Bowl of vegetables

Eating and Exercising for Life

How to make lasting lifestyle changes
Author: Sarah M. Aldridge, MS

Dieting is not a dynamic way to lose weight. Those fad diets soon fade as dieters discover that eliminating certain foods can cause cravings. That’s because we need some fats, carbs and proteins for bodily functions to run smoothly. “There’s a lot of discouragement connected with the word ‘diet,’” says Tina Willis, MA, RD, registered dietitian at the Indiana Hemophilia & Thrombosis Center in Indianapolis. “A healthy lifestyle is more manageable and less intimidating for people than a diet.”

Making healthy lifestyle changes is easier than you think. If you need to lose weight, you’ve got a ready source of support. There are nutritionists and dieticians, physical therapists and nurses at your hemophilia treatment center (HTC) who can help you.

Why diets don’t work

Dieting may seem like a good idea. After all, people do lose weight that way. Staying power, though, is another story. “When people go on a diet, it’s usually a drastic change from the way they normally eat,” says Willis. Changing what you eat and how much you eat during a very short period can doom you to failure. “When you try to change a habit that quickly, it isn’t going to stay for long,” she says. You miss the foods you used to eat, and wind up overeating when self-control is weak. The yo-yo effect is all too common. Chronic dieters lose weight, then regain it when they revert to former eating patterns.

Facing reality

The first step to healthier eating in the future is cataloging what you take in now. “If you’re not fully aware of what you’re eating, it’s hard to make changes,” Willis says. When she meets with patients, together they review not only what they currently eat, but also what they drink. “The #1 area I look at first is beverages. Many people drink a lot of beverages with sugar, which have a lot of empty calories,” she says. That one soda at the diner may actually grow to three or more, if you factor in the endless refills, she cautions.

Grazing, snacking here and there throughout the day, might seem healthier than eating three large meals daily. But even healthy snacks can add up, says Willis. “To me it’s important to know if they’re snacking on foods that are sweet or salty, then I can make some substitutions.”

Meals also matter. Willis accumulates food facts on her patients by asking questions: Are they big breakfast eaters? When they cook at home is it from scratch or do they used boxed meals? Do they eat fruits and vegetables? How often are fried foods eaten? With this detailed food history, Willis can then make recommendations. “I start with one or two areas. When they get some success, then I build from there,” she says.

Portion distortion

Portion sizes have grown so large that most of us don’t have a sense of what a regular size should be. For instance, you get a lot of bang for your buck at the drive-thru, but you also get a lot of calories. In the past 20 years, French fries have super-sized from 2.4 ounces and 210 calories to 6.9 ounces, packing 610 calories, according to, a US Department of Agriculture (USDA) website. That breakfast muffin was once a reasonable 1.5 ounces and 210 calories; now it’s more than double the size and calories, averaging 4 ounces and 500 calories. Beverages are also to blame. “A large drink was 12-18 ounces; now it’s 32 ounces or more,” Willis says.

Sit-down restaurants also have increased the size of their menu items. Even the plates are larger these days. For example, ½ cup of rice, the typical serving size according to Willis, looks tiny on a large plate. No wonder we’re often served enough carbs to feed a family of four.

The exercise element

Because activity boosts your metabolism, the best way to lose weight is to combine it with an exercise program. Exercise builds lean body mass. “Lean body mass is more metabolically active than fat mass, so it will increase your metabolism somewhat,” says Willis. Plus, being active helps your heart, lungs and gastrointestinal systems work more efficiently, she says.

But watch out for excuses. Some patients tell Willis, “I eat healthy and my weight is good, so I don’t need to exercise.” Not so, she says. “They really perform two distinct, different functions. Both are necessary.” Or she hears patients say, “I exercise a lot, so I don’t need to eat healthy.” That’s a fallacy, says Willis. “When you’re eating a healthy diet, it gives your body the fuel it needs to do daily activities.”

For people with a bleeding disorder and joint issues, exercise is still possible. “A physical therapist can help them modify, so they can help achieve their exercise goals,” Willis says. Weight loss benefits your joints. Being overweight taxes your joints, which can increase your risk for bleeds, says Willis. “It can also increase your risk for arthritis.”

Successful strategies

One successful strategy for a healthier lifestyle is goal setting. (See Sidebar, “Healthy Eating and Exercising Tips.”) “Goals should be specific and they should be measureable,” says Willis. And they should be in writing. ”If you write them down, you’ve gone one step further in making the commitment.” It’s better to aim for a 5-pound weight loss this month by reducing your daily soda consumption from 4 cans to 1, than to decide to simply lose some weight, she says.

Counting calories can seem like a chore, but it can be enlightening. When Willis asks patients what they eat, they tend to provide the highlights, not the details. “They might forget about several of their snacks,” she says. By counting your daily caloric intake, your eyes may be opened. “It makes us more aware of how much we’re eating and what we’re eating,” Willis says. Find out your calorie limit to lose weight in a healthy manner over weeks, not days.

With round-the-clock snacking and bigger meals, we easily miss the signs and signals of real hunger. “A lot of people don’t even go two hours between eating,” says Willis. She advocates spacing your meals and snacks farther apart, and eating smaller portions. “Then you can feel the hunger pains or hear the tummy growling,” she says.

In this digital age, there are many ways to track your food intake, meet your diet goal and get credit for exercise endeavors. “My favorite is MyFitnessPal, because it’s easy to use,” says Willis. The device is available on your computer or cell phone. You can scan bar codes on food, and the nutrition information pops up. A food database of more than 5 million food items comes in handy at home and for a night on the town. “For people who eat out a lot, they have the entire menu from national chains,” says Willis. MyFitnessPal also has an exercise calculator. Just plug in the activity and duration, type in your weight and it estimates how many calories you burned.

Partners can help you stay on track in meeting your healthy lifestyle goal. “Get somebody who needs to lose weight or has lost weight to help keep you accountable,” Willis says. Your accountability partner could be a co-worker, friend, family member or neighbor. Make arrangements to walk together during your lunch hour, bike after dinner or meet at the park with your kids when food is tempting you.

Liquid lunches, skipping meals

Smoothies and juices can be healthy ways to get your nutrition if you’re on the run or crave a healthy beverage. If you add honey, milk or yogurt to a fruit smoothie, limit the quantity. “It’s not a question of nutrition, but of calories,” says Willis. A serving size is 4-6 ounces, but most people drink 16 ounces or more, she says. Consider a veggie drink. “Vegetable juices have fewer calories than fruit juices and have quite a few nutrients,” says Willis. But limit your liquid meals to once a day, she says. “I still think it’s better if people have regular meals.”

Skipping a meal may sound like a good weight loss idea, but it’s not. The Academy of Nutrition and Dietetics says that missing a meal has a rebound effect—you can wind up overeating. In addition, your body senses that it’s being starved, so it slows your metabolism, preventing weight loss. Plus, skipping a meal can put you in a funk and affect your concentration.

Breakfast is the most important meal of the day. With it, you break the long fast from the previous night and fuel your body for the day ahead. Studies show that those who skip breakfast eat more calories throughout the day.

Healthy for life

Marketing ploys for trendy diets are trying to sell you a product. You can avoid the expense and empty promises by creating your own healthy eating plan. Just enlist the help of a partner, start tracking your food and exercise daily, and reward yourself when you meet your goals. “If you look at it as eating healthier for the rest of your life, that’s more doable than if you think ‘diet,’” says Willis.