Ask an Expert: Losing the Last 10 Pounds

Q: “I have always carried extra weight, and have always dieted. Even though I lost around 40 pounds in my early 20s, I’m still carrying around 10 or 12 extra pounds. I rarely eat fatty foods or junk, but I have a low metabolism and I hate exercising. Do you have any advice to help me lose those last few pounds for good?”
Answer provided by Valerie Edwards, M.S., R.D., L.D., clinical dietitian, Providence Portland Medical Center, and Michelle Guitteau, M.D., director of ambulatory education, Providence Portland Medical Center: 

First, congratulations on losing 40 pounds! Taking off that much weight, and keeping it off, is a big success. That tells us that you have the skills to lose the rest — you just need some new ideas to get you to your goal, and to keep you there.

For inspiration, consider some strategies that have worked for thousands of participants in the National Weight Control Registry.  The NWCR gathers information from people who have lost at least 30 pounds and kept if off for at least a year. According to the registry, most participants eat a low-calorie, low-fat diet and have a high level of activity. In addition:
  • 78% eat breakfast every day
  • 75% weigh themselves at least once a week
  • 62% watch less than 10 hours of TV per week
  • 90% exercise, on average, about 1 hour per day
Weighing these ideas with what you have told us about yourself, we recommend five strategies that may help you lose those last few pounds.

1. Eat smaller, more frequent meals.

You say that you don’t eat fatty foods or junk — that’s great. You probably don’t need a lot of advice on what to eat, then, so let’s focus on how you eat. Are you a three-meals-a-day person? Many people find that they lose weight more easily when they switch to eating smaller meals more frequently throughout the day. Eating more often keeps metabolism higher and prevents you from getting too hungry, which can lead to overeating.

When we talk about small, frequent meals, we don’t mean snacking all day. We mean eating regular, balanced meals — including protein, complex carbohydrates and small amounts of healthful fats — but in smaller portions, spread more evenly through the day. For example, make yourself a sandwich for lunch, but just eat half of it with a piece of fruit for one meal. Three hours later, eat the other half with some raw, crispy vegetables.
2. Don’t skip meals — especially breakfast.

Skipping meals or going more than five hours without eating slows metabolism, so we wouldn’t recommend skipping meals — especially breakfast. The importance of eating breakfast has been well-researched and substantiated. Most people who skip breakfast make up for the skipped calories by overeating later. The net effect can be weight gain, rather than loss. So even if you’re not a morning person, try to eat a little something within two hours of getting up.

3. Eat more produce.

Eat at least three to five servings of vegetables and three servings of fruit every day. Besides providing essential nutrients and fiber, eating more fruits and vegetables will leave less room in your belly for higher-calorie foods that you might normally eat.

Researcher Barbara Rolls, Ph.D., has found in multiple studies that people generally eat about the same volume of food every day, so when they eat more low-calorie foods, they consume fewer calories overall and lose more weight.

(View study 1.) 
(View study 2.) 

Since fruits and vegetables have high water content, they are naturally low in calories. Eating more of them, therefore, is a great way to reduce your daily calorie intake. One easy strategy is to include more vegetables in main dishes, like pastas and casseroles. You’ll increase your vegetable intake and reduce your total calories at the same time (as long as you don’t increase your portion size). 

One caution: a lot of people think they eat more fruits and veggies than they actually do. As you are developing this new habit, write down every serving of fruits and vegetables you eat each day, just to make sure you’re hitting your targets. For that matter...

4. Write down everything you eat and drink.

Have you ever kept a food diary to see exactly what you have been eating? Many studies of weight control show that writing down what you eat is helpful both for losing weight and for maintaining weight loss. Don’t forget to write down what you drink, too — beverages can be a huge source of hidden calories (see Ask an Expert: Beverage Guidelines)

Get a small notebook to use as your food diary, or go online to find a diary program — there are several available at no charge. Many even give you an analysis of what you’re eating. The main point, though, is just to keep a record that you can refer to if you need to make adjustments, and to keep you focused on your goal.

5. Be a NEAT freak.

You say that you don’t like to exercise, but if you really want to lose the rest of that weight, you need to increase your activity level, whether you call it “exercise” or something else. In the end, weight loss all comes down to calories in and calories out. There are only so many calories you can cut from your “calories in” — your body requires at least 1,200 calories a day just to function correctly. To lose the last 10 pounds, therefore, you need to look at increasing your “calories out” — the calories you burn through activity.

That doesn’t mean you have to get the dreaded gym membership and spend hours a week forcing yourself to do “exercise.” As a self-described exercise hater, you might try a new approach called non-exercise activity thermogenesis (NEAT).  NEAT refers to the amount of energy we expend throughout the day with normal activity — such as cleaning house, gardening and walking to the mailbox. There’s some great research going on that suggests that the percentage of calories we burn through NEAT could be much higher. All we have to do is to find ways to be more active throughout the day. 

If you work in an office, for example, find more reasons to get up from your desk: go talk to people instead of e-mailing; walk somewhere for lunch; get up and pace when you’re on the phone. In the evenings, if you watch television, get up on every commercial break and walk around the house; balance on an exercise ball; run outside and pull a few weeds. Once you start, it can be a fun challenge to find new ways to tuck activity into the corners of your life. For more ideas, see Ask an Expert: Finding Time for Fitness

One tool you might use to measure your NEAT, as well as your overall level of activity, is a pedometer. Using a pedometer has been shown to increase activity and weight loss, and to lower blood pressure, as well.

Good luck!

If all this advice seems a little overwhelming, pick just one or two of these strategies to focus on. When those no longer seem like a challenge, add another new one.

Finally, be kind to yourself. Some people set overly ambitious weight-loss goals, or find that achieving the “perfect weight” takes more time and energy than is realistic. You might decide that it’s OK to weigh a few pounds more than your ideal, and as long as your weight isn’t having a negative impact on your health, that’s perfectly acceptable.

Whatever you decide, we wish you good luck!

May 2008

Ask an Expert is a public education forum only.
Questions are selected for the Web site based on their general interest to a wide audience. Ask an Expert does not respond directly to your questions or provide personal medical advice, diagnoses, treatment recommendations or second opinions through our Web site or by e-mail. Please talk with your health care provider about any questions specific to your medical care.