Barring overweight due to a medical disorder, such as depression or thyroid problems, very overweight people lose weight the same way everybody else does. They make changes to their diet, activity level and lifestyle that create a daily calorie deficit. However, Oregon-based fitness coach Ben Cohn describes challenges, and even some advantages, unique to the obese when it comes to losing weight.
According to Cohn, weight loss is at its heart a matter of applied physics. If you burn more calories than you take in, you lose weight. One way to do this is to log your daily calories for two weeks, then develop a meal plan that cuts your intake by a few hundred calories per day. According to Harvard nutritionist Walter Willett, author of "Eat, Drink and Be Healthy," it's best to cut out calories that come from sweets, snack foods and unrefined grains. These foods, according to Cohn, are often overrepresented in the diets of the severely overweight.
Easy Does It
Cardiovascular exercise is a integral part of many weight-loss plans. By aggressively burning calories for 30 to 60 minutes at a time, you can attack the calorie equation from both fronts simultaneously. However, Dr. Mehmet Oz warns that obese bodies might not be ready for vigorous cardio workouts. Joints, especially knees and hips, might not be ready to bear the load, and pushing too hard too fast can risk heart attacks or even a stroke. Oz recommends starting slow with exercises such as simple walking, basic tai chi or aqua exercises.
Although resistance training doesn't burn calories like cardiovascular exercise, it does boost the metabolism. The hotter your metabolism runs, the more calories you burn, even at rest. Cohn notes that overweight people are sometimes at an advantage with this method. Their already high body mass often means they can lift impressive amounts, giving their confidence an oft-needed boost. Cohn also recommends caution when starting out, for the same reasons Oz lists about cardio.
Cohn reports that many people who are severely overweight got that way in part because of food addiction or other compulsive habits. In such cases, Cohn recommends joining a support group, such as the food addicts' 12-step program Overeaters' Anonymous, or even seeking professional counseling, to help mitigate this potentially destructive factor.
Health counselor Maya Paul recommends against diets that shed more than a pound or two per week, because these diets are difficult to sustain and often unhealthy in the long term. Cohn agrees, with one exception. Severely overweight people have often failed to lose weight throughout their lives. A short-term stint on an aggressive diet can give immediate results, creating excitement and a feeling of success. Cohn warns that, after a two- to three-week aggressive period, the best plan is to ride that success into a more sustainable, lifestyle-changing weight loss plan. Otherwise, the risk of "falling off the wagon" and putting the weight right back on is substantial.