The principle behind weight loss is pretty basic: Eat less, move more.
Yet, for all its simplicity, we can't seem to get this formula right. In Illinois, 63 percent of the population is overweight or obese, according to the Centers for Disease Control and Prevention. And more than 90 percent of Americans who shed pounds gain them back, experts said.
How to explain such a relapse rate? After all, it's not like we don't value fitness. One glance at any magazine rack — with all those sculpted abs — speaks volumes about society's ideal.
"The reason obesity has been rising — and why it's so difficult to reverse — is that our environment and biology are working against us," said Marlene Schwartz, deputy director of the Rudd Center for Food Policy and Obesity at Yale University.
The environment is at fault because of the easy accessibility of unhealthy, highly palatable foods that are heavily marketed, she said.
"It would be like someone trying to stop smoking — but spending all their time around other people puffing away and with free cigarettes," Schwartz said.
At the same time, biology works against us because weight loss means bucking centuries of evolution, Schwartz explained. "For most of human history, the ability to hold on to body fat protected us against famine. It's only in the recent era that we've wanted the exact opposite."
Given the implausibility of throwing a barricade in front of every fast-food window or undoing how we're wired, clinicians are studying those rare success stories for clues.
Changing behavior is never easy, said Dr. Robert Kushner, clinical director of the Northwestern Comprehensive Center on Obesity. But he identified three factors shared by those who have beaten the odds:
•Vigilance. Achieving over the long haul means monitoring behaviors and decision-making, Kushner said. "Weight loss doesn't just happen any more than being a successful entrepreneur just happens. These people have a plan."
•Seamless integration. For successful dieters, good habits are woven into their daily routines, not something temporary. They don't stand at the elevator, but automatically take the stairs. At the movies, they don't even think about stopping for popcorn. "It's become a way of life," he said.
•Assertiveness. Gaining control over your surroundings is key. People who keep off the weight aren't shy about moving the office candy dish or questioning a waiter on whether a vegetable can be swapped for a potato. "You can't swim against the stream every day and be successful," Kushner said.
Josephine Reed, 35, of Richton Park, embraced all those principles in 2009. The 5-foot-1 trauma nurse whittled her 270 pounds down to 114 — a weight she maintains to this day, give or take a few pounds. Her effort landed her on the cover of "People" in January 2011, for the annual "Half Their Size" issue.
The scale started inching upward in college, where she developed a chronic pizza habit. After graduation, a stressful job piled on more pounds until her doctor threatened to start blood pressure medication.
"I was getting nosebleeds and headaches," she said. "That was the turning point."
Reed went to Jenny Craig and still grabs frozen meals "for portion control." As for pizza, she indulges every so often — but now it's just a slice, following a hefty portion of vegetables. "If you deny yourself totally, you're just setting yourself up for failure."
But a commitment to activity also has helped keep off 156 pounds for two years. Her foray into fitness started with a Zumba class, and now she's the teacher. In addition, Reed works with a trainer weekly and recently hired a swimming instructor. "I discovered that exercise can be a lot of fun … and I'm just a lot happier."
Such satisfaction is essential to breaking the endless lose-and-gain cycle, said Lisa Menninger, a La Grange-based wellness coach.
"Whether it's food or exercise, we have to shift the paradigm, from viewing healthy living as punishment and something horrible … to one of enjoyment," Menninger said. "It's based in respect and deep care for your body. … You start feeling so good that you're not interested in returning to your old ways."
The successful dieters aren't immune to a backslide, but they prevent a one-night lapse from turning into a monthlong binge, Reed said.
"We're not going to be perfect. If you haven't made the best decision today, be patient with yourself … because tomorrow is a whole new day."