I have a new favorite quote from weight loss doc Yoni Freedhoff:
Lose weight in the kitchen, gain health in the gym.
Read the backstory in Yoni’s Weighty Matters post on exercise and food intake.
Blogger and activist Candice Russell writes frankly about life, major weight loss, excess skin in the Truth About ‘Before and After’ Weight Loss Photos:
Life as an “after” is not perfect. You won’t suddenly get the guy, the promotion, or the popularity you’ve always wanted just because you are thin. If you are looking for a fairytale ending, you won’t find it no matter how much weight you lose. And if you focus only on the aesthetics, your journey won’t ever really be complete. …
You are the same person you were, just with slightly different packaging. And unless you learn to love the person that you see in the “before,” nobody will ever accept you as an “after”. Not even you.
Canadian obesity doc/researcher/professor Dr. Arya Sharma has the results of a new meta-analysis of 37 RCTs looking at behavioral interventions and weight loss. The result? Not exactly promising … ~5 pounds weight lost over 12 months.
On calorie counting:
[T]here is enough evidence in the literature to show that most “successful” dieters develop a somewhat obsessive relationship to accounting for every bite they put in their mouths – measuring, counting, adding, journaling, avoiding and restricting become part of their daily routine. For some it becomes so automatic a behaviour, that they are no longer even conscious of doing it (nor do many stop to realise just how “abnormal” such a behaviour actual is).
If this helps them better manage their weight – good for them. As a strategy for the population – or in other words when measured in terms of “effectiveness” – such an approach is bound to fail. This is because most people are simply not going to live their lives that way (and who can blame them?).
On behavioral interventions and weight loss (emphasis mine):
This is not to say that behavioural interventions in obese individuals (including physical activity) are not beneficial – they are, just not for weight loss.
As I have said before (and restate every time I get a chance) – improving health behaviours can certainly lead to a healthier you – whether that you is leaner or not is an entirely different (and less important?) question.
It turns out that getting your cortex to run your hypothalamus is far more difficult that you may think.
While I’m not sure I’m on board with all of Dr. Sharma’s approaches to obesity (he’s not opposed to interventions like weight loss surgery or prescription drugs), I think the point about looking at this at a population level is important. Not everyone is ready or able to do a VLF or VLC diet and/or avoid grains or dairy or meat and/or turn into Michael Pollan and start cooking every meal and/or do weight loss surgery.
IMO, that’s what makes it a cultural or societal issue.
Many moons ago, I blogged author/pastor Steven Furtick’s perception vs reality quote about insecurity:
One reason we struggle w/ insecurity: we’re comparing our behind the scenes to everyone else’s highlight reel.
I was reminded of this when I came across this pic/post by Michelle Yeager on my Facebook feed recently:
Yeager’s “behind the scenes” might surprise you:
I feel like if everyone, myself included back when I was this lean, actually shared how we are really feeling deep down instead of just positing [sic] a picture of a body and saying “eat clean, train hard” or something along those lines, people would be a lot better off. … But no one wants to talk about how miserable they might be feeling. I know for me I was trying to put on a happy positive face, but on the inside I was a mess. I had sooo much anxiety around food. Everything I put into my body had to be perfectly measured to the gram and calculated for the day. I couldn’t focus on much other than the next time I got to eat, my workout for the day, and taking selfies.
Across the pond, twin doctors Alexander and Chris Van Tulleken attempted to “answer the hottest question in nutrition” for the BBC documentary Sugar v Fat. In a piece for the Daily Mail, they share their take on the sugar vs fat question:
The most interesting thing we found was that we were asking the wrong question. It’s not which is worse for you, fat or sugar, but rather which foods are making so many of us gain weight and why? …
What we discovered is that the real reason we’re all getting fatter isn’t fat or sugar.
Furthermore, sugar alone isn’t very addictive – only horses snack on sugar cubes and very few people gorge on boiled sweets or dry toast.
And fat isn’t really addictive either: when did you last sneak a spoonful of butter from the fridge late at night?
The modern processed food industry knows this and that’s why you’re rarely sold the two separately – what is addictive is the combination.
As it turns out, the relatively short duration of the experiment — one month — meant that the low-carber had issues with adaptation (ref his comment that ketones aren’t “great brain food” or his performance problems in tests against his twin). OTOH, he had more weight loss thanks to the loss of his stored glycogen.
But it turns out that neither diet was palatable to either twin: “both of these diets were miserable.”
If you want to lose weight it will be much easier if you avoid processed foods made with sugar and fat. These foods affect your brain in a completely different way from natural foods and it’s hard for anyone to resist eating too much.
And any diet that eliminates fat or sugar will be unpalatable, hard to sustain and probably be bad for your health, too.
Their experiment has its flaws, but on the other hand, I think it does show that for the average person, either diet is too restrictive for the long term. That said, I suspect that the real truth is that any diet that has you minimizing hyperpalatable foods is a step in the right direction. Here’s hoping this program helps get that message across.
Are you in the market for a New Year’s resolution related to your weight in 2014? If so, please consider Yoni Freedhoff’s suggestion to treat yourself with love and respect:
New Year’s Resolutions are a dime a dozen, and many will have to do with weight management, healthful eating and fitness. This year, in addition (or instead), consider resolving to treat yourself with just as much love and respect as you do your closest friends and relatives. … Because you deserve to love and respect yourself too; no doubt, doing so will confer onto you tremendous health and life benefits.
If you need another resolution, then Go Kaleo’s Amber suggests making consistency your goal in 2014:
When you eat a reasonable, healthy amount of mostly healthy food, and engage in reasonable, healthy physical activity, consistently, over time…your body will eventually stabilize at a healthy weight.
Until your habits are consistent, your weight will be inconsistent. …
Create the healthy balanced habits, and let the healthy balanced habits shape your body. And there you will stay.
I wish you a happy and healthy 2014!
Go Kaleo’s Amber Rogers on her Facebook page:
The reason I struggled unsuccessfully with my weight for 25 years was because I was struggling with my weight.
My weight wasn’t the problem. My weight was a symptom of the problem.
The problem was my habits. I treated myself poorly. My internal dialogue was abusive and unkind. When I exercised I did it to punish myself, and when I dieted I allowed myself an inhumanely small amount of food. These are not behaviors and habits that will produce a healthy body. These behaviors tear a person down, reduce self esteem, trigger binge eating, make exercise unpleasant, reduce a human to nothing more than a collection of body parts that are treated with contempt. And I did it to myself. And I bet many of you reading this do it to yourself.
The Obesity Society, the American Heart Association, and the American College of Cardiology have recently release their 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults (free full text available here). Dr. Arya Sharma has had a look and offers that the report is “big on how little we know” (emphasis mine):
[The report shows the] rather poor level of evidence that exists for virtually all of the dietary recommendations. …
Thus, low fat approaches appear no better than high-fat (strength of evidence: “moderate”), while the evidence in support of low-calorie diets, complex vs. simple carbs, glycemic load, Mediterranean-style diets, lower-fat lacto-ovo-vegetarian or vegan-style, or lower fat high dairy/calcium with added fiber and/or low glycemic index/load foods, use of liquid and bar meal replacements, or even very low calorie approaches is largely “insufficient” to make any reasonable recommendations in favour of any of these strategies versus any other.
Not that people do not lose on any or all of these diets as long as they are “energy restricted” – of course they do!
But, what is lacking is evidence that any of these countless dietary approaches confer any meaningful advantage (in terms of amount of weight lost, metabolic benefits or sustainabilty of weight loss) compared to any other.
So, whilst millions of “bestseller” diet books may continue to make millions for their authors and publishers by touting one revolutionary weight loss solution after another, they are essentially closer to religious belief systems than scientific fact. …
Perhaps, what we need to accept, is that there simply is no “superior” dietary approach to managing your weight – it’s whatever works best for you.
I suspect that the real trick is for susceptible folks to figure out a way to exist in an environment that strongly promotes obesity. Eliminating fat or carbs or meat may not be sufficient. And for some, it may not be worth perpetually tilting at windmills.
Imprüvism blogger Armi Legge has four essentials to flexible dieting:
If this sounds interesting, be sure to read the full post for details.
I realize that this approach may not work for everyone, but I suspect that, as for gluten intolerance, more folks are following severe dietary restriction than they need to.