How Much Weight Can You Lose

Transcript

Jim Hill: Welcome to Weight Loss And, where we delve into the world of weight loss. I'm Jim Hill.

Holly Wyatt: And I'm Holly Wyatt. We're both dedicated to helping you lose weight, keep it off, and living your best life while you're doing it.

Jim Hill: Indeed, we now realize successful weight loss combines the science and art of medicine, knowing what to do and why you will do it.

Holly Wyatt: Yes, the “And” allows us to talk about all the other stuff that makes your journey so much bigger, better, and exciting.

Jim Hill: Ready for the “And” factor?

Holly Wyatt: Let's dive in.

Jim Hill: Here we go.

Jim Hill: Welcome to another episode of Weight Loss And… Holly, this is the time of year for New Year's resolutions. We know what the big one is, right?

Holly Wyatt: Well, I'm excited about this because this is the question. These are the questions everybody is answering. My inbox is absolutely full. How much weight should I lose? How fast should I lose it over what period of time - does it matter? How do I set these goals when it comes around weight loss? This is the time everybody wants to set the perfect goal. So these are great questions, I think, to ask right now.

Jim Hill: And do we know the answers?

Holly Wyatt: No. No. We do. We know some. It never, right? Sometimes it always depends. That's why I think it's a good question. And that's why it's confusing. It is confusing.

Jim Hill: But these are important topics. And I'm glad we're taking them on. So let's dive right in with how much weight you should lose. How do you know how to set a weight loss goal?

Holly Wyatt: Okay, so I’m going to put my medical hat on first because I’m an MD. And the correct medical answer (where we have lots of good data) is if you’re trying to lose weight, if you can lose between 5-10% whatever your starting weight is (if you calculate 5-10% weight loss) - that is enough weight to have a meaningful medical impact. A good impact on your health in terms of preventing diabetes or treating high cholesterol or high blood pressure or sleep apnea. So 5% to 10% weight loss is what the doctor in me says is the amount that we should be encouraging people. That's a great goal of 5% to 10%.

Jim Hill: But Holly, are people happy with that?

Holly Wyatt: No, never. And that's what I tell my colleagues. I'm like, come on, guys.

Jim Hill: There are a couple of interesting studies that I want to tell people about briefly. Two very famous obesity researchers, Gary Foster and Tom Wadden and colleagues did a study where they took people entering a weight loss program, and they simply asked them, how much weight do you want to lose? What's your dream weight? What's your acceptable weight? So right up front, before they started losing weight, they said, “How much weight would you be happy with?”

You and I worked with these guys to repeat this a few years later, but the results were fairly similar. The weight that people wanted to lose, Holly, was much closer to 15% to 20% than to 5% to 10%. And it's even higher like a dream weight would be like 30%, 35%. But what people would begin to get excited about is this weight loss of 15% to 20%, not 5% to 10%. 5% to 10% for most of these people would be seen as a disappointment. So even though medically, we know what's good, what we know in real life is people want more weight loss than that.

Holly Wyatt: I know. And I think being excited is important. I understand from a medical standpoint that this information is important. If you lose 5%, that has a significant impact on your health.

The more you lose, the better. And I want to get that information out. But I also know just from working with lots of people that that is not something that excites them. And I do think being excited about a goal is important. It helps you keep going. It makes you want to do it.

So I do think we need to kind of put the two together. And, we can talk about the 5% to 10%, but what about a goal that makes you happy?

Jim Hill: Is it OK to set bigger goals, Holly?

Holly Wyatt: I think it is. Once again, I think that's controversial. Some people would say, no, set this 5% to 10%. You don't want to disappoint people. I'm saying they're already going to be supported. We already know 5% to 10% disappoints people.

For me personally, I like to set a big, big goal because it excites me and it gets me energy going toward it. The other thing I wanted to point out because we have a different episode where we talk about how to measure weight. We talk about body mass index and how to measure body state and all of that. We discussed how body mass index determines if you are in the overweight category, which means it is medically necessary to lose weight. But interestingly, and I find this interesting, we don't set a goal based on a BMI. We may use a BMI, a body mass index, which is that height and weight measure, to say, yes, you're in this category that you would benefit, that you're at risk and you would benefit from some weight loss. But we don't set a BMI as the goal to get to. People ask me this all the time, should I be trying to get to a BMI less than 25? Should that be my goal? And we don't recommend that. That's not how we do it in the medical field right now.

Jim Hill: In many people, that's not feasible. So if you're starting with a BMI of 40 and getting to 25, that's virtually impossible for most people. But the good news is you don't have to get to a BMI of 25 to have a positive impact on your health, but also on how you feel. And that's what you're getting at. If you look at health, we can say 5% to 10% is good, but that's a tough sell. And what it says is health is certainly one reason people want to lose weight, but there are some other reasons as well.

Holly Wyatt: It just kind of depends on the person too. I get excited by big goals. Therefore, I want to think of it that way. But if you're one of those people who likes that small goal type that feels good to you, then I think that's good too. I don't know that we should limit people to say, there's one way to set a goal. You have to set a 5% weight loss goal, or you have to set a larger goal than that.

Jim Hill: You don't discourage people from setting big goals for weight loss.

Holly Wyatt: I don't. Now, other people disagree with me on this for sure. I think that motivation and the energy you need to move forward is way more important. We have to deal with the idea of what happens if you don't hit that goal. So for some people, that might be discouraging.

But for me, it's like, I set that bar high. I go for it. And maybe if I don't quite make it so what? I've set the bar.

And I've set it where I could, what I'm going for. And I don't see that as a failure. Some people might see that as a failure. And if you tend to be one of those people, then you might decide not to set that big a goal.

Jim Hill: If you do set bigger goals and achieve those goals, one of the things I think we want people to realize is that's more of a behavioral gap. In other words, you've got to change your behavior more to maintain that higher weight loss.

Holly Wyatt: Right. So when we talk about how much weight you want to lose, the more weight you want to lose, the bigger the changes have to be. What you're doing right now in terms of what you're eating and how much you're moving and what you're thinking and everything has produced the body state, the body weight you're at. If you want to lose a little bit of weight, you can make some little bit of changes that would accomplish that. If you want to lose a lot of weight, you've got to bigger changes over a longer time.

Jim Hill: People get confused in thinking you can make some small changes and lose a lot of weight. Holly, I'm a big fan of small changes, but small changes produce small results.

And there's a time for that. And if you're someone who needs to lose 5%, this whole small change thing can work. But if you want to set bigger goals, 15, 20%, it's going to take big behavior changes.

Holly Wyatt: Right. And I think to be aware of that, and here's what I tell patients too, if like right now I can't make some big changes, I've got tons of stuff going on in my life, I think I can make some small changes, but I can't change how I'm eating completely and I can't get that many minutes of exercise. And I can do some small things, then by all means, let's do that. We'll probably get some small weight loss, then you can go from there. So it's kind of you got to decide what fits you better, I think.

Jim Hill: Well, one of the other questions we hear a lot is after you set goals, how fast or how slow should you work to produce that weight loss?

Holly Wyatt: Oh my gosh, so much out there, so much controversy over that. How many times have you heard that, oh my gosh, you have to lose it slow. If you lose it slowly, you're going to keep it off and if you lose it fast you're going to regain it.

Jim Hill: Is there any science behind that?

Holly Wyatt: Not really. I think when we look at the science, it shows whether you lose it fast or slow, there's not a big difference in terms of the ultimate how much you keep off at the end.

You may regain a little bit more if you've lost a little bit more, but in the end, the end game, I don't think the data shows that there's very much difference. What do you think?

Jim Hill: Well, I agree. And when I first started in this field, the dogma was, oh, I lose a pound a week, losing it very slowly. And I've come to believe that it doesn't matter.

I think, again, like the goals, it's a personal choice. I do not think there's anything wrong with losing weight quickly. Again, some things are too radical and unsafe, but I don't think you have to look at slow, steady weight loss. I think it's okay to make bigger behavior changes for more weight loss, but it's important to maintain those changes over time. I'm okay with people achieving rapid weight loss.

Holly Wyatt: I don't think there's any data to say that that's a bad thing. Once again, extremes. There are always extremes that we don't want, but I don't think there's any strong data to say that you have worse outcomes. I don't know that there's data to say you have better outcomes either. So in that case, when I see data like that doesn't point to one or the other. It's like, well, what works best for you?

Let's individualize it. What feels best for you, whether that be rapid, I want to just do it, get as much off as I can, and then move into weight loss maintenance. Or no, I'm better at slow and steady over time. That feels better to me.

Jim Hill: So there's a theme emerging here, Holly, that there are a lot of choices. There's not one way to do it. If someone says that this is the only way to lose weight, it's not true according to our research and contribution to the existing knowledge. There are a lot of options. And what we're trying to do is to discuss those options so that you, the listener, can make a reasonable choice that fits for you.

Holly Wyatt: Right. People like guidelines, though. And one of the guidelines, people say, okay, well, give me a guideline, give me something. One of the things that you can play with a little bit and adjust to you. And this is just something that we've kind of come up with that just helps people. But once again, I don't think it's written in stone. You don't have to use it as this 1% guideline.

We use it in State of Slim. And the idea is 1% weight loss per week. So, Jim, whatever your starting weight is, you can calculate 1%, which is easy to do. I like it because that's easy too. Whatever your weight is.

Jim Hill: So if you weigh 200 pounds, and you want to lose weight, that would be two pounds away, a week.

Holly Wyatt: You use a decimal between the first and second number for percentages. While scientists think in numbers, not everyone does. So decimal between the first and the second number of your weight. So 150, 1.5, 160, 1.6 pounds.

Jim Hill: And that's a general guideline. So if your goal is 1.6 and you get 1.5 or 1.7, that's okay. This is a general guideline.

Holly Wyatt: General guideline. So 250 pounds, 2.5 pounds per week. Like I said, 170 pounds or 1.7 pounds per week. That gives you an aggressive goal. I would say that's aggressive. It's not small, but it's obtainable for some people. So it's kind of a little bit aggressive.

You could back off on it. And it also then gives you, okay, how fast every single week. So I kind of like that people like to have a number. And then you can kind of play with that. So it kind of gives you both how much, how fast.

I also like it because it takes into account your starting weight. So, Jim, someone who weighs like 250 pounds and wants to lose weight, is that the same?

Jim Hill: No.

Holly Wyatt: Someone who weighs 150 pounds and wants to lose some weight.

Jim Hill: The potential is for greater weight loss, the more you weigh.

Holly Wyatt: And you can lose more each week. And so that's what I kind of like to think about it in terms of this 1% because of larger weights, more weight loss each week. And as you lose weight, that number decreases. So you lose 50 pounds, you're now 200. Now you're to 2 pounds per week.

Jim Hill: And we found in State of Slim that that's doable for many people. Not everybody, but many people can do this 1%.

Holly Wyatt: It's doable. I will say, it's aggressive. So if you can back off of it a little bit, it doesn't mean if you don't hit that, you're not successful. It's just kind of a place to start and then back off a little bit if you don't want to be as aggressive or you can even push it a little bit. But that's where we start. And I found that to be helpful for some people just to kind of get a number in their head. What I do want to talk about though, Jim, is whether you can lose 15 pounds in one week.

Jim Hill: That's unrealistic. Now, a lot of times when you first go on, especially in extreme diet, a lot of the weight lose is water. And that's temporary because that isn't going to last. So there are extremes that you want to avoid. And so 15 pounds in one week, nobody can do that. You can do that if you didn't eat all week.

Holly Wyatt: Like you said, the exception may be when you first start it and you're going to lose a bunch of water. I always say, if you lose like 10 pounds in a week, you've had a lot of water that you're losing. When you start a diet, you reduce your calorie intake and burn the glycogen stored in your muscles and liver. And when you burn that glycogen for fuel, water is with that water comes out with that. So you get this big diuresis or big flux of water out that will stop after a week or two. So the first couple of weeks.

Jim Hill: Which is again, why over and over, we've said, don't pay a lot of attention to a single weight. Look at trends over time because weights can vary a little bit. And that variation is oftentimes due to water, which is not what you're looking at in terms of long-term results.

Holly Wyatt: Right. So like the 1% rule is kind of like after you've lost that first couple of weeks, where you get the big flux. And I think that brings us to a lot of people who want that to continue. They think, “Oh, I lost.”

Jim Hill: But it isn't, right? You can't lose weight forever.

Holly Wyatt: You can't lose weight forever. And the beginning is going to be more rapid because of the water. And then you're going to kind of start to lose that.

Jim Hill: The 1% rule sort of takes that into account, right? Because as you lose weight, your goal is lower because it's 1% of a lower number.

Holly Wyatt: And I always say at the beginning, like week one and week two, you may hit more than 1%, but that's that water. So you kind of then see that over time coming out to 1%.

Jim Hill: And the other thing that relates, we've talked about setting goals, low or high. We're talking about rapidity, fast or slow. Let's take on this issue of how long should you give yourself to reach a weight loss goal.

Holly Wyatt: I think we've talked about this in some other episodes. And I know we'll talk about it again because this is one thing that I think we are consistent. You can't lose weight forever. So I do like if you're going to set a weight loss goal, you're going to set it for a finite period of time, which means a certain number of months. You're not going to think you're going to be in weight loss for two years. I like to say, let's set, look six months, three to six months, six months being about the max, and then see how it's going and then move into weight loss maintenance. So you can kind of calculate if I was in weight loss for six months max, how much weight could I lose if you wanted to use the 1% rule or estimate that? But the key with that is I'm not saying you can't lose more, you're then weight loss maintenance for some time, and then you can go into weight loss again. So you can set a big goal, but you may need to think about it in chunks. I'm going to lose this amount in my first chunk of weight loss. I'm going to maintain it and lose this amount in my second chunk of weight.

Jim Hill: We've seen people be successful with that, sort of like a stepping-stone approach. Go for six months, hit your goal, and show that you can maintain it for a while. You get comfortable with those behavior changes. And you may feel like at that point, boy, I've done all the behavior changes I can. I can eat differently or I can exercise more. Well, you probably have your answer. You can maintain it there. But if you feel like you could make some additional changes, then you can go and set additional weight loss goals.

Holly Wyatt: So that's an important thing to say. This goal may need to be broken down into chunks or sections.

Jim Hill: That's something you and I talk about a lot. Most people didn't gain their extra weight in six months or a year. And you have to take a long-term approach. Does that mean you can't get some rapid success? But over time, if you see weight loss as a “I'm going to give it everything for a year and then I'm not going to worry about it anymore.” That's not what works. This is a permanent kind of change. And so you need to take a long-term approach at how you're going to achieve over periods of years a weight that you're comfortable with, but a weight that you can maintain.

Holly Wyatt: So I agree with that. And, but you can set a big goal. There's something about setting a big goal that excites people. If you want to set a big goal, I encourage people to do that because I don't like people feeling like, oh, I have to settle. You don't have to settle.

It may take you a while to get there, but set a goal that gets you excited. And that goes to our next question. How do you monitor this over time? So now we've said you can set a big goal. You can do it quickly or slowly or whatever. You can do it in chunks, all that kind of stuff. But then how do you monitor? Do you weigh yourself? Well, the big question is, should I get on the scale?

Jim Hill: We've studied for many years, as people who are successful long-term. And one of the things that we find is they do. They get on the scale regularly. Probably the most typical is they weigh themselves once a day. Some people weigh themselves twice a week.

Some people even more. I don't know that we have a definite here's how often you should weigh yourself. But when we talk to these people, they say, how am I going to know how I'm doing unless I get on the scale and see how I'm doing?

When you do it, it's important to do it the same way. I weigh myself every morning. When I get out of bed, compare long-term, that same way of weighing yourself. But my strong advice is to weigh yourself periodically and look at the trends. And if you're keeping weight off, it's an early warning system. If your scale goes up a few pounds and everybody sort of they'll figure out the range of variability over time, but if it goes above a certain level, you want to take action. So I think the scale is the first way you measure your success.

Holly Wyatt: I agree with people weighing themselves. It's one of the things that I encourage. But there is a lot of baggage and emotional stuff tied to the scale. So I understand why some people say, “No, if I get on the scale at the beginning of the day, and it hasn't gone down, then it just impacts how I feel.”

So we've got to take the power away from the scale. I always say, I think of it like blood glucose. Someone who has diabetes, hard to manage your blood sugar if you have diabetes, if you don't check your blood sugar and know what's going on. And now with diabetes, we even have continuous glucose monitoring, where we're monitoring it continuously to get the best control. I believe we don't need to constantly monitor weight, but we should monitor it regularly. So I'm trying to get people to think about getting on the scale every morning as a data point. It's nothing, it's not associated with who you are. It's not even associated with how you're doing at that moment, because that weight fluctuates. But we need some data to be able to understand you and what's working, and what's not working. We need it in weight loss maintenance to know if you're starting to gain and to intervene before. But I think it's even helpful in weight loss. But we've got to learn to kind of separate it from who we are. It's a tool.

Jim Hill: It's simply one of several tools that you might want to use. And again, with weight loss, one data point, one weight is not as important as the trend. When we follow people in their weight loss, it's not a straight line. You don't lose the same every day. What you want to see is generally a pattern where your weight goes down. One day it may go up, another day it goes down. But over time, the trend should be down.

Holly Wyatt: The other thing I see is it's hard at the beginning for some people to get on the scale. But the more you do it, it's uncomfortable, right? It's uncomfortable at the beginning. But the more you do it, the easier it gets. Sometimes it's just about developing the habit of writing every single morning. And when people go through some of my programs and they've done that for a while, then they're like, “It's not a big deal. I understand it now and I do that.” This leads me to say, that “I don't just have people monitor their weight.”

Jim Hill: What else can people look at here, Holly?

Holly Wyatt: I love the ribbon around the waist, getting that waist circumference. There isn't as much stigma around that. And it's a piece of ribbon. I can keep that and check it over time to see it getting smaller and smaller. So using a ribbon to measure waist circumference, cutting it, and then checking it over time. I love clothes. Like, okay, let me find a piece of clothing, put it on.

How does it feel? That can be important. I love just pictures. I know people don't like to take pictures, but for me personally, I love to take a pictures because I like to see that change. So the scale is not the only thing that changes. It's important to measure your weight and other factors. Sometimes, the scale may not change, but if your waist circumference is decreasing and you're feeling better, you can use that as motivation. If your clothing fits better, it's another positive sign, even if the scale doesn't show the desired results.

Jim Hill: I've heard a lot of people say, “I haven't lost that much weight, but my clothes fit better. I feel better about it.”

Holly Wyatt: So I say, when you start, take several measures. Use the scale. I think it's going to be pictures, even somebody states things like “Can I reach down and touch my toes? Or how does it feel to walk up some stairs?” Things like that can be used in addition to monitor changes.

Jim Hill: There could be positive changes happening that may not show up on the scale right away. You may notice changes in your body composition over time, which will eventually be reflected on the scale. In the meantime, focus on the positive feedback you get from other sources.

Holly Wyatt: And one more thing, this is the other thing. This is one of my other little tips and tricks that I like to help people. Part of the problem is day to day, you've got that fluctuation on the weight and it can be very discouraging to one day it'd be up two pounds, and you don't know why. So I don't necessarily look at a day-to-day. I weigh every single day, but what I have my patients do is average out the week. So take the seven days, average to get a weight, and then look for the lowest weight that week and write that down. So follow the average from week to week is that going down? It kind of gets rid of that up-and-down nature of it. It smooths it out is the average going down and am I hitting a new low weight each week? And that can be a little bit more, you get those changes, and can be helpful. So you're not just looking at a day-to-day change, you're looking at a weekly kind of change.

Jim Hill: Wow. Lots of good stuff, Holly: weight loss goals, rapidity, measuring your success. So, we always have a part of our podcast where we ask each other some personal questions. So what's your strategy if you want to lose weight?

Holly Wyatt: If I want to lose weight, I set the bar high, and do all I can. Once again, you probably know that's my personality. I love to use pictures. So I take pictures and clothing. I weigh myself every day to help with weight loss and to track progress over time.

But I love pictures, I love clothing. Everyone needs to enjoy the weight loss process at this time of year..

I'm learning. This is hard for me because I'm a goal-oriented person. It's like, I'm just going to celebrate when I get to check the box that I did the goal. I believe it's increasingly important for me to celebrate and enjoy the process of working towards my goal as much as achieving the goal itself. I want both. I want to check the box of hitting my goal, but I want to enjoy the process of going there and getting there just as much. And so I work on that piece of it.

Jim Hill: So often you hear that, oh my gosh, weight loss is awful. You just have to hold your breath. It's going to be terrible. I think we've found for a lot of people the process can be enjoyable. Not that it's easy. Yes, you have to make some behavior changes, but it's not something that is that aversive if you do it right.

Holly Wyatt: Totally agree. I think that is a kind of tip, strategy, a trick, or whatever people want to call it, is to... So many of us say, okay, I'm goal-oriented, and I'm just going to dig my fingers in and I'm not going to celebrate anything until I succeed. But man, I think being able to enjoy the process makes it so much easier and I think more effective.

Jim Hill: Cool. Let's get the pie on the plate, the take-home messages.

Holly Wyatt: What do you think? What's the thing you want them to take away?

Jim Hill: In terms of weight loss goals, there's no question that five to 10% weight loss can help metabolic health. And we're going to, in a future episode, we're going to dive deep. But for most people, that isn't what gets them excited. And it's okay to have higher goals. People get excited when they reach 15%, 20%. It's okay because we see a lot of people reach those goals.

Holly Wyatt: People can reach that goal, and let's not take away that from them. I just don't like it... I don't like the philosophy of let's not allow them to set a goal that means something to...

Jim Hill: It allows people to get excited. Get excited about going on a weight loss journey.

Holly Wyatt: Fun with it. Get excited. Yes.

Jim Hill: The 1% rule is something people might want to look at, lose 1% of your starting weight each week. Doesn't have to do that, but that's something some people might find helpful.

Holly Wyatt: Dial it up, dial it down, but it gives you a number to start with and you could back off a little bit if you wanted to.

Jim Hill: Fast or slow? It's your choice. It's up to you. You can do it fast. You can do it slowly. Decide what's right for you. And then maybe the best one is to enjoy the journey.

Holly Wyatt: I wish I had realized this sooner, but now I see it happening repeatedly. It doesn't have to be hard. I mean, I know we say it's hard. I don't even think it has to be hard, but you can enjoy it. And that to me is the key to long-term success.

Jim Hill: Lots of good stuff in this episode. So thank you all for joining us. We're going to follow up on many of these issues, and we're looking forward to seeing you on the next episode of Weight Loss And...

Holly Wyatt: Love you all. Bye.

Jim Hill: And that's a wrap for today's episode of Weight Loss And ... We hope you enjoy diving into the world of weight loss with us.

Holly Wyatt: If you want to stay connected and continue exploring the “Ands” of weight loss, be sure to follow our podcast on your favorite platform.

Jim Hill: We'd also love to hear from you. Share your thoughts, questions, or topic suggestions by reaching out at [weightlossand.com](http://weightlossand.com/). Your feedback helps us tailor future episodes to your needs.

Holly Wyatt: And remember, the journey doesn't end here. Keep applying the knowledge and strategies you've learned and embrace the power of the “Ands” in your own weight loss journey.