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Losing weight and keeping it off: Why it’s more than just diet and exercise

January 26, 2017 | Steve Tischler
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Doing activities you enjoy and using exercise apps are two ways to make exercise more enjoyable.

It’s no secret that America has a weight problem.

More than 38 percent of adults are now considered to be obese, which is defined as having a body mass index (BMI) of 30 or higher, this according to 2014 figures from the National Center for Health Statistics. Another 31 percent of us are overweight (BMI of 25 to 30). What's your BMI? ›

The obesity figure has risen steadily for decades despite all of the diet plans, media attention and concern from doctors.

While the problem is well documented, the solution is less obvious.

In fact, we may be thinking about it all wrong, according to Dr. Bavani Nadeswaran, a UCI Health primary care and internal medicine specialist.

Weight loss: not just exercise and diet

Nadeswaran, who heads a UCI Health obesity management effort, notes that just as obesity results from many factors, losing weight is not necessarily as simple as dieting and exercising.

“First, consider that modern society is full of factors that encourage weight gain,” she says.

“Our jobs tend to be sedentary, our urban environment encourages driving rather than walking, we have been trained to eat larger portions and we are surrounded by highly processed and sweetened food choices. Even many medicines have weight gain as a side effect.”

How metabolism works against you

Once we’re overweight, our bodies’ metabolism changes to make it more difficult to lose that weight as easily as you put it on, she says. This physiological effect apparently hearkens all the way back to our hunter-and-gatherer days when losing weight could have deadly consequences.

Those who are successful in losing 10 percent of their body weight mostly through exercise soon have a rude awakening. It takes twice as much daily exercise to keep that weight off permanently.

Despite these challenges, weight loss is still quite doable.

Tips for long-term weight loss success

“Weight loss is a very personal journey,” notes Dr. Nadeswaran. “The fact is, any calorie-restriction diet can be successful. The key is to choose one that you are willing to follow in the long-term. That is what works.”

So, what techniques will work for you in the long run? Consider these options:

  • Dieting: Compare Atkins, DASH, The Zone, South Beach and so on. There is no significant difference in their effectiveness. Each can work, but only if you are able to stick with it.
  • Planning meals in advance: Too many restaurant or on-the-go meals can undo an otherwise healthy diet.
  • Meal-replacement plans: Some people thrive on a regimen of two meal replacement meals, two shakes between meals and six or seven servings of fruit and vegetables. The UCI Health Weight Management Program offers this kind of plan.
  • Food diaries: Recording what you eat tends to make you more thoughtful about your food choices. Most of us underestimate our calorie intake by one-third.
  • Exercise apps: The worthy goal of 10,000 steps per day is very motivating for many people and can help you burn off hundreds of calories.
  • Making daily exercise normal: Do the little things like taking stairs instead of the escalator. Park your car away from the store and walk a bit farther. Walk whenever you can.
  • Aerobic exercises: It takes about 30 minutes of exercise five times per week, along with strength training, to lose weight, but you need to double this amount to keep it off.
  • Surgery: If your BMI is 40 or higher, consider bariatric surgery. Options include gastric bypass, laparoscopic banding, laparoscopic sleeve gastrectomy and more. Studies have shown that surgery, along with lifestyle changes, is often an effective combination for those who struggle to lose weight.
  • Endoscopic procedures: You may also be a candidate for procedures such as gastric balloon placement, endoscopic sleeve gastroplasty or revision of Roux-en-Y gastric bypass.

Find your own path

Finding your own weight-loss path is important, Nadeswaran emphasizes.

The list of health complications due to excess weight is a daunting one:

And that's to name just a few. These are life-shortening conditions that shouldn’t be ignored.

While it may be a cliché, the new year is as good as time as any to begin a weight-loss journey.

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