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Urology pearls: Choices, habits, second nature play a part in weight loss

Dr. Shahar Madjar

We live in a time of plenty, in a world of excessive calories: the cookie jar at the office, the bucket of popcorn at the movie theater, and the all-you-can-eat buffet. A temptation is lurking anytime and everywhere. Almost everyone is dieting, but even those who are successful at losing weight can’t keep it off. The result is a yo-yo diet. You lose some, you gain even more, life goes on, but you end up living in a body heavier than the one you had once occupied.

Yet, there is a subset of dieters who do extremely well. Somehow they manage to lose the weight, and then to maintain their lower weights for years. How do they pull it off?

In a recent study published in the medical journal ‘Obesity,’ Suzanne Phelan, a professor at California Polytechnic State University, tried to answer this question. She compared two groups of individuals. The first group, the weight-loss-maintainers, included 4,786 participants in a Weight Watchers program who lost 20 pounds or more, and kept the weight off for an average of 3.3 years. The second group, the weight-stable individuals, included 528 obese individuals who didn’t lose weight. They hadn’t participated in WW weight loss program. Some of them might had tried to lose weight using other strategies, and some hadn’t, but in the end, none of them had lost any significant weight.

The weight-loss-maintainers lost, on average, 24.7 kg (54.4 pounds), or 23.8% of their initial body weight. They employed several strategies that seemed to have helped them lose weight and maintain their lower body weight:

First, they employed strategies to support healthy dietary choices: they chose lower-calorie foods, they kept low-calorie food accessible, and they consumed more fruits and vegetables. More specifically, they reported eating lower-fat meals and lower-fat dairy products. They preferred meats, fish, and vegetables that were baked, broiled, or grilled (rather than deep-fried, for example). They also measured their food (by weighing it, or by using measuring cups, for example).

Second, weight-loss-maintainers took steps to self-monitor their weight and behavior: They set a daily caloric goal. They recorded their daily caloric intake. They were more likely to record the type and amount of food they ate. They weighed themselves at least once a week and recorded the results, sometimes plotting their daily weight on a graph.

In the group of weight-loss-maintainers, these strategies were employed frequently, often as a daily routine, and for long periods of time. Many of them followed these routines “automatically,” describing their new habits using expressions such as: “It makes me feel weird if I do not do it,” “I am doing it before I realize I am doing it,” and “That’s typically me.”

And last, weight-loss-maintainers employed psychological coping mechanisms: if they regained weight, they made a point of thinking about their past successes and reminded themselves that they can get back on track. They encouraged themselves to think positively even when they regained weight, and they demonstrated self-compassion, self-kindness, and self-acceptance.

The difference in physical activity was also statistically significant. The weight-loss-maintainers were more physically active than those in the weight-stable group.

The group of weight-loss-maintainers scored higher in measures of the effort they put toward maintaining their weight. But ultimately, they also scored higher on their quality of life measures.

What does it take to lose and maintain a lower weight? In short, according to this and other studies, a lasting success is dependent upon strong, consistent healthy habits. It is the frequency, repetition, and automaticity of exercising and healthy eating choices. The good news is that once the change in behavior becomes a habit, it requires less intentional effort. Healthy choices turn into habits and then into second nature.

Sounds easy, right? And yet most of us just can’t stick with the program long enough to form good habits. This study gives us hope, though. Almost 5000 individuals in this study, and many, many more have done it before. We now know how. And now that we know how, we can do it too.

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