like millions of others, you have tried it all to lose weight but not only are the pounds not melting away, they are piling on. >> the notion that we can lose weight and go on and be cured is not true. >> we have gathered a group of experts to weigh in on what works and what doesn't. >> it's almost impossible to lose weight all on your own. >> from the late of the research on pills and surgery to the latest fad diet that could be the real deal. good morning. i'm rosemary connors. weight loss is an issue that nearly all of us face. we break down what works, what doesn't and how to know when it

has turned from diet to disorder. with me now is drexel university professor of psychology evan forman. his research includes developing treatments for obesity, overeating and food cravings. and dr. janine kyrillos. she specializes in obesity management. thank you both for joining us this morning. let's get started. tell us what's the latest research on why people cannot lose weight. >> something we have known for a long time now is that the way that we have evolved as biological organisms is to always be seeking out food. because we evolved in a time where it was -- we were at risk for starvation. it took a huge amount of effort to seek out food, to hunt and gather food. that's the kind of organism we have. we are driven towards food, food which we find reward, higher calorie food. today, none of that is in place anymore. so we know through a number of

different scientific studies that we remain driven to seek out food when it's available, especially food that tastes good and is rewarding to us. what that means is that we start off with a very difficult challenge ahead whenever we're going to lose weight. what we have learned in part is that it takes a number of different pieces to come together to be successful to lose weight. especially to keep it off. so, for example, we know that it's almost impossible to lose weight all on your own. we need a sustained program that's going to support you and hold you accountable and offer all sorts of skills and strategies to help you make a complete lifestyle change and to sustain that. >> you seem to be nodding your head when dr. forman said there are things that have to come together to help you lose weight. considering we are fighting that inner drive to want to eat. >> that's right. there's so many more factors that go into it. the owed myth, calories in, calories out, it's not true.

we know sleep is very important. the type of food we eat, not so much even the quantity. all of the highly processed foods, we store them as fat. it works against us. >> you are touching on my next point here. it seems that every day there's a new food item on shelf that maybe claims to be healthy. we think it's reality but iheal may not be. talk to me about that. >> that works in both directions. we have ideas maybe one of the latest notions is that a gluten-free diet would have health benefits, including weight loss. that doesn't seem to be true all by itself. maybe as part of a global program of eating. we also know the flip side is true, too. certain foods that we once thought were all important for weight loss such as fat actually don't seem to matter where it

seems like added sugge eed sugaa lot. how much energy we take in matters the most in terms of how much weight we loose or we maintain weight loss. >> you touched on processed foods. >> right. a lot started when we were all very low fat and everybody thought, great, then i can eat jelly beans because they don't have fat. we have realized that's worked against us and has made a more obese generation. >> has it created a real addiction to sugar? >> i would say yes. scientists debate whether addiction is the right term. the similarities are close enough that that is the right term to use. maybe not just sugar but other foods which we find so appealing that it becomes incredibly difficult to give up those habits of what we eat and when we eat them. i think addiction is actually the right model to look at this through.

>> you know, our society does not channel us toward losing weight. there are marketing, where they know lights our brain up. they channel food toward that. we don't move at all. we sit at our desks. we fault people for doing what we are geared to do. >> what's around us all the constantly, all the time. let's talk about weight loss drugs. what's safe? what's effective? what's in the pipeline? >> so there are several new medications that came out in the past few years. they all work in different ways. some on appetite, some on hormonal balance. there are barriers, insurance coverage and cost. but a lot of things we do that i do as a physician is looking at maybe what medications they are already on that are working against them and cause weight

gain. >> what have you seen? >> a lot of antidepressants, ssris, some of the seizure medications, things like that. even blood pressure medicines, beta blockers, i don't recommend people stop them without talking to their doctor. but sometimes if you can -- if there's an alternative and you can switch something out, sometimes you do see -- maybe someone could not lose weight, maybe their efforts are more productive. >> it sounds like obviously before you prescribe a weight loss drug and when patients come to you, first thing you want to find out is what is their medical history and what are they take sing? >> correct. >> let's talk about surgery. there are many programs that document weight loss surgery. it also seems as though when they follow the people who have had surgery that often times, or sometimes, people tcontinue to

struggle with eating habits, exercising and, of course, weight management. >> yeah. there's a lot of research that shows that bare surgery is effe. usually, it's considered safe and the first line of treatment for a small group of people who are the most overweight and have shown inability to change some amount of their dietary habits. even those people who are -- who have surgery and are successful, tend to regain the weight or much of it. so it's not just about having the surgery. first of all, most people can't have the surgery and need other approaches. you need psychological or other kind of strategic help to make lifestyle changes. in fact, my research group has tried to develop some of the programs that help people after they have had surgery to not regain the weight back or to stop regain that's happening by helping them learn new sfr strategies. >> i want to talk about the fasting diet that's become very

popular. it sounds as though there's some research to support that it does have some positive affects. walk us through what it is and what we're learning about it. >> so some you literally fast on some occasions where you don't eat anything at all. in most, you tend to eat a very small amount of food on some days and more on other days. the patterning can vary. there's a five two diet where you eat more on five days and less or nothing on two days. there's others where you are alternating. every other day you eat a full intake and then a very low amount of intake. what the research shows that he they are effective. they're not necessarily more effective than any other diet. if you look across hundreds and hundreds of studies, most of these diediets, if this -- if t are representable, they do work. the two takeaways are, diets work, die

work, as long as you can follow them. two, which is very difficult to do. two, who can follow them seems to vary by person and different diets work for different people. that's a new area of study that we're just now getting into it, which is trying to figure out which kind of dietary modification will work for which person. most won't work. >> it sounds like for your patients whom you advise, fasting may work for one and not for the other? >> correct. i actually don't like the word diet to go on a diet. the notion that we can do short bursts of uncomfortable starvation and lose and then go on and be cured is not true. it's changing lifestyle and learning how to eat properly and healthy. if alternate day fasting is a good tool for you that might work, either on and off or ongoing, then that's great. but there's nothing short-term

that's going to work for everybody. >> something that dr. forman touched on is there's a mental component to all of this, a psychological component to weight loss and weight management. >> there is. i think one thing that we miss a lot is obesity bias. part of the psychological difficulties people have is that they have been beating down for so long and told it's their fault or they are lazy. really, while personal responsibility is very important, it's not everything. so really, having people accept that, okay, this is a chronic disease and i need to treat it chronically -- sort of learning that is very helpful. unlearning behaviors of using food for anxiety and other triggers. >> i couldn't agree more. that's partly why i led with the idea of how we have evolved as an animal. essentially, this is true for everybody. in fact, you unusual if you are

not overweight at this point. more than two-thirds of americans of adults are overweight because given our biology and given the food environment that we are in, it's more likely than not that we will end up overweight at some point. so to attach blame to it or to think of it through the lens of pathology, sickness or illness, doesn't seem right at all and it isn't helpful when you are struggling uphill against that biology to lose weight and keep it off. >> your final takeaway, one piece of good advice that you want to share with our viewers? >> we need people to be trying it out new ways of losing weight. a lot of the first tries won't work. you need to persist, get all the people -- people need to get all the help they can. they need to take advantage of every possible support. join a study. try out a new kind of eating plan. enlist support from people who are around them in their home. sign on to a program that will exist maybe for the rest of their lives, that they will stay in. >> surgery is very beneficial.

you said earlier about a lot of patients gaining back their weight. that's not exactly true. most people do remain much less -- lighter than they were. even if they do gain back weight, they're not why they would have been. one last thing is, realistic expectations. 10% of weight loss shows major affects on health. really having realistic expectation, you may not lose 100 pounds. that's okay. >> thanks so much for joining us. we appreciate it. >> thanks for having us. coming up, we continue our discussion about weight loss with a local dietician who believes the secret to staying slim is by taking small steps that she says really work. but first, a question. which state in our area has the highest percentage of adults who are overweight? is it pennsylvania, is is it new jersey or is it delaware? see if you got it right next.

before the break we asked chd state in our area has the

highest percentage of adults who are overweight. is it pennsylvania or is the highest percentage in new jersey? what about delaware? well, the most recent data finds in pennsylvania, nearly 34% of all adults are above their ideal body weight. in new jersey, it's 36.3%. and in delaware, it's 36.8%. it's close. if you answered delaware, you are right. the diet industry rakes in billions of dollars every year just in the united states alone. every day, we learn about a new weight loss quick fix. they don't always live up to their claims. joining me now is nutritionist ashvini. she's not a fan of fad diets. you say it's possible to drop a dress size or two when you realize why you are sabotaging your weight loss goals and your diet. thanks for being with us. >> thank you for having me. >> in terms of what is safe, what is healthy, you write about

taking small steps. talk to us about it. >> yes. weight loss is all about taking small steps towards your goal. people venture out to lose 30 pounds or 40 pounds. and 50 pounds or whatever the weight loss goal is. it's about breaking it down into small steps and focusing on one pound a week, which is a safe wait loss goal. one pound a week is safe way to lose weight so you can sustain it. focus on one pound a week. by the end of the year, it's 52 weeks in a year, by the end of the year, you have lost 52 pounds that you can sustain. i always say this, that the winner in the weight loss game is not the person who loses weight the quickest. but the person who keeps it off the longest. that's what weight loss is all about, the longer you can sustain it, and the only way you can sustain is by doing lifestyle change by taking small steps. >> what's your best tip that you would like to share with some of our viewers? >> don't diet.

diets don't work. it's all about making a lifestyle change, changing your eating habits, behavior. changing the combination of foods you are eating and how you are eating it. obviously, exercise is a major way to lose weight and maintain wait as well in the long run. yes, don't diet. diets don't work in short. >> i'm sure we have probably quite a few viewers at homeworking mhomework i who have busy schedules. small steps, that sounds easy. but it's hard to take that first initial step. what do you recommend to them? >> everybody has to start somewhere. just making a phone call to a professional that can help you is a first step. or just taking -- making healthy meal or lunch, packing a healthy lunch for yourself is the first step or starting to eat breakfast -- a healthy breakfast

in the morning. most people skip that. even starting ten minutes at the gym. taking any first small step is -- will bring you closer to your goal. it's all about starting somewhere. >> what about do you find that there are clients who come in who maybe they have started taking the small steps, they are listening to what you are telling them, but they fall into the trap of emotional eating? >> that is a cycle to break. so that's one of the cycles that are hard to break. it can be broken by making behavior changes. people can come up -- coming up with ideas or i know one of my clients likes to clean her kitchen after she eats dinner. whatever works for them, just to break the cycle, is what i recommend. >> she doesn't grab the ice cream carton and sit in front of the television.

which is one of my downfalls. thanks for being with us. >> thank you. >> she has written a book called "small steps to slim." it's available through her office. next we will discuss how to know when you are or a loved one has gone from a diet to a disorder. first, according to latest statistics, how many americans undergo weight loss surgery every day, 250, is it closer to 500 people a day or do you believe it's nearly 1,000? find out if you are right when we come right back.

before the break we asked how many americans do you think undergo weight loss surgery every day. is it 250? is it closer to 500 people a day  surgery? or do you think it's nearing 1,000? according to the american society of surgery, the answer is 500. that's how many people go under the knife every day to lose

weight. the data is from 2013. the number is likely even higher today. along with the new trends in dieting, unfortunately, come new trends in eating disorders.>mco it's not always obvious when you move from a diet to something closer to a disorder. joining the discussion is dr. is a msamantha da a/kdacara. >> thank you for having me. >> first, how do we know if someone has taken their diet too far? >> i think it's important tots eating disorders. if you have genetic vulnerable, cultural vulnerability, diets can trigger it. there are signs that can tell you if it's gone in that direction. if you have been become obsessed by calories, obsessed about your weight, it's all consuming,

taking over your life, you are cutting out friends, it's aff t affecting schools, your work. are you weighing yourself multiple times a day? are you exercising even though you are injured? are you unable to stop? these are some of the signs we know a diet has moved into the realm of an eating disorder. >> what are some of the eating disorders that you are seeing? >> some of the new trends -- they're not classified as disorders, they are trends and terms out there. there's orthorexia, an unhealthy obsession with healthy eating. the irony is that they are sticking to rigidly to certain foods, they might cut out food groups or they might be -- they might skip an entire meal because it doesn't have the safe foods in it. the eye irony is they are heati healthy food but they are becoming unhealthy. there's a term out there called

drunkarexia. someone who is engaging in behaviors where they are not eating. they are cutting out calories, exercising to save up calories to spend them on binge drinking. it's dangerous. we are seeing an earlier onset. we see young girls and boys in grade school with disorder eating, hating their body and developing eating disorders. it's much younger than what we have been seeing historically. also, midlife eating disorders we're seeing. we're seeing the onset in midlife but also maybe someone who has had an undetected eating disorder early on maybe relapse, maybe they have had a period of stability and relapse due to a stressor. >> is part of this for lack of a better way to put it new trend that there are body image challenges that we're seeing on social media and online? is that contributing to it? >> i think it can be a contributing factor. some of the challenges out there are really disturbing.

there's the paper challenge where people are encouraged to hold up a piece of paper to see if they are smaller than it. the collarbone coin challenge. you put coins on your collarbone and trying to balance them. the thigh gap. these are disturbing ways that people are comparing themselves. it can contribute to triggering an eating disorder. it doesn't cause it. it can be a factor. eating disorders, they are emotional disorders also. you need to work through the underlying factors to recover. >> thank you so much for being with us. we appreciate your insight. >> thank you so much. >> we'll be right back.

this is nbc 10. >> that's it. you can join me every saturday beginning at 5:00 in the morning and sunday at 5:30. thanks for joining us and have a good one.

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