At one point I weighed 248 pounds. I was able to lose almost 60 pounds and I have interviewed thousands of patients who struggle with weight loss. These are some of the things I’ve concluded about obesity and weight loss. A few thoughts on the weight loss . While liposuction is generally not prescribed as a treatment for obesity most patients who get liposuction are somewhat overweight. From having met thousands of people interested in liposuction I have had ample opportunity to talk to many people about their struggle with weight. A few repeating patterns seemed to emerge. Perhaps the most common one is people not eating frequently enough. Losing weight by not eating is a fallacy. In reality we tend to over eat when we eat after having gone hungry for long periods of time. This was my personal issue and when I addressed it by eating frequently I lost weight(60 lbs) Another common misunderstanding is the relationship between weight and exercise. Most patients are not successful at losing weight by exercising without changes in diet. In my opinion weight is 90% diet and 10% exercise. Exercise has to do with fitness and good health and certainly can help with weight loss. Exercise also helps us feel better about ourselves and that's key in successful weight loss. Think of diet and exercise as two separate entities with two separate purposes. That said I encourage everyone to exercise on a regular basis. The majority of people get hungry from working out and tend to over eat afterwords. Sometimes feeling justified to do so after a strenuous workout. The number of calories burned during a typical workout session is far less than people believe. Any successful weight reduction program has to be based on permanent change. Any temporary diet plan will ultimately fail if not followed by permanent changes in behavior. This one is fundamental. Understand the role that insulin plays in obesity and what causes insulin surges. If you read the late Dr. Atkins book(old school now called ketogenic diet) you will learn that his obsession was with controlling insulin much more so than with eliminating carbohydrates. Learn what glycemic index and glycemic load's are. Avoid eating meals that give a high glycemic load. This is somewhat similar to saying avoid eating large carbohydrate based meals though understanding what foods constitute as bad carbohydrate meals is critical. This will be learned after mastering the concepts of glycemic index and glycemic load. Here are my rules to keep weight under control. 1. Never go hungry 2. Never eat a large meal. 3. Never, never, never eat a large meal when your hungry. 4. Avoid large carbohydrate based meals with a high glycemic index. 5. Don’t expect exercise to get your weight down. Don't blame the lack of exercise or the inability to exercise for not being able to maintain a healthy weight. 6. Step on the scale every day after you get out of the shower in the morning. 7. Accept weight fluctuations. None of us stay at the same weight or continue to go down in weight. Don't beat yourself up if you gained a few pounds. It's the long term, rest of your life, progress that matters. I hope that is of some help. Good luck, Mats Hagstrom, MD