How to Lose Weight (again)… and Keep it Off (really)

CARE Weight Loss & Lifestyle Program

How to Lose Weight (again)... and Keep it Off (really)

Learning How to Live Outside the “Crib”

The Short Story for How to Lose Weight

The basic formula for how to lose weight doesn’t elude us (we’ll get to important nuances about diet quality and changing relationships with food in Weight Loss Programs: Make Sure Yours Fits Like a Glove, but let’s start here with the true basics). To lose weight, you need to:

  1. Reduce caloric intake and/or
  2. Increase physical activity

There are hundreds of interpretations available for how to apply this formula. All weight loss programs and diets reduce caloric intake whether this reduction is obvious through calorie or point counting, restriction of food groups, or more subtle through natural “displacement” of calories (for example when whole foods replace calorie-dense packaged foods).

The ability to temporarily apply one of the hundreds of interpretations of this formula for how to lose weight isn’t all that elusive either. Globally, millions of pounds are lost each year.  Speaking of, how many of these pounds did you personally contribute to this total last year? The year before? Over the past 10 years?

The Conflict Created by the Crib

It was a member of CARE that first shared the term “being in a crib” with me in reference to what it feels like to “be on a diet”; diet, of course, being our default answer to our question of how to lose weight (again).

Though restrictive and unsustainable, being in a crib came to be comforting in its own way. Being in the crib eliminated diet and lifestyle decisions. “Do this, not that” lists quieted the confusing and all-consuming self-talk around every single food decisions.

She shared that she was more fearful and overwhelmed to live “outside of the crib” because she didn’t know how to anymore.

The cycle of being “on a diet” or “off a diet” creates distrust of our own mind and bodies, ambiguity in how to achieve results others seem to have effortlessly, and gives a megaphone to the voices inside our heads demanding we figure it out or go crazy trying.

Her “being in a crib” analogy has resonated, with piercing accuracy, to everyone I’ve shared it with that has struggled with their weight.

Let’s look at it in more detail together as we explore the more needed formula of how to keep the weight off (finally) by learning to finally live comfortably outside of the crib this time.

The Longer, More Needed Story, of How to Lose Weight (again) and Keep it Off (really)

The formula that is much more elusive than just how to lose weight is how to keep those lost pounds permanently lost while protecting nutritional adequacy (making sure you get all the nutrition you need to sustain your cells) and while protecting mental wellbeing (actually strengthening your relationship with food and health over time).

Without putting our full attention to defining this more important formula ‘how to keep weight off (really)’, rather than constantly trying to answer the more simple question of ‘how to lose weight (again)’, we are destined to stay on this exhausting hamster wheel of either being ‘on a diet’ or ‘off a diet’.

The exhausting hamster wheel of being ‘on a diet’ or ‘off a diet’:

  • Search for “how to lose weight” (again). The search for how to lose weight is an exhausting process because it feels like you are just throwing darts blindly against a wall.
    • How do you pick a weight loss program? Is it the person with the most followers on social media? Your hospital? The method your neighbor swears by?
    • Or is it something you’ve already tried because maybe you just weren’t “really ready” last time?
  • Take the plunge (again). After several months of considering this and that (and that again) you take the plunge; a plunge no more comfortable than jumping into freezing water, but at least you have made your choice.
  • Emerge safely back in your “crib” (again). You now have your newest “list of do’s and don’ts”, you start losing weight (again); you are safely in your “crib” again – daily decisions removed, you have your lists to follow, and the restrictions still feel tolerable.
  • Sneak out of your “crib” (again). After several months (or even weeks) of “being perfect,” you jump out of your crib one night for a special event – maybe for a birthday party – and find freedom intoxicating! Plus, people are noticing your weight loss and insist that “You look great! A couple of cookies or a piece of this cake won’t set you back!” You’re convinced!  No list, not tonight (but just tonight).
  • Promise it will be “just one more day” (again). Leftover cake and brunch reservations the next day entice you to stay out of the crib “for just one more day”; you promise yourself, just one more day.
  • 6-months’ worth of “one more days” later (again). All your weight is regained. Defeated, you feel like screaming “See, I HAVE tried it ALL but NOTHING works!”.  You resentfully avoid trying to do anything (what’s the effort for, anyway??), but, cruelly, you cannot avoid the daily shouting inside your head. The negative self-talk consumes you until, admirably, you prepare to start the cycle all over again. Starting with the simple search “how to lose weight” (again).

First, you are far from alone if this sounds familiar to you. Second, there really can be a different way, a quieter more comfortable way, than this exhausting hamster wheel.

Where to start this time

  1. Rather than starting with the priority of rapid weight loss, start with the priority of learning how to live outside of the crib this time.
  2. Start with maintenance, learning how to keep the weight off while you’re losing it, on day one of your next plunge.

I think we are closer, than many believe, to knowing how to sustain weight loss and other healthy lifestyle changes, from day one.

Continuing to talk about sustainable weight loss as a complex unsolvable puzzle with a million lost pieces only leads individuals to give up on trying; unfortunately, the medical and research community (even if unintentionally) are largely the ones perpetuating this view.

Harold McGee says in his book On Food and Cooking that “scientists always simplify reality in order to understand it”. I think the opposite is happening with weight loss and preventative health. Research, though it has a fundamental role in medicine, has (again unintentionally) complicated reality in this case in order to try and understand it.

Each single study that isolates only one component of diet under accelerated clinic conditions then competes for national attention demanding a swift change in direction to follow its findings – hinders the much more needed project which is to synthesize the already-known commonalities of a healthy lifestyle into actionable, skill-building guidance.

Skill-building guidance is focused on the application of information, of practicing it in within your real life – not just passively consuming the information. Jumping from book to blog post or Facebook to Pinterest feels more comfortable than pulling away and practicing daily veggie prep in the kitchen.

But this is the opportunity. When we match individuals with the right learning tools, we can help them uncover, for themselves, how the effort and intention of a healthier lifestyle really are worth it.

Finding the Right Learning Tools

This skills-building guidance must also be affordable and accessible for an extended duration because habits as entrenched as food that has reigned for 20+ years won’t be broken in mere weeks.

Finally, to really keep weight off we need weight loss guidance that can clearly articulate which individuals it best supports and how, because the choice of weight loss program must fit an individual like a glove if they are to do it consistently and permanently for long-term results.

We don’t need the expense or complication of “individualized nutrition plans” to reduce the risk of chronic lifestyle diseases or achieve weight loss; there are established commonalities for what works that apply to everyone with these goals:

  • Improve overall diet quality
  • Moderate portion sizes
  • Increase physical activity
  • Manage stress through self-CARE
  • Stop smoking, if applicable

What we do need is appropriate support and mentoring to help individuals learn how to make these healthier choices, even when that choice isn’t easy (because much of the time it isn’t).

In short, for both our formulas to work (how to lose weight and how to keep it off), individuals need education tailored to where they are today.

They deserve to be taught how to live outside of the crib on their own; breaking the cycle of dependency on a health and weight loss industry that glamorizes perfection, encourages skipping from one fad to the next, and relies on perpetuating the hamster wheel of “how to lose weight (again)” for its very survival.

Enough, we say. Now can be different. We can focus on sustaining healthy changes. Starting today, we can shift our priority to maintenance.

Maintenance: The Formula for Turning New Healthy Changes into New Healthy Habits


I stated that I believe we are closer than many believe to finding the formula for how to sustain weight loss. I also stated that we need more focus from the healthcare and research community on how to synthesize what we do know into actionable steps individuals can take – starting today.

I sincerely believe that if we give individuals tangible tools and guidance on how to practice a new lifestyle, tools and guidance that match their learning style and where they are today, they will demonstrate remarkable dedication and accountability to using them, adapting these tools to include their own innate wisdom, and (finally) experiencing a new relationship with health.

The following summary provides a very brief introduction to a consolidated formula, Do-Reward-Repeat, I created for CARE as a tangible tool for members to use in their daily lives when attempting to first recognize and break old habits and then reprogram new healthy changes as new habits, which is possible at any age (really).


1. DO: First learn what to ‘do’

  • Learn the basics of a therapeutic lifestyle (nutrition, physical activity, stress management and recovery, and smoking cessation if applicable).
  • Find a weight loss program that fits you like a glove. Slowly practice integrating new healthy actions into your daily lifestyle, embrace incremental change (remember with incremental change you still control the pace, you can still control what size “increments” you take; a good program will offer this flexibility).
  • Then, refine these healthy actions into your own personal “health to-do list”; one you can see yourself doing for the rest of your life.
  • Next, align your core values (traits like creativity, leadership, and community-building that make you the person you are or want to be) with the increased health and wellbeing you receive from consistently choosing the items on your health to-do list. Be led by these internal motivators rather than external sources like the weight on the scale, clothing sizes, temporary challenges, or others’ expectations of you.

Getting Started Activity: For one week, give attention to how various lifestyle choices make you feel. What characteristics about yourself are compromised or muted because of indulgent choices?

Do you highly value social connection but become withdrawn at night after a heavy meal? Do you highly value creativity but feel more anxious than creative after certain choices like high sugar intake or being inactive?

Without directly 1) feeling health; the result of your cells having the proper tools to do the jobs they have the potential to do, and 2) associating a healthy action to a specific positive benefit, you will be challenged to ever align what you wished you did with what you actually do long-term.


2. REWARD: Answer the most important question raised by your health journey: “What will I do instead?”

  • Identify health-promoting alternatives to food, alcohol, and overused technology that provide needed sources of pleasure, reward, and comfort. Focus on what to add versus take-away.
  • Identify health-promoting rewards that you can give yourself for making and sustaining the choices you want to be making. Your brain needs reinforcement that the perpetual effort needed to sustain your choices is worth it.
  • This is an opportunity to reframe what a reward really is; so many have been raised to think of food as the reward for effort, so it can be challenging to think of and find new non-food rewards.

As we’ve mentioned, to maintain weight loss you must pick a way to lose weight that you can do consistently, permanently.  Period.

And to do this consistently, you have to really want to do it consistently.  Not want as in wishing or longing for things to be different, but want as in motivated to make health-promoting choices consistently.

Because that’s what a healthy lifestyle is for the majority, a choice. It’s not always the easy choice, many days not even close, but it is always your choice.

Everyone needs (and deserve) pleasure, reward, comfort, and connection

Food, alcohol, and overuse of technology are also choices; choices that provide an effective (even though temporary) sense of pleasure, reward, and comfort. For better or worse, food, booze, and technology have become our ‘fun’.

So when we make (or try to make) a choice (even though healthy) that threatens to take that ‘fun’ away, we also threaten our ability to receive pleasure, reward, comfort, and connection.  And who wants to make that choice?

Even though healthy choices make us physically healthier, we can also be (temporarily) taking our ability to feel good away right with it. This might make us realize that we lack hobbies we once had, we aren’t doing the things we wanted, or that somehow we just lost our interests and passions. It’s sure easier at night to pour a drink or eat at our favorite restaurant than it is to figure out what we’d rather do instead. 

Without health-promoting rewards at the ready, we don’t stand a chance at the end of a long, stress-filled day, to make a different choice. Food, booze, and technology will continue their reign.


3. REPEAT: Practice making the choices you want, weekly, daily, hourly. Practice.

  • Your brain has had 20+ years to develop your current habits; expecting to install a new go-to pattern within days or even a few months just isn’t going to happen.
  • Understanding our formula for sustaining weight loss – Do-Reward-Repeat – isn’t the trickier part, practicing it is.

Practicing how to insert yourself and your goals into multiple daily lifestyle choices is what is hard to sustain.

Why is inserting ourselves, getting our foot in the door of automatic behaviors before it slams shut, so hard?

Because this is the current environment of many individuals trying to make or sustain healthy lifestyle change:

  • Imbalances in physiology (lack of nutrients, unregulated blood sugar, excess intake of chemicals, lack of sleep, lack of activity, elevated stress hormones)
  • Reward deficiencies (hobbies are forgotten, ‘play-time’ is never prioritized)
  • Lack of stress recovery (days lack pacing placing burden of all stress recovery in the limited hours after work before bed)
  • Feeling isolated (whether socially or feeling like you are the only one ‘trying’ within your immediate environment)

At any point in this environment, how is someone who hasn’t learned how to secure pleasure, reward, comfort, and connection away from food or without the restrictions imposed by a “crib”, supposed to make the “right” choice? Choices that need to be made multiple times a day?

To recap our formula for how to lose weight (again) and keep it off (really)

This time, learn how to live outside of the crib. Start maintenance on day one. Learn how to sustain the changes you want to make right away when you start.


What is the One Step to Take Today?

     “DO” – Prioritize Physiology First

  • Find a weight loss program that starts helping you correct imbalances in your physiology
  • Make sure your next program was written for your goals with a structure you can follow, make sure it uses tools that are comfortable and fit your current lifestyle, and make sure it is written in a voice you’d like to continue a conversation with (for more help evaluating programs read our article that outlines these program design features here: Weight Loss Programs: Make Sure Your Next One Fits Like a Glove)

And finally, reach out to me if I can be a resource. I, too, am vulnerable to having real-life push me in the direction of the ‘easy’ choice instead of the ‘right’ one. But with the right tools, we do stand a chance.


Teri Rose, MS, LN

CARE Weight Loss & Lifestyle Program