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Expert Q&A

Losing weight: Where do I begin?

Asked by Marta, El Paso, Texas

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Hello!

I am 26 years of age. I weigh approximately 300 pounds and I am 5 feet 2 inches tall. I have thought about weight loss surgery, but I don't feel as though that is the correct way for me to go. I am scared of it.

I suffer from asthma, Meniere's disease, kidney stones, high cholesterol, allergies and depression.

My question to you is, what is a good starting point to help me lose weight. I have to be careful because of the asthma and such. It's all so overwhelming that I literally lose ambition because I'm not sure where to start.

I am already on a diet because of the cholesterol, and my dad is diabetic so we all support him in his diet. I didn't put the weight on overnight, and I don't expect to lose it that way. I just want a starting point to help out.

Expert Bio Picture

Diet and Fitness Expert Dr. Melina Jampolis Physician Nutrition Specialist

Expert answer

Hi Marta. I commend you for your desire to try and tackle your weight problem without resorting to surgery. You have a long journey ahead of you, but you seem to have a good attitude, and I'm happy to hear that you don't expect to lose the weight overnight. I get very concerned that some of the weight loss television programs cause people to have unrealistic weight loss goals. And with all the diet information out there, I'm not surprised that you are overwhelmed. Here are a few tips and comments to get you started.

1. Keep a food journal -- I refuse to see patients if they do not keep a food journal. It really helps not only keep you aware of what you are eating, it can also help you figure out the best way to eat specifically for you. If you find through your journal that you get super hungry after eating a certain food or at a certain time of day, you might want to plan a different type of food or perhaps schedule a mini meal instead of just a snack. Keeping a journal can also help you trouble shoot if the scale is refusing to budge. Review your journal carefully and see if there are any extra calories that may be sneaking into your diet. Oils, dressings, cheese, toppings and sauces are common culprits.

2. Get a pedometer -- A pedometer, or step counter, is a handy little device that you can strap to your waistband or even your purse. Many experts recommend aiming for 10,000 steps per day, but I would start by seeing how many steps you take in an average day and try to increase by 500 steps per week until you hit 10,000. Asthma should not be a barrier to exercising regularly. If you get symptomatic during exercise, talk to your doctor about changing your medication regimen. Many professional athletes including football players, Olympic track athletes and pro basketball players have asthma, so don't let that stand in the way of exercising. If the Meniere's disease makes walking long distances difficult, you may want to try a stationary bike. You can probably get a fairly inexpensive one at your local sporting goods store or buy a used one on Craigslist.

3. Talk with your doctor about your medications -- Some medications, including some antidepressants, can cause weight gain, so it is important to review your medication list with your doctor to make sure that no medications are interfering with your weight-loss efforts. Your doctor may even be able to prescribe an antidepressant that can help slightly with weight loss.

4. Plan ahead -- It may help to sit down Sunday night and try to plan your meals (approximately -- I know things come up) for the week. This can help keep you on track and ensure that you have healthy eating options wherever you go and whenever you need them. I always carry a protein bar, apple, small bag of almonds and a bottle of water to keep me out of trouble if I'm running around or traveling. If you are eating out, try to think about healthy eating options ahead of time, and if you are going to a restaurant that has delicious bread or tortilla chips, have a small snack (turkey slices or veggies and hummus) before you leave so you aren't famished when you get there and devour the bread basket. Having a plan can go a long way toward keeping you on track.

5. Don't have an all-or-nothing mentality -- If you get off track or make a bad eating choice, don't let that ruin your entire day/weekend/week. Just resolve to make better choices right away and don't beat yourself up. Many people feel so badly about making poor choices, they end up just giving up and really doing a lot of damage. One ice cream cone is not going to ruin your diet, but a weekend of pizza, nachos and ice cream can do a lot of damage.

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