Last week, I was interviewed by one of our local news channels about a ‘new’ strategy for weight loss. The idea goes a little bit beyond “thinking your way thin” – which focuses on behavior change when it comes to food choice – to something more like, “believing your way thin”. It’s basically an attitude adjustment. If you tell yourself – and believe – that you’re already a healthy, active person who eats well, then you’re much more likely to behave like one. And those healthy behaviors should, in turn, lead you closer to your goal.

The psychology of weight loss focuses mostly on shifting one’s approach to food – like determining what it is that leads to overeating, and how to replace bad behaviors with good ones. It also means teaching our inner voices to ‘talk nice’. Positive self-talk means that we don’t beat ourselves up when we slip – instead, our inner voices remind us that just because we slipped, it doesn’t mean we have to fall.

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You would think that people who eat healthy and stay slim would be the ones who spend a lot of time thinking about what they eat.  After all, how else could they maintain a healthy weight unless they’re focusing on every bite?  There are some clear differences in the way normal weight and overweight people approach food and eating – but what we’ve learned is that naturally trim people actually tend to think about food less than those who are watching their weight. 

Naturally slim people have a relatively comfortable relationship with food, so they don’t really focus on it all that much.  But for heavier people, the relationship is often more difficult and complex.  Overweight people tend to be preoccupied with food – which ones are good or bad, how much or how little they should eat (and when) – to the point where they end up thinking about food all the time. 

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A few weeks ago, the US Coast Guard announced a major downsizing.  Not in their staff, but in the number of passengers that will be allowed to travel on commercial boats.  The reason?  The average passenger weight is being bumped up by 25 pounds – which will determine, and now lessen, the number of people a boat can safely hold. It’s yet another nod to the staggering statistic that two-thirds of adults in this country are overweight or obese.

It’s well documented that we’re getting bigger and bigger.  And it seems that as we get larger, everything else is getting larger, too – from dinner plates to dashboards.  Like the “chicken and egg” question, though, it’s not always clear which came first. 

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A few months ago, I got a call from a long-time patient who hadn’t been in for a while. The last time I had seen her, she was doing so well with her diet and exercise program – she lost about 25 pounds with another 20 to go – that we agreed to loosen the reins between us a bit. So when she called, I expected her to give me the good news that she’d reached her goal. Instead, she asked if she could come back in to see me – and if she could bring her husband.

 “You need to talk to him,” she said, “because lately, I feel like he’s sabotaging me. Every time I turn around, he’s bringing goodies into the house. Then last night he told me that he liked me better when I had more meat on my bones!”

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Another Monday is coming around, and you’re gearing up for another round of dieting.  Checklist in hand, you’re feeling in charge.  Tempting foods out of the house?  Check.  Bowl of fresh fruit on the counter?  Check.  Cut veggies placed front and center in the ‘frig?  Check.  But as you stride into work with your healthy homemade lunch, you’re faced with cinnamon rolls in the breakroom, a vending machine full of junk food, and a co-worker with a jar of chocolate candies on her desk.  Check, check and check.  

I once worked in an office where fresh doughnuts were delivered to the breakroom every morning – and this was a cardiologist’s office.   I don’t even like doughnuts, but it was still hard to resist a bite or two every time I’d go in to refresh my coffee.  Despite my protests that we were perhaps sending the wrong message, the doughnut delivery persisted, so I bought a little coffee maker for my office so I could avoid the lunch room altogether. 

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Let’s face it – losing weight is no simple task.  If it were, we’d surely see fewer people struggling to get their weight down and keep it off.  Taking in fewer calories than you spend every day sounds like a simple enough formula, but counting calories accurately – both the ones that you eat and the ones that you burn – takes considerable practice. 

 On top of the calorie counting problem, I’ve found many dieters – with good intentions, mind you – who make critical mistakes when it comes to devising their own health plans.  So when patients tell me they can’t lose weight, it’s often because they’re committing a few of these common dieting mistakes.

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Quick – how many people do you know who are too heavy?  And how many do you know who aren’t?  Chances are, you know more overweight people than thin ones, since normal weight people are now in the minority – two-thirds of US adults are either overweight or obese.  How we got this way has been endlessly discussed – we eat too much of the wrong foods, we eat all the time and we don’t exercise enough.  So given what we eat and how little we move, the real question is “why isn’t everyone fat?”. 

Humans are designed to stockpile calories.  We’re genetically programmed – just like our ancient hunter-gatherer ancestors were – to hang on to every calorie we can.  These thrifty genes can work against us by helping us to store more – and the wide availability of cheap, tasty food just makes it even easier to do so.  But there’s a bit of genetic programming that determines how much energy we spend every day, too – even influencing how much we move when we’re not exercising.

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It’s been said that there are no bad foods, only bad diets. The idea is this: if we simply ate a wide range of foods – mostly healthy foods – and didn’t eat too much, we’d all be better off. But even though most people might understand the concept of a diet based on variety, balance and moderation, for many it’s still difficult to put into practice.

We crave variety. Humans evolved in surroundings overrun with a huge range of plant foods. And the drive to consume them was nature’s way to ensure that nutrient needs would be met. We carry this same urge with us today – which would still serve us well if we were merely selecting from a spread of edible plants. But we’re not. We’re faced with way too many food choices – not all of them good for us – and studies show that the more choices we have, the more we eat.

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