“I want to lose weight, can you help me?” This is a common question from my patients, but now that the holidays are over and we have started a new year, even more are focused on weight loss

When I ask patients what they are doing to lose weight, many don’t have a plan. Most say they have started a strict diet, have joined a gym, or bought new exercise equipment.

While these are all smart choices, I recommend making smaller more gradual changes that can add up to pounds lost and improved health. Restrictive diets tend to make people feel deprived and often fail shortly after they begin.

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The first bit of advice I give patients is basic arithmetic — move more and consume less. It seems obvious, but some patients benefit from a reminder. Adequate sleep is also crucial to weight loss, which surprises many people. Sleep deprivation directly affects hormones that regulate hunger as well as the body’s ability to process insulin and leads to weight gain.

I encourage my patients not to diet but to make changes in their eating habits that can be sustained over time. The easiest things to cut out are sugary drinks. Sodas, sports drinks, juices, and fancy coffees are loaded with empty calories. Replacing these with water every day can result in weight loss and improved health.

Another common mistake dieters make is skipping breakfast. Breakfast has been proven to be the most important meal of the day when it comes to losing weight, so I encourage patients to eat a healthy breakfast every day.

One of the biggest but most important steps to take to lose weight and improve overall health is to eliminate processed foods and replace them with whole foods. Processed foods are designed to be addictive and usually offer little to no nutritional benefit. I’ve had patients not only lose significant weight, but also overcome issues like acne, irritable bowel syndrome, and even infertility by simply removing processed foods from their diets.

While gyms and fancy exercise equipment are great for weight loss, it is easy to burn calories inexpensively from home. Choices like taking the steps or parking the car further away add up in calories spent. Taking a daily 30 to 60 minute brisk walk is free and is also a great first step toward physical fitness. Exercise can decrease stress and improve sleep.

Small steps are often more sustainable in everyday life than major diet overhauls or exercise programs. Though progress might be slower initially, the physical changes that come from these types of changes are often easier to maintain over time.

Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.