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only temporarily. So where does all of this information lead us? One of the first facts to consider is that we should be realistic about weight loss expectations. The second important fact is that a weight loss pro gram should focus on lasting change, not tempor ary change. Lasting change requires behavior modification that has a duration of no less than three or four months. The longer the program lasts, the easier it becomes. The longer we stay on a modified diet, the more likely we are to achieve the desired goal. Ideally, behavior modification will become part of our lifestyle and this is the key to success. Behavior modification begins with psychology. It helps to say to yourself that you are on a “modified-eating plan”, something which sounds better than being “on a diet”. Behavior modifica tion also relies on honesty. Eat breakfast, lunch, dinner and a small late evening snack. There should be no eating between meals and (you knew this was coming!) keep track of your caloric intake. It is a good idea to write down at least for the first two weeks, everything you eat and count the calo ries. They add up more quickly than you know and by counting calories, you will see where the prob lem lies. Be honest — if you ate that chocolate cake, you ate that chocolate cake. Write it down. Once you have established a list of foods normally eaten and know where all those calories come from, you should begin caloric restriction. Start with cutting about 500 calories per day based on what you normally would have eaten, or eating 25 calories per kilogram of ideal body weight per day. The ideal body weight information is readily available in books, libraries and at your physicians office. The Matropolitan Life Insurance Height- Weight Table also provides this information. Your behavior modification program includes making changes in your food shopping routine and your food preparation routine. Do not buy foods that you know will be tempting and hard to resist. If you leave that chocolate cake at the bak ery, you won’t have to resist temptation! Buy more high fiber plant foods. There are many interesting ways to prepare low fat, or even no fat, foods. Recipes are readily available and are quite satisfy ing. Don’t fry. Try baking, broiling, steaming or microwaving food instead. Behavior modification also requires self-disci- pline. Control your dietary portions. Adding “just a little more” or even eating the rest of what is left over adds unnecessary calories. Those special events that seem to be outside of our control — restaurants, banquets, weddings, cruises, etc. — are events that merely present other choices. Many facilities are well aware of their health-conscious and weight-conselous clientele and provide appro priate choices. They are often there for the asking. If they are not, control the meal instead of letting it control you. Decide how much of it you will eat and how much of it you will leave untouched. Exercise self-control by sticking to that decision. Exercise your body too. Individuals who exer cise at least 3 to 5 hours per week do much better in keeping weight off than those who do not. Before starting any exercise program, make sure to consult with your physician. Supervised programs may be helpful for those individuals who need or choose to be monitored more closely. Some people are more successful if they are accountable to another person. Joining a weight loss program can be quite expensive, but may be a good start to those who find a “solo” behavior modification program too demanding. Some individuals who fail conventional appro aches may opt for pharmolocologic therapy. This is not always successful, can be dangerous and should always be physician supervised. It is basi cally a “crutch” and only to be used for short term treatment. There are no “miracle” medications available. Sustained behavior modification is a much safer and much surer approach to weight loss management. Be realistic in your expecta tions, work at it diligently and it will work for you.
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