Better Health & Living: Article: Got a Lot To Lose?

Issue: September 2008

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Got a Lot To Lose?

The road to dropping 100 pounds or more starts with these 4 steps

by Stephanie Stephens

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Cathi Lee’s weekly agenda used to include planned “action items” like: “Sunday: four chocolate whoopie pies with vanilla topping. Tuesday: Big Mac with large fries.” At age 44, the Waterville, Maine, college administrative assistant weighed 506 pounds and couldn’t stand up for more than 10 seconds at a time.

Deeply depressed and isolated—“I’d never been on a date; I didn’t have friends,” she says—Lee had been on “every diet there is” but was never able to stay motivated for the amount of time it would take her to lose 100 pounds, let alone 300 or more.

Then, at a party, something happened that galvanized her. “I was in a line where people were being introduced, and I was just skipped over. The people to the right and left of me were introduced, and I wasn’t. And no one even noticed,” she recalls. “I didn’t get upset or cry. I just thought, ‘Holy cow, you have to exist to be ignored, and now I don’t even exist.’ It was a catalyst for me to lose weight.”

Within three years, Lee had dropped 340 pounds—without surgery. She didn’t even join a diet program. She put one year into researching and developing her own plan and the other two into steadily losing until she reached her goal weight (around 170 pounds).

a lot to lose

Lee was among the 9 million American adults who are 100 or more pounds overweight—the so-called morbidly obese whose weight puts them at significantly higher risk of heart disease, stroke, high blood pressure, type 2 diabetes, sleep apnea, and premature death. A study released last year found that morbid obesity is growing three times faster in the United States than obesity, which is itself epidemic.

Losing weight is tough even if you’re just trying to drop 20 or 30 pounds. Losing hundreds of pounds? “That’s going to be difficult, no question, and will require a tremendous effort over the long haul,” says Howard Eisenson, MD, director of the Duke Diet and Fitness Center in Durham, North Carolina. “This goes beyond a lifestyle change to being a life change that often requires a fundamental reexamination of priorities—of what we value most.”

But it can be done. Here’s how.

a lot to lose

Develop Good Tools

Cathi Lee’s experience isn’t the only proof that you can lose 100 pounds or more without surgery. Last year, research done by James W. Anderson, MD, professor of medicine and clinical nutrition at the University of Kentucky, found that one in four people can drop 100 pounds if they limit themselves to 1,000 to 1,200 calories a day and exercise regularly. There were 118 men and women (average weight, 353 pounds) enrolled in Dr. Anderson’s study. Their average weight loss? An astonishing 134 pounds in just 44 months.

It wasn’t easy, says Dr. Anderson, medical director of the H.M.R. Program for Weight Management at the University of Kentucky and cofounder of the Obesity Research Network in Lexington. “This kind of weight loss requires changing behavior with regimentation and determination,” he says. “You must practice, practice, practice this behavior until it becomes a habit, like brushing your teeth or tying your shoes.” Here’s how to start.

Make the decision. “You need to decide that you are going to change your life forever. If you fail to convince yourself that no matter what happens you have to lead a new life, success is unlikely,” says Michael Dansinger, MD, an assistant professor at Tufts University in Boston and weight-loss and nutrition advisor to NBC’s popular reality show The Biggest Loser. The habits that got you where you are—eating too much, using food to soothe your emotions, giving in to cravings, never exercising—have to go for good. “In order to really make the change, you have to accept a large amount of what seems at the time to be sacrifice,” says Dr. Dansinger.

Take your time. You may be tired of hearing that you won’t lose weight overnight, but it’s true. “Given our human biology, given our world, it’s very easy to gain weight, yet certainly very challenging to achieve major weight loss,” says Dr. Eisenson. On a sound lifestyle-change program, you can expect to lose 1 to 1.5 percent of your weight per week. That means if you weigh 300 pounds, in a month you should expect to lose between 12 and 18 pounds.

Even if you’re very overweight, you can do something. You can walk slowly, sit in a chair and lift weights, swim, pedal a bicycle.

Move it and lose it. When she was physically able, Lee—then 16 months into her weight-loss program—began walking daily. She chose a route through a local cemetery so she wouldn’t have to deal with the stares and taunts of passersby (early in her walking program, teenagers jeered and tossed bottles at her). Today, she goes to the gym at 4:30 a.m. and exercises an average of two to three hours a day to maintain her weight. The woman who couldn’t stand for more than seconds now walks marathons.

“Even if you’re very overweight, you can do something,” says Dr. Dansinger. “You can walk slowly, sit in a chair and lift weights, swim, pedal a bicycle. Where there’s a will, there’s a way.” He recommends getting seven hours of physical activity a week, “and you can break it up however you want.”

Give yourself a break. Monumental weight loss takes monumental effort, and you’re going to slip sometimes. Don’t let a slip become a backslide into old habits, says Dr. Eisenson. “Just don’t quit. If you relapse, don’t tell yourself, ‘I’m weak,’ or ‘I’m undisciplined,‘“ he says. “Lose that judgmental, self-critical approach in order to transition yourself to the happier, healthier place you deserve.”

Cathi Lee offers her best advice for joining the big-loser club: “Dig your heels in; there’s a fight ahead.” Lee, who kept dropping pounds even when she went through menopause, adds, “You really have to believe you’re worth all the effort and stick with it.”

Freelance writer Stephanie Stephens splits her time between California and New Zealand.

Weight-Loss Advice for Big Losers

On NBC’s popular reality show The Biggest Loser, the average contestant drops about 90 pounds. They stick to a 1,500-calorie diet and exercise like fiends, but they also adhere to the five psychological rules for big weight loss identified by psychologist and The Biggest Loser coach Alexa Altman, PhD. Here’s her advice.

Write down a list of your goals and look at it daily.
Create and expand support by developing and nurturing a healthy social network. Surround yourself with healthy, positive people who say, “Yes, you can!”
Stop thinking in black and white. Don’t interpret a small slip as a failure; slips happen.
Utilize every resource, including nutritionists, fitness instructors, support groups, online chat sites, life coaches, and food journals.
Address any emotional roadblock in your path instead of avoiding it. See a mental health professional if you need help.