Diet: Simple Secrets of Success

No doubt you've heard this grim statistic about weight loss: 90 percent of dieters who lose weight regain it -- and sometimes more - within five years. This has become an article of faith among dieters, and it leaves many people hopeless about slimming down.

But it shouldn't - because it's a myth, says Kelly Brownell, Ph.D., director of the Yale University Center for Eating and Weight Disorders.

The statistic is based on a study, published in 1959, of 100 people treated for obesity at New York Hospital. Researchers gave them a handout about dieting, sent them on their way, and tracked them down five years later. The study involved no exercise program, no professional counseling, no support group, in short, nothing that most weight-control programs include today.

Wanted: Successful Dieters
Back in 1992, nutritionist James Hill, Ph.D., of the University of Colorado Health Sciences Center in Denver, and psychiatrist Dr. Rena Wing, of the University of Pittsburgh Medical Center in Pennsylvania, had no idea the 90-percent rule was questionable. But they looked at it from a different perspective: If 90 percent of dieters regain their weight, 10 percent keep it off. Sure, the percentage is low, but with millions of Americans trying to shed pounds, hundreds of thousands must be succeeding. The researchers wondered: How do those people do it?

The researchers placed ads in magazines soliciting stories from people who had lost at least 30 pounds and kept it off for more than a year. Their mailbox was soon crammed with responses. Drs. Hill and Wing established a database, the National Weight Control Registry, at the University of Pittsburgh. They have continued to enroll people, and the registry now has more than 2,500 success stories -- 80 percent from women, average age 45. The typical registry participant has lost 67 pounds (from 220 to 154) and kept if off five years. Ten percent of registry members have lost more than 100 pounds.

Recipe for success

• Diet and exercise. About half of all dieters rely entirely on food restrictions to lose weight. About one-third simply exercise more. Fewer than 25 percent of dieters combine the two, the most effective approach. Among weight loss successes in the Pittsburgh registry, 89 percent changed their eating and exercise habits. All had previously failed to lose weight or had regained it after changing one or the other.
  
• A low-fat, low-calorie diet. Most successful dieters cut down on fat and calories. Drs. Hill and Wing estimate that the typical participant's diet has around 1,500 calories a day, with 24 percent of calories from fat. Eighty percent of the participants used ordinary food, 20 percent used liquid formulas, 4 percent used diet drugs. Only a smattering used fad diets. All participants wound up adopting a diet they were content to maintain. They enjoy occasional indulgences, such as ice cream and cheesecake, but in small portions.
  
• Regular exercise. Almost all registry participants - 96 percent -- exercise regularly. They burn about 2,800 calories a week in physical activity, the approximate number consumed by walking briskly for 45 minutes a day. Walking was the most popular exercise, but some participants also do aerobics, cycling, stair-climbing and other activities. As they lost weight, they continued to exercise. Many gradually increased the intensity and duration of their workouts. Ninety two percent get most of their exercise at home, not gyms.
  
• Realistic goals. If you set out to lose 40 pounds, you're likely to get discouraged. Most successful dieters set a goal of 10 percent of their body weight -- 20 pounds for a 200-pounder. After achieving that, they set a new goal, perhaps 5 to 10 percent of their weight.
  

Genetics, and other myths
The stories in the registry have poked holes in other pieces of conventional weight-loss wisdom:

• "If your parents were overweight, you're genetically fated to be fat." More than 70 percent of registry had at least one obese parent, yet they succeeded in losing weight.
  
• "If you were fat as a child, you're fated to be an obese adult." Half of the successful dieters were overweight as children.
  
• "If you try to lose weight and fail, you can never succeed." More than 90 percent of participants spent years in endless yo-yo diets before successfully losing weight permanently. They learned from their mistakes.
  
• "To lose weight, you can't snack." Registry participants eat between meals, but avoid high-fat, high-calorie snacks such as chips and candy bars. They typically snack on fruit, vegetables, low-fat pretzels.
  
• "To lose weight, you have to stay out of restaurants." Registry participants eat out two to three times a week. They try to avoid fast-food restaurants.
  
• "Losing weight makes you miserable." On the contrary, 92 percent of participants say that losing weight, though challenging, has improved their lives.
  
• "Losing weight is hard. Keeping it off is harder." Almost half the participants say that keeping it off is easier. Why? After successfully losing weight, they have confidence that they can keep it off. In addition, they've stopped "dieting," by definition a temporary lifestyle adjustment. They've made permanent changes in their diet and exercise habits, which they're comfortable maintaining for life.
  

Finally, when dieters succeeded in losing weight, they did it for themselves -- not for carping relatives, not to look good at their high school reunions. Internal motivation kept them going. As one registry participant put it, "Sure, I'd like to pig out on brownies and hot fudge sundaes, but for me, maintaining my weight is more important."