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Experts offer advice for those with lots to lose

When Lisa Goetze tipped the scales at 550 pounds, she wanted to put her fingers in her ears and scream "Stop!" every time a well-meaning friend advised her to start exercising.

"It wasn't that I didn't want to exercise,'" says Goetze, now a svelte size 14 and an American Council on Exercise-certified personal trainer and weight management consultant.

"No one understood that when you are very large, even holding up your body for a three-minute shower is a painful, and sometimes nearly impossible, feat. Walking around the block, it's just impossible."

For the group of people doctors call "morbidly obese" -- those struggling to lose 100 pounds or more -- losing weight is fraught with challenges others may never imagine.

"When you're large, the same weight loss and exercise rules don't apply. They can't apply, but nobody really gets that, not even many doctors," says Goetze, whose company aims to address the needs of what she says is this forgotten group.

From bathroom scales that can't measure your weight, to exercise equipment built for someone half your size, to the health problems associated with being extremely overweight, frustrations abound.

What's more, experts say, the nuts and bolts of dieting -- including caloric intake -- is different for those who need to lose a lot.

"You can't just toss a very overweight person the latest diet book or piece of exercise equipment and expect it to work. There is a whole different mindset to large-scale weight loss, and a whole different approach becomes necessary," says Warren Huberman, PhD, a behavioral consultant for the surgical weight loss program at New York University Medical Center.

That can make finding the right diet plan a challenge. But fortunately for WebMD Weight Loss Clinic members, the WLC eating plan takes current weight and calorie intake into consideration, rather than setting a "one-size-fits-all" calorie limit.

So where do you begin, and how do you stay motivated, when your goal is to lose 100 pounds or more? Three weight loss experts -- including one who shed nearly 400 pounds herself -- offer these 10 strategies to set you on the right path.

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