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On January 30, visitors to Lifespan.org received online advice about weight loss from Rena Wing, PhD, director of the Weight Control & Diabetes Research Center at The Miriam Hospital. Below are excerpts from the chat. Moderator: Welcome to today's Doc Chat with Rena Wing, PhD, weight researcher at The Miriam Hospital and founder of the National Weight Control Registry. Dr. Rena Wing: Let me begin by introducing myself. I am Rena Wing, the director of the Weight Control & Diabetes Research Center at The Miriam Hospital. The center is involved in a large number of research studies designed to develop more effective weight loss programs. These programs are free and open to the general public. Each study has different entry criteria, so you need to call our program and fill out some information and we will see if you qualify for any of our programs. gaf321: Hello, Dr. Wing. What is the best way for someone who is serious about losing weight and getting fit to go about it. Break into exercising? Change eating habits? Dr. Rena Wing: The best approach is with a combination of diet and exercise. While exercise is important, it is very important to start slowly. gaf321: Do you feel that for a person who hasn't exercised regularly to use walking 2 miles per day would be sufficient for weight loss? Dr. Rena Wing: Start slowly and build up. Two miles a day is a very good goal. Some of our most recent research suggests that successful weight losers eventually work up to even higher levels. We have different programs available at our center, including programs for individuals with diabetes and those who need help maintaining weight loss. For more information, you can call us at 401-793-5599 or visit www.weightresearch.org. We know a lot about how people who are most successful at weight loss accomplish this feat. They eat a low-calorie, low-fat diet and exercise a lot. Have any of you tried to change your eating or exercise? gaf321: How do you feel about substituting meals (breakfast or lunch) with Slim Fast? ncawley: Dr. Wing - I eat a low-fat, fairly low-carbohydrate diet, and exercise 4-5 times per week, including cardio and weights. I have lost 34 pounds in the last year, and still need to lose more, but seem to be stalled now. Can you recommend something? Dr. Rena Wing: Gaf321, we find it helpful to use any type of structured eating that makes it simpler to eat well, including Slim Fast or Lean Cuisine, or other structured approaches to eating. Dr. Rena Wing: Ncawley, as you lose weight it becomes necessary to further change your energy balance, so it may take further increases in exercise or decreases in food. ncawley: OK, thank you! gaf321: I have tried many diets from fad to healthy over the course of my 25 years of being overweight and find that the biggest challenge is being able to remain focused after the first week or two. Dr. Rena Wing: Gaf321, some people find they can lose weight on their own, but others need a program to help them stay motivated. Dr. Rena Wing: Have you recently been as careful about your diet as you were in the beginning? gaf321: Not recently. I have made some minor changes since the holidays but definitely need to be much more structured. Dr. Rena Wing: There are a lot of good programs available. You certainly can contact us as one possibility. ncawley: If your question was to me, absolutely! I allow myself some indulgences, but few and far between. gaf321: I have tried a weight loss program through Rhode Island Hospital many years ago, it was the liquid diet and did quite well. However, over the past 10 years have not been on a structured weight loss program. My plan is to call the phone number you have given and see what the options are. Dr. Rena Wing: Ncawley, sometimes when you hit plateaus it's because the number of indulgences has increased, so just double-check your eating. ncawley: I will do that, and will definitely keep this in mind! Thanks again! Dr. Rena Wing: What do all of you think is the hardest part of losing weight and maintaining it? gaf321: For me, it is getting motivated enough to start. Dr. Rena Wing: Gaf321, most people identify something that "triggers" them to lose weight--like a health problem or an upcoming event. ncawley: Going out to eat is definitely a problem when you're dieting! Mercedes: Dr. Wing -- I am a 23 year old woman who hates to exercise and has no motivation to begin an exercise program. Without exercise, approximately how many calories should I consume in a day to lose weight at a healthy rate? I am currently trying to limit myself to 1200-1400 calories a day. Is this too much/too little? Thanks. Dr. Rena Wing: Mercedes, we recommend you aim to lose 1-2 pounds a week. 1200-1400 calories per day sounds about right, however, I would strongly encourage you to combine diet and exercise. gaf321: Dr. Wing: Sounds good. At this point I have no health problems but will focus on preventive measures. Dr. Rena Wing: The single best predictor of long term maintenance of weight loss is physical activity. Mercedes: Thanks, Dr. Wing. I will try to increase my activity. I used to walk a lot, so maybe I'll try that again. Dr. Rena Wing: Ncawley said going out to eat is a problem. The big portions served can make dieting difficult. What strategies work for you all when you are eating out? ncawley: I TRY to do low-fat, and bring home leftovers... but sometimes the menu is just too tempting! gaf321: Would walking be considered enough physical activity for a person who hasn't exercised? Enough to lose weight? Dr. Rena Wing: Walking is a terrific form of exercise for weight
loss. It burns a lot of calories because you are carrying a heavy weight
(your body) over a distance. gaf321: I always eat a small salad before my meal without dressing which fills me a bit so I don't eat the entire main course. Dr. Rena Wing: Starting with a salad or low-fat soup can be
helpful. You can even order without looking at the menu--it keeps you from
being so tempted. Mercedes: If I know I'll be eating out, I limit what I eat for the rest of the day. I try very hard not to finish everything on my plate and if I have dessert, I try to split it with someone. Dr. Rena Wing: Mercedes, those are good strategies. Do any of you choose specific restaurants because they have healthier items? Dr. Rena Wing: I have a registry of individuals who have lost
weight successfully. On average, they have lost more than 60 pounds and
kept it off more than 6 years. They report eating a low-calorie, low-fat
diet with less than 24% of calories from fat. They all eat breakfast
regularly! This is interesting because many dieters try to skip breakfast.
The successful weight losers also do a lot of physical activity, almost an
hour a day. ncawley: Dr. Wing, what is your best diet recommendation in terms of types of food - do you believe the food pyramid should be followed, or that carbohydrates should be limited? Dr. Rena Wing: Ncawley, I feel strongly that it is most important to limit your fat intake to lose weight. Fat is fattening. There are some popular diets that limit carbohydrates, but I do not recommend them for long-term weight loss. In our successful weight losers, very few eat a low-carbohydrate diet. They eat a low-calorie, low-fat diet. ncawley: Understood! I actually did the Atkins diet a few years ago, lost about 15 pounds in a very short time span, and gained it all back and then some! The only thing that seems to have worked is a strong dedication to exercise, and low-fat diet. Dr. Rena Wing: You hit it on the head! The Atkins diet produces fast weight loss, but it is mainly water loss. We recommend low-fat, low-calorie for long-term weight control. ncawley: gaf321 - a helpful hint in starting physical activity - have a partner - it's motivational and you feel guilty if you don't go and let someone else down! Sue: Dr. Wing, are there any dietary suppressants that are safe? I have noticed many "natural" supplements being advertised now. Dr. Rena Wing: Sue, I would caution you to be very wary of natural supplements. Most have no data to support their efficacy. Some may actually not be safe. There are two FDA-approved weight loss medications. These would be recommended only for individuals who are significantly overweight. Dr. Rena Wing: We are offering several programs that may interest you. We have a program for people with diabetes. We have an Internet program. For information about our programs, call 401-793-5599 or log on to www.weightresearch.org. Sue: Speaking of getting a partner...we just adopted a dog...I have lost 2 lbs. in 5 days, just from all the extra walking I am now doing! Dr. Rena Wing: Sue, exercising with a dog is a great way to be active. Good for you and good for the dog! Dr. Rena Wing: Someone asked about the Food Guide Pyramid. This
emphasizes a high intake of grain products and decreased consumption of
high-fat foods. It fits very well with my general suggestion to try to
limit dietary fat. Be careful to watch portion sizes. Too much of anything
is fattening. guitar179: what about this stuff I have heard of called "hydroxycut" and also pills that stop your body from absorbing carbohydrates? What do you think of those? Dr. Rena Wing: Guitar, there are pills that stop your body from absorbing some of the fat you eat. They are useful for people with significant weight problems. The name is Xenical (or Orlistat).) guitar179: have you heard of the ones that stop your body from absorbing carbs? I don't eat much fat at all, just carbs. And I was wondering if those are safe and effective? Example is "Carbblocker." Dr. Rena Wing: Guitar, there is no research on the medications you're mentioning, so I would be careful. Dr. Rena Wing: Many foods are now labeled as "no fat" foods. However, check the calories on these. Sometimes a low-fat or no-fat food still has a lot of calories. Emmy: Hello, doctor. Dr. Rena Wing: Emmy, hello -- what questions do you have about weight loss? Emmy: Are there any genetic issues that would inhibit weight loss? Dr. Rena Wing: Yes--obesity definitely has a genetic component. Some may lose weight more easily than others, but everyone CAN lose weight. guitar179: Thanks. Also my other question was that I was wondering if there were any foods that could "boost metabolism." I know how to eat healthy and do, but seem to just sit at the same weight. Dr. Rena Wing: Guitar, there are no foods that boost metabolism. You seem to be looking for "a magic bullet." Unfortunately, the only magic bullet is eating less and exercising more. Emmy: How would you find out if you have a genetic issue? Dr. Rena Wing: Emmy, we don't know what genes are related to obesity. However, we do know that everyone can lose weight. Emmy: Thank you, doctor. Dr. Rena Wing: In my registry of successful weight losers, most had a strong genetic predisposition to obesity, but they were able to succeed anyway. guitar179: I guess it may seem that way, it's just that I exercise every day and eat a low calorie healthy diet, extremely low in sugar and fat, and I don't seem to lose any weight or body fat. Emmy: I have another question--as I age my body mass decreases but my weight stays the same; how do I compensate for that? Dr. Rena Wing: Emmy, you may be suggesting that your metabolism is decreasing with age (which it does), or that you are losing bone mass. Exercise can help with these. gaf321: My primary care physician mentions the genetic factor in losing weight as well. She did mention that a medication is being researched for people who have that problem. Do you know anything about new research in that area? Dr. Rena Wing: Guitar, I know that can be frustrating. Sometimes people are eating more than they think they are, so checking portion sizes may help you. gaf321: Are there guidelines for portion size? Dr. Rena Wing: Gaf321, what I recommend is getting a book that
indicates the calories and fat in given portions of foods. Then you can
figure out how many calories and fat grams are in the foods that you are
eating. Emmy: What are you lacking in your diet if you get leg cramps? Dr. Rena Wing: Emmy, for health problems I recommend you check with your primary care physician. gaf321: Thank you Dr. Wing, you have been very helpful. Dr. Rena Wing: If you need further assistance with weight loss, we have programs available at the Weight Control and Diabetes research center. These programs are free and open to the general public. Call us for more information at 401-793-5599 or visit us at www.weightresearch.org. Dr. Rena Wing: We only have a few more minutes--any more questions before we conclude? Emmy: For a child 10 years old, 5 foot 5 and 180 pounds, what should her calorie intake be and are there any programs for children through Lifespan? Is Weight Watchers okay for a 10-year-old? Dr. Rena Wing: I recommend a program through Lifespan that is
run by Dr. Elissa Jelalian. For more information, call the Lifespan Health
Connection at 401-444-4800. Emmy: Thank you, doctor. Dr. Rena Wing: Thanks, everyone, for chatting with us. For more information about weight loss programs available through the Weight Control and Diabetes Research Center, call 401-793-5599 or visit our Web site at www.weightresearch.org. Moderator: This concludes today's Lifespan Doc Chat with Rena Wing, PhD. Thanks for participating. Check Lifespan.org for chat transcripts and more information about weight loss. Find out more: |
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