It's easy to get answers about health and nutrition! Just send your question by email to firstname.lastname@example.org and Dr. Harlan will respond to selected questions of general interest. Answers will be posted in the Ask Dr. Gourmet newsletter (sign up now!) and archived in the Ask Dr. Gourmet section of the website.
I cannot stay on a diet. I have gained 40 lbs in 2 years and my doctor wants me to only eat 850 calories per day. I crave sweets and cannot pass them by at work, so I am gaining more. I have high cholesterol, total 358, take Zocor, 80 mgs, I walk 1 mile every day and take blood pressure medicine. What can I do? I need help. I read your website and agree with everything I read, but are there some people who cannot lose weight?
One reason that you might not be able to stay on a diet is that many diets are so drastic. For instance, we now know that an 850 calorie diet is just too few calories and will set you up for failure. Once you eat under about 1,000 calories per day the body metabolism slows and weight loss becomes very difficult.
There are five steps to eating healthy and losing weight. The first is to assess where you are and how many calories you should be eating to lose weight. Read my article on "How Much Should You Weigh?" to find out what a normal weight range is for you.
As a general rule of thumb you can multiply your Ideal Body Weight by 11 and that will give you about the number of calories that you need to maintain your weight. You will then need to either eat 300 - 500 calories less per day or burn the extra calories by exercise.
The second step is preparation and planning. This is the key step and one that is often difficult for folks. You should take time to plan what you are going to have each day for the week at the beginning of the week. Make sure that you have foods for breakfast, for instance, and that you eat regular meals. It has been shown over and over that being satisfied will help you avoid those sweets at the office.
The third step is to follow your plan. Take some action. Make sure that you have great sweets to eat. We know, for example, that folks are just as satisfied having fruit as they are eating chocolate (and they feel much less guilty). You must plan so that you have something on hand at the office to let you take action.
Step four is assessment. Keeping a food and exercise diary is key. Weighing yourself regularly and keeping track is part of this. Challenge yourself to reach certain goals.
Last is rewarding yourself. This should be a non-food reward. Buy some shoes, go on a trip, get that new iPhone you want, but remember that donuts are not rewards!
You can lose weight and you can be healthier. It's actually pretty easy, but first and foremost it is about planning. Plan what you are going to eat and when and how you are going to eat well all the time.
Thanks for writing,
Timothy S. Harlan, MD, FACP