June 2, 2004 -- Lee Allen just doesn't look at fattening foods the same way anymore.
Before losing 50 pounds, he saw high-calorie, low-nutritional-value foods as simply a delicious meal or snack. But now that Allen is slimmer and wiser, he looks at all food as a numbers game: How many calories does it contain and how long would it take to burn off said calories on the treadmill, Stairmaster or exercise bike?
"I look at a piece of food on the table, I say, 'There's 500 calories, that's 45 minutes, on that machine,' " Allen said.
The battle of the bulge has become a nationwide war, and as American waistlines expand, so do the costs of obesity-related disease, which add up to about $100 billion a year. As Americans spend about $33 billion annually on weight loss products and services, a 10-year study called the National Weight Control Registry has tracked more than 5,000 participants to see how they lost weight and, better yet, how they kept it off.
Funded by the National Institutes of Health and headed up by Dr. Rena Wing, director of The Weight Control and Diabetes Research Center at Miriam Hospital in Providence, R.I., the study collects and analyzes data from successful weight losers. Allen was one of 12 participants from the Boston and Providence-area who spoke to Good Morning America. As a group, they have lost some 950 pounds, and all said the key to their successful weight loss was to stop thinking of weight loss as dieting and instead think of it as a lifestyle change.
"The magic bullet is hard work," Wing said. "It's changing your whole lifestyle, to a healthier eating and exercise approach to living. And that's the only magic bullet we have for long-term weight loss."
The study found that women tend to lose weight in groups, while men tend to lose weight on their own. The dozen subjects are just a fraction of the 5,000 participants in the study, but their backgrounds and weight loss strategies mirror that of the group.
"I always used my kids as an excuse as to why I was overweight," said one participant, Debbie Higgins, who lost 100 pounds. "'Oh, I just had a baby, I just had a baby.' But when they were about 7 it didn't work anymore."
Another woman explained that seeing photographs of herself on vacation was all that it took to get cracking on her diet.
"My husband and I went on a trip to Egypt and [looked] at the pictures when we got back, and I went, 'That cannot possibly be me,' " said Robbie Kohn, who went on to lose 60 pounds.
One Hour of Exercise Daily
Those in the study lost weight in a variety of ways, but to keep it off, researchers found they share key things in common: a low-calorie, low-fat diet and a high level of physical activity. But what was more surprising was the level of exercise it took to keep off the pounds. All 12 said they exercised regularly, and for long periods of time. Three-quarters of the participants walked as a form of exercise.
"They actually report doing large amounts of physical activity, close to an hour a day of physical activity," Wing said. "And that seems to be one of the key characteristics for maintenance of weight loss."
That doesn't mean they immediately embraced exercise.
"I absolutely hated to exercise," Kohn said. "It took me a really long time to get over that, but it's had a lot of rewards. I found myself calmer, I sleep better."
Another woman said that regular exercise not only helped her lose weight, but also helped ease her depression
"I feel that it wasn't the dietary changes that took away the depression, but it was the actual exercise that helped to enhance my mood," said Lori Austin, who lost 100 pounds. "And it was a nice cycle where that helped me to lose the weight. It helped me to eat right."
Margaret Mungovan, another participant, dreaded exercise because it took an hour to 90 minutes out of her day. "One of the best strategies for me has been splitting it up into bouts of physical activity," Mungovan said. "So I can do a walk in the morning, I could do another walk in the evening, and it's not so tedious, and yet I still get that level of physical activity in that helps me manage my weight."
Weigh In Regularly, No Cheating
Another key to success was consistency. Participants who lost weight ate breakfast daily. Those people who did not give themselves a day or two off to cheat were 1 ½ times more likely to maintain their weight loss.
"Perhaps once you start giving yourself some breaks on the weekend, that maybe you start then giving yourself some breaks on Friday, and then maybe Thursday," Wing said. "And little by little, you're taking more breaks and that may be a problem in terms of long-term maintenance of weight loss."
Stepping on the scale regularly can also help. Nearly three-quarters of participants weighed themselves at least once a week.
"It allows them to catch small increases in weight very quickly and take some corrective action," Wing said.
If you think genetics, not willpower, might be hampering your weight loss, think again. Even though about half the people in the registry were overweight as children, and three-quarters had at least one parent that was overweight, they were still able to lose the pounds.
"Childhood obesity and a family history of obesity would suggest a strong genetic predisposition to obesity," Wing said. "So it's very interesting that even despite this genetic predisposition these individuals in the registry have been able to lose weight and keep it off."
Mungovan, who was overweight as a child, remembers the pain of being called names.
"I was the last kid picked at gym class, "she said.
Others said they were not heavy as children.
"As a child I was a pretty skinny little kid," recalled Barbara Fields. "And my family kept saying eat, eat, you got to eat. So I finally ate."
Health Concerns a Strong Impetus
The health risks of being overweight have been well documented. Obesity causes 300,000 deaths a year, and is the second leading cause of preventable deaths in the United States. But those who lose weight for medical reason are much more likely to keep it off. Those in the study who started off for medical reasons only regained half as much weight compared to others who followed over time.
Pauline Marcussen, who lost 100 pounds, said the catalyst was her health-care job in a correctional facility.
"I couldn't run up the three flights of stairs," Marcussen said. "I would get to the top of the stairs and I'd be breathing really hard. And all the officers would be around me saying 'Are you going to have a heart attack?' And I was barely 40 years old at the time."
Henry Olds, who lost 40 pounds, was inspired by his 12-year-old daughter to lose weight and get healthy.
"When I found out I was a stage two diabetic, I really looked at myself and I said, 'You know, I want to stay alive and healthy for that girl,' " Olds said.
The study has also found that those who maintain weight loss for two to five years cut their risk of regaining the weight in half.
To learn more about the National Weight Control Registry, go to http://www.lifespan.org/services/bmed/wt_loss/nwcr/.
Thea Trachtenberg produced this story for Good Morning America.