Anyone who has experienced significant weight loss must then face what may be the real challenge, keeping the weight off. The most important factor, I believe, is setting attainable goals. If you try to do something that is too difficult, then you will not be able to do it for any sustained period of time. I believe that finding a realistic, doable approach that works for you is the key element in keeping off the weight you have lost. In listing my recommendations below, I classify each as:
Focus on numbers 1 and 2 and see what can realistically be done to move a number 3 down to a number 2.
First, the easy ones eat breakfast daily. Avoiding this meal is a natural, yet wrong approach that many people use. It might seem that if you are not really hungry for breakfast and you eat less by skipping a meal that cannot hurt, but skipping breakfast or any other meal is a terrible strategy that has been shown time and time again to undermine the effort to keep off the weight you have lost. Your body is pretty smart and if you skip a meal, you will more than make up for it later. Again, this is an easy commitment you can make, just do it.
Next, weigh yourself regularly. Another easy one, there is nothing to it, just commit yourself to getting on the scale at least once per week. This forces you into confronting the reality of regaining any of the weight you have lost. If you avoid facing a small amount of weight gain, you let things slip away until you have gained back so much weight it becomes discouraging to do anything about it.
Next to number 2, not too hard. Walking for exercise. Exercise is one of those things dieters do when they are in a highly motivated weight reduction phase and then they quit. Using a treadmill or other equipment at a gym involves a membership and changing in clothes, schedule, interruptions, etc. If you can walk, you can exercise. You need not suit up and go anywhere special to do this. Your body does not know if you are walking down your block, in a mall or on a trail in the countryside. Consistency is the key and continuing to do a moderate amount of exercise by walking is probably the most important single thing in keeping weight off.
Next, number 3, too hard. The hardest thing of all, of course, is never eating the fattening foods you love to eat in excess, which got you into all that trouble to begin with. The most realistic approach to number 3 is doing numbers 1 and 2. You will not want to waste the effort of the number 1s and the number 2s. There are so many approaches to the diet itself and there is no magic for anyone. Do not expect, or even try too hard, to avoid foods that you will probably never completely eliminate. That will set you up to fail when you do eat them. Eat them occasionally and follow a generally low-fat, low-sugar diet. Combining that with doing our easier suggestions winds up being the most realistic approach to keeping off the weight you have tried so hard to lose.
Henry C. Sobo, MDInternal Medicine
Stanford, Connecticut
Certified, American Society of Bariatric Physicians