It helps to take a long-range view
January 7, 2019
Your
clothes haven’t been happy with your weight for a while. And neither have you.
What’s
the best strategy for losing weight and getting into better shape?
“Losing weight is not that difficult. The
complicated part is maintaining weight loss long-term,” says
endocrinologist Bartolome Burguera, MD, PhD.
Obesity
is a major health problem that’s
on the rise. And, unfortunately, current treatments are not effective, he says.
“One
reason is that we’re using short-term treatments, like diets, for a chronic
disease,” he says. “It’s imperative to treat obesity with a long-term plan.”
Is lack of willpower an issue?
The
failure of medical treatments for obesity has nothing to do with willpower,
says Dr. Burguera. Multiple body mechanisms influence your appetite.
“Treatment
for obesity should address nutrition, physical activity, optimal sleep and
stress management,” he adds. “People often need appetite suppression through
FDA-approved anti-obesity medications, too.”
Can the keto diet help you lose body fat?
When
combined with overall lifestyle intervention, the ketogenic (keto”) diet can produce
significant short-term weight loss, says Dr. Burguera.
On
this very low-calorie diet, you’re less hungry because you achieve ketosis.
That’s a state in which your body burns stored fat because sugar calories
aren’t available.
The
keto diet may be recommended when:
·
Your body mass index
is 30 or above.
·
You have
weight-related health problems.
·
Other weight-loss
interventions haven’t helped.
If
you have type 2 diabetes, very low-calorie meal plans can improve hyperglycemia
and insulin sensitivity, too.
But
it’s not a long-term solution. “Ketosis is difficult to maintain because you
severely limit calories, and eliminate sugar and alcohol,” explains Dr.
Burguera.
Plus,
your body converts extra calories — even from protein — to glucose, which can throw you off ketosis and make you
hungrier.
Do high-protein or fasting diets help?
High-protein
diets, done under a doctor’s supervision, can also bring rapid, substantial
weight loss. But the weight loss won’t stick unless you significantly increase
physical activity or take anti-obesity medication, says Dr. Burguera.
Some
studies also suggest that intermittent fasting aids weight loss.
“People seem to eat fewer calories, and higher growth hormone and lower insulin
levels may increase body fat breakdown,” he says.
Your basal metabolic rate — the amount of
energy your body burns simply by existing (when you’re resting and not moving)
also seems to rise slightly. So more calories get burned.
Finally,
intermittent fasting may reduce insulin resistance in type 2 diabetes. “But
more solid scientific evidence is needed to fully document its long-term
benefits,” Dr. Burguera maintains.
What does a long-term weight loss plan look like?
OK,
you’re committed to making lifestyle changes for the long haul. Which
strategies are best? Dr. Burguera recommends the following:
1.
Consider doing a keto
diet for two to three months, and then introduce a Mediterranean diet.
2.
Eat slowly, and drink
mostly water.
3.
Increase your level of
physical activity.
4.
Sleep six to seven
hours every night.
5.
Learn to manage
stress, and get help for depression.
6.
Consider seeing a
dietitian and/or psychologist.
7.
If your appetite is
out-of-control, ask your doctor about FDA-approved weight-loss medications.
8.
Consider lifestyle
support groups and shared medical appointments.
What are shared medical appointments?
“Many
people find participating in shared medical appointments very helpful
for weight loss,” says Dr. Burguera.
In
these group visits, doctors focus on obesity itself, instead of the health
issues it causes. Besides education and individualized care, patients enjoy the
support of others who are on the same journey.
So
if you want to smile when you look in the mirror (and have your clothes smile
back at you), consider a long-term approach to weight loss. You’ll be glad you
did.
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