Cover Story

If you're like most Americans, you could stand to lose a few pounds: According to the National Center for Health Statistics, 61 percent of U.S. adults are either overweight or obese.

You may be in good company, but your health is at risk. Carrying around too many pounds increases your chances of diabetes, stroke, joint disease, cardiovascular disease, sleep apnea and cancer. Upper body fat puts people at higher risk.

The dilemma, of course, is that many people want to lose weight, but few are successful at it, especially for the long term. But, say psychologists who specialize in weight issues, losing as little as 5 percent of your body weight can reduce your risk of disease, even if you remain overweight.

"Modest weight losses do improve your health," says Kelly D. Brownell, PhD, professor of psychology at Yale University and director of the Yale Center for Eating and Weight Disorders. "Losing weight isn't a dichotomy where either you lose weight and you're successful, or you don't and you're a failure. Small losses can make a big difference."

A study in the Feb. 7 issue of The New England Journal of Medicine is the most recent to support the point. Researchers found that obese participants who lost just 7 percent of their body weight reduced their chances of developing Type-II diabetes by 58 percent. Other studies show that losses of 5 to 10 percent reduce blood pressure.

Small weight losses also make a big difference in quality-of-life issues, adds psychologist Gary D. Foster, PhD, associate professor and clinical director at the Weight and Eating Disorders Program at the University of Pennsylvania School of Medicine. "By losing small amounts of weight, you can go up the steps with less shortness of breath or roll around on the ground with your kids or grandchildren."

What's the best way to lose those pounds and maintain your weight? Self-monitoring, say the experts. Monitor your weight, your intake, your exercise.

"Research finds that the weeks that you self-monitor are the weeks you are most likely to lose weight," explains psychologist Patrick O'Neil, PhD, director of the Weight Management Center at the Medical University of South Carolina.

To begin with, look at your physical activity: Exercise is the single best predictor of long-term weight control, a sobering thought for many busy professionals. "By and large, psychologists are in very sedentary careers, whether they are in practice, research or teaching," says O'Neil. "That's a lifestyle that creates problems."

The trick, says Brownell, is finding a routine that you can live with and enjoy. "Some people find that they need a regimen, the same activity at the same time of day," he says. "Others need variety, different activities at different times of the day. Others keep at an exercise plan if they make it a social event with a partner." (See other exercise tips)

You don't need aerobics classes five times a week, says Foster. Small changes over time make a difference, such as taking 10-minute walks instead of coffee breaks, or even standing up when you're talking on the phone. "Little chunks of physical activity--I'm talking about minutes a day--that can be integrated easily into a busy life," Foster says.

The goal is simple: "You need to get more than you do now," says Brownell, "and the more you get, the better off you'll be."

Also, weigh yourself at least once a month so you're not surprised by a 10-pound gain in one year. If you have a body mass index (BMI) of 30 or more (see chart) or have a family history of diabetes, weighing in more often may be better. "Weighing yourself more frequently gives you more data to make sense of in terms of real trends," says Foster. "With a once-a-month reading, it's easier to say, 'Oh this weight gain is just something flukey.'"

If you do gain weight or regain weight you've lost, take action quickly, advises Foster. "Intervene at a three-to-five pound weight gain, don't let it get to 10, 15 or 20."

As for food intake, "In general, you can't go wrong by starting with the National Institutes of Health recommendation to eat five servings of fruits and vegetables each day," says O'Neil.

And don't fall into the trap of thinking of specific foods as either "good" or "bad." It's often better to put healthy foods into your diet than focus on getting junk food out. "If you tell yourself that you may never, ever, for the rest of your life have whatever your favorite food is, you may end up preoccupied with it and experience cravings, which could lead to overeating," says O'Neil.

Another pitfall for psychologists is letting themselves get too hungry. "If you are working six or seven hours on a grant application or seeing patients and not taking a break for food," says O'Neil, "you may be ravenous later and find it difficult to control your intake."

Overall, keep in mind that, just like with exercise, simple diet changes make a big difference. If every day you take in just 100 calories more than you burn--the equivalent of a lite beer or two-thirds of a can of soda--over a year, "you'll be the owner of 10 pounds of new body fat," says O'Neil.

The good news is that the formula works in the opposite direction as well: By burning 100 calories more than you take in each day, perhaps by walking 20 minutes more, you could lose that 10 pounds by year's end.

Further reading

  • Blackburn, G.L. (1995.) Effect of degree of weight loss on health benefits. Obesity Research, 211-216.

  • Foster G.D., Allison D.B., & Pi-Sunyer F.X. (1995). Reasonable weights: Determinants, definitions and directions, In Obesity Treatment, (pp. 35-44). New York: Plenum Press.

  • Knowler, W.C., Barrett-Connor, E., & Fowler, S.E. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. The New England Journal of Medicine, 346, 393-403.

  • Yanovski, S.Z., & Yanovski, J.A (2002). Obesity. The New England Journal of Medicine, 346, 591-602.