How To Set Goals for Weight Loss

Setting Goals for Weight Loss
There are lots of reasons for people who are overweight or obese to lose weight. To be healthier. To look better. To feel better. To have more energy.
No matter what the reason, successful weight loss and healthy weight management depend on sensible goals and expectations. If you set sensible goals for yourself, chances are you’ll be more likely to meet them and have a better chance of keeping the weight off. In fact, losing even five to 10 percent of your weight is the kind of goal that can help improve your health.
Most overweight people should lose weight gradually. For safe and healthy weight loss, try not to exceed a rate of two pounds per week. Sometimes, people with serious health problems associated with obesity may have legitimate reasons for losing weight rapidly. If so, a physician’s supervision is required.
What you weigh is the result of several factors:

  • how much and what kinds of food you eat
  • whether your lifestyle includes regular physical activity
  • whether you use food to respond to stress and other situations in your life
  • your physiologic and genetic make-up
  • your age and health status.

Successful weight loss and weight management should address all of these factors. And that’s the reason to ignore products and programs that promise quick and easy results, or that promise permanent results without permanent changes in your lifestyle. Any ad that says you can lose weight without lowering the calories you take in and/or increasing your physical activity is selling fantasy and false hope. In fact, some people would call it fraud. Furthermore, the use of some products may not be safe.
A Realistic Approach
Many people who are overweight or obese have decided not to diet per se, but to concentrate on engaging in regular physical activity and maintaining healthy eating habits in accordance with the Dietary Guidelines for Americans, emphasizing lowered fat consumption, and an increase in vegetables, fruits and whole grains. Others — who try to diet — report needing help to achieve their weight management goals.
Fad diets that ignore the principles of the Dietary Guidelines may result in short term weight loss, but may do so at the risk of your health. How you go about managing your weight has a lot to do with your long-term success. Unless your health is seriously at risk due to complications from being overweight or obese, gradual weight loss should be your rule — and your goal.
Here’s how to do it:

  • Check with your doctor. Make sure that your health status allows lowering your caloric intake and increasing your physical activity.
  • Follow a calorie-reduced, but balanced diet that provides for as little as one or two pounds of weight loss a week. Be sure to include at least five servings a day of fruits and vegetables, along with whole grains, lean meat and low fat dairy products. It may not produce headlines, but it can reduce waistlines. It’s not “miracle” science — just common sense. Most important, it’s prudent and healthy.
  • Make time in your day for some form of physical activity. Start by taking the stairs at work, walking up or down an escalator, parking at the far end of a lot instead of cruising around for the closest spot. Then, assuming your physician gives the okay, gradually add some form of regular physical activity that you enjoy. Walking is an excellent form of physical activity that almost everyone can do.
  • Consider the benefits of moderate weight loss. There’s scientific evidence that losing five to 10 percent of your weight and keeping it off can benefit your health — lower your blood pressure, for example. If you are 5 feet 6 inches tall and weigh 180 pounds, and your goal weight is 150, losing five to 10 percent (nine to 18 pounds) is beneficial. When it comes to successful weight loss and weight management, steady and slow can be the way to go.

For many people who are overweight or obese, long-term — and healthy — weight management generally requires sensible goals and a commitment to make realistic changes in their lifestyle and improve their health. A lifestyle based on healthy eating and regular physical activity can be a real lifesaver.
Determining Your Weight/Health Profile
Overweight and obesity have been associated with increased risk of developing such conditions as high blood pressure, Type 2 diabetes and coronary artery disease.
For most people, determining the circumference of your waist and your body mass index (BMI) are reliable ways to estimate your body fat and the health risks associated with being overweight, overfat or obese. BMI is reliable for most people between 19 and 70 years of age except women who are pregnant or breast feeding, competitive athletes, body builders, and chronically ill patients. Generally, the higher your BMI, the higher your health risk, and the risk increases even further if your waist size is greater than 40 inches for men or 35 inches for women. There are other ways, besides BMI, to determine your body fat composition, and your doctor can tell you about them, but the method recommended here will help you decide if you are at risk. Use the chart to determine your BMI. Then, measure your waist size. Now, with your BMI and waist size determined, use the table below to determine your health risk relative to normal weight.
Risk of Associated Disease According to BMI and Waist Size
Waist less than or equal to
40 in. (men) or
35 in. (women)
Waist greater than
40 in. (men) or
35 in. (women)
18.5 or less
18.5 – 24.9
25.0 – 29.9
30.0 – 34.9
Very High
35.0 – 39.9
Very High
Very High
40 or greater
Extremely Obese
Extremely High
Extremely High
Several other factors, including your medical history, can increase your health risk.
See your doctor for advice about your overall health risk and the weight loss options that are best for you. Together, decide whether you should go on a moderate diet (1200 calories daily for women, 1400 calories daily for men), or whether other options might be appropriate.
Once you and your doctor have determined the type of diet that makes the most sense for you, you may want to choose a product or a plan to help you reach your goal. Consider: b If your doctor prescribes a medication, ask about complications or side effects, and tell the doctor what other medications, including over-the-counter drug products, and dietary supplements you take and other conditions you’re being treated for. After you start taking the medication, tell the doctor about changes you experience, if any.
* If your treatment includes periodic monitoring, counseling or other activities that require your attendance, make sure the location is easy to get to and the appointment times are convenient.
* Some methods for losing weight have more risks and complications than others. Ask for details about the side effects, complications or risks of any product or service that promotes weight loss and how to deal with problems should they occur.
* Where appropriate to the program, ask about the credentials and training of the program staff.
* Ask for an itemized price list for all the costs of the plan you’re considering, including membership fees, fees for weekly visits, the costs of any diagnostic tests, costs for meal replacements, foods, nutritional supplements, or other products that are part of the weight loss program or plan.
Where To Get More Help
The Partnership for Healthy Weight Management is a coalition of representatives from science, academia, the health care professions, government, commercial enterprises, and organizations whose mission is to promote sound guidance on strategies for achieving and maintaining a healthy weight.
Partners with information that can help you with issues about overweight and obesity or design your own healthy weight management plan are:
American Dietetic Association
Get Nutrition Fact Sheets at:
American Dietetic Association
Consumer Education Team
216 West Jackson Boulevard
Chicago, IL 60606
(Send self addressed stamped envelope), Call 800-877-1600 , ext. 5000 for other publications or 800-366-1655 for recorded food/nutrition messages.
American Obesity Association
1250 24th Street, NW, Suite 300
Washington, DC 20037
American Society of Bariatric Physicians (ASBP)
5600 S. Quebec, Ste. 109-A
Englewood, CO 80111 USA
Phone: (303) 779-4833 , (303) 770-2526
Fax: (303) 779-4834
The Council on Size and Weight Discrimination
PO Box 305
Mt. Marion, NY 12456
(Send self-addressed stamped envelope)
Department of Nutrition Sciences
University of Alabama at Birmingham
Birmingham, AL 35294
Federal Trade Commission
Consumer Response Center
600 Pennsylvania Avenue, NW
Washington, DC 20580
National Institute of Diabetes and Digestive and Kidney Diseases
31 Center Drive
Bethesda, MD 20892
North American Association for the Study of Obesity
8630 Fenton Street
Silver Spring, MD 20910
Shape Up America!
For access to helpful information from our commercial partners, write: Federal Trade Commission
Consumer and Business Education Office
600 Pennsylvania Avenue, NW
Washington, DC 20580

Weight and Waist Measurement

Weight and Waist Measurement Tools for Adults

  • Body Mass Index
  • Waist circumference
  • How does overweight or obesity affect my health?
  • What should I do if my BMI or waist measurement is too high?

Health care providers use body mass index (BMI) and waist circumference measures to assess a person’s risk of developing diabetes, heart disease, or other health problems. This fact sheet tells you how to measure your BMI and waist circumference, and what these measures mean for your health.
Body Mass Index
Today, 64.5 percent of adults in the U.S. are overweight or obese. How do you know if you are among them? Two simple measures, body mass index (BMI) and waist circumference, provide useful estimates of overweight, obesity, and body fat distribution.
BMI measures your weight in relation to your height, and is closely associated with measures of body fat. You can calculate your BMI using this formula:

For example, for someone who is 5 feet, 7 inches tall and weighs 220 pounds, the calculation would look like this:

A BMI of 18.5 to 24.9 is considered healthy. A person with a BMI of 25 to 29.9 is considered overweight, and a person with a BMI of 30 or more is considered obese.
You can also find your weight group on the chart below. The chart applies to all adults. The higher weights in the healthy range apply to people with more muscle and bone, such as men. Even within the healthy range, weight gain could increase your risk for health problems.

Find your weight on the bottom of the graph. Go straight up from that point until you come to the line that matches your height. Then look to find your weight group. The higher your BMI is over 25, the greater chance you may have of developing health problems.
* Without shoes **Without clothes
Because BMI does not show the difference between fat and muscle, it does not always accurately predict when weight could lead to health problems. For example, someone with a lot of muscle (such as a body builder) may have a BMI in the unhealthy range, but still be healthy and have little risk of developing diabetes or having a heart attack.
BMI also may not accurately reflect body fatness in people who are very short (under 5 feet) and in older people, who tend to lose muscle mass as they age. And it may not be the best predictor of weight-related health problems among some racial and ethnic groups such as African American and Hispanic/Latino American women. But for most people, BMI is a reliable way to tell if your weight is putting your health at risk.
Waist circumference
Excess weight, as measured by BMI, is not the only risk to your health. So is the location of fat on your body. If you carry fat mainly around your waist, you are more likely to develop health problems than if you carry fat mainly in your hips and thighs. This is true even if your BMI falls within the normal range. Women with a waist measurement of more than 35 inches or men with a waist measurement of more than 40 inches may have a higher disease risk than people with smaller waist measurements because of where their fat lies.
To measure your waist circumference, place a tape measure around your bare abdomen just above your hip bone. Be sure that the tape is snug, but does not compress your skin, and is parallel to the floor. Relax, exhale, and measure your waist.
How does overweight or obesity affect my health?
Extra weight can put you at a higher risk for many health problems including type 2 diabetes, high blood pressure, and heart disease.
Extra weight can put you at higher risk for these health problems:

  • type 2 diabetes (high blood sugar)
  • high blood pressure
  • heart disease and stroke
  • some types of cancer
  • sleep apnea (when breathing stops for short periods during sleep)
  • osteoarthritis (wearing away of the joints)
  • gallbladder disease
  • liver disease
  • irregular menstrual periods

What should I do if my BMI or waist measurement is too high?
If your BMI is between 25 and 30 and you are otherwise healthy, try to avoid gaining more weight, and look into healthy ways to lose weight and increase physical activity. Talk to your health care provider about losing weight if

  • your BMI is 30 or above, or
  • your BMI is between 25 and 30 and you have:
  • two or more of the health problems listed above or
  • a family history of heart disease or diabetes, or

your waist measures over 35 inches (women) or 40 inches (men)-even if your BMI is less than 25-and you have:

  • two or more of the health problems listed above or
  • a family history of heart disease or diabetes.


Body Mass Index (BMI)

Body Mass Index

  • BMI Calculator
  • What iS BMI?
  • BMI Categories
  • The BMI Controversy

BMI Calculator
To calculate the body mass index (BMI) use our BMI Calculator. The BMI Calculator uses the following formula to calculate the BMI:


What is BMI?

The body mass index (BMI), or Quetelet index, is a statistical measurement which compares a person’s weight and height. Though it does not actually measure the percentage of body fat, it is a useful tool to estimate a healthy body weight based on how tall a person is. Due to its ease of measurement and calculation, it is the most widely used diagnostic tool to identify obesity problems within a population. However, it is not considered appropriate to use as a final indication for diagnosing individuals. It was invented between 1830 and 1850 by the Belgian polymath Adolphe Quetelet during the course of developing “social physics”. Body mass index is defined as the individual’s body weight divided by the square of his height. The formulas universally used in medicine produce a unit of measure of kg/m2. BMI can also be determined using a BMI chart, which displays BMI as a function of weight (horizontal axis) and height (vertical axis) using contour lines for different values of BMI or colors for different BMI categories:
Click on the graph below to enlarge it

A graph of body mass index is shown above. The dashed lines represent subdivisions within a major class. For instance the “Underweight” classification is further divided into “severe,” “moderate,” and “mild” subclasses, based on World Health Organization data.
BMI Categories
A frequent use of the BMI is to assess how much an individual’s body weight departs from what is normal or desirable for a person of his or her height. The weight excess or deficiency may, in part, be accounted for by body fat (adipose tissue) although other factors such as muscularity also affect BMI significantly (see discussion below and overweight). The World Health Organization (WHO) regard a BMI of less than 18.5 as being underweight indicating possible malnutrition, an eating disorder, or other health problems; while a BMI greater than 25 is considered overweight and above 30 is considered obese.
There are differing opinions on the threshold for being underweight in females, doctors quote anything from 18.5 to 20 as being the lowest weight, the most frequently stated being 19. A BMI nearing 15 is usually used as an indicator for starvation and the health risks involved, with a BMI <17.5 being an informal criterion for the diagnosis of anorexia nervosa.
These ranges of BMI values are valid only as statistical categories when applied to adults, and do not predict health:
BMI range – kg/m2
BMI Prime

Mass (weight) of a 1.8 metres (5 ft 11 in) person with this BMI

Severely underweight
less than 16.5
less than 0.66
under 53.5 kilograms (8.42 st; 118 lb)
from 16.5 to 18.5
from 0.66 to 0.74
between 53.5 and 60 kilograms (8.42 and 9.45 st; 118 and 132 lb)
from 18.5 to 25
from 0.74 to 1.0
between 60 and 81 kilograms (9.4 and 13 st; 130 and 180 lb)
from 25 to 30
from 1.0 to 1.2
between 81 and 97 kilograms (12.8 and 15.3 st; 180 and 210 lb)
Obese Class I
from 30 to 35
from 1.2 to 1.4
between 97 and 113 kilograms (15.3 and 17.8 st; 210 and 250 lb)
Obese Class II
from 35 to 40
from 1.4 to 1.6
between 113 and 130 kilograms (17.8 and 20.5 st; 250 and 290 lb)
Severely Obese
from 40 to 45
from 1.6 to 1.8
between 130 and 146 kilograms (20 and 23 st; 290 and 320 lb)
Morbidly Obese
from 45 to 50
from 1.8 to 2.0
between 146 and 162 kilograms (23.0 and 25.5 st; 320 and 360 lb)
Super Obese
from 50 to 60
from 2.0 to 2.4
between 162 and 194 kilograms (25.5 and 30.5 st; 360 and 430 lb)
Hyper Obese
above 60
above 2.4
above 194 kilograms (30.5 st; 430 lb)
The U.S. National Health and Nutrition Examination Survey of 1994 indicates that 59% of American men and 49% of women have BMIs over 25. Extreme obesity — a BMI of 40 or more — was found in 2% of the men and 4% of the women. The newest survey in 2007 indicates a continuation of the increase in BMI, 63% of Americans are overweight, with 26% now in the obese category.

The BMI Controversy

As a measure, BMI became popular during the early 1950s and 1960s as obesity started to become a discernible issue in prosperous Western societies. BMI provided a simple numeric measure of a person’s “fatness” or “thinness”, allowing health professionals to discuss over- and under-weight problems more objectively with their patients. However, BMI has become controversial because many people, including physicians, have come to rely on its apparent numerical authority for medical diagnosis, but that was never the BMI’s purpose. It is meant to be used as a simple means of classifying sedentary (physically inactive) individuals with an average body composition. For these individuals, the current value settings are as follows: a BMI of 18.5 to 25 may indicate optimal weight; a BMI lower than 18.5 suggests the person is underweight while a number above 25 may indicate the person is overweight; a BMI below 17.5 may indicate the person has anorexia or a related disorder; a number above 30 suggests the person is obese (over 40, morbidly obese).
BMI can be calculated quickly and without expensive equipment. However, BMI categories do not take into account many factors such as frame size and muscularity. The categories also fail to account for varying proportions of fat, bone, cartilage, water weight, and more.
One basic problem, especially in athletes, is that muscle is denser than fat. Some professional athletes are “overweight” or “obese” according to their BMI – unless the number at which they are considered “overweight” or “obese” is adjusted upward in some modified version of the calculation. In children and the elderly, differences in bone density and, thus, in the proportion of bone to total weight can mean the number at which these people are considered underweight should be adjusted downward.
For a fixed body shape and body density, and given height, BMI is proportional to weight. However, for a fixed body shape and body density, and given weight, BMI is inversely proportional to the square of the height. So, if all body dimensions double, and weight scales naturally with the cube of the height, then BMI doubles instead of remaining the same. This results in taller people having a reported BMI that is uncharacteristically high compared to their actual body fat levels. This anomaly is partially offset by the fact that many taller people are not just “scaled up” short people, but tend to have narrower frames in proportion to their height. It has been suggested that instead of squaring the body height (as the BMI does) or cubing the body height (as seems natural), it would be more appropriate to use an exponent of between 2.3 to 2.7.
The medical establishment has generally acknowledged some shortcomings of BMI.[12] Because the BMI is dependent only upon weight and height, it makes simplistic assumptions about distribution of muscle and bone mass, and thus may overestimate adiposity on those with more lean body mass (e.g. athletes) while underestimating adiposity on those with less lean body mass (e.g. the elderly).
One recent study Romero-Corral et al. found that BMI-defined obesity was present in 19.1% of men and 24.7% of women, but that obesity as measured by bodyfat percentage was present in 43.9% of men and 52.3% of women. Moreover, in the intermediate range of BMI (25-29.9), BMI failed to discriminate between bodyfat percentage and lean mass. The study concluded that “the accuracy of BMI in diagnosing obesity is limited, particularly for individuals in the intermediate BMI ranges, in men and in the elderly… These results may help to explain the unexpected better survival in overweight/mild obese patients.”
The exponent of 2 in the denominator of the formula for BMI is arbitrary. It is meant to reduce variability in the BMI associated only with a difference in size, rather than with differences in weight relative to one’s ideal weight. If taller people were simply scaled-up versions of shorter people, the appropriate exponent would be 3, as weight would increase with the cube of height. However, on average, taller people have a slimmer build relative to their height than do shorter people, and the exponent which matches the variation best is between 2 and 3. An analysis based on data gathered in the USA suggested an exponent of 2.6 would yield the best fit for children aged 2 to 19 years old. The exponent 2 is used instead by convention and for simplicity.
Some argue that the error in the BMI is significant and so pervasive that it is not generally useful in evaluation of health. Owing to these limitations, body composition for athletes is often better calculated using measures of body fat, as determined by such techniques as skinfold measurements or underwater weighing and the limitations of manual measurement have also led to new, alternative methods to measure obesity, such as the body volume index. However, recent studies of American football linemen who undergo intensive weight training to increase their muscle mass show that they frequently suffer many of the same problems as people ordinarily considered obese, notably sleep apnea.
In an analysis of 40 studies involving 250,000 people, heart patients with normal BMIs were at higher risk of death from cardiovascular disease than people whose BMIs put them in the “overweight” range (BMI 25-29.9). Patients who were underweight (BMI <20) or severely obese (BMI >35) did, however, show an increased risk of death from cardiovascular disease. The implications of this finding can be confounded by the fact that many chronic diseases, such as diabetes, can cause weight loss before the eventual death. In light of this, higher death rates among thinner people would be the expected result.
A further limitation relates to loss of height through aging. In this situation, BMI will increase without any corresponding increase in weight.
To overcome the shortcomings of BMI, and some of the less acknowledged limitations inherent in body fat percentages, the concepts fat-free mass index (FFMI) and fat mass index (FMI) were introduced in the early 1990s (VanItallie TB, Yang MU, Heymsfield SB, Funk RC, Boileau RA. Height-normalized indices of the body’s fat-free mass and fat mass: potentially useful indicators of nutritional status. Am J Clin Nutr. Dec 1990;52(6):953-959).

Very Low-Calorie Diets

Very Low-calorie Diets

  • What is a very low-calorie diet?
  • Who should use a VLCD?
  • Health Benefits of a VLCD
  • Adverse Effects of a VLCD
  • Maintaining Weight Loss

What is a very low-calorie diet?
A very low-calorie diet (VLCD) is a doctor-supervised diet that typically uses commercially prepared formulas to promote rapid weight loss in patients who are obese. These formulas, usually liquid shakes or bars, replace all food intake for several weeks or months. VLCD formulas need to contain appropriate levels of vitamins and micronutrients to ensure that patients meet their nutritional requirements. Some physicians also prescribe very low-calorie diets made up almost entirely of lean protein foods, such as fish and chicken. People on a VLCD consume about 800 calories per day or less.
VLCD formulas are not the same as the meal replacements you can find at grocery stores or pharmacies, which are meant to subsitute for one or two meals a day. Over-the-counter meal replacements such as bars, entrees, or shakes should account for only part of one’s daily calories.
When used under proper medical supervision, VLCDs may produce significant short-term weight loss in patients who are moderately to extremely obese. VLCDs should be part of comprehensive weight-loss treatment programs that include behavioral therapy, nutrition counseling, physical activity, and/or drug treatment.
Who should use a VLCD?
VLCDs are designed to produce rapid weight loss at the start of a weight-loss program in patients with a body mass index (BMI) greater than 30 and significant comorbidities. BMI correlates significantly with total body fat content. It is calculated by dividing a person’s weight in pounds by height in inches squared and multiplied by 703.
Use of VLCDs in patients with a BMI of 27 to 30 should be reserved for those who have medical conditions due to overweight, such as high blood pressure. These diets are not appropriate for children or adolescents, except in specialized treatment programs.
Very little information exists regarding the use of VLCDs in older people. Because people over age 50 already experience depletion of lean body mass, use of a VLCD may not be warranted. Also, people over 50 may not tolerate the side effects associated with VLCDs because of preexisting medical conditions or the need for other medicines. Doctors must evaluate on a case-by-case basis the potential risks and benefits of rapid weight loss in older adults, as well as in patients who have significant medical problems or are on medications.
Health Benefits of a VLCD
A VLCD may allow a patient who is moderately to extremely obese to lose about 3 to 5 pounds per week, for an average total weight loss of 44 pounds over 12 weeks. Such a weight loss can rapidly improve obesity-related medical conditions, including diabetes, high blood pressure, and high cholesterol.
The rapid weight loss experienced by most people on a VLCD can be very motivating. Patients who participate in a VLCD program that includes lifestyle treatment typically lose about 15 to 25 percent of their initial weight during the first 3 to 6 months. They may maintain a 5-percent weight loss after 4 years if they adopt a healthy eating plan and physical activity habits.
Adverse Effects of a VLCD
Many patients on a VLCD for 4 to 16 weeks report minor side effects such as fatigue, constipation, nausea, or diarrhea. These conditions usually improve within a few weeks and rarely prevent patients from completing the program. The most common serious side effect is gallstone formation. Gallstones, which often develop in people who are obese, especially women, are even more common during rapid weight loss. Research indicates that rapid weight loss may increase cholesterol levels in the gallbladder and decrease its ability to contract and expel bile. Some medicines can prevent gallstone formation during rapid weight loss. Your health care provider can determine if these medicines are appropriate for you.
Maintaining Weight Loss
Studies show that the long-term results of VLCDs vary widely, but weight regain is common. Combining a VLCD with behavior therapy, physical activity, and active follow-up treatment may help increase weight loss and prevent weight regain.
In addition, VLCDs may be no more effective than less severe dietary restrictions in the long run. Studies have shown that following a diet of approximately 800 to 1,000 calories produces weight loss similar to that seen with VLCDs. This is probably due to participants’ better compliance with a less restrictive diet.
For most people who are obese, obesity is a long-term condition that requires a lifetime of attention even after formal weight-loss treatment ends. Therefore, health care providers should encourage patients who are obese to commit to permanent changes of healthier eating, regular physical activity, and an improved outlook about food.
*Endnote: This fact sheet is an updated, modified version of a previously published review article appearing in the August 25, 1993 issue of the Journal of the American Medical Association. Both the review article and this fact sheet were developed with the advice of the Clinical Obesity Research Panel, formerly known as the National Task Force on Prevention and Treatment of Obesity.

Low-Carbohydrate Diets

Low-carbohydrate Diets

  • Introduction
  • Atkins Diet
  • South Beach Diet

Weight loss diets that are low in carbohydrates, such as the ‘Atkins Diet’ or the ‘South Beach Diet’, have been inappropriately criticized in the media as being inherently unhealthy because they encourage a higher fat consumption. The truth of the matter is, that almost any diet which effects weight loss: will lower cholesterol, lower blood pressure, lower the incidence of type-2 diabetes, and increase cardiovascular health.
Eating a low-carb diet improves the hormonal signalling involved in obesity and improves the sense of fullness, allowing weight loss; according to a 2007 study conducted by Matthew R. Hayes, a postdoctoral fellow at the University of Pennsylvania.
The Atkins Diet: Ten Easy Steps to Induction
This is an excerpt from the book: Dr. Atkins’ New Diet Revolution, Revised Edition by Robert C. Atkins, 2003:
Ready to start losing weight on Atkins? Induction is the first phase of the Atkins Nutritional Approach™. Stay on it for at least two weeks, and follow these 10 steps to get on your way:

  • Eat either three regular-size meals a day or four or five smaller meals. Don’t skip meals or go more than six waking hours without eating.
  • Eat liberal amounts of protein, such as poultry, fish, shellfish, eggs and red meat, as well as natural fats, such as butter, mayo, olive oil and safflower oil (see the Acceptable Foods List).
  • Eat about 20 grams of carbs each day, mostly in the form of salad greens and other vegetables. You should eat at least four cups of salad vegetables, or three cups of salad vegetables plus one cup of other vegetables (see the Acceptable Vegetables List).
  • Don’t eat any fruit (except for avocados, tomatoes and olives), bread, pasta, grains, starchy vegetables or dairy products other than cheese, cream or butter. Don’t eat nuts or seeds in the first two weeks. Foods that combine protein and carbohydrates, such as lentils, chickpeas, kidney beans and other legumes, are not permitted at this Acceptable time.
  • If you’re hungry between meals, enjoy a low-carb snack, such as a hard-boiled egg, some cheese, olives or a low-carb snacks.
  • Do not eat anything that is not on the Foods List.
  • Take a daily multivitamin, essential fatty acids and a fiber supplement.
  • Adjust the quantity of protein you eat to suit your appetite, especially as it decreases. Eat the amount that makes you feel satisfied but not stuffed.
  • Limit coffee, tea and soft drinks that contain caffeine to one or two cups per day. Excessive caffeine has been shown to cause unstable blood sugar and trigger cravings.
  • Drink at least eight 8-ounce glasses of water each day to hydrate your body, avoid constipation and flush out the byproducts of burning fat.

The Atkins Diet: Acceptable Foods
These are the foods you may eat liberally during Induction:
All fish. All fowl. All shellfish.* All meat.** All eggs.
*Oysters and mussels are higher in carbs than other shellfish, so limit them to four ounces per day.
**Processed meats, such as ham, bacon, pepperoni, salami, hot dogs and other luncheon meats-and some fish-may be cured with added sugar and will contribute carbs. Try to avoid meat and fish products cured with nitrates, which are known carcinogens. Also beware of products that are not exclusively meat, fish or fowl, such as imitation fish, meatloaf and breaded foods. Finally, do not consume more than four ounces of organ meats a day.
You can consume three to four ounces daily of the following full-fat, firm, soft and semisoft aged cheeses*, including:

  • cheddar
  • cow, sheep and goat cheese
  • cream cheese
  • Gouda
  • mozzarella
  • Roquefort and other blue cheeses
  • Swiss

*All cheeses have some carbohydrate content. The quantity you eat should be governed by that knowledge. The rule of thumb is to count 1 ounce of cheese as equivalent to 1 gram of carbohydrate. Note that cottage cheese, farmer’s cheese and other fresh cheeses are not permitted during Induction. No “diet” cheese, cheese spreads or whey cheeses are permitted. Individuals with known yeast symptoms, dairy allergy or cheese intolerance must avoid cheese. Imitation cheese products are not allowed, except for soy or rice cheese-but check the carbohydrate content.
You can have two to three cups per day of:

  • alfalfa sprouts
  • daikon
  • mushrooms
  • arugula
  • endive
  • parsley
  • bok choy
  • escarole
  • peppers
  • celery
  • fennel
  • radicchio
  • chicory
  • jicama
  • radishes
  • chives
  • lettuce
  • romaine lettuce
  • cucumber
  • mache
  • sorrel

These salad vegetables are high in phytonutrients and provide a good source of fiber.
Other Vegetables
You can have one cup per day of these veggies if salad does not exceed two cups. The following vegetables are slightly higher in carbohydrate content than the salad vegetables:

  • artichoke
  • celery root
  • pumpkin
  • artichoke hearts
  • rhubarb
  • asparagus
  • chard
  • sauerkraut
  • bamboo shoots
  • collard greens
  • scallions
  • dandelion
  • snow peas
  • bean sprouts
  • dandelion greens
  • spaghetti squash
  • beet greens
  • eggplant
  • spinach
  • broccoli
  • hearts of palm
  • string or wax beans
  • broccoli rabe
  • kale
  • summer squash
  • brussels
  • kohlrabi
  • tomato
  • bean sprouts
  • leeks
  • turnips
  • cabbage
  • okra
  • water chestnuts
  • cauliflower
  • onion
  • zucchini

If a vegetable, such as spinach or tomato, cooks down significantly, it must be measured raw so as not to underestimate its carb count.
Salad Garnishes

  • crumbled crisp bacon
  • grated cheese
  • minced hard-boiled egg
  • sauteed mushrooms
  • sour cream

All spices to taste, but make sure none contain added sugar.

  • basil
  • garlic
  • rosemary
  • cayenne pepper
  • ginger
  • sage
  • cilantro
  • oregano
  • tarragon
  • dill
  • pepper
  • thyme

For salad dressing, use oil and vinegar (but not balsamic vinegar, which contains sugar) or lemon juice and herbs and spices. Prepared salad dressings without added sugar and no more than two carbs per tablespoon serving are also fine.
Acceptable Fats and Oils
Many fats, especially certain oils, are essential to good nutrition. Olive oil is particularly valuable. All other vegetable oils are allowed, the best being canola, walnut, soybean, grapeseed, sesame, sunflower and safflower oils, especially if they are labeled “cold-pressed” or “expeller-pressed.” Do not cook polyunsaturated oils, such as corn, soybean and sunflower oil, at high temperatures or allow to brown or smoke.
Butter is allowed. Margarine should be avoided, not because of its carbohydrate content, but because it is usually made of trans fats (hydrogenated oils), which are a serious health hazard. (Some nonhydrogenated margarines are available in health-food stores.)
You don’t have to remove the skin and fat from meat or fowl. Salmon and other cold-water fish are an excellent source of omega-3 fatty acids.
Remember that trying to do a low-fat version of the Atkins Nutritional ApproachTM will interfere with fat burning and derail your weight loss.
Artificial Sweeteners
You must determine which artificial sweeteners agree with you, but the following are allowed: sucralose (marketed as Splenda™), saccharin, cyclamate and acesulfame-K. Natural sweeteners ending in the suffix “-ose,” such as maltose, etc., should be avoided. However, most sugar alcohols have a minimal effect on blood sugar and are acceptable.
Saccharin has been extensively studied, and harmful effects were produced in the lab when fed to rats only in extremely high doses. The Food and Drug Administration (FDA) has removed saccharin from its list of carcinogens, basing its decision upon a thorough review of the medical literature and the National Institute of Science’s statement that there is “no clear association between saccharin and human cancer.” It can be safely consumed in moderation, meaning no more than three packets a day. Saccharin is marketed as Sweet’n Low™.
The Atkins preference, however, is sucralose (Splenda™), the only sweetener made from sugar. Sucralose is safe, noncaloric and does not raise blood sugar. It has been used in Canada for years, and the FDA recently approved it after reviewing more than 100 studies conducted over the past 20 years. Note that each packet of sugar substitute contains about 1 gram of carbohydrate, so don’t forget to include the amount in your daily totals.
Acceptable Beverages
Be sure to drink a minimum of eight eight-ounce glasses of water each day, including:

  • Filtered water
  • Mineral water
  • Spring water
  • Tap water

Additionally, you can have the following:

  • Clear broth/bouillon (not all brands; read the label)
  • Club soda
  • Cream, heavy or light (limit to two to three tablespoons a day; note carbohydrate content)
  • Decaffeinated coffee or tea*
  • Diet soda made with sucralose (Splenda™); be sure to count the carbs
  • Essence-flavored seltzer (must say “no calories”)
  • Herb tea (without barley or any fruit sugar added)
  • Lemon juice or lime juice (note that each contains 2.8 grams carbohydrate per ounce); limit to two to three tablespoons

*Excessive caffeine may cause unstable blood sugar and should be avoided by those who suspect they are caffeine dependent. Everyone should try to avoid caffeine. Grain beverages (coffee substitutes) are not allowed. Alcoholic beverages are also not permitted during Induction; those low in carbohydrates are an option, in moderation, in later phases.
Special Category Foods
To add variety, each day you can also eat 10 to 20 olives, half a small avocado, an ounce of sour cream or three ounces of unsweetened heavy cream, as well as two to three tablespoons of lemon juice or lime juice. But be aware that these foods occasionally slow down weight loss in some people, and may need to be avoided in the first two weeks. If you seem to be losing slowly, moderate your intake of these foods.
Convenience Foods
Although it is important that you eat primarily unprocessed foods, some controlled carb food products can come in handy when you are unable to find appropriate food, can’t take time for a meal or need a quick snack. More and more companies are creating healthy food products that can be eaten during the Induction phase of Atkins. Just remember two things:

  • Not all convenience food products are the same, so check labels and carbohydrate content.
  • While any of these foods can make doing Atkins easier, don’t overdo it. Remember, you must always follow The Rules of Induction.

The Atkins Diet: The Rules of Induction
This phase of the Atkins Nutritional Approach™ must be followed precisely to achieve success. If you do it at all incorrectly you may prevent weight loss and end up saying, “Here is another weight-loss plan that didn’t work.” Also, check out “Extra Cautions,” below.
Memorize the following rules as though your life depends upon it. In fact, it does.

  • Eat either three regular-size meals a day or four or five smaller meals. Do not skip meals or go more than six waking hours without eating.
  • Eat liberally of combinations of fat and protein in the form of poultry, fish, shellfish, eggs and red meat, as well as pure, natural fat in the form of butter, mayonnaise, olive oil, safflower, sunflower and other vegetable oils (preferably expeller-pressed or cold-pressed).
  • Eat no more than 20 grams a day of carbohydrate, most of which must come in the form of salad greens and other vegetables. You can eat approximately three loosely packed cups of salad, or two cups of salad plus one cup of other vegetables (see Acceptable Foods).
  • Eat absolutely no fruit, bread, pasta, grains, starchy vegetables or dairy products other than cheese, cream or butter. Do not eat nuts or seeds in the first two weeks. Foods that combine protein and carbohydrates, such as chickpeas, kidney beans and other legumes, are not permitted at this time.
  • Eat nothing that isn’t on the Acceptable Foods list. And that means absolutely nothing. Your “just this one taste won’t hurt” rationalization is the kiss of failure during this phase of Atkins.
  • Adjust the quantity you eat to suit your appetite, especially as it decreases. When you’re hungry, eat the amount that makes you feel satisfied, but not stuffed. When you’re not hungry, eat a small controlled carbohydrate snack to accompany your nutritional supplements.
  • Don’t assume any food is low in carbohydrate-instead, read labels. Check the carb count (it’s on every package) or use a carbohydrate gram counter.
  • Eat out as often as you wish but be on guard for hidden carbs in gravies, sauces and dressings. Gravy is often made with flour or cornstarch, and sugar is sometimes an ingredient in salad dressing.
  • Use sucralose or saccharin as a sweetener. Be sure to count each packet of any of these as 1 gram of carbs.
  • Avoid coffee, tea and soft drinks that contain caffeine. Excessive caffeine has been shown to cause low blood sugar, which can make you crave sugar.
  • Drink at least eight 8-ounce glasses of water each day to hydrate your body, avoid constipation and flush out the by-products of burning fat.
  • If you are constipated, mix a tablespoon or more of psyllium husks in a cup or more of water and drink daily. Or mix ground flaxseed into a shake or sprinkle wheat bran on a salad or vegetables.
  • At a minimum, take a good daily multivitamin with minerals, including potassium, magnesium and calcium, but without iron.

The South Beach Diet: Overview
This is an excerpt from the book: The South Beach Diet: The Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss by Arthur Agatston, 2003.
The South Beach Diet is not low-carb. Nor is it low-fat. Instead, it teaches you to rely on the right carbs and the right fats–the good ones–so you lose weight, lower your cholesterol, reduce your risk of heart disease and diabetes, and get rid of cravings without feeling hungry.
In one 12-week study of 40 overweight people, those who followed the South Beach Diet lost an average of 13.6 lb, almost double the 7.5 lb lost by those on the strict “Step II” American Heart Association (AHA) diet. And the South Beach group showed greater decreases in waist-to-hip ratio (belly fat) and triglycerides, and their good to bad cholesterol ratio improved more. Plus, only one person dropped out compared with five in the AHA group.
By choosing the right carbs and the right fats, you simply won’t be hungry all the time, and portion sizes will take care of themselves.
Caution: If you have kidney problems, talk to your doctor before starting this diet. If you have diabetes, get tested to make sure that your kidneys are not impaired before starting this diet.
Good Carbs versus Bad Carbs
Much of our excess weight comes from the carbohydrates we eat, especially the highly processed ones found in baked goods, breads, snacks, soft drinks, and other convenient favorites. Modern industrial processing removes the fiber from these foods, and once that’s gone, their very nature–and how we metabolize them–changes significantly, and for the worse.
One side effect of excess weight, we now know, is an impairment of insulin’s ability to do its job of processing fuel (fats and sugars) properly. This condition is called insulin resistance. As a result, the body stores more fat than it should, especially in the midsection.
Decrease consumption of those bad carbs, studies showed, and the insulin resistance starts clearing up. Weight decreases, and you begin metabolizing carbs properly. Even the craving for carbs disappears once you cut down on them. Finally, cutting out processed carbs lowers triglycerides and cholesterol.
The Right Fat
To make up for the overall cut in carbs, my diet permits ample fats and animal proteins. The low-fat regimen’s severe restrictions on meat were unnecessary. The latest studies had shown that lean meat did not have a harmful effect on blood chemistry. Even egg yolks are good for you, which is contrary to what we once believed. Chicken, turkey, and fish are recommended, along with nuts and low-fat cheeses and yogurt.
As a rule, low-fat prepared foods can be a bad idea; the fats are replaced with carbs, which are also fattening. But dairy products such as cheese, milk, and yogurt that are low-fat are exceptions to this rule; they are nutritious and not fattening.
I also allowed plenty of healthy monounsaturated fats such as olive and canola oils. These are the good fats. In addition to actually reducing the risk of heart attack and stroke, they taste good and make food palatable. They’re filling too.
Phase 1: Two Weeks of Restraint
This is the strictest part of the diet and is meant to last for 2 weeks only. But you could lose up to 13 lb depending on your starting weight. It allows ample portions of protein, good fats, and the lowest-glycemic index carbs needed for satisfaction and blood sugar control. By the time this phase ends, your cravings for sweets, baked goods, and starches will also have vanished.
Each day includes six different occasions to eat, so you should never feel hungry. If you do, maybe you’re being too stingy with your portions. Meals should be of normal size, enough to satisfy you, but no more than that. No need to measure most things.
Phase 1 Sample Meal Plan
Tomato juice, 6 oz
Scrambled eggs with fresh herbs and mushrooms
Canadian bacon, 2 slices
Decaf coffee or decaf tea with fat-free milk and sugar substitute
Midmorning Snack
Part-skim mozzarella cheese stick
Chicken Caesar salad (no croutons)
Prepared Caesar dressing, 2 Tbsp
Midafternoon Snack
Low-fat cottage cheese (1/2 cup) with 1/2 cup chopped tomatoes and cucumbers
Mahi mahi
Oven-Roasted Vegetables
Arugula salad
Low-sugar prepared dressing
Lemon Peel Ricotta Creme
Foods to Enjoy
Beef: Lean cuts such as sirloin (including ground), tenderloin.
Poultry (skinless): Cornish hen, turkey bacon, turkey breast, chicken breast.
Seafood: All types of fish and shellfish.
Pork: Boiled ham, Canadian bacon, tenderloin.
Veal: Chop, cutlet, top round.
Lunchmeat: Fat-free or low-fat.
Cheese (fat-free or low-fat): American, Cheddar, cottage cheese, cream cheese substitute (dairy-free), feta.
Nuts: Peanut butter, peanuts, pecans, pistachios, walnuts, cashews.
Eggs: Whole eggs are not limited unless otherwise directed by your doctor. Use egg whites and egg substitute as desired.
Tofu: Use soft, low-fat, or light varieties.
Vegetables and legumes: Artichokes, asparagus, beans and legumes, broccoli, cabbage, cauliflower, celery, cucumbers, eggplant, lettuce, mushrooms, red peppers, spinach, tomatoes, zucchini.
Fats: Canola and olive oils.
Spices and seasonings: All seasonings that contain no added sugar, broth, butter sprays, pepper.
Sweets (limit to 75 calories per day): Chocolate powder (no added sugar), cocoa powder (baking type), hard candy, sugar substitute (all sugar-free unless otherwise specified).
Foods to Avoid
Beef: Brisket, liver, rib steaks, other fatty cuts.
Poultry: Chicken wings, thighs, and legs, turkey wings, duck, goose, poultry products (processed).
Pork: Honey-baked ham.
Veal: Breast.
Cheese: Brie, Edam, all full-fat.
Vegetables and legumes: Barley, beets, black-eyed peas, carrots, corn, pinto beans, sweet potatoes, white potatoes, yams.
Fruit: Avoid all fruits and fruit juices during Phase 1.
Starches: Avoid all starchy food during Phase 1, including all types of bread, cereal, matzo, oatmeal, rice, pasta, pastry, potatoes, and baked goods.
Dairy: Avoid all dairy foods during Phase 1, including ice cream, milk, soy milk, yogurt.
Miscellaneous: Alcohol of any kind
Phase 2: More Liberal Meal Plans
Here’s where you gradually reintroduce certain healthy carbs into your diet: fruit, sweet potatoes, whole grain bread, whole grain rice, whole wheat pasta. Start with one piece of fruit a day for lunch or dinner, and continue with some cereal or a piece of bread. Weight loss will slow a little. (A healthy average rate of weight loss is 1 to 2 lb a week over time.) Stay on this phase until you hit your target weight. If you regain some weight, switch back to Phase 1 until you lose it.
A key to success is the glycemic index (GI) that ranks carbohydrate foods by their effect on your blood sugar levels. Focus on adding low-GI foods (apples, berries, grapefruit, high-fiber cereal, whole grain breads) to your diet instead of those with a high GI (cakes, cookies, crackers, pasta, white bread).
The goal is to eat more carbs again while continuing to lose weight. If you add an apple and a slice of bread a day, and you’re still dropping pounds, that’s great. If you try an apple, two slices of bread, and a banana daily and notice that your weight loss has stalled, you’ve gone too far. Cut back, or try some different carbs.
You’ll go on that cautious way as long as you’re in Phase 2, eating the most beneficial carbs and paying attention to how they affect you. You should also be aware of foods that increase cravings. No two people will experience this phase the same way. Some dieters can have pasta once a week with no detrimental effects. Others have to avoid pasta but can eat sweet potatoes. You’ll have to figure this dynamic out for yourself.
Phase 2 Sample Meal Plan
Berry smoothie (8 oz Dannon Light ‘n Fit fruit-flavored yogurt, 1/2 cup berries, 1/2 cup crushed ice, blended)
Decaf coffee or decaf tea with fat-free milk and sugar substitute
Midmorning Snack
1 hard-boiled egg
Lemon Couscous Chicken
Tomato and cucumber slices
Midafternoon Snack
Dannon Light ‘n Fit yogurt, 4 oz
Meat Loaf
Steamed asparagus
Mushrooms sauteed in olive oil
Sliced Bermuda onion and tomato with drizzled olive oil
Sliced cantaloupe with 2 Tbsp ricotta cheese
Foods You Can Eat Again
Fruit: Apples, blueberries, cantaloupe, grapefruit, grapes, mangoes, oranges, peaches.
Dairy: Milk (light soy, fat-free, or 1%), yogurt.
Starches (use sparingly): Bagels (small whole grain), bran muffins, bread (multigrain, bran, whole wheat), cereal (high-fiber, oatmeal [not instant]), pasta (whole wheat), pita, rice (brown, wild).
Vegetables and legumes: Barley, black-eyed peas, pinto beans, sweet potatoes, yams.
Miscellaneous: Chocolate (bittersweet or semisweet, sparingly), pudding (fat-free).
Foods to Avoid or Eat Rarely
Starches: Bagels (refined wheat), bread (refined wheat, white), cookies, cornflakes, dinner rolls, matzo, pasta (white), potatoes (white baked, instant), rice cakes, rice (white).
Vegetables: Beets, carrots, corn, white potatoes.
Fruit: Bananas, canned fruit, fruit juice, pineapple, raisins, watermelon.
Miscellaneous: Honey, ice cream, jam.
Phase 3: The Rest of Your Life
This is the maintenance phase: how you’ll eat for the rest of your life. It’s the most liberal stage. You can continue to eat snacks if you need them, but most people find that they are satisfied without them.
There will always be times when you overindulge a little even after years on the diet. Those are the times when you’ll switch back to Phase 1 for a week or two. You’ll get back to where you were, and then you’ll return
to Phase 3.
Phase 3 Sample Meal Plan
½ grapefruit
Tex-Mex eggs (2 eggs scrambled with shredded Monterey Jack cheese and salsa)
Whole grain toast, 1 slice
Decaf coffee or decaf tea with fat-free milk and sugar substitute
Roast Beef Wrap
Grilled salmon with tomato salsa
Tossed salad (mixed greens, cucumbers, green bell peppers, cherry tomatoes)
Olive oil and vinegar to taste or 2 Tbsp low-sugar prepared dressing
Chocolate-Dipped Apricots
Don’t Forget (All Phases)
1. Drink at least eight glasses of water or decaf beverages (club soda, unsweetened flavored seltzers, decaf tea or coffee [no sugar], decaf sugar-free sodas) per day.
2. Limit caffeine-containing beverages to 1 cup per day.
3. Take a daily multivitamin and mineral supplement.
4. Take a daily calcium supplement (500 mg for men of all ages and women under 50, 1,000 mg for women over 50).
South Beach Diet by Dr A Agatston
Its not low carb and its not low fat!
Teaches you to rely on the right carbs and the right fats-and enables you to live quite happily without the bad ones. You should lose somewhere between 8-13 pounds in the first two weeks alone.

  • You’ll eat normal size helpings of meat, chicken, turkey, fish and shellfish
  • You’ll have plenty of vegetables, eggs, cheese and nuts
  • You’ll have salads with real olive oil in the dressing.
  • You’ll have 3 balanced meals a day and it will be your job to eat so your hunger is satisfied
  • You’ll have dessert after dinner
  • You’ll drink water, plus tea & coffee if you wish
  • Phase 1
  • For the next 14 days you wont have any bread, rice, potatoes, pasta or baked goods. No fruit, no sweets, cakes biscuits, ice cream, beer or alcohol.
  • During the first week the craving for the above will disappear
  • You will lose between 8-13 pounds
  • Phase 2
  • Weight loss should be appx 2 lbs a week
  • You can start introducing more food back to your diet
  • Fruit can be added back to the diet, and pasta etc in reduced quantities
  • Phase 2 should last till you hit your target weight

Phase 3 is the rest of your life-when you’re into the habits of good healthy eating and back to normal foods – as long as you stick to a few basic rules!
Good carbs/ Bad carbs
Phase 1 begins to reverse the body’s inability to process sugars and starches properly. To do this we need to cut out all carbs but the healthiest ones ie those high in fibre and nutrients (and lowest in sugar and starch)-vegetables and salads only in other words!!
Typical brekkie-two egg omelette with two slices lean bacon cooked in a spray of olive oil
This combines protein (eggs & bacon) and good fats (oil and bacon). This will keep your stomach full and occupied with digestion ie no hunger pangs!
An alternative could have been an omelette with vegetables ie mushrooms, peppers, broccoli. Or an omelette with ham or low-fat cheese.
It is essential not to skip breakfast as this allows blood sugar to drop and results in cravings for dodgy carbs!
You can have up to 7 eggs a week.
You should be ready for a mid-morning snack about 10.30am whether or not you feel like you need one. The only low-fat food this diet recommends in low-fat cheese or low-fat yoghurt. (In other low-fat foods, the fat tends to have been replaced with carbohydrates)
Typical lunch could be mixed salad, with grilled chicken or fish, olive oil vinaigrette, grilled prawns, tuna nicoise salad. Eat until you are full.
Aim for good mix of healthy carbohydrates, protein and fats. The aim is to deprive your system of the low-quality sugar and starch that play havoc with your blood chemistry.
Mid-afternoon is another dodgy time as blood sugar levels drop again triggering cravings for chocolate/sweets etc. Nuts are a good thing to eat at this time. Not salted or smoked nuts though. Almonds, or Pistachios. Try and only eat a limited amount ie 15 almonds or 30 pistachios.
Dinner-again we rely on chicken, fish, lean beef and plenty of vegetables and salad to go with them.
Strong recommendation to have dessert after dinner as this is another prime time for blood sugar levels to drop. Two solutions-sugar free jelly (called gelatine in the book but I guess it’s the same thing!!) plus ample use of low-fat ricotta cheese.
Main aim is to slow the absorption of the sugars in the carbohydrates into the bloodstream. Fibre is a very good way of slowing this process down. Similar to drinking on an empty stomach-you get drunk faster than if you had food in your stomach to absorb the alcohol.
Fat also slows down the absorption of sugar. As well as acidic foods such as lemon and vinegar, which slow down the speed at which your stomach empties.
Basically anything that helps slow down the absorption of carbohydrate sugars is good!
You can split card sugars into two groups-slow and fast.
Fast sugar gives us a quick ‘hit’ but then increases cravings soon after the initial hit.
Slow sugar gradually raises our sugar levels but also lowers them slower so the cravings do not reappear so quickly.
Basically when we have low blood sugar, and we raise it quickly then pancreas increases insulin levels in the body, this then reduces the sugar level but often to a level that is too low thus creating more cravings, and so on.
The slower the rate that sugar is released into the body, the slower insulin is released into our bodies to counteract it. Ie no sudden rise/fall in blood sugar = no cravings
Timing your snacks to correspond with the daily lows in blood sugar can also help counteract the craving. There is a lag between your stomach starting to fill and your brain noticing it., so eating i.e. a few nuts before lunch will stop you eating so much
Certain foods cause our sugar levels to rise more quickly-i.e. white bread, white pasta, sugar, beer, rice, certain tropical fruit, anything made with white flour, potatoes and other starchy vegetables,
Phase 1 foods to enjoy :
Beef-Sirloin (including minced), Tenderloin, Top Round, Other lean cuts
Poultry (skinless)-Turkey/chicken breast, Poussin, Turkey Bacon (2 slices per day)
Seafood-all types of fish and shellfish
Pork-Boiled Ham, Lean Bacon, tenderloin
Veal-Leg Cutlet, Top Round, Veal Chop,
Lunchmeat-Non-fat or lower fat only
Cheese (fat-free or lower fat)-American, Cheddar, Feta, Mozzarella, Parmesan,
Ricotta, Provolone, String, Dairy free cream cheese, fat free cottage cheese
Nuts-30 pistachios, 20 small peanuts, 15 pecan halves, 1 teaspoon peanut butter
Eggs-7 eggs per week
Tofu-soft, low-fat or lite varieties
Vegetables-Artichokes, Asparagus, Aubergines, Beans (black, butter. Chickpeas,
Green, Italian, kidney, lentils, Lima, split peas) Broccoli, Cabbage, Cauliflower,
Celery, Courgettes, Cucumbers, Lettuce, Mushrooms, Spinach, Turnips
Fats-olive oil
Spices-all spices that contain no added sugar, extracts (vanilla, almond etc)
Horseradish sauce, low fat butter substitute) pepper 9black, white, red,
Sweet treats-limit to 75 calories per day-no added sugar chocolate powder, sugar
free ice-lollies, sugar free gelatine, sugar free hard sweets, sugarless chewing gum, sugar substitute.
Foods to avoid :
Fatty cuts of meat, chicken wings/legs, duck, goose, honey bake ham, brie, edam, beets, carrots, corn, potatoes, tomato (limit to 1 whole or 10 cherry per meal) sweet potatoes, apples, apricots, berries, melon, peaches, pears, all starchy food ie bread, cereal, oatmeal, rice, pasta, pastry, frozen yoghurt, ice-cream, milk, soy milk, yoghurt, alcohol of any kind.
Dessert ideas
-Basically all involved 110g low fat ricotta cheese mixed with: –
Sugar substitute, lemon zest, lime zest, vanilla extract, almond extract.
Mix up and serve chilled
After 2 weeks of phase 1 they recommend you switch to phase 2-ie gradually reintroducing certain healthy carbs ie fruit, granary bread brown rice, wholemeal pasta, sweet potatoes
Foods to reintroduce in phase 2:-
Apples, apricots, blueberries, melon, cherries, grapefruit, grapes, kiwi, mango, oranges, peaches, pears, plums, strawberries, light fruit flavoured yoghurt, light soya milk, plain lowfat or fatfree yoghurt, starches-use sparingly ie all-bran cereal, bran flakes, oatmeal, brown rice, wholewheat pasta, multigrain bread, popcorn, small sweet potato, wholegrain bagels etc, red wine.
Foods to avoid or eat rarely:-
White rice, baked white potatoes, instant potatoes, dinner rolls, white bread, white pasta, pretzels, rice cakes, cornflakes, biscuits, beetroot, carrots, corn, potatoes, banana, fruit juice, canned fruit, pineapple, raisins, watermelon, honey, jam, ice-cream.
What Is the Glycemic Index?
The Glycemic Index–or GI, for short–is a system that ranks foods by how they affect your levels of blood sugar. Low-GI foods (less than 55) produce a gradual rise in blood sugar that’s easy on the body. Foods between 55 and 70 are intermediate-GI foods. Foods with high-GI numbers (more than 70) make blood sugar as well as insulin levels spike fast. We now realize that’s a health threat.
Can choosing more low-GI foods make you healthier?
Mounting research suggests keeping blood sugar from spiking pays off in many ways. Low-GI foods appear to:
stave off heart disease
prevent type 2 diabetes
help you evade serious side effects if you have diabetes
curb your appetite so you lose weight
perhaps even help you feel more energetic
Is it hard to use the GI in real life?
Definitely not. Here are the general guidelines. Include at least one low-GI food at each meal or snack, advises top GI expert Jennie Brand-Miller, PhD, University of Sydney, Australia. No one’s suggesting you eliminate all high-GI foods, but you can use this guide to work toward more intermediate- and low-GI choices–with the exceptions noted below. So far, there’s no fixed rule as to the number of GI points that you are “allowed” at each meal.
* Eat sparingly any low- or intermediate-GI foods that are printed in red, such as candy bars. These are high in empty calories. Eat too much, and you’ll crowd out essential nutrients and gain weight.* On the other hand, don’t avoid or even limit high-glycemic index foods that are printed in green. These are low-calorie and very nutritious foods, such as watermelon and baked potato.
Low-Glycemic Index Foods: Less Than 55
* Eat foods printed in red sparingly; these are high in empty calories.
Artichoke <15
Asparagus <15
Broccoli <15
Cauliflower <15
Celery <15
Cucumber <15
Eggplant <15
Green beans <15
Lettuce, all varieties <15
Low-fat yogurt, artificially sweetened <15
Peanuts <15
Peppers, all varieties <15
Snow peas <15
Spinach <15
Young summer squash <15
Zucchini <15
Tomatoes 15
Cherries 22
Peas, dried 22
Plum 24
Grapefruit 25
Pearled barley 25
Peach 28
Canned peaches, natural juice 30
Dried apricots 31
Soy milk 30
Baby lima beans, frozen 32
Fat-free milk 32
Fettuccine 32
*M&M’s Chocolate Candies, Peanut 32
Low-fat yogurt, sugar sweetened 33
Apple 36
Pear 36
Whole wheat spaghetti 37
Tomato soup 38
Carrots, cooked 39
*Mars Snickers Bar 40
Apple juice 41
Spaghetti 41
All-Bran 42
Canned chickpeas 42
Custard 43
Grapes 43
Orange 43
Canned lentil soup 44
Canned pinto beans 45
Macaroni 45
Pineapple juice 46
Banana bread 47
Long-grain rice 47
Parboiled rice 47
Bulgur 48
Canned baked beans 48
Grapefruit juice 48
Green peas 48
Oat bran bread 48
*Chocolate bar, 1.5 oz 49
Old-fashioned oatmeal 49
Cheese tortellini 50
*Low-fat ice cream 50
Canned kidney beans 52
Kiwifruit 52
Orange juice, not from concentrate 52
Banana 53
*Potato chips 54
*Pound cake 54
Special K 54
Sweet potato 54
Eat foods marked with an asterisk (*) sparingly; these are high in empty calories.

Dieting and Gallstones

Dieting and Gallstones

  • What are gallstones?
  • What causes gallstones to develop?
  • What are the symptoms of gallstones?
  • Is obesity a risk factor for gallstones?
  • Is weight-loss dieting a risk factor for gallstones?
  • Is weight cycling a risk factor for gallstones?
  • Is surgery to treat obesity a risk factor for gallstones?
  • How can I safely lose weight and decrease the risk of gallstones?
  • What is the treatment for gallstones?
  • Are the benefits of weight loss greater than the risk of getting gallstones?
  • Additional Reading

What are gallstones?
Gallstones are clusters of solid material that form in the gallbladder. The most common type is made mostly of cholesterol. Gallstones may occur as one large stone or as many small ones. They vary in size and may be as large as a golf ball or as small as a grain of sand.
Experts estimate that 10 to 15 percent of people in the United States have gallstones-as many as 42 million Americans. Most people with gallstones do not know that they have them and experience no symptoms. Painless gallstones are called silent gallstones. Sometimes gallstones can cause abdominal or back pain. These are called symptomatic gallstones. In rare cases, gallstones can cause serious health problems. Symptomatic gallstones result in about 800,000 hospitalizations and more than 500,000 operations each year in the United States.
What causes gallstones to develop?
Gallstones develop in the gallbladder, a small pear-shaped organ located beneath the liver on the right side of the abdomen. The gallbladder is about 3 inches long and 1 inch wide at its thickest part. It stores and releases bile into the intestine to help digestion.
Bile is a liquid made by the liver. It contains water, cholesterol, bile salts, fats, proteins, and bilirubin (a bile pigment). During digestion, the gallbladder contracts to release bile into the intestine, where the bile salts help to break down fat. Bile also dissolves excess cholesterol.
According to researchers, cholesterol gallstones may form in several ways, such as:

  • When bile contains more cholesterol than it can dissolve.
  • When there is too much bilirubin or other substance in the bile that causes cholesterol to form hard crystals.
  • When there are not enough bile salts to break down fat.
  • When the gallbladder does not contract and empty its bile regularly.

What are the symptoms of gallstones?
Some common symptoms of gallstones or gallstone attack include:

  • Severe pain in the upper abdomen that starts suddenly and lasts from 30 minutes to many hours.
  • Pain under the right shoulder or in the right shoulder blade.
  • Nausea or vomiting.
  • Indigestion after eating high-fat foods, such as fried foods or desserts.

Is obesity a risk factor for gallstones?
Obesity is a strong risk factor for gallstones, especially among women. People who are obese are more likely to have gallstones than people who are at a healthy weight. Obesity in adults can be defined using the body mass index (BMI), a tool that measures weight in relation to height. The table below shows how the BMI calculation works. A BMI of 18.5 to 24.9 refers to a healthy weight, a BMI of 25 to 29.9 refers to overweight, and a BMI of 30 or higher refers to obesity.
As BMI increases, the risk for developing gallstones also rises. Studies have shown that risk may triple in women who have a BMI greater than 32 compared to those with a BMI of 24 to 25. The risk may be seven times higher in women with a BMI above 45 than in those with a BMI below 24.
Researchers have found that people who are obese may produce high levels of cholesterol. This leads to the production of bile containing more cholesterol than it can dissolve. When this happens, gallstones can form. People who are obese may also have large gallbladders that do not empty normally or completely. Some studies have shown that men and women who carry fat around their midsections may be at a greater risk for developing gallstones than those who carry fat around their hips and thighs.
Table 1. Body Mass Index

* Without Shoes
**Without Clothes
George Bray, M.D., Pennington Biomedical Research Center.
National Heart, Lung, and Blood Institute’s Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report.
Find your weight on the bottom of the graph. Go straight up from that point until you come to the line that matches your wheight. Then look to find your weight group.
Is weight-loss dieting a risk factor for gallstones?
Weight-loss dieting increases the risk of developing gallstones. People who lose a large amount of weight quickly are at greater risk than those who lose weight more slowly. Rapid weight loss may also cause silent gallstones to become symptomatic. Studies have shown that people who lose more than 3 lbs per week may have a greater risk of developing gallstones than those who lose weight at slower rates.
A very low-calorie diet (VLCD) allows a person who is obese to quickly lose a large amount of weight. VLCDs usually provide about 800 calories per day in food or liquid form, and are followed for 12 to 16 weeks under the supervision of a health care professional. Studies have shown that 10 to 25 percent of people on a VLCD developed gallstones. These gallstones were usually silent-they did not produce any symptoms. About one-third of the dieters who developed gallstones, however, did have symptoms and some of these required gallbladder surgery.
Experts believe weight-loss dieting may cause a shift in the balance of bile salts and cholesterol in the gallbladder. The cholesterol level is increased and the amount of bile salts is decreased. Following a diet too low in fat or going for long periods without eating (skipping breakfast, for example), a common practice among dieters, may also decrease gallbladder contractions. If the gallbladder does not contract often enough to empty out the bile, gallstones may form.
A drug called ursodiol that helps dissolve cholesterol in the bile may help prevent gallstones from developing during rapid weight loss. While ursodiol is not approved by the Food and Drug Administration (FDA) to prevent gallstones, its “off-label” use (the practice of prescribing medications for periods of time or for conditions not FDA-approved) has been shown to be effective and safe. If rapid weight loss is highly likely, you should consider talking with your health care provider about using ursodiol.
Is weight cycling a risk factor for gallstones?
Weight cycling, or losing and regaining weight repeatedly, may increase the risk of developing gallstones. People who weight cycle-especially with losses and gains of more than 10 lbs-have a higher risk for gallstones than people who lose weight and sustain their weight loss. Additionally, the more weight a person loses and regains during a cycle, the greater the risk of developing gallstones.
Why weight cycling is a risk factor for gallstones is unclear. The rise in cholesterol levels during the weight-loss phase of a weight cycle may be responsible. It is also thought that each cycle increases one’s risk for gallstones. However, further research is required to determine the exact link between weight loss and the risk for gallstones.
Is surgery to treat obesity a risk factor for gallstones?
Gallstones are common among people who undergo gastrointestinal surgery to lose weight, also called bariatric surgery. Gastrointestinal surgery to reduce the size of the stomach or bypass parts of the digestive system is a weight-loss method for people who have a BMI above 40. This procedure is also an option for people who have a BMI above 35 with comorbid conditions such as diabetes and high blood pressure. Experts estimate that about one-third of patients who have bariatric surgery develop gallstones. The gallstones usually develop in the first few months after surgery and are symptomatic.
How can I safely lose weight and decrease the risk of gallstones?
You can take several measures to decrease the risk of developing gallstones during weight loss. Losing weight gradually, instead of losing a large amount of weight quickly, lowers your risk. Depending on your starting weight, experts recommend losing weight at the rate of 1/2 to 2 lbs per week. Losing weight at this rate commonly occurs for up to 6 months. After 6 months, weight loss usually declines and weight stabilizes because individuals in lower weight groups use fewer calories (energy). You can also decrease the risk of gallstones associated with weight cycling by aiming for a modest weight loss that you can maintain. Even a loss of 5 to 10 percent of body weight over a period of 6 months or more can improve the health of an adult who is overweight or obese.
Your food choices can also affect your gallstone risk. Experts recommend including some fat in your diet to stimulate gallbladder contracting and emptying. Current recommendations indicate that 20 to 35 percent of your total calories should come from fat. Studies have also shown that diets high in fiber and calcium may reduce the risk of gallstone development.
Finally, regular physical activity is related to a lower risk for gallstones. Aim for approximately 60 minutes of moderate- to vigorous-intensity activity on most days of the week to manage your body weight and prevent unhealthy weight gain. To sustain weight loss, engage in at least 60 to 90 minutes of daily moderate-intensity physical activity.
What is the treatment for gallstones?
Silent gallstones are usually left alone and sometimes disappear on their own. Symptomatic gallstones are usually treated. The most common treatment is surgery to remove the gallbladder. This operation is called a cholecystectomy. In other cases, drugs are used to dissolve the gallstones. Your health care professional can help determine which option is best for you.
Are the benefits of weight loss greater than the risk of getting gallstones?
Although weight loss increases the risk of developing gallstones, obesity poses an even greater risk. In addition to gallstones, obesity is linked to many serious health problems, including:

  • type 2 diabetes
  • high blood pressure
  • heart disease
  • stroke
  • certain types of cancer
  • sleep apnea (when breathing stops for short periods during sleep)
  • osteoarthritis (wearing away of the joints)
  • fatty liver disease

For people who are obese, weight loss can lower the risk of developing some of these illnesses. A small weight loss of 10 percent of body weight over a period of 6 months may improve health and lower disease risk. In addition, weight loss may bring other benefits such as better mood, increased energy, and positive self-image.
If you are thinking about starting an eating and physical activity plan to lose weight, talk with your health care professional first. Together, you can discuss various eating and physical activity programs, your medical history, and the benefits and risks of losing weight, including the risk of developing gallstones.
Additional Reading
Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. National Institutes of Health (NIH) Publication No. 98-4083. September 1998. This National Heart, Lung, and Blood Institute report targets primary care practitioners and provides evidence for the effects of treatment on overweight and obesity.
Finding Your Way to a Healthier You: Based on the “Dietary Guidelines for Americans.” U.S. Department of Health and Human Services (DHHS) Publication No. HHS-ODPHP-2005-01-DGA-B. 2005. This brochure from the DHHS and the U.S. Department of Agriculture provides basic guidelines for eating a healthy diet and being physically active.
Gallstones. NIH Publication No. 05-2897. November 2004. This fact sheet provides basic information about gallstones and treatment options. Published by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and available through the National Digestive Diseases Information Clearinghouse, 2 Information Way, Bethesda, MD, 20892-3570, toll-free number: 1-800-891-5389.
Gastrointestinal Surgery for Severe Obesity. NIH Publication No. 04-4006. December 2004. This fact sheet provides basic information about bariatric surgery, including benefits and risks. Published by NIDDK and available through the Weight-control Information Network (WIN), 1 WIN Way, Bethesda, MD, 20892-3665, toll-free number: 1-877-946-4627.
Prescription Medications for the Treatment of Obesity. NIH Publication No. 04-4191. November 2004. Information, including potential benefits and side-effects of current FDA-approved prescription weight-loss medications, is provided in this fact sheet. Published by NIDDK and available through WIN.
Weight Cycling. NIH Publication No. 01-3901. August 2001. This fact sheet provides general information about weight cycling and associated health risks. Published by NIDDK and available through WIN.
Weight Loss for Life. Information about healthful weight loss as well as weight-loss program options is provided in this brochure. NIH Publication No. 04-3700. June 2004. Published by NIDDK and available through WIN.

Binge Eating Disorder

Binge Eating Disorder
Binge eating disorder is a condition that millions of Americans may have. People with binge eating disorder often eat large amounts of food and feel that they can’t control their eating.

How do I know if I have binge eating disorder?
Most of us overeat from time to time, and some of us often feel we have eaten more than we should have. Eating a lot of food does not necessarily mean that you have binge eating disorder. Experts generally agree that most people with serious binge eating problems often eat an unusually large amount of food and feel their eating is out of control. People with binge eating disorder also may:

  • eat much more quickly than usual during binge episodes
  • eat until they are uncomfortably full
  • eat large amounts of food even when they are not really hungry
  • eat alone because they are embarrassed about the amount of food they eat
  • feel disgusted, depressed, or guilty after overeating.

Binge eating also occurs in another eating disorder called bulimia nervosa. Persons with bulimia nervosa, however, usually purge, fast, or do strenuous exercise after they binge eat. Purging means vomiting or using a lot of diuretics (water pills) or laxatives to keep from gaining weight. Fasting is not eating for at least 24 hours. Strenuous exercise, in this case, means exercising for more than an hour just to keep from gaining weight after binge eating. Purging, fasting, and overexercising are dangerous ways to try to control your weight.
Binge Eating Disorder
How common is binge eating disorder, and who is at risk?
Binge eating disorder is probably the most common eating disorder. Most people with this problem are either overweight or obese,* but normal-weight people also can have the disorder.
About 2 percent of all adults in the United States (as many as 4 million Americans) have binge eating disorder. About 10 to 15 percent of people who are mildly obese and who try to lose weight on their own or through commercial weight-loss programs have binge eating disorder. The disorder is even more common in people who are severely obese.
Binge eating disorder is a little more common in women than in men; three women for every two men have it. The disorder affects blacks as often as whites. No one knows how often it affects people in other ethnic groups.
People who are obese and have binge eating disorder often became overweight at a younger age than those without the disorder. They might also lose and gain back weight (yo-yo diet) more often.
* The 1998 NIH Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults define overweight as a body mass index (BMI) of 25 to 29.9 and obesity as a BMI of 30 or more. BMI is calculated by dividing weight (in kilograms) by height (in meters) squared.
Binge Eating Disorder
What causes binge eating disorder?
No one knows for sure what causes binge eating disorder. As many as half of all people with binge eating disorder are depressed or have been depressed in the past. Whether depression causes binge eating disorder or whether binge eating disorder causes depression is not known.
It is also unclear if dieting and binge eating are related. Some people binge eat after dieting. Dieting here means skipping meals, not eating enough food each day, or avoiding certain kinds of food. These are unhealthy ways to try to change your body shape and weight.
Studies suggest that people with binge eating may have trouble handling some of their emotions. Many people who are binge eaters say that being angry, sad, bored, worried, or stressed can cause them to binge eat.
Certain behaviors and emotional problems are more common in people with binge eating disorder. These include abusing alcohol, acting quickly without thinking (impulsive behavior), not feeling in charge of themselves, not feeling a part of their communities, and not noticing and talking about their feelings.
Researchers are looking into how brain chemicals and metabolism (the way the body uses calories) affect binge eating disorder. Other research suggests that genes may be involved in binge eating, since the disorder often occurs in several members of the same family. This research is still in the early stages.
Binge Eating Disorder
What are the complications of binge eating disorder?
People with binge eating disorder are usually very upset by their binge eating and may become depressed. Research has shown that people with binge eating disorder report more health problems, stress, trouble sleeping, and suicidal thoughts than people without an eating disorder do. People with binge eating disorder often feel bad about themselves and may miss work, school, or social activities to binge eat.
People with binge eating disorder may gain weight. Weight gain can lead to obesity, and obesity puts people at risk for many health problems, including:

  • type 2 diabetes
  • high blood pressure
  • high blood cholesterol levels
  • gallbladder disease
  • heart disease
  • certain types of cancer.

Most people who binge eat, whether they are obese or not, feel ashamed and try to hide their problem. Often they become so good at hiding it that even close friends and family members do not know they binge eat.
Binge Eating Disorder
Should people with binge eating disorder try to lose weight?
Many people with binge eating disorder are obese and have health problems because of their weight. They should try to lose weight and keep it off; however, research shows that long-term weight loss is more likely when a person has long-term control over his or her binge eating.
People with binge eating disorder who are obese may benefit from a weight-loss program that also offers treatment for eating disorders. However, some people with binge eating disorder may do just as well in a standard weight loss program as people who do not binge eat.
People who are not overweight should avoid trying to lose weight, because it sometimes makes their binge eating worse.
Binge Eating Disorder
How can people with binge eating disorder be helped?
People with binge eating disorder should get help from a health professional such as a psychiatrist, psychologist, or clinical social worker. There are several different ways to treat binge eating disorder.

  • Cognitive-behavioral therapy teaches people how to keep track of their eating and change their unhealthy eating habits. It teaches them how to change the way they act in tough situations. It also helps them feel better about their body shape and weight.
  • Interpersonal psychotherapy helps people look at their relationships with friends and family and make changes in problem areas.
  • Drug therapy, such as antidepressants, may be helpful for some people.

The methods mentioned here seem to be equally helpful. Researchers are still trying to find the treatment that is the most helpful in controlling binge eating disorder. Other therapies being tried include dialectical behavior therapy, which helps people regulate their emotions; drug therapy with the anti-seizure medication topiramate; weight loss surgery (gastrointestinal surgery); exercise used alone or in combination with cognitive-behavioral therapy; and self-help. Self-help books, videos, and groups have helped some people to control their binge eating.
Binge Eating Disorder
You are not alone.
If you think you might have binge eating disorder, it is important to know that you are not alone. Most people who have the disorder have tried but failed to control it on their own. You may want to get professional help. Talk to your health care provider about the type of help that may be best for you. The good news is that most people do well in treatment and can overcome binge eating.
Binge Eating Disorder
The following programs are for patients with binge eating disorder or compulsive overeating.
Additional Reading
Grilo, CM. “The assessment and treatment of binge eating disorders.”Journal of Practical Psychiatry and Behavioral Health, 1998: Vol. 4, pp.191-201. This article, written for health professionals, reviews the literature on binge eating disorder with a particular focus on its assessment and treatment. Implications for practice and future research are discussed.
Stunkard AJ. “Eating patterns and obesity.” Psychiatric Quarterly, 1959: Vol. 33, pp. 284-295. This classic paper provides one of the first descriptions of binge eating in obese individuals.
Wilfley DE, Wilson GT, Agras WS. “The clinical significance of binge eating disorder.” International Journal of Eating Disorders, 2003: Vol. 34 Suppl., pp. S96-106. This article, written for health professionals, reviews the literature on binge eating disorder to examine whether it is serious enough to be classified clinically as a mental health disorder.
Binge Eating Disorder

Choosing a Safe and Successful Weight-loss Program

Choosing a Safe and Successful Weight-loss Program

  • Talk With Your Health Care Professional
  • Ask Questions
  • A Responsible and Safe Weight-loss Program
  • Get Familiar With the Program
  • Additional Resources

Choosing a weight-loss program may be a difficult task. You may not know what to look for in a weight-loss program or what questions to ask. This fact sheet can help you talk to your health care professional about weight loss and get the best information before choosing a program.
Talk With Your Health Care Professional
If your health care provider tells you that you should lose weight and you want to find a weight-loss program to help you, look for one that is based on regular physical activity and an eating plan that is balanced, healthy, and easy to follow.
You may want to talk with your doctor or other health care professional about controlling your weight before you decide on a weight-loss program. Even if you feel uncomfortable talking about your weight with your doctor, remember that he or she is there to help you improve your health. Here are some tips:

  • Tell your provider that you would like to talk about your weight. Share your concerns about any medical conditions you have or medicines you are taking.
  • Write down your questions in advance.
  • Bring pen and paper to take notes.
  • Bring a friend or family member along for support if this will make you feel more comfortable.
  • Make sure you understand what your health care provider is saying. Ask questions if there is something you do not understand.
  • Ask for other sources of information like brochures or websites.
  • If you want more support, ask for a referral to a registered dietitian, a support group, or a commercial weight-loss program.
  • Call your provider after your visit if you have more questions or need help.

Ask Questions
iFind out as much as you can about your health needs before joining a weight-loss program. Here are some questions you might want to ask your health care provider:
About Your Weight

  • Do I need to lose weight? Or should I just avoid gaining more?
  • Is my weight affecting my health?
  • Could my excess weight be caused by a medical condition such as hypothyroidism or by a medicine I am taking? (Hypothyroidism is when your thyroid gland does not produce enough thyroid hormone, a condition that can slow your metabolism—how your body creates and uses energy.)

About Weight Loss

  • What should my weight-loss goal be?
  • How will losing weight help me?

About Nutrition and Physical Activity

  • How should I change my eating habits?
  • What kinds of physical activity can I do?
  • How much physical activity do I need?

About Treatment

  • Should I take weight-loss medicine?
  • What about weight-loss surgery?
  • Could a weight-loss program help me?

A Responsible and Safe Weight-loss Program
If your health care provider tells you that you should lose weight and you want to find a weight-loss program to help you, look for one that is based on regular physical activity and an eating plan that is balanced, healthy, and easy to follow. Weight-loss programs should encourage healthy behaviors that help you lose weight and that you can stick with every day. Safe and effective weight-loss programs should include:

  • Healthy eating plans that reduce calories but do not forbid specific foods or food groups.
  • Tips to increase moderate-intensity physical activity.
  • Tips on healthy behavior changes that also keep your cultural needs in mind.
  • Slow and steady weight loss. Depending on your starting weight, experts recommend losing weight at a rate of 1/2 to 2 lbs per week. Weight loss may be faster at the start of a program.
  • Medical care if you are planning to lose weight by following a special formula diet, such as a very low-calorie diet.
  • A plan to keep the weight off after you have lost it.

Get Familiar With the Program
Gather as much information as you can before deciding to join a program. Professionals working for weight-loss programs should be able to answer the questions listed below.
What does the weight-loss program consist of?

  • Does the program offer one-on-one counseling or group classes?
  • Do you have to follow a specific meal plan or keep food records?
  • Do you have to purchase special food, drugs, or supplements?
  • Does the program help you be more physically active, follow a specific physical activity plan, or provide exercise instruction?
  • Does the program teach you to make positive and healthy behavior changes?
  • Is the program sensitive to your lifestyle and cultural needs?

What are the staff qualifications?

  • Who supervises the program?
  • What type of weight management training, experience, education, and certifications do the staff have?

Does the product or program carry any risks?

  • Could the program hurt you?
  • Could the recommended drugs or supplements harm your health?
  • Do participants talk with a doctor?
  • Does a doctor run the program?
  • Will the program’s doctors work with your personal doctor if you have a medical condition such as high blood presure or are taking prescribed drugs?

How much does the program cost?

  • What is the total cost of the program?
  • Are there other costs, such as weekly attendance fees, food and supplement purchases, etc.?
  • Are there fees for a follow-up program after you lose weight?
  • Are there other fees for medical tests?

What results do participants typically have?

  • How much weight does an average participant lose and how long does he or she keep the weight off?
  • Does the program offer publications or materials that describe what results participants typically have?

If you are interested in finding a weight-loss program near you, ask your health care provider for a referral or contact your local hospital.
Additional Resources
Federal Trade Commission
Consumer Response Center
600 Pennsylvania Avenue, NW
Washington, DC 20580
Phone: (202) FTC-HELP (382-4357)
Toll-free number: 1-877-382-4357
International Food Information Council Foundation
1100 Connecticut Avenue, NW
Suite 430
Washington, DC 20036
Phone: (202) 296-6540

Helping Your Overweight Child

Helping Your Overweight Child

  • Is my child overweight?
  • How can I help my overweight child?
  • Be supportive
  • Encourage healthy eating habits
  • Encourage daily physical activity
  • Discourage inactive pastimes
  • Find more help
  • Other resources

Healthy eating and physical activity habits are key to your child’s well-being. Eating too much and exercising too little can lead to overweight and related health problems that can follow children into their adult years. You can take an active role in helping your child— your whole family— healthy eating and physical activity habits that can last for a lifetime.
Is my child overweight?

Because children grow at different rates at different times, it is not always easy to tell if a child is overweight. If you think that your child is overweight, talk to your health care provider. He or she can measure your child’s height and weight and tell you if your child is in a healthy range.
How can I help my overweight child?
Involve the whole family in building healthy eating and physical activity habits. It benefits everyone and does not single out the child who is overweight.
Do not put your child on a weight-loss diet unless your health care provider tells you to. If children do not eat enough, they may not grow and learn as well as they should.
Be supportive

  • Tell your child that he or she is loved, is special, and is important. Children’s feelings about themselves often are based on their parents’ feelings about them.
  • Accept your child at any weight. Children will be more likely to accept and feel good about themselves when their parents accept them.
  • Listen to your child’s concerns about his or her weight. Overweight children probably know better than anyone else that they have a weight problem. They need support, understanding, and encouragement from parents.

Encourage healthy eating habits

  • Buy and serve more fruits and vegetables (fresh, frozen, or canned). Let your child choose them at the store.
  • Buy fewer soft drinks and high fat/high calorie snack foods like chips, cookies, and candy. These snacks are OK once in a while, but keep healthy snack foods on hand too and offer them to your child more often.
  • Eat breakfast every day. Skipping breakfast can leave your child hungry, tired, and looking for less healthy foods later in the day.
  • Plan healthy meals and eat together as a family. Eating together at meal times helps children learn to enjoy a variety of foods.
  • Eat fast food less often. When you visit a fast food restaurant, try the healthful options offered.
  • Offer your child water or low-fat milk more often than fruit juice. Fruit juice is a healthy choice but is high in calories.
  • Do not get discouraged if your child will not eat a new food the first time it is served. Some kids will need to have a new food served to them 10 times or more before they will eat it.
  • Try not to use food as a reward when encouraging kids to eat. Promising dessert to a child for eating vegetables, for example, sends the message that vegetables are less valuable than dessert. Kids learn to dislike foods they think are less valuable.
  • Start with small servings and let your child ask for more if he or she is still hungry. It is up to you to provide your child with healthy meals and snacks, but your child should be allowed to choose how much food he or she will eat.

Healthy snack foods for your child to try:

  • Fresh fruit
  • Fruit canned in juice or light syrup
  • Small amounts of dried fruits such as raisins, apple rings, or apricots
  • Fresh vegetables such as baby carrots, cucumber, zucchini, or tomatoes
  • Reduced fat cheese or a small amount of peanut butter on whole-wheat crackers
  • Low-fat yogurt with fruit
  • Graham crackers, animal crackers, or low-fat vanilla wafers

Foods that are small, round, sticky, or hard to chew, such as raisins, whole grapes, hard vegetables, hard chunks of cheese, nuts, seeds, and popcorn can cause choking in children under age 4. You can still prepare some of these foods for young children, for example, by cutting grapes into small pieces and cooking and cutting up vegetables. Always watch your toddler during meals and snacks.
Encourage daily physical activity
Like adults, kids need daily physical activity. Here are some ways to help your child move every day:

  • Set a good example. If your children see that you are physically active and have fun, they are more likely to be active and stay active throughout their lives.
  • Encourage your child to join a sports team or class, such as soccer, dance, basketball, or gymnastics at school or at your local community or recreation center.
  • Be sensitive to your child’s needs. If your child feels uncomfortable participating in activities like sports, help him or her find physical activities that are fun and not embarrassing.
  • Be active together as a family. Assign active chores such as making the beds, washing the car, or vacuuming. Plan active outings such as a trip to the zoo or a walk through a local park.

Because his or her body is not ready yet, do not encourage your pre-adolescent child to participate in adult-style physical activity such as long jogs, using an exercise bike or treadmill, or lifting heavy weights. FUN physical activities are best for kids.
Kids need a total of about 60 minutes of physical activity a day, but this does not have to be all at one time. Short 10- or even 5-minute bouts of activity throughout the day are just as good. If your children are not used to being active, encourage them to start with what they can do and build up to 60 minutes a day.
FUN physical activities for your child to try:
Riding a bike
Climbing on a jungle gym
Swinging on a swing set
Jumping rope
Playing hopscotch
Bouncing a ball
Discourage inactive pastimes
Set limits on the amount of time your family spends watching TV and videos, and playing video games.
Help your child find FUN things to do besides watching TV, like acting out favorite books or stories, or doing a family art project. Your child may find that creative play is more interesting than television.
Encourage your child to get up and move during commercials and discourage snacking when the TV is on.
Be a positive role model
Children are good learners and they learn what they see. Choose healthy foods and active pastimes for yourself. Your children will see that they can follow healthy habits that last a lifetime.
Find more help
Your health care provider
Ask your health care provider for brochures, booklets, or other information about healthy eating, physical activity, and weight control. He or she may be able to refer you to other health care professionals who work with overweight children, such as registered dietitians, psychologists, and exercise physiologists.
Weight-control program
You may want to think about a treatment program if:

  • You have changed your family’s eating and physical activity habits and your child has not reached a healthy weight.
  • Your health care provider has told you that your child’s health or emotional well-being is at risk because of his or her weight.

The overall goal of a treatment program should be to help your whole family adopt healthy eating and physical activity habits that you can keep up for the rest of your lives. Here are some other things a weight-control program should do:

  • Include a variety of health care professionals on staff: doctors, registered dietitians, psychiatrists or psychologists, and/or exercise physiologists.
  • Evaluate your child’s weight, growth, and health before enrolling in the program and watch these factors while enrolled.
  • Adapt to the specific age and abilities of your child. Programs for 4-year-olds should be different from those for 12-year-olds.
  • Help your family keep up healthy eating and physical activity behaviors after the program ends.

Other resources
MyPyramid Plan can help you make healthier food choices from every food group and find your balance between food and physical activity. MyPyramid replaces the Food Guide Pyramid. Available from the U.S. Department of Agriculture (USDA) at
Tips for Using the Food Guide Pyramid for Young Children 2 to 6 Years Old can help you teach your young child what to eat to grow and stay healthy. Available from the U.S. Government Printing Office, 202-512-1800 and at
Healthy Eating and Physical Activity Across Your Lifespan: provides healthy eating and physical activity tips for kids and parents. provides information about nutrition and fitness for kids. answers kids’ health questions about body and mind. encourages kids to get physically active.

What You’ll Eat Afterwards

Post Operative Period

The LAP-BAND® System should be considered to be a permanent medical device. Eating healthy food, exercise and behavior modifications are very important in the post-op period.


It is important that patients comply with specific dietary and other instructions after the LAP-BAND® System is in place. These instructions include the following:

  • Eat 3 smaller meals per day
  • Avoid snacking between meals
  • Eat slowly and chew food well
  • Stop eating as soon as you feel full
  • Do not drink liquids during meals or for one hour before and one hour after meals
  • Drink plenty of non-caloric liquids such as water in between meals. (at least 8 glasses per day to avoid constipation, to maintain normal kidney function and avoid kidney stones)
  • Avoid alcohol which is high in calories
  • Avoid high calorie foods (fats, sugars and carbohydrates) and eat primarily protein, i.e. fruits, vegetables and whole grains
  • Avoid aspirin and anti-inflammatory drugs (can cause stomach erosion)
  • Do not use a straw since it can put air into the stomach

Immediately after surgery, patients will start on a liquid diet and then progress to a soft diet. Patients should continue progress to a regular diet at approximately 6 weeks after surgery.*
* Results may vary. Complications are possible with any medical procedure.

Results may vary.
Dieting Following Lap-Band® System Surgery (5 minutes)

Exercise: We believe the Post-op LAP-BAND® System Patients who adhere to a consistent exercise program after surgery may lose the most weight and will also lose it faster.*
*Typical results. May vary from person to person.
Aerobic Exercise: Aerobic exercise burns calories and causes fat loss and also strengthens your heart.  In our opinion, this should be done 30 minutes every day. Examples of aerobic exercise are walking, swimming, bicycling, treadmill, stair climbing, tennis, etc. High impact aerobic exercise such as running, can cause injury to your joints.
*Typical results may vary from person to person.
Anaerobic Exercise: (weight training) Burns calories and causes fat loss and also builds muscles and bones. Anaerobic exercise should be done for 20 minutes every other day only. When performing anaerobic weight training exercise, patients should remember the following:

  • Each time you lift a weight is called a repetition (i.e. up and down) and the number of repetitions in a series is called a set.
  • Repetitions should be done slowly and smoothly
  • Pick the proper weight so that you can do 8 to 12 repititions before fatigue or muscle burn sets in. This will be your 1st set.
  • Rest a few minutes and then perform a 2nd set.
  • Rest again for a few minutes and then do a 3rd set.

Then move on to other weight exercises and do #3 sets for each exercise. It is ok to weight train both upper and lower body on the same day. Try to gradually increase the weight that is being lifted as your muscles become stronger. Some soreness after weight training is normal. Do not arch your back when lifting weights and do not hold your breath.
You can do both anaerobic and aerobic exercises the same day. If you are in your 40’s or older or have a medical condition such as heart or lung disease, check with your physician before starting any exercise program. It is important to warm up with gentle exercise and stretching before starting your exercise routine each day. Try to have a goal to exercise daily and if you don’t reach that goal, then 3 to 4 times per week should be adequate. The daily 20 -30 minutes of exercise does not have to be continuous. Research shows that the exercise can be done in multiple five to ten minute sessions with the same beneficial results. Try to vary your exercise program to avoid boredom. Also during exercise, remember to do it with enough vigor and effort to get your heart beating more rapidly.

Benefits of Exercise:

  • Adds muscle (More in men than in women. This results in an increase of your metabolic rate or the rate at which you burn calories. So you burn more calories and have better control of your weight)
  • Reduces cholesterol
  • Lowers blood pressure
  • Strengthens your joints
  • Reduces the risk of osteoporosis by building strong bones
  • Increases your energy.
  • Curbs your appetite.
  • Strengthens your heart and decreases heart rate and heart disease
  • Decreases your risk of cancer, diabetes and arthritis
  • Decreases anxiety, depression and stress.
  • Improves your self-esteem.
  • Improves your body tone and flexibility.
  • Improves sleep patterns.


You will require adjustments of the LAP-BAND® System after surgery so that the band is just tight enough to allow gradual and steady weight loss. * The adjustments are made in small increments and can usually be done as an office procedure and do not require additional surgery. If the LAP-BAND® System is correctly adjusted, you should be able to eat (3) smaller meals per day and feel full so you don’t feel the need to snack in between meals. The first adjustment is done at 6 weeks post-op. Subsequent adjustments are usually done at 4 – 6 week intervals. If patients are not losing adequate weight, the patient may need a fill (tightening of the band by injecting saline). If nausea and vomiting and reflux or heart burn symptoms occur then an adjustment will be necessary to decrease the saline fill amount.*
* Results may vary. Complications are possible with any medical procedure. Know your risks and talk to a medical professional.

Post-Op Appointments

Patients need to be seen at 6 week intervals during the 1st year and then every 3 months for the next 2 years. It will also be necessary for post-op patients to have follow-up appointments with a family doctor for medication adjustments and also follow-up appointments with a dietician and a support group.*
*Results may vary.

Cosmetic Surgery

Most patients need to have post-operative plastic surgery to remove excess skin and fat on various areas of the body after they have achieved their desired weight loss.* Our physicians and our practice is dedicated to providing our patients with any needed plastic surgery procedures, such as abdominalplasty (tummy tuck) and other various body lifts. Financing is also available for these cosmetic procedures. Please contact us if you have interest in financing your post-op cosmetic procedures.
*Results may vary.

Support Groups

Support groups are very important after the procedure is performed. These groups are available to assist patients in achieving the optimal weight loss result during the post-operative period. Please ask us for information regarding our support group or support groups in your area.

Miscellaneous Information

Postoperatively if you take any large pills that you have difficulty swallowing, you may cut or crush the pills.
If pregnancy or severe illness occurs after the LAP-BAND® System has been placed, the band may need to be deflated temporarily to assure adequate nutrition.*
It is very important to avoid vomiting during the post–op period because this can cause the stomach to slip upwards above the LAP-BAND® System and enlarge the new stomach pouch.*
* Results may vary from person to person.

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