Don’t Start to Lose Weight Until You Know Why You Gained It

Talk to yourself before you talk to the doctor.

Posted Dec 29, 2019

December seems to be a month of eating foods designed to cause weight gain, and January is the month to remove those extra pounds. It makes sense to start the new year by quickly losing those five pounds or so added during the last month of the old. But does it make sense to start a long-term weight loss regimen based only on a New Year’s resolution? If every year the same resolution is made, and every year, perhaps by early spring, the resolution is forgotten and the diet abandoned, perhaps it is time to ask why: Why am I unable to stick to a diet longer than a few weeks?

Several weeks ago, someone with whom I take a course told me he had started on a diet that involved shakes, snack bars, and one meal a day. “I already lost three pounds, and it has only been a week,“ he said.

Yesterday I asked him how the diet was going, and his answer was to show me a box containing pouches of shakes and bars. ”I have stopped the diet; it wasn’t working,” he explained.

“When will you start again?” I asked. "January, but I am not sure which year,“ he laughed.

He was not ready to make the difficult transition from eating what he wanted, and in whatever quantities he chose, to eating foods that would allow him to continue to lose weight and maintain that loss. His immediate weight loss during the first week of the diet fooled him into thinking that it would not be difficult to overcome the psychological/emotional reasons for his overeating. Once the novelty of eating shakes and bars wore off, the reality of having to drastically curtail his food intake was not one he was willing to accept.

January’s weight loss plans, heavily advertised by the end of December, rarely if ever discuss the hard part: how the weight loss will stay lost when the dieter realizes that a permanent change in lifestyle has to be made. Not reverting to the pre-diet weight means avoiding the tendency to use food to fend off the winter blues, resist giving into excuses why to not exercise today, tomorrow, or ever, being vigilant about portion sizes all the time, clamping down on the temptation to indulge in more than small amounts of fattening foods, being aware of calories consumed in mindless snacking, attentiveness to alcohol intake, and fighting off the fear of getting on the scale daily—even when you know the numbers won’t be good.

Even if these lifestyle changes can be achieved, there is an additional reason why weight loss may not be permanent: overeating during periods of stress. Some weight-loss plans incorporate this problem in their weight-management plan, but their suggestions are usually generic. Few plans understand that carbohydrate intake will decrease the emotional intensity of stress by increasing serotonin, and few plans offer personal counseling to help the dieter avoid repetitive situations that generate stress.

Consider this alternative to beginning a major weight loss effort in January. The winter months can be used to identify the various reasons why weight is gained and/or why it is so difficult to keep it off once it is lost. Once this is done, honestly, without denial or judgement, the wannabe dieters can attempt to diminish these weight-gaining behaviors before actually starting on a specific weight loss plan.

The most common behaviors associated with gaining weight include:

  • Skipping meals, especially breakfast.
  • Automatic munching on snacks, such as candy or nuts, without any awareness of how        much is being eaten.
  • Ignoring portion sizes regardless of how large (or overly large) they are.
  • Paying too little or no attention at all to alcohol/soda/fruit juice.
  • Being oblivious to high-fat ingredients, e.g., salad dressing, butter, cream, etc. being consumed.
  • Eating up leftovers while putting them away.
  • Waking up and eating, then going back to sleep.
  • Avoiding daily physical activity, or inflating its duration and intensity.
  • Minimizing the frequency of bouts of emotional overeating, and the amount of food eaten.

If, after a few months of self-observation of one’s eating and exercise behavior, a profile of the reasons behind the weight gain is identified, then the dieter is in a good position to evaluate what weight loss-programs might work best to decrease or eliminate these behaviors. What should be apparent is that the type of weight loss food plan—no carbohydrates, fasting and feasting, cleanses, shakes, snacks, raw foods, prepared foods delivered to the front door, supplements, surgery, or whatever 2020 will offer—is irrelevant, unless the dieter has a self-awareness of why the weight was gained. It might be helpful to consult with a dietician before deciding on a weight loss program or at the very least, to find out whether the weight loss program being considered includes support to change weight gaining behaviors.

Beware of programs that tell the dieter that once weight is lost, all the reasons that caused weight gain will also be lost. If this were true, then the billions of dollars already spent on weight loss programs, foods, books, apps, and the like would have decreased obesity in the United States. A report published recently in the New England Journal of Medicine found that in 10 years, 50 percent of Americans will be obese; in more than 29 states, more than half the population will be obese.

If the New Year’s resolution is not to gain back the weight that is lost this year, maybe the trend toward an ever-increasing obesity will be slowed.

References

Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity  Ward, Z, Bleich S, Cradock, A et al ,N Engl, J  Med 2019; 381:2440-2450.