The Hijacking of “Lifestyle Changes”

Out_for_A_Spin - cats cycling
Lifestyle changes are fun to make when they don’t involve thinking about weight loss.
I want to stage a coup. I want to take back the term “lifestyle changes” from the diet industry.

In my last post, I talked about the crazy things people will do in the name of losing weight. Pro-weight-loss people, allow me to speak for you because I know exactly what you’re going to say: “Obviously diets don’t work; everyone knows losing weight is really about making permanent lifestyle changes.” I have heard this refrain myself from well-meaning-but-not-yet-in-the-know colleagues many times.

The reality is something quite different. When we (non-diet advocates and just, you know, all the research) say that nothing has been shown to produce long-term (greater than 5 years) weight loss for most people, we are talking about everything: calorie restriction, exercise, and yes, even so-called lifestyle changes. (And if you can find proof otherwise, please send it my way)

I am not against lifestyle changes, not in the least. There are many things we can do to improve our health: we can eat more fruits and vegetables; we can move our bodies more; we can try to lessen our stress; we can quit smoking or just never start; and we can avoid excessive alcohol consumption. Doing all of those things will most likely help to make you a healthier person. I’m all about getting as healthy as we can.

But when the term “lifestyle changes” is meant to inspire weight loss…sorry, but that’s when it becomes just another diet. Most easy-to-make lifestyle changes don’t result in significant, long-term weight loss. They just don’t. That’s why most people who want to lose weight turn to more extreme, unsustainable measures – calorie restriction (aka dieting) or food-group elimination (think Atkins or Paleo). While these methods of eating do tend to produce immediate weight loss, the results are short-lived and nearly everyone gains the weight back and sometimes even more within 3 to 5 years.

I’m not saying lifestyle changes won’t produce weight loss – maybe sometimes they will. But when weight loss becomes the focus of the behavior change, and then the weight is regained (as tends to happen through natural, biological processes geared to maintain weight homeostasis), how likely are people to keep up those changes that they made? Maybe if outcomes goals of lifestyle changes were things like feeling better or improved metabolic measures, instead of unrealistic expectations of permanent weight loss, then people would be more willing to try them, or keep them up once started. As long as they masquerade as a diet, I predict resistance and disappointment for all.

Maybe it’s too late for “lifestyle changes,” but at least we still have Health at Every Size® – a term registered by ASDAH to protect it from this same hijacking. So suck it, weight loss industry: your profiteering stops here.

Bonus! Book Review: Secrets of the Eating Lab: The Science of Weight Loss, the Myth of Willpower, and Why You Should Never Diet Again

One of the most comprehensive, fact-laden books I’ve read on the subject of the failure of weight loss lately is Secrets of the Eating Lab: The Science of Weight Loss, the Myth of Willpower, and Why You Should Never Diet Again by Traci Mann, PhD. Mann runs the Health and Eating Lab at the University of Minnesota and is no stranger to the science of weight loss. The first section of the book is chock-full of references to the literature on the failure of intentional weight loss efforts (aka dieting). She writes engagingly on why diets don’t work and how the failure to maintain weight loss has nothing to do with willpower. I can’t recommend this book enough if you are still skeptical about the need to abandon dieting as a health intervention. The second part of the book delves into why diets are not only useless, but bad for you. This, of course, is my favorite part! Again, every statement is backed up by sound research.

The third section of the book is titled “How to Reach Your Leanest Livable Weight (No Willpower Required)” and is essentially a list of small changes you can make to help you eat healthfully and live at the lowest end of your weight range (although no advice on how to know what that personal range is). I tried to read this part with as little bias as I could muster, but as a recovered dieter, I will never be completely bias-free when it comes to talk about eating and I had mixed feelings about this section. However, as much as I love and promote intuitive eating, I also realize that there is no one definite way to eat for everyone. Tips include making healthier foods more readily accessible and creating obstacles to temptations (like taking the route to work that doesn’t pass your favorite bakery). Some of these tips I love, like not eating healthy food because it’s healthy but because you have other compelling reasons that are important to you (might I suggest taste?), and changing how you think about tempting foods. Others, I was not so keen on, like pre-committing to a penalty for indulging (because I don’t believe punishment and eating are good bedfellows).

Some of these tips felt a little prescriptive to me but may be useful for those who have never dieted and want more regimented ways to eat better. As long as the “tips” don’t become strict rules and aren’t tied to weight loss results, I think they could amount to good advice for some. Dieters in recovery may find some of the tips too rigid or similar to the diet rules they used to follow, as I did with some of them. And what works in the eating lab to get people to eat better (when they do not even realize their eating is being studied) may work differently when we are applying them more consciously to ourselves. However, I appreciated the final tip the most, “Savor (nearly) everything,” because I think it underscores the basic message of the book – don’t eat for weight loss, eat well, and enjoy life. As long as the little “lifestyle changes” recommended here don’t become “diet rules,” the book remains an important part of the non-diet canon. So yes, I’m recommending the book for its ardent, fact-based support of abandoning intentional weight loss. Happy reading!

The Fundamental Weirdness of Dieting

Diet Crap with outline(Potential trigger warning to recovering dieters/ED folks: I discuss ridiculous diet advice in this post)

Many people who have, perhaps, never dieted to try to lose weight often think it’s merely a matter of “eat a little less, exercise a little more” and then the magic happens. I’m here to tell you that when it comes to weight loss efforts, nothing could be further from the truth. If simple lifestyle changes like eating more veggies, eating fewer fried foods, and moving some more produced viable weight loss results, no one would be fat, because making those changes is relatively easy. They can make us healthier but they generally don’t work to make us a whole lot thinner. Thus, dieting behavior ensues.

Some of the weight loss tips I was given during my time at Weight Watchers (the weight loss company most people consider “the sensible one”) are downright laughable when I think about them now. Although contemplating doing them again actually makes me want to cry, not laugh.

Here’s some of the diet advice I’ve encountered over the years:

  1. Eat your salad undressed, with dressing on the side, and then dip the tines of your fork ever so gingerly into the dressing before spearing a bite of salad. Honestly, even in my most diety of diet days, this seemed utterly ridiculous, both for the effort it took and results it produced. I happen to think the best thing (or at least the thing that makes it edible) about a salad is the dressing, so plunging into a naked salad with but a microdrop of dressing on the fork seems downright obscene. The whole time I dieted (most of my adult life) I avoided salads for this very reason – too much dressing would make me gain weight, too little would render it inedible. Healthy, right? When I order salads now and the server asks me if I want the salad dressed or dressing on the side, it’s such a comfort to be able to have my salad made as the chef intended it – fully dressed.
  2. Don’t use butter or oil on your vegetables; instead try a squeeze of lemon…on literally every vegetable you eat. Hey, guess what vegetables always dressed in lemon juice taste like? LEMON! I mostly skipped this one too by mostly just skipping vegetable sides altogether. If there was a vegetable incorporated into my entree, such as a stir-fry (and therefore coated in some sort of sauce or seasoning), I’d eat it. Otherwise, I wouldn’t touch a plain, steamed vegetable with a ten foot fork. There are a million awesome ways to cook veggies to make them more delicious to pickier palates: roasting, baking, sautéing, and yes, even steamed, but with a dollop of butter or drizzle of olive oil to really make them sing. Dietitian fun fact: many vegetables contain fat soluble vitamins (A, D, E, K) which means having them with some fat makes the vitamins a whole lot more bioavailable to us. I like lemon as a seasoning – occasionally. But not to mask the flavor of my unfatted vegetables (yes I did just make that word up). By the way, if you have a hard time eating vegetables and squeezing lemon on them is the only way you can tolerate them, then I applaud you for your efforts, and it’s the way you want it. It’s when it’s not the way you want it that it becomes a problem.
  3. Eat “Zero Points” (aka fat free, low carb, low protein) soup to fill up before a meal. Anyone ever make a whole batch of this soup, recipe courtesy of Weight Watchers (basically vegetables boiled in broth), have one bowl, and then watch it go moldy in the fridge because while you didn’t have the heart to throw it out after all that effort, you also didn’t have the fortitude to force one more spoonful of this gruel down your throat? Yeah, I didn’t think it was just me. Notice no one eats this kind of soup while not on a diet? Know why? Because it tastes awful! I make amazing soups now. They often involve olive or canola oils (both rich in monounsaturated fats), butter, avocado (also rich in MUFA), cheese, meat and yes, vegetables. They are delicious, and while certainly not “zero points,” they are also not soul-crushing.
  4. Go to a restaurant, order a meal, and immediately have the server put half of it in a doggie bag. Okay, seriously? If ever there was a place I wanted to escape the grip of my dieting, it was at a restaurant. How sad I’d have been to see half of my lovely meal for which I’d “saved up” my calories all week then go directly into a doggie bag before I’d even had a single bite. And unless that bag was hermetically sealed, I know I’d be dipping into it before I even left the restaurant. I was so hungry back then that I wouldn’t leave one single scrap on the plate and usually over-stuffed myself, but by Thor’s hammer, I was not going to sacrifice my dinner to the Styrofoam container before its time. I don’t always finish my plate these days, either at home or eating out, and am happy to have leftovers, but that is always based on my fullness level, and it’s my choice, not someone else’s mandate, which really makes all the difference.
  5. The all-time weirdest: use spaghetti squash instead of actual spaghetti in any dish that calls for pasta. Two words: NOT PASTA. I did this once. The resulting fibrous strings coated with tomato sauce went right into the trash after one bite. I have a special hatred for one type of food pretending to be another in the name of calorie reduction. My friend had a similar experience with Shirataki noodles, which I have avoided rigorously ever since hearing her tale.

These weren’t ever a part of my diet, but I’ve gleaned them after a lifetime of listening to diet talk:

  1. Go Low-Carb. Ah, perhaps my biggest diet pet peeve. Even if it did work to produce long-term weight loss (and there is no evidence to show that it does), I’ve met tons of low-carbers who have lost weight and then gained it all back because they simply could not live with so few carbohydrates in their diet for very long. I’ve never heard anyone get excited about giving up carbs, though I’ve personally witnessed a few low-carbers get a little over-excited at the presentation of cupcakes at a birthday celebration and the contemplation of having a massive cheat moment. I am sorry for these folks because while man (and woman) certainly can’t live by bread alone, living without carbohydrates really sucks. I know many people who have tried some version of this diet, but very few people who have stuck with it long term. And in conversation, their alternating obsessions with not-eating-carbs and dying-to-eat-carbs is tiresome. If you’re going to do this, do us all a favor and stop talking about it.
  2. Eat a breakfast and lunch of [Special K, meal replacement shakes, fake food item] and then have a “sensible” dinner. I sure as hell do not want to eat anything twice a day, never mind the bland items on offer in these classic diets. I really enjoy the (perhaps unintentional) inference that while your dinner may be sensible, your breakfast and lunch sure weren’t. Is the concept here to bore you into thinness by making you sick of eating? I don’t think it would work for me; I’d be so off-the-rails with real-food cravings by dinnertime there would be a major diet fail daily. Sorry diet food companies, you’re not going to fool me into buying more of your product by making me eat it twice a day.

As one of the most ardent, “successful” dieters I knew, even I could not participate in a lot of this weirdness, opting instead to avoid healthy foods altogether to reduce calories (which is stupid in its own right). Most diet rules make eating completely unenjoyable, yet we are biologically geared to enjoy food. It makes no sense to deny our most basic instinct, but we do it every day when we diet. No wonder every diet ends up failing the dieter.

What are the most ridiculous diet tips you’ve heard or tried? Feel free to leave them in the comments section!

What HAES® is Not

HAES graphicThere are a lot of misconceptions about Health at Every Size®, even among people who know that dieting is futile. I want to talk about them here and why they are just plain wrong.

Misconception #1: HAES® is just an excuse to overeat all the time.
Why it’s wrong: You might have missed it, but “health” happens to be the first word in Health at Every Size®. Is constantly overeating healthy? I think most of us can agree it is not. The opposite of restrictive eating is not overeating, it is freedom to eat, which is a very different thing than overeating. In fact, many studies on restrictive eating show a strong association with overeating, which means that you are more likely to frequently binge-eat while on a diet than you are not on a diet at all. HAES® emphasizes getting in tune with internal signals of hunger and fullness to help guide eating, and contrary to popular dieting belief, most people will not eat themselves to death if the reigns come off. From my own experience with HAES®, I overeat A LOT less than I ever did when I was dieting (and it is normal to overeat occasionally for many people). Overeating while on a diet was such a hallmark of my eating that I thought my appetite was broken. It was not – I was just really really really hungry. Once I began eating for my health and pleasure and not my weight, this “problem” miraculously disappeared. So HAES® is not an invitation to overeat more, it’s actually enabling us to do it less.

Misconception #2: HAES® is “letting yourself go” and not worrying about health.
Why it’s wrong: Once again, notice the word health in HAES®? The only thing you let go of with HAES® is trying to manipulate your body size – which is largely dictated by genes, not to mention a whole host of other things – into something that might not be natural, or even possible, for you. You can still work on improving your eating habits, increasing the amount of exercise you get and managing your stress – all things that will help improve your health – which is challenging enough without having to worry about shrinking yourself to someone else’s idea of a “healthy” size.

Misconception #3: HAES® doesn’t work because fat is just unhealthy.
Why it’s wrong: This has been shown time and time again to be just plain untrue. Numerous studies have shown that a thinner body is not required for good health…only good health habits. Specifically the work of Matheson et al, Bacon and Aphramor, and Mann and Tomiyama have shown that healthy habits such as eating more fruits and vegetables and getting regular exercise, not smoking and avoiding excessive alcohol consumption have all improved health and that weight loss does not necessarily improve all parameters of health. Meanwhile, there are exactly zero studies to show that long-term (>5 years) significant weight loss is possible for more than a tiny fraction of people. So we don’t need to keep throwing the same worthless intervention (weight loss) at people to make them healthy; we just need to enable people to engage in healthy habits (if they choose, since health is not an obligation) to help them be healthier. Duh.

If you continue to feel skeptical about HAES® and still think weight loss is the one true way, ask yourself this: who makes money from HAES®? Is there a $60 billion industry that is fueled by self-acceptance and the adoption of healthy habits? No. You likely can achieve these things on your own and improve your health without spending an extra dime. The diet industry doesn’t care if we become healthier, it only cares that it can sell the dream of weight-loss over and over again, often to repeat customers. That is one of the best rationales for Health at Every Size®.

Do I Have to Love My Body?

I'm ok
Okay with the selfie at last.

“Allow me to suggest a revolutionary action: Let’s try to be okay with our bodies. I am not saying you have to love your body. I can’t help but notice that this goal is frequently pushed on women, but never men, and if men don’t need to love their bodies, it seems to me that women can get by without it, too…Perhaps loving your body is something to strive for, but all we really need to do is respect our bodies, appreciate them, and be generally okay with them.” –Traci Mann, PhD, author “Secrets from the Eating Lab”

As I mentioned a few weeks ago, I’ve been reading Secrets from the Eating Lab: The Science of Weight Loss, the Myth of Willpower, and Why You Should Never Diet Again. I love so many parts of this book, like all the scientific evidence for the failure of weight loss diets. I’ll talk more about the book in a future post, but for now…see above quote.

Why did I love this quote so much? Because I found it to be profoundly freeing.

Part of the talk around giving up dieting revolves a lot around learning to love your body. As someone who dieted for most of her adult life, I didn’t even know what this would look like in practice. I tried a fake-it-till-you-make-it approach, telling myself that I loved my body and that I wasn’t going to torture it anymore. In reality, I no longer wanted to punish myself with deprivation and food obsession not for the sake of my body, but for my peace of mind.

But I espoused body-love because it seemed like a good idea. Even on this blog I talk about learning to love one’s own body, and loving my own body. What I probably come closer to, though, is this idea of being okay with my body.

I was raised, as most of us were, in a world where fat bodies were not seen as attractive. We still live in that world. One of the first things I did, after discovering Health At Every Size®, was to find ways that I could see large bodies as attractive, or at least not unattractive. I’ve never been one to focus too much on the outsides of other people…I reserved that obsession for myself. But I bought the party line that fat was not attractive, because that’s how I had been treated and that’s what everyone said. So I spent time on fat fashion blogs and I started looking at fat people around me with a neutral eye and I realized that there is nothing inherently unattractive about fat bodies. With just a little bit of practice I soon was able to see every body without bias. While it was easy to see others’ fat bodies as completely acceptable and even lovable, I still struggled with my own evolving body.

As my body continued to change dramatically after quitting dieting, I was unable to look at it in photos for a long time. With GI problems that cause severe abdominal bloating after even a small meal, I sometimes even avoid mirrors. While I don’t particularly have any animosity toward my body, loving it just seemed…a tall order. And a lot of work.

All of that doesn’t mean I’m not 100 percent okay with my body. I’m not embarrassed about my body with others – I’m not shy about being in a bathing suit or wearing body-con clothing. I have enormous gratitude for my bod and what it allows me to do. When I have those momentary “ehhh” photo moments, I remind myself that I’ve been under the unrelenting influence of completely unrealistic expectations for how women should look for all of my life. I also remind myself that I want to be more than about how I look. How I look is really the very least of me. And in the end, I really did become okay with my body.

I don’t require others to love my body, so I’m not sure that I need to either so long as I respect it and have some gratitude for it. What I want most of all is for my body to occupy zero space in my brain for most or all of the day – for it to lose the importance it has held in the past. My body is not my life’s work. What I do, how I am, is. Being okay with my body is frankly enough for me for now.