In an era of catchy blogs, celebrity diets, weight loss surgeries, and access to all of the world’s information at your fingertips, managing a client's expectations for safe and healthy weight loss can be a challenge. Despite these challenges, the amount of information and recent research from nutrition science has taught us a lot about what is safe and healthy weight loss. In this article, we will break this down into three very simple rules.
1. Set realistic targets
One of the most effective ways to help a client lose weight safely is to understand what realistic targets are and articulate them to the client. Often times, clients have preconceived notions about goals that are achievable and sustainable.
For example, clients will often come to you and indicate they want to lose 30 pounds in 30 days and are willing to do whatever it takes to get there. This is an opportunity to discuss realistic targets for weight loss, including both total amount of weight loss and the time it will take to get there.
Setting realistic expectations as a nutrition specialist is key here.
For most clients who need to lose weight for health reasons, a solid target is to initially aim for ~10% of total body weight as a weight loss target. This target represents the benchmark for weight loss in which clients reap the majority of the health benefits of weight loss (Hamman et al. 2006).
For example, if a client comes to you and weighs 200 pounds and they indicate they want to lose 60 pounds and improve their health, you can help them reframe the magnitude of results they need to see before they start to see major health benefits.
Setting an initial target of ~20 pounds of weight loss (200 X 10% = 20 pounds) can get this client substantial results and is a realistic weight loss target. After this weight loss is achieved, a new goal can be set.
2. Set realistic timelines
Weight loss is not an expedient process, but it doesn’t need to be overly slow. Timelines should ideally be set based on a rate of weight loss and the overall goal.
There are two primary ways to set rate of weight loss. The first way is to set it based on total body weight. Guidelines typically suggest around 0.5-1.0% per week of weight loss. This formula can break down at higher body masses but is typically an accurate approach. The second way is to set it based on pounds per week, with a goal of ~1-2 pounds of weight loss per week.
After a range is set, it is up to the coach and client to determine how quickly the weight loss should occur. Should it be slower (0.5% or 1 pound per week) or should it be faster (1.0% or 2 pounds per week)? This depends on the client, their lifestyle, their ability to stick with a plan, and what their level of comfort is with managing hunger and their dietary needs.
After the rate of weight loss is determined, the timeline can be set based on the overall goal and the rate of weight loss. For example, if a client referenced above has a 10% weight loss goal of 20 pounds, and they decide to set their weight loss goal at ~1 pound per week, 20 weeks, or about 4.5 months is a realistic timeline.
3. Set their diet according to their lifestyle
An important scientific finding surrounding nutrition that we made during the cumulation of research over the last 25 years is this: safe, healthy, sustainable weight loss can be achieved through a wide variety of diets.
That is right. There doesn’t appear to be a singular, magical, dietary formula. To the contrary, you can use a wide range of dietary approaches as long as you follow several key principles:
- Establish caloric needs and required deficit to achieve goals
- Ensure adequate dietary protein
- Meet nutrient requirements
That seems overly simple, doesn’t it? If you can understand and convey these principles to your clients, you can help them achieve incredible results. Let’s see what this looks like in practice.
For the client mentioned above (200 pound client who wants to lose around 1 pound per week for 20 weeks for a total of 20 pounds of weight loss), we can start by establishing their caloric needs and then setting their required deficit.
Establish caloric needs and required deficit to achieve goals.
Determining caloric needs can be accomplished by calculating a person’s total daily energy expenditure. This can be achieved by using a variety of formulas (e.g. the Harris-Benedict Equation), or online calculators, such as the NIDDK body weight planner. Using the NIDDK body weight planner and assuming our client is a 45 year old, 6 foot tall, sedentary male, the total daily energy expenditure is 2,750 kcals per day.
To figure out our clients required deficit we can do a simple calculation. The average rule of thumb is that ~3500 kcal deficit yields ~1 pound of weight loss. Therefore, if we want to lose 1 pound per week, we would want to have a roughly 500 kcal per day deficit (3,500 kcals / 7 days per week = 500 calories per day). If we subtract 500 kcals per day from our clients total daily energy expenditure of 2,750 kcals per day, we can see that our client should consume ~2,250 kcals per day.
Ensure adequate protein.
During periods of weight loss, there are two big things that coaches should keep in the forefront of their mind when planning a diet hunger and lean body mass retention.
Dietary protein can directly impact both of these. Of all the macronutrients (protein, carbohydrate, and fat), dietary protein has the greatest impact on hunger/satiety. Studies indicate that higher protein intakes (~25% to 35% of total calorie intake) result in better satiety and less hunger than other dietary patterns (Paddon-Jones et al. 2008). The 25-35% of total daily calorie intake for promoting satiety and reducing hunger would set out clients protein intake to ~140-200 grams per day.
Maintaining lean body mass during periods of caloric restriction is also important. For most people, daily protein targets should be set between ~0.6 to 1.0 grams per pound of body weight. For clients who fall into the “general population” category, protein targets of ~0.6 to 0.7 grams per pound are appropriate, while athletes or individuals looking to maximize muscle growth and training adaptations should aim for ~0.7-1.0 grams per pound. Based on these recommendations, protein should be set between ~120-200 grams per pound per day.
Meet nutrient requirements
After calorie and protein targets are set, the rest of the plan for a client aiming for safe and healthy weight loss is up to the discretion of the client and the coach. From here, meeting nutrient requirements comes down to matching lifestyle and dietary habits with the client and their nutrient needs. As long as clients get a few servings of fruits and vegetables each day, they are likely to achieve their nutrient requirements.
This allows for carbohydrate and fat intake to vary from client to client. Ideally, these should fit their food preferences and also their physical activity levels. For example, people who engage in high-intensity exercise will require more dietary carbohydrates to fuel their workload than people who are largely sedentary.
Following three simple rules can help you set safe and healthy weight loss goals for your clients.
- Aim for 0.5 to 1.0% of total body weight, or 1 to 2 pounds of weight loss per week.
- Set a realistic timeline based on the selected rate of change.
- Determine the amount of calories and daily protein the client needs, and then round out the rest of their calories from carbohydrates and fats based on their lifestyle and personal preferences.