For years, I've been telling my patients that planning is the key to successful weight loss. You wouldn't build a house or tackle some other large project without a plan, would you? Weight loss is no exception, and for my patients I recommend a two-pronged approach: keeping a daily food diary, as well as planning meals ahead of time.
Keeping a food diary helps people track their caloric intake so that they are more aware of what they are eating. These diaries have worked well to help folks both lose weight and maintain their weight loss. In the past few years, however, there have been online food diaries available to help people with weight loss, and there are dozens, if not hundreds of sites that offer calorie and exercise tracking (and for the sake of full disclosure, my web site at www.DrGourmet.com is no exception).
The weight loss industry has long been targeting women, but since being overweight is by no means gender-specific, there's recently been more interest in helping men lose weight. A study out of Australia reported last year on the results of a 12-month, internet-based weight loss program, specifically for men (Obesity 2011;19:142-151).
The researchers recruited 65 men between the ages of 18 and 65, with an average age of about 36 and an average Body Mass Index of about 31, which is considered clinically obese. The men were randomized into two groups: one received a weight loss booklet and attended a one-hour information session, while the other group received the same weight loss book and attended the same information session, but they were also instructed in how to use the study's online weight loss web site: www.calorieking.com.au. (This website is specific to Australia; the US version charges a fee.)
Those assigned to using the website were instructed to record their weight on the website at least once per week, and to keep a daily online diary of their eating and exercise for the first four weeks of the study. In the second month of the study, they were only requested to submit records for two of the weeks and in the third month, only one week. The participants were also able to interact with the research group through a forum on the website.
After three months, the participants' weight, waist circumference, blood pressure and heart rate were measured and compared with their scores from the start of the study. While both groups lost weight, those using the website lost more than 50 percent more weight (4.8 kg, or 10.6 pounds, compared to 3.0 kg, on average).
What's especially interesting is that one year after the start of the study, both groups had kept the weight off and had even lost more weight. Those who continued to use the website, however, had lost an additional 0.5 kg, while those with just the program booklet had only lost an additional 0.1 kg.
The researchers in Australia did not report on the accuracy of the participants' food diaries, and, indeed, it's a tenet of diet and nutrition research that self-kept food diaries are notoriously inaccurate -- even when the person keeping a food diary is a nutritionist or dietitian!
One way to help keep your food diary accurate is my second suggestion to my patients who want to lose weight: planning. Most of the people who come to see me have their lives well-organized: They can tell me where they will be at 4 p.m. next Tuesday, when their kids are at band camp and what time they pick their son up from baseball practice. But they can't tell me what they will be having for dinner. If you take some time over the weekend, say, and plan out all of your meals for the coming week, then go to the grocery store and buy everything you need, you essentially have your food diary already filled out. You won't be stuck standing in front of the refrigerator at 7:30 p.m. after your daughter's soccer practice wondering what you're going to have for dinner, because you'll already know.
Even more than planning for the coming week, it's essential to plan how much you're going to eat at those meals. I'm sure you heard it too: "Clean your plate; there are children starving in Africa." We're well-programmed to eat everything we put on our plate. The vast majority of research done on how much people eat focuses on measuring how much people eat when they are able to eat as much as they want, until they are full. The assumption is that how much people eat at any one meal is dependent on mental and physical feelings of fullness, both of which occur while one is actually eating.
Researchers in England took another approach towards researching how much people eat at meal times. Their theory was that how much people eat at a meal is largely determined before someone sits down to eat (Appetite 2011;56:284-289).
To test their theory, they recruited 764 members of the staff and students at the University of Bristol to respond to an online survey of their eating habits. The participants were 78 percent women, almost 20 percent were dieting to lose weight and the group averaged about 25 years of age, with a Body Mass Index of 22.8 (in the normal range).
The survey questions the participants responded to were based on their recollections of their single most recent meal (not including snacks). They were asked, among other questions, what type of meal it was (breakfast, lunch, dinner), where it was eaten (at home or at a restaurant) and if they themselves selected the portion size. They were then asked if they had eaten everything on their plate, and if they did, could they have eaten more? Had they planned to eat everything on their plate? Did they take another helping? If they did not eat everything on their plate, why?
The researchers found that 91 percent of the respondents cleaned their plates, regardless of whether that meal was breakfast, lunch or dinner. Ninety-two percent of those people who cleaned their plates stated that they had planned to clean their plates at the start of the meal. Indeed, 28 percent of those people said that they were full before they ate everything on their plate, but they ate it anyway. Only 7 percent of the participants did not eat everything on their plate, even though they had planned to.
If you're working on your weight, whether you're trying to lose or just maintaining, planning is key to success. Planning your weekly meals, planning your portions and then tracking your intake with a food diary are proven tools to help you reach your goals.
Follow Tim Harlan, M.D. on Twitter: www.twitter.com/DrGourmet