By Michelle McMacken,
M.D.
(In case you missed it, here is Michelle on the recent RRP)
As an internal
medicine physician and director of an obesity program, I am all too familiar
with the struggle that many people face when it comes to weight loss. The
statistics in my primary care practice mirror the U.S. national numbers: more
than 70% of us are overweight or obese.[i] I’ve seen many people attempt
to lose weight, become frustrated and disheartened, and turn to supplements,
pills, meal replacements, unhealthy fad diets, and surgery. Unfortunately, most
of these are short-term solutions without long-term weight-loss benefits (often
accompanied by troubling health consequences).
The mechanisms that
regulate our body weight are highly complex – neurologic, genetic, hormonal,
environmental, social, and even microbiologic factors are at play. But these
factors do not necessarily determine our destiny! We have the power to override
them with the food and lifestyle choices we make every day.
Here are twelve of
my favorite weight-loss tips:
1. Start
“crowding out” animal products, high-fat foods, and processed foods.
Gradually add more
whole plant foods to your diet. You can begin with plant foods you already like
and build from there. Eat a whole plant food (such as a piece of fruit) or a
dish made from whole plants (such as a vegetable or bean soup or a salad)
before one of your usual meals, so that you won’t have as much room for the
less-healthful foods.
If you are ready to
make the full leap to a whole-food, plant-based diet, you will likely see
benefits even faster. Consider trying one of the many plant-based/vegan
“kickstart” programs available online or in print.
2. Focus
on the positive—the nutrient-dense, high-fiber foods you are adding to your
diet—instead of what you are taking away.
Enjoy experiencing
new flavors (this is what I call “taste-bud rehab”), rather than focusing your
mental energy on the unhealthy foods you are trying to remove from your diet.
3. Choose
the right kind of carbs!
Avoid processed
carbs, such as white bread, white rice, and white pastas, even if they are
vegan/plant-based. Stick to whole plant foods in their most natural form—brown
or wild rice, quinoa, barley, oats, sweet potatoes, beans, lentils, and of
course, an abundance of colorful vegetables and fruits.
4. Remember
that oil is a processed food.
Oil is very dense
in calories, so it can easily sabotage your weight-loss efforts. Oil-based
salad dressings, for example, dramatically increase the calories in a salad.
5. Avoid
liquid calories.
Don’t drink your
calories, especially in the form of sports drinks, sodas, other sweetened
beverages, and alcohol. The calories in these drinks add up fast and don’t fill
you up. And for weight loss, in my experience, eating whole fruit trumps
drinking fruit juice. Water is the only beverage we actually need.
6. Have
conversations with your family and/or close friends.
Talk to the people
you live with about how they can best support your weight-loss efforts. Many of
us have cravings for certain junk foods and/or sugary desserts, and when these
items are readily available in the kitchen, it’s pretty challenging to resist them.
Ideally, family members should be on board with not bringing these foods into
your house. In my practice, I encourage my patients to bring their partners and
other family members to their appointments with them, so we can talk about
behavior changes together.
7. Track
positive behaviors (such as taking a walk at lunch, trying a new vegetable, or
avoiding a sugary coffee beverage).
Keep track of the
positives, so that you can look back and see the progress you are making. Many
of these changes have important health benefits, independent of weight loss.
Also, keep in mind that losing just 5% of your body weight can have significant
health benefits if you are overweight or obese.
8. Aim
for at least 30 minutes of physical activity most days of the week.
Your daily activity
can be as simple as walking. Although dietary changes tend to be more effective
than exercise for weight loss, exercise is key to preventing weight regain and
has numerous other health benefits.
9. Eat
as mindfully as you can.
Whenever possible,
avoid reading or using technology (television, computer, phone, gaming, etc.)
while eating. Savor each bite and focus on the experience of tasting your food.
10. Be aware of your hunger cues.
Rate your hunger on
a scale of 1 to 10, where 1 is very full and 10 is extremely hungry. Don’t let
yourself get to a 9 or 10. This requires some planning. Eat something when your
hunger level reaches 7 or 8, so that you won’t become ravenous later and make a
desperate, unhealthy food decision.
11. Don’t
worry if you don’t lose weight right away.
The rate at which
people lose weight depends on many factors, including activity level, age,
muscle mass, health conditions and medications, and of course caloric intake. I
don’t encourage setting goals around the rate of weight loss. Rather, focus on
behavior and health goals, such as cooking at home more often, eating more
servings of whole plant foods, and increasing physical activity. For most
people, this approach will result in safe and sustainable weight loss. I’m not
a fan of fasting for weight loss, meal replacement programs, weight-loss
pills/supplements, or other practices that are not durable and do not promote
long-term health.
12. What
if you are already eating plant-based but not losing weight?
Examine whether you
are eating refined carbohydrates and other processed foods on a regular basis.
Look out for added oils and sugars in your food. Are you eating out at
restaurants and/or getting take-out regularly? These meals tend to be much
higher in calories than similar meals prepared at home. Finally, consider
reducing portions of calorie-dense foods such as dried fruits, nuts, olives,
seeds, and avocados.
So what is the best
way to eat for weight loss and overall health?
We’ve known for a
long time, from large-scale observational studies, that vegetarians and vegans
consistently have lower body mass indexes and significantly lower rates of
obesity compared with omnivores.[ii],[iii],[iv],[v],[vi] Research also
shows that animal products are linked to weight gain[vii],[viii],[ix],[x],[xi],[xii] and
that plant-based diets are effective for weight loss, [xiii],[xiv],[xv],[xvi] without
calorie counting or measuring portions. [v],[xv],[xvi] This is likely due
in part to the high fiber content, which promotes satiety without excess
calories.
Research aside,
thousands of personal anecdotal reports and years of clinical experience attest
to the fact that people who begin following a whole-food, plant-based diet
almost always lose weight, and sometimes dramatically!
Probably the most
important benefit of following a plant-based diet for
weight loss is that it also decreases the risk of heart disease, high blood
pressure, high cholesterol, diabetes, dementia, certain cancers, and even death.[xvii],[xviii] I
know of no other “weight-loss diet” that can make such a claim. As a physician,
I don’t think we should be separating weight issues from other health risks. I
question the wisdom of following a diet (high-protein, low-carb, for example)
that might help you lose weight in the short term but increases your chance of
having significant health problems later on.
Michelle McMacken, M.D., is a
board-certified internal medicine physician and an assistant professor of
medicine at NYU School of Medicine. She practices primary care at Bellevue
Hospital Center in New York City, where she also directs a medical weight-loss
program. An enthusiastic supporter of plant-based nutrition, she is
committed to educating patients, medical students, and doctors about the power
of healthy eating and lifestyle modification. Be sure to connect and follow Dr.
McMacken on Twitter.
This article was
previously published on Forks Over
Knives.
Sources:
[i]Prevalence of
Overweight, Obesity, and Extreme Obesity Among Adults: United States, 1960–1962
Through 2011–2012.
[ii] Rizzo
NS et al. Nutrient profiles of vegetarian and nonvegetarian dietary
patterns. J Acad Nutr Diet 2013 Dec;113(12):1610–9.
[iii] Spencer
EA et al. Diet and body mass index in 38 000 EPIC-Oxford meat-eaters,
fish-eaters, vegetarians and vegans. Int J Obesity 2003;27:728–734.
[iv] Tonstad
S et al. Type of vegetarian diet, body weight, and prevalence of type 2
diabetes. Diabetes Care 2009 May; 32(5): 791–796.
[v] Berkow
SE et al. Vegetarian diets and weight status. Nutr Rev 2006
Apr;64(4):175–88.
[vi] Wang
Y et al. Meat consumption is associated with obesity and central obesity among
US adults. Int J Obes 2009 Jun;33(6):621–8.
[vii] Vergnaud
AC et al. Meat consumption and prospective weight change in participants of the
EPIC-PANACEA study. Am J Clin Nutr 2010;92:398–407.
[viii] Rosell
M et al. Weight gain over 5 years in 21,966 meat-eating, fish-eating, vegetarian,
and vegan men and women in EPIC-Oxford. Int J Obes 2006
Sep;30(9):1389–96.
[ix] Halkjær
J et al. Intake of total, animal and plant protein and
subsequent changes in weight or waist circumference
in European men and women: the Diogenes project. Int
J Obes 2011 Aug;35(8):1104–13.
[x] Hernández-Alonso
P et al. High dietary protein intake is associated with an increased body
weight and total death risk. Clin Nutr 2015 Apr 7. pii:
S0261-5614(15)00091–6.
[xi] Vergnaud
AC et al. Macronutrient composition of the diet and prospective weight change
in participants of the EPIC-PANACEA study. PLoS ONE 2013;8:e57300
[xii] Vang
A et al. Meats, processed meats, obesity, weight gain and occurrence of
diabetes among adults: findings from Adventist Health Studies. Ann Nutr
Metab 2008;52(2):96–104.
[xiii] Turner-McGrievy
G et al. A two-year randomized weight loss trial comparing a vegan diet to a
more moderate low-fat diet. Obesity 2007 Sep;15(9):2276–81.
[xiv] Turner-McGrievy
GM et al. Comparative effectiveness of plant-based diets for weight loss: a
randomized controlled trial of five different diets. Nutrition 2015
Feb;31(2):350–8.
[xv] Barnard
ND. The effects of a low-fat, plant-based dietary intervention on body weight,
metabolism, and insulin sensitivity. Am J Med 2005
Sep;118(9):991–7.
[xvi] Barnard
ND et al. A systematic review and meta-analysis of changes in body weight in
clinical trials of vegetarian diets. J Acad Nutr Diet 2015
Jun;115(6):954–69.
[xvii] Fraser
GE. Vegetarian diets: what do we know of their effects on common chronic
diseases? Am J Clin Nutr2009;89(suppl):1607S–12S.
[xviii] Tuso
et al. Nutritional update for physicians: plant-based diets. Permanente
Journal 2013;17(2):61–5.
As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.
