carb eating plan over the course of 12 months, everyone lost about the same amount of weight.

7. Remember that not all strategies work for all people, but you might find something that works for you.

In weight loss, you’ve got low-fat, low-carb, Paleo, and vegan—but you’ve also got food journals, apps, regular weigh-ins, and progress pics to choose from as tools.

“[These tools’] potential benefit is awareness,” Fear says. “Knowledge can be power, but these things can be counterproductive when they simply create alarm without any clear course of action to take. Seeing your weight rise doesn't necessarily provide you with any action steps you can take. It's just upsetting, like a fire alarm going off with no exit routes identified.” Langer notes that “in people who have a history of or are at risk for an eating disorder or compulsiveness, tracking anything should be off limits.”

The diversity in tools and strategies that work for people is nicely illustrated by the National Weight Control Registry (NWCR), which, since 1994, has collected data on people who have lost 30 pounds or more and kept it off for at least one year. If you take a look at some of their findings, you’ll see some commonalities in various behaviors and strategies (such as increasing eating breakfast every day, watching fewer than 10 hours of TV per week, and weighing themselves regularly). But rather than looking at the NWCR’s data as a how-to guide—after all, these are the behaviors that correlate to weight loss, we can’t know if they’re the ones that caused weight loss—look at it as further evidence that there’s no one right way to live to lose weight and keep it off, and that finding the thing that will work for you is a personal journey, specific to you.

So, obviously, what is going to work for each person is different, and that’s OK. If your weight-loss practices help you identify areas for behavioral change and give you tools on how to make that happen, or just help keep your motivation up or feeling good, great. “But if you are not losing weight, then the tools you are using aren't working for you,” Fear says. “Many people keep doing the same monitoring even though it's actually not helping them. A sense of control and organization are not to be confused with efficacy.” Use this as an opportunity to try something else.

8. Know that restriction and depriving yourself will set you up for frustration and weight loss failure.

It’s true that a caloric deficit—burning more calories per day than you take in—is a requisite of weight loss. But creating a deficit doesn’t have to (and shouldn’t) involve deprivation. That goes for calories, carbs, sugar, fat, or any other commonly demonized nutrient. “No one food is responsible for your weight,” Langer says, explaining that a good vs. bad mentality sets people up for disordered eating and exercise habits. In fact, caloric deprivation increases how the brain responds to food, setting you up for binge-eating down the line, according to research from the Oregon Research Institute.

“The best way to stick with a diet, is for people to put the fewest restrictions on themselves as possible,” Langer says. “There shouldn't be anything in the world that they shouldn't ever eat again.” Similarly, Albers recommends ditching the “don’t” list entirely. “Instead of trying to stop an old negative habit, focus on building a positive new one,” she says. “New habits crowd out the old without the struggle of trying to stop a behavior.”

One thing that might help you move away from food rules based on restriction is mindful eating, which is a way of eating that is centered on being present and engaged not just with your food, but why you’re eating it, and how your body feels. Mindful eating can help people learn how to eat based on what they want and need, as opposed to what they feel they should or shouldn’t eat. Mindful eating isn’t a weight-loss diet, but it can help change your orientation to food and food “rules.”

9. Related: Whatever strategies you put in place should be based on flexibility, not perfection.

“Do what you can instead of quitting when you can't be ‘perfect,’” Fear says. As if there’s such a thing as “perfect.” After all, research suggests that perfectionism surrounding food and weight, especially coupled with body dissatisfaction, contribute to disordered eating and even obesity in women. Researchers note that perfectionism can contribute to poor self-esteem, dietary restraint, and binge eating.

Langer adds that when when people have good vs. bad, perfectionistic expectations for themselves, they tend to handle supposed misdeeds (like eating something they “shouldn’t”) one of two ways: languishing in their failure or compensating by restricting subsequent meals. People who do make sustainable weight loss work, however, can enjoy that piece of cake and then, in their next meal, eat just like they had before digging into that slice of cake.

10. Think of exercise as a thing to do because it makes you feel good and is great for your health, not because it’s burning off what you ate.

The benefits of exercise, at least as far as weight loss is concerned, have a lot more to do with building (think: health, energy, confidence, muscle) than burning calories or fat, says Zach Moore, C.S.C.S., a fitness and lifestyle coach at Precision Nutrition, tells SELF. After all, Albers notes that exercise is linked to improved moods, stress reduction, and the “wow, my body’s pretty cool!” attitude that you need to crush your goals.

On the physiological side of things, it’s important to realize that the vast majority of your daily caloric burn comes down to just basic functions like breathing and keeping your heart beating, Moore says. Called your basal metabolic rate (BMR), your muscle does play a role in setting it, but extra muscle isn’t going to turn you into a supercharged calorie-torching machine. And even though exercise does burn calories, that total is often significantly less than what we expect and would need to create a large daily caloric deficit, he says.

And that raises the most important point: Thinking about exercise as a way to work off food or simply allow you to eat sets up a host of unhealthy and unhelpful thought patterns and habits around food and exercise. For instance, one 2013 research review found that, not only did people generally overestimate how many calories exercise burned—when they did work out, they ramped up their food intake. And if you overeat following exercise, any caloric deficit created during your workout can become a wash. And related: thinking of food as a reward and exercise as a punishment is likely to sabotage your weight loss efforts anyway.

“Exercise should not be used to purge calories,” Albers says. “Instead, to boost your mood to keep you motivated.” The thing is, exercise is great for you and can make you feel awesome. And feeling good about yourself seems to be actually useful in weight-loss efforts. Plus, some research has shown that changes in exercise behavior can lead to changes in eating behavior. “In part, it is neurochemical. Movement and exercise you enjoy boosts your serotonin and dopamine levels, which makes you feel good all the way around,” Albers says.

In other words, sticking with an exercise regimen can trigger sticking with a healthier diet, but it's best if you don't think of it as a way of burning off calories for the sake of weight loss. So, cultivate an exercise practice you actually enjoy, stick with it, and know that it’s making you healthier, and let it inspire you to make the choices you consider healthy.

In case all that was daunting, remember that the take-home is that weight loss is actually more likely to work when you get rid of all the stuff that makes it unbearable (rules, deprivation, endless exercise) and when you approach it with flexibility and realistic expectations.

So, yeah, long-term weight loss is challenging. But by recognizing those challenges—and approaching them as very real opportunities for growth—it can also be doable, Albers says. Get help from a registered dietitian, work through food and body issues with a psychologist, and ditch perfectionism.

And, most importantly, turn some of your attention from the scale and toward living the life your body deserves. When people are not focused solely on weight, according to research from the University of California, Davis, they not only feel better—they get healthier and enjoy more sustainable weight loss.

Article source: https://www.self.com/story/healthy-way-to-lose-weight-and-keep-it-off