Manage Weight



Learn how to achieve a healthy rate of weight loss.  Assess your body composition with Body Mass Index and Abdominal Circumference measures.  Establish a realistic weight loss goal and estimate how many calories you need.  Tackle the behaviors that are creating barriers to your success by learning the ABCs of behavior change.  Discover strategies for success and learn from the success of others in the National Weight Control Registry. 


How do I assess my body composition?

How does my weight affect my health?

How do I set a realistic weight loss goal?

How do I achieve calorie balance?

How many calories should I eat to lose weight?

Tips for lifelong weight management

How do I control my appetite and hunger?

Emotional eating:  What's my trigger?

How do I take control of my eating?

The ABCs of behavior change:  Changing for good

Weight management:  Strategies for success

Learning from the success of others


How do I Assess My Body Composition?



Step 1.  Determine your Body Mass Index (BMI)

Use this CDC calculator to determine your BMI

http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_caclulator.html


What is a healthy BMI?


Healthy Range:  A healthy BMI is between 18.5- 25 kg/ m2


Underweight:  A BMI below 18.5 kg/ m2 is classified as underweight. Being underweight may increase your risk for amenorrhea, premature osteoporosis, decreased immunity, or reproductive complications.  


Overweight:  A BMI above 25 kg/ m2 is classified as overweight. Being overweight may increase your risk for chronic diseases such as heart disease, type 2 diabetes, and some forms of cancer. 


Is BMI accurate for everyone?

No.  BMI is not accurate for growing children, pregnant women, or individuals with large amounts of muscle mass.  Ask your physician how to assess your body composition if you fall into one of these classifications.

 

Step 2. Measure your abdominal circumference
With a measuring tape, measure the circumference of your abdomen at the level of the navel.

What is a healthy abdominal circumference?
An abdominal circumference greater than 40 inches for men or 35 inches for women may indicate a higher risk for chronic diseases, such as heart disease and type 2 diabetes.

How do I reduce abdominal fat?

To lose abdominal fat, follow a sensible weight loss program that incorporates eating less and exercising more.  Abdominal exercises will train your abdominal muscles but not reduce body fat in the abdomen. 

How does weight affect my health?

Being overweight or underweight can increase the risk of early death and disease. Click here to see a graph.

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Excess body fat may increase the risk of developing many serious medical conditions, such as:

Premature death.  The risk of death rises with increasing weight. 

Heart disease. The incidence of heart attack, congestive heart failure, sudden cardiac death, chest pain, and abnormal heart rhythm is increased in persons who are overweight.  High blood pressure, high cholesterol, high triglycerides, and insulin resistance are also more common.

Diabetes.  Excess weight, especially in the abdomen, may increase insulin resistance and the risk for type 2 diabetes.  Several studies suggest that type 2 diabetes can be prevented or delayed in pre-diabetics by maintaining a healthy body weight and being physically active.

Breast cancer.  Excess weight, especially in the abdomen, may increase the risk of breast cancer in males and post-menopausal women.  Fat cells release the hormone estrogen which may increase the risk for certain types of breast cancer.  Excess weight may also make it more difficult to detect a breast lump through breast exams or mammograms. 

Colon cancer.  Excess weight, especially in the abdomen, may cause the body to produce more insulin.  Insulin may increase the risk for colon cancer. 

Other cancers.  Excess weight may also increase the risk for endometrial, gallbladder, kidney, esophageal, ovarian, and pancreatic cancer.

Sleep apnea and other respiratory problems. Excess fat that is stored around the neck and chest may constrict the breathing airway.  This may contribute to asthma or sleep apnea, a condition where breathing briefly stops during sleep.

Osteoarthritis. Excess weight can increase the amount of stress on the joints, especially the weight-bearing joints such as the knees and hips.  Obesity has also been associated with rheumatoid arthritis but the exact mechanisms are still unclear.

Back pain.  Carrying excess weight, especially in the abdomen, puts added stress on your lower back.   

Gallbladder disease.  Excess body weight, especially in the abdomen, may increase the production of cholesterol in bile.  This can lead to gallstones and gallbladder disease.

Liver disease.  Obesity and type 2 diabetes can increase the risk of fatty liver and injury and inflammation to the liver. 

Reproductive complications.  Excess weight in men and women may make it more difficult to conceive a child.  It may also increase the risk of pregnancy complications for both the mother and the fetus.

Reduced psychological well-being.  Obesity has been associated with mood and anxiety disorders such as depression, bipolar disorder, and panic orders.  It may also affect self-esteem and body image.

Other conditions.  Excess body weight may increase the risk for carpal tunnel syndrome, kidney disease, pancreatitis, urinary stress incontinence, gout, heat injuries, surgical complications, and muscle and joint pain.  It may also impair immune function and wound healing.

Good news! If you are overweight, losing 5-10% of your body weight and becoming more physically active may improve many of these conditions.  This Healthy Living Guide will provide information to help you meet your goals.  You can do it and we can help.

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Losing 5-10% can make a big difference. 

Clinical studies have suggested that a 5-10% loss of total body weight may improve factors such as cholesterol, blood pressure, and glucose tolerance if you are overweight.  This may decrease risk for several chronic diseases including heart disease, Type II Diabetes, and some forms of cancer.  What is a 5-10% weight loss for you?  Make this your initial weight loss goal.

My Current Body Weight ______ ´ 5% = ______ pounds

My Current Body Weight ______ ´ 10% = ______ pounds

Aim to lose ½ - 2 pounds per week. 

A healthy weight loss program should focus on losing body fat while preserving muscle, water, and metabolic rate.   Rapid weight loss is usually followed by rapid weight gain.   How many weeks should it take you to reach your initial weight loss goal of 5-10%?

Initial Weight Loss Goal _____ ¸ ½ lb. per week = ______ weeks

Initial Weight Loss Goal _____ ¸ 2 lb. per week = ______ weeks

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Calories In:  How do I take in calories?

A calorie is a measure of energy.  You take in calories from four sources:

Fat                               9 calories per gram                  Protein             4 calories per gram  

Carbohydrate               4 calories per gram                  Alcohol           7 calories per gram  

 

Calories Out: How do I burn calories?

You burn calories three different ways: 

Resting Metabolic Rate (RMR) is the amount of calories you burn while at rest or sitting quietly without moving.   RMR includes the calories needed for your heart to beat, lungs to breathe, and organs to function at rest.  This accounts for approximately 55-75% of the calories you burn everyday.

Expenditure from Physical Activity is the amount of calories you burn during all activity (writing, vacuuming, walking, etc.)  This accounts for approximately 10-40% of the calories you burn everyday.

Expenditure from Feeding is the amount of calories you burn while digesting food and absorbing nutrients.  This accounts for approximately 5-15% of the calories you burn everyday.

 

How Many Calories Do I Need?

Your calorie needs are determined by your body size, body composition, activity level, and other factors.  Use the guide below to estimate your calorie requirements to maintain your weight.

If you are:

Inactive, multiply your body weight in pounds by 11. 

           Body weight ______ lb. × 11 = _____ calories per day

 

Moderately active, multiply your body weight in pounds by 13.

          Body weight ______ lb. × 13 = _____ calories per day

 

Very active, multiply your body weight in pounds by 15.

          Body weight ______ lb. × 15 = _____ calories per day

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Body fat is stored energy.  If you eat more calories than your body can use, you will store the excess calories as body fat.  In order to lose body fat, you must eat slightly fewer calories than your body needs.  Your body will burn the excess body fat for energy.

How fast can I lose the weight?

Aim to lose ½ - 2 pounds per week.  If you decrease your calorie intake too drastically, your metabolic rate may decrease and your body may burn muscle for energy.  Additionally, rapid weight loss may cause several health complications and can usually not be maintained long term.  

How many calories should I eat to lose weight?

Now that you have estimated your daily calorie needs, you can estimate how many calories you need to lose weight.  Because there are about 3500 calories in a pound of fat, you should eat 250- 1000 fewer calories each day.  This should translate into a weight loss of ½ - 2 pounds per week.

My estimated calorie need: ______– 250 cal = ______  cal/ day

My estimated calorie need: ______– 1000 cal = ______  cal/ day

Be sure to eat at least 1200 calories per day if you are a female and at least 1500 calories per day if you are a male.  This will help your body obtain enough nutrients to stay healthy.

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Calories count.  In order to lose weight, you must decrease your calorie intake.  Be aware that many fat-free or low-carb items are high in calories.  These foods will not result in weight loss if eaten in excess.

Choose lower-fat options.  Fat offers more than twice the amount of calories per gram than carbohydrate or protein.  By choosing lower-fat options, you can naturally lower your calorie intake. 

Fill up on fruits, vegetables, beans, and whole-grains.  These foods are naturally lower in calories and fat.  They are also high in fiber, vitamins, and minerals.  Fill ¾ of your plate with vegetables, fruits, beans, and whole-grains. 

Learn how to eat what you like!  You don’t need to abandon your favorite foods.  Lighten up your family’s favorite recipes.  Eat small amounts in moderation.

Eat regularly.  If you skip breakfast, you will probably overeat at lunch.  Rather than eating 3 large meals, consider eating half of your breakfast mid-morning, and half of your lunch mid-afternoon.

Stay hydrated.  Hunger is sometimes mistaken for thirst.  Drink at least 8 (8 oz.) glasses of water every day.

Control your portion sizes.  Try eating 25% less at every meal.  The calorie savings will quickly add up!

Get moving!  Aerobic exercise can help you lose more fat.  Resistance training can help preserve your muscle and metabolic rate.

Listen to your body.  Stop eating when you are no longer hungry.  Don’t eat until you are uncomfortably full or stuffed.

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What is appetite?

Appetite is a psychological feeling.  For example:

     “Even after a large meal, I still want dessert.”

     “When someone mentions a food I love, I feel like eating.”

     “When I drive by a restaurant, I want to eat.”


How can I control my appetite?

Distract yourself:  Ignore the craving by going for a walk, calling a friend, or engaging in some other type of activity.

Confront the craving:  Imagine the food is trying to tempt you.  Argue with it and say why you will not give into the urge.

 

What is hunger?

Hunger is a physical feeling.  Hunger cravings develop when you have not eaten for several hours or skip a meal.  Your stomach is empty and telling you that it is time to eat.  For example:

     “I have a gnawing feeling in my stomach.”

     “I feel light headed after not eating for hours.”

 

How can I control my hunger?

Eat 5-6 small meals per day.  You’ll keep your energy level constant and may prevent overeating.     

Avoid skipping meals.  The deprivation will lead to binging later on.

Balance your meals and snacks.  Include carbohydrate, fat, and protein because they release energy at different intervals.

Bulk up with plants.  Fiber-rich foods, fruits, vegetables, and water fill you up without a lot of calories.

Limit sugar.  You’ll stabilize blood sugar and feel satisfied longer. 


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What is emotional eating?

Emotional eating occurs when you eat not because you are hungry but because you are trying to deal with emotions.  These emotions may include anger, boredom, stress, happiness, loneliness, or sadness. 

 

How can I deal with emotional eating?

Keep a food record for 3 days.  Write down what you ate and why you ate it.  For example, were you hungry?  Happy or sad?  Bored or stressed?  Once you find your trigger, try these suggestions:

Ask yourself, “Am I really hungry?” Before you sit down to a meal, make sure that your body is really hungry.  If you do not sense any physical hunger, then you may be eating in response to other factors, such as boredom, anger, or loneliness.

The next time you feel…

Happy, excited, or proud you could tell someone, call or visit a friend, go for a walk, or reward yourself with a small gift.

Sad, discouraged, or lonely you could confide in a friend or family member, look through photo albums, go for a walk, or do something nice for someone else.

Nervous, worried, or stressed you could call a friend, breath deeply, clear your head, listen to soothing music, take a yoga or relaxation class, get a massage, pray, go for a walk, or try to write down possible solutions to your problems.

Bored you could exercise, read a book, volunteer, clean the house, or take up a new hobby

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Make healthier choices at the supermarket.

Shop on a full stomach.  If you go to the store hungry, you are more likely to make impulse purchases, like chips and cookies.

Shop from a list.  And stick to it!  Plan your meals ahead and buy only the necessary ingredients.  If you don’t want to eat a certain food, don’t bring it home.

Buy foods that require preparation.  High-calorie convenience foods can be very tempting when you are hungry. You may be less likely to overeat a batch of cookies if you have to take the time to prepare them yourself. 

Buy ready-to-eat fruits and vegetables. When you need a quick snack, keep healthy options the most convenient.  You’ll be more likely to grab them first.

 

Make healthier choices at the table.

Serve smaller portions.  Don’t eat from large portions of food or keep serving dishes on the table because you will be more likely to overeat.  You can always get more if you are still hungry.

Slow down.  Try putting your fork down in between bites and taking the time to enjoy your food.  Wait a few minutes to get another serving if you are still hungry. 

Leave the table after eating.  Again, this will avoid overeating and will keep you from feeling stuffed after a meal.  If you are dining with family or friends, move the conversation to another location, such as the living room.

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How do I change an unwanted behavior?

First, identify what happens before, during, and after the behavior.

Antecedents include thoughts, actions, events and situations that happen before the behavior and contribute to the behavior.

Behavior includes the actual activity itself as well as thoughts, situations, and events that occur during the activity. 

Consequences include feelings, thoughts, and actions that occur after the behavior.  Many times the consequences of a negative behavior cause the behavior to be repeated again.

Example:  Learning from Cheryl

Cheryl was home one Friday evening watching television because she was bored.  She saw a commercial for potato chips and suddenly felt a snack craving.  She went into her kitchen and grabbed a bag of potato chips.  Cheryl ate the chips very quickly, without really tasting each one.  Soon she looked down and the entire bag was empty.  Cheryl had eaten until she was very full and felt guilty about what she had done.  

Let’s help Cheryl determine what went wrong:

Antecedents (Before)

Behavior (During)

Consequences (After)

Cheryl did not occupy herself when she was bored.

Cheryl ate when she wasn’t hungry.

Cheryl ate until she was uncomfortably full.

Cheryl kept potato chips in the house when she was trying to eat less.

Cheryl ate out of the bag rather than giving herself a small portion.

Cheryl felt guilty about overeating.

Cheryl did not keep healthier snacks in the house that she could have substituted.

Cheryl ate while watching TV and didn’t focus on her eating.

Cheryl decided that weight loss was too difficult and she decided to give up.

 

What could Cheryl do to prevent this behavior in the future?

Antecedents (Before)

Behavior (During)

Consequences (After)

Cheryl could read a book or call a friend.

Cheryl could realize when she isn’t hungry and tell the urge she won’t give in.

Cheryl could stop eating when she is no longer hungry.

Cheryl could hide the potato chips in the back of the cabinet or not buy them.

Cheryl could give herself a small portion on a plate and put the package away.

Cheryl could tell herself that she ate a healthy diet all week long and is allowed a small snack.

Cheryl could keep her kitchen stocked with healthier snacks like fruits & vegetables.

Cheryl could slow down her eating rate and eat at the table rather than in front of the TV.

Cheryl could realize that weight loss is a marathon, not a sprint.  She must take one day at a time.


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Think small!

Shrink it!  Use smaller plates, bowls, and glasses.   Don’t eat from large containers (such as the potato chip bag).

Split it!  Split a restaurant meal with a friend or carry half of it home if it is too large. 

Beware!  Use warehouse clubs with caution because larger portions encourage larger servings. 

Pay attention!  Teach yourself to stop eating when you are no longer hungry, not when your plate is empty.


Change the number of choices!

Scan your options!  At buffets or cafeterias, briefly scan all of your options and select a couple of items.  Don’t feel pressured to try everything. 

Use variety to your advantage!  To encourage your family to eat more fruits and vegetables, give them a large variety.  For example, serve fruit salad or mixed vegetables instead of a single item. 


Eat more!

Try mini-meals!  Rather than eating a large breakfast (cereal, milk, banana, orange juice, and a small muffin), eat the cereal, milk, and banana at home.  Bring the orange juice and muffin to work or class for a mid-morning snack. 

Start with breakfast!  Try whole-grain cereal, low-fat milk, and fruit.  Or grab a container of 100% juice and whole-grain muffin on your way out the door.  Not hungry in the morning?  Don’t eat late in the evening and your hunger will surely return come sunrise.

Plan snacks!  Plan healthier snacks and include them throughout the day.  You’ll be less likely to hit the vending machine or overeat later.

Fill your dinner plate!  Fill half of your plate with vegetables and fruits.  Include whole grains and lean protein on the other half.


Get moving!

Don’t just sit there!  Aim to decrease the sedentary activities in your life, such as television viewing and sitting for long periods of time. 

Write it down!  Schedule exercise into your day and make it a priority. 


Dine smart!

Make smart choices!  If you dine out frequently, look for healthier options and watch portion sizes. 

Cook at home!  Learn how to cook healthy meals at home, even lightening up your restaurant favorites.


Watch the TV trap!

Set a limit!  Try to limit television, video games, and internet surfing to less than 2 hours per day. 

Scan the listings!  Scan the television program listings at the beginning of the week and select one or two shows that you would really like to see.

Slow down on soda!

Drink smarter!  Reach for thirst quenching water first.  Fruit juice (100%), low-fat milk, apple cider, and herbal tea are also good choices. 

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The National Weight Control Registry (NWCR) tracks the habits of individuals who have lost 30 pounds or more and kept if off for at least one year.  According to the NWCR, individuals who successfully maintain their weight loss share these characteristics:

 

Weigh regularly.  Consider weighing yourself no more than once per day and no less than once per week.  Try to weigh yourself at the same time of day and on the same scale.  Realize that your body weight will fluctuate throughout the day and changes may be occurring that are not reflected on the scale.

 

Monitor food intake frequently.  Consider writing down what you eat, how much you eat, and when you eat.  More detailed records may include where you eat and how you are feeling when you eat.

Eat breakfast regularly. The majority (78%) of NWCR participants eat breakfast every day of the week.  In addition, participants who eat cereal or grains for breakfast have lower Body Mass Indices (BMIs) than participants who eat meat or eggs or skip breakfast all together.

Consume a lower-fat diet.  NWCR participants consume about 24% calories from fat to lose weight and maintain their weight loss.  Lower-fat diets can fill you up without a lot of calories. 

Are physically active on a regular basis.  Approximately 90% of those who maintain their weight losses are physically active.  Walking is the most preferred form of exercise.  Physical activity may help manage weight, decrease appetite, and maximize motivation with a healthy lifestyle.

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