Chapter One
CALORIES COUNT
Are you overweight? You're not alone. Today more than half of all adult Americans weigh at least 20 percent more than their ideal weight, and nearly a quarter of them weigh far more than that.
Would you like to lose weight? You're not alone there either. At any given time, about a quarter of all adult Americans are on a diet. Americans spend $33 billion annually on weight-loss products and services, but despite all that money, the number of overweight people continues to rise.
In today's world of fast-food restaurants, convenience foods, and busy schedules that leave little time for exercise, it's all too easy to become overweight by taking in too many calories and using too few. Reversing the process isn't quite as easy, but it's nowhere near as hard as you might think. In fact, you don't even have to go on a diet to do it. All you have to do is reduce your daily calorie intake by a small amount and increase your daily activity, also by just a small amount each day. When you take in fewer calories than you use—even by a small amount—you lose weight, steadily, safely, and for good.
What you're doing is counting calories, a weight-loss approach that is the simplest and probably most successful method of all. Teaching you how to track your daily calories and cut back on them easily is what this book is all about.
WHAT'S A CALORIE?
If you're going to lose weight the calorie-counting way, a good place to start is by understanding exactly what a calorie is.
A calorie is a unit of energy. To be precise, 1 calorie is the amount of heat (another way of saying energy) it takes to raise the temperature of 1 gram of water by 1 degree Celsius. So, if you burned a chocolate chip cookie completely and measured the amount of heat it gave off, you could then figure out how many calories the cookie contained. As it turns out, the cookie will give off about 50,000 calories. When dealing with the calories in foods, though, nutritionists make the numbers easier to deal with by giving them in kilocalories. There are 1,000 calories in 1 kilocalorie, so our chocolate chip cookie contains 50 kilocalories (abbreviated Kcal). The kilo part of kilocalories gets dropped when it comes to food labels and the like, so for all practical purposes our chocolate chip cookie is said to contain 50 calories.
By measuring the number of calories in a food, we're actually measuring how much energy that food contains. The foods we eat are made up of three basic components: carbohydrates (starches and sugars), protein, and fat. There are 4 calories in every gram of carbohydrate and protein, and there are 9 calories in every gram of fat. So, the 50 calories in that chocolate chip cookie come from the sugar and flour (carbohydrates), the eggs and milk (protein), and the vegetable oil (fat) that are in it.
Your body converts the food you eat into energy to keep you alive and moving. More calories mean more energy—but only up to a point. Take in as many calories as you expend, and your body weight will stay the same. Take in more calories than you expend, however, and you will gain weight as your body stores the extra energy as fat. But if you take in fewer calories than you expend, you will lose weight as your body burns fat to make up for the missing energy.
To gain 1 extra pound of weight, you have to take in approximately 3,500 more calories than you expend. And to lose 1 pound of weight, you have to expend approximately 3,500 more calories than you take in.
Don't panic—3,500 calories may sound like an impossibly big number, but it really isn't. To lose a pound in a week, you'll need to expend 500 more calories every day than you take in. That actually gives you a lot of flexibility. You could cut 500 calories from your daily diet, but that probably would mean feeling hungry all week. It's much simpler to cut just 250 calories from your daily intake and increase your activity level by another 250 calories.
As you'll discover from the calorie counter in Chapter 6, it's easy to cut 250 calories from your diet. There are about 250 calories in just two ounces of potato chips, in just one candy bar, or in just three Oreos. As you'll learn in Chapter 3, there are plenty of delicious, low-calorie substitutes for junk-food snacks. And by replacing empty calories in your diet with high-quality ones, you'll be getting better overall nutrition while you lose weight.
It's also easy to increase your activity level by 250 calories. As you'll learn in Chapter 4 on exercise, a 30-minute walk not only burns off about 130 calories, it gives you a lot of other health benefits as well. Sneak in some additional exercise besides your walk—take the stairs instead of the elevator, for example—and you're well on your way to using more calories than you take in. The result is weight loss. It's that simple.
HOW MANY CALORIES DO YOU NEED?
Before you decide how many daily calories you should eliminate from your diet, figure out how many you need to take in. About 66 percent of the calories you eat each day go to keep your body functioning normally. These are the calories that you use to keep your heart beating, your lungs breathing, your digestive system working, and so on. You burn them even when you're sleeping. About 10 percent of the calories you take in go for digesting and metabolizing your food. The rest go toward physical activity—all the moving around you do as a normal part of your daily activities. Most of your leftover calories are stored in your body as fat.
How many calories do you need each day to maintain your current weight? That depends a lot on who you are and how active you are, but you can use a simple formula to get a pretty good idea.
Let's start with what nutritionists call your basal metabolism rate (BMR). That's the number of calories you need just to maintain your basic body functions and stay alive. To find your BMR if you're a woman, take your current weight in pounds and multiply it by 10. If you're a man, multiply your current weight by 11. The result is your basal metabolism rate. So, a woman who weighs 145 pounds has a BMR of 1,450 calories a day (145 × 10 = 1,450). A man who weighs 180 pounds has a BMR of 1,980 calories a day (180 × 11 = 1,980).
To figure out how many calories you need each day beyond your BMR, you'll need to estimate how active you are, using a measure called the lifestyle. percentage (L%). This number is found by estimating how active you are as a percentage of your basal metabolism rate. It's less complicated than it sounds. Start by finding the lifestyle percentage that best fits your activity level:


Sedentary (lifestyle with little physical activity): Your L% is 20 percent of your BMR.


Somewhat active: Your L% is 30 percent of your BMR.


Moderately active: Your L% is 40 percent of your BMR.


Very active: Your L% is 50 percent of your BMR.
To determine your daily calorie needs, add your BMR and your lifestyle percentage together.
So, going back to our example, let's assume you're a somewhat active 145-pound woman. Your BMR is 1,450 calories a day, and your lifestyle percentage is 30 percent of that, or an additional 435 calories (1,450 × .30 = 435). Add your BMR and your lifestyle percentage together, and you come up with a daily calorie total of 1,885 (1,450 + 435 = 1,885). That's the number of calories you need each day to maintain yourself at your current level of weight and activity.
As a rough rule of thumb, you can estimate that a moderately active woman needs about 2,000 calories a day and a moderately active man needs about 2,500 calories a day. Eat more calories than that or become less active, and you'll gain weight. Eat more and become less active, and you'll gain weight faster. The opposite is also true. Eat fewer calories or become more active, and you'll lose weight. Eat less and become more active, and you'll lose weight faster.
The combination of reduced calorie intake and increased activity is the true secret of painless, permanent weight loss. When you learn how to count your daily calories and keep them to the right number for you, you'll be able to balance your energy equation and control your weight.
ARE YOU OVERWEIGHT?
Before you start counting calories to lose weight, it's important to have an accurate idea of exactly how overweight you are. That will help you set a realistic goal for weight loss and help you maintain your new weight.
Traditionally, the ideal weight for your height was determined by a table originally compiled by the Metropolitan Life Insurance Company. The table gave weights depending on your frame—light, medium, or heavy. That's a pretty subjective measurement, however, because you can't
Table 1.1 Weight-for-Height Chart
HeightWeight in Pounds19 to 34 yearsOver 35 yeas5 ft 0 in97–128108–1385 ft 1 in101–132111–1435 ft 2 in104–137115–1485 ft 3 in107–141119–1525 ft 4 in111–146122–1575 ft 5 in114-150126–1625 ft 6 in118-155130–1675 ft 7 in121–160134–1725 ft 8 in125–164138–1785 ft 9 in129–169142–1835 ft 10 in132–174146–1885 ft 11 in136–179151–1946 ft 0 in140–184155–1996 ft 1 in144–189159–2056 ft 2 in148–195164–2106 ft 3 in152–200168–2166 ft 4 in156–205173–2226 ft 5 in160–211177–2286 ft 6 in164–216182–234 Source: U.S. Department of Agriculture

really know if you have "heavy" bones: Also, the Metropolitan Life table didn't take your age into account. A somewhat better table based on your height, weight, and age comes from the U.S. Department of Agriculture. As shown in Table 1.1, it's a useful tool for giving you a rough idea of what your weight should be.
The weight-for-height chart takes a one-size-fits-all approach that's not very realistic—the range within the normal weight for your height is around 30 pounds. Because the range is so large, the chart doesn't really help you figure out if you're normal weight, overweight, or obese.
A more accurate way to figure out if you're overweight is to measure the amount of body fat you have. Men with more than 25 percent body fat are obese; women with more than 30 percent body fat are obese. Measuring your body fat is a little tricky, however. It takes some special equipment and even then it's not always accurate.
Table 1.2 Body Mass Index (BMI) table

Source: National Institutes of Health

Ever since 1998, doctors have used the simple body weight guidelines issued by the National Institutes of Health. These guidelines are based on your body mass index (BMI). The BMI compares your height to your weight to help figure out the amount of fat you have compared to the amount of muscle, bone, and other tissue in your body. It's a more realistic assessment, because it measures the proportion of your body that is fat and helps you determine exactly how overweight you are.
You can use a fairly complex formula to figure out your BMI, but it's a lot simpler to just look it up in Table 1.2.
Find your height in inches in the left-hand column, then look across to find your weight. Use the BMI numbers at the top of the chart to find your body mass index. If your BMI is between 20 and 24.9, you're at a normal weight for your height. If your BMI is between 25 and 29.9, you're overweight. A BMI of 30 and up means you're obese, and if your BMI is over 40, you are severely obese. (The term "morbidly obese" is sometimes used for people who are so overweight that their weight interferes with basic physical functions such as breathing.)
Using the chart, a woman who is 64 inches tall (5 feet 4 inches) and weighs anywhere between 110 and 145 pounds is within the normal weight range for her height. Ideally, though, she'd want her BMI to be in the 20 to 22 range, or between 116 and 128 pounds. The advantage of the BMI chart is that you can easily see how close you are to being overweight and get a better picture of what a healthier weight range would be for you.
There are some limitations to the BMI chart. If you're very muscular, your BMI may fall into the overweight category, even though you're very fit and healthy. Elderly people who have lost muscle mass and body fat from illness may fall into the healthy category, even though they're actually quite frail and should weigh more. For the average person under age 70, however, the BMI is a good indication of where your weight is compared to the normal range.
YOUR WAIST MEASUREMENT
If you're a woman with a waist measurement of more than 35 inches or a man with a waist measurement of more than 40, you're more likely to develop heart disease, high blood pressure, diabetes, and certain types of cancers. You can get a more accurate idea of how much more at risk you are from another important measurement of your weight: your waist-to-hip ratio (WHR). Research has shown that "apples"—people who carry their extra weight around their middles—are more likely to develop health problems associated with overweight. "Pears"—people who carry their extra weight around their thighs and buttocks—are less likely to have health problems from being overweight, although they are more likely to develop arthritis and back problems. Fortunately, apples generally find it easier than pears to lose their extra pounds. Men tend to be apples and women tend to be pears, but that's not a hard-and-fast rule. Women who gain weight after menopause tend to be apple shape.
To figure out your WHR, use a tape measure to find your waist measurement. (Measure around your torso just above your belly button.) Then find your hip measurement. (Measure around the widest part of your rear end.) Divide your waist measurement (the smaller number) by your hip measurement (the larger number). The result is your WHR. If your WHR is less than 1, you're a pear. If your WHR is 1 or more, you're an apple. A woman with a 35-inch waist and 46-inch hips is a pear, because she has a WHR of 0.76 (35 ÷ 46 = 0.76). While pears tend to have fewer of the health problems associated with being overweight, carrying too much weight around is bad for your health no matter where it is.
OVERWEIGHT AND YOUR HEALTH
People who are overweight or obese put their health at very serious risk. If you're 40 percent overweight (your BMI is over 30), you're twice as likely to die prematurely as someone the same age who's normal weight. You're also much more likely to develop life-threatening medical conditions, including diabetes, heart disease, high blood pressure, and stroke. In fact, 90 percent of the people who have adultonset diabetes (also called Type 2 or non—insulin—dependent diabetes) are overweight. Complications from diabetes, including heart disease, kidney disease, and stroke, are the sixth leading cause of death in the United States.
Obesity is also associated with higher rates of certain types of cancer. Obese men are more likely than normal-weight men to die from cancer of the colon, rectum, and prostate. Obese women are more likely than normal-weight women to die from cancer of the breast, uterus, cervix, and ovaries.
Some of the other health problems linked to obesity include gallbladder disease and gallstones, osteoarthritis (joint deterioration), and gout. In addition, if you're obese you may develop sleep apnea, or interrupted breathing during sleep. Sleep apnea causes loud snoring and daytime sleepiness and can lead to heart rhythm problems and high blood pressure.
LOSE A LITTLE, GAIN A LOT
The good news about your health is that losing even a small amount of weight—as little as 10 pounds—can lead to a noticeable improvement in how you feel and in your long-term health. If you have high cholesterol, for example, losing 10 pounds could lower your total cholesterol by about 16 percent—an amount that could bring your high cholesterol number back down into the normal range. If you have high blood pressure, every 2 pounds you lose translates into a 2-point drop in both your systolic and diastolic blood pressure. Losing 10 pounds means your blood pressure might drop about 10 points. That might not put you back in the normal range, but it could mean a reduction in the amount of medication you need to take. In many cases, overweight people with high blood pressure can stop taking medicine for it if they lower their weight by 10 percent. If you weigh 200 pounds, that means losing 20 pounds.
Overweight people are twice as likely to develop adult-onset diabetes as people who are normal weight. The heavier you are, the greater your risk—even being at the high end of the normal weight range nearly triples your diabetes risk compared to people. at the low end.
Studies have shown that nine out of 10 cases of adult-onset diabetes could be prevented by losing weight and exercising more. If you already have diabetes, losing as little as 5 to 10 percent of your body weight could do a lot to help control your blood sugar level, reduce your need for medication, and lower the chances of long-term diabetes problems such as heart disease, kidney disease, amputation, and blindness.
IT'S IN MY GENES
Obesity tends to run in families, but is that because you share "fat genes" or because you share eating and lifestyle habits? It's probably some of both. Your genes do play a role in your weight, and if there are many overweight people in your family, you'll be more likely to be overweight as well. If members of your family have developed health problems related to being overweight, such as diabetes, you're more likely to develop them too if you're overweight or even on the heavy end of the normal weight range.
You're not genetically doomed to a life of fatness, however. Your environment plays a big part as well. You can't change your genes, but you certainly can be aware of them and change what you eat and how active you are.
WHAT IS SAFE WEIGHT LOSS?
Slow and steady weight loss of 1 to 2 pounds a week is the safest and surest way to lose weight. Why? Because the only way to lose a pound or two a week is to make simple, long-term changes in your eating habits and activity level. No crash diets, no weird food restrictions, no rapid weight loss followed by equally rapid weight gain—just small, positive changes you can live with on a permanent basis.
ASK YOUR DOCTOR
Before you start on a weight-loss program or start to become more physically active, visit your doctor for a checkup. You need to be sure that your weight gain isn't caused by a health problem such as an underactive thyroid gland (hypothyroidism) or depression. Some drugs, including birth control pills, hormone replacement therapy to treat menopause symptoms, steroids, and some antidepressants can be an underlying cause of weight gain. You also need to be sure that increasing your level of physical activity will be safe for you, and you need to know if there are any restrictions on the types of activities you can do.
As part of your examination your doctor will take your blood pressure, check your heart, and measure your blood cholesterol levels and the amount of glucose in your blood (a marker for diabetes). The results will be your baseline numbers—the numbers that losing weight will almost certainly improve.
At the end of your checkup your doctor may ask you to come back in three to six months. If you lose 1 pound a week for six months, you will lose 21 pounds between this visit and your next. When those baseline numbers are checked again, there is a very good chance that they will be sharply improved. There's no better proof of how weight loss helps your health.
PREVENTING GALLSTONES
Although weight loss will improve your health in almost every way, there is one health problem that is of real concern if you lose weight improperly. Gallstones are a painful and serious health problem that can affect dieters, especially if they lose weight rapidly.
Gallstones are clumps of solid material that accumulate in your gallbladder, a small, pear-shape organ in your abdomen. Your gallbladder contains bile, a fluid made by your liver and used in digestion. As food passes from your stomach to your small intestine, your gallbladder contracts and releases bile through ducts into the intestine. If a gallstone gets stuck in the bile duct, the result is severe pain and possibly surgery to remove the gallbladder. Every year in the United States there are more than 600,000 hospitalizations for gallstones and over 500,000 operations to remove gallbladders.
Being overweight is a strong risk factor for gallstones. In fact, a woman with a BMI of 30 or more has at least double the risk of developing gallstones as a woman with a BMI of 25 or less.
For reasons researchers still don't understand, however, losing weight actually increases your odds of having a gallstone. If you lose weight rapidly or follow a very-low-calorie diet, your odds go up even more. Gradual weight loss, the kind you get by counting calories, may help reduce your risk of getting gallstones.
The risk of gallstones from rapid weight loss is real, but it's still small—about 4 to 6 percent. The risk if you lose weight gradually is probably even less. And while you do have a small chance of getting gallstones from weight loss, you have an almost certain chance of getting diabetes, heart disease, high blood pressure, and other potentially fatal health problems if you stay overweight.
WEIGHING YOURSELF
You may have noticed that your weight seems to vary a bit depending on what time of day you weigh yourself and also on which scale you use. Your weight at your doctor's office, standing on an expensive beam scale, is probably different from the weight you get on your bathroom scale.
As long as you weigh yourself on the same scale at the same time of day, it doesn't matter which weight is your "true" weight. What matters is that each time you step on that scale, you weigh a little bit less than you did the time before.
If you weigh yourself every day, you won't really be able to detect your weight loss if you're losing a pound a week. Most scales can't detect a difference of just a few ounces from day to day. Weight-loss specialists recommend that you weigh yourself only once a week or even less often. Do it first thing in the morning, without any clothes on, and always use the same scale. Keep a written record of the date and your weight. For extra encouragement, keep a running total of all the weight you've lost.
ALL ABOUT YOU
Before you begin counting calories, write down some basic information about yourself, as shown on the sample data sheet on pages 16–17. Write down your height and weight, and then use the Body Mass Index table to find your current BMI. Figure out your waist-to-hip ratio as well. Write down the baseline information you've gotten from your doctor about your cholesterol levels, your blood sugar, and your blood pressure. Next, put your personal data sheet away someplace safe and don't look at it for a month.
After you've been counting calories for a month, weigh yourself, figure out your BMI and WHR, and write it all down on your data sheet. Compare your new data to your old and see if there's been any improvement. You've probably lost a few pounds by now, and you might even have moved into a lower BMI number.
As you continue to count calories and lose weight, record your personal data once a month on the data sheet. In a few months' time you should see an encouraging trend of continuing weight loss. When you go back to your doctor after six months or so, you may see that your new cholesterol and blood pressure numbers are also moving into a healthier range. If you've been diagnosed with high blood sugar or diabetes, those numbers may be improved as well.
Let's face it—weight loss is a slow process. It can get discouraging sometimes, but if you keep records, you can see that you're making progress, even if it's only a few pounds a month.
PRESCRIPTION WEIGHT LOSS
Wouldn't it be great if you could take a magic pill and lose weight? That's what a lot of people thought when Pondimin ® (fenfluramine hydrochloride) and Redux® (dexfen-fluramine hydrochloride) were introduced in 1995. Hailed as the miracle solution to obesity, these drugs were taken off the market in 1997 after they were shown to cause serious heart problems in some patients. Today the only prescription drug designed specifically for weight loss is Xenical® (orlistat). This drug works in your intestines by blocking about a third of your absorption of dietary fat. There are some serious drawbacks to Xenical®, though, including digestive problems. It's not a long-term solution for permanent weight loss, but when it's combined with a low-calorie diet, it can help start you down the weight-loss path and keep you on it. Some people find that antidepressants such as Prozac© (fluoxetine) help them control their appetites and stick to a healthier eating plan. If you think medication might help you, discuss your weight-loss plans with your doctor.
DIET PILLS AND DIET SCAMS
The shelves of any health-food store are crammed with all sorts of pills, teas, and supplements that claim to help you lose weight. The labels say that whatever is inside will burn fat faster, or block fat, or melt fat away. Will it? Of course not.
Be very cautious about these so-called shortcuts to weight loss. They won't really help you lose weight, and they could be dangerous to your health. Just read the warnings and possible side effects of over-the-counter diet pills, such as Acutrim®, and you'll understand why these drugs should be avoided. Herbal weight-loss supplements and teas often contain ephedra (also called ma huang), a stimulant that has been linked to a number of deaths. Other diet teas contain diuretic herbs such as uva ursi (also called buchu or bearberry) that increase urination. The water loss makes you lose a few pounds quickly, but at the price of possible dehydration and kidney damage. Remember, just because a product is "natural" or "herbal" doesn't mean it's safe or that it works.
Personal Data Sheet


Nonprescription fat-blockers such as chitosan are said to work by binding fat in your intestines, but as with prescription Xenical®, there are some serious drawbacks to this approach to weight loss. Chitosan can cause intestinal discomfort, including gas, cramping, and leakage. And as with Xenical®, just taking the supplement won't cause long-term weight loss unless you also change your eating patterns.
Because so many people are eager to lose weight, they are easy targets for scam artists peddling fad diets and "miracle weight-loss systems." Watch out for anything related to weight loss if it promises you a quick fix, bans whole categories of foods, or is based on selling you some sort of product or supplement. If you fall for one of these scams, the only thing that will lose weight will be your wallet.
VERY-LOW-CALORIE DIETS
If you're very overweight and you need to have significant short-term weight loss, your doctor may prescribe a very-low-calorie diet (VLCD). When you're on a VLCD, you drink a commercially prepared formula containing less than 800 calories a day instead of eating your usual meals. These formulas aren't the same as over-the-counter meal replacements, such as SlimFast®, which are meant to be substituted for one or two meals a day. (See Chapter 5 for more on SlimFast®.)
VLCDs are definitely not the way to permanent weight loss. You'd go on such an extreme diet only if your BMI is over 30 and if your doctor prescribes it. Very-low-calorie diets are used only to treat medical complications of obesity, such as breathing difficulties or if your excess body fat would complicate needed surgery.
GETTING STARTED
If you're ready to get started on the path to permanent weight loss, you're ready to start counting calories. But before you do, make sure this is a good time for you. Is the food-rich holiday season coming up? Are you scheduled for a lot of business travel or a vacation? Is anything highly stressful coming up in your life? Are you pregnant or having a serious health problem? It's hard to stick to counting calories under these circumstances, especially if you're new to this approach. Don't sabotage yourself. Pick a relatively calm and healthy time in your life to start calorie counting.
Ask yourself one final question: Why do I want to lose weight? The desire to lose weight has to come from inside you. If you're dieting because you're getting pressure from family members, friends, or your doctor, the chances are good that you won't keep the weight off. It's only when you lose weight for yourself, not others, that dieting works in the long run.
Are you ready? It's time to learn the easy, practical way to count calories for weight loss.

Copyright © 2002 by Sheila Buff.