Keys to Success

Exercise
Intentional weight loss occurs when the energy (calorie) expenditure (output) is greater than the energy (calorie) intake. The goal of the dietary portion of the program is to decrease calorie intake whereas this exercise portion is designed to increase the calorie loss. Just as maintaining proper nutrition is critical when there is restricted food intake, it is equally necessary to develop a pattern of physical fitness. The improved health benefits of moderate exercise are well-documented in the scientific literature.

Exercise has been shown to improve cardiovascular and pulmonary health, as well as improve muscle tone and flexibility of joints. Exercise also tends to improve mental health in reducing depression and other stress-related mood disorders. Many women describe increased energy and a generally improved sense of well-being. Weight-bearing exercise also improves bone density and helps to prevent osteoporosis. Exercise is a very individual effort and requires self-motivation. If you can find 20 minutes per day, this would help. A list of exercise activities is included. In order to decrease body fat, energy intake must be less than energy output. It is estimated that a pound of body fat provides 3,500 calories. Therefore, to lose a pound of fat, one must decrease energy intake by this amount or increase energy output by this amount. For most people, a loss of 5-15% of body weight, most of which is fat, will significantly reduce the risk for many diseases.

Approaches to Weight Loss Management
Although the arithmetic is simple (calories in versus calories out), achieving a reduction in body weight is not that easy. There are regulatory mechanisms in your body designed to keep weight stable. There are environmental and emotional motivators to increase food intake and reduce the inclination to exercise. Nonetheless, reductions in calorie intake, increases in activity and changes in behavior can promote weight loss and long-term weight management.

Decreasing Energy Intake
For safe and effective weight loss, the diet must be low in energy but provide for the body’s nutrient needs.  With energy intakes of less than 1,200 calories per day, it is difficult to meet the requirements for micronutrients, so that multivitamin and mineral supplements are recommended. Medical supervision is recommended if intake is 800 calories per day or less.

Increasing Physical Activity
Physical activity is an important component of any well-designed weight management program. Exercise promotes fat loss and weight maintenance. It increases energy expenditure, so if intake remains the same, energy stored as fat is used for fuel. Also, exercise promotes muscle development and increasing muscle mass helps to maintain a higher BMI which speeds up weight loss. Weight loss is also better maintained when physical activity is included in the weight-management program. In addition, physical activity improves overall fitness and relieves boredom and stress.

Modifying Behavior
In order to keep weight at a new lower level, food consumption and exercise patterns must be changed for life. Changing these behaviors requires identifying the old patterns that led to weight gain and replacing them with new ones to maintain weight loss. This is accomplished through a process called behavior modification which is based on the theory that behaviors involve (1) antecedents or cues that lead to the behavior, (2) the behavior itself, and (3) consequences of the behavior. The first step in a behavior modification program is to identify cues that lead to eating. This is usually done by keeping a log of all food consumed, where it was consumed, what other activities were involved, and what motivated the eating. The log can then be analyzed to determine what led to the behavior (eating) and what the consequences were (weight gain). If we can identify these cues or contributors to the behavior then alternatives or modifiers could be used to avoid or alter the causes for the weight-gaining behavior. This alters the consequences in that you have only consumed the food you planned, you do not gain weight and you feel a sense of accomplishment. Changing eating behaviors (amount and types of foods) is critical in the long-term weight maintenance phase; otherwise, you go back to the former patterns and gain the weight right back

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