The primary goals of behavioral strategies for weight control are to increase physical activity and to reduce caloric intake by altering eating habits (Brownell and Kramer, 1994; Wilson, 1995). A subcategory of behavior modification, environmental management, is discussed in the next section. Behavioral treatment, which was introduced in the 1960s, may be provided to a single individual or to groups of clients. Typically, individuals participate in 12 to 20 weekly sessions that last from 1 to 2 hours each , with a goal of weight loss in the range of 1 to 2 lb/wk . In the past, behavioral approaches were applied as stand-alone treatments to simply modify eating habits and reduce caloric intake.
Coronary heart disease remains the number one of killer of women in the United States . Epidemiological evidence suggests that a modest reduction in weight (i.e. 5% of body weight) in female subjects reduces the incidence and progression of CHD . Although several diet strategies exist to help individuals lose weight, one regimen that has gained considerable popularity in the past decade is intermittent fasting . This diet strategy generally involves severe restriction (75-90% of energy needs) on 1 or 2 days per week. Results from a recent 24-week randomized clinical trial revealed that IF can reduce body weight by 7% in obese women . LDL cholesterol and triglyceride concentrations also decreased by 10% and 17%, respectively, in these subjects .
Though these findings are promising, this regimen is limited in that a long duration of time (i.e. 24 weeks) is required to experience only modest reductions in body weight. One possible method of augmenting the rate of weight loss is to combine IF with a daily calorie restriction protocol. In this way, the individual would fast one day per week, and then undergo mild CR (i.e. 20% restriction of energy needs) on 6 days per week. This combination therapy produces greater reductions in weight and superior changes in CHD risk parameters when compared to each intervention alone in animal models .
Whether the beneficial effects of IF plus CR on weight and CHD risk can be reproduced in human subjects has yet to be elucidated. You will likely lose weight on any diet if you eat less than 910 calories a day. But losing 10 pounds in 3 days is both unlikely and unhealthy.
To lose just 1 pound of body fat, you need to reduce your daily calories by about 500 a day for a whole week. That's giving up 3,500 calories over the course of 7 days. To lose 10 pounds in 3 days would mean decreasing your calorie intake by 35,000 calories in just 3 days! The Academy of Nutrition and Dietetics recommends a slow and steady weight loss of no more than 1/2 to 1 pound a week.
Otherwise you are losing muscle and water, as well as weakening your bones. The largest amount of weight loss occurred early in the studies (Ditschuneit et al., 1999; Heber et al., 1994). One study found that women lost more weight between the third and sixth months of the plan, but men lost most of their weight by the third month (Heber et al., 1994).
All of the studies resulted in maintenance of significant weight loss after 2 to 5 years of follow-up. Active intervention, which included dietary counseling and behavior modification, was more effective in weight maintenance when meal replacements were part of the diet (Ashley et al., 2001). Meal replacements were also found to improve food patterns, including nutrient distribution, intake of micronutrients, and maintenance of fruit and vegetable intake. Very-low-calorie diets were used extensively for weight loss in the 1970s and 1980s, but have fallen into disfavor in recent years (Atkinson, 1989; Bray, 1992a; Fisler and Drenick, 1987). FDA and the National Institutes of Health define a VLCD as a diet that provides 800 kcal/day or less.
Since this does not take into account body size, a more scientific definition is a diet that provides 10 to 12 kcal/kg of "desirable" body weight/day . The primary goal of VLCDs is to produce relatively rapid weight loss without substantial loss in lean body mass. To achieve this goal, VLCDs usually provide 1.2 to 1.5 g of protein/kg of desirable body weight in the formula or as fish, lean meat, or fowl. Fisler and Drenick reviewed the literature and concluded that about 70 g/day of protein is needed to ensure that nitrogen balance is achieved within a short period of time on a VLCD. Increased physical activity is an essential component of a comprehensive weight-reduction strategy for overweight adults who are otherwise healthy. Referral for additional professional evaluation may be appropriate, especially for individuals with more than one of the above extenuating factors.
The benefits of physical activity (see Table 4-1) are significant and occur even in the absence of weight loss (Blair, 1993; Kesaniemi et al., 2001). It has been shown that one of the benefits, an increase in high-density lipoproteins, can be achieved with a threshold level of aerobic exercise of 10 to 11 hours per month. This study is limited in that it did not tease apart the effect of IF and CR on body weight and CHD risk.
Thus, the independent contributions of the IF diet versus the CR diet on these various parameters, are not known. In order to answer these key questions, a future study should be performed that compares the effect of IF combined with CR, to that of IF alone, and CR alone. If meals were provided, a more precise measurement of energy restriction and dietary adherence could have been obtained.
The study is also limited in that it employed HippoFat software to quantify visceral fat mass from MRI images. This software is limited in that it underestimates visceral fat and overestimates subcutaneous fat, particularly in larger individuals . Another limitation of the study is that we employed food records to estimate overall calorie restriction in each group. It is well known that obese individuals underreport food intake by 20-40% when completing food records .
Future studies in this field should therefore implement more robust measures of energy assessment such as the doubly-labeled water technique . The last disadvantage of the study is that only female subjects were employed, and as such, the applicability of these findings to males remains uncertain. Success in the promotion of weight loss can sometimes be achieved with the use of drugs. Almost all prescription drugs in current use cause weight loss by suppressing appetite or enhancing satiety. One drug, however, promotes weight loss by inhibiting fat digestion. To sustain weight loss, these drugs must be taken on a continuing basis; when their use is discontinued, some or all of the lost weight is typically regained.
Therefore, when drugs are effective, it is expected that their use will continue indefinitely. For maximum benefit and safety, the use of weight-loss drugs should occur only in the context of a comprehensive weight-loss program. In general, these drugs can induce a 5- to 10-percent mean drop in body weight within 6 months of treatment initiation, but the effect can be larger or smaller depending on the individual. As with any drug, the occurrence of side effects may exclude their use in certain occupational contexts.
However, the long-term effectiveness of these diets is somewhat limited. Approximately 40 to 50 percent of patients drop out of the program before achieving their weight-loss goals. In addition, relatively few people who lose large amounts of weight using VLCDs are able to sustain the weight loss when they resume normal eating. In two studies, only 30 percent of patients who reached their goal were able to maintain their weight loss for at least 18 months.
Within 1 year, the majority of patients regained approximately two-thirds of the lost weight (Apfelbaum et al., 1987; Kanders and Blackburn, 1994). In a more recent study with longer followup, the average regain over the first 3 years of follow-up was 73 percent. However, weight tended to stabilize over the fourth year. At 5 years, the dieters had maintained an average of 23 percent of their initial weight loss. At 7 years, 25 percent of the dieters were maintaining a weight loss of 10 percent of their initial body weight (Anderson et al., 1999, 2001).
For previously sedentary individuals, a slow progression in physical activity has been recommended so that 30 minutes of exercise daily is achieved after several weeks of gradual build-up. This may also apply to some military personnel, especially new recruits or reservists recalled to active duty who may be entering service from previously very sedentary lifestyles. The activity goal has been expressed as an increase in energy expenditure of 1,000 kcal/wk (Jakicic et al., 1999; Pate et al., 1995), although this quantity may be insufficient to prevent weight regain. For that purpose, a weekly goal of 2,000 to 3,000 kcal of added activity may be necessary (Klem et al., 1997; Schoeller et al., 1997). Thus, mental preparation for the amount of activity necessary to maintain weight loss must begin while losing weight . The most important component of an effective weight-management program must be the prevention of unwanted weight gain from excess body fat.
The military is in a unique position to address prevention from the first day of an individual's military career. There is significant evidence that losing excess body fat is difficult for most individuals and the risk of regaining lost weight is high. How many calories you burn depends on the frequency, duration and intensity of your activities. One of the best ways to lose body fat is through steady aerobic exercise — such as brisk walking — for at least 30 minutes most days of the week.
Some people may require more physical activity than this to lose weight and maintain that weight loss. Physiologically, calorie restriction has been shown in animals to increase lifespan and improve tolerance to various metabolic stresses in the body. Although the evidence for caloric restriction in animal studies is strong, there is less convincing evidence in human studies. Proponents of the diet believe that the stress of intermittent fasting causes an immune response that repairs cells and produces positive metabolic changes . An understandable concern of this diet is that followers will overeat on non-fasting days to compensate for calories lost during fasting.
However, studies have not shown this to be true when compared with other weight loss methods. Recent studies of individuals who have achieved success at long-term weight loss may offer other insights into ways to improve behavioral treatment strategies. However, this population was self-selected so it does not represent the experience of the average person in a civilian population. Because they have achieved and maintained a significant amount of weight loss , there is reason to believe that the population enrolled in the Registry may be especially disciplined.
As such, the experience of people in the Registry may provide insight into the military population, although evidence to assert this with authority is lacking. Lose weight, eat well and feel great with this easy weight loss diet plan. This simple 1,200-calorie meal plan is specially tailored to help you feel energized and satisfied while cutting calories so you can lose a healthy 1 to 2 pounds per week. Each day of this 7-day diet plan features the best foods for weight loss, being high protein, high fiber foods , and strategically balances calories throughout the day so you won't feel starved.
The calorie totals are listed next to each meal so you can easily swap things in and out as you see fit. Couple this healthy meal plan with daily exercise and you're on track to lose the weight. The efficacy of individual interventions is poor, and evidence regarding the efficacy of combinations of strategies is sparse, with results varying from one study to another and with the individual.
Recent studies that have focused on identifying and studying individuals who have been successful at weight management have identified some common techniques. These include self-monitoring, contact with and support from others, regular physical activity, development of problem-solving skills , and relapse-prevention/limitation skills. Regular weighing and recording of daily food intake and physical activity for the first month or two of the maintenance period and during periods of increased exposure to food (e.g., during the holidays).
If weight gain occurs, reinstitution of this practice may help bring weight back into control. Frequent follow-up contact with counselors is also crucial (Perri et al., 1993). Effective follow-up consists of a schedule of regular weekly to monthly contacts by mail, phone, or in person. Support groups may substitute for some of this follow-up with a health care provider, but should not replace it.
A nutritionally balanced, hypocaloric diet has been the recommendation of most dietitians who are counseling patients who wish to lose weight. This type of diet is composed of the types of foods a patient usually eats, but in lower quantities. There are a number of reasons such diets are appealing, but the main reason is that the recommendation is simple—individuals need only to follow the U.S. In using the Pyramid, however, it is important to emphasize the portion sizes used to establish the recommended number of servings. For example, a majority of consumers do not realize that a portion of bread is a single slice or that a portion of meat is only 3 oz. You can lose up to 2 kg simply by reducing carbs in your diet because each pound of carbs that is stored in your body contains about 3-5 pounds of water packed into it.
So if you don't consume too many carbs for two days, the carbs that are already stored in your body will burn up for energy as will the water packed in it. You can eat fruits and vegetables to help your body reduce the water weight from carbs for two days. For example, eat salads instead of sandwiches and avoid breads, pastas and other products with refined grain. Studies have proven that if you maintain a low-carb diet for just three days a week, it can not only help you lose weight but also maintain it better. Our body weight is composed of muscle, water content, and fat, which vary as per our diet, lifestyle, and the physical activities we perform.
When rapid weight loss such as losing 5 pounds of weight a week is achieved with a highly calorie-restricted diet, you lose out on the muscle mass and water as well. Without hydrating yourself, you can fall prey to dehydration. Losing on the muscle can make your metabolism slower because metabolism also depends on your muscle mass. A slower metabolism makes it hard for you to lose weight. Body weight, body fat, energy metabolism, and fat oxidation are regulated by numerous hormones, peptides, neurotransmitters, and other substances in the body.
Drug companies are devoting a large amount of resources to find new agents to treat obesity. Neuropeptide Y and galanin are central nervous system neurotransmitters that stimulate food intake (Bray, 1998; Leibowitz, 1995), so antagonists to these substances might be expected to reduce food intake. Beta-3 adrenergic receptor agonists reduce body fat and increase lean body mass in animals (Stock, 1996; Yen, 1995), but human analogs have not been identified that are effective and safe in humans. Many individuals and companies promote the use of dietary fiber supplements for weight loss and reductions in cardiovascular and cancer risks.
Numerous studies, usually short-term and using purified or partially purified dietary fiber, have shown reductions in serum lipids, glucose, or insulin (Jenkins et al., 2000). Long-term studies have usually not confirmed these findings (LSRO, 1987; Pasman et al., 1997b). In addition, the restriction of CHO intake leads to the loss of glycogen and marked diuresis (Coulston and Rock, 1994; Miller and Lindeman, 1997; Pi-Sunyer, 1988). Thus, the relatively rapid initial weight loss that occurs on these diets predominantly reflects the loss of body water rather than stored fat.
This can be a significant concern for military personnel, where even mild dehydration can have detrimental effects on physical and cognitive performance. For example, small changes in hydration status can affect a military pilot's ability to sense changes in equilibrium. Maintaining a healthy weight is an ongoing, life-long pursuit. But sometimes you want to shed a few pounds quickly, whether it's to meet a weight requirement, feel better in a bikini, or fit into your dream wedding dress. To really shed calories, burn fat, build muscle, and achieve longer lasting results, you'll have to tackle some bigger dietary and lifestyle changes.
11 pounds over 12 weeks and eat 441 fewer calories each day, without intentionally restricting any foods or working out. So if you want to lose weight without exercise or strict dieting, start by upping your protein intake. Try eating eggs for breakfast instead of cereal, or adding almonds throughout the day as a snack. Australian Dietary guidelines as well as WW's program guidelines, recommend a safe weight loss rate of 500g-1 kg a week. You may lose more in the first few weeks, but this should even out over time.
