Dear DOCTOR Owen:

I have lost and gained back my weight several times on different diets, which is very frustrating. Several friends of mine have done the same thing. Why can’t I keep the weight off? It makes me not want to try again.

Loser

Dear “Loser”:

Do not feel alone. Most people who lose weight put the “lost” weight back on. Only a minority, historically, keep the weight off. About half of the patients in my clinic keep more than 50% of their lost weight off, which is very favorable compared to most structured diet programs. This is after they take advantage of available weekly behavioral education counseling, exercise facilities, medical management, and dietary food supplements. Imagine the results in less structured settings!

It is very difficult to be a successful dieter in our current culture and society. The pressure is to eat, to be sociable, to not take time for ourselves, and so on. However, success is possible!

Several studies have been published on Diet Therapy program “graduates,” who successfully maintain their weight loss. However, there has been little reporting on individuals who have lost weight on their own—without a structured program and external source of motivation. Results of one of these studies are interesting. The University of Pittsburgh Medical Center, reporting in Obesity Research, Vol. 7, No. 4, contacted two groups of people at random over the phone and polled those who had accomplished such feats: weight-loss “maintainers” and “re-gainers.”

The maintainers lost an average of 37 pounds, which they kept off for more than seven years. The results were similar to maintainers enrolled in structured Diet Therapy programs. Behavioral strategies universally used by successful maintainers who did not follow a structured Diet Therapy program included modified meat preparation, no fat as a seasoning, no fried foods, and substituting low-fat for high-fat foods.

In this study, “Leisure Time” questionnaires were used to assess physical activity. Maintainers who had lost weight on their own were much more likely to engage in strenuous activity with at least three or more sweat-producing exercise sessions per week. This group was much more likely to be successful than those who engaged in mild activity for three or more days a week.

The last item marking the difference between the two study groups was daily weighing. Successful individuals who lost on their own universally weighed daily. The group that re-gained all previously lost weight never weighed daily—even when at peak low weight.

This confirms what I tell patients daily: A diet is a conscious method of eating. The key word is “conscious.” That word needs to be in front of your brain daily! Weighing is a form of confrontation—self-confrontation. Confrontation is a conscious activity. In all aspects of unsuccessful life experiences, we must face our demons if we are to change and improve.

It proves very interesting that there were no differences between the two groups in terms of dietary restraint—that is, food portion size, avoidance of snacks, and so on. Both groups showed the same level of concern, guilt, and emotion toward weight and eating. The only difference between the successful and unsuccessful self-help people was that the successful weight-loss maintainers incorporated behavioral strategies into their normal day—every day.

A large percentage of the weight “re-gainers” were members of emotional support groups, including Overeater’s Anonymous and TOPS (Taking Off Pounds Sensibly), but no conclusions were drawn as to why this occurred. My experience is that emotional eaters will do just as well as emotional icebergs—provided they practice specific dietary methods daily. For example, every soldier is terrified of going into battle, but will. People who are untrained and undisciplined will bolt and run under fire. Not one single good soldier in the world walks into training ready for battle, but learning skills, practicing those skills, and seeing the results of that training give them the confidence needed to run into battle.

If you, the dieter, find yourself running into hostile enemy territory (“Oh! You can have just one”), bullets flying everywhere (mama’s meatballs and spaghetti followed by pie and ice cream), and have few skills and little self-confidence, you will “go off” your diet.

Get some help. Learn some skills. If you wish to try it alone, remember what works:

1.  Make conscious changes in food selection and preparation.
2. Exercise vigorously at least three days a week.
3. Weigh daily.