Each year Americans spend more than $33 billion on weight-loss products and services, including drastic stomach-reduction surgeries, which have nearly doubled since 1998. And yet the nation has never been fatter: According to a recent report conducted by the U.S. Surgeon General, 61 percent of American adults are either overweight or obese. How to explain this seeming disparity? Instead of getting the recommended 30 minutes of exercise five times a week (only 22 percent of the population does so) and watching calories (restaurant serving sizes have also gotten larger in the past decade), Americans are looking for "a quick fix," says Monica Krygowski, a dietitian with the Eating Disorders Treatment Team at the University of Texas at Austin. "But that never works."

At the National Weight Control Registry, which monitors about 3,000 individuals who have lost at least 30 lbs. and maintained their new size for a year or longer, doctors are proving what has long been suspected: The only way to lose weight -- for good -- is by committing to a combination of regular exercise and a low-calorie, low-fat diet.

That's no surprise to Tina Marron and the three others on the following pages who have dropped from 66 to 184 lbs. each and kept them off. "I'm more on a lifestyle change than a diet," says Franano, who lost 84 lbs. over the past 12 months. When it comes to weight loss, that's the right outlook, says Dr. Peter Vash of the American Obesity Association. "Small steps can get you there," Vash says, "so long as you're patient."

• Tina Marron
• Olga Arias
• Cedric Williams
• Judy Wood