Ask Your Family Doctor

Developed by the College of Family Physicians of Canada

Why don't diets seem to work?

"Going on" a diet is not the answer to losing weight. This is because the weight is soon regained after you "go off" your diet. If diets really worked, there wouldn't be so many of them! Instead, your usual eating and exercising patterns need to be changed so that your weight stays right for you.

How much should I weigh?

This is a tough question. Even though everyone talks about weight, it's really how much fat you have that matters. Two people can be the same height and weigh the same, but one person may look overweight and the other may look fine. Someone who exercises regularly and has more muscle looks thinner than someone who is inactive and has more fat.

You may think you should weigh less when your weight is already a healthy one. Pictures of models in magazines pressure people into thinking that they should be very thin. This isn't true. Talk to your family doctor about what is right for you.

What things contribute to being overweight?

Many things may contribute to weight problems. Overweight people often have struggled with their weight for a long time. You may believe that you don't have enough willpower to lose weight or to keep it off. But lack of willpower may not be the problem. Many other things may be at the root of your weight problem, such as the things listed below.

Some causes of overweight

	Weight problems which run in your family
	Eating when lonely, sad or stressed
	Being pressured to eat by friends or family
	Using food for recreation
	Taking medicine that makes you feel hungry
	A low metabolism (the rate you burn calories)
	Problems with hormone levels

What about when I eat because I feel sad or lonely?

Let yourself feel how you're feeling without eating. It's not the emotions that are making you gain weight. It's the eating that you may do in response to them. After you let yourself feel your emotions without eating, you may discover that eating doesn't really help you feel better. In fact it may make you feel worse. Making healthy food choices when you're stressed will get easier as you do it and see how good you feel later.

How can I lose weight?

The best way is to work on the things that have contributed to your being overweight. A new diet plan may help you lose weight for a little while. But the weight often comes back unless you find new ways to deal with the things that have contributed to your being overweight. This may include learning new ways to deal with your stress, finding ways to feel less lonely or talking with a counselor about how you're feeling.

A few general tips may help you.

1. A regular exercise program. Few people lose weight and keep it off without exercise. Your doctor can help you plan an exercise program that will be right for you.

2. A regular eating pattern. For most people, this will be three meals a day. The three meals should be about equal in size, and the foods eaten should be low in fat.

3. Support. Support from family or friends is very important for long-term success in losing weight.

Why is exercise a big deal?

Exercise has so many benefits for people who want to lose weight. Regular exercise helps you burn calories faster, even when you're sitting still. Exercise does this by raising your metabolism. It also helps you burn fat and build muscle. So, even if you don't lose pounds, you may lose inches.
Exercise also tends to curb your appetite. It's a healthy alternative to eating for entertainment. It can help reduce stress. Exercise is good for the health of your heart and bones too.

What's the best type of exercise?

The best kind of exercise is exercise that you'll keep doing throughout your life. Aerobic exercise raises your heart rate and helps burn calories. The longer you exercise, the more your body will burn fat. Working out for even as little as 10 minutes at a time will help you get some benefit from aerobic exercise. Aerobic exercises include swimming, walking fast, jogging and bicycling. Try to work up to 20 to 30 minutes at leas three times a week.

Walking, even at a slow rate, can be very helpful. If you choose this as your exercise, work up to walking for one hour, five times a week.
The main thing to remember is that any sort of exercise is better than none at all.

How can I make exercise a habit?

To be helpful in the long run, the exercise you choose can't be a drudge or a chore. Choose an exercise you enjoy. Exercising with a friend may help. It may be hard for you to keep at something if you do it alone all of the time.

Tips on achieving a healthy weight

	Eat only until you feel satisfied.
	Begin meals with clear soups, broth or something light.
	Eat vegetables, grain foods or other starchy foods and protein foods at each meal.
	Eat slowly so your body has time to know when it's full.
	Drink 8 glasses of water a day.
	Exercise.
	Stock your desk or home cupboards with low-fat snacks.
	Don't keep high-fat foods in the house.
	Avoid alcohol.
	Let yourself indulge now and then. This helps you not feel deprived, which may cause you to eat too much later.

How can I change my eating habits?

You have learned your eating habits over time. Don't expect to change them overnight. Change them one by one. Start by training yourself to eat without doing anything else at the same time. Focus on what you're doing and try to eat slowly. For example, don't eat while you watch TV. It may not be easy at first. And it will probably be easier to start slowly-maybe adding one new health habit at a time (like taking the stairs instead of the elevator or starting a walking program) or stopping one unhealthy habit at a time (like not eating donuts every morning).

Foods high in fat

	Pastries, donuts, cakes, cookies, sweet rolls
	Crackers (other that saltines)
	Chips (potato chips, corn chips)
	Cheeses (other than cheeses made from skim milk)
	Nuts, peanuts, peanut butter
	Corn, soy, olive, peanut, coconut and all cooking oils.
	Margarine, shortening
	Butter, cream, ice cream
	Fried foods, hot dogs, luncheon meats

What's so bad about high-fat foods?

Fat has more than twice the calories of carbohydrates and protein. Also, your body more easily uses fat calories to make body fat, compared with calories from carbohydrates or proteins. Fat in your diet may also confuse your appetite, not letting it tell you when you're full.

Why is skipping meals not helpful?

Though skipping meals may work for a while, it backfires in the long run. This is because you get hungry and frustrated, and then eat too much at once.
You may be so used to skipping meals that you don't feel hungry at normal mealtimes. For example, you may not be hungry in the morning. But after about a month of eating a normal breakfast and lunch and a light dinner, your body will readjust.

What can I say when my friends or family pressure me to eat?

Social pressure can be hard to resist. Sometimes a direct explanation and a request for support are enough to get people to understand. When that doesn't seem to be enough, telling them it's your "doctor's orders" may do the trick. If not, you may have to avoid those people until you feel comfortable enough with your new habits.

Won't diet drugs help?

Drugs that control your appetite (called appetite suppressants) may make it easier for you to lose weight for a while but they don't help you keep the weight off after you quit taking them. This is because taking drugs doesn't help you learn to change your habits.
Appetite suppressants can also raise blood pressure and cause other side effects and making permanent changes in your eating and exercise habits is the only way to lose weight and keep it off.

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Revised 2007 The College of Family Physicians of Canada

This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor. This health education material has been favorably reviewed by the Patient Education Review Committee of the College of Family Physicians of Canada: Dr Cathy MacLean, Halifax, NS (Scientific Editor) Dr C. Richard Fischer, Pickering, ON Dr Patrice Laplante, Fleurimont, QC Dr Richard Moffatt, Red Deer, AB Dr David Nunn, Kentville, NS Dr Cornelius Woelk, Winkler, MB The College of Family Physicians of Canada, one of the nation's largest medical groups, is committed to promoting and maintaining high standards for family physicians - the doctors who provide ongoing, comprehensive care for people of all ages. This patient education information was developed by The College of Family Physicians of Canada in cooperation with the American Academy of Family Physicians.

Support for this program has been provided by an educational grant to the Research and Education Foundation by Scotiabank.