An estimated 45 million Americans go on a diet each year, and spend $33 billion each year on weight loss products. Yet, nearly two-thirds of Americans are overweight or obese. But what does “being on a diet” mean exactly? As you probably heard, 80% of your physical results come from your nutrition, while only 20% comes from exercise. For many people, the nutrition part means going on a diet, restricting calories, having limits, and being miserable.  But it should mean having a meal plan, healthy and balanced lifestyle you can live with and enjoy. It is true that for some medical conditions a very strict diet is recommended (specific carbohydrate diet, low-FODMAP diet, carb counting for diabetes, etc.), but for weight management it should not be something you “give up”, rather a continuation of mindful choices.

Restricting calories below your basal metabolic rate (energy needed to perform basic physiological functioning) will cause what is known as “starvation mode”. This is when your body adapts by reducing the amount of energy it uses to accomplish these tasks. Your basal metabolic rate, which accounts for more than 60% of the calories your body burns daily, slows down and causes you to burn fewer calories Your body may also turn to lean muscle mass for energy to conserve its fat stores, just in case it doesn’t receive more food anytime soon. I have many adult patients who since a very young age continue to have difficulty managing their weight. My following question to them is: why hasn’t it worked (excluding endocrine or other possible metabolic factors)? And thus, here comes the dieter’s dilemma created by psychologist John P. Foreyt and G. Ken Goodrick:

How to break the cycle?

Step 1: Identify why your previous attempts failed

Are you eating when you feel sad, bored or tired rather than hungry?

Do you have a supportive environment to help you achieve your nutritional goals?

Are you constantly self-doubting yourself?

Were you only trying to lose weight to please others?

 

Your Goal: Distract and Dispute

You can use the STOP method to distract your attention from your negative beliefs:

S is for Slow down.

T is for Take a breath.

O is for Observe objectively without attitude or emotion.

 P is for Plan a different strategy

 

Step 2: Stop looking for the next big thing or trendy diet that will only give you temporary results. New goal: identify your hunger cues

It is important that you honor your biological hunger. Each time you eat ask yourself: “Am I hungry? What’s my hunger level?” Here is how hunger (for most people) feels raging form gentle to ravenous:

• Mild gurgling stomach
• Growling stomach noises
• Light-headiness
• Difficulty concentrating
• Uncomfortable stomach pain
• Irritability
• Feeling faint
• Headache

The Hunger Discovery Scale

The problem: when you go longer than 5 hours without eating you tend to overeat at your next meal or snack. This is because your liver runs out of “fuel” or energy coming from carbs every 3-6 hours. Therefore, use a scale from 1-10 every time you start to eat to check your hunger level.

Ideally aim for around a level of 3 to begin eating. If you are at a 5 or above you are not biologically hungry, if you are at al 2 or lower you are at risk of overeating due to extreme hunger.

 

Step 3: Embrace a positive body image

Pay attention to your positive body image experiences, such as:

– Getting a new hairstyle

– Buying new makeup

– Participating in sports such as walking or swimming

– Buying new clothes

 

Think about activities you used to enjoy but stopped doing. Use these thoughts to create new positive body image exercises:

– Write down two activities that you would like to start doing again.

– Explore a range of activities that will help you better enjoy your body.

 

Step 4: Embrace all foods in moderation

– Remind yourself that no single food causes weight gain. Weight management is based on total calories and not on restricting certain foods or food groups.

– Instead of thinking about foods as being “good” or “bad,” change your food language.

 

Word Choices When Talking About Food

– Instead of saying “This is a bad food,” say “This food has a lot of calories; if I

want it, I will eat it in moderation.”

– Instead of saying “I cheated,” say “I ate more than I wanted to, but that happens

to everyone occasionally. It is normal and I won’t beat myself up over it.”

–  Instead of saying “I was bad,” say “I ate more calories than I intended, but I am

in control now.”

– Instead of saying “I feel so guilty,” say “I did nothing wrong. I ate a moderate

portion of something I wanted to eat and I enjoyed every bite.”

– Instead of eating quickly out of packages, make food special by putting it on a real plate or bowl and using silverware.

 

Step 5: Socialize and Enjoy

– Enjoy once “off-limit” foods in the company of others. This may help you avoid overindulging when you are alone.

– When you are in a restaurant with companions, order what you want, not what you “should” eat:

– Savor every bite and enjoy it slowly

– Stop eating when you feel the first signs of fullness. Don’t feel that you must clean your plate

– If you have difficulty eating certain foods in small amounts when home alone, practice eating “safe portions” in “safe places” (places where you’re less likely to overeat)

 

References

Nutrition & Weight Management. http://www.bmc.org/nutritionweight/services/weightmanagement.htm  Accessed December 18, 2017

Tribole E, Resch E. Chapter 6: Honor your hunger. In:  Tribole E, Resch E. Intuitive Eating a Revolutionary Program that Works. 1^st ed. St. Martin’s Press, New York, NY; 2012: 59-70.

Kushner, RF, Kushner, N, and Jackson Blatner D. Counseling Overweight Adults: The Lifestyle Patterns Approach and Toolkit. Chicago: American Dietetic Association, 2009.

Gropper SS, Smith JL. Chapter 8: Integration and regulation of metabolism and the impact of exercise and sport. Advanced Nutrition and Metabolism. 6^th ed. Wadsworth Publishing, Belmont, CA; 2012: 239-242.