Since all weight loss comes from calorie deficit (burning more than eating), the key to all successful weight loss is to create a calorie deficit. There are many great tools to help track this and most of them are free. My favorites are the iPhone app, "LoseIt"; www.FitDay.com and www.Livestrong.com go to Calorie Tracker and myPlate and create an account. These programs track your deficit and help point out areas of improvement. In general, you should get about a third of your calories from each of the main food groups: proteins, fats, carbs. If you see higher percentages of fats or carbs, replace those calories with protein calories and it will really help you eat smarter instead of just less. Over the past 20 years we are eating many more calories and burning far fewer calories. The secret to weight loss is to work toward a calorie deficit whatever it takes. Most people losing weight successfully are eating about 1200 calories per day (women) and 1400 calories per day for men. Below this, your body tends to start freaking out and hanging on to everything you eat.

It is also important to drink at least 64 ounces of water per day. Our bodies store environmental toxins in the fat and when you lose weight, all this stuff is coming out and your kidneys will really appreciate it if you drink plenty of water. This helps battle constipation as well. Also, take a multi-vitamin every day. The calcium and B-vitamins really help with weight loss not to mention the other minerals.

Nutritional psychology is a hot new topic. Bad nutrition causes depression and low energy which makes us want to eat more to feel better and we snowball into bad weight gain. Better nutrition is required for successful weight loss and we feel better. Also, we eat way too much sugar and this raises our insulin levels which takes all that blood sugar and turns it into fat which drops the blood sugar which makes us hungry and we eat more sugar and this snowballs into weight gain. We eat way too much processed food and we have to get back to healthy foods. Brilliant food chemistry has not helped us. Cheap food sweetener (HFCS - high fructose corn syrup) is in everything now (sugary drinks, pasta sauce, ketchup) and our bodies don't know what to do with this stuff so we store it as fat. We consume massive quantities of this stuff and it doesn't help us lose weight. High tech fats such as trans fats and hydrogenated oils allow foods to have a much longer shelf-life because bacteria can't break it down but the problem is that we can't break it down either and we just store it as fat. A great rule of thumb is that if it doesn't spoil we shouldn't eat it. The classic example is an oatmeal pie that our kids drop in the mini-van and we find it a year later and it still looks good. We shouldn't be eating brilliant food chemistry. The more we preare our own meals and take our lunch instead of getting most of our meals at restaurants, the easier it is to lose weight successfully.

Proteins - we should get about 45gms of protein a day (women) and about 60 grams per day for men. A 20gm protein portion (meat, chicken, fish, etc) is about the size of the palm of your hand or a deck of cards. Protein keeps us full longer because it doesn't mess with insulin and we need protein while we're losing weight so that we lose fat and not muscle.

Fats - are the highest caloric density food. Each gram of fat has twice the number of calories as proteins and carbs. Believe it or not there are actually "good" fats (unsaturated). You want to avoid saturated (bad) fats. Saturated fats raise our cholesterol and clog our arteries. Unsaturated fats actually lower our cholesterol. To lose weight, you should limit fat grams to 20 gms per day and keep saturated fats below 10gms per day. Trans fats and hydrogenated oils should be zero. All this is easier these days with nutrition labels. Examples of good (unsaturated) fats include avocados, peanuts, soybeans, olives and oils such as olive, canola, peanut, corn, safflower, sunflower. French fries from peanut or safflower oil are actually healthier than those fried in saturated oils - ask your restaurant which they use. Fats actually release a gut hormone called CCK (cholecystokinin) which causes the gallbladder to contract and it is a powerful natural appetite suppressant. If you give CCK to rat they won't eat. Therefore, if you snack on a handful of almonds or dip vegetable sticks in olive oil, you manage your hunger and it is healthier. Bison (buffalo) has a great beef flavor and it has much less saturated fat than cow beef. Bison burgers and steaks are a much healthier way to enjoy beef than the cows that predominate our diet.

Carbs - when eaten shoot up the insulin levels which turn blood sugar into fat and this drops our blood sugar level which makes us hungry. If you want to lose weight you have to manage carbs (sugar, bread, potato, rice - "white foods"). I see a lot of patients who go all day without eating and then eat a huge pasta dinner before going to bed. This is a perfect way not to lose weight. Carbs are best eaten earlier in the day when you have a chance to burn off all that energy. Eating three meals per day will keep us out of intense hunger and we eat fewer calories overall. I don't like Atkins type diets simply because they are hard to sustain. Better to manage carbs - keep them below 33% of total calories and eat them earlier in the day. Ice cream is enemy number one for weight loss. A great substitute is to make your own fruit smoothies at home. It is a sweet dessert but it is fruit instead of sugar and fat. Many stores have smoothie blends so you just toss it in the blender with diet apple juice or plain yogurt and it's easy. Be careful and avoid sugar added smoothie blends. Just get plain frozen fruit or make your own from fresh fruit. Great way to spoil yourself and eat healthier.

I will post topics on Fitness and Brain Stuff (I don't like terms like behavior modification) which are the other two main disciplines of successful weight loss. I put this info and much more on YouTube if you search Watkins Weight Loss Class. Weight loss surgery simply makes all this stuff much easier but knowledge plus change is where you will find success.

I hope this helps.

Brad Watkins MD

Source: Maximizing weight loss - Nutrition