By Mary Carter
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(CNN) -- Matt McKenna's dramatic weight loss gets high praise from one diet pro.
"He really has done an unbelievable job," says Cathy Nonas, director of obesity and diabetes programs at North General Hospital in New York. "He did it in a very good way."
Accountability -- allowing yourself to be held responsible for your actions -- is critical to any successful weight loss program, says Nonas, a spokesperson for the American Dietetic Association. She found McKenna's high level of family support remarkable. (Matt's journey. )
"You have to find somebody you can be accountable to, who isn't going to be weak-kneed and say, 'Oh all right, whatever,' but who will actually hold you to your promises," Nonas says. "He was very lucky that he had not only such a loving family but a strong family that they could stand up against him."
She also was glad to hear that he saw his doctor at the beginning and in the early phases of his diet.
"I'm always a proponent of somebody having a full physical before starting any diet where it's either unbelievably restrictive where the weight is very rapidly lost or where the person has a lot of weight to lose," she says.
Matt's physician, Barry Schwartz, M.D., says he had mentioned the idea of gastric bypass surgery to Matt at one point, but Matt told him he thought he could do it on his own. "He was right," Schwartz said. "It's remarkable. He had a strong motivation. He took it to heart. He took action. It's pretty impressive."
People who are obese already have high cardiac risk because the heart is stressed at having to pump blood through a large body. A diet adds more stress, so professional monitoring is critical, Nonas says. Also, many obese people are on medication for high blood pressure, as McKenna was, or diabetes. Weight loss brings changes in metabolism, which can mean medication will need to be adjusted.
McKenna chose a diet plan that Nonas believes is well-rounded. Other people might benefit from professional help in making that selection, she says.
"For Matt, he found the South Beach Diet, but as we know, everybody's a little different. A registered dietitian can really be helpful in helping guide you. You have to find the diet you feel you can live with."
Perhaps the most important factor, she said, was McKenna's own determination to get fit.
"He started on his exercise with very little at the beginning," she says. "A lot of people would say, 'Well if I can't do it more than 5 minutes then there's no use in me doing it and I'll wait until I lose some weight.'
"He decided he was going to be dedicated to exercise even if he was just starting a kind of habit for himself. That is wonderful. Most people don't have the patience for it. So that was terrific."
McKenna's hard work isn't over, she says. "A whole new phase is starting."
"He's learning right now to find his new equilibrium. He knows how to gain weight. He knows how to lose weight. Now he has to learn how to maintain weight."
Matt McKenna has done "an unbelievable job" in losing more than 200 pounds, says dietitian Cathy Nonas.
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