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Tim Harlan, M.D.

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The Key To Successful Weight Loss: Planning

Posted: 05/14/11 12:27 PM ET

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

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 ...
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 ...
 
 
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10:41 AM on 06/03/2011
Great points, Tim. Planning for weight loss makes so much sense in the life of busy Americans. We plan everything else, why not this? To go along with this, I also like to recommend that dieters set goals for their weight loss. This can help in both the losing and maintaining phases. Thanks for the post.

Dr. Anh Ngo
Final Inches
http://ar.gy/Q0I
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HerrMonk
Son of Apollo
01:15 PM on 05/17/2011
The key to losing fat is to cut out bad food from your diet, and limit the consumption of foods that aren't really good for you...

...throw out hat "everything in moderation" slogan fat Americans are so in love with and get results: it's really not that hard.
08:34 AM on 05/17/2011
I use "FitDay" free on line. Keeping the diary absolutely helps me stay on track. In addition, I keep a spreadsheet of the distance and time I am on the treadmill. I am 63 years of age and since starting this routine on January 1,2011, I have lost over 40 pounds.
06:03 PM on 05/16/2011
I always tell my therapy clients on weight loss, "Fail to plan, plan to fail!" Great article!

As a psychotherapist, and avid fitness/health enthusiast, I know firsthand the benefits of mind body connection to fat loss. We have to get our mind-set in the right place before we can ever hope to achieve that ultimate body and optimum fitness for the long term.

After working with many clients in my therapy office, and teaching yoga and fitness classes, my partner, Demi Langford and I have developed a system of tools and secrets to help our clients align their minds and bodies to optimal fat loss.

Your mind is more powerful than any muscle in your body. We’ve all heard about what and how to eat and how to exercise. That’s essential information, for sure, BUT none of it will work, especially in the long term, unless your mind is in the right place.

Many Thanks,
Sunny Strasburg, MA, LMFTI
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dubbleplusgood
turned off CNN, turned on CurrentTV
10:20 AM on 05/16/2011
I fully expect a fair amount of negative replies but I'm not here to sell anything, just to tell you what I know works and where people fail all the time.

Drinks:
When you are thirsty, drink water. It has zero calories. Soft drinks, diet drinks, juices, milk, whatever, need to be digested and processed so they are all technically food, not drinks. Drink water regularly, except during mealtime.

Dairy:
It's food for infant mammals, not adult mammals. You know that spare tire around your waist and those ripply waves of fat connecting your ass and thighs? Blame cheese and milk.

Fat-free, Low Fat, Low Sodium, Low Sugar, No Sugar Added, etc:
Food companies lie their a55es off all the time and it lands on your a55. No added sugar is a favorite for juices these days but check the ingredients for "grape juice concentrate" - that's how they add the sweetener. Sometimes "water" in juices is actually salt water.

Flour: Probably harder to manage than dairy and soda because it's found in damn near everything in stores. Regardless, reduce your flour/bread intake and your stomach will be a much smaller food baby than it is today.

When you eat is almost as important as what you eat:
Think of it this way, for thousands of years man ate quick foods in the morning (fruits, nuts, etc) and heavier foods after the hunt/harvest during the day/evening (meat, fish, big meals). Eat when you're hungry, don't wait.
ThinkCreeps
Seriously, it's time.
08:40 PM on 05/15/2011
Planning? To eat less, do more exercise? Excellent Way to go!
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naschkatze
A free man creates himself.
05:57 PM on 05/15/2011
You are right on about keeping a food log.
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JenniferWest
FORWARD FOR OBAMA 2012! We Won't Go Back!
05:09 PM on 05/15/2011
I've had success losing and maintaining a 70 pound weight loss. For me keeping a journal is one of the tools I use to keep myself accountable. It's also helpful if I have a craving for a treat like Pizza or A Sundae, I can plan on fitting these into my life. And planning is key. I believe it's OK to eat anything you want, as long as it's planned. I never feel guilty either. and I'm not rigid in this. We are way too hard on ourselves. If I stumble and eat too much, I don't allow myself to fall back into old habits. I just pick myself back back up and start over again. I would finish by saying maintenance is the hard work. Anyone can keep momentum going and lose weight, sheer will power, etc. But you need to figure out how to keep that feeling going once the honeymoon phase is over.
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OMGWTH
I'm here for the party.
07:51 AM on 05/15/2011
The online food/weight/exercise journaling works very well for me. There is something rewarding about entering the exercise I have completed and there is something very gratifying about watching the lines on the weight loss graph moving downward. I'm a very visual person, so this definitely works for me. The food journal is helpful, too, but not always exact with regard to calories and other nutrient measurements. But I am able to keep myself trim and in shape and the site I use makes it much easier for me to do so.
09:00 PM on 05/14/2011
I know many people who don't like the idea of a food diary so I ask them to just for a week to journal their food. More often then not they are so surprised by hidden calories and realize they are taken in more fat,sodium, and cholesterol than they thought. If anything at least this week of journaling has led them to be more self conscience of what they eat.
http://exerciseandnutritiontips.com
07:27 PM on 05/14/2011
I have to disagree about the food diary. Even though it works for a lot of people, it doesn't work for everyone. Years ago I got into the whole food diary thing, and the only place it lead me to is food obsession. I know a lot of trainers recommend food diaries to their clients, but I am not one of them. I blogged about my experience with a food diary here:

http://www.lovingfit.com/nutrition/food-diary-fact-or-fiction/
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mkthinker
07:37 PM on 05/16/2011
I agree somewhat. I lost a bit of weight, (like 50 pounds, i wasn't too bad before) a couple of years ago by counting every calorie. I have memorized most foods by now. However I don't count calories now unless i'm on the higher side of my acceptable range or 10 pounds. If I had to do that everyday i think I would feel trapped or subjected to a life of fighting food. I think one part of our obesity epidemic is that we live in a skewed culture. People eating appropriately for their size and activity level are a minority and you somewhat have to 'make a new eating culture'. I've changed what I buy at the store, how often we go out and the house rule is -we split entrees almost all the time. That is the new 'norm' for us. If I hadn't gone through the process of counting and researching and all that I couldn't have created the new 'family way of eating' that works now. But now I only count if I want to shave off 3-4 pounds to go to the beach in a month.
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mkthinker
07:40 PM on 05/16/2011
(part 2) I think a lot of people that went through losing weight try and get people to start their journey where we ended up. It's a little unfair because losing weight is a process and you have to adjust as you go. I started by just eating less and eating basically the same 3-4 foods all the time. I had to make food not 'fun' because I missed the fun yummy junk food. After that for awhile I started expanding my diet to a lot of new foods. But it was after I broke that thing in my head when I woke up that immediately thought 'what can i have for lunch today?'. Would not have worked otherwise.
10:35 PM on 05/16/2011
Wow, congrats on 50 lb's weight loss, that's amazing.
You are definitely right about skewed culture we are living in, the portions they serve at restaurants are insane. I've taught my self to stop eating when I'm full. For years I had a problem where I ate way too much at one sitting.
When I tried the food diary thing it was like 7 years ago. I definitely try to make food fun, but thankfully I am not a lover of junk food. I had some problems with sugar before but I kicked that habit as well.
Right now I if I am craving things it's mainly fruit. I might be weird, LOL

Visit my health and fitness blog when you have a chance, I am always researching for super foods and write about fitness advice. Hope to see you there.

http://www.lovingfit.com
12:24 PM on 05/14/2011
I would carry this mantra of "planning" even further. It works for your exercise schedule as well. If you plan for cardio on Tuesday and Thursday with resistance on Monday, Wednesday, and Friday, you are more apt to keep the schedule-especially if you plan each event with an exercise partner.

Just as you plan to closely monitor your calories and the appropriate breakdown of protein, carbs, and fat, you need to plan your exercise routine. I normally sit down on Sunday evening when it is calm and write out my pairing of exercises like chest/back, or upper body versus lower body. If you plan ahead, you are more prone to complete each session in 30-45 minutes where you may tend to wander around too much if no plan is staring you in the face. I never exercise more than 45 minutes and on cardio days, I tend to use HIT sessions and finish in under 30 minutes.
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VJSleight
Tobacco Treatment Specialist
12:10 PM on 05/14/2011
We don't plan to fail, but fail to plan. I use the same techniques with smokers wanting to quit. You can't know where you're going unless you know where you've been. By writing down your food intake (or when you smoke) BEFORE you eat or smoke, gives you a chance to evaluate your behavior---"Do I really need this second doughnut? Do I really need to smoke right now?" Instead of engaging in automatic behavior, it allows the dieter or smoker more control over their actions. Too many dieters (and smokers) rely on willpower alone but both food and smoking hit the survival part of our brain and the survival instinct is so much stronger than the thinking part of the brain (or what we call willpower). Having a plan, supplements willpower enough to have a chance of being stronger than the survival instinct.
www.stopsmokingstayquit.blogspot.com