Continued from Page 2

"It's a red flag when total groups of foods are eliminated," Gigliotti said. She asks people in her weight management program classes, "Did anybody really get here because you ate too many carrots?" Most people have problems, she said, because they eat too many foods that are "calorie dense."

For instance, a cup of broccoli has 50 calories, a cup of rice has 200 calories and a cup of fettuccine Alfredo has 500 calories.

"A cup is a cup. We eat based on volume," she said. "If you eat fruits and vegetables, you will be more satisfied on fewer calories."

Join the movement

Exercise and activity also contribute to how much weight a person loses and even more to how long and how well weight loss is maintained, research shows. Participants in the National Weight Control Registry based at the University of Colorado, which includes more than 3,000 people who have lost at least 30 pounds and kept it off for at least a year, exercise an average of 60 to 90 minutes a day at moderate intensity. Most of them report doing at least two types of exercise, such as cycling and weight training or walking and yoga.

People who exercise more or are more physically active can have more flexibility in their diets, Layman said. But "if you're a couch potato and you decide you want to be a couch potato, you can have no flexibility in your diet."

To increase and measure activity, Layman suggested getting a pedometer and walking at least 10,000 steps a day. He also suggested establishing a regimen of stretches and weight-training exercises. If you're still gaining weight with this amount of exercise, he said, "then you're overeating."

Choosing exercise is as important as choosing a diet. For any exercise plan to work, it has to be something you like and something you will do regularly. For obese or morbidly obese people, "it's movement," said Abby Hyman, RN, coordinator for the Cooper Institute Weight Management Program in Dallas. Many in her program start with walking, then progress to treadmills and other forms of exercise.

Medeiros, who is actively managing her weight, drives with her son for 20 minutes to a path along a river where she walks and he rollerblades. The drive is worth it, she said, to exercise in a place they both enjoy.

Get with the program

Circuit-training programs especially for women, such as Curves, have become popular with many people who are trying to manage their weight. "Those programs are good for someone who has the strength and who wants to get out and socialize," Hyman said. But you have to do any physical activity consistently, she said. "If you join a gym and never use it, it's not right for you." Most people cannot lose weight through exercise alone, nutritionists and weight control researchers say. They need to limit calorie intake as well.

Research shows that people can lose weight and keep it off, but it is difficult work and takes constant vigilance, at least for a while.

About half the participants in the National Weight Control Registry reported losing weight through a program and half lost weight on their own. Regardless of how they lost weight, most reported that they ate breakfast; ate a low-fat, high-carbohydrate diet; frequently monitored their weight; and exercised regularly. Registry members who had maintained long-term weight losses said keeping to their diet and exercise program became easier and more automatic over time.

A 1999 study of participants in Medeiros' Rhode Island weight management program showed that they lost an average of 67 pounds. After a year, 10 percent gained the weight back; 30 percent gained back more than half; 30 percent kept more than half off; and 30 percent kept all the weight off.

Those who were successful at keeping weight off attributed their success to exercise, keeping food diaries, starting again after a five-pound gain, completing the program and practicing their skills at home, Medeiros said.

Those who gained the weight back reported problems with stress, such as work or marital problems, and unexpected events like a death in the family.

"People deal with stress in different ways," she said. Planning for stressful situations should be part of any weight management plan. People can keep problem foods out of the house, walk or exercise instead of eating, have set portions of food for their meals and avoid workplace areas where food is laid out, she said.