Keeping It Off Forever

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Beverly's lost 29 pounds, and now she's smiling like the cat who just swallowed the (low-fat) canary. She has boundless reserves of energy, she looks terrific in shorter skirts and though she's been slowly losing for seven months, the compliments are still trickling in. She even gets an appreciative wolf whistle from her husband every now and then.

Beverly's a happy woman, no question, but she's also a little scared. After all, she's reached this stage before, and she wasn't able to maintain her weight loss then. In fact, when she regained her weight she put back even more than she had taken off. (Sound familiar?) Her determination is high at the moment, but will it last?

Meeting the Biggest Challenge

The truth is, Beverly's right to be concerned. Any diet veteran will tell you the same thing: Weight loss is simple. Weight maintenance is much tougher. For one thing, after the initial euphoria dies down, real life inevitably intrudes.

"In the beginning, there are a lot of factors helping to keep you motivated, such as getting compliments as you lose weight," says Susan Zelitch Yanovski, M.D., an obesity expert at the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland. "But as time goes on, people stop commenting on how good you look, and there might be stress at work, or family problems--things that happen day to day. It's very difficult to keep up that level of motivation over a lifetime without some reinforcements."

"What works today doesn't necessarily work tomorrow," adds Joyce D. Nash, Ph.D., a clinical psychologist in the San Francisco Bay area and the author of several books on weight maintenance, including Now That You've Lost It: How to Maintain Your Best Weight. "Our health changes, our metabolism changes. And we always have to adjust to transitions in life: going off to college, which is often a source of weight gain, especially for females, or having a first child, or divorce, or menopause. Life changes can impact our weight level, so we must constantly adapt to our environment."

Saying No to the Yo-yo

If in the past "handling" life changes has usually meant pigging out, that's out. Forget falling back on your "Oh, well, I can always lose it next time" excuses. The diet yo-yo is a no-no. Why?

Researchers have discovered that there may be negative health consequences of having fluctuating weight. That was the conclusion reached by Kelly D. Brownell, Ph.D., a Yale University psychologist and obesity expert who reported the results of a 32-year study on weight fluctuations and their consequences.

What's more, if it seems as though it gets harder and harder to drop the weight each time you try, you're right. That's because whenever you lose weight, you lose fat and some lean muscle mass; whenever you regain weight, you add only fat. As a result, with each subsequent diet effort, you're struggling with even more tough-to-shed fat than you had the last time around.

It may also be psychologically stressful to be on and off (and on and off) diets. Which is why Dr. Brownell insists, "People should not undertake a diet unless they are really ready not just to lose the weight but to keep it off indefinitely."

Weight-Loss Winners: What's Their Secret? Some people shed pounds and keep them off, seemingly with ease, while others struggle for a lifetime to maintain their ideal weight. How do you separate the winners from the, er, gainers diet-wise? "In my research, I've looked at the differences between successful maintainers and those who relapse at one time or another, and I have found two significant differences in the way the maintainers think," explains Joyce D. Nash, Ph.D., a clinical psychologist in the San Francisco Bay area and the author of Now That You've Lost It: How to Maintain Your Best Weight. "First, they stay aware of what they're doing. They don't go 'unconscious' or on 'automatic pilot.' " Which means they know just when they're about to have more pasta than is good for them, or that they need to get back to their walking program. "Those who don't maintain their weight use denial--'It won't hurt me to have it this one time'--or a variety of excuses," says Dr. Nash. "This gives them permission to engage in behaviors that undo their weight-loss success." Successful maintainers have a set of guiding principles they refer to on a regular basis, says Dr. Nash. "People need guiding principles to hold the decision power for them. Things like, 'I don't eat that' or 'I want to stay away from too many fat calories.' The diet or program you're following usually defines the rules for you. This is a strategy that shifts your attention away from the immediate situation to a superior set of values." Having an established set of values that you refer to regularly will remind you of the goals you're trying to achieve, and help keep you on target.

Strategies for Success

So assuming you're in the process of accomplishing mission number one--weight loss--and are about ready for mission number two--weight maintenance--there's something you should know. That is: While it'll be a challenge, it will not be a mission impossible. Look around. People do manage to shed pounds and keep them off, and you can join that select and slender club!

The key to successful weight maintenance: commitment to a new, slimmer way of life. We all say we want to be thin, and most of us are committed enough to do what's needed to lose that extra weight. But unless we're ready to permanently change those habits and attitudes that got us overweight in the first place, we're likely to see those pounds creep back on.

A tall order, but you can do it! Just follow these steps for a forever-
slim body.

Get real about your weight goal. If you're aiming for a weight that's too low for your height and build, or if you come from a family of big people, or if you are over 50 and have been heavy for some time, getting to and remaining at your goal weight may be a constant struggle. Keep all these factors in mind as you fine-tune your goal.

"Once you establish a weight that's both healthy and one you can live with, you have your target," says Dr. Nash. "It's actually a range; for example, my healthy range is 128 to 140 pounds. If you maintain your weight within an appropriate range, you'll avoid a major relapse, and I don't consider movement within the range a major relapse."

Sound the three-pound alarm. Indeed, you'll never have a major relapse if you sound what Dr. Nash calls the three-pound alarm and take immediate action once you see you're that much outside your range. Similarly, if your eating behavior should temporarily go out of kilter--say, if you overdo things at the restaurant tonight--compensate right away by cutting back a bit on your food and exercising more.

"That way," says Dr. Nash, "self-regulation goes on all the time. What we want to do is to avoid waking up one morning to find we're 40 pounds away from a healthy weight."

Make a commitment to yourself. Tell yourself (and mean it!) that this time you're losing the weight for good. You might find it helpful to actually write out a brief statement, a contract with yourself, spelling out what your health and weight goals are during this period of maintenance and how you intend to achieve them. Your contract might include such terms as, "If I overeat at the company banquet tonight, I'll ride my bike for an extra 60 minutes this week." The terms don't have to have a negative edge to them, they can also include positive rewards, such as, "If I stick to my strength-training program for four straight weeks, I'll reward myself with a new CD."

Refer to this contract whenever you feel your motivation slipping.

Keep low-fat in the forefront. Continue to focus on the variety of low- and nonfat foods that helped you reach your goal weight, and plan on maintaining this healthy program with some adjustments here and there. Add some extra food to your menu during the first week, a bit more during the second week, and so forth. Fine-tune your fat and calorie intake until you see your weight stabilize.

Continue to check nutrition labels at the supermarket, and aim for no more than 25 percent of your calories from fat. And make sure you include some of your favorite foods each day to avoid feelings of deprivation.

Keep up that workout! By now you've probably become a lot more active than you were at the start of your diet, and if you've chosen activities you enjoy, you'll find it no problem to continue your regular aerobic workouts.

Aim for a minimum of three 30-minute sessions weekly, increasing that schedule if you start to notice a few pounds creeping back on. And as soon as you start getting a bit bored with your jogging, stair-climbing or whatever, switch to something new. Don't forget your twice-a-week resistance training either.

"Exercise can also be used more specifically for relapse prevention," note Dr. Brownell and Carlos M. Grilo, Ph.D., in a report on the importance of exercise in weight loss. "First, planning exercise during vulnerable times--lonely weekends or periods of high stress--represents an excellent preventive coping strategy. Second, using exercise during a tempting situation is likely to be effective. If you are home alone, feeling bored and wish to eat the junk food in the cabinet, going for a walk instead can prevent the overeating, weaken the temptation, burn calories and lead to increased confidence. Third, the use of exercise after a high-risk situation, regardless of whether overeating occurred, can also enhance maintenance."

Not bad for a simple walk around the park!

Write it down. "After people lose their weight, they often start relaxing in terms of their eating and exercise pattern--first a little, then a little more. And eventually they may relax completely," notes registered dietitian Judy E. Marshel, director of Health Resources of Great Neck, New York, and a member of the American Dietetics Association. "They've grown used to their slimmer body, which was once so new and exciting, and now keeping it slim through exercise and a sensible diet seems like too much trouble."

The cure for sagging motivation? Write it down! "Your Perfect Weight Success Diary," on page 275 is a great place to start, but a simple spiral-bound notebook is equally fine. Jotting down that frozen yogurt bar you nearly forgot you ate while watching TV, or the Jazzercise class you skipped because you had the flu last week, will help you stay focused on your fitness program and keep you going.

Be your own cheerleader. As we mentioned before, once the praise drops off, the pounds often pile back on. Says Marshel: "A person who gets accustomed to hearing compliments during her journey to her goal weight will stop hearing them once she gets there. And if you're not an inner-
directed person--someone who can motivate herself and doesn't wait for outside pressures or influences--you'll have a harder time keeping your weight off without that outer support."

The trick, then, is to be your own best diet buddy. Constantly remind yourself of your weight-loss achievements by reviewing the positive steps you took to get you to where you are now. Periodically dig out some "before" pictures of yourself for a quick ego boost. Treat yourself to a small gift every month that you're within two or three pounds of your desired weight. You deserve it!

Develop stress-management techniques. You may be feeling on top of the world now that you're finally at (or very close to) the weight you want to be. But face it: You're not always going to feel this great. The day will soon come when you and your spouse get into an argument, or your teenage son dents the car, or your boss criticizes your work. You're going to be awfully tempted to take out your aggression on a family-size bag of chips, but not if you plan your bad-mood strategy.

How will you foodlessly handle your anger/stress/sadness/boredom when it inevitably strikes? Make a mental or written list of pleasurable activities, such as going for a walk, calling a friend, working on a hobby or soaking in a warm, scented bath. Take your pick, and steer clear of food.

Prepare for special occasions. You won't always be in situations that you can easily control, such as your kitchen. Life is, after all, full of restaurant dining, vacations and other good times. In fact, Dr. Nash's research reveals that nearly twice as many people found positive situations more challenging to their diet than negative emotions. "Any kind of socializing occasion presents a challenge to weight management," she says. "There's often the inclination to say, 'What the heck! This time it won't matter.'"

Again, planning will head trouble off at the pass. If you know that special events with bigger-than-usual meals are coming up, prepare for them by cutting back a little before and afterward, and plan on dining sensibly at the party or restaurant. If drinking alcohol tends to make you careless about your eating habits, stick to club soda with lime, or some fruit juice.

Memorize a diet mantra. Says Dr. Nash, "People have told me about a phrase they repeat to themselves: 'Nothing tastes as good as being thin feels.' This is great--it's a little aphorism that keeps reminding them of their long-term goal."

Take a refresher course. Periodically, urges Dr. Yanovski, "look and see what you're doing or, more likely, what you've stopped doing. Exercising? Keeping food records? Watching the fat in your diet? If you've dropped out of a weight-loss program, check in again. Or call a nutritionist for a booster session or two. You need to realize what kind of help you need, and when you need it."

Forgive yourself if you slip up. Face it: You're a food lover, and only human. You're not always going to be able to control your eating and your weight perfectly, so don't beat yourself up if you have a minor (or even a major!) relapse. If you've put back a couple of pounds--something everybody, no matter how vigilant, does sooner or later--don't get disgusted and throw in the towel. Instead, remind yourself how far you've come with an I-did-it-
before-and-I-can-do-it-again attitude. Learn to focus on the bigger picture, get back to your good habits, and the extra few pounds will soon be gone.

Remind yourself why you dieted in the first place. Once you've reached your desired weight, you no longer have a weight-loss goal, but rather a lifestyle goal. There's no immediate reward to look forward to; what you're now embarking on--weight maintenance--is a lifetime endeavor.

As Marshel says: "During maintenance, there isn't that psychological reward of getting on the scale and seeing a smaller number each week. Now your goal is to see the same number all the time, and for some people it's not nearly as satisfying." When all is said and done, your focus has to shift so it seems worth the constant effort. For example, there's the psychological reward of waking up each morning knowing your clothing will fit.

But remember, you've just devoted the last weeks or months of your life to a program designed to enhance nothing less than your looks, your health, your self-esteem and your happiness. Aren't these things important enough to hold on to forever?

Talking to Yourself Those little voices that you hear in your head may be driving you . . . off your diet. The things that you tell yourself both during and after a concerted weight-loss effort can have a powerful impact on your long-term success, says Joyce D. Nash, Ph.D., a clinical psychologist in the San Francisco Bay area and the author of Now That You've Lost It: How to Maintain Your Best Weight. The trick to keeping your self-talk from undermining your accomplishments is to talk back. Any time you catch yourself putting down your own efforts, you need to be ready with a quick comback. Here's how it works. "I'm gaining weight--I might as well quit." "No, I need to reevaluate my strategy and make the right changes. If I keep making healthy choices, the weight will come off." "I was meant to be fat." "Genes are not destiny. Even if I have a fat family, I can minimize a tendency to fatness by adopting a healthy lifestyle." "If it weren't for my (job, kid, etc.) I could lose weight." "My job (or my kid) may be demanding, but I just need to be more creative in finding a way to deal with this." "She (or he) insists that I eat." "I won't let myself be pushed around. I need to stand up for my well-being and say no." "I deserve a little treat now and then." "Yes, I do deserve a treat now and then, but it doesn't have to be food. How about a bubble bath or a long walk in the woods?" "It's not fair that others can eat what they want and I can't." "I have to work with my metabolism and my needs, no matter what others do. It's not fair to my body to make unhealthy choices." "I'll start tomorrow." "Today is the only time I've got--there are no guarantees about tomorrow. If I don't start now, it may be too late tomorrow."