Category Archives: Lose Weight Fast

A size 24 carer who battled with weight issues for years was so determined to be fit at 40 that she shed six stone, conquered her food demons and landed a job as a weight loss coach.

Amy Rowlands, now 41, says her confidence "hit rock bottom" and decided things had to change.

Amy, of Grimsby, Lincolnshire, managed to drop five dress sizes in seven months after joining a WW slimming group and even landed a job helping other dieters to lose weight.

A carer for her partner Neil Armstrong, 44, who has a long-term illness, she was unhappy with her weight as she approached her 40th birthday.

Now at 5ft 9in, weighing 13st 4lb and wearing a size 14, Amy, who has four stepchildren said: When I reached 19-and-a-half stone, I stopped caring and didnt look after myself.

I would never look in the mirror and my confidence was at rock bottom.

I put my life on hold. I would say to myself, Well Ill go for a new job when I lose weight.

Amy continued: I used to sing in a band and I stopped that, but told myself Id do it again after Id lost weight.

I would bury my head in the sand. People around me would gently try and tell me I should lose weight, but I would just brush it off.

Amys unhealthy relationship with food started when she was aged just 12 and gained some puppy fat prompting her to try and lose weight and leading to a two year battle with the disease anorexia nervosa, starting when she was 13.

My weight problems spiralled out of control and I would go from one extreme to another, she recalled.

I weighed five stone, and after being admitted into a special unit for teenagers, that helped me get sorted.

After having anorexia, I went the other way and gained more and more weight.

She said: Then, in my 20s, I managed to lose seven stone through dieting.

But I put it back on again, and in my 30s went up to more than 20 stone losing nine stone again through dieting, before putting it all back on.

It would never stay off. Life would get in the way and I would pile the pounds back on. I would be in denial about how big I was getting and my weight just spiralled out of control.

Eating calorie-laden food like pizza, as well as snacking on chocolate and crisps, with scant regard for portion control, did not help.

Amy said: I would eat six biscuits as a mid-morning snack and a family sized bag of kettle chips in the evening after dinner.

I also used to drink a bottle of wine a night.

With a body mass index (BMI) used to gauge a healthy weight of 40.4, compared to the NHS recommended range of between 18.5 and 24.9, Amy was classed as obese.

But as her 30s drew to a close, weighing 19-and-a-half stone and wearing a dress size 24, she was determined not to be fat at 40.

And when her partner spent a month in hospital with a chest infection, it served as a real wake-up call, forcing Amy to look closely at her own health.

As soon as he was discharged, I thought, Im not putting it off anymore. I have to sort myself out. It was a wake-up call for me, she said.

I joined WW and started to reduce my calories using the points-based system. It was about changing my lifestyle. Im an all or nothing person so took it very seriously.

I started to lose weight quite quickly about five or six pounds in the first week, which spurred me on.

She added: I felt in control of something, because I could see the results from the changes Id made.

Within seven or eight months I looked and felt like a different person. It was amazing.

By January this year Id lost 6st 3lb and now weigh 13st 4lb and wear a size 14. Im hoping to get to my goal weight of 10st 7lb by the end of the summer.

As an added incentive, Amy put a pound in a jar for every pound in weight she lost, meaning she could soon treat herself to a brand new wardrobe.

When youre bigger you dress for your size rather than your taste or style, but when youre smaller you dress for yourself, she said.

My confidence has really grown. I can look in the mirror with pride.

I enjoy getting dressed up and going out when, before I lost weight, I would make an excuse not to go out, Amy explained.

Best of all, losing weight has given Amy a marvellous new work opportunity.

She said: Id been caring for my partner full-time, but I think I was also using that as an excuse, because I didnt have the confidence to go out to work.

Amy added: In the New Year, my WW coach asked if Id ever thought about becoming a coach myself, so I did as I really wanted to share my story and encourage others.

I find it really rewarding and I know it makes such a difference when youre being coached by someone who has been through the same thing.

Now Amy sticks to healthy meals, eating porridge for breakfast and chicken or fish for dinner, as well as working out three times a week.

I have an exercise machine at home, she said. I also have a fitness hula hoop and will do home workouts three times a week, as well as taking our Golden Labrador dog Whammo for a walk.

Now I want other people to know that whatever has happened, they can change, too.

Today I have a bounce in my step. Before losing weight, I felt so sluggish, but Ive got loads of energy now.

She said: I dont think you realise how much that extra weight impacts on your life until you lose it.

I used to wear a coat 12 months of the year, just to cover up my body, but not anymore.

I cant wait to wear shorts in the summer even if its just to go in the garden.

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How a carer lost six stone and conquered her demons - Cambridgeshire Live

Trying to hack fitness is a multi-million-dollar industry; weve all seen at least one ad featuring a purported miracle product that claims it can make people lose weight and look greatwithout even trying. From low-effort exercise machines to strange-ingredient diets to fat-burning belts and bands, theres no shortage of attempts to make it easy to be fit.

A gene therapy trial performed on mice may foreshadow yet another way to hack fitness. In a study done by a team at Washington University in St. Louis medical school, mice quickly built muscle mass and reduced obesity after receiving the therapy, even while eating a diet high in fat and not exercising. The results were published last week in a paper in Science Advances.

Sound appealing? Heres how it worked.

The gene targeted was FST, which is responsible for making a protein called follistatin. In humans and most other mammals, follistatin helps grow muscle and control metabolism by blocking a protein called myostatin, which acts to restrain muscle growth and ensure muscles dont get too big.

The researchers injected eight-week-old mice with a virus carrying a healthy FST gene (gene therapy involves adding healthy copies of a gene to cells, usually using a virus as a deliveryman).

Over a period of 18 weeks, or about 4 months, the team observed that the muscle mass of the treated mice more than doubled, as did their strength level. They also experienced reduced damage related to osteoarthritis, less inflammation in their joints, and had healthier hearts and blood vessels than mice that didnt receive the gene therapyeven though all the mice ate the same high-fat diet and did the same amount of exercise.

Going into the study, the researchers worried the muscle growth catalyzed by the gene therapy could harm the heart, mainly through thickening of the hearts walls. Surprisingly, though, heart function and cardiovascular health of the treated mice actually improved. In subsequent studies, the team will continue to monitor the treatments effect on the heart, as complications could emerge over time.

Talk about a fitness hack; imagine being able to build muscle and maintain a healthy metabolism while lounging on the couch eating burgers and fries. There have been similar studies to replicate the effects of exercise by commandeering the genetic instructions that control the way cells interact with proteins; though various exercise pills have successfully mimicked the effects of regular cardiovascular activity in mice, scientists still dont fully understand how, at a molecular level, exercise has the effects it does on the human body.

This may change in the next couple years, though; a National Institutes of Health consortium called the Molecular Transducers of Physical Activity is in the midst of an in-depth study on the molecular effects of exercise on tissues and organs in 3,000 people.

If the muscle-building gene therapy eventually reaches a point where it can be used in humans, though, the research team isnt viewing it as a quick-fix health hack. Rather, it would be used to help get people with conditions like muscular dystrophy or severe obesity to a baseline from which they could adopt tried-and-true muscle-building practices like weight lifting or physical therapy.

In cases of severe obesity or muscle loss, it is extremely difficultif not impossibleto lose weight or improve muscle strength through normal exercise and diet, said Farshid Guilak, orthopedic surgery professor and director of research at Shriners Hospitals for Children in St. Louis. The goal of this study was to show the importance of muscle strength in overriding many of the harmful effects of obesity on the joint.

If every condition, process, and trait in our bodies is tightly linked to our genes, its conceivable that almost any aspect of our health could be manipulated using gene therapy and related tools. Maybe one day there will indeed be a pill we can take or a shot we can get to give us svelte, muscular bodies without any of the effort.

The fact that this would ruin the pleasure and satisfaction of a good workout is another conversationand one not everybody would be interested in having. But even if genetic or chemical exercise-replacement tools become safe to use in humans in the foreseeable future, theyll likely be limited, at least at first, to those who need them due to debilitating health conditions.

That saidfor the time being, keep hitting the treadmill, the weight room, or your other off-the-couch, effort-intensive workout of choice.

Image Credit: Aberro Creative from Pixabay

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Forget ExerciseThese Mice Got Ripped With Gene Therapy - Singularity Hub

Dr. Sushil Kumar Sharma

World Hypertension day is celebrated annually on the 17th May. The main aim of the day is to educate the public and increase awareness of hypertension, which is also commonly known as high blood pressure.Traditionally held on May 17th, due to covid-19 pandemic, The World Hypertension League (WHL) has announced that it will postpone the celebration of World Hypertension Day (WHD) 2020 until October 17, 2020. The expanded theme for World Hypertension Day is Measure Your Blood Pressure, Control It, Live Longer, with a goal of increasing high blood pressure (BP) awareness in all populations around the worldPrevalence:Hypertension is a major cause of a range of health problems such as strokes, heart attacks and kidney disease, and can also contribute to dementia. Globally, an estimated 26% of the worlds population (972 million people) has hypertension, and the prevalence is expected to increase to 29% by 2025, driven largely by increases in economically developing nations.The high prevalence of hypertension exacts a tremendous public health burden. As a primary contributor to heart disease and stroke, the first and third leading causes of death worldwide, respectively, high blood pressure was the top modifiable risk factor for disability adjusted life-years lost worldwide. In some recent studies both covid-19 case fatality rates and hypertension prevalence increases with age, reaching 8.0% and over 50% respectively for the 70 to 79 year age group.Symptoms of hypertensionHypertension is generally a silent condition. Many people wont experience any symptoms. It may take years or even decades for the condition to reach levels severe enough that symptoms become obvious. Even then, these symptoms may be attributed to other issues.Symptoms of severe hypertension can include:* headaches* shortness of breath* Epistaxis* flushing* dizziness* chest pain* loss in VisionThese symptoms require immediate medical attention. They dont occur in everyone with hypertension, but waiting for a symptom of this condition to appear could be fatal.The best way to know if you have hypertension is to get regular blood pressure readings.Categories of BP in AdultsBP Category SBP DBPNormal <120 mm Hg And <80 mm HgElevated 120-129 mm Hg And <80 mm HgHypertensionStage 1 130-139 mm Hg Or 80-89 mm HgStage 2 140 mm Hg Or 90 mm Hg

High blood pressure EmergenciesHigh blood pressure is usually a chronic condition that gradually causes damage over the years. But sometimes blood pressure rises so quickly and severely that it becomes a medical emergency requiring immediate treatment, often with hospitalization.In these situations, high blood pressure can cause:* Memory loss, personality changes, trouble concentrating, irritability or progressive loss of consciousness* Stroke* Severe damage to your bodys main artery (aortic dissection)* Chest pain* Heart attack* Sudden impaired pumping of the heart, leading to fluid backup in the lungs resulting in shortness of breath (pulmonary edema)* Sudden loss of kidney function* Complications in pregnancy (preeclampsia or eclampsia)* BlindnessPrevention of high blood pressureHealthy lifestyle changes can help you control the factors that cause hypertension. Here are some of the most common home remedies.Developing a healthy dietA heart-healthy diet is vital for helping to reduce high blood pressure. Its also important for managing hypertension that is under control and reducing the risk of complications. These complications include heart disease, stroke, and heart attack.A heart-healthy diet emphasizes foods that include:* fruits* vegetables* whole grains* lean proteins like fish* Increasing physical activityReaching a healthy weight should include being more physically active. In addition to helping you shed pounds, exercise can help reduce stress, lower blood pressure naturally, and strengthen your cardiovascular system.Aim to get 150 minutes of moderate physical activity each week. Thats about 30 minutes five times per week.Reaching a healthy weightIf you are overweight or obese, losing weight through a heart-healthy diet and increased physical activity can help lower your blood pressure.Managing stressExercise is a great way to manage stress. Other activities can also be helpful. These include:* meditation* deep breathing* massage* muscle relaxation* yoga or tai chiThese are all proven stress-reducing techniques. Getting adequate sleep can also help reduce stress levels.Adopting a cleaner lifestyleIf youre a smoker, try to quit. The chemicals in tobacco smoke damage the bodys tissues and harden blood vessel walls.If you regularly consume too much alcohol or have an alcohol dependency, seek help to reduce the amount you drink or stop altogether. Alcohol can raise blood pressure.Key Message* Proper management can control hypertension and prevent its complications.* Effective lifestyle and drug treatments are available that could control hypertension in most individuals. Newer drugs provide better control while avoiding the side effects that have limited therapy in the past.* A close collaboration between the physician and patient is needed to optimize better health outcomes.There is as yet no evidence that hypertension is related to outcomes of COVID-19, or that ACE inhibitor or ARB use is harmful, or for that matter beneficial, during the COVID-19 pandemic. Use of these agents should be maintained for the control of blood pressure, and they should not be discontinued, at least on the basis of current evidence at this timeThe unintended consequences of discontinuing effective treatments for hypertension, without a suitable replacement titrated against blood pressure measurements under direct medical supervision, could put patients at needlessly increased cardiovascular and possibly coronavirus risk. In addition, managing such titration currently, when primary care is prioritizing acute illness over routine contacts (including blood pressure checks), makes the proposed strategy impractical and risks further diluting access to care.(The author is Head Department of Cardiology)feedbackexcelsior@gmail.com

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Measure your BP to live long - Daily Excelsior

Shawn Marion had made only one ProBasketballTalk headline since retiring five years ago. During the 2018 playoffs while LeBron James shouldered a historic burden Marion argued people were treating LeBrons Cavaliers unfairly harshly. Otherwise, Marion has largely faded from the forefront of the basketball conversation.

Hes back with new gripes.

Much better gripes.

Marion on his Basketball Hall of Fame candidacy, via Michael Lee of The Athletic:

I think the legacy I left for the game is there. But who is it to decide? Who is making the decisions? What do they base it off of? If you look at all the numbers, to me, I should be a shoo-in. Should I not? Marion asked. What am I supposed to do? What am I not supposed to do? Its out of my control. I know its a political thing. Its a lot more other stuff going on. But certain things, you earn that. I earned that.

Marions complaints about the process are wholly justified. The Basketball Hall of Fame has secretive voting procedures and strange outcomes. I have little faith in the organization.

Should Marion be a shoe-in for enshrinement? No. Hes a borderline case.

But Id lean toward putting him in.

Marion leads unselected Hall of Fame-eligible players in career win shares:

Win shares obviously arent the be-all, end-all. But they indicate the significant production Marion provided for the the Suns, Heat and Mavericks.

Marions combination of versatility and durability allowed him to make SO MANY positive plays.

Ahead of his time as a small-ball power forward, Marion did everything. He defended multiple positions. He helped all over the floor, swarmed passing lanes and protected the rim. He scored inside and out. He ran the floor. He rebounded.

And he did it all while playing big minutes, increasing his value to his team.

Marion made four All-Star teams and two All-NBA third teams. He played 16 seasons. At the tail end of his prime, he won a championship ring as Dallas starting small forward in 2011.

He definitely belongs in the Hall of Fame conversation.

At the very minimum.

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Report: All NBA players who tested positive for coronavirus recovered in short order - NBCSports.com

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When we traipse around the house or step out for a stroll, most of us don't think twice about putting one foot in front of the other. For many people, it's a given to take the ability to walk (and to walk well) for granted. That is, until something goes wrong. Then we develop a newfound appreciation for our former ambulatory prowess.

Your walking style can reflect a host of physical, physiological, neurological, and even psychological influences and problems. "Your gait reveals a lot," says Jessica B. Schwartz, a doctor of physical therapy and a spokesperson for the American Physical Therapy Association. "I see health issues manifested not only in my patients' steps, but among the general public when I see people walking in a mall or airport," says Dr. Schwartz, who is also a physical therapist at Physical Therapy to Go based in New York City.

So, wonder what your walking style can reveal about your health? We spoke with medical experts who share how certain walking styles can shed light on specific health conditions. (Also, here are the health benefits and risk of walking barefoot.)

Favoring one leg when bearing the weight and impact of each step suggests that a joint injury is present. This can come from structural problems like a muscle strain, sprained ligaments, a torn meniscus, or other damaged joint structures, arthritis, leg length differences, or foot problems. And it can get worse because an off-balance stride affects other body parts, too.

"The body is amazing at creating compensation mechanisms for ailments of the lower extremity," says Henry C. Hilario, a physician specializing in foot and ankle surgery at The Orthopaedic Clinic in the Willis-Knighton Health System in Shreveport, Louisiana. "Some patients may have always had one leg that is shorter but might only notice it later in life as their body's compensation over time, eventually wears joints out faster and contributes to back-, hip-, knee- and foot pain. The foot and ankle also compensate for being flatfooted or having a high instep which can then lead arthritis later in life."

If pain in your lower extremities becomes chronic and actually alters your gait, it's important to get help. "The causes of limping can be evaluated and treated by a skilled physical therapist," adds Dr. Schwartz. You can find a physical therapist here.

"Age can be tied to how fast or slow a person's walks," says Dr. Hilario. Lower body muscles like the glutes, tend to weaken with age, according to a 2017 study published in BMC Geriatrics. Also, the fast-twitch muscle fibers in the lower body can decline, suggests a 2013 study in Experimental Gerontology. Together, these two things may result ina loss of power and, therefore, slower walking.

"Someone with obesity or pain from joint injuries or osteoarthritis tends to walk slower as well," adds Dr. Schwartz. "With obesity, a person may have a wider stance and spend a longer time in each phase of the stepping motion since transferring the excess body weight quickly can be more difficult, especially if a person is out of shape."

Of course, walking, along with a nutrient-rich, lower-calorie diet, is a great way to help a person who's obese lose weight if done frequently enough and for long enough.

A shuffling step where the feet don't lift high off the ground and instead scoot, rather than roll, through the full heel-to-toe range of motion could also be indicative of Parkinson's disease, according to Dr. Schwartz. "If your walking is altered by pain or dysfunction you need to see a PT," she says.

Many people do not realize that you do not need a prescription or referral from a physician to see a physical therapist. In a policy known as Direct Access, a person can have at least one exam by a physical therapist without a referral, and in many states, you can have up to 30 days of treatment before you need a prescription. "There are often things we can do to help with pain and dysfunction," says Dr. Schwartz.

Some exercises that can help strengthen the muscles that lift your feet with each step are heel lifts (rise up and down on the balls of your foot to develop calf strength, which helps to push your body weight forward with each step) and knee lifts (raise your thigh to hip level to strengthen the hip flexors, which help raise your leg and foot with each step.)

Some people have a tough time staying centered and appear to waddle from side to side. Sometimes veering in a sideways direction from the continual imbalance with each step. "This can be a sign of gluteal muscle weakness," says Dr. Schwartz.

"This pattern, known as the Trendelenburg gait, that resembles a penguin walk is often due to hip osteoarthritis." Exercise can help since the condition stems from muscle weakness and imbalances in the pelvis. "You can do the old-style fire hydrant exercise also known as doggy kicks, where you get on your hands and knees and raise your bent leg up and down on each side," says Dr. Schwartz.

These moves target the gluteus medius and gluteus minimus muscles which, when strong, help keep the legs better aligned.

Think about when you've felt happy, excited about something, or even in love. These emotions can carry-over into your walking style, as well. "You can tell a lot about a person's mental state from their physical demeanor," explains Barry Gritz, MD, a psychiatrist based in Houston. "Someone who is in a good place ambulates differently, almost gliding when they walk."

Since you're energized when you're experiencing positive emotions, it's a good idea to take a walk. Walking more and bumping up your intensity a notch can help you reap even greater physical and mental benefits from your workouts. (Plus, check out these tips to get the most happiness from your daily walk.)

Some people experience those out-of-the-blue, muscle-clenching cramps that leave you frozen until the pain resides. "If leg muscles cramp when walking, it could indicate the presence of a disease that has not yet been diagnosed like pulmonary disease or peripheral artery disease, (PAD)" says Jenna Yentes, PhD, assistant professor, department of biomechanics and associate director, nonlinear analysis core at the Center for Research in Human Movement Variability at the University of Nebraska at Omaha. (PAD is caused by a clogging of the arteries that supply the legs with blood; it is a risk factor for heart trouble, which is also due to clogged arteries.)

"Rather than thinking that this is just a sign of aging, it's not normal and it's better to speak to your doctor because even if you have a more serious health condition, early diagnosis is typically better." Also, know your status. This can help when potential red flags arise and allow you to start effective treatments faster.

Stumbling over the occasional crack in the sidewalk is normal. But don't write yourself off as clumsy if you have a regular habit of tripping.

"There can be a neurological undertone to tripping," explains Dr. Schwartz. "Diabetic neuropathy is commonand commonly under-diagnosed." As diabetes progresses the feet can become numb and a person may not feel temperature changes in their feet, or have a solid awareness of where their body is in space.

Eventually, this condition can become painful. Controlling blood sugar with exercise, healthy eating, and medication, if necessary, can reduce the risk of diabetic neuropathy.

If you're power-walking with fast feet and pumping arms, then you should get out of breath. If you're walking, even slowly, but it's uphill or upstairs, it's normal to end up huffing and puffing, too. But if you are walking slowly on flat terrain, or walking for just a short time before you start to feel breathless, that could be a warning sign that you have a heart or lung condition.

Many conditions can cause shortness of breath, including asthma or a respiratory infection. These conditions can make it tough to get enough oxygen. A common lung disease, chronic obstructive pulmonary disease, also known as COPD, also leaves those who have it at higher risk of falls, explains Yentes.

"You can do exercises such as pursed lip breathing to improve your lung function and be able to walk further or for longer periods," she says. "But you should speak with a doctor and start with pulmonary rehabilitation so you can start an exercise program in a safe environment."

A person who is feeling down, whether it's from sad or stressful moments in life or due to diagnosed clinical depression is going to walk just like they feel. "If they have depression, their posture may be stooped or slumped and their gait slower, says Dr. Gritz.

Of course, walking and other types of exercise are one of the best antidotes for depression and a 2012 study published in Mental Health and Physical Activity showed that regular walking can result in measurable clinical improvements.

"Exercise is definitely one of the non-pharmacological treatments I recommend for depression," explains Dr. Gritz. "In fact, we can tell when a patient is feeling better through these non-verbal indicatorsthey will tend to walk faster and with a lightness in their step."

So, how much should you walk? The U.S. Physical Activity Guidelines recommend that adults do at least 150 minutes to 300 minutes per week of moderate intensity exercise, or 75 to 150 minutes per week of moderate-to-vigorous intensity aerobic activity, preferably spread throughout the week. If you're just starting out, take it easier and shorter, and build up to longer harder sessions.

Before you start, make sure you have the best walking shoes for your feet.

Slideshow: Doctors reveal the real questions you should be asking them (The Healthy)

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What Your Walking Style Can Reveal About Your Health - msnNOW

"That's something we've talked about, building that culture and that toughness, knowing how to finish games," Crosby said. "We tell them it's a process and you have to trust the process. This is a setback, without having spring ball, but I think the kids will come back more hungry than before.

"I think it's going to impact everybody, all positions on the team. I think the skill guys are probably doing some things to get out there and play some backyard football and work on things. Hopefully they are being active. Kids are going to be kids and not stay in the house all day."

Crosby believes most teams will show signs of weakness or inexperience in the first part of the season, whenever high school games return.

"I think it will show up early, but come region time, you want to be ready," he said. "But, we might not start till we have region games.

"If we have non-region games, we will use the early games as preseason games. There are new challenges, changing regions and coming back to 3A. It's a tough region to be in, (Region 5) with Strom Thurmond and Gilbert and Brookland-Cayce and Swansea and Fox Creek. We will have to respond quickly and get things done."

There will be some sense of relief and a return to normal life when teams can get back to activities.

"Playing football is playing football, whether we get five or six games in, or a full season," Crosby said. "It's just having the opportunity to play, especially for our upcoming seniors who have put in the work before all this happened.

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COPING WITH CORONAVIRUS: O-W Bruins 'trying to keep in a football mindset' - The Tand D.com

ABSTRACT

There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that 20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity (1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 25 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success.

The perception of the general public is that no one ever succeeds at long-term weight loss. This belief stems from Stunkard and McLaren-Humes 1959 study of 100 obese individuals, which indicated that, 2 y after treatment, only 2% maintained a weight loss of 9.1 kg (20 lb) or more (1). More recently, a New England Journal of Medicine editorial titled Losing Weight: An Ill-Fated New Years Resolution (2) echoed the same pessimistic message.

The purpose of this paper is to review the data on the prevalence of successful weight loss maintenance and then present some of the major findings from the National Weight Control Registry (NWCR), a database of more than 4000 individuals who have indeed been successful at long-term weight loss maintenance.

Wing and Hill (3) proposed that successful weight loss maintainers be defined as individuals who have intentionally lost at least 10% of their body weight and kept it off at least one year. Several aspects of this definition should be noted. First, the definition requires that the weight loss be intentional. Several recent studies indicate that unintentional weight loss occurs quite frequently and may have different causes and consequences than intentional weight loss (4,5). Thus, it is important to include intentionality in the definition. The 10% criterion was suggested because weight losses of this magnitude can produce substantial improvements in risk factors for diabetes and heart disease. Although a 10% weight loss may not return an obese to a non-obese state, the health impact of a 10% weight loss is well documented (6). Finally, the 1-y duration criterion was proposed in keeping with the Institute of Medicine criteria (7). Clearly, the most successful individuals have maintained their weight loss longer than 1 y, but selecting this criterion may stimulate research on the factors that enable individuals who have maintained their weight loss for 1 y to maintain it through longer intervals.

There are very few studies that have used this definition to estimate the prevalence of successful weight loss maintenance. McGuire et al (8) reported results of a random digit dialing survey of 500 adults, 228 of whom were overweight or obese [body mass index (BMI) 27 kg/m2] at their maximum nonpregnant weight. Of these 228, 47 (20.6%) met the criteria for successful weight loss maintenance: they had intentionally lost at least 10% of their body weight and maintained it for at least 1 y. On average, these 47 individuals had lost 20.7 14.4 kg (45.5 lb; 19.5 10.6% from maximum weight) and kept it off for 7.2 8.5 y; 28 of the 47 had reduced to normal weight (BMI <27 kg/m2).

Survey data such as these have the perspective of a persons entire lifetime and thus may include many weight loss attempts, some which were successful and some unsuccessful. It is more typical to assess success during one specific weight loss bout. In standard behavioral weight loss programs, participants lose an average of 710% (710 kg) of their body weight at the end of the initial 6-mo treatment program and then maintain a weight loss of 56 kg (56%) at 1-y follow-up. Only a few studies have followed participants for longer intervals; in these studies, 1320% maintain a weight loss of 5 kg or more at 5 y. In the Diabetes Prevention Program (9), 1000 overweight individuals with impaired glucose tolerance were randomly assigned to an intensive lifestyle intervention. The average weight loss of these participants was 7 kg (7%) at 6 mo; after 1 y, participants maintained a weight loss of 6 kg (6%), and, at 3 y, they maintained a weight loss of 4 kg (4%). At the end of the study (follow-up ranging from 1.8 to 4.6 y; mean, 2.8 y), 37% maintained a weight loss of 7% or more.

Thus, although the data are limited and the definitions varied across studies, it appears that 20% of overweight individuals are successful weight losers.

Although it is often stated that no one ever succeeds in weight loss, we all know some people who have achieved this feat. In an effort to learn more about those individuals who have been successful at long-term weight loss, Wing and Hill (10) established the National Weight Control Registry in 1994. This registry is a self-selected population of more than 4000 individuals who are age 18 or older and have lost at least 13.6 kg (30 lb) and kept it off at least 1 y. Registry members are recruited primarily through newspaper and magazine articles. When individuals enroll in the registry, they are asked to complete a battery of questionnaires detailing how they originally lost the weight and how they now maintain this weight loss. They are subsequently followed annually to determine changes in their weight and their weight-related behaviors.

The demographic characteristics of registry members are as follows: 77% are women, 82% are college educated, 95% are Caucasian, and 64% are married. The average age at entry to the registry is 46.8 y. About one-half of registry members report having been overweight as a child, and almost 75% have one or two parents who are obese.

Participants self-report their current weight and their maximum weight. Previous studies suggest that such self-reported weights are fairly accurate (slightly underestimating actual weight) (11,12). In the NWCR, participants are asked to identify a physician or weight loss counselor who can provide verification of the weight data. When, in a subgroup of participants, the information provided by participants was compared with that given by the professional, the self-report information was found to be very accurate.

Participants in the registry report having lost an average of 33 kg and have maintained the minimum weight loss (13.6 kg) for an average of 5.7 y. Thirteen percent have maintained this minimum weight loss for more than 10 y. The participants have reduced from a BMI of 36.7 kg/m2 at their maximum to 25.1 kg/m2 currently. Thus, by any criterion, these individuals are clearly extremely successful.

Previously, we reported information about the way in which registry participants lost their weight (10); interestingly, about one-half (55.4%) reported receiving some type of help with weight loss (commercial program, physician, nutritionist), whereas the others (44.6%) reported losing the weight entirely on their own. Eighty-nine percent reported using both diet and physical activity for weight loss; only 10% reported using diet only, and 1% reported using exercise only for their weight loss. The most common dietary strategies for weight loss were to restrict certain foods (87.6%), limit quantities (44%), and count calories (43%). Approximately 25% counted fat grams, 20% used liquid formula, and 22% used an exchange system diet. Thus, there is variability in how the weight loss was achieved (except that it is almost always by diet plus physical activity).

The earliest publication regarding the registry documented the behaviors that the members (n = 784) were using to maintain their weight loss (10). Three strategies were reported very consistently: consuming a low-calorie, low-fat diet, doing high levels of physical activity, and weighing themselves frequently. Recently, a fourth behavior was identified: consuming breakfast daily (13). Each of these behaviors is described below. Registry members reported eating 1381 kcal/d, with 24% of calories from fat. In interpreting their data, it is important to recognize that 55% of registry members report that they are still trying to lose weight and to consider that dietary intake is typically underestimated by 2030%. Thus, registry members are probably eating closer to 1800 kcal/d. However, even with this adjustment, it is apparent that registry members maintain their weight loss by continuing to eat a low-calorie, low-fat diet.

More recently, we have examined other aspects of their diet. Of particular interest is the fact that 78% of registry members report eating breakfast every day of the week (13). Only 4% report never eating breakfast. The typical breakfast is cereal and fruit. Registry members also report consuming 2.5 meals/wk in restaurants and 0.74 meals/wk in fast food establishments.

Another characteristic of NWCR members is high levels of physical activity. Women in the registry reported expending an average of 2545 kcal/wk in physical activity, and men report an average of 3293 kcal/wk (10). These levels of activity would represent 1 h/d of moderate-intensity activity, such as brisk walking. The most common activity is walking, reported by 76% of the participants. Approximately 20% report weight lifting, 20% report cycling, and 18% report aerobics.

Registry members also reported frequent monitoring of their weight (10). More than 44% report weighing themselves at least once a day, and 31% report weighing themselves at least once a week. This frequent monitoring of weight would allow these individuals to catch small weight gains and hopefully initiate corrective behavior changes.

The vigilance regarding body weight can be seen as one aspect of the more general construct of cognitive restraint (ie, the degree of conscious control exerted over eating behaviors). Registry members are asked to complete the Three Factor Eating Inventory (14), which includes a measure of cognitive restraint. Registry members scored high on this measure (mean of 7.1), with levels similar to those seen in patients who have recently completed a treatment program for obesity, although not as high as eating-disordered patients. These findings suggest that successful weight loss maintainers continue to act like recently successful weight losers for many years after their weight loss.

Registry participants are followed over time to identify variables related to continued success at weight loss and maintenance. Findings from the initial follow-up study (15) indicated that, after 1 y, 35% gained 2.3 kg (5 lbs) or more (7 kg on average), 59% continued to maintain their body weight, and 6% continued to lose weight.

Participants who regained weight (>2.3 kg) were compared with those who continued to maintain their body weight to examine whether there were any baseline characteristics that could distinguish the two groups. The single best predictor of risk of regain was how long participants had successfully maintained their weight loss (Table 1). Individuals who had kept their weight off for 2 y or more had markedly increased odds of continuing to maintain their weight over the following year. This finding is encouraging because it suggests that, if individuals can succeed at maintaining their weight loss for 2 y, they can reduce their risk of subsequent regain by nearly 50%.

Duration of weight loss maintenance and 1-y risk of weight regain among successful weight losers1

Duration of weight loss maintenance and 1-y risk of weight regain among successful weight losers1

Another predictor of successful weight loss maintenance was a lower level of dietary disinhibition, which is a measure of periodic loss of control of eating. Participants who had fewer problems with disinhibition [ie, scores <6 on the Eating Inventory subscale (14)] were 60% more likely to maintain their weight over 1 y. Similar findings were found for depression, with lower levels of depression related to greater odds of success. These findings point to the importance of both emotional regulation skills and control over eating in long-term successful weight loss.

Several key behavior changes that occurred over the year of follow-up also distinguished maintainers from regainers. Not surprisingly, those who regained weight reported significant decreases in their physical activity, increases in their percentage of calories from fat, and decreases in their dietary restraint. Thus, a large part of weight regain may be attributable to an inability to maintain healthy eating and exercise behaviors over time. The findings also underscore the importance of maintaining behavior changes in the long-term maintenance of weight loss.

Another variable that has been examined in the registry is the presence of a triggering event leading to participant successful weight loss. Most registry participants reported a trigger for their weight loss (83%). Medical triggers were the most common (23%), followed by reaching an all time high in weight (21.3%), and seeing a picture or reflection of themselves in the mirror (12.7%).

Because medical triggers have been shown to promote long-term behavior change in other areas of behavioral medicine (16), we examined whether individuals who reported medical triggers were more successful than those who reported nonmedical triggers or no triggers. A medical trigger was defined broadly and included, for example, a doctor telling the participant to lose weight and/or a family member having a heart attack. Findings indicated that people who had medical reasons for weight loss also had better initial weight losses and maintenance (17). Specifically, those who said they had a medical trigger lost 36 kg, whereas those who had no trigger (17.1%) or a nonmedical trigger (59.9%) lost 32 kg. Medical triggers were also associated with less regain over 2 y of follow-up. Those with medical triggers gained 4 kg (2 kg/y), whereas those with other or no medical triggers gained at a significantly faster rate, averaging 6 kg in both groups.

These findings are intriguing because they suggest that the period following a medical trigger may be an opportune time to initiate weight loss to optimize both initial and long-term weight loss outcomes.

The topic of dieting consistency was also recently examined in the registry. Participants were asked whether they maintained the same diet regimen across the week and year, or if they tended to diet more strictly on weekdays and/or nonholidays (18). Few people said they dieted more strictly on the weekend compared with the rest of the week (2%) or during holidays compared with the rest of the year (3%). Most participants reported that their eating was the same on weekends and weekdays (59%) and on holidays/vacations and the rest of the year (45%). The remaining groups reported that they were stricter during the week than on weekends (39%) and during nonholiday times compared with holidays (52%).

We evaluated whether maintaining a consistent diet was related to subsequent weight regain after 2 y. Interestingly, results indicated that participants who reported a consistent diet across the week were 1.5 times more likely to maintain their weight within 5 lb over the subsequent year than participants who dieted more strictly on weekdays. A similar relationship emerged between dieting consistency across the year and subsequent weight regain; individuals who allowed themselves more flexibility on holidays had greater risk of weight regain. Allowing for flexibility in the diet may increase exposure to high-risk situations, creating more opportunity for loss of control. In contrast, individuals who maintain a consistent diet regimen across the week and year appear more likely to maintain their weight loss over time.

We also examined different patterns of weight change among registry participants followed over time. We were particularly interested in evaluating whether participants who gained weight between baseline and year 1 were able to recover over the subsequent year. We found that few people (11%) recovered from even minor lapses of 12 kg. Similarly, magnitude of weight regain at year 1 was the strongest predictor of outcome from year 0 to 2. Participants who gained the most weight at year 1 were the least likely to re-lose weight the following year, both when recovery was defined as a return to baseline weight or as re-losing at least 50% of the year 1 gain.

Although participants gained weight and recovery was uncommon, the regains were modest (average of 4 kg at 2 y), and the vast majority of participants (96%) remained >10% below their maximum lifetime weight, which is considered successful by current obesity treatment standards.

These findings, nonetheless, suggest that reversing weight regain appears most likely among individuals who have gained the least amount of weight. Preventing small regains from turning into larger relapses appears critical to recovery among successful weight losers.

Results of random digit dial surveys indicate that 20% of people in the general population are successful at long-term weight loss maintenance. These data, along with findings from the National Weight Control Registry, underscore the fact that it is possible to achieve and maintain significant amounts of weight loss.

Findings from the registry suggest six key strategies for long-term success at weight loss: 1) engaging in high levels of physical activity; 2) eating a diet that is low in calories and fat; 3) eating breakfast; 4) self-monitoring weight on a regular basis; 5) maintaining a consistent eating pattern; and 6) catching slips before they turn into larger regains. Initiating weight loss after a medical event may also help facilitate long-term weight control.

Additional studies are needed to determine the factors responsible for registry participant apparent ability to adhere to these strategies for a long period of time in the context of a toxic environment that strongly encourages passive overeating and sedentary lifestyles.

RRW is the cofounder of the National Weight Control Registry (with James O Hill). RRW coauthored the manuscript with SP, who is a coinvestigator of the National Weight Control Registry. RRW and SP have no financial or personal interest in the organizations sponsoring this research.

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Long-term weight loss maintenance | The American Journal ...

There are a lot of mobile apps and other tools for tracking your weight loss, but do you always have your phone with you at the time that you typically check your weight each day? I don't. That is one of the reasons I created this printable weight loss log. You can print it out and keep it in a bathroom drawer (along with a pen or pencil).

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If you do not have Excel, or do not need to customize the weight loss log, you can download one of the 2 printable weight loss logs below in PDF format.

The logs include columns for recording your weight, the amount of time you've exercised (the 'Exe' column), and the number of calories consumed during the day (the 'Cal' column). The difference between the male and female version is only what measurements are listed.

For: Excel 2007 or later & Excel for iPad/iPhone

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"No installation, no macros - just a simple spreadsheet" - by Jon Wittwer

This weight loss log worksheet provides a simple way to record your weight each day. It is designed to be printed and folded along the center and middle so that you can keep it in a cabinet in your bathroom or wherever it is that you weigh yourself.

Disclaimer: The worksheet and information on this page should not be treated as medical advice. You should seek the advice of qualified professionals regarding medical, fitness, and health decisions.

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Printable Weight Loss Log - Vertex42.com

Eating healthy can feel like torture in the country that's home to the Crunchwrap Supreme.

Dieting is expensive. Working out is time consuming. On top of all that, weight loss can be somewhat of an uphill battle for people with genetic predispositions to obesity.

Yet if your social media feed is anything like mine, it's replete with inspirational images of couples teaming up to lose weight together and killing it.

Enlisting a significant other in your weight loss plans could be a great way to help ensure your success, but only if your partner is just as committed as you are, recent research suggests. Conversely, if they struggle to lose weight, your performance may take a similar dive.

Amy Gorin, a professor of behavioral psychology at the University of Connecticut and the lead author of a new study on these impacts, calls this the "ripple effect."

Lisa Creech Bledsoe / Flickr "When one person changes their behavior, the people around them change,"Gorinsaid in a statement.

The study was funded by Weight Watchers, which merits some skepticism. Still, it's one of the first of its kind to use a randomized, controlled design in its study approach, which lends some heft to its findings.

It is also not the first study to come to these types of conclusions.

A 2008 study Gorin published in the International Journal of Obesity (which did not receive Weight Watchers money) reached a similar finding. That paper was actually the first to use the term "ripple effect" to describe how social networks could impact weight loss.

For her most recent study, which involved 130 overweight or obese couples age 25 or older, Gorin and her team found that when one member of a couple lost weight, it significantly raised the chances that the other partner would too even if that partner wasn't actively participating in any weight loss program. Similarly, when one partner struggled to slim down, it made it more likely for the other person to have problems as well.

To come to these conclusions, Gorin split the couples into two groups. In one group, one partner joined Weight Watchers. For six months, they got in-person counseling and a host of online tools to help them lose weight. In the other group, one partner got only a printed handout on healthy eating, exercise, and weight-control strategies.

After six months, a third of the untreated partners in the study lost 3% or more of their initial body weight, a figure that dietitians consider a sizeable benefit. These people participated in no weight loss program at all; only their significant others did. Half of them used Weight Watchers, the other half used an approach of their own.

In other words, it didn't matter if the partner who was trying to lose weight participated in Weight Watchers or not. All that mattered was that they were trying to lose weight.

"Whether the patient works with their healthcare provider, joins a community-based, lifestyle approach like Weight Watchers, or tries to lose weight on their own, their new healthy behaviors can benefit others in their lives," Gorin said.

Originally posted here:
Couples may help or hinder each other's weight loss goals ...

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