Countless women have had the same disturbing thought: “I lose one pound in a week, after starving and exercising. And then there’s my husband – he thinks about losing weight and the pounds fall off.”

Even on the popular television show “The Biggest Loser,” of 14 winners, nine have been men.

While nearly the same number of men are obese as women in the United States (more than 60 percent of American women are overweight, and one-third of those women are obese), the fight seems harder for women. For females, their bodies don’t seem to be their friends when battling the scale.

Dr. Lisa Medvetz

“Women are built to have more body fat, where men have more muscle mass,” says Lisa Medvetz, MD, director of bariatric and metabolic surgery at Lourdes Medical Center of Burlington County. “Even when you’re at rest, muscle burns more calories than fat – one pound of muscle burns roughly 50 calories per hour, while one pound of fat only burns about two calories per hour. That’s a huge difference.

“Most women don’t want to lift weights, because they’re afraid they’re going to bulk up. But just adding even one or two pounds of muscle through strength training will burn significantly more calories without any bulk,” she adds.

Along with more body fat and less muscle mass, women also have estrogen, which contributes to the storage of fat, explains Cherry Hill’s Peg Manochi, a registered nurse who lost 30 pounds this year on a high-protein, low-carb diet.

“I was a mindless eater who went from snack to snack, and the more carbs you eat the more you want,” she says. Manochi, 57, has kept the weight off by eating chicken, fish and vegetables, only having treats on special occasions and exercising regularly.

Some studies show that women have to exercise more than men to reap the similar benefits. At the University of Missouri, researchers put men and women on the same exercise regime, and the men benefitted from the exercising program more than the women, according to Metabolism Journal.

But women can have weight-loss success whether through a lifestyle change, diet improvements or, for an increasing number of obese people, through surgeries like gastric bypass. But even surgery is only successful if patients change their habits after the operation.

For Tami Gordon-Brody of Cherry Hill, it was only a few years ago when she was looking at pictures of herself with her family and had a revelation. That was the moment she knew she couldn’t go on at 250 pounds, with body pains and trouble getting up the steps in her own home.

“I was humongous,” she says. “I looked at one of the pictures and said, ‘This has to stop. This is it.’ I was out of breath all the time. I had reflux, sleep apnea, high blood pressure, high cholesterol and bad circulation. What I was doing to myself was self-destructive. I would soothe myself with food. I would eat when I was happy, when I was sad and when I was stressed out. I correlated food with celebration. I finally had to realize I had to get real about it. I was going to have a heart attack or diabetes. I was shaving years off my life.”

Gordon-Brody, who is now 50, had tried every diet and even had success at times, but like millions of American women, the weight returned. As the years went on, losing weight became harder than ever.

Wanting to be healthy for her sons, now 18 and 21, Gordon-Brody turned to Rohit Patel, MD, director of Cooper’s Bariatric and Metabolic Surgery Center, for gastric bypass surgery. At the beginning of last year, weighing almost 250 pounds, she had the operation.

Today, she wears a size 10 dress and enjoys being able to choose where to shop instead of finding clothes at a specialty store. She has lost 100 pounds. It’s allowed her to take up some former hobbies like community theater, plus she exercises and easily walks up and down steps. “I have so much energy now,” she says.

But it hasn’t been easy. Her stomach is about the size of an egg. She eats six very small meals a day, like one banana, one small salad, one scrambled egg or one protein smoothie. She still cooks for her family, but she eats very small portions. If she wants to try a dessert, one bite is enough. Instead of eating when under stress, she will call a friend, watch a movie or go out shopping. “I have learned to re-direct,” she says.

Before surgery she met with psychologists and nutritionists, because the surgery was just one step in the process. “It’s not easy. You have to change your life. The surgery is just a tool. It’s okay to be selfish about your health and make you a priority. We deserve to be healthy. I used to laugh when people say my body is a temple, but it is.”

Patel says women are typically more interested or open to the option of weight loss surgery, and the reasons for their obesity are multi-faceted. Stress, culture, access to food and genetics can all play a role. “It can be different for each patient, and it’s not just fixed with surgery,” he explains. “It is about understanding why that person struggles.”

Patel believes women’s weight-loss challenges are caused more by their priorities than their physiology.

“Women put family and children first,” he says. “Women don’t put the focus on themselves.” Often when women come to Patel for surgery, their reason to have the procedure is to be healthy for others. “‘I need to do this because I want to provide and take care of my family,’ they say. Many women have not had time to focus on themselves.”

Many of Patel’s female patients, like Gordon-Brody, spent years losing weight, then gaining it all back (and more). While obesity is a disease, Patel sees that curing it makes people healthier in many ways. “You can help to treat and prevent a number of diseases with this operation,” he says. That includes heart disease, cancer and stroke.

Jamie Wood, fitness manager for Virtua’s William G. Rohrer Center for HealthFitness, says women need to embrace a lifestyle change in order to lose weight and keep it off.

“Women want results sooner,” says Wood. “That’s not realistic, and it can become discouraging.” Losing one or two pounds a week is reasonable and some weeks there is no loss, but the next week the scale should drop again.

“Set realistic short-term goals and then reward yourself,” Wood says. “And remember the scale doesn’t tell the whole story.” If your clothes start fitting better and your blood pressure is lower or your cholesterol drops, those are successes too, she says.

Wood doesn’t favor extreme diets. Instead she recommends combining exercise and better eating. Make meals that are half vegetables accompanied by lean meats or fish and whole grains. Try to eat five vegetables of different colors each day.

While working out with a friend, partner or spouse can help you stay accountable and make exercise more fun, Medvetz urges women to set – and stay focused on – their own weight-loss goals.

“It can be difficult to lose weight alongside someone else – especially if it’s a man,” she says. “You can’t compare your progress to anyone else. It shouldn’t matter if someone else lost 20 pounds to your two pounds. Celebrate the fact that you lost those two pounds, and keep working at your own pace.”