The key to losing: exercise or diet?

Weight loss q&a by Suzanne Schlosberg

It's difficult for me to concentrate on calorie cutting and my workout program at the same time. Which is more important for weight loss? ... and more of your questions answered here.

Q I find it hard to stick with a diet while I'm trying to maintain my exercise program. Which one should I focus on more for weight loss: exercise or diet?

A "Exercise is less important than diet for losing weight, but once the weight is off, exercise becomes almost essential for keeping it off," says Robert H. Eckel, M.D., chairman of the American Heart Association's Nutrition, Physical Activity and Metabolism Council and professor of medicine at the University of Colorado's Health Sciences Center in Denver.

Dietary changes tend to have more of an impact on weight loss because it's relatively easy to reduce calories through improvements to your diet, while it takes a lot of exercise to burn off an equal number of calories. For instance, you could cut 230 calories a day--enough to lose 2 pounds in a month--simply by skipping that afternoon candy bar; to burn 230 calories through exercise, you'd have to run or walk two miles, which could take up to 40 minutes. "That doesn't mean you can't lose a little weight by exercise alone," Eckel says. "But the caloric value of exercise is modest. You have to exercise a lot to make up for that malt over the weekend."

But don't use this as a reason to give up on exercise. Among people who lose weight without working out, the vast majority regain the pounds. However, research shows that 95 percent of those who succeed in keeping the weight off exercise almost daily. Rather than making drastic changes to both your eating and your exercise habits, make more modest improvements to both.

Q The more I promise myself I'm going to diet, the worse I eat. I find myself going to McDonald's for a McFlurry frozen dessert every day. How can I stick to my diet and stop thinking about junk food and ice cream all the time?

A "When foods are put on the forbidden list, you start to crave them," says Atlanta nutritionist Kathleen Zelman, R.D., a spokeswoman for the American Dietetic Association. Rather than deprive yourself of the foods that you love, Zelman suggests, "give in to your cravings, but in a controlled manner."

For instance, allow yourself to buy a McFlurry once a week and savor every bite. "Don't eat it standing up or in your car," Zelman says. "Sit down and really enjoy it instead of just wolfing it down." You may want to bring some home to put in the freezer and scoop out a small portion each night. Simply knowing the dessert is available to you might be enough to keep you from thinking about it all the time, Zelman suggests. The cravings and obsession will wane.

Another strategy is to satisfy your craving for sweet, cold, creamy foods with a lower-calorie alternative to a McFlurry (about 600 calories for 12 ounces). For instance, Haagen-Dazs chocolate sorbet contains 120 calories per 1/2 cup serving (which at 4 ounces is a more sensible serving size for a frozen treat).

Q My girlfriend is smart and beautiful, but her obsessive dieting is starting to worry me. She is 5-foot-5 and wants to weigh 110 pounds (currently she weighs 115). She never eats more than 1,000 calories a day and runs for at least 40 minutes. After her workouts, she says things like "I feel like I am going to faint," but still she won't eat anything. What can I do to help her?

A "Tell her gently but firmly that you're very concerned and that you believe her behavior is heading in the direction of an eating disorder," says William Davis, Ph.D., director of research for The Renfrew Center Foundation, a nonprofit organization in Philadelphia that designs programs to advance the awareness of eating disorders. If she dismisses your concerns--a reaction that is likely, Davis says-remain supportive and let her know that you plan to bring up the issue again.

Urge her to see a therapist who specializes in eating disorders. If she won't agree to that, try getting her to a registered dietitian. "To people with eating disorders, nutritionists tend to be less threatening than therapists," Davis says. A nutritionist can explain to her that drastically cutting calories will actually backfire; when you eat fewer calories than your body needs to maintain itself, your body thinks it's being starved and your metabolism slows down.

Although many people with disordered eating tend to ignore the health risks of anorexia and bulimia--everything from flaky skin to life-threatening organ damage--you still might tell her that you fear what may happen to her down the line. Perhaps a more effective strategy, Davis says, is to take pictures of your girlfriend from the neck down, in hopes that she will see that her body is not, in fact, fat. If she's looking at an image of her body without her face, Davis explains, she's more likely to see it realistically.

Getting through to people with disordered eating can be an uphill battle, Davis says, "but that doesn't mean it can't be done." Some people defiantly refuse to get help, while others are just waiting for someone to care enough to take an interest. If all else fails, "you may even want to arrange an intervention with people she trusts, like girlfriends who know about her obsession with weight," Davis adds. "You then can tell her, 'Look, it's time to do something about this.'