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The psychology of weight loss.

Do I Really Need to Count Calories to Lose Weight?

When nothing else works, why calorie counting does.

Imagine a friend came to you and said she needed help balancing her budget.  She’s spending more than she earns and getting into some real financial trouble---so much she may lose her home. Here is a likely exchange between you and this friend:

You: Well, for starters, what is your income?

Her:  I’m not sure. I have multiple sources of income and I never really add it up.

You:  Ok, well, how much do you spend each month?

Her:  I’m not sure, I never keep track.

You:  Well, the first step will be to figure out your total earnings and your monthly bills so we can develop a budget for you. A budget will prevent you from spending more than you earn.

Her:  That sounds like a lot of hassle. I used to do that and it just made me anxious because I could see I was spending way too much. I can’t deal with the anxiety plus who has the time to track every single purchase!

You:  Hmmmm…ok. Well, maybe try to cut back on spending here and there. For example, instead of buying coffee at Starbucks every day, make coffee at home. Little cuts can make a big difference.

She tries your suggestion for a month or so.

Her:  I made some cuts but it didn’t work, I am still falling short on my bills.

You:  I really, really, really think you need to figure out how much you make and how much you're spending so we can come up with a budget. I’m just not sure how to help you otherwise.

Her:  I think I’m just a failure.  It’s probably genetic. Nobody in my family is good at finances and math. Sigh.

You:  Sigh.

We're stuck. Your friend is trying to solve a problem, but without the information she needs to make progress.

Tracking your calorie intake and expenditure is exactly the same type of problem. It is very difficult to strike the right balance (or create a deficit!) without knowing what is on both sides of the equation. The challenge for the friend above is that when she peeks at the balance she gets anxious, so she avoids it.  When you pushed on that a bit at the end, she became demoralized—“I’m just a failure.”

Avoidance only makes anxiety worse and eventually it leads to demoralization. The only way to overcome anxiety is to confront what is making you anxious. Tracking calories is hard. It brings up bad feelings, but hopefully it is clear why it is such a necessary evil when other strategies aren't working.

See this post for some tips on lessening the burden of the task.

See this post for some common ways we "cheat" while we track.

Sherry Pagoto, Ph.D., is an Associate Professor of Medicine, Division of Preventive and Behavioral Medicine, Department of Medicine at the University of Massachusetts Medical School.

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