Expert Q&A: Losing a Lot of Weight
An interview with Michael Dansinger, MD.
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
How can I keep up my motivation over the long term?
Maintaining motivation is crucial for long-term success. Initially, you
might be rewarded all the time, as you see the scale moving daily or weekly,
start fitting into smaller-sized clothes, and get compliments on how you
look. But the rate of weight loss inevitably slows, so then the motivation
must come from within.
You must keep reminding yourself of your reasons for taking care of your
body and putting in the effort. Keep a written list of reasons and refer to
them often. A photo of yourself at your start weight can be a helpful reminder
of how far you’ve come.
It also helps to rely on others who will help you stick to your plan. This
could be a personal trainer, or your health care provider, or a support group.
The more authority you give them and the more accountable you feel to them, the
more likely you are to maintain your weight loss. You may want to find someone
who isn’t so polite -- often, the drill sergeant approach is the most
How do I know if weight loss surgery is right for me?
I’m a big advocate of weight loss surgery for people who qualify – they
either have a BMI over 40 or a BMI over 35 with a related medical problem. It’s
a last resort, but it’s very effective. Still, I think most people would rather
try a strategy focused on healthier eating and increased exercise first.