Maria came into session, plopped down on the couch, and blurted, “I did it again. I was doing so well, and then I cheated on my diet.” Maria had been riding a dieting rollercoaster for most of her adult life, trying unsuccessfully to maintain a weight which was 15-20 pounds less than she weighed when she first came in to see me.
I have heard a myriad of dieting stories just like Maria’s: people trying to stick to a diet and being unable to do so, often times losing weight only to gain it back. Maria found it particularly frustrating since she was 61-years old and had been told by her doctor that she needed to lose weight for health reasons.
Even with her doctor’s advice, she still couldn’t stick to a diet, begging the question: why? If we know the benefits of maintaining healthy eating habits, why is it still so hard for people to diet? The answer — which I shared with Maria — is that the change doesn’t begin with what we eat or don’t eat, but with how we understand food and our relationship with it.
Think Gain, Not Loss
People hear the word diet, especially people who’ve struggled with weight on-and-off throughout their lives, and they think deprivation. For people who think of a diet as cutting out foods that they enjoy, it’s a time of restriction and loss. This is a problem. Think of cliché’s like: the grass is always greener, or, we always want what we can’t have. These suggest that there is a universal propensity to desire things that feel out of our reach.
This happens with food. If being on a diet is experienced as having desirable foods taken away, then the natural inclination is to want those ‘forbidden’ foods more. People report craving foods that they no longer let themselves eat. Diets that cut out full meals set people up to crave food even more. Worse, the state of starvation that these diets cause slows down our metabolism, most often leading to greater weight gains once the person returns to eating full meals.
As we get older, the deprivation may seem greater. We have already endured losses; now eliminating some favorite foods may be added to that list. This turned out to be Maria’s biggest obstacle.
The first thing we need to do — before embarking on the dietary changes, is to shift our thinking from seeing the diet as a loss of foods and instead, thinking of the gains we receive from making healthier food choices. Think healthy, think active, think better mood. These are the gains that eating healthy provide us with. I know, easier said than done, but it’s like a muscle that you have to keep working to strengthen. The more you practice thinking about your diet differently, the easier it will get. In the long term, the best way to stick to a diet is to not see it as a diet at all, but as your lifestyle.
Making Time for Exercise
Our biggest ally in the quest to maintain a healthy body weight is exercise. Exercise allows for some latitude with diets because extra calories are burned; it also often leads to healthier choices. We feel better about ourselves when we exercise. We see ourselves more positively. When we feel better, we are more likely to eat healthier, picking foods that fuel our active lifestyle.
Don’t make exercise a means to an end, though. For example, don’t think: I’m going to go to the gym for the next month to lose weight for my daughter’s wedding. Instead, make going to the gym part of your daily routine and a long term aspiration. The goal isn’t to be thin, but to be fit. To be strong. To be healthy. To feel good.
Hunger versus Appetite
Another obstacle to eating better is an inability to distinguish hunger from appetite. People who eat because of hunger are more likely to be a healthy weight. Unfortunately, most of us never learned the difference and, to some degree, eat based on appetite.
Hunger is our physiological need for nutrients; we eat because our body needs fuel; it’s a physical necessity. We eat to live. We eat to maintain a healthy, active life.
Appetite, on the other hand, is our emotional response to sensations from our environment that makes us want to eat: the smell of food, the taste of food and the social aspect of eating.
People who struggle with weight are more likely to eat based on appetite, and are more likely to continue eating once full. Additionally, people can lose the ability to recognize the physical sensation of hunger because they’ve spent most of their lives responding to environmental cues, rather than the sensations in their body. I have worked with patients who have lost the ability to register their stomach growling.
There has been a movement toward mindful eating, which emphasizes paying attention while eating and listening to your body. Don’t eat while distracted by the television or the computer. Even while out to eat, don’t let conversations distract you from the food you are putting in your mouth. Think about what you’re eating, stop between forkfuls, ask yourself if you feel full. The more you do this, the more likely you are to eat in response to your body and what your body needs — your hunger, instead of your appetite.
Finishing everything on your plate is not always a good thing, either. One of the biggest factors in weight management is eating when you’re hungry and stopping when you’re full. And although food choices are important, especially if your diet is to help with a condition such as diabetes, portion size is just as important, if not more so, in maintaining a healthy weight.
When to Seek Help for Emotional Eating
When we eat for comfort or use food as an attempt to quell difficult emotions, we’re more likely to gain weight. Emotional eating can be in response to external stressors, such as grief and loss, retirement, downsizing your home, empty nest. But it can also result from an internal sense of emptiness, but no amount of food can satiate them. In this case, the desire to feel full stems from some sort of emotional deprivation. The person may require professional assistance to understand what’s underlying the use of food to fill an emotional void.
As for Maria, once we addressed her psychological obstacles, she started a healthy lifestyle program, including eating healthy foods, eliminating empty calories, meditation and exercise. Slowly she began to lose weight, but the weight didn’t come off as quickly as she had hoped. This was a good sign. The more slowly we lose the weight, the more likely it is to stay off.
Editor’s note: Maria’s name was changed to protect her anonymity.