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Old 01-29-2001, 09:25 PM   #1  
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There is a way to keep off the weight
By Nanci Hellmich, USA TODAY

Before Neil Grigg of Fort Collins, Colo., discovered CRE, his weight was like a roller coaster, always going up and down. An eating binge at the holidays would put five pounds on him practically overnight. A single ice cream cone seemed to show up immediately on the scales, where it remained despite his best efforts to get rid of it.
But for the past 20 years, Grigg, 61, has managed to maintain a healthy weight of 190 pounds on his 5-foot, 11-inch frame, all because of a skill he developed to a high art: CRE, or chronic restrained eating.
Researchers are finding that, for most people, chronic restrained eating is what it takes to keep obesity at bay in this country, which is glutted with tasty, inexpensive high-calorie foods.
Chronic restrained eating is not a formal, structured diet with specific foods or portion sizes. Instead, it is a general philosophy about food.
People who practice CRE to manage their weight are constantly vigilant about what they eat: They often eat less than they want, plan their meals ahead of time, and think through what they'll eat before they go out to dinner, attend a party or sit down to a big family dinner. They don't sit around and mindlessly nosh while watching TV. They go back for seconds only when they're hungry and don't routinely indulge in sweets and other high-fat foods.
"Most people have to be chronic restrained eaters to maintain a healthy weight," says Thomas Wadden, director of the Weight and Eating Disorders Program at the University of Pennsylvania School of Medicine in Philadelphia. "They have to eat less than they'd like to, and eat less than they are being encouraged and urged to eat by neighbors, friends, advertisements."
Research is backing up this idea. People who have successfully lost weight and routinely kept it off use about the same amount of restraint and vigilance in eating as those who have just finished a weight-loss program, according to a study of participants in the National Weight Control Registry, a group of more than 3,000 people who have maintained at least a 30-pound weight loss for a year or more.
Registry members also are very physically active, typically exercising for at least an hour a day.
The habits of registry members are being examined in ongoing studies so scientists can pinpoint the keys to being a successful loser. The dieters share information about what worked for them, but the researchers do not offer any intervention or help. Grigg is a member of that registry.
The people who succeed at controlling their weight do it by using "cognitive control," agrees James Hill, an obesity researcher at the University of Colorado Health Sciences Center in Denver and co-founder of the weight control registry.
Diet doctors have been talking about chronic restrained eating for years, but now people are becoming more aware of it.
"For most of mankind's history, we haven't had to regulate our body weight," Hill says. "It's something that happened naturally. But in the current environment, if you let it happen naturally, you become overweight or obese. If you trust your instincts, you'll overeat and under-exercise. You have to override your instincts."

A rotund America
Millions of people in this country are losing the battle against the bulge. A startling 61% of Americans weigh too much, and about 27% of them are obese 30 pounds or more over a healthy weight, according to preliminary results of a new government survey. Experts say they expect the problem to get worse over the next decade if Americans don't get a grip.
On average, adults are gaining about a pound a year, says George Blackburn, director of the Center for the Study of Nutrition Medicine at Harvard-affiliated Beth Israel Deaconess Medical Center in Boston. "Anybody who is gaining more than five pounds in three years is asleep at the switch," he says.
Some people of average weight are always practicing chronic restrained eating, experts say. Others try CRE for a short period of time, become frustrated because it's so much work, and give up.
Still others may be restrained eaters most of the time but have gained five to 20 pounds because they've let their guard down occasionally, falling prey to sweets and other high-fat treats. They have indulged themselves too much, too many times, or been lax about doing physical activity.
CRE has its downside: The chronic restrained eater can go overboard, becoming an extreme restrained eater who is obsessed with an unrealistic body weight, Blackburn says.
The trick to being a happy restrained eater is to limit what you eat without completely depriving yourself. If you cut back so far on the foods you love that you no longer enjoy food, you'll end up feeling hungry, unsatisfied, unhappy, he says.
Restrained eating also can backfire with children and teenagers and actually predispose them to becoming overweight, says William Dietz, director of the division of nutrition and physical activity for the Centers for Disease Control and Prevention in Atlanta.
One new study from Harvard Medical School shows that normal-weight girls who diet are more likely to become overweight than those who don't diet. One possible explanation: The frequent teen dieters may be overeating or binge eating during the times when they're not watching what they eat.

Genetic differences
Experts say some people have to struggle more to control their weight than others.
There is a small segment of society whose members don't have to worry about their weight at all because they seem "genetically protected" from gaining too much, Hill says. And there is a small group of people who are going to be obese no matter what they do.
But the vast majority fall somewhere in between. Whether they can maintain a healthy body weight depends, in large part, on how much effort they are willing to put into it. Genes and physiology play a role in how easy or difficult that is going to be, Hill says.
Genes don't dictate weight but help set the upper and lower weight limits, experts say. Genes affect how the body is going to relate to the environment.
For instance, a 5-foot-10 man may have a genetic predisposition to obesity that will put him in a range of 190 to 230 pounds, Wadden says. He'll be bigger than most guys his height. But if he eats a low-fat diet and gets plenty of exercise, he'll probably settle at 190 to 200 pounds, Wadden says.
On the other hand, if he spends most weekends on the couch, watching football and chowing down, he'll settle at 220 to 230 pounds.
Eating and exercise habits make a difference even if someone has a genetic predisposition to obesity, Wadden says. Studies have shown that some people gain weight more easily than others. When people in one study were overfed by 1,000 calories a day, there were remarkable differences in weight gain. Some gained as little as nine pounds in 12 weeks, and others gained as much as 29 pounds. "That looks like it's due to genetic differences," he says.

A constant vigilance
Most people have to pay attention to changes in the scales, waist size, belt size and skirt size. When they see that they're climbing up, they need to "put the brakes on" when it comes to eating, Blackburn says.
They must use common sense and have a strategy every day for controlling their eating and working exercise into their lives. That's where CRE comes in.
When they go out into the world, they must realize that the portion sizes are huge, and plan accordingly. Bagels, muffins and sandwiches are big and getting bigger. "It used to be that one restaurant dinner would feed two people," Blackburn says, "but now one dinner will feed four."
Before going to a buffet, he says, ask yourself: "Am I going to wallow in it, or am I going to prepare myself and imagine what I'm going to eat when I'm there?"
Many people also need to do about 60 minutes of physical activity a day to control their weight, he says. One way to do that: Buy a pedometer and try to take 10,000 steps a day, which is equivalent to walking about five miles.
People know what they should do, but they aren't doing it, Blackburn says. "We're all talking the talk, but not walking the walk."
Grigg, a professor of civil engineering at Colorado State University, is one who is walking the walk. He watches everything he eats, limits his calories to 2,100 a day, jots down the calories of foods he has eaten in his day planner, and walks at least three miles a day. He has learned how many calories he burns in a day through his own experience and by visiting a scientific laboratory that was able to help him figure it out.

Keeping track of calories
Writing down calories keeps him honest and makes him think twice about wolfing down food. When he is less vigilant, he finds his weight starts creeping up.
Grigg doesn't completely deprive himself. If he wants an ice cream cone, he has a small one and counts it in his calorie total for the day. He eats only his favorite kinds and doesn't settle for less than the best.
In addition to his daily walks, Grigg does some weight training and calisthenics. He tries to integrate exercise into all aspects of his life. He sometimes walks home for lunch and parks his car in the farthest corner of parking lots to get in more walking.
"I'm really consistent with exercise, just like I am with eating. I figure this is the key to longevity, health and vigor."
He was heavy as a child and teen and knows the unpleasant social consequences of being overweight. That motivates him.
"Nothing works for the long term except restrained eating," Grigg says. "I'm very disciplined. The fact is that not gaining weight and remaining healthy is more important to me than indulging."

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