Kelly Anne Spratt, D.O., Director of Women's Cardiovascular Health at the University of Pennsylvania Presbyterian Medical Center, answers your questions.

Q. I am 32 years old, 5 feet 5 inches tall, and over 200 pounds. How or where does one get the motivation to lose the weight?

A. Great question!

Just for the record, this will be one of the most rewarding and yet toughest tasks you will undertake. You are right that the key here is motivation and, for many women, this takes various forms. Some diet to achieve a short-term goal (their sister's wedding, a vacation, etc.) but this often results in gaining the weight right back since this does not involve a realistic lifestyle change. No one can live on a few hundred calories for long or give up cake forever. Let's be real! Keep the changes simple and a few at a time. The reason to do this is to avoid heart and joint disease and diabetes.

Do this for yourself, not for a parent or a spouse. If you are not ready yet, you might put off starting and consider professional counseling to help you understand your personal roadblocks regarding your weight and how to overcome them. When YOU have decided the time is right, be sure to get the help of a nutritionist or respected weight-loss program to help you with the keys towards proper nutrition. Fad diets do not work (I cannot say that enough) and you will need a diet that is balanced and can be followed for life, through dining out and birthdays and special occasions. Make sure that 15 to 30 minutes of daily exercise is included in your plan since this will cut your appetite, help you burn calories even after the exercise is done, and tone up muscles to keep your bones and joints supple.

Don't expect things to change quickly; trying to do too much too fast will result in failure and more self-condemnation. You shouldn't expect, and shouldn't try, to lose more than a half-pound to one pound a week. Keep a food diary to track not only what you eat and when but what you are feeling, since most of us overeat for emotional reasons (sad, angry, frightened, bored) than because we are actually hungry. Try this for two weeks prior to actually starting your diet so your can learn your triggers and have a solution already worked out, so when it happens on the diet you will be prepared.

For real motivation, think of all the complications from a lifetime of being overweight and then decide this is not going to be you.



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