Calorie restriction and exercise help many people lose weight, but only for as long as they keep up the effort. And the same environmental and psychological factors that accounted for the weight gain in the first place can play a role in causing someone to stop exercising or start consuming too many calories. The difficulty in sustaining a diet and exercise routine is one of the main reasons that people who lose weight fail to keep it off. But the difference between long-term success and failure is the ability to make the changes in your diet and activity level permanent. Certain strategies are useful for everyone who wants to lose weight, regardless of the main causes or severity of their obesity. Many of the following strategies seem like common sense, but they are easily overlooked. You're most likely to follow them if you plan for them in advance.
Eat slowly. Chewing and swallowing your food at a leisurely pace can help you keep from overeating. Here's why: It takes about 20 minutes for your brain to "tell" you when you feel full. Until then, you continue to feel hungry and want to eat. If you eat quickly, you'll end up consuming more than you need to feel full. But eating slowly gives your brain the time it needs to signal that you've had enough.
Make changes gradually. Don't expect to change your diet and activity level overnight. Instead of switching all at once to a low-calorie eating plan, try gradually decreasing the calories of your meals and snacks. For example, start by cutting out snacking or limiting yourself to certain snacks at certain times of day (such as a mid-morning banana or a late-afternoon apple). Also, gradually reduce the calorie content of particular foods. For example, if you're used to drinking whole milk, first switch to milk with 2% fat; then, as you get used to the taste of less fat, go on to milk with 1% fat and finally to skim milk. Another strategy is to lower the calorie content of one meal at a time. In the first week, you might want to eat a low-calorie breakfast, but keep lunch and dinner the same as before. During the second week, you might reduce the calorie content of your lunch. Finally, you can begin eating low-calorie dinners.
Keep a record. Keeping a daily log of what you eat and what physical activities you engage in can help keep you motivated to stay with your diet and exercise plan. Looking over a week's worth of entries can tell you how successful you've been and can help you identify areas where you need to improve.
Seek social support. You'll find it easier to maintain behavioral changes if you have the support and encouragement of others. Social support can come in many forms and from various people. For starters, ask your family members to keep high-calorie foods out of the house, or at least to refrain from eating them in front of you. You might even try to enlist your family to eat the same meals you do. Exercise with someone else, or join a support group. The camaraderie can help keep your spirits up during the inevitable periods when you become discouraged with your progress.
Use a list when buying food. Stick to your grocery list, and steer clear of those aisles or areas with the kinds of calorie-dense foods that you need to avoid.
Out of sight, out of mind. At home, put the most tempting foods high up in the cupboard, at the very back of the fridge, or in other inconvenient spots. Replace the cookie jar and candy bowl with a fruit bowl. Never eat directly out of a large package; many small containers are better than a few large ones, because they provide convenient stopping points. And don't put out too many different varieties of the same kind of food �?you'll be tempted to sample from each one and eat a lot more than if you were faced with fewer choices.
Don't go all out when eating out. Eat a low-calorie snack before going out; you're less likely to go off your diet if you're feeling full when you get to the party or restaurant. Go elsewhere for after-dinner coffee so you are less tempted to segue right into dessert.
Make a plan for special occasions. Decide how much you're going to eat before an event, and do your best to stick with that plan. Set some limits before you go to the movies or watch the Sunday afternoon football games. It's so easy to mindlessly munch when you're in front of a screen of any kind.
Be a copycat. When eating with a group of people, look around. Who's eating the least? Who has the healthiest food on their plate? Model your eating habits on those people's.
Find physical activities that you enjoy. For example, if you don't like exercising outdoors on cold days, join a fitness club, or get an exercise bicycle and hand weights to use at home. If the problem is a time crunch, exercise in increments of 10 minutes whenever you have the time �?before work, after work, or during your lunch hour.
Reduce stress. If you overeat when you are under stress, find a stress-reduction method that works for you: meditation, relaxation techniques, listening to music, exercising, or talking to a friend.
Keeping the Weight Off
There is nothing more discouraging to someone embarking on a weight-loss plan than the oft-cited statistic that 95% of people who lose weight will regain it within a few years. The difficulty in sticking with a long-term weight-maintenance plan is one of the main reasons that weight-loss programs fail. Recently, however, researchers have decided to study the success stories �?people who have lost weight and kept it off for many years �?to look for clues that might be applied more broadly. Researchers in a project called the National Weight Control Registry have been collecting information on such people and recording what they did to achieve their goals.
Such research has disclosed that people who maintain weight loss over the long term are those who develop methods of incorporating healthy, low-calorie eating and regular physical activity into their daily lives. They are also highly motivated to continue doing so over the long term. Some are motivated by an experience that frightened them �?for example, finding out that they were at high risk for a serious illness. Others reported feeling extremely unhappy with the way they looked and felt.
Their diet plans and physical activities differed widely, but one thing that these individuals had in common was that they chose strategies that they liked, that fulfilled some personal goal, and that they could stick with. For example, one man reported that, as a teenager, he was able to lose 75 pounds, reducing his weight from 240 to 165 pounds, because he wanted to make himself more attractive to girls. Over the next 19 years, he gradually regained 24 pounds, reaching 189 pounds. In 1994, however, he decided to prevent further weight gain by committing himself to regular exercise on a treadmill. Since then, his weight dropped to 185 pounds and he has maintained this weight for two years.
In what was certainly one of the greatest success stories in the registry, one woman managed to overcome a strong genetic predisposition toward obesity and lose more than half her weight. She had had obesity since childhood, and at age 36 she reached her greatest weight, 325 pounds. The turning point came when an earthquake shut down the elevator in her apartment building, and she found herself unable to climb the stairs to her apartment. Over the next two years she lost 160 pounds by dieting and exercising. She ate smaller portions of food, cut back on fat, and started walking regularly. She added biking, weight training, and yoga to her regimen of physical activity. She has maintained her new weight at 165 pounds for four years. "People told me that fat was in my genes, and there was nothing I could do about it," she wrote to the researchers. "I say, my ‘jeans�?are now size 11/12!"
Not everyone can rely on an earthquake for motivation, but it is possible to search for motivating factors in your own life. For some people, serious health problems may serve that function; for others, a romantic interest or career advancement may be key. Likewise, no weight-loss plan will work for everyone. Ultimately, you have to find a way to eat healthfully and get regular physical activity that you enjoy. For some people, the answer may be a vegetarian diet, scheduled tennis matches, and biking. Others might prefer having at least some lean meat or fish, and taking long walks for exercise.
Research has shown that the more freedom people have in planning their weight-loss plans, the greater their prospects for success. A 1997 study in the British Medical Journal compared the outcomes of women following two maintenance-diet plans having lost weight through a medically supervised weight-loss plan. Over a yearlong period, one group of women selected meals and snacks from a menu of foods that added up to a set number of calories per day. The other group could eat whatever they wanted within certain general guidelines. The guidelines involved avoiding fried foods, cutting back or eliminating the use of butter or margarine on bread, eating lean meats, and eating more complex carbohydrates, such as brown rice or whole-wheat bread. After one year, the women on the calorie-restricted diet regained an average of nine pounds, but those who ate what they wanted �?within the healthy-eating guidelines �?regained less than half that amount.
To sum up, research has identified several characteristics of people who have successfully kept pounds off. People who want to lose weight might consider following their example.
- About half the people in the National Weight Control Registry who maintained weight loss for six years did so on their own, without help from health professionals, weight-loss drugs, or personal trainers. The rest entered programs or saw weight-control physicians. Less than 2% had had gastric surgery.
- The people in the registry ate on a schedule of three meals and two snacks a day and didn’t deviate from it.
- They also ate healthier foods in smaller amounts and exercised regularly �?and kept on doing these things even after they reached their target weights.
- They reduced their consumption of junk foods, such as cookies, donuts, and ice cream.
- They did not lose weight quickly, but they lost it consistently. Some people lost weight over a period of years.
Other research shows that among perhaps half of all people who lost weight over the long term, frequent contact with a healthcare practitioner led to more successful weight-loss maintenance. Such visits, even if they lasted only a few minutes and consisted of little more than being weighed by a nurse, helped keep people motivated to eat healthfully and stay active enough to maintain their weight loss. 
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