What are the keys to weight loss?

In this video, surgeon Dmytro Havaleshko, MD from Portsmouth Regional Hospital discusses the two deciding factors for weight loss and why a patient is never too old to achieve a healthy weight.
Keith Kreitz, MD
Bariatric Medicine
Number one, a person must have their diet under control. The number of calories taken in is very important—if you take too many calories in, it's going to show up on your waist line.
 
Secondly, the Surgeon General recommends you exercise for between 150 and 300 minutes per week. That may be a little antiquated at this point, but you really have to get active. Everybody should be briskly walking for 30 minutes, or even 60 minutes, a day. A healthy diet and a good amount of exercise are the two key hallmarks.
 
In terms of weight loss surgery, you have to be in a supportive environment. All of my patients have to commit to going to a support group for a couple of reasons: One is education and information—we can get information from patients to track them. And two, people do better when they are supported to live a healthy lifestyle.
 
You have to see a doctor regularly. In my particular specialty, patients have to commit to seeing me life-long after their surgery, so I can really engage and help them if they run into stumbling points. Even if you haven't had surgery, make sure you have a good physician relationship, so you can be guided to achieve a healthier lifestyle and weight.
 
It's difficult sometimes for patients and physicians to talk about weight. Oftentimes patients don't see themselves as being unhealthy, and doctors are sometimes afraid to bring it up—it's a sensitive issue. It benefits the patient if the doctor says, “You know what, your weight is really doing this, or it's affecting your health, or it's giving you high blood pressure, or it's giving you diabetes, you have to get it down.” And if the patient can recognize that their health is tied to their weight, it will help them to engage and be more proactive about managing it.
 
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Khoi H. Du, MD
Bariatric Medicine
The most important part of weight loss is being committed to being healthy. Patients need to look at the big picture when it comes to their health.
 
Weight loss requires a lifestyle change, which includes modifying your behavior and making the correct choices, and staying with it over time. That translates into eating healthier and being more active with exercising. Most patients think weight loss is just losing weight, but it’s really more of a lifestyle change.
 
When considering bariatric surgery for weight loss, you need to realize that the surgical element is just one component. Think of bariatric surgery as part of an overall wellness program.
The keys to weight loss are surgery, diet, exercise and consistency. Diet and exercise work only for a very small percentage of the population. The problem is that the weight loss isn’t durable even if there is success initially. The majority of individuals will regain all their weight and may even be heavier afterwards (see the past contestants on The Biggest Loser). After weight loss surgery, dieting is more feasible and the weight loss is much more durable. Exercise will be important in order to maintain that weight loss, especially once the weight loss plateaus at the 1- to 2-year mark after surgery. Consistency, with diet and exercise, is also key because obesity is a chronic disease. People need to remind themselves that obesity didn't come overnight, so they shouldn't expect results overnight. Long-term results demand long-term commitment, and to do that requires consistency in dieting healthier and exercising before and after surgery.
Although there are a myriad of misconceptions about becoming overweight and losing weight, the bottom line to losing and gaining weight/body fat comes down to the Law of Thermodynamics.

Simply stated, if you take in more calories than you burn (via exercise and metabolism), you will store the excess calories for later use and gain weight/body fat. In other words, if you continuously fill up your gas tank without depleting the gas through driving, eventually the gas tank will overflow, forcing the gas to spill out of the tank. This is the same as storing excess calories in your body. However, if you take in fewer calories than you burn, you will lose weight/body fat. If you consume the same amount of calories as you burn, your weight will remain the same. This can easily be expressed through the following:
  • Consume more calories than you burn = weight gain
  • Burn more calories than you consume = weight loss
  • Consume the same calories as you burn = weight maintenance
Understanding this law gives you a concrete answer to the question "how do I lose weight?" Simply eat less and/or move more. Given this, if weight loss is your goal, then your body must be in a calorie deficit. Regardless of whether you eat a high-protein, low carbohydrate or balanced diet, in order to lose weight, you must create a calorie deficit so your body will transfer energy from the storage units you carry around as fat. By including healthy fats, fruits, vegetables and limiting saturated fat within the proper calorie allotment, you help optimize your health and minimize the risk of chronic disease. As a result, you'll have a greater potential to live a longer and more productive life.
Paula Greer
Midwifery Nursing

I have tried just about every diet that ever was from Atkins to Suzanne Somers, the grapefruit diet, and even the cabbage soup diet. All of these diets were tough to follow long term and eventually I just couldn't stick to them. Any weight I lost eventually returned. Then I started the YOU ON A DIET with the YOUdocs and it has been 2 years and 86 pounds is gone forever. A year to lose it and a year of maintenance already, I never calorie counted. I just eliminated the five food felons, ate 5-6 times a day with portion control and started walking 10,000 steps a day. I got rid of all the hidden calories in the processed foods and started eating fresh. I cut way back on meat and increased my healthy fiber foods. My weight started to just disappear from my belly. My waist went from 45 inches to 25 inches. The key to my successful weight loss and maintenance to date was making lifestyle changes. Eating healthy and burning off those calories by staying active. The foods I eat are very filling and I am never hungry. I eat more now than I ever did when I was dieting. If I can do it I know you can too.

The keys to weight loss are all wrapped up in the simple truth that fat loss can only be accomplished in a negative energy balance. You must eat less than you need on a daily basis. Everything else is insignificant. You must eat less than you need on a daily basis. Eating less, exercise and a good night's sleep all assist in this process but you absolutely must take in less than what you need.

Dr. Andrea Pennington, MD
Integrative Medicine
Practice good sleep hygiene. Get your body conditioned to go to bed at the same time every night. Your goal is to get 7-9 hours per night to help fight fatigue and boost weight loss. Eat a balance of good fat, proteins and carbohydrates at every meal. Beware of trans-fats which lead to heart disease.

Read labels carefully and stay clear of things with any hydrogenated oils. Increase your fiber by adding a variety of fruits and vegetables to your diet. Cut out sugary drinks or snacks that have high fructose corn syrup on the ingredient list. Exercise and move your body every day, even if it's simple as stretching to your favorite food TV show. Exercise while relaxing. Never skip breakfast. Keep your metabolism going in the morning by eating a healthy breakfast. Never microwave in plastic. Heat food when possible in the oven.

Cut back on alcohol and caffeine. Women who have more than two alcoholic drinks a day are at higher risk of osteoporosis. Caffeine consumption interferes with hormone levels and also increases the loss of calcium. Try to limit alcohol consumption to one glass a day and caffeine to one cup a day.

Keep your intake of food healthy, limit the amount of sugar you eat and have your cholesterol checked annually. Know your family history -- from heart disease and diabetes to breast cancer and prostate cancer, many illnesses run through family lines. The good news is that by knowing your family history and taking a proactive approach to screening and prevention, you can take steps to protect yourself early and in many cases, break the cycle.

Become aware.  Being blind leads to excuses, being aware leads to change.  Many people believe they are active, many people believe they eat well but how do they really know?

Most people are shocked when they actually log their food and track their caloric consumption or activity outputted.  The reality is when you become aware of what you are doing you are most likely to change and be mindful of all choices you make.  Little choices make a big difference over time and the only way to make better little choices is to be completely aware of what you are doing.  Awareness comes from accountability through tracking your nutrition and exercise.

Taking ACTION is key to weight loss. Most of us know the basics of what to do. Nurture our body with healthy portions of whole foods and, exercise. Being mindful to expend more energy (calories) than we consume. we have plenty of resources (such as this community site) to help us learn all we need about the right approach for weight loss. The question is....what it will take to "DO" what we know. Our "reason" for making the change can be a powerful motivator so we should be clear on that. Nutrition and exercise (or physical movement for those that have negative thoughts towards the word "exercise") are two areas we need to take action in. How can we improve in these two areas?  In addition, I believe support is an important key as well through the process, both in giving and receiving. Keep it simple and take it one step at a time. This is a process...trust it, and know that we get out of it what we put into it. Focus on progress, not perfection each step of the way and you are on your way.

There are two main keys to weight loss. Nutrition, your overall diet must be balanced and have the proper amount of calories. A good diet is critical to achieving weight loss results. Exercise is the next component, keeping active is the second key to successfully losing weight. Higher intensity activities such as running, biking, and circuit training will help burn more calories however an activity such as walking can also help you reach your goal.
There are many factors that go into weight loss.  Really the one that matters the most is holding yourself accountable to your goals.  Remember if you don't hold yourself accountable no one else will.  Also having a support structure is nice to have too.  If you have family, friends, co-workers, boyfriend, girlfriends no matter who it is it will help you to have someone there to keep you motivated.  Track your progress is another key. It is one thing to workout but if you don't track what you are doing and see the progress it is hard to know if you are really making any progress at all.  Finally get guidence if you are not sure what to do.  When working out if you can meet with a fitness professional to make sure you know what you are doing and if your program will produce those goals. 
Crystal Wilkins
Nutrition & Dietetics

To put it very simply...eat less, move more! It really is a balancing act. If your calories in are more than the calories you expend or use... you will gain weight. If you use more calories through exercise or eat less calories than your body needs... you will lose weight. When it comes to food choices, you want to choose less calorically dense foods (less soda, sweets, ice cream, fried foods, etc.). You want to choose more nutrient rich foods; lean protein, good fats, fruits and vegetables, whole grains. These foods will make you feel full because of the protein, fiber and/or fat. And, of course, exercise is essential. At least 150 minutes each week. Start slow and gradually increase as you are able.

Learn more from Dr. Michael Rakotz on behalf of NorthShore University HealthSystem about the keys to weight loss.

Continue Learning about Weight Loss

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.