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It's hard to lose weight. A doctor shares 6 essential tips to make it easier

A Harvard doctor shares her best strategy for measuring progress — and it has nothing to do with the scale.

A lot of us have struggled with weight gain, obesity, and diabetes or pre-diabetes. And we’ve tried all kinds of diets. Sometimes they work — the weight comes off for a while. But most of the time, the weight comes back. We see numbers on the scale higher than our pre-diet weights. We get discouraged, and sometimes we give up.

In a recent documentary called "BETTER", Harvard doctors explain why there’s more to weight loss than “calories in, calories out” and how all calories are not created equal. And real people share their struggles with obesity, the shame that can go along with it, and the solutions that worked for them.

One of those doctors, JoAnn Manson, MD, chief of the division of preventive medicine at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School, sat down with TODAY to explain why losing weight is so difficult and to share her insights to make the process easier.

Why cutting calories doesn’t work

The problem with diets that severely restrict calories is that they backfire. That’s because when you don’t eat enough, your body responds by slowing your metabolism down.

“The slowing down of the metabolism then sabotages the effort to lose weight or to maintain a healthy weight,” Manson said. “Then, when you’re eating even the same number of calories you were eating before, you’re more rapidly gaining weight. This is one of the reasons that so often people will briefly lose weight on a diet. They may lose weight for the first few months, but then they gain it back.”

How unhealthy foods sabotage your system

Choosing unhealthy foods can also lead to weight gain. And it’s not as simple as just eating too many calories. An unhealthy diet triggers changes in the way your brain, gut, and hormones work together. “An unhealthy diet will lead to more inflammation. That includes inflammation in the brain, and adverse effects on hormones that influence brain function,” Manson said.

Ever notice how you can burn right through an entire bag of potato chips or a sleeve of cookies? Highly processed foods, refined carbohydrates, and sugar don’t make you feel full. “In fact, they lead to a sort of rebound hunger where you’re eating many more calories than you would need if you had a high-quality diet,” Manson said.

Processed foods often have the nutrients and fiber stripped out of them. They are more likely to be absorbed into the bloodstream quickly, which leads to an insulin surge. That’s what makes you feel hungry and can lead to overeating and weight gain.

Processed foods can change your gut microbiome, too. Your microbiome is made up of the bacteria that live in your gut. Eating lots of red meat, processed food and fried food can make your gut microbiome less healthy, while eating a lot of plant-based foods and high-fiber foods like legumes and beans can make it healthier.

5 foods that can help you lose weight

A diet that’s heavy on whole foods and plants, such as the Mediterranean diet, can help you reach satiety — you feel full — while you don’t feel deprived. And it won’t slow down your metabolism, Manson said. So, it won’t sabotage your plans to lose weight or maintain a healthy weight.

You want to reach for:

  • Non-starchy vegetables. A good rule of thumb is, if it grows above ground and you can eat it raw, it’s probably non-starchy.
  • Low-fructose fruits. Berries are especially good, but Manson said most fruits are fine as long as you’re not eating excessive amounts.
  • High-fiber carbs such as whole grains, legumes, and beans.
  • Unsaturated fats like the ones found in olive oil and fish.
  • High-quality proteins like lentils, salmon and shellfish.

These standout foods can help your mental health, too. “When you have a healthy dietary pattern, it gets your hormones back in balance,” Manson said. “It has a favorable effect on mood and emotional well-being.”

Healthy eating shouldn’t make you feel deprived

If your diet tends toward less-healthy foods, you might think making this switch means making sacrifices. But Manson said that’s not the case: “When you have a healthy, high-quality diet, you should not feel deprived in terms of having the foods that you enjoy.”

In fact, it’s crucial that you don’t feel deprived by the food choices you’re making. “If you feel deprived, all kinds of things will happen to sabotage your ability to maintain a healthy weight,” she said. You might find yourself binging, or derailing your whole diet because it’s making you unhappy.

And a high-quality diet means choosing these foods most of the time. You can still find room for foods like pizza, French fries and ice cream. “If there are specific foods that don’t fall under the healthy diet umbrella, you would still be able to have those foods periodically,” she said. You just can’t have them every day, or several times a day. A treat meal on the weekends, or a small treat every day, is fine.

Exercise is critical for overall health, too

Manson said it’s important not to overlook exercise when it comes to managing your weight. “It’s really important to have a physically active lifestyle in order to maintain a healthy weight and have optimal health,” she said. Resistance exercises help you avoid the loss of lean body mass and muscle that comes with aging. And building muscle mass can boost your metabolism and help you maintain a healthy weight.

How to measure your progress

You don’t need to count calories or weigh yourself, Manson said. If you’re eating the right foods, you can count on satiety to guide you. You can track your progress by the way your clothes fit, and by measuring your waist circumference every few weeks. That’s a key marker because abdominal fat is more likely to be linked to Type 2 diabetes, heart disease and other chronic illnesses.