Practical Tips for Losing Weight: What I Tell My Patients

By Shawn Stevenson, DO, FACS – Chief of Bariatric and Foregut Surgery, Dignity Health

When patients ask me for “tips” on losing weight, I want to be clear about one thing up front: there is no single trick or shortcut that works for everyone. But there are patterns I see over and over again in patients who are successful long term.

These aren’t extreme rules or rigid plans. They’re principles that help put your body and your mind in the best position to succeed.

1. Start With Health, Not the Scale

Weight loss works better when the focus is on health instead of chasing a number. Improvements in blood sugar, blood pressure, joint pain, energy, and sleep often matter more. In many cases, those changes also support sustainable weight loss over time.

When the scale becomes the only measure of success, people get discouraged quickly. Health is a much better starting point.

2. Be Honest About What Hasn’t Worked Before

Many patients come in after trying multiple diets or programs. Instead of repeating the same approach, it’s important to ask why those efforts didn’t last.

This isn’t about blame. It’s about learning. Understanding what didn’t work helps you avoid setting yourself up for the same frustration again.

3. Avoid All-or-Nothing Thinking

Weight loss doesn’t require perfection. It requires consistency.

I see patients struggle when they feel that one off day means they’ve “failed.” In reality, progress comes from what you do most days, not every day. A plan that allows flexibility is far more sustainable than one that demands constant discipline.

4. Focus on Structure, Not Restriction

Successful weight loss usually comes from having structure, such as regular meals, predictable habits, and clear expectations. It does not come from extreme restriction.

When people try to cut too much, too fast, hunger and fatigue tend to win. A structured approach supports your metabolism instead of fighting it.

5. Prioritize Protein and Hydration

Without getting overly technical, protein and hydration matter more than most people realize.

Adequate protein supports muscle mass and helps with fullness. Hydration can affect hunger signals and energy levels. These are simple areas that often get overlooked, and they can make a meaningful difference when addressed consistently.

6. Understand That Hunger Is Biological

Hunger is not a character flaw. It’s a biological signal.

Hormones, stress, sleep, and metabolism all influence how hungry you feel. Recognizing this helps reduce frustration and opens the door to strategies that actually work for your body. That may include nutrition planning, behavioral support, or medication when appropriate.

7. Don’t Ignore Sleep and Stress

Poor sleep and chronic stress make weight loss significantly harder. They affect hormones that regulate hunger, fullness, and fat storage.

Weight loss plans that ignore sleep and stress often stall, even when nutrition and activity are addressed. These factors are part of the medical picture and deserve attention.

8. Use Medical Tools When They Make Sense

For some patients, medical tools such as weight-loss medications or bariatric surgery are appropriate. These options exist because we understand more about how the body regulates weight than we did in the past.

Using a medical tool is not giving up. It’s about choosing the right support for your situation, based on health and long-term goals. It should never be driven by trends or pressure.

9. Think Long Term, and Take It One Day at a Time

One of the biggest mistakes I see is focusing only on how to lose weight without thinking about how to maintain it.

A good plan should still make sense one year from now, not just one month from now. If an approach feels impossible to maintain, it’s probably not the right one.

At the same time, long-term success is built through day-to-day decisions. The goal is to choose habits you can follow for an extended period, ideally permanently, while focusing on what you can do today. As healthier routines take hold, the process becomes more natural, and most patients start to feel better in noticeable ways.

10. Don’t Do This Alone

The patients who do best are the ones who don’t try to figure everything out by themselves.

Support can include medical care, nutrition guidance, behavioral coaching, or surgical follow-up. It helps reduce guesswork, build confidence, and keep progress moving forward.

Knowledge is power here. The more you understand your options, the more capable you are of finding the path that fits you best. Regular follow-up with a weight-loss professional can also help with accountability and can identify when it’s time to adjust the plan or introduce new strategies to help you reach your health and weight goals.

The Bottom Line

There is no perfect formula for losing weight, but there is a thoughtful way to approach it.

Focus on health. Build structure. Be realistic. Use support when you need it, and choose a plan that’s designed to last, not one that promises quick results.

That’s how meaningful, long-term change happens.