HEALTH: Weight Loss Is Possible

From: Chris Rasch (
Date: Sun Feb 11 2001 - 21:26:08 MST

New York Times On the Web
Women's Healthe
Special Edition
September 16, 1997

Personal Health: Weight Loss Is Possible

By Jane E. Brody

Professional beliefs about the possibility of long-term weight loss
by those who have a lot to lose have not changed much since 1958,
when the renowned obesity specialist Dr. Albert J. Stunkard of the
University of Pennsylvania said: "Most obese persons will not stay
in treatment. Of those who stay in treatment, most will not lose
weight, and of those who do lose weight, most will regain it."

Dr. Stunkard may be right about "most obese persons." But what
about the uncounted thousands who do manage to lose many pounds,
sometimes a third or half of their original weight, and also manage
to keep it off -- not just for a year or two, but for life? Might
not their success stories be a better example for those struggling
to lose weight?

Weight Loss Is Possible

Anne M. Fletcher, a registered dietitian who has counseled hundreds
of overweight patients, thought so when she wrote the inspiring and
informative book "Thin for Life" (Chapters, 1994; in paperback,
Houghton Mifflin, $13). In it, she distills 10 secrets of success
from the stories of 160 "masters of weight control," defined as
people who have managed to keep off at least 20 pounds for a
minimum of three years.

Actually, the average weight loss for her subjects was 63
pounds. Seventy percent lost 40 pounds or more, more than half lost
50 pounds, and most have been maintaining their losses for five or
more years. And they did it without appetite-suppressing drugs, the
long-term safety of which is now very much in question. Yesterday
the Food and Drug Administration asked manufacturers of two of the
most popular diet drugs -- Redux, the trade name for
dexfenfluramine, and Pondimin, or fenfluramine, half of the
fen-phen combination -- to withdraw the drugs because they have
been linked to heart damage.

Ms. Fletcher also explodes many of the prevailing myths about
weight loss, like, "If you've been overweight since childhood, it's
next to impossible to lose weight and keep it off," and, "If you've
dieted and failed many times before, there's little hope of ever
licking your weight problem." Close to half of Ms. Fletcher's
"masters" had been heavy since childhood, and nearly 60 percent had
tried to lose weight at least five times before they finally

Debunking other myths, Ms. Fletcher says her masters do not eat
like birds or exercise fanatically to maintain their losses. Most
eat several meals a day, including snacks and an occasional
high-calorie treat. And while most exercise much more than typical
Americans, 60 percent of whom do not exercise at all, few overdo
it. About 70 percent exercise three or more times a week, but only
16 percent do so daily. Walking, not running, is their leading

Lest you think Ms. Fletcher's subjects are an aberration, the
National Weight Control Registry, an ongoing study, has just
published an analysis of 629 women and 155 men who lost an average
of 66 pounds and have maintained at least a 30-pound loss for five
or more years. They reduced their body weight by 29 percent, on
average, successfully moving to a normal weight
range. Ms. Fletcher's conclusions are corroborated by that study,
which was conducted by Dr. Mary L. Klem and her colleagues at the
University of Pittsburgh School of Medicine and the University of
Colorado Health Sciences Center in Denver and published in August
in The American Journal of Clinical Nutrition.

Most of the registry's participants had been overweight since
childhood, nearly half had one overweight parent, and more than a
quarter had two overweight parents. Their genes may have
predisposed them to obesity, but their sustained weight losses
prove that heredity need not confer a lifelong destiny.

How They Do It

To lose weight, about 55 percent of the registry study participants
used a formal program or professional assistance, like Weight
Watchers, Overeaters Anonymous or sessions with a psychologist or
registered dietitian. The remaining 45 percent did it on their
own. Nearly 90 percent modified both their eating and their
exercise habits, reducing the amount and kind of calories consumed
and increasing the number of calories expended. Only 10 percent
used diet alone to shed those unwanted pounds, and only one in five
used a liquid diet formula. Fewer than 6 percent used medication or
surgery to lose weight.

The most popular diet strategy, used by nearly 90 percent of
participants, was to restrict the intake of certain types or
amounts of foods. Forty-three percent counted calories, a third
limited their fat intake, and a quarter counted fat grams. More
than 44 percent ate the same foods they had been eating but limited

As for exercise, 92 percent exercised at home, and about a third
regularly exercised with a group or a friend. The women primarily
chose walking and aerobic dancing for exercise, while the men
tended to choose competitive sports and weight-lifting.

More than three-fourths of the study participants said their
successful weight loss had been prompted by a particular
event. Many were motivated by health problems -- like varicose
veins, low back pain, sleep apnea or fatigue -- or emotional

One woman, for example, said that she had lost weight after her
lawyer told her that her husband had left her because she was too
fat. Another said she wanted to look good for her approaching 25th
anniversary. But many others reported that the trigger, according
to the research team, was simply "ongoing discontent" and the
decision to "just do it."

Ms. Fletcher's subjects also reported that something had prompted
them, as she put it, "to take the reins." She added, "They stopped
looking to others for all the answers and decided to lose weight
for no one other than themselves."

Try, Try Again

More than 90 percent of the registry study participants had tried
several times to lose weight before they were successful, shedding,
on average, a total of 53 to 487 pounds in the course of their
lives. They said their efforts had worked this time because they
had greater social or health reasons for losing weight.

More than 80 percent said they had been more committed to making
behavioral changes, 81 percent said they had exercised more than in
past attempts, and 63 percent said they had used a stricter
diet. They also developed ways to deal with cravings and stress
that enabled them to stick to their diets.

The people interviewed by Ms. Fletcher likewise learned from past
mistakes. They became more realistic about their weight goals,
staying within a range that they could maintain without having to
go to painful extremes. They learned to monitor their weight (most
of the registry study participants weighed themselves more than
once a week) to keep within a 10-pound range. Most had plans of
action ready when their weight began to creep up -- stopping
snacks, increasing exercise or reducing portions until they
returned to their desired weight.

The masters at weight control have made gradual but total changes
in how they eat and exercise and do not think of themselves as on a
diet. They have accepted the fact that they cannot go back to
their old eating habits. As one woman put it, "I'd like to be
eating hot fudge sundaes or brownies, but for me, the weight is
more important."

Much of their resolve stems from the fact that they find life is
simply better when they are thinner. At least 85 percent of the
study participants reported that their lives had improved since
losing weight. The benefits included gaining self-confidence,
getting jobs, becoming more involved in their communities and
cultivating a fulfilling social life.

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