Health

Getting Started

Gretchen Mottice, a registered dietician with a practice in Fort Myers, wants to get something out of the way up front. "There is no quick fix," she says. "Sometimes it just takes some hard work." In a country where 72.6 percent of women and 75.6 percent of men are clinically overweight, it’s easy to get discouraged by a comment like that, but it doesn’t mean weight loss is impossible.

People gain weight when they consume more calories than they expend, and figuring out how to change that is a very individualized process. For Mottice, getting a client on a healthy plan starts with a few questions. "What is their pattern of eating? What do they do for exercise, if anything? Are they ready to start making changes?" she asks. "Because it’s all about changing what you’re doing that’s causing you to stay heavy." She also recommends that clients tell their physician of planned changes to make sure they have the all-clear before starting any new routines.

Control Portions

"The hardest part, people tell me, is the temptation," says dietician Denise Boutwell of the NCH Wellness Center. "Everywhere you go there’s food, everything is celebrated with food."

Social functions, trays of doughnuts at the office, the estimated $10 billion spent on food advertisements last year—it’s hard to keep snacks out of sight or mind. Not only is food everywhere, but portions are larger than ever. Recent films like Supersize Me and Fast Food Nation have charted the expanding influence of burger empires on consumer waistlines, but even staples like grocery-store bagels are twice as large and 200 calories more than they were 20 years ago. You would never know walking through the supermarket that—according to the United States Department of Agriculture charts—a cup of cereal (roughly the size of a closed fist) is actually a whole serving of grain or that a three-ounce chicken fillet (picture a deck of cards) is an entire protein serving. "We’re also told as a kid we have to clean our plate," says Boutwell. "So we eat these big portions, and we take in too many calories, and then we gain weight."

To help clients gradually reduce food intake despite the bigger-is-better trend, Mottice suggests eating the USDA-recommended smaller servings of protein and starch, but filling up on nonstarchy vegetables like tomatoes, lettuce and carrots. "Eat as much as you want, don’t limit those. In general, we don’t get enough of them anyway," she says. Also, don’t leave serving dishes on the table where you’ll be tempted to finish them. And in restaurants, "you could even ask for the box initially and take half of it off your plate so it isn’t sitting there," says Mottice.

Stop Dieting

Sure, it sounds counterintuitive, but dieting is not the way to lose weight, at least not if you want to keep it off.

"I try to get them to understand not to be on a diet," says Boutwell. "That’s a very hard thing; You’re so used to thinking, ‘When I want to lose weight, I’m gonna be on a diet.’"

The difference between healthy habits and a fad diet is abstention. "That should be a red flag if any diet tells you to eliminate any kind of food," says Boutwell. A popular diet like Atkins might help someone immediately drop pounds, but it’s difficult to sustain. As soon as the dieter reverts to previous eating habits and reintroduces whatever was cut, the weight comes back. "You’re just not able to cut bread out the rest of your life," says Boutwell. "That’s a sad life." Even if a dieter could stay off the demonized food forever (like those poor, slandered carbohydrates), most pop diets are not designed with long-term nutritional needs in mind.

"You often get a mix of some good and not-so-good things in the so-called fad diets," says Mottice. When a popular diet includes evidence-based suggestions—like the current movement towards reducing saturated fats—it usually comes bundled with the weakly supported remedies of the author. "That makes it confusing for the person looking at it," says Mottice.

Positive Feedback

"It’s not complicated," says Penny Barbakow, whose husband, Dennis, has been losing weight with the support of a nutritionist.

"But it takes a lot of discipline," says Dennis.

When he reached 292 pounds and was diagnosed with beginning stages of type 2 diabetes last April, Dennis realized he needed help getting healthy. "I was growing more and more uncomfortable," he says now. "As he gained, it got harder, so he did less," adds Penny. After 37 years of marriage and all the comfortable patterns that go with it, the Naples couple is learning new habits like reading nutrition labels, recognizing portion sizes and ordering smartly in restaurants. Now Dennis weighs in at 265 pounds and dropping.

Dennis does sometimes miss the big, greasy lunches he used to enjoy regularly—"nothing comes for free," he says—but he’s happy to be losing weight. His daily two-and-a-half-mile walk along the beach is getting easier, and that makes his resolution firmer. "I have to get this weight off," he says.

"That’s a good reward for doing the right things," says Mottice. Getting healthier can be motivation in itself as someone makes changes. "And that will keep them going."

Most Days

So whether you’re working to shed a few holiday pounds, or you’re overhauling your whole lifestyle, "there are no real tricks, it’s just establishing a habit," says Boutwell. After all, it’s not like you have to commit yourself to a life of asceticism—you can still enjoy food and occasionally indulge in a rich treat. "It just matters what you do most days," says Boutwell.

Web Resources

www.mypyramid.gov

The consumer site for the USDA food pyramid. The site features My Pyramid Tracker, an interactive tool to help you calculate how much of each food group you need in your personal diet and how many calories you should consume daily.

www.eatright.org

The official Web site of the American Dietetic Association. It’s full of great resources for healthy nutrition as well as a searchable database to help you find a nutrition professional locally.

hin.nhlbi.nih.gov/portion

Home of the Portion Distortion quiz. This collaboration between the National Institute of Health and the Department of Health and Human Services is a slideshow that puts some much-needed perspective on American portion sizes.