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The Skinny on Weight Loss

By Kim Franke-Folstad

"Diet" spelled out in vegetables

Americans like a fast fix. A 10-minute oil change. Glasses in an hour. A new romantic interest with the swipe of a finger. So when it comes to losing weight, diets that promise quick and easy results – 20 pounds in 30 days! – are tough to resist.

We are not a patient people. Our focus is fleeting. Which is why, in a nutshell, most diets don't work. "They cycle in fads, just like clothes and hairstyles, with about five or six overall themes," says Theresa Crocker, PhD '13, assistant professor in the College of Public Health and director of the nutrition and dietetics program.

If you change how you normally eat, you'll likely have some success, she says. But restrictive diets are doomed to fail. If you don't lose the weight in a way that's sustainable – while eating with your family, dining out with friends, shopping for and preparing the food yourself – you're going to struggle. Most people, 80 to 95 percent depending on the study, gain the weight back. Many regain more than they lost.

Meanwhile, with restrictive diets, you're performing a bit of a science experiment on your body, messing with your metabolism, depriving yourself of the nutrients you need, and possibly causing muscle loss, bone loss and other long-term damage. The trouble, says Dr. Watson Ducatel, '06, is that people desperate to lose weight get taken advantage of by companies more interested in selling them something than improving their health. 

They see commercials that put a priority on pounds lost, goal weights, and before-and-after photos. Unless you look closely, it's easy to miss the disclaimer: "Results Not Typical."

Dr. Watson Ducatel

Dr. Watson Ducatel, '06

"Developing a proper weight-loss program takes time," says Dr. Ducatel, an internist who shares a practice in Brandon, Healthy Bodies Medical and Dental Center, with his wife, Dr. Martha Ducatel, '06, a dentist. Both believe in educating patients. "The first thing you need to know is why your weight is a problem," he says. He starts by talking to patients about what they think is normal or abnormal, and asks them to assess their own weight, and how that makes them feel. "Let's find out about you," Ducatel says, "because you're the one controlling this thing."

The conversation moves on to what could have caused the weight gain: a health problem, bad habits, genetics, cultural norms, or something else. For most people, it's necessary to determine what will work long-term.

You're not going to want to hear this (though, surely, you've heard it before), but the key to weight loss is making lifestyle changes you can successfully embrace over your lifespan, says Heather Agazzi, '97, MS '11 and PhD '07, Life Member. She's an assistant professor and psychologist in pediatrics at the USF Health Morsani College of Medicine. "Take small steps and make them the new normal."

And remember, the choices you make don't affect just you. If you're a parent, you're passing those behaviors on to your children, Agazzi says.

Children learn our preferences for salty and sugary foods, and they don't always make the best choices when not at home. So, it's up to parents to set limits, Agazzi says. That means 10 M&M's, not the whole pack; one cookie instead of four; and whole-grain crackers that are rich in fiber instead of refined grain products that have been stripped of their natural nutrients. They can learn and use those habits as they begin to make their own choices.

When you go out to eat, check the calorie counts on the menu to help with your decision-making, says Joe Askren, PhD '17, a professor at the College of Hospitality and Tourism Leadership at USF Sarasota-Manatee and a certified executive chef. Or have what you want but skip or share the high-calorie dessert.

And try not to label foods as bad or good. We think of yogurt and granola bars as good for us, but there are brands that are full of added sugars. We tend to broad-brush all frozen foods as bad – but if you can't get in-season local produce, frozen can be a fine nutritious, alternative, Crocker says.

Then there's the battle over butter – is that fat killing us or good for us? "Everything in moderation," Askren says. And, again, some choices are better than others. There are grass-fed cow butters that are antibiotic-free, hormone-free and additive-free – and as a chef, he prefers the flavor.

So, should every person who needs to lose weight seek some kind of counseling to get it right? It's a good step to take if you can, Agazzi says. That is, if the resources are available and health insurance will cover the expense. But health care providers are increasingly looking at ways to fight the country's overweight and obesity epidemic.

USF's Healthy Weight Clinic, founded in 2007 by Dr. Denise Edwards, MD '01, offers a multi-disciplinary approach for children, adolescents and adults with a variety of weight-related problems. Clients have access to a nutritionist, psychologist, psychiatrist, pediatric nurse practitioner and athletic trainer. They get the benefit of physical activity – another vital part of a healthy lifestyle – and also learn about food choices and goal-setting.

Picture of Denise Edwards

The USF Healthy Weight Clinic is directed by Dr. Denise Edwards, assistant professor of internal medicine and pediatrics at the USF Health Morsani College of Medicine.

In USF's new integrated dietetic internship and master of public health program, students learn to develop and implement advanced nutrition programs that promote health in the community. That includes coming up with a meal plan for a family of four on a budget that meets the dietary guidelines for each family member.

"A frequent comment I hear is that eating healthy is too expensive," Crocker says. "But with a little savvy, and some professional input if you're not sure how to do it on your own, it can be done."

Those fast-fix diets you hear about on TV are appealing, Ducatel says, but they don't address the real-life issues that contribute to an individual's weight gain. Your health professional can help you look at your lifestyle and come up with realistic goals.

Want to keep it simple? Focus on being happy with how you feel and being able to get up, get out and do the things you enjoy, Ducatel says. "Be inspired to be a better version of yourself."