If you've got 100 pounds or more to lose, chances are you've already been on numerous diets and exercise programs, without long-term success. So, the standard advice -- eat less, exercise more, and don't give up -- just isn't enough.
WebMD polled weight loss experts -- as well as men and women who have lost 100 pounds or more and kept it off -- to ask for their best tips for those who have lots to lose. Here’s their advice.
1. Shrink Yourself: Analyze the Payoff You Get from Excess Weight
The question can startle people, but Anne Fletcher, RD, a Minnesota dietitian and author of the "Thin for Life" book series, asks it anyway. "What is your excess weight doing for you?"
Put another way, she asks: "What are you getting out of NOT losing weight?"
Her clients and those she has interviewed for her weight loss books have given her some surprising answers. Some told her they were hiding behind their weight as a way to avoid intimacy.
Others had less complicated reasons, she says. "One man said he didn't like mowing the lawn, and he didn't have to do it when he was heavy."
Identifying and understanding your underlying motivation to stay heavy -- and getting help if you need it to address the underlying issues -- can help spur your motivation to lose.
2. Assess Your Readiness
Your readiness to lose weight, once and for all, is crucial, says Fletcher. For her books, she has interviewed 20 people who lost 100 or more pounds. In general, the more ready they were -- with few distractions or excess stress in other areas of life -- the better they did.
How do you assess your readiness? Fletcher suggests asking yourself these questions: "Is my financial situation reasonably stable?" "Is my job and my spouse's job likely to stay the same [for the foreseeable future]?" "Do I have the time to devote to weight control?" "Are my relationships stable?"
That's not to say if your life isn't perfect you shouldn't still embark on a weight loss program, she says. But it is easier to focus on weight loss if you don't have multiple stresses elsewhere, she says.
Of course, there is always the exception. "I had one person who said her life was in complete chaos when she began to lose weight," Fletcher tells WebMD. "She felt the weight was the one thing she could control. So there's no one-size fits all."
3. Consider the Options
A plan that works for some people won't work for others.
"Get multiple sources of advice," suggests Victor Stevens, PhD, senior investigator at Kaiser Permanente Center for Health Research, in Portland, Ore., who has researched weight loss.
Whether you choose a supervised, structured weight loss and exercise program, go it alone, or undergo gastric bypass surgery, the process will be a life change, experts say. Instead of thinking you'll go on a diet (or that gastric bypass surgery will solve all your weight problems), understand that you are adopting a new, life-long plan of better eating and exercise, Stevens says.
4. Build in Accountability
Being accountable for following your weight loss plan -- whatever it is -- is crucial, says Stevens. "Almost all organized weight loss programs include some sort of accountability," he says. It could be attendance at a meeting, a weekly weigh in, or other structured program components.
You can build in your own accountability, of course, or partner with a friend. Your structure can be similar to those set by organized programs, or you can make them action based. For instance, you might set a goal and schedule for exercise each week (such as “I’ll walk three times this week after work for at least 45 minutes). Also set a day mid week to evaluate how well you are sticking with your plans. Adapt them if necessary -- or play makeup. For instance, if by Wednesday, you haven’t walked any night, you know you need to walk each night for the rest of the week to meet your goal.
Seeking medical help, especially when you have many pounds to lose, is wise. "It's always a good idea to consult with a doctor," Stevens adds. A doctor may also recommend other experts, such as a personal trainer or nutritionist.
5. Adjust Your Expectations
It's frustrating but true. That extra 100 pounds didn't come on overnight, and it's going to come off slowly. "We recommend people cut back 500 calories a day," Stevens says. Losing just one to two pounds a week is best, he says. So it could take a year or two to lose 100 pounds.
Set short term goals, Stevens and other say, instead of focusing on the 100 pounds. Think about it, for instance, as a plan to lose 20 pounds -- five times.
To stay motivated, set realistic goals beyond a specific number of pounds, advises Daniel Stettner, PhD, director of psychology at UnaSource Health Center, Troy, and adjunct professor of psychology at Wayne State University, Detroit, Mi. Think about getting to a certain weight, for instance, by a holiday -- Thanksgiving, Halloween, whatever -- when it's likely you'll be in a photo, he says.
Or think about an upcoming special event and decide you want to fit into a favorite, currently snug, dress or suit by then.
Focus on short-term weight loss goals that will help you meet the long-term ones, says Marisa Moore, RD, an Atlanta dietitian and spokeswoman for the American Dietetic Association. "If your goal is to drop three dress sizes, that's long term. Short term is answering the question, what am I going to do to get there?" You could cut a three soda-a-day habit to one a day, for instance, taking a week to do it. And you could park farther from stores, requiring you to walk more.
6. Develop a Healthy Selfishness
As Fletcher counseled overweight clients, she noticed that many women, in particular, had a difficult time putting themselves first. All day long, they'd help their spouse, family, friends, and co-workers. At the end of the day, these women were exhausted. And they often turned to food. "The only 'nice' thing they did for themselves was eat," she says.
"People who lose weight and keep it off have developed a kind of healthy selfishness," she says. That means saying no sometimes and putting yourself first at least sometimes.
One woman who learned ''healthy selfishness" told Fletcher she would do anything to stay on track, including carrying baked potatoes in her flight bag to avoid having to eat airport food.
The healthy selfishness helps, too, when dining out, Stettner says. "Pick a place that has the kind of food you want to eat."
7. Fat Proof Your Environment
Even if you're committed to following a new, sensible eating plan, it can be difficult when, say, your teens' tortilla chips fall out of the cupboard every time you open it.
That's why it can help to "fat-proof" your environment as much as you can, says Stettner. "Get rid of 'off-program' or impulse foods at home and work," he says.
Call a family meeting and brainstorm options, he says. Say your teen can't exist without tortilla chips. You might decide as a family that the tortilla chip lovers keep their own stash, not in the kitchen, out of sight. This allows the person trying to lose to feel more in control, Stettner says.
8. Pick the Brains of Healthy-Weight People
Stevens advises those who need to lose 100 pounds to get insight from people who are at a healthy weight. He tells them: "Talk to people who are maintaining a steady weight, who have maintained it for three or four years, and who are your age."
Then ask them how they stay that way, he says. "You may be amazed," he says. Many overweight people think people at a healthy weight don't have to work at it, but those maintaining a healthy weight typically tell an unexpected story. It's an ongoing effort to stay lean. "They are careful what they eat; they pay attention every day," Steven says.
Hearing this may help those with lots to lose understand that life is going to be different if the weight is going to stay off, Stevens says.
Those who have lost substantial amounts of weight and kept it off say they stay true to their eating plan and their exercise plan. Wade Wingler, 37, of Danville, Ind., an executive with Easter Seals, took off 100 pounds, going from 317 pounds to 217 pounds.
"I do yoga every day," he says. He also does long-distance bicycling and follows a sensible eating plan.
Linda Thacker, 60, of Norfolk, Va., lost 120 pounds and has kept it off for 16 years. Healthy eating and working out regularly are habits now. "I do Jazzercise, speed walking, bicycling, and the Stairmaster," she says. "I try to exercise every day, [though] I don't always make it." But if a few days go by without working out, she gets right back to it.
9. Find Your Secret Weapons
Most people who have lost a substantial amount of weight and kept it off have a tool or strategy -- or several -- that help them stay on track and make this time the time they don't quit or regain.
Keeping a graphic record of weight loss helps people see the big picture and stay on track, finds Stevens of Kaiser Permanente, especially when they are regaining weight. Looking at the downward trend on the weight loss graph helps people cope with minor weight fluctuations, he finds.
Finding a way to stay focused is crucial, says Allan Goldberg, 54, of St. Clair Shores, Mich., who has lost 150 pounds by cutting calories and exercising. When faced with the temptation of overeating, he says, he asks himself: "Do I want to eat this and undo my hard work?"
10. Reward your Success -- in the Right Way
Anyone who's gotten weight loss guidance already knows the rule: no food rewards for taking off weight.
So what can you do? As you meet your short-term goals, buy something new, get a new nail polish color, or book a day at the spa, Moore suggests.