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DEAR MAYO CLINIC: My mother, age 64, has been on a weight-loss roller coaster for years. She will stick to a strict diet for many months, sometimes losing 50 pounds or more. Then, those eating habits fade, she gains all the weight back and feels terrible about it. Right now, she’s quite overweight again and is thinking about starting another big diet. Would moderate weight-loss she can sustain long term, even if it doesn’t get her to an ideal weight, be healthier than these extremes?
ANSWER: Your mother’s pattern of weight loss and regain — weight cycling — is very common. Because she hasn’t had success keeping weight off in the past, it would be a good idea for her to use a different approach. Rather than following a strict diet, adopting healthy, ongoing lifestyle changes would be a more effective way for your mother to lose weight, improve her health and maintain her weight loss long term.
The typical approach to losing weight uses a dieter’s mentality. People follow a restrictive program that forces them to always limit what they eat. This type of strict diet often makes people feel deprived. When dietary habits are negative and restrictive, they’re likely to be temporary. Eventually, people feel they can’t keep it up any more, so they abandon their efforts and often gain back any weight they lost.
Contrary to what many people think, this cycle of losing and gaining weight does not increase a person’s risk for health problems. In addition, weight cycling does not make it more difficult to lose weight again. That said, weight cycling can be very frustrating and undermine a person’s self-confidence and self-esteem.
There is a more effective approach. First, one of the most important steps to successful weight loss is planning. Before you make any changes, set goals. Beyond sustained weight loss, do you want to feel better? Do you want to decrease health risks? Do you want to be able to be more active? If you decide on those goals first, you may find that you realize them as you make healthy lifestyle changes — even if you don’t reach a specific number on the scale. Reaching those goals may be motivating enough to help you maintain your changes.
Once you set your goals, think about lifestyle changes that can help you achieve them. You should be able to incorporate these changes into your daily life, so they become long-term habits. Try to make them specific, realistic and positive. For example, you could say, “I’m going to start walking 15 minutes a day, three days a week,” or “I’m going to eat one more serving of fruits and one more serving of vegetables each day.” As you achieve those changes, continue to build on them. It is possible to decrease calories, follow a practical and tasty dietary pattern, and feel good at the same time.
Mayo Clinic has a program based on these principles. The Mayo Clinic Diet decreases calories, but instead of taking a negative and restrictive approach, we encourage people to eat healthy, tasty food. By changing the way people eat in a positive manner — for example, they can eat as many fresh or frozen fruits and vegetables as they want — the Mayo Clinic Diet emphasizes a healthier, lower-calorie pattern of eating that is practical, enjoyable and sustainable.
Whatever approach she takes, as your mother moves forward with her weight loss, I would encourage her to think about how she can make positive lifestyle changes in diet and physical activity that will help improve her health. Beneficial lifestyle changes that can be sustained over time will lead to much more desirable and lasting weight-loss results, and an overall improved quality of life. — Dr. Donald Hensrud, Preventive Medicine, Mayo Clinic, Rochester, Minnesota