Scale back the daily weigh-ins

DEAR DR. GOTT: I am a 61-year-old woman with a history of breast cancer, parathyroid disease and knee problems. I had a lumpectomy for the cancer seven years ago, a parathyroidectomy five years ago and knee replacement last year. I have run in more than 60 marathons, so I am fairly active. However, since my lumpectomy and within the last two years, I have gained 20 pounds and weigh more than 180 pounds. I know this is too much, so I have been using your no-flour, no-sugar plan for the past six weeks. I have made big changes in my eating habits and, although not perfect, have been essentially true to the diet. I have also tried to exercise more - swim a half-mile, walk four to five miles, or bike for 45 minutes.

My concern is that I am not consistently losing weight. I seem to have a two-pound range that varies from day to day. Is it possible that I am gaining more muscle or, if I had muscle, would it be harder for me to see a consistent weight loss? I do think my clothes feel better.

DEAR READER: If you have had a knee replacement, I bet your knee problems were severe enough to affect your exercise routine. If you did not change your eating habits, you likely started gaining weight that was otherwise held off by the exercise. If you are healthy now, the exact cause of the weight gain doesn't matter.

I applaud your efforts to increase your exercise and start a diet plan. The good thing about my plan is that it can be as strict or as relaxed as the user wants or needs and is implemented easily. It doesn't involve special brand foods, weighing, measuring, or counting. Four simple words encompass the whole thing: no flour, no sugar.

Now, to your specific concerns about inconsistent weight loss: Daily weigh-ins often lead to anxiety and frustration that a diet isn't working, even if it is. Our weights change daily based on time of day, amount of food or fluids ingested, absorption and expulsion, the amount of urine in the bladder and more. Unless you do the exact same activities, eat the same foods, and urinate and defecate the same precise amounts at exactly the same time each day, your weight will never be the same.

The solution? Don't weigh yourself daily. Instead, do it once a week. This will provide a more accurate account of how much weight you have actually lost (or gained).

As for muscle weight, it is possible to become slimmer without losing weight. One pound of fat takes up more space than one pound of muscle. If you gain one pound of muscle for every pound of fat you lose, your weight will not change, but your appearance will.

If your clothes fit better and you are feeling stronger, stick with the plan and continue to exercise. Weigh yourself only once a week. An average weight loss of one to two pounds per week is healthful. My diet plan often results in more drastic losses in the first few weeks, sometimes up to six or eight pounds the first week, and then slowly tapers off to the lesser amounts. Some people may find that they lose three or four pounds one week but none the next. The important factor, however, is the end goal and its maintenance once reached.

Dr. Peter Gott is a retired physician and the author of the book "Dr. Gott's No Flour, No Sugar Diet," available at most chain and independent bookstores, and the recently published "Dr. Gott's No Flour, No Sugar Cookbook." Copyright 2010, United Feature Syndicate Inc.