How NOT to lose weight.

OK, here we go. A quick review of some of the more popular methods that do not work. Saran wraps, saunas, steam baths, rubber suits (sauna suits), rubber waist belts (you cannot spot-reduce--weight comes off the body rather uniformly), diet pills (any pills), shots, grapefruit (sorry, it doesn't burn calories), electrical stimulation of muscles (socalled massive exercises), fasting (you cannot shrink your stomach), severe restriction of calories (so-called starvation diets), high-protein diets, low-carbohydrate diets, skipping meals, drinking eight glasses of water a day (nothing wrong with that; it just won't help keep weight off), very low-calorie liquid diets (prescribed for certain very overweight persons, but only as a temporary measure and only under medical supervision; their success is totally dependent on how well the person learns behavior modification techniques), jaw wiring (a forced fast), liposuction (a cosmetic reshaping and contouring of certain body areas), and certainly not "Dream Away" pills. The people who market those pills should be incarcerated. Maybe they could dream their way out of jail!

I don't mean to burst your bubble if you're currently using one of these methods. However, if you've tried one or more in the past, you no doubt can nod in agreement--they just don't work!

Now, let me back up a bit. There are right ways and wrong ways to lose weight. Right means that it's safe, effective, and more likely to endure. Wrong means that it's unsafe, counterproductive, and not enduring--as is the case of those I've mentioned.

Why would anyone opt for a "wrong" way to lose weight? Perhaps it's because he or she doesn't know what's right and what's wrong. More likely it's because the wrong way works much quicker (at least initially), and impatience rules. Most of us become disenchanted when the weight doesn't come off now!

People "hurry up" to lose weight so they can "get on with their lives." But getting on with your life necessitates a lifelong commitment to changing the circumstances that are responsible for the weight gain in the first place.

The sad truth is that nothing worthwhile comes easy--not even (especially!) losing weight. It's tough enough to lose those extra pounds; it's even tougher to keep them off. Ninety-five percent of persons who lose weight regain every pound within two to five years. Some even gain more than they lost!

To keep it off

To keep it off, you must change forever what caused the weight gain in the first place. When you go on a diet, you lose weight. Any diet, if followed, will cause weight loss. That shouldn't come as a surprise, because all diets adhere to a basic principle-- caloric restriction. If you eat less, you will lose weight. The problem comes when the diet is abandoned. No one can stay on a diet forever, and when the diet ends, the weight returns. The old adage goes, "If you always do what you've always done, you'll always get what you always got!" You cannot go back to your old ways if you expect to maintain your lower weight. And that means you have to change your lifestyle. It means that you have to learn new ways of doing things. It means that you must master some basic behavior modification techniques.

"Techniques like hypnosis, herbal diets, and self-help diet books rarely work because they fail to incorporate a behavioral approach to weight control that emphasizes permanent changes," says Dr. Kelly Brownell of Yale University, an internationally known weight-loss expert.

So what is needed is not a diet, but a permanent change in those behaviors that brought about the weight gain in the first place. Think of it this way: anything done to lose weight that isn't done regularly (i.e., on a day-to-day basis) won't sustain weight loss. If you go on a diet to lose weight, then you're going to have to stay on that diet for the rest of your life if you expect to maintain a lower body weight. So if what you do to lose weight isn't a permanent change, you can forget about maintaining a lower weight.

Quick fixes--the wrong way

Again, what doesn't work are quick-fix gimmicks. Diets that emphasize the elimination of certain foods, or an overabundance of another type of food, are providing false hope at the expense of the consumer.

Diet books sell primarily because they promise quick results with relatively little effort. We love that scenario! Suggestions of lifestyle changes are generally not well received by the public. If it isn't convenient, uncomplicated, socially compatible with current lifestyle, and quick, it probably won't receive much attention from the weight-conscious person. The authors of diet books know this and are careful to avoid suggesting major or sweeping changes in the way a person lives. Most books that are marketed as "diet" books should be avoided.

"The only way to lose weight and keep it off is to make really big changes in your lifestyle," says Dr. Albert Stunkard, a leading obesity researcher. There are no exceptions to this rule, and only those who come to grips with this fact will be successful.

The right way

Before embarking upon a weightloss effort, you must answer this question as honestly as possible: Am I ready to make some basic (and in some cases major) changes in my lifestyle? If you can honestly answer yes and are firmly committed to learning new ways of living, then you'll be successful. So the first step is to be firmly committed to making permanent lifestyle changes.

The next is to recognize that your weight loss has to be based in a twopronged approach: caloric restriction and physical activity. Caloric restriction means that the number of calories currently being consumed will probably have to be reduced, but more important, the source of those calories (for most persons) will have to be changed. That means eating a lot less fat!

Research indicates that calories in the form of fat are much more easily converted to fat storage (body fat) than are calories in the form of carbohydrates or protein. And while it remains true that all excess calories (calories not used immediately by the body) are ultimately stored as body fat, more of excess fat calories end up stored than an equal number of excess carbohydrate or protein calories. So to paraphrase a popular quote "A calorie is not a calorie by any other name," at least not as far as the body is concerned.

Know your ABCs

Learn when, where, and why you're eating. This goes back to behavior modification, "the cornerstone of any enduring weight-control effort," says Dr. George Bray, a physician who specializes in the treatment of obesity.

The principles involved are really rather simple. Think of them as the "ABCs" of behavior change. The A is for the antecedents of eating (i.e., the events immediately preceding eating). Very often these events are stimuli (something that triggers the behavior) and can be anticipated and controlled. If whatever causes the eating is eliminated or at least controlled, then the behavior that normally follows (in this case, inappropriate eating) can be prevented.

Typical antecedents to inappropriate eating are sometimes referred to as high-risk situations that evoke tension, anxiety, or depression. In other words, watch out for stress-provoking situations. Another cause for lapses in behavior is unstructured environments in which the person loses the control.

A good example of this is eating out with friends who aren't at all concerned with watching their weight.

The B is for behavior. Since the concern is gaining weight, the behavior is inappropriate eating (such as overeating or eating a high-fat diet).

But it also stands for another behavior, namely exercise. If that word intimidates you, use "increased physical activity."

I'm not talking about running or even jogging. Aerobic activities such as these are wonderful for increasing cardiovascular fitness (and for weight control), but they are not required activities for weight loss. The goal for weight loss is to expend calories so they don't wind up being stored as fat. Remember, if you don't use the calories, they have to go someplace, and that someplace is on your body as fat!

The kind of activity I'm suggesting is walking. A person who walks a mile in about 15 to 20 minutes uses about the same number of calories as a person who runs the mile. It will take you longer to burn those calories if you walk, but you'll still expend the same amount of energy.

If behavior modification can work for controlling unwanted behavior, it can surely help incorporate desirable behavior.

Finally, the C refers to the consequences of the behavior. I know it' s not necessary to dwell on the consequences of overeating, inappropriate eating, etc. Many of you have learned painfully that the consequences are obesity, loss of self-esteem, feelings of inadequacy, and so on. Of course, consequences can be good, too. For example, the consequences of increased physical activity are many, not the least of which is help with weight control.

And finally...

Now go back to the beginning of this article and review all the popular weight-loss methods being touted today. Then remember this: if your program to lose weight doesn't consist of a low-fat diet, regular aerobic activity, and behavior modification, it's how not to lose weight. It's really that simple.

D. Craig Huddy, Ph.D., C.H.E.S., is an assistant professor in the Department of Health, Leisure, and Exercise Science at Appalachian State Universi.ty, Boone, North Carolina. He teaches and conducts research in health behavior change strategies, weight management, smoking-cessation programs, and alcohol treatment programs.