Some years ago, after a frugal six-month sojourn in Mexico, I returned gaunt to St. Louis. When my strudel-baking, Wiener schnitzel–making mother saw me, she wagged an admonishing finger and asked, “Are you getting enough sugar and butter, Richard?”
So you see the nutritional heritage I’ve been up against. On top of that layer:
1) my own sybaritic nature, honed over years of research vis-à-vis food, wine, and fiesta, 2) a supersized vanity, 3) a seemingly endless hunger to compete athletically, and 4) a desire for immortality (though I’d take 95 years, if offered). As a result, like many Americans, I’ve tried various diets with mixed results and watched my weight roller-coaster my entire life. Along the way, however, I’ve discovered dietitians do agree on certain things.
The Dilemma
The problem is in plain sight: Some two-thirds of us are overweight (with a body mass index, or BMI, over 25) or obese (a 30-plus BMI). In his nutritional bestseller, The Omnivore’s Dilemma, author Michael Pollan dubs it a “Republic of Fat”: a nation beset by leisure and physical inactivity, cheap and copious food and drink, and relentless media messages urging us to consume it all. No wonder the diet industry—from weight-loss clubs and TV shows to faddish diet books, potions, and pills guaranteed to shed pounds—booms despite the anemic economy.
But here’s the real skinny on weight management, culled from not only hard-won personal experience but also the American Dietetic Association, the National Weight Control Registry, the Centers for Disease Control and Prevention, and three St. Louis–area dietitians. The answer is not rigid discipline and self-denial. No, the actual key may be even more daunting. You’ll likely have to modify ingrained behavior, including how you think about food and exercise.
You’ll have to change.
“You often have to overcome a lifetime of habits,” says Heidi Paulsen, a St. Charles dietitian in private practice. “We live in an environment with an abundance of food and an abundance of cues to eat. It’s everywhere. It’s part of our lives, our entertainment, and what we do with friends”—even within these pages, with their tempting restaurant reviews. “You should enjoy these things,” says Paulsen. “But you need to plan for success.”
The Motivation
That success bodes bountiful benefits. Julie Reardon, outpatient dietitian at Fenton’s SSM St. Clare Health Center, rattles off a handful: “Reduced risk for type-2 diabetes, sleep apnea, osteoarthritis, heart disease, and cancer. People who lose weight can often get off medication. Blood pressure, diabetes, and cholesterol can be controlled with a healthy lifestyle”—preferable, says Reardon, to medications and their side effects, which for some men can include sexual dysfunction. “I’m not a therapist, but I see psychological benefits as well,” she adds, “and more zest for life.”
Even a 5 percent weight loss can reduce chronic disease, says Jennifer McDaniel, an instructor at Saint Louis University’s College of Health Sciences. “Energy levels go up with whole, fresh foods and weight loss, and you feel better. Your body image is improved, you feel stronger and sleep better.”
The bottom line: Being overweight or obese is inhibiting, costly, unhealthy, life-shortening, and depressing. Successfully managing our weight helps make us happier, healthier, more active, and more capable physically, mentally, sexually, and emotionally. Reasons enough, it would seem, to lose weight and keep it off.
Easier said than done.
“It’s not easy to lose weight. It’s complicated,” says Paulsen. “The biggest stumbling block is that many people aren’t ready to make a change.”
The Solution
So just what kind of change are we talking? McDaniel points to findings from the National Weight Control Registry, an organization that investigates the characteristics of individuals who succeed at long-term weight loss. Participants have lost 30-plus pounds and kept it off for at least a year. In fact, on average, they’ve lost 66 pounds for more than five years. Their experience suggests:
Don’t skip breakfast. “They found that 78 percent eat breakfast,” says McDaniel. “A third of daily calories should come from breakfast. Skip breakfast, and you’ll make up the calories and more later.”
Eat often. “Every three or four hours,” she says. “It allows you to have small meals. The key here is you’ve thought ahead about eating. You make poor choices when hungry.”
Monitor weight. Most participants tracked in the ongoing NWCR study are aware of small changes in weight, says McDaniel, who advocates weighing yourself daily. “Look at trends. Is my weight gradually moving up or down? We tend to pull back on eating when we weigh heavier.” She also suggests taking advantage of iPhone and Twitter applications and free online diet logs that help you track calories and weight.
Exercise daily. The most difficult weight-loss factor for most people to swallow is exercise. The vast majority of NWCR participants exercise 60 to 90 minutes daily. “That’s a hard one for most of us, given family demands and lifestyles,” admits McDaniel. Reardon says 15 minutes will do—but “every day, to instill the habit of daily exercise.”
Other key ingredients that dietitians recommend:
Control portions. “Portions are most important,” says Reardon, who rules out seconds and supersized meals. Paulsen says a 3-ounce hamburger should suffice in lieu of the quarter- or half-pounder.
Fix fresh, natural foods. That means cutting down on processed foods—white bread, pasta, pizza, packaged items, and fast food. “You don’t want to eat fast foods every day,” says Reardon. But when you do, you can make healthier choices such as salads, fruits, and yogurt in lieu of French fries.
Count calories. “You have to have a calorie deficit to lose weight,” says Paulsen. McDaniel touts “volumetrics”—that is, eating “low-calorie, coarse foods that make me feel full”—such as broccoli versus cake. Limit high-calorie soft drinks and fruit juices. Cut down on alcohol. Prepare foods the smart way—baked or broiled rather than fried.
Lift weights. “Building muscle mass speeds metabolism and burns calories,” says Reardon. Paulsen adds, “With diet alone, you lose muscle and fat.” After age 40, muscle mass also begins to atrophy, so weight training is essential to keep your BMI from tanking.
Practice forgiveness. It’s okay to splurge on occasion, though in moderation. But don’t beat yourself up when you slip. “Forgive yourself and move on,” says Paulsen.
Think long term. “Restrictive diets are not realistic,” says McDaniel. “Rather, employ change you enjoy and can maintain.” Paulsen adds that some may need “nutritional counseling to help overcome barriers to change.”
And the barriers are many: Busy lifestyles that make us eat irregularly, unhealthily, and thoughtlessly and that make exercise a low priority. A commercial culture that tempts us at all turns. A family that considers sugar and butter to be health foods.
What determines lasting success? A healthy mind-set and, more importantly, a healthy lifestyle.
Rick Skwiot is a writer whose 1998 novel, Sleeping With Pancho Villa, was a finalist for the Willa Cather Prize. He wrote a baby-boomer’s take on yoga and Pilates for SLM’s “Healthy Living” series in March. Skwiot divides his time between St. Louis and Key West, Fla.
