Tips for Controlling Your Weight and Lowering Risk of Heart Attack

A third of adults in the U.S. are obese and another third are overweight. And the number of teenagers with weight problems is on the rise. So it's not surprising that the number of people with high blood pressure and type 2 diabetes is also increasing, since excess weight—especially around the gut—contributes to both conditions. And it's a major reason so many people in the U.S. die of heart attacks and strokes.

Your doctor should have you stand on a scale every time you visit, and at least occasionally calculate your body-mass index, a measure of body fat based on height and weight. A result higher than 25 is overweight; higher than 30 is obese.

Even simpler and possibly even more accurate is to measure your waist. Belly fat is more metabolically active than fat stored in the hips and thighs, and increases the risk of heart disease and certain cancers. In women, a waist of 35 inches or greater is cause for concern; in men, it's 40 inches. To measure, wrap a measuring tape around your bare abdomen at about the level of your belly button. Stand straight, and don't suck in your gut. Relax, then measure after exhaling.

It's also a good idea to regularly weigh yourself at home, too, since that can keep you motivated. See our ratings to find the best bathroom scale.

The Consumer Reports National Research Center recently surveyed 21,632 readers about weight loss. Successful losers—people who, at the time of the survey, weighed at least 10 percent less than they did at their heaviest and had been at that lower weight for at least three years—represented just 15 percent. But there was some good news. More than half of the successful losers reported shedding the weight without a commercial diet program, medical treatment, a book, or diet pills. Six strategies seemed to work the best:

• Watch portions. Of all the eating behaviors we asked about, carefully controlling portion size at each meal correlated most strongly with having a lower BMI. Successful losers—even those who were still overweight—were especially likely to report practicing portion control at least five days a week (62 percent). So did 57 percent of the people who reported being always thin, but only 42 percent of the failed dieters.
• Limit fat. That means restricting fat to less than one-third of one's daily calorie intake. Fifty-three percent of the successful losers and 47 percent of the people who were always thin said they did that five or more days a week, compared with just 35 percent of the failed dieters.
• Eat fruits and vegetables. The more days that respondents ate five or more servings of fruit or vegetables, the lower their average BMI. Forty-nine percent of the successful losers and the always-thin respondents said they ate that way at least five days a week, while 38 percent of failed dieters did so.
• Choose whole grains over refined. People with lower body weights consistently opted for whole-wheat breads, cereals, and other grains over refined (white) grains.
• Eat at home. As the number of days a week respondents ate restaurant or takeout meals for dinner increased, so did their weight. Eating at home can save a lot of money, too.
• Exercise, exercise, exercise. Regular vigorous exercise—the type that increases breathing and heart rate for 30 minutes or longer—was strongly linked to a lower BMI. Although only about one-quarter of the respondents said they did strength training at least once a week, that practice was significantly more prevalent among successful losers (32 percent) and always-thin respondents (31 percent) than it was among failed dieters (23 percent).

Be leery of weight-loss supplements. Don't bother with weight-loss drugs or supplements. In March 2009 the Food and Drug Administration released a list of 72 weight-loss products that it found to be illegally tainted with prescription drugs, sometimes at doses several times the safe daily maximum. The agency also announced a recall of the dietary supplement Hydroxycut after reports linked it to 23 cases of serious liver damage, including one death. And our recent article on dangerous supplements identified several weight-loss supplements, including bitter orange and chaparral, that posed serious risks.

Drugs aren't much better. Our recent Best Buy Drug analysis of orlistat, the ingredient in the over-the-counter weight-loss drug Alli and the prescription drug Xenical, found numerous adverse events, including cases of rectal bleeding and kidney, liver, and thyroid problems. Orlistat offers modest weight-loss results at best and can cause embarrassing side effects.

Gastric bypass surgery can help some people who are extremely obese. But it also poses risks that might outweigh the benefits for people who are only moderately overweight.