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Major Weight Loss: How to Take the First Step

Just thinking about how to lose a lot of weight can be daunting. Here’s how to get started.
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WebMD the Magazine - Feature

Each month WebMD the Magazine puts your questions about weight loss and fitness to top exercise and motivational experts. This month, Guilleromo Bustos, 43, an LA-based television editor and father of three, asked for help losing 200 of his 452 pounds. We turned to Martin Binks, PhD, director of behavioral health at the Duke Diet & Fitness Center, who is helping Bustos with his weight loss, for advice on for advice on breaking big weight loss goals down into small steps.

Guillermo’s question: I have a sedentary job as a TV post-production editor. I work 10- to 12-hour days, and the fast pace of making deadlines and battling LA traffic means I eat a lot of convenience food. My typical meal has been a burger, fries, and soda, and I have a lot of Starbucks lattes throughout the day. Over time, it just adds up. And I ferry my kids to soccer and baseball practice all over town, because I want them to be active and not end up where I am—but I don’t join in. I finally realized that my whole life has to change.

Answer: According to Dr. Binks, who is supervising Guillermo’s weight loss, whether you have 100 pounds or 20 pounds to lose, the trick is to keep focused on losing one to two pounds each week, and be very consistent in what you do. People with a lot of weight to lose, like Guillermo, may lose more in the beginning and can do so safely under a doctor’s care. For the long haul, your body is capable of losing a certain amount of weight per week safely, and if you keep doing that, ultimately you will get there. Binks also recommended:

Add small amounts of exercise:  Binks recently did a study at Duke that showed you can improve your health by just becoming a bit more active. Push yourself a little each week by adding several more minutes to your exercise session or increasing your speed on the treadmill by half a mile an hour.

Fill up on low-calorie foods:  At Duke, Binks promotes the “volumetric” approach to eating developed by Penn State nutritionist Barbara Rolls, PhD. That means filling yourself up with foods that are high on the “satiety index” -- making you feel full while not adding a lot of calories. High-volume, low-calorie foods include salads, soups, and oatmeal. Eating a big salad before lunch or dinner every day, like Guillermo does now, is a great way to keep from overeating.

Don’t deprive yourself while dieting: Losing a large amount of weight is difficult, but if it feels horribly depriving, you’re never going to keep it up. You don’t have to torture yourself like the contestants on The Biggest Loser (and don’t expect to lose 10 pounds a week like they do). You want a sustainable approach you will stick with long term.

After four weeks at the Duke Diet & Fitness Center, Guillermo is now down to 421 pounds and says he has “jump-started myself on a journey to a complete lifestyle change.” 

Reviewed on February 23, 2009

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