Person stands on scale

Your efforts to peel pounds may seem ineffective and never-ending. But here’s the skinny: Great tools and tactics can whittle away weight and keep it off.

“There’s no magic bullet,” says Dr. Felix Spiegel, MD, Bariatric Surgeon with Memorial Hermann Medical Group Galleria Bariatric Surgery. “It takes baby steps.”

Dr. Spiegel provides directional lighting on your path to a slimmer, healthier you.

Problem: Out-Of-Control Calorie Consumption

SIGNS: Your clothes are getting tight—even those with elastic waists.

CAUSE: You’re eating more than you’re burning off. Perhaps your portions are too big, you’re overindulging in fast food or you’re stuffing yourself as a response to anxiety, uncertainty and other stressors.

DIAGNOSIS: A food diary can reveal your nemesis, and your scale will snitch on you.

TREATMENT: A healthy diet is more important than exercise to trim down. “The trick is to keep the calories a little bit lower than what your body requires, and that’s based on your weight,” Dr. Spiegel says.

Generally, people need about 10 calories per pound of weight daily. So, a person who weighs 200 pounds will stay the same weight with 2,000 calories but lose a pound or more weekly of fat if they shave their total to 1,600, he says. “That’s without exercise, though with mild exercise you may lose an extra pound.”

Dr. Spiegel recommends weighing portions on a food scale or using measuring cups. You’ll see to what degree you’ve been overserved. If that’s not your style, talk to the hand: Your palm is about the size of a 3 oz. portion of lean meat or fish. A fist is about an ounce of cold cereal or two of rice, pasta or oatmeal. A thumb is about one serving of cheese, and a handful is a serving of nuts or small candies.

MYTH: “Dieting is not the end-all.” But “it is at least 80% of the battle,” he says. “Exercise helps, and if you smoke, stop.”

Problem: Fascination with Fads

SIGNS: Weight drops, but around the corner it returns, and often with extra baggage.

CAUSE: You may be trapped on the weight rollercoaster of lows and highs because you rely on fickle fads. The fast track takes you nowhere because speed loses steam, Dr. Spiegel says. “Radical diets have been around since the beginning of time. They’re doomed to failure because they’re unsustainable.” Your body’s physiology counters fasting and rapid pound shedding by slowing your metabolism, hiking the hunger-stoking hormone ghrelin and lowering the hormone leptin that signals you’re satiated. This only worsens your battle against bulge. “Don’t starve yourself or skip meals—breakfast included,” he says. “You’ll just end up binging later.”

DIAGNOSIS: It’s not about being the biggest loser or the fastest one. It’s about losing the weight long-term.

TREATMENT: To keep pounds off forever, your lifestyle needs to change—forever. Go slowly, optimally shedding 1-2 pounds weekly, Dr. Spiegel says. That way you’ll drop not just weight but body fat more than muscle mass.

“Also, listen to your body’s signals: If you’re hungry, your body needs energy, so give it fuel. Eat small, nutritious meals and you’ll maintain a higher metabolism that’s helpful to weight loss,” he says. That often dictates a balancing act: Ideally consume three to four small meals daily. Rather than keto or other unbalanced schemes, strive for 40% lean fish, meat or other protein; 40% whole grains, fruits, vegetables and other complex carbs; and 20% or less fat, ideally plant-based, such as avocados and olive oil. “That’s sustainable.”

Once you reach your desired weight, continue on your path, pumping up the volume a little bit. “If you go back to high-calorie foods and huge portions, you’ll regain what you’ve lost—or more,” Dr. Spiegel says.

MYTH: “You must deny yourself.”

Actually, he says, you can eat anything, but within reason.

Problem: Inactivity

SIGNS: Lifting grocery bags, climbing stairs or chasing your kids leaves you breathless.

CAUSE: You’ve grown roots too deeply while planted in front of your screens: TV, laptop and otherwise.

DIAGNOSIS: A fitness journal will spill the truth. The good news: Housecleaning and gardening count as activities.

TREATMENT: Get moving—ideally 30 minutes daily for six days weekly, Dr. Spiegel says. Mix it up, with light weights and some cardio, including walking, swimming, biking or kayaking. Don’t get overly ambitious: Just because you ran on the track team or played soccer in your youth doesn’t mean you can keep pace with your past self. “Remember those baby steps,” Dr. Spiegel says.

MYTH: “Anyone can exercise on their own.”

True, but a personal trainer, such as those at the Memorial Hermann | Rockets Sports Medicine Institute, can help you avoid injury. After all, even pro athletes are surrounded by such specialists to keep them on the field.

Problem: Emotional Eating

SIGNS: You gravitate to unhealthy, sugar- and fat-filled choices when you’re not hungry.

CAUSE: It’s called comfort food for a reason. Unconsciously you may be trying to drown anxiety, sadness, loneliness, anger, stress, fatigue or even boredom.

DIAGNOSIS: Take note how you feel when you’re tempted to binge.

TREATMENT: There’s no shame to psychological counseling. “The mental part of the weight-loss game is really important,” Dr. Spiegel says. Therapists and food counselors can tease out why you graze. “You may be using food as a substitute for other things in your life.”

MYTH: “Cutting calories and working out are sufficient.”

Not so, he says. Address the mind traps you’ve set over the years so you can cease self-sabotaging.

Problem: Lack of Accountability

SIGNS: Weight gain can creep.

CAUSE: What you don’t know about your weight can hurt you.

DIAGNOSIS: You do know more if you log meals, weigh food, work out or step on the scale.

TREATMENT: “The only way you’ll know you’re gaining—or losing—weight is to weigh yourself. It keeps you accountable,” Dr. Spiegel says. “People who never weigh themselves lose track, and when they get on a scale, they’re shocked.” For consistency’s sake, weigh yourself once weekly, first thing in the morning, before you dress, drink or eat. Then record the results.

MYTH: “The race ends at the finish line.”

Actually, you must keep focused. There is no finish line.

Problem: Failure to Launch

SIGNS: You’ve been trying for several months, and nothing’s happening, or you’ve spent years going up and down.

CAUSE: Trying to manage your weight alone isn’t working for you.

DIAGNOSIS: You may need help, whether it’s a weight management clinic, personal trainer, registered dietitian, therapist—or bariatric surgeon.

TREATMENT: To break the yo-yo cord, explore help from professionals. “Weight-management centers offer nutritional and psychological counseling—not just surgery,” Dr. Spiegel says. “We also offer support groups.”

MYTH: “It won’t take long.”

You may expect too much too soon. It’s better to be realistic than frustrated. “Losing weight may be slower than gaining it,” he says.

What: Morbid Obesity

SIGNS: You need to lose an extreme amount, usually 100 pounds. Your age and weight coupled with diabetes, heart disease or other lethal conditions can threaten your life.

CAUSE: Extreme obesity can transform your body into a padded cell, making it harder for you to move, much less exercise.

DIAGNOSIS: “It’s really difficult to lose 100 pounds on your own,” Dr. Spiegel says. But surgery can improve your odds of shedding and keeping off pounds.

TREATMENT: “Weight-loss surgery gives you a very small stomach, which controls your portions and takes away your hunger,” he says. “Keeping weight off becomes easier.” Gastric bypass reroutes the digestive track, trimming the stomach into a pinky-sized pouch and then connecting it to the intestines. Another popular surgery is a gastric sleeve or gastrectomy, in which surgeons remove 70% of the stomach, leaving only a sleeve the size and shape of a banana. 

MYTH: “Surgery is a one-and-done.”

You may need nutritional, physical and psychological after-care.

Problem: No Problem

SIGNS: After weight loss or weight-loss surgery, your mood, confidence and energy can lift. “Until you’ve experienced a healthy weight, you may have no idea how happy it may make you,” Dr. Spiegel says.

CAUSE: Peeling pounds may improve or resolve your chronic health conditions, including joint and back pain, type 2 diabetes, hypertension, high cholesterol, sleep apnea or heart, lung and liver disease.

DIAGNOSIS: You can bend over to tie your shoes, fit comfortably in an airplane seat or work out without pain. That freedom is a reward beyond measure.

TREATMENT: While your calorie-cutting can be less drastic, you still need to monitor your intake. “You’ll have lot more energy.” Take advantage of it. 

MYTH: “The weight will return.” 

Not necessarily. Keep up the good work. That’s how you prevail against pounds permanently.

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