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Expert Q&A: Losing a Lot of Weight

An interview with Michael Dansinger, MD.
By
WebMD Feature
Reviewed by Louise Chang, 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 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.

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