Expert Q&A: Losing a Lot of Weight
An interview with Michael Dansinger, MD.
If you’re very overweight or obese right now, you might feel like the odds
of ever achieving a healthy weight are pretty remote. But you can do it. And
the benefits will be tremendous.
So how do you begin? WebMD asked Michael Dansinger, MD, an assistant
professor at Tufts University School of Medicine in Boston. He’s a leading
authority on diet and weight loss, and he’s had plenty of experience helping
obese people slim down – he’s the nutrition doctor for the TV show The
Biggest Loser. Here’s what he had to say.
How do I know if I'm really ready to lose weight this time?
If you're ready to record your reasons on paper and ready to pick a start
date, then you're ready to try again. I think the battle is halfway won once
you commit, once you decide that you’re never going to give up trying to
control your weight.
Don’t let past failures discourage you from trying again. Almost everyone
who loses weight has tried unsuccessfully many times before. Finding the right
path to weight loss is like finding the person you eventually marry. You
probably have to kiss a few frogs on the way. So don’t look at past weight loss
attempts as dead ends. They’re just stages on the path to ultimate success.
There are some practical things to consider. You need to commit to the rules
you’re going to follow and figure out some logistics. How will you find time to
follow your plan? Do you have a support system that includes your health care
professionals, your family, and your friends?
Do I need to see a doctor before starting a weight loss program?
Unless you have a chronic illness or take regular medications, you don’t
really need medical supervision when you’re starting a weight loss program,
even if you’re obese. There are hundreds of diet books at your local bookstore,
and I doubt that following any of them would cause any harm. While a really
extreme low-calorie diet – 500 calories or so – could be risky, nobody can
really stick to that anyway.
However, I do think you should include your doctor as part of your support
system and ideally as a lifestyle coach. Your doctor can help you monitor
your progress as well as provide external accountability.
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
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