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Dear Dr. Z: I’m an overweight, big-boned Wisconsin girl who wants to shed some pounds. I’ve done this time and time again. I take it off and it comes right back. What am I doing wrong? — Overweight Sue

Dear Sue: That’s the $64,000 question. Studies show if you lose weight today, there’s an 85 percent chance it will be back by the end of the year.

That’s an awful statistic isn’t it?

One possible explanation I have read is that your body adapts to weight loss by expending less energy and increasing hunger. Why? Because years ago — I’m talking centuries ago — we were hunters and gathers. We never knew where our next meal was coming from. So in a low-calorie state, which you and I would call dieting, our body responded by conserving energy (burning fewer calories) and increasing appetite so we’d eat more calories when they became available.

This was great when we lived in the bush, but it’s the pits in 21st century Wisconsin.

When you diet, your goal is to get your body to burn more calories. You do this by exercising, but a new study published in the Journal of the American Medical Association points out that where your calories come from might also be important.

Researchers took 21 men and women and put them on a standard weight-loss diet. Several months later, after they lost 10 percent to 20 percent of their body weight, they put them on one of three maintenance diets: an Atkins low-carb diet, a high-carb diet and a third diet in between the two. Then they measured their resting energy expenditure — how much energy they expended by just sitting around, no jogging, no swimming, no walking, no nothing.

They found the Atkins diet people were burning off more calories at rest than high-carb people. They burned 250 calories more a day just sitting around. That’s equivalent to jogging at a fast clip — two miles in 20 minutes. This may be the secret to keeping off that weight.

Why? Not quite sure, but the editorial accompanying the research pointed out the Atkins diet folks were eating more protein, and protein stimulates energy expenditure. Perhaps they’re right — just perhaps.

What we do know from this study is a calorie is not just a calorie as far as body weight is concerned. And we doctors have to rethink our romance with high-carb, low-fat diets. Since they’ve become our diet of choice, Americans have become fatter and fatter.

My spin: If you’re going toward an Atkins model, then be wise. Choose lean, healthier protein — boneless and skinless chicken breast, fish, beans, tofu and legumes. Make your fat healthier by using extra virgin olive oil or canola oil.

Stay well.

This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Paster to people submitting questions.

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