One of the most common New Year’s resolutions is to lose weight or at least eat more healthfully. Several Web sites offer tips and tools for getting there.

A Better Food Pyramid: Harvard nutritionists say their revamped food pyramid is based on the latest science and is “unaffected by businesses and organizations with a stake in its messages.” It starts with exercise and encourages adding more plant-based foods and cutting back on “American staples” like red meat, refined grains, potatoes and sugary drinks.

Dr. Gourmet: New Orleans physician Timothy S. Harlan, also known as Dr. Gourmet, has created free diet software that helps you plan more healthful meals. He calls it the Quality Calorie Diet Plan to reflect his belief that it’s the quality of the calories we eat that counts the most. The site creates meal plans and even offers ways to use leftovers later in the week. It includes food and exercise diaries as well as goal-tracking features, and a place for users to analyze their own recipes.

3FatChicks.com: This Web site began as a personal source of diet support for sisters Suzanne, Jennifer and Amy and has now grown into a community of over 70,000 registered members. It has the typical diet-site resources and tools, but the main appeal is the forum for dieters to share stories and find support.

Cooking Light: A great site for finding healthy and delicious foods that won’t make you feel like you’re on a diet. You’ll find recipes, nutrition information and advice on cooking techniques.

Food Blog Search: It’s not a diet site, but if you’ve resolved to cook at home more, this is a great resource for finding new recipes. This custom-built search engine uses Google technology to search for recipes in more than 2,600 food blogs.

National Body Challenge: Discovery Health’s National Body Challenge is a free fitness and weight loss program. After registering online, participants set their personal goals and create a customized eating and exercise plan. Registration gives users access to customized meal and fitness plans, a community of other Challenge participants, weight and fitness trackers and video and interactive tools as well as a 30-day free health club membership.

Weight Watchers — Although the site is offering a one-week free trial to it’s online plan, you’ll have to pay $65 for a three month subscription if you stick with it. While it’s true that most people who diet end up gaining back their weight, much of what Weight Watchers claims is backed by science. An April 2008 article in the British Journal of Nutrition looked at success rates of lifetime Weight Watchers members. They found that a year after reaching goal weight, 80 percent of participants had maintained at least 5 percent of the weight loss a year later and 27 percent of the dieters had stayed below their goal weight. While that means a lot of people regained their weight, it’s still more evidence for success than offered by most commercial diet plans.

South Beach Diet: This diet gained popularity as an alternative to the strict low-carb regimen of Atkins, with an emphasis on “good carbs” like high-fiber vegetables and whole grains. It also offers a free week trial, followed by a $5 a week membership fee.

So what have I missed? Are there other websites you’d recommend to help people lose weight and live healthier in 2009?

And for more on resolutions, read New Year, New You? Nice Try.

Anyone who has ever tried to lose weight knows it’s tough to stay motivated. Researchers at the University of Pennsylvania wondered if cold, hard cash might do the trick.

I.B.M. employee Jodi Morrison won cash incentives for tracking her exercise at work.

The investigators studied how cash incentives influenced weight loss among 57 people who were obese but otherwise healthy. One group of dieters was given $3 a day plus additional matching funds for meeting weight loss goals, meaning they could earn up to an extra $168 during a four-week period. A second group was eligible to compete in a cash lottery for $10 to $100 a day during the study period if they achieved weight loss goals. A third control group simply attended monthly weigh-in sessions.

At the end of 16 weeks, the dieters in the lottery group had lost an average of 13.1 pounds each, while those in the matching-funds group had lost an average of 14 pounds each, compared to just 3.9 pounds in the control group, according to a report published today the Journal of the American Medical Association.

Five people in the lottery group and seven in the matching-funds group lost more than 20 pounds each during the study period. Only one person in the weigh-in group lost that much weight.

The downside was that some of these dieters gained back much of the weight once the cash prizes dried up. Still, seven months later they remained an average of six to nine pounds lighter. Read more…

How accurate are your exercise estimates? (Eric Thayer for The New York Times)

When people with weight problems talk about their exercise and eating habits, many doctors and nutritionists don’t believe them. That’s because studies show that overweight people commonly underestimate the amount of food they’re eating.

But exercise habits appear to be a different story. New research shows that people with weight problems are far more tuned into how much they exercise than they are often given credit for.

In a study presented at the Obesity Society’s annual meeting, researchers from Temple University’s Center for Obesity Research and Education in Philadelphia found that obese women were more accurate in reporting their activity levels than overweight or normal weight women. Read more…

Obesity is widely viewed as the nation’s biggest health problem. But research last week showing that one-third of obese people are “metabolically” healthy suggests that health can’t be judged by fat alone.

Indeed, there’s a growing body of evidence suggesting that many of our attitudes about health and weight are misguided. While excess weight clearly is a risk factor for poor health, it doesn’t appear to be the most important issue. About half of overweight people and one-third of obese people have normal “good” cholesterol, blood pressure and other cardiovascular risk factors. And several studies show physical activity is a far more important predictor of health than body size is.

“We know that obesity by itself is a major coronary risk factor,” said Dr. Kenneth Cooper, the fitness expert who launched the aerobics movement. “But you can’t just rely on weight. You’re better off being fat and fit than skinny and unfit.”

To read more about weight, fitness and health, read my full Well column here and then post your comments below.

In the future, everyone will be fat — or so warns a new study published online last month in the medical journal Obesity. About 66 percent of American adults are now overweight or obese, according to government estimates, and the report makes the dire prediction that, based on current trends, by 2048 the figure will reach 100 percent.

But that projection, which presumes a linear increase in the number of people who are overweight, is logically impossible, say several top statisticians. The reasons are outlined in one of my favorite columns, “The Numbers Guy,” written by the Wall Street Journal’s Carl Bialik.

“Employing that same logic, 13 out of every 10 adult Americans by then won’t have landlines,” Mr. Bialik wrote. “The phone forecast is impossible, of course, but it’s arguably no less solidly grounded than the obesity forecast.” Mr. Bialik also interviewed top statistician Donald Berry, chairman of the department of biostatistics at the University of Texas M.D. Anderson Cancer Center.

“Extrapolations are dangerous,” Dr. Berry explained. “Especially dangerous is to assume that trends are linear. Otherwise we’d conclude that Olympic swimmers will one day have negative times, there will be more Internet users than people, and more people on Earth than molecules in the universe.”

To read Mr. Bialik’s column, click here.

Good health comes in a variety of shapes and sizes. (Josh Haner/The New York Times)

Many overweight and obese people are metabolically healthy, while large numbers of slim people have health problems typically associated with obesity, a new study shows.

The findings, based on national health data collected from 5,440 adults, shows that weight often is not a reliable barometer for health. In addition to looking at height and weight, the study, published this week in The Archives of Internal Medicine, tracked blood pressure, “good” cholesterol, triglycerides, blood sugar and an inflammatory marker called c-reactive protein, all of which are viewed as indicators of cardiovascular health.

Overall, thin people were still metabolically healthier than people who were overweight or obese. But being a normal weight was not a reliable indicator of health. In the study, about 24 percent of thin adults, or about 16 million people, posted unhealthy levels for at least two of the risk factors.

By comparison, among the overweight, Read more…

Few topics generate more heated discussion than diet and weight loss, and for the past week, readers have posted hundreds of comments reacting to the latest diet research.

The latest study, published in The New England Journal of Medicine, compared three diets. Some participants cut fat, others counted carbohydrates in a version of the Atkins diet, while others adopted Mediterranean-style eating habits. Some people declared the research a vindication for Atkins, others criticized my view of the study as more evidence that diets don’t really work.

For some needed perspective, I turned to Gina Kolata, a New York Times reporter and author of the wonderful book, “Rethinking Thin: The New Science of Weight Loss — and the Myths and Realities of Dieting.” Not only is Gina well versed in the science of weight loss, but she has an unusually compassionate take on the efforts of the dieters in this recent study and all people who struggle with their weight. Read more…

As if we needed a reminder that diets mostly fail, The New England Journal of Medicine has published a new report on an intense, tightly controlled experiment involving more than 300 moderately obese people.

After two years of effort the dieters lost, on average, 6 to 10 pounds. The study, funded in part by the Atkins Research Foundation, seemed designed to prove that low-carb diets trump low-fat diets. But in the end, all it really showed is that dieters can put forth tremendous effort and reap very little benefit.

Dr. Dean Ornish, a proponent of low-fat diets, is critical of the study design, particularly the fact that the so-called “low-fat” diet group was really only a moderate-fat diet that included about 30 percent of calories from fat. He writes more about the issue in a Newsweek column here.

The New England Journal report also affirmed something many women have believed all along — that low-carb diets work better for men than women. Male low-carb dieters lost about 11 pounds, compared to about 9 pounds on a Mediterranean diet. Women low-carb dieters lost only about 5 pounds, compared to about 14 on the Mediterranean diet. To read more about the new research, click here.

Overweight people already know they are overweight. So should doctors keep nagging them to lose pounds?

No surprises here. (PictureNet/Corbis)

That’s the issue tackled recently by one of my favorite medical blogs, called “Musings of a Distractible Mind.” The author, who goes by “Dr. Rob,” is Dr. Robert Lamberts, an Augusta, Ga., physician who is board certified in internal medicine and pediatrics. On his blog, Dr. Rob muses about a variety of topics like llamas, twinkies and favorite patients. But I was particularly moved by a recent post, which was written after Dr. Rob’s encounter with an overweight patient who was clearly accustomed to being lectured about obesity. As Dr. Rob was about to discuss whether the man needed surgery for sciatica and back pain, the patient interrupted him, hanging his head in shame and blaming his weight for the problem. Read more…

Young, fit and feeling fat? (Janet Hostetter for The New York Times)

At a time when much of the Western world is focusing on obesity problems, even teens who are at a healthy weight may develop a distorted body image.

That’s what German researchers found after surveying nearly 7,000 11- to 17-year-olds, asking them to describe their bodies. Options included far too thin, a bit too thin, just the right weight, a bit too fat and far too fat.

About 75 percent of the kids fell into the normal-weight category. However, half the normal-weight girls and a quarter of the normal-weight boys still described themselves as being too fat.

When those teens were given quality-of-life and self-esteem tests, normal-weight children who believed they were fat scored as poorly as children who really were obese. And normal-weight children who felt fat actually scored worse on family relationship questions than obese children. The findings were published in the current issue of Deutsches Ärzteblatt International, a German medical journal.

Although the data come from Germany, studies in the United States also suggest body image concerns are prevalent among American teens and adolescents. A 1999 study from the American Dietetic Association found that 55 percent of 7- to 12-year-old girls said they wanted to be thinner.

The data suggest that efforts to address unhealthy weight gain and obesity among young people have the the potential for “collateral” damage in normal-weight kids, who may develop self-esteem problems. An accompanying editorial noted that adolescents are exposed to considerable social pressure to be thin.

I first met Austin opera singer Cindy Sadler through her blog, “The Next Hundred Pounds.” After a lifetime of being overweight, Ms. Sadler last September set out on a journey to gain control of her health. Nine months later, on June 12, she reached an important milestone, losing 100 pounds.

“Diets do fail,” Ms. Sadler wrote me recently. “I have never liked the term diet, and I don’t consider myself to be on a diet. (I have many alternate names for it … “fat relocation project” is one of my faves.) I consider myself to be in the process of making a lifestyle change, and to a large degree I have made that change, though there is a lot of work still to be done and there will never be a time when I don’t have to work at it. Some days I simply have to work harder than others.”

To stay motivated, Ms. Sadler regularly refers to a book she has filled with reminders and sayings that keep her on track.

“I have a lot of tools to help me keep motivated, but the main thing is to get what my friend Karen calls the mental game in place,” she said. “The mental game has to be tight. That is what I have been able to do this time that I never was able to do before…. I’ve been able to counter every roadblock (eventually — some are harder than others!) and learn to demand honesty from myself. The main motivation, though, is probably that I like how I look and feel now, and I like eating and exercising the way I do now, better than I liked the way I looked, felt and ate before.”

To learn more about Ms. Sadler’s weight loss journey, watch the video below.

A new study suggests that the epidemic of childhood obesity finally may be leveling off. (Matt Slocum/Associated Press)

A glimmer of hope has emerged in the battle against childhood obesity. As I wrote about in today’s Times, the Centers for Disease Control and Prevention is reporting that childhood obesity rates appear to have hit a plateau.

Nobody is celebrating just yet. Now health officials and families need to focus on helping the one out of three children in the United States who are already overweight or obese. Fortunately, the problem is potentially easier to battle in children than adults.

“Childhood is the ideal time to address this problem for a lot of reasons,” said Dr. David Ludwig, director of the child obesity program at Children’s Hospital in Boston. “The lifestyle habits that cause the problem haven’t been entrenched as long with children as they have with adults. And all but the most heavy children can basically outgrow their problem by holding their weight constant as their height increases or at least slow their rate of weight gain.”

Because kids are constantly growing, it can be tough to figure out how much your child should be eating. They key is to provide a ready supply of healthful foods and limit so-called “energy dense” foods — things like fried chicken nuggets or pastries that pack a lot of calories in each bite.

A number of Web-based tools can also help. The Children’s Nutrition Research Center at the Baylor College of Medicine provides an energy calculator that can help you determine how many calories your child should be eating each day. To use the calculator, click here.

To find out whether your child is at a healthy weight or at risk of being overweight, you should use a childhood body mass index calculator. The C.D.C. provides one here. And click here to learn more from the C.D.C. about using B.M.I. calculations in childhood health.

Is it possible to legislate against thinness?

Thin and beautiful? (Remy de la Mauviniere/Associated Press)

That’s what lawmakers in France are attempting to do. The French parliament’s lower house has approved a bill that would make it illegal for anyone — including fashion magazines, advertisers and Web sites — to publicly incite extreme thinness, The Associated Press reports.

The bill is the latest effort to address concerns surrounding the fashion industry’s use of ultra-thin models. In November 2006, 21-year-old Ana Carolina Reston, a top Brazilian model, died as a result of anorexia. At the time of her death she weighed only 88 pounds.

French politicians and fashion industry members signed a nonbinding charter last week on promoting healthier body images. And last year Spain banned ultra-thin models from catwalks.

But Conservative politician Valery Boyer, who introduced the proposed law, argued that efforts to promote “extreme thinness” should be punishable in court. One target is Web sites that promote anorexic behavior with such advice as eating little more than an apple a day.

Although it’s not clear how the fashion industry would be affected by the rule, Ms. Boyer says she believes the legislation would force changes in how fashion houses depict women. The law would give judges the power to imprison and fine offenders up to about $50,000 if found guilty of “inciting others to deprive themselves of food” to an “excessive” degree.

The legislation goes to the Senate in the coming weeks. To read today’s full Times story on the topic, click here.

Women’s weight discrimination. (Jodi Hilton/The New York Times)

It only takes a modest weight gain for a woman to experience weight discrimination, but men can gain far more weight before experiencing similar bias, a new study shows.

The notion that society is less tolerant of weight gain in women than men is just one of the findings suggested by a new report from the Rudd Center for Food Policy & Obesity at Yale University, published this month in the International Journal of Obesity. Read more…

Dieters are more likely to lose weight and keep it off if they have contact with a weight-loss counselor, a new study shows.

The report, led by researchers at Duke University Medical Center and published today in The Journal of the American Medical Association, shows just how difficult it is for dieters to maintain their weight loss. The study began with 1,685 overweight or obese adults who weighed on average 213 pounds. The group was successful at losing weight, with an average weight loss after six months of 18.7 pounds.

About 1,000 people who lost 9 pounds or more took part in the second phase of the study. Some used an Internet-based weight counseling tool, while others had regular personal contact with a weight-loss counselor. A third group received basic instruction on maintaining weight loss, and those dieters attempted to keep the weight off on their own.

Monthly personal contact meant the participants had telephone contact with a counselor for 5 to 15 minutes each month, except for every fourth month, when they had a 45- to 60-minute individual face-to-face session. The Web-based program gave participants unlimited access to a Web site designed to support weight loss maintenance, with interactive features allowing participants to set personal goals and action plans for the next week and to graph personal data over time.

More than two years later, most everyone had gained back some of their weight. The people who tried to maintain their weight on their own fared the worst, gaining back an average of 12.1 pounds. People who used the Web-based tool gained back 11.5 pounds. However, those people who took part in the personal contact group gained back the least — regaining 8.8 pounds.

Although personal contact only resulted in a 3.3 pound additional benefit, the study authors noted that even small losses can improve health. Every kilogram (2.2 pounds) of weight loss is associated with an average decrease in systolic blood pressure of 1.0 to 2.4 mm Hg and a 16 percent reduction in diabetes risk, the authors said. At the end of the study, more than 45 percent of those who had received counseling were still maintaining at least 9 pounds of weight loss, an amount with clear clinical benefits, they noted.