Anyone can lose weight just by eating less and exercising more, but keeping it off long term is another matter. This is partly because the body has a natural tendency to fight against losing weight - after losing weight your appetite can increase to try to regain the weight and your metabolism can slow down so that less fat is burned.

Is it impossible to keep that weight off long term? Not according to a study by Dr James Hill from Colorado. He developed a register of obese people who had lost more than 13.6 kilos of weight and kept it off for more than one year. That was some years ago and he now has about 3000 people like this who have kept the weight off for more than five years.

So how have they managed to do this? Well, there are four keys to their success.

1. They eat breakfast every day.
Many people don’t eat breakfast, and some think this helps them to eat less overall. Wrong! They seem to eat more. Having a low fat, high fibre breakfast is filling and seems to reduce eating later in the day.

2. They monitor themselves regularly.
This means that if they begin to stray off the rails they pick this up early and do something about it before too much damage is done.

3. They eat low fat food.
This doesn’t mean replacing the fat with sugar as found in some low fat cereals or energy bars that can be full of sugar.

4. They exercise a lot.
That is, they take about 60-90 minutes of moderate intensity exercise every day. This is well above the 30 minutes of walking a day recommended for the general population to keep healthy and not to put on too much weight in the first place. Translating this into steps taken as measured by a pedometer, we are talking about 11-12,000 steps compared with 7-9,000 for those just trying to stay healthy.

So clearly we are talking about a very highly motivated group of obese people who can manage this long term weight loss. The benefits of this weight loss however are enormous:

• Reduces risk of developing heart disease.
• Reduces risk of developing diabetes.
• Lowers the bad type of cholesterol (LDL), whilst the good heart protective cholesterol (HDL) goes up significantly.
• Lowers blood pressure.
• Lowers sugar levels in those who already have diabetes.