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Live Chat on Weight Loss Strategies--Wednesday, January 2, 12:30 P.M. EST [Transcript]

Join us for a live online chat with Edward Phillips, a Harvard physician who helps patients meet weight management goals with lifestyle changes
weight management goal chat



iStockphoto/YanLev

Join us below at 12:30 P.M. EST on Wednesday, January 2, for a live 30-minute online chat with Edward Phillips, a physician who specializes in lifestyle health at Harvard Medical School, Massachusetts General Hospital and other institutions. He will discuss how he helps patients meet their weight management and other related health goals. 

Phillips will answer questions about the most effective changes--large and small--that people can make to lose weight, keep it off and stay healthy. He will also talk about why some of the trends and fads in weight loss might not be the most scientifically sound options. We invite you to post questions below in advance of the chat. 

Phillips is an assistant professor of Physical Medicine and Rehabilitation at Harvard Medical School, director of outpatient medical services at the Spaulding Rehabilitation Hospital Network in Boston, physiatrist in the Physical Medicine and Rehabilitation department of Massachusetts General Hospital, and serves other advisory roles. He also founded, in 2007, the Institute of Lifestyle Medicine, which helps to train doctors and other health care professionals to better care for patients' long-term health by helping them make healthful choices on a daily basis. 

Chat Transcript

Ever Matus G
What are common or popular misconceptions about weight loss and popular weight loss strategies that doesn't work?

MartyRoden
What strategy do you suggest to implement these 'lifestyle changes'?

Robin Lloyd
I'm Robin Lloyd, Scientific American's news editor. SA's health editor Katie Harmon will moderate the chat. Our expert will join in and start answering questions at 12:30 pm.

Andy Semler
Is there any truth that certain types of foods significantly change the metabolism (e.g. fructose)?

MartyRoden
Given the high prices of fresh produce, which do you recommend as a list to choose from?

katherineharmon
Hello, everyone, and welcome. Thanks for tuning in early! I'm Katherine Harmon, a health editor at Scientific American, and I'll be moderating the chat. I'll introduce our guest, Edward Phillips, in just a little bit, so stay tuned, and have your questions ready!

katherineharmon
Welcome, everyone, to our live chat today on weight management and behavioral changes that work. Our guest expert today is Edward Phillips, of Harvard Medical School. Dr. Phillips studies how lifestyle changes can improve our health.

John Ratto
The way we compute calories is over 100 years old. Is it obsolete?

Ephillips1M
Calories are simply a measure of energy. The calculations are still accurate. Expend more than you take in and you will lose weight.

Robin Lloyd
Welcome, all. There are 75 people now participating in this chat on this page. We welcome your questions for Dr. Phillips. (I'm another Scientific American editor, lurking in this chat. Katherine Harmon is our moderator today.)

Ryan Sims
Why is it so difficult to stay on a completely razor edge diet, such as raw veggies and a vegan attitude?

Ephillips1M
It is difficult to stay on a razor edge diet likely because it may be very different from your current diet.

katherineharmon
So, Dr. Phillips, next question: What are some of the most common mistakes that people make when trying to lose or maintain their weight?

Ephillips1M
The most common mistake is to make too radical a change in an effort to lose weight quickly. Think long-term sustainable changes. Another big failure in attempting weight loss is attempting too large a goal. 5-10% weight loss is sufficient for significant health gains. Another cause of failure in weight loss is not realizing that the new way of eating needs to be permanent. If you resume eating like you did before the diet you will reliably regain the weight.

Ivan Taylor
Are the claims of low-carbs diets accurate?

Ephillips1M
I would not necessarily avoid or reduce any certain food group such as going low-carb. Better to balance the entire diet and cut back.

katherineharmon
Excellent insight, Dr. Phillips, thanks!

thilda_
Dr Phillips, please let me know, if you won't suggest anything but variety, I will turn to study my final exams :)

Ephillips1M
In regard to suggesting variety of food in moderate portions, you got it. Now go study. No magic bullets here.

alex_mass
What is the relative importance between regular sport (let's say bicycling 6 hours per week) and nutrition?

Ephillips1M
Maintaining adequate Physical Activity (at least 2.5 hours per week) is critical to general health. Exercise is necessary but not sufficient for weight loss. Successful losers all maintain high levels of activity weekly.

katherineharmon
Thanks, all, for the great questions so far. Keep them coming!

John Ratto
Since fiber does not enter into the digestion process and it is calculated at 12 kcal/gram, is this accurate???

Ephillips1M
Fiber is still digested unless you are eating something like grass that we are not equipped to eat.

katherineharmon
Dr. Phillips, for people who aren't accustomed to regular physical activity, does it help to start slowly? Or jump right in?

Ephillips1M
The goal is 150 minutes per week. It is ok to increase up to this level in a measured manner increasing your activity by 10% per week. Physical activity/exercise is protective for many of the health problems of being overweight.

katherineharmon
And to an earlier question from Ever Matus G, What are some of the most common misconceptions about weight loss?

Andy Semler
Why is it that sometimes a person can maintain their diet/exercise the same for weeks, but lose more weight some weeks than others?

Ephillips1M
Weight loss will vary week by week. When exercising another component is change in body composition, i.e. increased muscle mass, so it is probably best to look at body composition, losing fat and increasing muscle rather than just looking at the scale.

Tara Koyama
What tools do you use to motivate people to make/maintain behavior change?

katherineharmon
Great question, Tara Koyama! Changing these things can be tough. What do you find are some effective motivating factors? Thinking about health? How good one will feel?

Ephillips1M
I am a big fan of Health Coaching to help establish your 'value' for the proposed change in your behavior. Motivation needs to be 'activated' in the individual by aligning what you find most valuable in your life and agreeing to small initial, sustainable changes. Working with Lifestyle Medicine doctors or health coaches will help with accountability.

Robin Lloyd
What about Weight Watchers? I know a handful of people lately who are having success at least over several months with it.

Ephillips1M
Weight Watchers is one of the more well-established and sane programs available. The social support is critical for many of us.

MartyRoden
Please define health coaching.

Ephillips1M
Health coaching is an evolving profession of specialists in motivation and lifestyle change. They work with you in person or over the phone. As a physician I try to personalize the health benefits of physical activity or weight loss to my patients particular history.

Robin Lloyd
How does one find a reputable health coach?

Ephillips1M
You may look at the Harvard Institute of Coaching on the web or consider Wellcoaches.

Robin Lloyd
Just 5 more minutes folks. About 70 people are on this chat page, so we hope you all ask questions you have soon.

katherineharmon
Dr. Phillips, you also work to train doctors and clinicians—do they sometimes have misconceptions about weight loss?

Ephillips1M
Doctors need education on the profound impact they can have to help start the weight management process.

katherineharmon
What should people be asking their doctors?

Ephillips1M
I would ask my doctor if my weight is ideal. Ask for help and suggestions. Unfortunately many doctors are reluctant to ask or discuss weight with their patients.

katherineharmon
So it sounds like it might be up to the patient to start the conversation with their doctor about lifestyle changes and weight management?

Ephillips1M
Yes the patient should bring this up as a concern. Too many of us think it is ok to continue to gain weight. Not so.

Adrienne Bonvini
What are your thoughts on sites like MyFitnessPal, which give users an allotted amount of calories to consume (i.e. 1200 calories/day)?

Ephillips1M
I am a big fan of the many apps and pedometers that track your eating and activity. If it feels right and you are motivated give it a try.

Chris Zimmerman
Can a person succeed on a low calorie diet if the nutritional value of the food is very high or will the bod still go into starvation mode?

Ephillips1M
Your body is seeking sufficient energy (calories) regardless of the quality. Of course healthier food is always better. Don't starve yourself in an attempt to lose weight quickly. It simply won't work.

Nita Sood
Is there a science to fighting cravings?

Tara Koyama
Nita, look up 'Craving Change' - it is a series of workshops where triggers for cravings are identified and strategies used to combat them

Robin Lloyd
Here's a story Katherine wrote recently on the ills of high fructose corn syrup: http://blogs.scientificamerican.com/observations/2013/01/01/how-corn-syrup-might-be-making-us-hungry-and-fat/

Ephillips1M
Final thoughts: As a start become more conscious about your eating and take the time to plan out your meals. Packing up leftovers in advance, buying food in frozen form, and carrying your lunch are all part of meal planning.

Andy Semler
I find that frozen meals (even if homemade and then frozen) help plan out future meals.

Robin Lloyd
Andy, I find that works too for planning meals. Cooking ahead. Or spending a bit of time on Sunday planning out the week's dinners.

katherineharmon
Great tip, Dr. Phillips, about thoughtful eating! I have one final question: What should people do if lifestyle changes are feeling too difficult to make? Any final tips or motivation?

Ephillips1M
Make the initial change something that is small but achievable (e.g. carrying your lunch once per week). As you achieve the first goal your self-confidence will improve. Now move on to the next goal.

katherineharmon
Great, thanks so much, Dr. Philips. And thanks everyone for your excellent questions. Best of luck for a healthy 2013!

Robin Lloyd
Thanks, all. Good chat!

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