One physician’s story of weight loss

Having now lost more than 30 pounds, I am very close to declaring victory (maybe a few more pounds over the next few months).  A colleague has asked me to write my tips as a handout for patients.  This is a daunting task, but that has never stopped me!

The weight loss formula is simple and well known.  Achieving lasting weight loss remains challenging.  The mathematical formula is simple.  Weight loss requires burning more calories than we eat.  We could potentially lose weight through increased exercise or through decreasing calorie intake.  Physicians consistently recommend a combination of both strategies.

Decrease calories eaten

Most experts strongly suggest that we actually go through the process of counting calories.  Many smartphone apps exist for making the process more doable.  While I agree with this recommendation, I did not ever count calories.

My success key involved understanding my eating strengths and weaknesses.  Many people will need to use calorie counting to succeed.  Personally I used and continue to use these principles:

1. Try not to eat when I am not hungry.  This concept includes leaving food on the plate.  Most people find this very difficult.  Many people are taught from an early age to “clean their plate.”

2. Strive for portion control in a world that rewards super sizing.

3. Avoid wasted calories.   Each person must understand which calories they can avoid.  I have eliminated a few foods from my diet (at least 95% of the time).  I do not need doughnuts (really love them but don’t need them).  I avoid french fries — do not even like them that much, but often they come with my food, so I would eat them.  Now I purposely ask to not bring the fries.

4. Eat small meals at night when I can.  I have a rotating selection of low calorie meals that I eat for dinner when I am eating at home.

5. Think of each day’s calorie intake as a whole.  When I know that I will have a larger dinner, I will work at eating a bit less for breakfast and lunch.

6. Do not go on a “diet,” rather modify your diet.  The word diet here is the key.  Drastic diets will not last.  We need, I need, to change how I approach eating so that my daily caloric intake is reasonable.

Burn calories

I think everyone understands this, but many people do not attack this.  The first step we must all take is to move.  Movement is good, sitting on our butts is bad.  My burning calorie strategies started out rather simple, and have become more aggressive over time.  Here are my ideas.  You should modify based on your athleticism, your health, and your time availability.

1. Move — move regularly.  I started with walking.  When I first started, my plan was walking 3-5 miles each day.  Knowing what I know now, I would have started measuring my steps.  A great start is 10,000 steps each day.

2. Over time you can increase your rate of movement.  I personally went from walking to running.  Now I run between 2 and 3 miles each day.  Running burns more calories than walking (for the same time and for the same distance), but not everyone can run.  Biking, elliptical machines, rowing are all alternatives.  But walking is sufficient.

3. Figure out how to modify your life to achieve movement goals.  Each week I think about when I will exercise, and then do my best to schedule my exercise times.

4. Measure your exercise.  I have many friends who are using fitness trackers.  I use a Nike FuelBand, but more friends seem to use Fitbit gadgets.  Many more companies are releasing fitness trackers.  For me, the fitness tracker gives me a daily goal.  The daily feedback stimulates me to move each day.  I have a daily goal and work very diligently to achieve it.

Summary

Weight loss and then weight maintenance works best when we attack both variables in the equation.  My success has come from both burning more calories and decreasing caloric intake.  Changing one’s lifestyle and achieving weight loss success is not easy.  We should admit that weight loss is a difficult project.  I can personally attest that achieving major weight loss makes one feel better, look better, and live better.  But be forewarned, you will have to spend money on new clothes!

Robert Centor is an internal medicine physician who blogs at DB’s Medical Rants.

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  • betsynicoletti

    Great, practical advice. I think it’s easier to spend money on new clothes if I’ve lost weight than if I somehow can’t get into the dress anymore…

  • JR

    I was once on this “don’t eat unless you’re hungry diet” and it actually backfired. I found I wouldn’t start cooking until I was hungry, and by the time I had food ready I was STARVING and ended up eating more.

    I think the best diet is to not diet at all. Just pick one healthy change (maybe get rid of surgary drinks). Once you’ve stuck to that for a while, pick one more healthy change (maybe start doing a few body weight exercises a few times a week, or taking a walk). Eventually those changes add up.

    At least that’s the way I lost, and have kept off, the weight.

  • rbthe4th2

    WAY TO GO DR. CANTOR!!!! Great to hear you are able to lose the weight. Hope it stays off and you enjoy the benefits of feeling better.

  • Steven Burnett

    Well April 3rd has come and gone. I lost 31 lbs! As you stated RN, I requested a lipid panel. The physician said, “I’ll see you in 3 months, and we’ll do the lipid panel then.” I’ll let you know how it goes at that time. Good advice otherwise.

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