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Do you feel that there are many different paths to successful weight loss?

The idea that there's one best plan for successful weight loss is incorrect. It’s like saying there's one best color, or one best type of music. For each individual there very well may be one best dietary approach. But there is a broad spectrum of eating strategies -- dozens of unique approaches -- that all work well for weight loss and overall health improvement. The most important thing is to find an approach you can stick to, because adherence, rather than diet type, is the key to success. 

I do think that good plans tend to have some common features. They often include a daily food journal with calorie counting, 90% adherence to a strict eating plan, and about seven hours a week of exercise – cardio and strength training.

What are some safe, painless ways I can exercise?

Almost all people are physically capable of walking. So if you’re in poor physical shape, start with that. Aim for seven hours a week, regardless of your current health status. You start with seven hours a week of slow walking and gradually increase it to seven hours a week of moderate walking. Eventually, you can work up to running.

If you have problems with your hips or feet, upper body exercises can be useful. Almost anybody can use 1- to 3-pound dumbbells to achieve beneficial levels of exercise.

Some obese people find exercise painful, and they get stuck in a bind: You can’t exercise because you’re too heavy, but you’re too heavy because you can’t exercise. Try to push through. In many cases, exercise becomes less uncomfortable as you shed the weight.

How quickly can I expect to lose?

If you’re really sticking to it, a good plan will produce 10% weight loss in three to four months and up to 20% weight loss at one year. A less ambitious effort will typically produce 5% weight loss in three to four months and 10% weight loss at a year.

People often say that losing 1 to 2 pounds a week should be your goal. But I typically see more than that in the short term and less than that in the long term. It doesn’t really worry me if someone’s losing 3 to 4 pounds a week at the outset.

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