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There are no magic diets, pills, or operations for long-term, healthy weight loss.
A useful approach is to select the best diet that works for you. This is the eating plan you can live with.
A total of 3500 calories equals 1 pound of body weight. This means if you decrease (or increase) your intake by 500 calories daily, you will lose (or gain) 1 pound per week. (500 calories per day × 7 days = 3500 calories.)
All foods have carbohydrate, protein, and fat. Carbohydrates provide 4 calories per gram. Proteins provide 4 calories per gram. Fats provide 9 calories per gram.
Carbohydrates are either simple or complex. Simple carbohydrates cause more weight gain than complex carbohydrates. Simple carbohydrates include sugar and starches (potatoes, pasta, and rice). Complex carbohydrates include fruits, vegetables, and whole grains.
Know your starting point. Keep a food diary for 3 to 5 days. During this time, eat what you usually eat. Write down everything you eat or drink. Measure portions for items without a nutrition label. For each item, determine the total calories and the grams of carbohydrate, protein, and fat. (You can get this information from calorie-counting books, smartphone apps, or computer programs. A database of food nutrients is available at ndb.nal.usda.gov/ndb/foods.) For each item, record the total calories and grams of carbohydrate, protein, and fat.
Find the problem. Look at your daily calorie totals. If you are gaining weight, you are eating too many calories. If your weight is stable, you know that this many calories works for weight maintenance. But you will need to decrease your calorie intake to lose weight.
Fix the problem. Stop eating (or eat less of) foods with empty calories. Such foods do not provide enough of the nutrients you need. Examples are sodas, alcohol, and sweets.
Pick a reasonable calorie goal. Start by cutting 500 to 1000 calories from your current daily intake. Within this range, adjust your calories so that you lose 1 to 2 pounds each week. If you are comfortable after 1 or 2 weeks and want to lose weight more quickly, you can cut back further. Do not eat less than 1000 calories each day without medical supervision. Some people can lose weight eating 3000 calories each day. Others may need to limit intake to 1100 calories each day.
There is no ideal blend of carbohydrate, protein, and fat for weight loss. However, most health experts recommend a balanced diet that provides approximately 15% to 20% of calories from protein, 20% to 35% of calories from fat, and the rest from complex carbohydrates.
Make sure you eat enough protein. The average-sized woman needs 50 to 60 grams each day. The average-sized man needs 65 to 75 grams each day. If you are bigger, athletic, or ill, your protein needs could be much higher. Eat more protein if you are hungry after regular meals. If you eat only a small salad all day, your metabolism will slow down. This is not helpful if you want to lose weight. Here are some typical protein amounts in common foods: 3 ounces of lean meat = 25 grams; 3 ounces of fish = 20 grams; 8 ounces of milk = 8 grams; 1 ounce of cheese = 7 grams; 1 egg = 6 grams.
Snack on vegetables and fruit. For example, eat baby carrots or celery sticks with salsa instead of chips. Use berries instead of chocolate chips. Eat apples instead of apple pie.
To lose weight, you must change your habits. This will happen slowly. Losing 1 to 2 pounds each week is great progress.
Your goal should be better health and well-being. Speak with your doctor if you have significant health problems. Such problems include type 2 diabetes, heart disease, or kidney disease. If you take regular medications, check with your doctor because the doses may need to be adjusted as you lose weight. This is especially important if you have diabetes or high blood pressure.
Choose a fun activity and start moving. For example, walk or hike. Take tai chi or tap dancing classes. Or join a bowling or basketball league. Exercise will tone your muscles and help to limit flabby skin. Exercise also builds muscle. This will increase the number of calories you burn each day. Aim for at least 30 minutes of activity each day. Walking, even slowly for 10 minutes, is excellent. Pedometers (step counters) can help you track how much you walk. They can also motivate you.
NAT (Nutrition Analysis Tool)www.myfoodrecord.com
US Department of Agriculturewww.choosemyplate.gov
Academy of Nutrition and Dieteticswww.eatright.org/public
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at jama.com. Many are available in English and Spanish.
Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Source: Nabel EG. Diet and exercise. In: Scientific American Medicine. New York, NY: WebMD; 2010:chap 3.
Topic: Food and Nutrition
Guth E. Healthy Weight Loss. JAMA. 2014;312(9):974. doi:10.1001/jama.2014.10929