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From Fat To Fit

Being at a healthy weight is a nice idea, but if you’ve ever tried to lose weight, you may know that translating good intentions into good results can be difficult—so difficult that you may wonder if it’s worth the effort in the first place.

It is. The reason is within—that fist-sized organ just below your breastbone, slightly to the left. The heart pumps life-sustaining blood throughout the body, but when the body isn’t healthy—burdened by too much fat—the risk to the heart increases. If you’re overweight, the heart has to work harder. Excess body weight raises blood pressure, increases the risk of diabetes, and can lead to elevated cholesterol levels, so people who are overweight are more likely to suffer a heart attack or stroke.

So you need to lose weight—but how do you do it? There is no shortage of weight-loss messages in our society. Diet supplements, diet books, hypnosis, deliver-to-your-door meal plans—it’s not surprising that we get confused. Going from fat to fit can pose a challenge not only to people who are overweight but also to their physicians, who may be unsure how to help patients put their medical advice into daily practice.

“Advice is not enough,” notes Dr. Alison Bailey, chief cardiology fellow at the UK HealthCare Linda and Jack Gill Heart Institute at the University of Kentucky. Bailey tackled this subject with other heart specialists at a recent meeting of the American College of Cardiology, where she reviewed clinical weight loss studies.

The simple equation
What works, notes Bailey, is a simple equation—use more energy than you consume. In a review of clinical weight loss studies, Bailey found that patients did best at losing weight and keeping it off months and years later when they followed these steps:

• Plan meals to reduce calories, and keep a food diary. In general, 1,200 calories per day for women and 1,500 for men is recommended for weight loss. In all the studies reviewed, dietary change was the most important component for successful weight loss.

• Exercise regularly. Physicians recommend moderate-intensity exercise for 30 to 40 minutes most days of the week.

• Expect to go slow—and be patient if you stall out. Patients who followed these guidelines experienced an average weight loss of approximately 11 to 19 pounds during the first six months. Weight loss leveled off at about six months, and patients regained 1 to 3 pounds by the end of the year. Still, these patients were able to maintain a loss of 5 to 8.5 percent of their starting body weight.

• Have a support system, even as simple as brief, weekly telephone conversations to help keep track of your progression. Patients who had personal interaction with a weight-loss counselor regained significantly less weight than those who worked alone.

Change your lifestyle
What doesn’t work? Crash diets, for one. Drastically cutting calories or starving can lead to dramatic weight loss, but also dramatic weight gains—“rapid and substantial,” Bailey says.

“Overall, tackling weight loss requires changing your lifestyle to be successful in the long term. We’ve all seen this in our daily lives when someone (physician or not) suggests we should lose weight,” Bailey says. “It sounds good. We know we should do it, but it just doesn’t happen. To truly be successful at weight loss, you must change your diet and increase your physical activity so that you are burning more calories than you are taking in. It sounds easy, but this can be among the most challenging things to actually accomplish.”

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