ADULT OBESITY
A Resource from the American College of Preventive Medicine

A GUIDE FOR PATIENTS
Simple Steps to Healthy Fat Loss

When it comes to "weight” loss or "weight” gain, one thing is for certain … the calorie is king.  Calories, or kcals as they are often referred to, are a measure of energy. 

• We consume energy as food and drink.
• Our body uses some of this energy for all of its processes, like digestion, cell repair, etc.
• We use energy for everything we do.
• Energy that is not needed is primarily stored in fat cells.

The amount of energy we store in fat cells is an important part of our body weight.  But, it is important to remember that about half of the weight of our body is water.  When we speak of healthy "weight” loss, we really mean fat loss.

The first principle of fat loss is:  Forget about diets and dieting.  Instead, focus on healthy eating -- increase whole grains, legumes, vegetables, and fruits and reduce the amount of high-fat, high-cholesterol-containing meat, dairy, and eggs that you consume.

The second principle of fat loss is:  The amount of fat we store is related to the balance between the calories we consume and the calories we use as energy.  It’s like a balance scale – "calories in” on one side, "calories out” on the other side. 

To reduce fat stored, all we have to do is tip the balance the other way by taking in fewer calories than we use during the average day.   Sounds simple enough, but we all know that it is not simple when we try to do it. 

We have a couple of things working against us.  First, our body is designed to favor fat storage.  It’s a survival mechanism because food has never been so readily available as it is today.  When we eat less, our metabolism slows down so we burn fewer calories.  Eating a smaller amount of food is not the answer.  Second, for every pound we lose, our body needs a few less calories to function and move.   So, each pound of weight loss becomes a little harder. 

The reality is sobering.  Having too much fat stored in your body contributes to a lot of health problems, including most chronic diseases.  It often shortens life, and it makes life harder and sometimes less enjoyable if you have to give up things you used to enjoy.

Finally – the good news! 

• First, losing fat is about a healthier lifestyle that you live every day.  It’s about learning to eat healthier and becoming more active -- small changes that really do add up. 
• Second, and most important, you don’t have to lose a lot of fat weight to have a big impact on your health.  A 5-10% weight loss from fat can reduce your blood pressure and blood sugar levels and improve your cholesterol, and may even get you off some prescription medicines.  5-10% isn’t much: if you weigh 200 pounds, it’s just 10 to 20 pounds. 
• Third, your healthier lifestyle will have many other benefits beyond losing a few pounds, and you will feel better and everything will be just a little easier to do.  

So, how do we get started? 

The Simple Steps to Losing Fat

1. Make a commitment to yourself.  Do this in writing, like a contract to yourself.  List the reasons you want to lose weight once and for all.  After you have completed the next three steps, add them to your personal contract.  Write down your beginning weight and a few measurements if you’d like (e.g., waist, thighs). 
2. Keep a food and activity diary for a few days.  Try to write down everything you eat, and if possible the situation (e.g., breakfast at home, watching TV, etc).  Track your physical activity too -- time spent walking, sitting, lying, other physical activity.  Ask your doctor for a log to do this, or where you could get one. 
3. Reflect on your current lifestyle.  Write down some things that make lifestyle changes challenging (e.g., travel, friends, injuries, etc).  Think about ways to handle these challenges.  Identify a few opportunities that you may have that could help.  
4. Set a few short-term goals for actions, not pounds.  They must be realistic, specific and something that you know you can do.  Set one goal for increasing physical activity and one for cutting a few calories.  For example, aim to walk 15 minutes three days next week and cut down on sodas at work from three to two (have water instead).  Establish specific rewards for achieving goals.
5. Talk to your doctor about your plans.  Ask about health risks that your weight may be causing and ask for advice to help you reach your goals. 
6. Find some support.  A friend or family member to share your plans, perhaps join you in your journey.
7. Continually "check in” with yourself to monitor progress.  Revisit your goals weekly, or at least every two weeks.  Evaluate what is working and what is not.  Adjust your goals and plans as necessary.  Add new goals as you continue on your journey.  Reward yourself for success; accept setbacks as part of the process.  Be patient.  Gradual weight loss is more likely to be lasting. 
8. Ask your doctor about resources and programs that could help you.This would include health educators and dieticians, as well as scientifically-based weight-loss support programs that are available in your community. 

Remember that you are on a lifelong journey to better health.  It becomes an attitude about life.  Just thinking more about what you eat, looking for opportunities to be a little more active, and being more optimistic about being more in control of your body will carry you a long way toward a healthier weight. 

Click here to download a printable version of the Adult Obesity Patient Guide.

For more information on these steps, as well as links to other useful websites, visit the American College of Preventive Medicine website at www.acpm.org.

Copyright 2009 American College of Preventive Medicine. All Rights Reserved