Weight loss that works: A true story – Harvard Health

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Harvard Health Blog
Many people struggle with being overweight, or even obese. It’s a common topic at office visits. As a doctor, I know that excess weight is associated with potentially serious health conditions —  high blood pressure, high blood sugar, high cholesterol —  not to mention sleep apnea, fatty liver disease, and back and knee problems, among other things. Patients may also worry about their appearance.
Whether a patient is at risk for medical problems due to being overweight, or if it’s a personal health goal, then it’s my job to provide counseling.
In my experience, most patients consider weight loss drugs or surgery only as a last resort.  “I want to lose weight naturally,” they say. Once we screen for (and treat) any contributing medical problems that could be causing weight gain (low thyroid function, polycystic ovarian syndrome, prediabetes, among others), or psychological issues (bulimia, binge-eating disorder, depression, anxiety), I encourage a diet-and-lifestyle approach for many reasons, among them my own personal experience.
A few years ago, I embarked on a personal weight loss journey. I had had two pregnancies back-to-back, and had gained considerable weight, to the point where my own body mass index was over 30 (obesity range). I was many months postpartum, and realized that the “baby weight” wasn’t going anywhere. As a matter of fact, I had gained even more weight since my daughter was born.
At that point, I had a quandary many people can identify with: I was one of two working parents, with two kids under two. How on earth does one tackle weight loss when one is busy and distracted? What I did was fairly basic, and there is research to back up this approach:¹
Here’s what worked for me:
What does the science say about my approach? Let’s take a look.
Studies have shown that just about any diet will result in weight loss, if it’s one that someone can follow.^1,2 Esteemed Yale physician and nutrition expert David Katz examined over 58 popular diets and found that the most successful in terms of both weight loss and nutrition consist of “real food.” By that he means plants, whole grains, nuts and seeds, as well as meat (ideally, from animals that ate plants). Basically, foods closer to nature. The other key is minimizing processed foods, including sugars and flours.³
Without realizing it, I followed Katz’s advice: I ate mostly fruits and vegetables, nuts, seeds, and dairy. I occasionally had whole grains like quinoa or farro, even rice or corn chips. And, of course, an occasional treat. But I had sworn off sugars and flours, for the most part.
It’s hard to keep track of how much we eat. But a lot of research shows that when we keep track of intake, we eat less. This is called self-monitoring, and why writing down what I ate and weighed helped me.^4,5,6 There are so many ways to do this nowadays: from the old-school paper-and-pencil method, to apps like MyFitnessPal, or the Weight Watchers points system.⁷
Another key approach: forgive your failures. Studies show that people who “mess up” their diet plan and then “give up” end up gaining, while people who forgive themselves and move on continue to lose. It’s called self-acceptance.^8,9 Look, we’re human. Birthdays, office parties, weddings, random movie nights: they happen, and we celebrate by having the amazing chocolate cake, or Betsy’s famous buffalo chicken dip, waaaay too much champagne, or buttered popcorn. Expect this, enjoy, and then move on.
Most major weight loss is followed by weight gain, as people revert to their old habits. But, some folks manage to keep it off. How do they do it? Researchers have found that maintaining a healthy diet, ongoing self-monitoring, plenty of self-acceptance, as well as a high level of physical activity are all associated with keeping the pounds off.¹⁰
When I feel like I’m slipping, I start logging again. Nowadays, I use an online fitness app on my phone to more easily keep track of my daily food intake. Red wine and dark chocolate are always in stock in our house, and that’s OK. Exercise is important, too, but in my book, any and all physical activity counts. Two or three workouts a week help me maintain muscle tone and cardiovascular fitness. If I can’t get to the gym, I run. If I can’t run, I do something at home, like five minutes of in-place kickboxing moves, or dancing around the living room like a crazy person with my kids. I take the stairs wherever I am as often as possible. I use a carry basket at the grocery store, and switch from arm to arm while I shop: biceps curls! Hey, it all counts.
The old adage is “eat less, exercise more,” and this is still true, to some extent. But human beings are psychologically and sociologically complex creatures, and that adage is a lot harder to follow than it sounds. For average adults who do not have contributing medical or psychological issues, a nutritious plant-based diet low in processed foods and carbohydrates, consistent self-monitoring of intake and progress, forgiving oneself when expected lapses occur, all combined with regular physical activity, can result in weight loss for life.
 
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Hi,
I read your blog it is very knowledgeable and interesting. I’m a professional gym trainer daily exercise and work out is very important for fitness and healthy life. Make your workout your priority.
Very good blog I love it 🙂 Thanks for sharing.
Thanks for sharing the article Monique. Obesity and more body fat can make people weak and accustomed to several diseases. Diet is the single most important thing when losing weight along with regular exercise and sipping green tea. Love the idea about self-monitoring though. This is something many people totally ignore. Stuffing down whatever is served on the plate is an unhealthy way of eating. While losing weight people should make sure they are receiving enough nutrition.
Your story demonstrates that the NY Times is sending so the wrong message with “Americans Blame Obesity on Willpower, Despite Evidence It’s Genetic” – by stating genetic predisposition and contrasting it against will power, they are asking people to resign themselves… ah.. its in my genes, sorry. What your and thousands of story e.g. on forum.lowcarber.org show is that will power has a lot to do with it – even if some people are more genetically predisposed than others, the epidemic isn’t here because our genes changed. I had a fairly similar story except the excess weight was due to stopping smoking, so it was tempting – I knew exactly how to lose weight, but did not want to start smoking again
I think (in my case also) was accepting that there are no quick fixes. Interesting article and thanks for the share
I agree and thank you!
Dr Tello

How do you feel about almond milk? Do you believe it’s more healthy than skim milk?
Not necessarily healthier, but it is a healthy alternative. Many people cannot tolerate dairy, or can only tolerate so much. Having all the varieties of nut milk nowadays is a really nice thing for people.
Thanks for this article. I too have found that whole foods worked for me when I wanted to lose weight along with drastically reducing sugar. I also found a high fat diet, as illustrated on healthyfittips.xyz also helped.
I have largely a Vegan diet but still was overweight and bloated – until I cut out bread, wheat products and dairy – lost 10 kg in 2 months and people tell me I look amazing! I eat a lot of food too, lots of olive oil and avocado.
Yes, decreasing the amount of certain foods that more easily convert into fat can help with weight loss. However, for some people it can be very difficult and unappealing to completely exclude whole categories of food.
Hi. I too read Dr Gregers How Not to Die and have found followed his
Diet suggestions for over a year now in an attempt to reverse prediabetes, atherosclerosis, who knows what else after years of the kind of diet recommended here. I’m a 75 year old. With the diet (giving up animals and dairy ) and more exercise, I feel great. I went camping in Yosemite up 8 and 9k ft which I couldn’t have done a year ago. I also,want to keep my mind clear. Keeping my circulatory system seems to me the smartest thing I can do. As heart disease is preventable and reversible so I am hoping is dementia. It seems to me Harvards new diet is primarily plant based with small amounts of animal proteins — 200 mg. Why not give it up? I’m a foodie and enjoying my new way of life. Oh and I lost 10 pounds without counting calories.
Sounds like veganism is working well for you! That’s nice, but it can be really hard for people to completely cut out all animal meats/ products. I think a diet that is largely based in fruits and veggies with occasional animal protein is fine as well, and the world would be a better place if we all adopted some version of that.
Thank you Doc. for your submission.
Please are groundnuts okay, i mean a lot of them when you want to loose weight?
Like peanuts? These are healthy, in moderation. They are concentrated sources of calories, so one needs to watch the intake.
Out of curiosity, which commercial diet did you (more or less) follow?
Hi Doris, South Beach, but not to a “T”. I never eliminated any food groups completely (like, fruit). And I never bought any prepared foods. It was kind of the “hot” diet at the time.
I like this article and my heart goes out to everyone struggling with obesity. I think the comments demonstrate that no one method works for everyone. Because of both mental and physical genetic variation we must find the way that works for us. Clearly physical activity and essential nutrients are play a huge role in health and weight loss. How you accomplish these goals can be done in may ways. Thanks for sharing this info.
Thanks so much for reading and commenting!
Good and educative article. We must discipline ourselves otherwise we commit suicide. We are killing ourselves through our eating habits and lifestyles. Thanks for demonstrating to us that nothing is impossible with discipline. This formula has less financial implications – yet it reduces expenditures on foodstuffs
Thanks- a diet high in fruits and veggies can seem like it’s going to be expensive, but there are ways to stay on budget, you are correct. Frozen produce, CSA’s, cooking in bulk are all useful tricks.
Thank you so much for this beautiful article..i have never had problems with weight loss until after i had my last child and hysterectomy years later because i am always finding myself going back to the gym which has helped me greatly.Lately I have found it difficult to lose the pounds because I mess up my diet plans and think it wont work , so I give up..thank you for encouraging us forgive ourselves and continue on with the diet..i am now encouraged and energised the to do it once again..
Oh, wonderful! Yes, forgive yourself and move on towards your goals, and you will do fine!
I’m not an expert, but I read the article and follow-up comments with great interest. Thank you.
It is kind of entertaining, isn’t it?
Sorry, I should have read those articles on carbohydrate in full first before I got on my soap box. They’re inaccurate too. In 2015 the Scientific Advisory Committee on Nutrition (SACN), advisors to the UK government, did a meta-analysis of all the best research and found none of the effects on health, i.e. heart disease, cancer and diabetes, reported by small scale studies and the likes of Robert Lustig. Link: https://www.gov.uk/government/publications/sacn-carbohydrates-and-health-report
Demonising whole food groups isn’t helping anyone. Yes, cut down refined flour but only because it lacks fibre and micronutrients such as folate. Sugar isn’t great for your teeth and easy to over-consume, which is really the actual problem. It’s simple maths, consume more than you burn, regardless of whether it’s fat, sugar or protein, you gain weight. Consume less than you burn, you lose it.

I will say the report above does note a casual link between sugary drinks and type 2 diabetes but, as they suggest, more research is needed. It doesn’t really make sense. Soda raises blood sugar no faster than a banana (glycaemic index). Also, why not confectionary too?
Food is information regarding of the numbers. It’s not just simple maths. Calories in vs Calories out will have an very different outcome in someone who consumes a healthy mainly plant based diet than someone who just eats junk. We are much more complex than that type of old school thinking.
Also, “demonising food groups”???. as far as I know Flour and sugar are not food groups. They might be part of one but sure as hell do not compriseone. The author never wrote she stayed away from carbs but simply stated what worked for her by staying away from sugar and flour. Many people have been successful at eliminating anti-inflammatory foods in their weight loss efforts. Bashing people’s personal experience in the efforts of conveying your own perception and information is not kind. You are not right and she is not wrong. We are all different.
Bill

I started my journey just about 1 year ago to the day and have lost 42 lbs. The hard part will be keeping it off. I used the same ideas as the author and will tell you they work. Be kind to yourself and forgive yourself if you slip up. Log your food and by all means do your exercise. My wife and I walk approximately 2 miles a day in addition to the normal walking we do around the house.

It also helps to have a partner to whom you are accountable!
Wow, that’s quite an accomplishment! Thansk so much for sharing your experience and your tips!
I’m a nutrition graduate (MSc dietetics student) and I’m frankly shocked that this has been allowed to be published. It’s borderline “clean eating”, now proving to be an antecedent to eating disorders and pro Atkins. It also contradicts other articles written by Harvard: https://www.hsph.harvard.edu/nutritionsource/carbohydrates/low-carbohydrate-diets/
https://www.hsph.harvard.edu/nutritionsource/carbohydrates/

Contradictory, confusing and purely anecdotal.
Yes, it is purely my experience and my take on the data, I am pretty honest about that.
Keep researching. I’ve recovered from sciatica pain, lost 19 lbs, dramtically reduced my cholesterol and lowered by blood pressure from 137/93 to 125/89 in 3 months ! Read Dr Greger’s book: “How Not to Die” and Dr Campbell’s book: “The China Study.” Watch the documentary “Forks Over Knives.” Look up Dr Ornish, Dr Barnard and Dr Esselstyn. I’m convinced that eliminating all (or almost all) animal protein from your diet is the way to go. There’s a mountain of evidence that shows a whole food, plant based diet can prevent many cancers including prostate and breast cancer and even reverse many major diseases like heart disease (Dr Esselstyn). Dairy is very bad for you, your patients and your kids. But, don’t take my word for it, you’re a doctor, do the research. Dr Greger’s book references thousands of studies. May be the best place to start.
That’s great that you have had success with a diet that you enjoy! Everyone is different, and many diets will work.
I already have type 2 diabites, high cholesterol and tryglicerides. My downfall is an addiction to bad carbohydrates, especially bread and butter. I’ve tried to resist but I can’t fight the cravings. Is there anything that can help?
Excuse me for butting in; I’m just a passer-by but:

It seems you are talking of white bread and there is NEVER any reason to eat that. A seedy, fibrous, whole wheat bread, thinly sllced, is the way to go; it gives you many nutrients, fiber and a delicious taste treat.
Try it, you’ll like it.

Naomi
Hi Rory, as someone has mentioned, you can try healthier substitutions. But there really exist issues such as food addictions, and these may be best addressed with a psychiatrist, therapist or a specially trained nutritionist who can help you work through it. I don’t know your case, but for others, overeating or overeating certain foods is self-medication, as it can trigger similar neurochemical responses to certain drugs.
Great Article but so way OFF THE MARK to such a degree as to make me cry. Controlling weight gain can only be done by controlling, and reducing, blood levels of INSULIN – and there is no medication that can do that. But, and its a big BUT, one can reduce Insulin very precisely by eliminating sugar and carbohydrates from the diet and fasting, preferably at least 16 hours (I try for 20 hours) between meals. I am a type two diabetic of 25 years duration, and have been doing this for 3 months and not one hypoglycemic attack during this time with a weight loss of 19kgs, down to 69Kgs. To prevent hunger add a healthy, natural fat, such as butter, to your diet. Does wonders. If I understand it correctly the reduction of Insulin below a certain level allows the body access to the body’s fat stores so that it can finally burn off these fat stores.stores. Once Insulin reaches a certain blood level it PREVENTS the burning of fat stores – hence the need to FAST and reduce the Insulin. The fasting is also wonderful for Calorie restriction and it’s benefits. – Just my two cent’s worth – hope its been useful.
your reply is not very useful to me, and I find your “made me cry” most hyperbolic and disparaging; especially since you’re wrong on many counts.

you’re half-right on most of what you’ve written. Anyone who wants to correct what I’m writing, please feel free, I welcome it. My ego is not involved in this conversation. 🙂

you’re partially describing a ketogenic diet. Instead of getting energy from carbs, you get energy from (good) fat; the intro of sugar into your system is slower and so the pancreas doesn’t have to produce as MUCH insulin; recent British studies show that a pancreas can rejuvenate itself and increase its ability to produce more insulin after given “rehab” time off from constantly producing insulin, too! Amazing.
The ketogenic diet also has been proven most helpful to epileptic folks, by increasing the ketones in the body’s system.
And if you noticed, in the article, the phrase “for those who don’t have medical or psychological issues” – believe that that includes DIABETICs.

And the BAD thing about fasting is that it signals to the body to go into survival mode (since it doesn’t know when the next food is coming in, after about 3 hours; it pays to keep the furnace stoked and the metabolism rate higher. Fasting lowers the metabolism and burns much less fat (or carbs) or protein.

And another point is that, if you keep carbohydrates low (25-100g per day), and get some added protein without too much saturated fat, the body will use the FAT provided, since the carb count is kept low. If carbs aren’t used, the sugar level doesn’t spike, and no insulin is created by pancreas.

I was diagnosed diabetic, with A1C of 8.8. Three months of my own low-sugar diet (almond milk instead of cow milk, e.g.) and my A1C just got reported to me as 6.5! And my cholesterol level went from 165 to 145 in the same 90 days. I also lost 30+ lbs (now 38) (USA) – what is that 13.5kg? From 302 to 264.6lbs.
At least 50lbs more to go.

And as far as keeping it off, not something that I’ve ever done for long, successfully, the threat of diabetes (just had a guitar-playing friend lose a toe from undiagnosed diabetes) is an adequate motivation to KEEP the weight off.

I’m not trying to disparage or be critical of anyone but incorrect information is incorrect information and I have to say about your parentage or character for providing it. LOL

Background:
I’m a USAF Viet vet; 66 years of age; diagnosed with hernias (surgery not required now); nerve impingement that I just fully recovered from (it happened a couple of months before the diabetes diagnosis). Now I have to rebuild atrophied leg muscles from when the nerves were not innervating the muscles in my left side – the feeling in my arm came back the next day, but numbess from waist down on left side for a few months – some chiro, mainly a lot of scans (MRI, cardiac ultr-sound, etc.) to insure that it wasn’t a stroke.
The hilarious part of this (there were many!) is that I got the Diabetes II diagnosis the day before Thanksgiving. LOL
No, I started the diet the following Monday after a lovely Virginia Beach vacation. 🙂
As an exercise physiologist, life coach, personal trainer and group fitness instructor for many years I have promoted these ideas and they work. Not only does this approach effectively result in a sustainable weight loss, it promotes good health in general. At age 73 I have had bypass surgery and lived many years with advanced prostate cancer. Walking the walk has kept me fit and healthy regardless of my diseases. I test in the excellent percentile in ACSM fitness tests for my age, actually in the good percentile for 50 year old men. Remember that the three pillars of good health are: routine exercise, healthy diet and positive attitude.
I do agree with you, and I am glad that you have had such good health!
Many people think that they can eat what they want if they take Lipitor. Lipitor doesn’t seem to take care of triglycerides. However, drop the junk foods, processed foods and stick with a plant based diet and you’ll see those triglyceride levels drop. So…. taking Lipitor but still eating whatever your sweet/ salty tooth desires, your triglycerides may still be high. Ouch!
“Look, we’re human. Birthdays, office parties, weddings, random movie nights: they happen, and we celebrate by having the amazing chocolate cake, or Betsy’s famous buffalo chicken dip, waaaay too much champagne, or buttered popcorn. Expect this, enjoy, and then move on.”
The above exceptions may work for some overweight people. But both in my practice as a psychologist and from personal experience I can attest to the fact that such exceptions can be disastrous. There is increasing evidence of an addictive component to overeating, especially when it comes to sugar and refined grains such as those in pasta and bread products. For many people, suggesting that an occasional indulgence is OK is tantamount to telling an alcoholic s/he can have an occasional beer. Its much easier not to start than to stop. After a few months of eliminating sugar and flour from one’s diet, those “occasional treats” will seem unhealthy and the high likelihood that eating them will trigger a cascade of further unwanted cravings will serve as ample deterrent to indulging in them. I have stayed off those “treats” for over 8 years, eating ample amounts of fruits, nuts, raw and cooked veggies, beans, fish, chicken and small amounts of cheese, oatmeal and brown rice and I have never enjoyed food as much as I do now
I am a 70 year old prostate cancer patient. My doctor did a series of tests and passed me to his nutritionist while telling my wife that I would not die of cancer but of a heart attack. I was keeping blood sugar at about 130 ng/dl without any medication and had thought that was fine. It is not!
The nutritionist has slowly led me into a ketogenic diet and within 2 months my PSA has gone from 8 to 6.6 and the latest reading is 6.0. I have gone from 62 kilos to 58 kilos in about 2 weeks and it is fair to say that I do not feel hungry although I have one meal or at most 2 meals a day. I jog almost every day for about 60 minutes keeping my heart rate above 120. My diet bothers everyone else but not me.
A couple of learnings. Firstly, there are so many sources of sugar in food outside our home that I realize it is best to accept an increase in blood sugar if one is eating out. Secondly, I used to love bread but I have not had a toast in 2 months so one can get used to it.
Absolutely, and why we screen for eating disorders such as food addiction/ binge eating disorder before making any recommendations. (See first part of the article) These are distinct and complex medical/ psychological issues that need to be specifically addressed and treated very differently than what I have outlined here. I am in agreement with you.
I am not as much in favor of ‘forgiving’ as you mention. Let’s be honest about realizing that if you want good health, stop giving in to the miriad of food temptations. I am in my 70’s and hear all the time from my contemporaries that they think keeping to a good eating regime is only necessary if one has a ‘health problem’. The most valuable asset we all have the potential to possess is good health.

Among older people, much of their disability is due to lax attitudes toward diet and exercising, and always forgiving themselves for eating more than they should, approaching exercise as if it is something only for the young.

Linda W
If your contemporaries don’t keep to a good eating regime sooner or later they will have a health problem!
Ah! The difference between what you are describing and what I encourage is the concept of the occasional treat. I really mean occasional treat. That can mean different things to different people, but generally should mean that MOST of the time, one is sticking to one’s healthful diet. But even if one indulges in a weeklong all-you-can-eat cruise, one should still be able to forgive oneself and move on, pick up where they left off, or progress will not occur.
Overall, great article! Especially the emphasis on self acceptance, which is often lost in weight loss plans playing on false notions “transformation” and “finding the new you,” while subliminally encouraging body-shaming along the way. I do have a question about the very last sentence of the article though. You specify that these things work “for average adults who do not have contributing medical or psychological issues,” but what about those who do have such issues?
Absolutely! Doctors are supposed to consider, screen for, and treat any underlying issues that could be causing weight gain or difficulty losing weight. As above, “Once we screen for (and treat) any contributing medical problems that could be causing weight gain (low thyroid function, polycystic ovarian syndrome, prediabetes, among others), or psychological issues (bulimia, binge-eating disorder, depression, anxiety), I encourage a diet-and-lifestyle approach for many reasons, among them my own personal experience.”
Como conocedor sobre este tema me gustaría añadir en este comentario que mucha gente quiere perder peso muy rápido y no saben los problemas de salud que esto le puede acarrear, por lo tanto quisiera decirles que una dieta correcta, equilibrada y de sentido común y con un tiempo lo suficientemente largo es cuando se puede llegar a tener éxito.
This article is excellent! Many people struggle realizing that although they can lose weight fast, it does not happen overnight and takes work. Much of that work being outside of the gym in their day to day lives whether it be eating or maintaining the proper mindset. Check out a few weight loss techniques here: grab.fitbytim.com/weightloss
Thanks Tim!
If you or someone you love suffers from obesity, I can HIGHLY recommend “The Obesity Code” by Dr. Jason Fung https://www.amazon.com/Obesity-Code-Unlocking-Secrets-Weight/dp/1771641258/ref=cm_cr_arp_d_product_top?ie=UTF8
he has a website too. Oh, and down 140 pounds and counting.
Yes, Dr Jason Fung’s work needs to be highly commended, and his Book “The Complete Guide to Fasting”, is a great guide. He also has a wonderful way of explaining this issue and has a wonderful series of videos on Youtube – just enter Jason Fung into you tube and the whole series shows up.
Having the right attitude plus exercise is the best and healthiest way of losing weight. Cutting calories is vital too. One just needs to be consistent in his/her weight loss efforts to really succeed.
Agreed!
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