Achieving Sustainable Weight Loss: Key Principles and Strategies

By, Kevin McCall – O2X On-Site Specialist

Despite the prevalence of weight loss efforts, long-term success rates remain low. Research indicates that within one year, 50-70% of individuals who attempt to lose weight regain all the weight they lost. This figure rises to 85% within two years and to 95% by three years, resulting in a long-term success rate of merely 5% (Dulloo et al., 2015). Additionally, one-third to two-thirds of those who regain weight end up heavier than before they started dieting (Mann et al., 2007). 

One primary reason for the lack of long-term success is the focus on “weight loss” rather than “fat loss.” This article explores the reasons for prioritizing fat loss, outlines the guiding principles for achieving fat loss, and provides a practical “prescription” to embark on a fat loss journey. 

Weight Loss vs. Fat Loss 

Weight loss refers to a decrease in overall body weight, which includes fat, muscle, water, and sometimes stored carbohydrates. The primary requirement for weight loss is a caloric deficit. Conversely, fat loss specifically targets the reduction of body fat while preserving muscle mass. 

Why Focus on Fat Loss? 

Focusing on fat loss rather than weight loss is crucial because rapid weight loss often triggers a defensive reaction from the body. This “self-defensive system” perceives rapid weight loss as famine and counteracts it through three primary mechanisms: 

1. Slowing metabolic rate through metabolic adaptation. 

2. Activating genes that favor weight regain. 

3. Inducing biological changes that make future weight loss more difficult (Norton, 2019). 

When weight loss exceeds 1 lb per week, significant muscle mass loss can occur. This is problematic because muscle mass significantly contributes to resting metabolic rate (RMR), the number of calories burned at rest (Hunter et al., 2008). Preserving muscle mass is essential for overall metabolic health, strength, mobility, mental health, cognitive function, bone health, and general quality of life, particularly as we age (Dreyer & Volpi, 2006). 

Being overweight or obese, particularly with high amounts of central adiposity, can be detrimental to health, however, weight cycling (also known as “Yo-Yo-ing”) is definitely harmful,

both biologically and psychologically. Understanding the principles of sustainable fat loss can help prevent this cycle, enabling you to achieve your long-term health and body composition goals. 

Principles of Fat Loss

Principle One: Caloric Deficit 

The most critical tool for fat loss is maintaining a caloric deficit. However, it is important to create a relatively small and consistent deficit, as a large deficit can lead to a decrease in total caloric expenditure (Rosenbaum & Leibel, 2010). Cycling on and off the diet can be effective, avoiding a consistent caloric deficit for more than 12 weeks at a time. 

To control caloric balance and create a deficit, one can either reduce caloric intake or increase physical activity. Practical strategies include making small substitutions to lower-calorie options, avoiding liquid calories, and incorporating daily walks. 

Principle Two: Strength Training 

Strength training is vital for preventing muscle loss during a caloric deficit. Activities such as free weight lifting, using machines, resistance bands, or body weight exercises provide the necessary stimulus for muscle growth. Training close to failure—where one can no longer complete the final repetition—promotes muscle growth most effectively (Morton et al., 2016). Proper technique is essential to avoid injury. 

Principle Three: Prioritize Protein 

Protein is the building block for muscle. During a fat loss phase, aim for 0.8 to 1.2 grams of protein per pound of body weight daily (Phillips & Van Loon, 2011). Distributing protein intake evenly throughout the day in doses of at least 30 grams every three to four hours maximizes muscle protein synthesis and prevents muscle loss. 

Principle Four: Cardio 

Cardiovascular exercise aids in mobilizing fat stores and creating a caloric deficit. While higher intensity exercise can increase hunger and soreness, low-intensity steady-state cardio might be more sustainable and act as active recovery from strength training sessions (Tremblay et al., 1994). 

Principle Five: Hunger Management 

Mild hunger and cravings are common in a caloric deficit. Eating foods that promote satiety, such as high-volume, low-calorie foods (fruits and vegetables) and protein-rich foods, can help manage hunger. Balanced meals and snacks containing lean protein, healthy carbohydrates, and vegetables at regular intervals throughout the day are recommended to manage hunger and prevent cravings (Rolls, 2009).

Principle Six: Sleep 

Quality sleep regulates hunger hormones and prevents late-night snacking. Deep sleep promotes muscle growth, recovery, and fat loss. To improve sleep quality, maintain a regular sleep schedule, keep the bedroom dark, quiet, and cool, get morning sunlight, turn off screens an hour before bed, avoid caffeine after noon, and develop a bedtime ritual (Hirshkowitz et al., 2015). 

Principle Seven: Stress Management 

Effective stress management is crucial for regulating the nervous system, promoting recovery, and supporting muscle growth. High stress levels can decrease RMR, especially when combined with overtraining and under-recovery (Tomiyama et al., 2010). Techniques for managing stress include removing stressors, performing breathing exercises, engaging in enjoyable activities, spending time outdoors, and seeking social support. 

Important Considerations When Attempting Lifestyle Modifications 

As a dietitian, one of the most common questions I get is, “What is the best diet?” I will ALWAYS answer this the same way. The best diet is the one that you can stick to. 

To be successful with your health and fitness goals, there are strategies we can use to maximize adherence to your diet and exercise goals. Some easy things to do are to create an intention and set goals. An intention is a plan. If you want to lose weight, how much weight? By when? When will you weigh yourself to check in? Who will you tell about this plan to help keep you accountable? The more detailed plan the better. Without an intention, we waste our motivation by directing it towards random directions. Next, set some measurable goals. Here are some examples: 

● I will have at least 30 grams of protein with breakfast five days per week. ● I will lift weights three days per week. 

● I will go on a thirty-minute walk after lunch four days per week. 

Don’t skip this piece. Remember that we don’t typically fall off our diet and exercise plans when life is going smoothly. We typically fall off when life gets hectic. So, have a plan that is manageable through the ups and downs. 

A “Prescription” for Sustainable Fat Loss 

1. Reduce your calorie consumption by about 250 calories per day:

An easy way to do this is to start by writing down everything you eat and drink on an average day and then finding three to five foods/drinks that you could substitute for lower calorie options. This typically involves finding lower fat cuts of meat, lower fat dairy options, lower fat/lower calorie condiments, and sugar free or lower 

calorie beverages.

2. Strength train three or more days per week: 

Helps prevent muscle loss while in a calorie deficit. The exercise has also burned at least another 250 calories. If you’re short on time, focus on compound movements and training with heavier loads. Of course, always lift with proper technique and modify lifts if you experience any pain. 

3. Perform 30 minutes of low intensity, steady state cardio four or more days per week: 

This will burn another 250 calories. You’re now in a 500 calorie deficit per day which will result in one pound of weight loss per week. Over 8 weeks, you’ll lose 8 lbs of tissue (and if you did everything right, the vast majority will be fat). This is an appropriate and sustainable rate of weight loss. 

4. Consume at least four “doses” of protein per day of at least 30 grams per dose:

Spread these doses evenly throughout the day (ideally every three to four hours). This prevents muscle loss (and subsequent reduction in metabolism) while you are in a calorie deficit. 

5. Consume balanced meals and snacks: 

Each meal should contain a portion of lean protein, a healthy carb source, and a serving of fruits or vegetables. Make sure to provide all the nutrients your body needs while including adequate protein and fiber to help manage hunger and cravings. 

6. Stress management: 

Start reducing stress by scheduling self-care weekly. This could include a fun, outdoor activity, performing breathing exercises, etc. 

7. Sleep 7-9 hours per night: 

Start improving your sleep quality by getting morning sunlight and avoiding caffeine after noon. 

★ Bonus: Track your macros 

The reason I include this as a “bonus” is because there is an associated “ick factor” when it comes to tracking the foods we eat. However, this one thing may be the most effective tool for achieving your nutrition goals. People often ask me how many calories they should be eating to lose weight. There are some predictive equations we can use to figure this out, but truly, the best way to determine calorie goals is to accurately track everything you eat and then weigh yourself frequently. If your weight decreased, you were in a calorie deficit. If your weight increased, you were in a calorie surplus. 

A Final Word on Fat Loss

The landscape of nutrition information is like the wild wild west. If you’ve been tuned in to that whole scene, you’ve probably seen just about every food or food group be demonized at some point. In recent years, fruits, vegetables, meat, carbs, gluten, oats, seed oils, and many other foods have all taken the blame for the health problems we face in America. It’s hard to make sense of all of this, and sadly, the constant bombardment of information from fear-mongering fitness influencers causes much more harm than good (though, you’ll never see them admit to or address this). 

The fact of the matter is this, we eat far more calories than we used to, and we burn far fewer calories than we used to. Between 1971 and 2016, the average American eats 23% more calories. This is in large part due to the prevalence of ultra-processed, hyper palatable foods, fast foods, and increased food advertising. Meanwhile, the average American is less active than we used to be. These two factors combine to create a calorie surplus in the average person and this calorie surplus alone is a major contributor to the prevalence of obesity, heart disease, diabetes, and strokes in America. While this sounds concerning, it actually provides us with an obvious solution for you to achieve your health and body composition goals: eat mostly whole foods and move more.

References: 

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Dreyer, H. C., & Volpi, E. (2006). Role of protein and amino acids in the pathophysiology and treatment of sarcopenia. Journal of the American Medical Directors Association, 7(6), 428-434. https://doi.org/10.1016/j.jamda.2006.06.002

Dulloo, A. G., Jacquet, J., & Montani, J. P. (2015). How dieting makes some fatter: From a perspective of human body composition autoregulation. Proceedings of the Nutrition Society, 74(4), 357-368. https://doi.org/10.1017/S0029665115004223

Hill, J. O., Wyatt, H. R., Reed, G. W., & Peters, J. C. (2003). Obesity and the environment: Where do we go from here? Science, 299(5608), 853-855. https://doi.org/10.1126/science.1079857

Hirshkowitz, M., Whiton, K., Albert, S. M., Alessi, C., Bruni, O., DonCarlos, L., … & Ware, J. C. (2015). National Sleep Foundation’s sleep time duration recommendations: Methodology and results summary. Sleep Health, 1(1), 40-43. https://doi.org/10.1016/j.sleh.2014.12.010

Hunter, G. R., Byrne, N. M., Sirikul, B., Fernández, J. R., Zuckerman, P. A., Darnell, B. E., & Gower, B. A. (2008). Resistance training conserves fat-free mass and resting energy expenditure following weight loss. Obesity, 16(5), 1045-1051. https://doi.org/10.1038/oby.2008.38

Mann, T., Tomiyama, A. J., Westling, E., Lew, A. M., Samuels, B., & Chatman, J. (2007). Medicare’s search for effective obesity treatments: Diets are not the answer. American Psychologist, 62(3), 220-233. https://doi.org/10.1037/0003-066X.62.3.220

Morton, R. W., Oikawa, S. Y., Wavell, C. G., Mazara, N., McGlory, C., Quadrilatero, J., … & Phillips, S. M. (2016). Neither load nor systemic hormones determine resistance training-mediated hypertrophy or strength gains in resistance-trained young men. Journal of Applied Physiology, 121(1), 129-138. https://doi.org/10.1152/japplphysiol.00154.2016

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About O2X On-Site Specialist Kevin McCall:

Kevin McCall is an O2X On-Site Human Performance Specialist with the City of Berkeley Fire Department who specializes in nutrition. Dedicated to his role as the department’s dietitian, Kevin strives to implement comprehensive strategies that not only optimize performance but also prioritize the long-term health and well-being of the firefighters under his care. His commitment extends beyond conventional nutrition practices, aiming to cultivate sustainable lifestyle changes that profoundly impact the department’s personnel. With a wealth of experience in the field, Kevin transitions to O2X following his tenure as a dietitian for the San Francisco 49ers and the Ultimate Fighting Championship. His diverse background includes serving as an Ocean Lifeguard and EMT for California State Parks, as well as fulfilling duties as a Reserve Harbor Patrol Officer for the City of Morro Bay. This multifaceted experience equips him with a nuanced understanding of the unique challenges faced by individuals in demanding physical professions.

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