If you're 100 pounds or more overweight or your body mass index measures 40 or higher, doctors classify you as morbidly obese. This level of obesity puts you at a dire risk of health complications and early death. A woman who is morbidly obese must take extra effort to reduce her weight, using lifestyle, dietary and possibly medical interventions, to reduce her risk of chronic disease. Before making changes, however, discuss your weight loss strategy with your doctor to make sure it's a safe plan that's right for you. When you're obese, exercise feels harder -- every step puts excessive pressure on your joints. Once you've lost about 10 percent of your weight with dietary intervention, add light- to moderate-intensity exercise. In addition to burning calories, moderate exercise decreases blood pressure, increases your levels of good cholesterol and may delay the onset of type 2 diabetes. When you first start exercising, even just 20 to 30 minutes every day of low-intensity movement will help.

Break this up into 10-minute intervals, if needed, for stamina and adherence. Over time, work up to a more moderate intensity that makes you feel breathy and will raise your heart rate slightly. Eventually, do up to 90 minutes daily to lose weight, but this amount daily may take several months or even years to achieve. Brisk walking, water exercise and cycling are appropriate forms of exercise, as they don't put too much additional impact on your back, ankles, hips and knees. Working with weights when you're morbidly obese -- which means your body is easily physically stressed and your range of motion is limited -- may be contraindicated. Talk to your doctor about when you can safely add regular strength training, which helps build muscle to assist in weight loss. Incorporate lifestyle measures to help improve your adherence to a low-calorie diet and more physical activity. Enlist friends and family to encourage your efforts or seek support from the medical community and support groups, if you don't have the resources at home.

Keep a food journal to track your intake and physical activity; seeing what you eat daily written on paper can help keep you accountable. A journal can also help you identify which types of triggers cause you to overeat -- whether it's that time of the month, stress, anxiety, boredom or loneliness. When you know these triggers, you can take steps to avoid them.Patio Furniture Cushions Overstock You might hope to lose weight quickly like people on reality weight-loss shows, but keep your expectations realistic. Repair Hot Tub Cover VinylLosing more than 3 pounds a week two weeks after you changed your routine, increases your risk of medical complications related to weight loss, such as gall stones. Corvette Grand Sport Tires For Sale

Reality shows are about people who are on a 24/7 regimen and who have constant access to dietitians, fitness professionals and support from medical professionals. Real life is different -- you'll encounter day-to-day obstacles, personal defeats and temptations that you'll need to navigate on your own. Weight loss is a process, and when you have a lot to lose, it can take years to achieve a healthy weight. Sometimes, depression accompanies severe obesity. If you feel this might be the case for you, talk to your doctor to get the appropriate help you need. A very-low calorie diet that's medically prescribed and supervised may be warranted if you have immediate health issues that only quick weight loss will mitigate. These diets usually consist of 800 to 1,000 calories per day and yield about an average 3-pound per week-loss rate. Because they're so radical, you'll likely only be kept on this extreme calorie restriction for 12 weeks or less. A very low-calorie diet usually consists of specifically measured meal replacements, sometimes in the form of shakes, and require regular monitoring by your doctor.

Weight-loss surgery is also indicated in some cases of morbid obesity. This is not a treatment to enter into lightly; the risks of complications are great. Your doctor will determine if you're a good candidate, based on criteria such as your psychological stability, motivation level and social support. Bariatric surgery should be a last resort when efforts to exercise and following a lower calorie diet plan have proven insufficient.It's All About Planning When you have a lot of weight to lose, it means playing the long game. And during that time, you'll face challenges. Weight loss experts and people who have done it offer you their ideas to cut calories, fight the "hangry," make exercise easier, stay on track, and more. Some are tried-and-true, and others may surprise you. Go Big for Breakfast People who eat more in the morning and less at night tend to lose more weight. Some studies suggest that starting your day with a high-protein meal -- especially warm, solid food -- helps you feel fuller and less hungry later.

Shoot for 350-400 calories with at least 25 grams of protein, says Domenica Rubino, MD, director of the Washington Center for Weight Management & Research. Keep a Photo Diary "We have horrible memories in terms of what we eat," says Susan Albers, PsyD, author of EatQ. Save your food photos in a daily file. Before your next snack or meal, review them. They'll remind you what you've already eaten. And that may help you decide to downsize or choose something else. "I just do not see food and portions the way normally thin people see them," blogger Lisa Durant says. She used My Fitness Pal to focus on her relationship with food. She tracked what she ate and how much. That helped her be honest with herself. She also set weight loss and fitness goals to track her progress. Without an app, "I would absolutely gain some weight back." Try a Meal Replacement Plan Under a licensed professional's care, you'll eat one regular meal per day and swap the others for special shakes, soups, or bars.

"If you can stick to it, you'll see big results in 6 months to a year," says Ken Fujioka, MD, an obesity specialist at the Scripps Clinic in San Diego. Set Up Your Food Storage Out of sight, out of mind -- and mouth. After you purge your home of those treats you can't resist, Albers recommends taking the idea a step further: Assign shelves in the pantry and the fridge so your healthy food becomes easy to see and reach. Put fresh veggies and fruit at eye level instead of inside a drawer, and you're more likely to grab them when you open the door. Don't leave your meals to chance. Have ingredients on hand so you aren't tempted to resort to take-out. Think about menus that work for the household: Maybe your veggie stir-fry can be their side dish, too. Make a grocery list together, even if you're cooking separately. Stay out of bulk warehouse stores, Albers says. The oversized items can invite overeating. Find a Fan Club Support from a group can help you lose more weight than going it alone.

You'll gain perspective, encouragement, tips -- even a little competition, if that's the kind of thing that gets you motivated. Durant, who lost 115 pounds, started with Weight Watchers. "My leader was fantastic," she says. Besides in-person meetings, check out online forums and social media. Support from family and friends helps keep the weight off, too. Outsmart Your Inner Critic When (let's be honest, there's no "if" about it) you get off-track, it can be hard to forgive yourself. So pretend it's a friend who slipped up and is upset, Rubino says. Write a note to them. Then read it out loud -- to yourself. It will likely be kinder and more encouraging than anything the little voice in your head would say. You'll learn to reconnect with your body, Rubino says. A physical therapist is trained to work with people who have medical issues and trouble moving in their daily lives. Think of them as someone who'll get you ready for the personal trainer. Your therapist will design a program, tailored for you, to improve your balance, strength, and range of motion.

PT can often help ease joint pain you may have, too. You may not realize it, but you've built them up just by moving your extra weight around. And as you lose body fat, you want to keep those muscles. They burn fat and calories! But if you don't use them, you'll lose them. Mira Rasmussen, an exercise physiologist, likes wall squats, with the help of an exercise ball for body alignment. These work most of the major muscles below your waist at once. Get in the Pool Swimming is a whole-body, non-impact workout with a fantastic calorie burn, Rasmussen says. The water helps hold you up, so there's no pressure on your joints. Plus, it saves time by combining cardio and muscle-building in a single activity. If exercise is hard for you, try doing it in chest-deep water, which can reduce swelling, enhance circulation, and help relieve pain from inflammation. Look Past the Pounds Regardless of what the scale says, your body may still be changing in a good way. Rubino says, "Remind yourself what you've gained by losing the weight."

Are your clothes getting looser? Are you losing inches? Is your blood pressure better? If you have diabetes, have your sugar levels improved? Can you handle more exercise? Celebrate those non-scale victories, too! Get Checked for Sleep Apnea You may not be resting as well as you think you are. This condition, which interrupts your breathing while you sleep, often affects people who are overweight. It can disrupt your slumber and you won't know it. Studies show that a lack of sleep alters hormones that control hunger. Rubino suggests being tested and treated. Ask About Weight Loss Medicine Once you've lost 5% to 10% of your weight, your body makes adjustments to fight losing any more, Fujioka says. Hormones that signal you've had enough to eat don't get sent to your brain, and you're still hungry. "We use medications to give that feeling of being full," he says. When that point comes, talk to your doctor about whether a prescription drug or over-the-counter product could help you keep going.