Overweight

Overweight

Getting Yourself Down to Size

See that slender woman leading the aerobics class? There used to be 200 pounds on her five-foot-five frame. Can you believe it?

Those were heavy days for Karen Faye, a nurse in her forties who got in shape and is now the owner of Body Basics Aerobics Workout in Tyngsboro, Massachusetts.

"I was mentally and physically exhausted all the time, which just added to the burden of being overweight," she recalls. Like many women, she struggled with her weight from adolescence on. "I remember that when I was sixteen and went to the beach with my mother, the boys whistled at my mother, not at me. I didn't feel like the young person I was supposed to be."

That feeling of being older than her years stayed with her well into adulthood, for as long as she was overweight, Faye says. "Mentally, I was a young person--I had three little children and a thin husband who could still fit into his Marine uniform. But physically, I felt like my own grandmother, and I couldn't believe what was happening to me. I felt the real me was trapped in an older person's body."

For years, Faye thought that her thyroid problem was the cause of her weight. But when she hit 200 pounds, she says, "I saw the handwriting on the artery wall. And it was my artery." She went on a low-fat eating and exercise regimen. Within eight months, she lost 80 pounds, became fit for the first time in her life and has maintained her weight for 11 years.

After she got her weight under control, she became a fitness consultant and opened Body Basics Aerobics Workout. In August 1993, she won the physical fitness award at the Mrs. United States pageant, competing with some women who were in their twenties.

As Faye knows, overweight is a burden on body and soul. You feel you've lost your youth and vitality. And you've opened yourself up to ailments of aging such as heart disease, high blood pressure, diabetes, arthritis and high cholesterol--not to mention the backaches and other pains caused by carrying around more than you should.

There is a cancer connection as well. "When you're overweight, you also have increased risk for several cancers, including cancer of the endometrium, uterus, cervix, ovaries and gallbladder," says John Foreyt, Ph.D., director of the Nutrition Research Clinic at Baylor College of Medicine in Houston.

Bigger Isn't Better

Most studies of the connection between overweight and heart disease have been limited to men. But that's beginning to change. In one study of 116,000 women, researchers at Harvard University in Cambridge, Massachusetts, found that the relationship of overweight to heart disease is just as strong for women as it is for men. Being overweight was the cause of heart disease in 70 percent of obese women in the study and 40 percent of other women who were above their ideal weights.

High blood pressure has a strong link to overweight. When a heart has to work overtime to carry extra pounds, blood pressure shoots skyward.

Type II diabetes is also tied to being overweight. Carrying those extra pounds directly affects the body's ability to utilize blood sugar. Many overweight people with diabetes who need regular medication find that once they drop 20 or more pounds, they may also drop their prescriptions.

The connection between overweight and arthritis is fairly obvious: The more pounds you carry, the more pressure you put on your joints. The Framingham Knee Osteoarthritis Study, using data gathered from the more than 5,200 residents of Framingham, Massachusetts, in a landmark heart study, showed that overweight women who lost just 11 pounds reduced their risk of developing arthritic knees by almost 50 percent.

And when it comes to cancer, particularly breast cancer, losing those extra pounds may give you extra protection. Research from the federal Centers for Disease Control and Prevention in Atlanta shows a particular danger for women who are 25 percent or more over their optimal weights at the time their breast cancer is diagnosed. These women face a 42 percent greater risk that the cancer will return.

Being overweight may also increase a woman's risk of developing breast cancer, says Dr. Foreyt. "A high-fat diet leads to obesity, and fat in the diet is associated with an increased risk of breast cancer," he says.

Aging Ups the Ante

Most of us have already realized that it's getting harder to lose weight. That's because our metabolism, the process by which our bodies burn calories, slows down over time. Reubin Andres, M.D., clinical director of the National Institute on Aging in Bethesda, Maryland, believes it is harmless to gain about five pounds each decade after age 20--but only if you are in good health to start with and remain free of ailments such as diabetes and heart disease. But many experts say any weight gain should be avoided throughout the years.

But it's best to keep the weight off. After following a group of Harvard University alumni for 27 years, researchers found the lowest mortality rate among men who were 20 percent below the average weight for men of similar age and height. This finding held firm even after the researchers accounted for underweight from smoking or illness, which they believe may have distorted the results of previous studies.

The study also showed that men who were only slightly overweight--2 to 6 percent over their desirable weights--still had a significantly greater chance of dying from heart disease and that men who weighed 20 percent more than their desirable weights actually doubled their risk.

But regardless of where you fit on the charts, if you feel you're struggling with more than a few extra pounds and you don't have thyroid or other health problems, you may be eating too much--particularly fatty foods--and exercising too little.

What to do about it? Well, you could put yourself on a crash diet. But that probably won't get you anything but frustration. "Diets just don't work," says Janet Polivy, Ph.D., professor of psychology at the University of Toronto Faculty of Medicine. "Diets become popular because they work for a week or two and everyone says 'You gotta try it.' Well, speak to those people in a year or two, and you'll find they've failed." When you fall for one of those speedy five-pounds-a-week programs, you lose it, all right--but you lose pounds of fluid, not fat. And as soon as you abandon the diet, the weight comes right back on.

In the long run, what works best to achieve a healthy weight is to modify your eating habits and to get more exercise.

It worked for Karen Faye. "Now I'm 45 and really a grandmother," Faye says. "But since I've lost the weight, when people see me with my 25-year-old son, they think he's my boyfriend! If I can do it, you can do it."

Setting the Stage

The first step toward successful weight loss is accepting yourself as you are right now, says Thomas A. Wadden, Ph.D., associate professor of psychology and director of the Weight and Eating Disorders Program at the University of Pennsylvania in Philadelphia. Then you have to draw up a strategy for taking control of your weight. Here's how.

Make a long-term commitment. The key to healthy and successful weight loss at any age, experts say, is to make the changes gradually. Losing no more than 1/2 pound a week is ideal, says George Blackburn, M.D., Ph.D., associate professor of surgery at Harvard Medical School and chief of the Nutrition/Metabolism Laboratory at New England Deaconess Hospital, both in Boston. So aim to attain a healthy weight a year from now, not next week, he says.

Don't try to be a model. Never mind that professional models are often as skinny as straws. Many of them are teenagers in heavy makeup. "You have to recognize that you can't look like those skinny little models in the magazines, and middle age is a good time to do this," says Dr. Wadden. Once you let go of unrealistic fantasies and accept the notion that it's unfair to model yourself after an adolescent, then you can get on with a healthy and attainable weight loss plan, he says.

Surround yourself with support. A good support system is a key to successful weight loss, says Dr. Foreyt. Ask your family and friends to cheer you on. Maybe they could join you in eating low-fat, healthful meals.

"Form a neighborhood group that walks together, or look to the YMCA, the Jewish Community Center or your local church or college for weight loss support groups," Dr. Foreyt says. "And groups such as Weight Watchers, which teach self-maintenance, can be very, very useful." If you tend to lose control and overeat compulsively or go on big food binges followed by a sense of shame, an Overeaters Anonymous group or professional counseling can be a tremendous help, he says.

Pay attention to your emotional needs. Sometimes you can confuse hunger with other feelings, especially if you're feeling depressed or stressed or just responding to a luscious photo spread in a gourmet food magazine. If it's not your stomach talking, you need to figure out what kinds of emotions or discomforts are triggering your urge for food, Dr. Foreyt says. Then develop a problem-solving approach. "How can you answer that need without eating? Walk around the block, call a friend, meditate, take a bath, brush your teeth, or gargle with mouthwash," he says. "This breaks the chain and develops an alternate behavior pattern."

Boycott the fat box. If you watch more than three hours of television a day, you double your risk of being saddled with extra pounds, says Larry A. Tucker, Ph.D., professor and director of health promotion at Brigham Young University in Provo, Utah. Slouched on the couch, you're not burning many calories, and you're likely to be taking in more by eating fattening snacks. So turn off the tube (plus the junk food habit that usually comes with it) to boost your weight loss campaign.

How to Eat and Lose Weight

The latest nutrition research shows that there really is a whole new way to lose weight--without dieting and without hunger. It's based on understanding which kinds of food revitalize you and give you real energy and which foods go right to your thighs. You may be surprised to find that the most crucial changes don't require that you eat less--just differently. Here's how.

Forgo excess fat. Dietary fat makes us gain weight because it's stored in the body far more easily than either carbohydrates or protein, says Peter D. Vash, M.D., assistant clinical professor of medicine at the University of California, Los Angeles. The body burns those for fuel almost immediately, while the more calorie-dense fat burns slower and is more likely to be left over--on you.

Start by cutting fat in the obvious places: Eat fewer fatty meats, fried foods, high-fat dairy products and desserts. Also, beware of salads slathered in oil or other fatty dressings. It's recommended that you keep your total calories from fat to 25 percent or less of your daily diet.

"A high-fat diet has been linked to obesity, which in turn is associated with an increased risk of various cancers. Prudence says that a high-fat diet is a factor in so many illnesses that it only makes sense to eat low-fat foods instead," says Dr. Foreyt.

Drown it. "Drinking generous amounts of water is overwhelmingly the number-one way to reduce appetite," says Dr. Blackburn. Not only does water keep your stomach feeling fuller, but also many people think they're having food cravings when in fact they're thirsty, he says. So aim for 8 cups of fluids daily, sipping 1/2 cup at a time through the day.

When you're sipping away through the day, keep in mind that caffeine--in cola, coffee or tea--has its drawbacks. Caffeine is a diuretic, which removes water from the body. For that reason, most doctors recommend that people on weight loss programs drink no more than three caffeinated beverages a day.

Count on carbs. Don't go hungry. When you replace the excess fat calories you've been eating with foods such as carbohydrates, you can actually eat more and still lose pounds. In one study at the University of Illinois at Chicago, people on moderately high-fat diets were told to maintain their weights for 20 weeks while switching to low-fat, high-carbohydrate diets. They ate all they wanted and still lost more than 11 percent of their body fat and 2 percent of their weight. So enjoy plenty of carbohydrate-rich pasta (without fatty sauces), low-fat cereals, breads, beans, crunchy fresh vegetables and fruits to fill you up while you're losing weight.

Allow a few splurges. If you feel that all you're saying to yourself about food is no-no-no, you may eventually let slips turn into a downhill slide, says Susan Kayman, R.D., Dr.P.H., a dietitian and consultant with the Kaiser Permanente Medical Group in Oakland, California. That's why she advocates following the 80/20 rule. If you eat low fat 80 percent of the time, then when you're dining with friends, out on the town or over at the in-laws, enjoy an occasional higher-fat treat without beating yourself up about it, she says.

Break up the deadly duo. That's fats and sweets. When the body gets a jolt of sugar, it releases lots of insulin in response. Because insulin is a storage-prone hormone, it opens up fat cells, preparing them for fat storage. So when you eat sugar, keep your fat intake low. Also, fats and sugar taken together can turn up your appetite to unmanageable levels. Eating sweets leads to an increase in the amount of sugar in the blood, which, because of a chain of reactions in the body, pumps up your appetite, says Dr. Wadden. So soothe your sweet tooth with a juicy fresh fruit or bowl of low-fat sugared cereal instead of doughnuts and candy bars.

Stay with it. Here's a fat-fighting tip to hang on to: If you stick with it, you'll actually lose your taste for high-fat foods after a while. A four-year study of more than 2,000 women at the Fred Hutchinson Cancer Research Center at the University of Washington in Seattle showed that women who limit their fat intakes lose their taste for fat in six months or less, eventually finding fatty foods unpleasant to eat.

Eat often. Some researchers support the idea of grazing--eating numerous small meals throughout the day instead of three larger meals--to control appetite and prevent bingeing. "But you cannot graze on M&M's, potato chips and Häagen-Dazs," says James Kenney, R.D., Ph.D., a nutrition research specialist at the Pritikin Longevity Center in Santa Monica, California. "But if you graze on low-fat, high-fiber foods that aren't packed with calories, such as carrots, apples, peaches, oranges and red peppers, you'll keep your appetite down."

Turn up the heat. Be lavish with hot spices such as cayenne pepper and horseradish to boost your metabolic rate, which may help your body burn more calories, says Dr. Kenney. "When people eat hot foods, they often sweat, a sure sign of increased metabolic rate. And the faster the metabolic rate, the more heat produced by the body. Remember, whatever warms you up in turn slims you down," he says. But be sure to avoid high-fat dishes, even if they're loaded with spices.

Start with soup. A soup appetizer tends to reduce the amount you eat at a meal, several studies suggest. In one study from Johns Hopkins University in Baltimore, people who had soup before a meal ate 25 percent fewer calories of the entrée than those who started the meal with cheese and crackers. It may be the volume of space that soup takes up in the stomach or the fact that most of soup's calories come from carbohydrates rather than fat, researchers say. Or there may be a psychological factor at work, Dr. Kenney says. "Hot soup is very relaxing if you have a nervous, gnawing appetite."

Ride out a craving. When the urge strikes for a chocolate eclair, don't confuse the craving with a command, says Linda Crawford, an eating behavior specialist at Green Mountain at Fox Run, a residential weight and health management center in Ludlow, Vermont. Though many people think cravings keep getting stronger until they're irresistible, research shows that food cravings actually start and escalate, then peak and subside. Distract yourself with a walk or something else incompatible with eating, Crawford says, and ride out the craving. "Just like with surfing," she says, "the more you practice riding a craving wave, the easier it becomes." But if you still have the craving after 20 minutes, go ahead and satisfy it with a small portion--and enjoy it, she advises.

A Woman's Weight Loss Workout

Adopting a healthier diet will help you lose weight, but you'll acquire a firmer figure faster--and keep it--if you combine your healthy new eating habits with exercise.

Exercise also strengthens your heart and arteries, and it boosts your self-confidence--in short, it will counteract many of the harmful effects of overweight. Exercise can even help to curb your appetite.

If you're unaccustomed to exercising, see your doctor before you get started. After you have her okay, you'll be ready. Here are some tips to get you going.

Keep it up. "The best predictor of long-term weight management is regular aerobic activity, which boosts your heart rate," says Dr. Foreyt. "Brisk walking is a great choice because it's very easy for most people to do on a regular basis. But the effectiveness of any aerobic activity for weight control has been proven repeatedly." Any kind of daily exercise helps. Thirty minutes of aerobic exercise burns flab and tones muscles--as long as you do it regularly.

Burn by building. Aerobic exercise should always be part of your weight loss plan, but when you add resistance training such as weight lifting, you'll keep your weight down with the help of "hungry muscles. Muscle tissue needs more calories," says Janet Walberg-Rankin, Ph.D., associate professor in the Exercise Science Program in the Division of Health and Physical Education at Virginia Polytechnic Institute and State University in Blacksburg. "So if you increase muscle mass while you lose fat, you boost your ability to burn fuel." It's later in the day, when you're in a meeting or waiting in line at the bank, that your new, ravenous muscle is grinding away calories, she says.

"Resistance training isn't just about lifting barbells," adds Dr. Foreyt, though that's great for firming the arms. To really work the different groups of muscles, your best bet is to go to a gym and ask a trainer there to show you how to circuit-train, he says. You use a series of different weight machines to press weights against muscles in the neck, arms, chest and legs. You can accomplish the same thing by working with free weights at home, he says. "Putting your muscles against something that doesn't yield--that's resistance."

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