May 31, 2016

Healthy narcissism,’ a relapse plan and other ways to keep lost weight off

Person on scale

As published in the Washington Post, May 31, 2016

Q: I’ve recently lost weight and kept it off for a while. Now a few of those pounds have crept back on. What are the best ways to keep lost pounds off?

A: If you are disheartened by the recent headlines about the weight regained by a handful of “Biggest Loser” participants due to metabolic slowdown, you shouldn’t be. Their experience is not applicable to you if you want to lose, and keep off, 10, 20 or even 40 pounds.

“Obesity experts estimate that the metabolic adaptation, or handicap, from weight loss is roughly about 15 calories for every percent of weight loss,” says Donna Ryan, a physician and obesity researcher at the Pennington Biomedical Research Center in Baton Rouge. That’s about 150 calories if a person loses 10 percent of their weight. To compensate for the lower calorie needs, you can eat that number fewer calories, burn the calories through exercise or do a combination of the two.

Philip Pelzman, 36, from Silver Spring, and Aysegul Acer-Dreyer, 56, from Falls Church, are two people who have lost weight and are coming to grips with what it will take to keep these pounds off over the years.

Two years ago Pelzman found himself at his lifetime high weight and suffering from immobilizing back pain. With the assistance of an app to track calorie intake and exercise, he lost 20 pounds in three months. His back pain was greatly reduced. Since then, his weight hovers slightly above 190 as he masters the eating habits and behaviors he must practice to keep the pounds at bay. His motivation? A healthy back and three young children.

Acer-Dreyer also found herself at her lifetime high weight two years ago with a stern warning from her cardiologist and a diagnosis of prediabetes. By reducing added sugars (she quit drinking regular soda), replacing starches and sweets with fruits and vegetables, splitting restaurant meals and exercising an hour a day, she lost 30 pounds. Because of personal hurdles and the long, chilly winter, she regained 12. But, knowing how much healthier she felt being thinner, she’s determined to stop the regain there.

Let’s identify the actions that are essential to keeping weight off.

Alter your mind-set

“People must accept that the changes they’ve made in their lifestyle during weight loss must be maintained,” says Anne Wolf, a registered dietitian and weight management specialist in Charlottesville. “Adopt an attitude of healthy narcissism. Put yourself and your needs to live healthfully high on your priority list.”

Before you set a weight-loss plan in motion, make sure it’s the right time: You’re willing and able to make this long-term commitment to healthier living. “I just couldn’t have committed to this effort mentally and physically a few years ago when I was working full time and completing an MBA,” Pelzman says.

Develop a relapse prevention plan. Implement it as soon as possible to recover from slip-ups, which are an expected part of this journey. Many people enroll in weight-loss programs and then stop going when they’ve lost the weight. But continuous support to reinforce the lifestyle changes, research shows, is essential, too.

Tweak what you eat

Make eating a variety of whole foods, including fruits, vegetables, whole grains, beans, nuts, lean sources of protein, low-fat dairy and healthy fats, your mainstays. Research from the National Weight Control Registry, which regularly surveys those who lost weight and have kept it off for years, shows that counting the amount of fat you eat is important.

Tweak, rather than radically change, your food choices and eating habits. Over time, people gravitate back to their previous patterns.

Apply the 80/20 concept. “Eat healthfully and calorie-conscious 80 percent of the time and allow for planned splurges,” Wolf suggests.

Pelzman now makes trade-offs when he eats. For example, baked chips offer the same salty taste and crunch of fried chips.

Acer-Dreyer learned to add volume to her meals with vegetables. She bulks up tabbouleh, mashed potatoes and soups with cauliflower she’s cooked and put through a ricer. She uses spiralized zucchini instead of spaghetti.

Exercise

To keep pounds off, you must integrate physical activity into your lifestyle. “It must be your religion,” says Ryan. According to the National Weight Control Registry, people who’ve lost weight and have kept it off for years do about 60 minutes of exercise a day.

Aim for an hour of moderate aerobic physical activity a day, six days a week. Fit in resistance training, using weights or bands, two to three times a week. This helps maintain muscle mass as you lose weight and also minimizes that metabolic slowdown.

Sit less in front of a screen or TV.

Practice makes perfect

Choosing healthier foods, taking home half your restaurant meal, lacing up your sneakers for a walk: It’s all about making and repeatedly practicing healthier behaviors until they become your new way of living.

One behavior that experts agree can help is getting on the scale several times a week. If your weight begins to creep upwards, put your relapse prevention plan into action immediately. Pelzman has identified a weight he won’t let himself go above. If he approaches that weight, he gets back to measuring food portions and tracking calories.

Create a healthy environment

Make the places where you spend big chunks of time — your home, workplace, where you socialize — supportive of your healthier weight and lifestyle.

Focus on the benefits you derive from keeping pounds off, not a number on a scale. “People can get significant health improvements with a 5 to 15 percent weight loss,” says Ryan. Studies show this amount of weight loss can enable some people to stop or take fewer medications, improve sexual function, experience less urinary incontinence, decrease sleep apnea, increase mobility and more. Not bad for keeping off 10 to 20 pounds.