The Margin: Your no B.S. guide to losing weight in the New Year

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Want to lose weight in 2020? It’s time to cut the crap.

And that’s not just the junk food sabotaging your diet, or the time suckers keeping you from working out. We’re also talking about the fad diets, fitness trends and questionable studies that have made reaching and maintaining a healthy weight more confusing than ever by promising this superfood or that super intense workout is the quick fix to tip the scale in your favor. (They’ve also spawned a global weight loss market expected to hit $253 billion by 2024.)

As a result, about four in 10 Americans are obese — that’s a whopping 93.3 million adults — which increases their risk of heart disease, stroke, type 2 diabetes, certain cancers and early mortality, and cost the country $147 billion in medical costs in 2008, according to the CDC. Nearly 80% of American adults are also not getting enough aerobic and muscle-strengthening activity, which is linked to about $117 billion in annual health care costs and 10% of premature mortality, according to the U.S. Department of Health and Human Services.

So it’s no wonder that losing weight and getting in shape are among the most popular resolutions year over year, because so many people can’t keep them; 80% of New Year’s resolutions fail by February. So MarketWatch spoke with several leaders in the field of obesity research and prevention who have reviewed the science surrounding weight gain and loss to explain what to eat and avoid; how much exercise you need and which workouts work best; as well as their tips for making these moves a part of your new, well-balanced life in the New Year.

Sorry keto — the Mediterranean diet is king. Endurance athletes and celebrities like LeBron James and the Kardashians have raved about the high-fat, low-carb ketogenic diet — which was among Google’s most-searched terms in 2018. But Dr. Louis Aronne, an endocrinologist at NewYork-Presbyterian and Weill Cornell Medicine who runs the Comprehensive Weight Control Center, noted that the Mediterranean diet “is the only diet that has been proven in trials to promote weight loss and reduce the risk of heart attack, stroke and other cardiovascular diseases.” This meal plan includes using olive oil rich in healthy omega-3 fatty acids as your main cooking oil, and loading your plate with fruits and vegetables, whole grains and lean protein like fish and chicken, with the occasional piece of red meat. The American Heart Association recommends a similar diet that emphasizes whole, unprocessed foods, particularly fruits, veggies and whole grains, as well as low-fat dairy products, nuts and legumes, and non-tropical vegetable oils, while reducing salt, sugar and trans fats.

Many plant-based meat alternatives are highly processed. Those Beyond Meat BYND, +1.75%  and Impossible Foods products being dished in fast food chains such as Burger King QSR, -0.19%, Dunkin DNKN, +0.44%  and White Castle aren’t necessarily healthier than the original beef and sausage patties they’re substituting. (They’re also often $1 or $2 more expensive.) “There’s a misconception that anything ‘plant-based’ is instantly ‘healthy’ … but even though these products are plant-based, many of them still have a bunch of additives — or even more sodium than a regular hamburger,” Hannah Kittrell, a registered dietitian and manager of the Mount Sinai Physiolab, told MarketWatch. (Compare nutritional information here.) “You really want to focus on just whole, natural plant foods.” Indeed, the National Institutes of Health warned last May that eating highly processed foods is linked to weight gain. So read labels and nutritional information to determine whether these meat alternatives fit into your health plan.

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The Mediterranean diet is the most scientifically-proven to support weight loss.

Eating less does more for weight loss than exercising more. Consider putting the money you’d spend on a gym membership toward healthy groceries, instead. “Trying to exercise your way out of your weight problem is very difficult (because) it’s very hard to exercise that much,” explained Dr. Aronne. Burning about 3,500 calories equals one pound; someone weighing 150 pounds walking for an hour would burn around 250 calories. “You really need to cut down on calorie intake to lose the weight. Exercise is better at preventing weight gain.” The recommended daily diet is around 2,000 calories, but if you want to lose weight, Dr. Avigdor Arad, the director of the Mount Sinai Physiolab, suggests that women consume between 1,200 to 1,500 calories a day on average, and men between 1,500 and 1,800 calories. But visit your doctor to see how your own metabolism, family history and any medications you’re taking could be influencing how easily you gain and lose weight, and what your nutritional needs are. “There is a lot of variation,” he said.

A note on intermittent fasting: Intermittent fasting was Google’s GOOG, -0.15% most-searched diet of 2019, thanks in part to notables like Twitter TWTR, -0.05%  and Square SQ, +1.28%   CEO Jack Dorsey and golf pro Phil Mickelson advocating for meal timing strategies as part of their wellness and weight-loss plans. (This can include only eating between noon and 8 p.m., and fasting for the other 16 hours, although there are many different methods.) There is some preliminary evidence to suggest that regular fasting can help boost weight loss, fight obesity and rev up metabolism, as well as treat Type 2 diabetes by lowering blood sugar, blood pressure and cholesterol. But there are also conflicting studies that claim fasting can actually increase diabetes risk, and a 2018 German study found that fasting was no better than conventional calorie-cutting for weight loss. There are also concerns about these fasts fueling disordered eating. “It does seem promising for weight loss, but there’s just not enough research yet,” said Kittrell. “And keep in mind that there’s going to be a lot of individual variability — so it might work great for some people, and it might not work at all for others.” Before starting any new eating approach, speak with a doctor, registered dietician or psychologist.

Read more: Celebs, CEOs and even athletes keep feeding the fasting fad, even as evidence piles up that its effects are unknown

Carbs aren’t evil — but sugar might be. “The concept of carbohydrates has really gotten such a bad reputation, and we need to understand that there are complex carbohydrates and ancient grains that can really help us not only lose weight, but increase satiety so we stay full longer and want to eat less. It actually decreases the cholesterol and stabilizes the blood sugar, and all of these things are a really important part of a weight loss program,” said Dr. Suzanne Steinbaum, an American Heart Association volunteer medical expert. These “good” carbs include whole grains, vegetables, fruits and beans; the refined carbs (including refined grains and starches like white bread, white rice, pasta and mashed potatoes) should be consumed in limited amounts. “They are high in simple sugars, and that’s what adds weight,” said Dr. Steinbaum.

Read more: This is the right way to eat carbs

“We try not to vilify any food, except sugar,” added Dr. Aronne. “Having it as a treat is what sugar is for; it’s not meant to be the main part of your meal.” Yet added sugars in the form of sweeteners and syrups to flavor processed foods sees the average adult eating 20 teaspoons of hidden added sugar every day, or an extra 320 calories, according to the USDA’s recent nationwide food consumption survey. And then there’s sugar-sweetened beverages like sodas, sports drinks, juices and flavored coffees and teas stirred with empty calories. “The typical glass of orange juice has three oranges in it; that’s the calories of three oranges. But it’s easy to drink a glass of orange juice and still eat a number of other things,” added Dr. Aronne. “You’re better off just eating a single orange and feeling full.”

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Sit less; move more. Make small changes like taking the stairs instead of the elevator or escalator.

You’re only losing one or two pounds a week. Sustainable weight loss is slow and steady. “It depends on where you start — if you have quite a bit of weight to lose, you tend to lose the initial weight faster,” noted Dr. Steinbaum, “but losing more than a pound a week is quite a bit. A gradual decrease in weight loss implies that your dietary changes are sustainable. If you lose weight very quickly, it means that there has been a calorie restriction or an increase in activity that is really significant, and it is really hard to sustain that.” That’s why so many yo-yo dieters gain the weight back. But aiming for smaller targets can add up to big changes — and reaps more health benefits than the numbers on the scale suggest. “Even when you lose only 3% of your body weight (six pounds for a 200-pound person), your blood sugar improves; your insulin sensitivity is improved; inflammation goes down; your cholesterol goes down,” said Dr. Arad. “You don’t have to cut down half of your weight; even losing 3% to 5% is an excellent goal.”

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All workouts are created equal. Should you be focusing on high intensity interval training (HIIT), training for a marathon or getting on the bodyweight bandwagon to torch the most calories and fat? “The best exercise is one that you enjoy, and one that you will actually do,” said Lieutenant Commander Katrina Piercy of the U. S. Public Health Service Commissioned Corps, and the federal lead for the 2018 Physical Activity Guidelines for Americans. Dr. John Jakicic, who chairs the American College of Sports Medicine Obesity interest group, agreed. “There is no perfect exercise,” he said. “They all count, and they all contribute in different ways. You might get something with HIIT that you might not get with yoga, and you get some benefits from yoga that you might not get with HIIT. It’s about moving, and it’s about burning calories.” So find what you can stick with in your life for weeks, months and years — not just the first week of January. But don’t become one of the 67% of gym membership holders who never go; at around $60 a month on average, that’s wasting $720 a year.

Any movement counts. The numbers are daunting: The 2018 Physical Activity Guidelines for Americans suggest a minimum of 150 minutes (2.5 hour) of moderate-intensity aerobic activity a week (walking briskly, playing doubles tennis, raking leaves), or 75 minutes (one hour, 15 minutes) of vigorous-intensity activity (running, a strenuous fitness class, carrying groceries up stairs), as well as muscle-strengthening activities (resistance training and weightlifting) two days a week. But if you want to lose weight, work up to 300 minutes of moderate-intensity activity a week, or 150 minutes of vigorous-intensity activity. “But doing something just a few minutes a day to get started has benefits,” said Piercy. “So parking farther away when you’re running errands, getting up from our desks and going down the hall instead of sending an email — those are things people can start incorporating into their daily lives now that may be a little easier than saying, ‘Oh my gosh, I have to figure out how to fit 2.5 hours of activity into my week.” If you are starting from zero physical activity, Dr. Jakicic suggests taking a 10-minute walk five times a week, shooting for 50 minutes a week, and building on from there once it becomes habit.

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You can’t skimp on sleep. Losing weight for good calls for a total lifestyle change — and that includes getting more Zs. Missing the recommended seven to nine hours of shut-eye has been linked repeatedly with increased obesity rates. “When you don’t sleep enough, it certainly affects your brain,” explained Dr. Arad. “What we’ve learned is that people who don’t sleep well are making poor choices — eating more unhealthy diets, and they are obviously more fatigued, so they become less physically active.” In fact, people who sleep six hours or fewer per night on average consume about 300 extra calories the following day.

Mindfulness matters. “If you slow down and stop just mindless eating, you often realize you don’t need to eat as much as you thought you did; you’re already full,” said Dr. Steinbaum.” Part of this is watching portion sizes, which have ballooned in restaurants over the past 40 years, leading adults to consume an average of 300 more calories per day now than they did in 1985. Did you know that one serving of bread is actually just one slice? Or one serving of pasta or rice is just half a cup? And a serving of cheese is only two ounces, or the size of a domino? You’re probably eating much more than you realized. “There have been multiple studies that see keeping a food journal is effective,” said Dr. Steinbaum. “When you start paying attention, you can really see what you’re doing.”

This article was originally published in January 2019, and has been updated with new research, including intermittent fasting and plant-based meat alternatives.

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