The role of appetite-related hormones, adaptive thermogenesis, perceived hunger and stress in long-term weight-loss maintenance: a mixed-methods study

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LI couple share dramatic weight-loss story on 'Rachael Ray'

A Long Island couple appears Tuesday on cooking and lifestyle maven Rachael Ray's namesake syndicated TV show, airing locally on WABC/7 at 2 p.m., to showcase their serious weight loss and current regimen.

Gregg Casarona, 34, who was born and raised in Smithtown and now lives in Centereach, lost 220 pounds over the course of five years, halving his maximum weight. Shayna Mulhall, 26, who was born in Stony Brook and grew up in Ronkonkoma, where she still lives, had hit 193 pounds and shed 50. In the wellness-focused episode, shot on Jan. 22, they meet with Ray and guest co-host Bob Harper from USA's weight-loss competition "The Biggest Loser," and describe their successful dieting strategy.

"I created a weight loss program called Fat-to-Fit Fridays," Casarona tells Newsday, "which was a calorie-tracking diet that gave you a short-term goal of two weeks to maintain a certain calorie limit. And then on that Friday you were allowed to eat whatever you wanted for dinner. Then you had to reduce your total calories by a hundred for the next two weeks. So for my first two weeks, I ate 3,500 calories [daily], I went out to eat dinner on Friday, whatever I wanted, then starting that Saturday, I did two weeks of 3,400 calories."

He repeated the pattern, dropping a hundred daily calories every two weeks, until leveling off at 2,200.

When he and Mulhall began dating roughly two-and-a-half years ago, she took up that diet as well. "It was pretty awesome in making me not want to slip up," she says, "because getting a little bit of a break from being so disciplined allowed me to have a little bit of the things I crave." She found that eventually her nutritional habits changed, and that "when you go to the things you thought you were craving, you realize they don't taste as good as you thought they were going to."

Casarona — who had appeared on TLC's "Sex Sent Me to the ER" in 2013 for a story on how his then 434-pound frame in 2009 had injured his girlfriend at the time — says he works in law enforcement for a state agency. Mulhall is a legal secretary.

"The biggest thing I try to tell people," Casarona advises those struggling with weight, "is that you need to create small goals toward the bigger goal. It's more mental than physical."

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By Frank Lovece Special to Newsday

How to lose weight and keep it off in a healthy, effective way

To lose weight at a healthy pace, aim to lose around 0.5% to 1% of your body weight each week. 

Some helpful eating tips include swapping out processed foods for whole food options and replacing refined grains like white rice with whole grains like old fashioned oats.

Eating slowly may also help you lose weight, as studies show that this makes participants consume less.

This article was reviewed by Samantha Cassetty, MS, RD, nutrition and wellness expert with a private practice based in New York City.

Visit Insider's homepage for more stories.

For 71.6% of American adults who are overweight or obese, weight loss is a healthy goal to strive for, but it is often difficult to maintain. And researchers have found that most people who lose weight regain some, or most, of that weight in two to five years. So, what is the healthiest way to lose weight and keep it off?

Insider spoke with registered dietitian Brian St. Pierre, Precision Nutrition's Director of Performance Nutrition, about how to lose weight and keep it off through diet and patience. 

What is a healthy rate of weight loss

Of course, the amount of weight you lose and how quickly you lose it largely depends on your starting weight. 

"Fat loss is often faster when first starting out and when you have more body fat to lose," St. Pierre says. Adding that "in general, research shows that making some strong initial progress out of the gate leads to increased motivation and then continued loss. However, it's not all-or-nothing. Slow and steady can win the race too."

Whether you're interested in the slow-and-steady method or you're looking to lose weight more quickly, there's a point when it becomes too much, too fast. That point is when you're losing more than 1.5% of your body weight per week, says St. Pierre. 

Therefore, a comfortable, slow-and-steady, pace would be if you lost about 0.5% of your body weight per week. Whereas a more rigorous, but still reasonable, pace would be to lose 1% of your body weight.

To put that into perspective, for a 180-pound person trying to lose 40 pounds, this means if they lost:

0.5% of their body weight per week consistently, it would take 50 weeks for them to reach their goal weight of 140 pounds.

0.75% of their body weight per week consistently, it would take 34 weeks.

1% of their body weight per week consistently, it would take 25 weeks.

In reality, it's unlikely that a person can lose weight so consistently, so it may take longer. That's because "the leaner one becomes, the slower the rate of loss becomes, with more frequent plateaus," says St. Pierre. 

Moreover, the hormones that control your hunger, like leptin and ghrelin, will become unbalanced as you continue to lose weight, which can make you feel hungry more often.

That's why "it's also important to realize that fat loss is seldom linear. It fluctuates from day to day and week to week. The goal is to see an overall trend downward over time."

How to track weight loss

Since weight loss is not linear, tracking your progress may be tricky. Of course, one of the simplest ways to track your weight is to hop on the scale each morning. 

A small 2015 study published in the Journal of the Academy of Nutrition and Dietetics found that participants who weighed themselves daily for 6 months lost more weight than people who weighed themselves about every 5 days.

"However, if weighing yourself makes you feel anxious, or you attach your 'goodness' or 'badness' to your weight then it may be more beneficial to weigh yourself less frequently, and use other outcomes measures such as your fitness, strength, energy, how clothes fit, etc.," says St. Pierre. 

Focusing on your behaviors rather than the outcomes is likely to be more effective and potentially less stressful.

What to eat to lose weight

St. Pierre recommends focusing on basic nutrition principles rather than a specific diet plan such as keto, Mediterranean, Paleo, vegetarian, or otherwise. 

Instead, follow the basics of a healthy diet. This requires that you take a look at your diet and see what you should, and are willing, to change. Let's say, for example, your daily diet looks like this:

35% of your daily caloric intake comes from processed meats like bacon, deli meat, and frozen dinners.

35% of your daily caloric intake comes from refined grains and sugar like breakfast cereals and pre-sliced bread.

30% of your daily caloric intake comes from fruits and vegetables.

St. Pierre says it's important that, in order to lose weight, you should eat mostly minimally-process foods. For example, limit processed meat like bacon and eat more veggies. Or replace refined grains, like instant oatmeal, for whole grains like old fashioned oats.

A 2019 study in Cell Metabolism related to the consumption of processed foods shows that even when calories and macronutrients are presented, eating processed foods resulted in overeating and weight gain.

St. Pierre also says to incorporate more vegetables than you're probably including right now. So an updated daily diet for you may start out looking like:

Change 35% of your daily caloric intake from processed meats to 35% of leaner meats like seafoods and chicken.

Change 35% of your daily caloric intake from refined grains and sugars to 25% whole grains and natural sugars.

Boost the 30% of your daily caloric intake from fruits and vegetables to 40% with the ultimate goal being around 50%. 

You could start achieving this by identifying swaps for certain meals, like replacing a breakfast biscuit with an apple and some peanut butter, or having a side salad for lunch instead of fries. 

How to eat to lose weight

St. Pierre says that it's important for you to eat your meals slowly until you're satisfied. He's not the first person to offer this advice. 

A 2015 review, in the journal Physiology & Behavior, of 22 studies found that people who eat their meals more slowly tend to consume less calories compared to people who eat more quickly.

Another small 2008 study, published in the Journal of the American Dietetic Association, found that the 30 female participants consumed less and drank more water during a meal when they were instructed to eat more slowly. 

How to deal with hunger when losing weight

Hunger is an issue when losing weight and can derail your progress if not well managed. "There will often be some level of hunger when losing weight, yes. But you should not be ravenous or constantly hungry," says St. Pierre.

When it comes to dealing with hunger, everyone is different. Finding the balance that works for you is best. And discovering new ways to cook and eat can help you manage hunger more effectively.

"Ultimately, it's about following whichever approach you enjoy and can follow most consistently," says St. Pierre.

No matter what method you choose, remember that there will be good days and bad days.  

"It's not about perfection, it's about doing the best you can, wherever you are, with whatever you have," St. Pierre says "Sometimes you can crank that dial to 10, and sometimes it can only be at a 2 or 3. That's ok, any step along that dial can create meaningful change and progress. The key is to always keep it above 0!"

Walking or Running, Here's How Long You Should Hit the Treadmill to Actually Lose Weight

© Getty / skynesher Walking or Running, Here's How Long You Should Hit the Treadmill to Actually Lose Weight

Cardio is a key piece of the puzzle when you're trying to lose weight, and you have lots of options to choose from. One classic, popular choice is the treadmill: easy to use and accessible if you have a gym membership or a machine in the basement. But although it's easy to just hop on and run, you want to be strategic if you're looking to drop pounds.

The treadmill "can be an extremely effective tool for building aerobic capacity, burning calories, and developing your fitness level," said Lee Wratislaw, NASM, CPT, a GOLD's AMP trainer for Gold's Gym. So what kinds of treadmill workouts should you do, and just how long do you have to spend on it per session to see results?

How Long Should I Work Out on the Treadmill to Lose Weight?

How long you spend on the treadmill depends on whether you're doing high-intensity interval training or a steady-state workout. Both are effective for weight loss, Lee explained.

"HIIT training sessions, comprised of shorter bursts at higher speeds followed by periods of active recovery or complete rest, are perfect ways to burn more calories in a shorter amount of time," Lee told POPSUGAR. This has to do with EPOC, or excess post-exercise oxygen consumption, a high-metabolism state your body enters after intense exercise, in which the increased amount of oxygen requires increased energy and calorie burn. Though EPOC won't last for hours (and, contrary to popular belief, doesn't burn hundreds of calories), it's still an added benefit of choosing a HIIT workout when you're on the treadmill. For these types of workouts, you'll want to keep it short: Lee recommended 20 minutes.

Steady-state treadmill workouts can last a little longer. Try 30 minutes for a moderate-intensity workout like light jogging, or 40 minutes for low-intensity walking. "Steady-state training is best for building aerobic capacity, or the body's ability to efficiently use oxygen for exercise," Lee said. You'll increase your cardiorespiratory fitness, he explained, which will help you run or walk farther and faster in time, ultimately helping you lose weight.

These recommendations are a good starting place, but you should always base the time and speed of your treadmill workout on your current fitness level. If you're a beginner, Lee recommended focusing just on steady-state workouts at first. Start at a speed you can comfortably maintain for at least 20 minutes while maintaining your form, so you feel challenged but not like you're about to lose your balance or fall off the machine, he suggested. Once you get used to the machine and can speed up a bit, you can start challenging yourself with HIIT workouts.

Weight-Loss Treadmill Workout Plan

For the most effective weight-loss plan, Lee said, combine treadmill cardio workouts with strength training. Here's what a sample five-day week of workouts could look like:

Monday: 20-minute treadmill HIIT session (you can shorten this 30-minute treadmill workout)

Tuesday: 45-minute full-body strength workout

Wednesday: 30-minute moderate-intensity steady-state running session

Thursday: dumbbell resistance workout

Friday: 40-minute walking session

Don't forget to incorporate chiller movement on your rest days (like this 30-minute yoga flow) and healthy eating (we recommend this two-week clean eating plan) to see the best weight-loss results.

Video: 7 incredible results you'll get from walking 30 minutes a day (Courtesy: Prevention) 

Click to expand

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What are smoothies help you lose weight fast and safe for health?

Nutrition plays a very important role in the process of weight loss. Using smoothie to lose weight is a smart choice to safely reduce excess fat quickly and effectively.

Do not add sugar, milk to weight loss smoothies or juices in general. Because in many fruits already have a certain amount of sugar to provide energy for the body. Adding sugar will cause the body to accumulate sugars, which will be converted into belly fat.

No eating, drinking, bluffing. If you keep relying on vitamins to lose weight and eat bluff will make the process of weight loss ineffective but also cause weight gain. Fat will accumulate more in the abdomen, thighs, calves ...

Not only do you use smoothies for absolute weight loss, you need to know the amount of nutrition in the day. Using too many vitamins without tolerating other foods will cause you to have many negative consequences for the body.

Need to balance using vitamins to lose weight with exercise. This will help the body to reduce excess energy, to avoid accumulating excess fat. In addition, using vitamins will help provide the body with abundant protein and fiber, preventing many diseases.

Do not use weight loss smoothies for people with peptic ulcer disease, acute or chronic gastritis, people with allergic ingredients in fruit smoothies, and people with weak kidney and liver.

These vitamins help you lose weight quickly at home 1. Avocado smoothie effective weight loss

Avocado is high in unsaturated fat, contains no cholesterol and is very rich in potassium, so it is extremely good for the human cardiovascular system. Avocado also contains vitamins A, C, iron, magnesium and a range of other nutrients. To be able to prepare a delicious avocado smoothie for weight loss, there is nothing better than mixing butter with yogurt.

Using yogurt butter smoothie will significantly reduce your weight because it helps to fill for long, reduce cravings. From there you will get the desired waist and a healthy body. Use avocado smoothies in the morning daily and replace breakfast.

2. Oat smoothie for quick weight loss

Oats are one of the grains that contain lots of fiber and protein, minerals like magnesium, zinc, iron, copper, and manganese. It is also rich in B vitamins and powerful antioxidants.

However, oats contain very few calories, very suitable for women who want to lose weight quickly. Mixing oat smoothie for weight loss helps you feel full for a long time but without excess, it has the effect of beautiful skin. You can use oatmeal for breakfast, still ensuring the energy needs of the body.

3. Pineapple smoothie for safe weight loss

Pineapple is one of the most used weight loss fruits. Pineapple smoothie is both delicious and rich in vitamins A and C, and is available with sugar to help fuel the body, creating a feeling of fullness. Pineapple also provides the body with potassium, sodium and a few other essential minerals.

The women use pineapple smoothie regularly will bring slender physique, fresh skin. Pineapple should be used after a meal about 15 to 30 minutes to benefit the digestive system and reduce the body's ability to absorb sugars and starches.

Watch next: GREEN SMOOTHIE RECIPE FOR WEIGHT LOSS

4. Spinach smoothie to lose weight quickly

Spinach or spinach is a vegetable that contains a lot of fiber, vitamins A, C and E, proteins necessary for the body to help increase resistance and support extremely effective weight loss. In addition, spinach also contains essential minerals such as iron, magnesium, calcium and extremely rich in potassium, which is good for the cardiovascular system.

Spinach you puree or accompanied with a little vegetables to make it easier to drink. Spinach smoothie used regularly after about 30 minutes after meals will help the body prevent the absorption of starch and sugar, thereby good for your weight loss.

5. Tomato smoothies help slim waist

This is a very effective weight loss smoothie because it is low in sugar and low in calories and extremely high in fiber. The content of vitamin A, vitamin C and B vitamins is extremely abundant and good for health. Tomato smoothies will help prevent the body from absorbing excess fat, providing energy and water for your skin.

Use tomato smoothies, the best time is after breakfast, this time the body will absorb vitamins easily, the body will feel full and still have enough nutrition.

6. Spinach smoothie with flax seeds

This is a mixed smoothie between spinach and flaxseeds that has many health benefits as well as supports weight loss effectively. Just combine spinach with 1 spoon of flax seeds, chia seeds a day, you will have enough amount of fiber, vitamins A, C, E and minerals like iron, magnesium, potassium, ... for the body without being many calories, do not worry about accumulating body fat. You can use this smoothie after eating to achieve the best effect on belly fat reduction

Watch next: My Top 3 Weight Loss Smoothie Recipes

A new kind of weight loss approach helps people deal with self-loathing instead of just ignoring it

Weight stigma is associated with depression, anxiety, binge eating and even increased risk of cardiovascular disease.

A new study found positive results in helping people grapple with their internalized self-loathing, along with traditional weight loss methods.

While it might seem contradictory to tell people to accept themselves as they are while losing weight, study authors found that increasing acceptance actually made people more open to changing.

Visit Insider's homepage for more stories.

When Aaron Thompkins got on the plane, someone else got off. 

Thompkins was on his way to California, to participate in the filming of season 10 of The Biggest Loser, a reality show dedicated to competitive weight loss. 

"I was over 400 pounds at that point," Thompkins said. "We were about to take off, and this guy was so upset that he had to sit next to me." 

The man got up, complained to a flight attendant, and got off the plane. 

"He said nothing to me, but I remember I put my head down," Thompkins said. "I always think back on that moment, and think I should've just said something, but I didn't. I put my head down and I was so ashamed that I didn't want to bring more attention to myself and the situation."

Thompkins got sent home from The Biggest Loser during the eighth episode. He was nervous entering the airport, hoping there wouldn't be another incident. "I was scared that whole scenario was going to happen all over again, where somebody was going to be mad because they were sitting next to me," he said.

This sort of internalized weight stigma which emerges from public fat shaming is common for fat people, and is associated with some serious health outcomes, from depression to anxiety to binge eating and even increased risk of  cardiovascular disease.

But a new study — led by former Weight Watchers consultant and current Assistant Professor of Psychology at the University of Pennsylvania Rebecca Pearl — experimented with a newer method of weight loss, where people are encouraged to accept themselves, even as they try to change their bodies.

Study participants who received 'stigma reduction intervention' were less likely to hate themselves because of their weight

The study divided participants into two groups.

One group received a typical weight loss management program, with the usual cooking tips and recipes, while the other received a specialized "stigma reduction intervention," along with the typical weight loss management program. The stigma intervention used gave participants the skills to cope with self-hating thoughts, experiences where they are treated badly due to their weight, and increase feelings of self and body acceptance.

In the screening process, applicants had to confirm to a psychologist that their weight negatively affected how they felt about themselves. They were only eligible for the study if they reported a history of being bullied or discriminated against due to their weight. 

Crystal Cox/Business Insider

For 12 weeks, participants attended regular group meetings. At the end of the six month study, participants filled out surveys with self-evaluating questions like "I am less attractive than most other people because of my weight" and "I hate myself for being overweight."

The second group was less likely to hate themselves due to their weight compared to participants who only received weight loss treatment. While it may sees obvious that a comprehensive approach to weight loss would involve tackling people's mental health as well as their physical health, this is the first study with proof that advocating for a weight loss management routine involving mental health treatment is beneficial .

The study was conducted on 72 participants, 84% of them female, and 66% of them black. (That the study was conducted on a majority of black women was unintentional. Pearl recruited her participants in West Philadelphia, where there is a sizable black population.)

 All participants had a body mass index of 35 or higher. The BMI cutoff for obesity is 30. 

The study told participants to accept their bodies while encouraging them to lose weight

"Acceptance and change might seem to be on opposite poles, but actually what we find is that by increasing acceptance, we can also open up people for change and vice versa," Pearl told Insider. 

In designing the study, Pearl drew on the work of Dialectical Behavior Therapy developer Marsha Linehan, with phrases like "I can accept and love myself as I am right now, while also working to change my health behaviors and lose weight to improve my health."

Some participants told Pearl they almost felt guilty because, as feminists, they knew that they should love themselves for how they were, but wanted to lose weight for health reasons. Many participants told Pearl they wanted to lose weight to lower their blood pressure and run around with their grandkids, not to look a certain way.

"I've certainly talked to researchers and clinicians who worry that if we promote too much body acceptance, or focus too much on reducing stigma, that people will get the message that it's accepted, or that people will feel less motivated to want to change their health behaviors or lose weight," Pearl told Insider.

Though Pearl's study used traditional weight loss methods, it also used aspects of Health At Every Size philosophy, which espouses intuitive eating, giving up diets and accepting bodies as they are. 

The study was limited in its small size and short duration, especially given that research shows many diets don't work in the long term. Pearl is currently recruiting for a 16-month version of the study with more participants, hoping to repeat the same results.

The study was funded by Weight Watchers, and three of the study authors were former Weight Watchers consultants, but Pearl says Weight Watchers was not involved in the study design at all. 

One expert was impressed that this study found a happy medium between the two extremes of diet and self-acceptance

Charlotte Markey, a Professor of Psychology at Rutgers University who wasn't involved in the study, said she isn't too concerned about the Weight Watchers connection.  Markey told Insider she feels the study's weight loss method exists in a happy medium between the anti-diet Health At Every Size movement and traditional diet culture — which Health At Every Size was created to combat. 

"In this area of research too many people have taken sides," said Markey. "You're either pro self-acceptance, just love yourself as you are, it doesn't matter if you have type two diabetes, or you're pro-weight loss, because we have this accumulation of research suggesting that it would benefit people's health in some cases."

But Markey pointed out that you'd have to ignore a lot of research to say that weight and health aren't at all linked, and that some people would benefit from weight loss. If you think you have to beat yourself up in order to lose weight, however, Pearl's study suggests that isn't the best approach. 

"Consider having a little self-compassion while working on improving health behaviors," said Pearl.

The Biggest Loser also offered therapy, even though it wasn't often shown onscreen

During Thompkins' time on The Biggest Loser, the contestants were taken to an upscale community pool to swim.

"That was probably the most overweight people that pool has ever seen in their entire lives come out all at once," he said. "I told them 'I do not take my shirt off for anybody, I'm not going to do this.'" 

But seeing everyone else strip down to their bathing suits, Thompkins did as well. Watching all those people out there that day, proudly splashing around in bathing suits on camera, Thompkins stopped being embarrassed for a moment.

He chalked that growth up to the therapy the show offered, even if wasn't shown onscreen very often.

"When it comes to weight, there's a mental part of it that you've got to try to figure out and work through," he said. "It's about figuring out why you're doing the things you're doing." 

Read more:

Many thin people have no idea what it really takes to lose weight

Why you should think twice before complimenting someone's weight loss

5 things the weight loss industry doesn't want you to know

If You're Trying to Lose Weight, Stop Doing These 5 Things

© POPSUGAR Photography / Nicole Perry If You're Trying to Lose Weight, Stop Doing These 5 Things While some have tried pretty shocking techniques to lose weight, there are also some common, long-held techniques that seem like a good idea - and may even work at first - but are absolutely going to backfire and end up causing weight gain. If you're on a quest to a slimmer you, avoid doing these five things.

Having a Cut-Off Time For Eating

If you've heard that you shouldn't eat past 6, 7, or 8 p.m. in order to lose weight, that's just not true. Food eaten at night doesn't automatically get stored as fat, as previously believed. What time you stop eating has nothing to do with how much weight you'll gain or lose - it's the total calories you consume in a day that matters. If you are a late-night snacker, opt for healthier options that are easy to digest.

Deprivation

Whether it's all carbs, all gluten, all sugar, all baked goods, or all whatever, certified dietitian Leslie Langevin, MS, RD, CD, of Whole Health Nutrition believes this is not a life your pizza-ice-cream-pasta-loving self can sustain. After a period of forced deprivation, most people will just throw in the towel and devour an enormous plate of whatever they're living without, says Langevin. Or, if they are able to go through a period of elimination, once they go back to eating these foods, the weight they lost will slowly creep back on. When it comes to maintaining weight loss, moderation is key.

Subscribing to a Low-Fat Diet

Going no fat or low fat was a huge trend back in the '90s, a fad that we are glad has mostly passed. Most low-fat foods are packed with sugar to add flavor, and as a result, they end up causing weight gain - especially belly fat. Also of importance is that we've since learned that eating healthy fats like avocado, olive oil, and nuts can actually help to increase metabolism and can burn away belly fat. Healthy fats also fill you up longer, so go ahead and add nuts to your smoothie, avocado to your soup, or roast your veggies in olive oil.

Skipping Out on Meals

In order to lose weight, you need to create a calorie deficit. And while reducing the number of calories in your diet is one way to do this, skipping an entire meal is not the way to go. Starving the body can slow down its metabolism and lead to overeating later. And let's face it, if you're running on empty, you won't have the energy for a calorie-crushing workout later. Beyond adopting a healthier diet in general, the best way to reduce your calorie intake is to find ways to make healthy swaps in your favorite foods and also by choosing lower-calorie foods that are high in fiber, protein, or whole grains, which can better keep you full.

Only Exercising

Working out is definitely part of the weight-loss equation, but if you think it means you can eat whatever you want, you're not going to be happy with the results. Keep in mind that a 30-minute run at a pace of six mph (10 minutes per mile) burns about 270 calories. In order to lose a pound a week, you need to burn or cut out 500 calories a day. So that means coupled with your 30-minute workout, you still need to cut out 220 calories from your diet, which most likely does not translate to eating everything in sight. Research actually proves that "abs are made in the kitchen," which means that what you eat - focusing on eating healthy portions throughout the day - can be even more important than how much you work out.

Video: Could intermittent fasting help you live longer? (Provided by Buzz60) 

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