Women's Health Specialists of St. Louis
Obstetrics and Gynecology

Articles - Weight Loss

Weight loss is always a top New Year resolution. We are bombarded with weight loss plans and pills. So what works? Many diet pills and supplements work by causing a decrease in appetite. They may also decrease the absorption of food or increase metabolism. The problem with supplements is that they can cause unwanted side effects such as nervousness, diarrhea, etc. As many people are aware, there were some diet pills that were removed from the market because of the risk of heart damage and even death. Supplements have no effect on fitness and rarely provide long term results. A fitness program however, provides health benefits in addition to weight loss. With proper diet and exercise women may decrease their risk of heart disease, high blood pressure, diabetes, osteoporosis, and depression. Though the benefits of diet and exercise are undeniable, the question for most is how to do it.

The goal for any weight loss program is to expend more calories than you eat. This is why both diet and exercise are so important. You want to reduce your total caloric intake and increase the number of calories that you burn . Exercise programs that teach you how to count calories can be helpful in selecting foods that give you energy without giving you unnecessary calories. For example, simply reducing the intake of soda can help a great deal. Non-diet soda contains about 140 calories for 12 ounces, so a 32oz soda contains almost 400 calories. So lets talk calories. If you drink 32 ounces of soda every day you will ingest about 2800 calories a week. You need to expend about 3500 calories to lose one pound of fat. Walking at 3 mph burns about 4 calories per minute in the average size woman. This works out to be about 240 calories per hour. So to expend 3500 calories you need to walk about 14 hours. Now of course I am not advocating walking a 40 mile round trip for weight loss. This example is just to give an idea of the cumulative calories we get with one or two large sodas a day and how even small adjustments in our diets do count.

Many women ask me which diet programs I recommend. It is important that a diet that is balanced, gives you energy, and helps you feel full. To achieve this goal, I recommend that women eat smaller meals more often. If women eat regular meals they will have more energy and are less likely to binge eat. Diets that have high amounts of fiber and protein are better at helping people feel satiated. A very low calorie diet will be of little benefit if it ultimately results in binge eating or if the diet is so restrictive on foods that it is difficult to follow while at work or traveling. With portion control and exercise then you can enjoy a variety of foods.

As for exercise, I recommend 20-30 minutes of sustained exercise three times per week. The key word here is sustained. You may need to dedicate an hour of time in order to get 20 or 30 minutes of strenuous exercise. Strenuous exercise is exercise of enough intensity to raise your heart rate and keep it elevated so that you are doing sufficient work to cause weight loss and improve fitness. I often tell my patients to warm up for five or ten minutes then perform exercise (walk, run, bike, or swim) for 20 minutes at a pace that is challenging (causes them to sweat or breath faster). I then tell them to cool with lighter exercise or weights and stretching for five or ten minutes more. Some people find that a target heart rate is useful for determining if they are exercising with enough intensity. The formula for target heart rate is (220-age) X 0.6. This will give you a heart rate that is 60% of your expected maximum heart rate. The key to exercise is to do it and to challenge your self.

Patients often tell me that they do work out and have not seen any change or have even gained weight. Since muscle weighs twice as much as fat it is possible to gain weight or more commonly see very slow decrease in weight while exercising. Pay more attention to how clothes fit rather than the weight on the scale. Your daily activities at work or at home do not count as exercise. Your body is already accustomed to that level of activity, so to lose weigh you need to further increase activity. This is the same with an exercise program. As your level of fitness improves you will need to increase the intensity of the workout to continue to have weight loss. Rather than increasing the time of the work out, increasing the intensity may be of more benefit. For example, on average walking 3 mph burns 4 calories per minute but running 4 mph will burn 9 calories per minute. So you could run for 30 minutes and burn more calories than if you walked for an hour. Some women are not physically able to run but fortunately there are other exercises that can be performed. Swimming, for example, expends even more calories at about 12 calories per minute.

Many people begin the first of the New Year highly motivated and then quit. The reasons are always the same. Lack of time, or no appreciable results from the effort. As far as time, you have to dedicate time for work outs. Women will have much more success if work outs are at an appointed time. Protecting that time is essential. I strongly recommend the use of a personal trainer for two reasons. First, it makes you show up. You are much more likely to go work out, if not going meant you would stand someone up. Second, the trainer will push you. You wont be at the gym talking with your girlfriend or gingerly moving from machine to machine. A trainer will make certain that you are there to work out. Though trainers can be expensive it may be a better investment than un-used gym memberships, failed diet programs, or chronic disease from obesity.