An interview with James O. Hill, PhD.
So you’re gearing up to eat better and lose some weight. Good for you. But how do you get started? With the hundreds and hundreds of diets out there, how do you choose the best approach?
To find out, WebMD turned to James O. Hill, PhD, director of the Center for Human Nutrition at the University of Colorado in Denver. Much of Hill’s research has focused on the habits of people who manage to achieve what we all want: stable and sustained weight loss. So how do these people lose weight and how do they keep it off? Hill has.
I want to lose weight but have no idea where to start. What should I do?
Before you try to make any changes to your habits, first you need to see where you are right now. Find out what your body mass index (BMI) is. See how it compares to a healthy weight. Start keeping a record of what you eat each day and how much exercise you get.
Now people say, “Why bother? I already know what I’m eating right now!” But you really don’t. Eating is something that we do every day without really paying any attention. Once you start writing it down, you may learn things you never knew about your habits. You could be drinking five pops a day and have no idea. Taking stock of where you are now gives you a sense of what needs to change.
The next step is really important. You have to make a long-term commitment. If you’re going to change your eating and exercise habits, you won’t be done after six weeks or six months or six years. You have to decide that you’re motivated to make changes that will last for the rest of your life.
Which commercial diet books, programs, or plans really work?
Basically, almost any diet plan will work for weight loss. Go to a bookstore and buy any diet book. It will give you tips on eating less and you can lose weight. But the problem is that almost none of them work for weight loss maintenance.
If you want to lose weight, I don’t think it matters how you do it or what plan you use. But to keep it off, you will probably have to use different strategies.
I co-founded the National Weight Control Registry, which tracks about 6,000 people who have, on average, lost 70 pounds and kept it off for seven years. What we’re doing is trying to learn how these people manage to do it. What strategies really work? We’ve found some common factors. People in the Registry tend to do a lot of physical activity. They tend to eat a low-fat diet and pay attention to overall calories. They self-monitor: they weigh themselves and keep periodic food diaries. And they eat breakfast every day.
Do I really need to exercise to lose weight?
No. If you cut way back on your calories, you can lose a lot of weight without doing a lick of exercise. But you absolutely need to exercise to keep the weight off. I tell people that if they’re not prepared to substantially increase their physical activity, they shouldn’t even bother trying to lose weight. It won’t have any lasting benefit. Exercise is the key.
How much exercise should I be doing?
My recommendation is to shoot for about an hour a day. We’ve found that people who successfully keep off lost weight tend to exercise for 60 to 90 minutes daily.
Now, people will say, “60 to 90 minutes a day? That’s terrible!” But the people in the National Weight Control Registry have maintained an average weight loss of 70 pounds. I think a lot of people would say that giving up an hour a day to keep off 70 pounds is not a bad deal.
The good news is that you can spread out the exercise throughout the entire day. You don’t have to do it all at once. Most people still have some planned exercise at a specific time each day. For instance, they take a walk or a bike ride right after work every day.
You could also try using a step counter, which I think is a wonderful tool. They give you immediate feedback and make setting goals easy. We find that people in the National Weight Control Registry take an average of 11,000-12,000 steps a day, which works out to about five to six miles. But when you’re just starting out, take it slowly. Work up to an hour a day slowly in 15 minute increments.
Getting in your physical activity will never be easy. Even people who have been doing it for years will tell you that they still have to force themselves to get out there every day. But if you want to keep off weight, exercise has to be a priority.
How many calories should I be eating?
To lose weight, you can go on a 1,200- or 1,400-calorie diet. Eating that amount will work very well for weight loss. The problem is that although you can eat 1,200 calories for a few months, you can’t eat that way forever. You won’t be satisfied by so few calories and won’t be able to keep it up.
So I have a radical idea. I think you should eat as many calories as you can. But the only way you can eat more calories is if you balance them with increased exercise. The more exercise you do, the more you can eat.
How can I stay motivated to lose or maintain my weight?
People have no problem staying motivated in the short-term. A person will think, “Gosh, I’m going to a wedding in six weeks – I have to lose some weight.” And as you start to lose the weight, it can be pretty easy. You get a lot of positive feedback, because everyone’s telling you how good you look.
But as time goes on, you get diminishing returns. You stop getting compliments because people are used to your new appearance. Then you have to rely on internal motivation, which is a lot harder. So that’s why it’s so important to start weight loss with a real commitment to making changes forever. It’s not easy. But we’ve found that the longer you keep weight off, the better your odds. People report that after they keep the weight off for three years, their likelihood of ongoing success is pretty high.
What kind of foods should be on my weight loss diet?
We’ve found that although all sorts of diets help people lose weight, the people who keep it off tend to eat a high fiber, moderately low-fat diet.
But most importantly, you should eat foods that you’re going to be able to eat your whole life. You have to be realistic. If you love ice cream and go on a diet that makes you give it up, that diet is probably not going to work for you.
Are there any supplements that can help me lose weight?
My sense is that most of them are probably neutral: they won’t help and they won’t hurt. However, there’s very little evidence about these supplements and it’s possible that some could even be harmful. For now, my advice is to steer clear of them. I think you’d just lose your money and not get any benefit.
Obviously, if you see someone selling a supplement promising easy, rapid weight loss, run the other way. Believe me, if it were true, everybody would be thin.
Should I take prescription diet pills?
There are some prescription diet pills that can help some people. But they’re not for everybody and they’re not magic bullets. The weight won’t melt off once you start taking them. In fact, these medications don’t do much on their own – you still have to do the diet and exercise part.
If you’re interested, you obviously can’t take them on your own. Your physician can help you decide if they make sense for you.
Has your research changed any of your own dietary and exercise habits?
I’ve always tried to make physical activity a priority, so my research just reinforced this. If anything, it did make me realize how important it is to eat breakfast every day.