The Problem with Going On a Diet
I have always had a problem with the phrase “going on a diet.” When you go “on” a diet, it implies that, at some point, you’re going to go “off” the diet. The language surrounding diets is so bizarre - we commonly use the term “cheat days” because the assumption is that the diet you’re “on” is so restrictive and frustrating that you have to “cheat” to enjoy life. That we have to “give up” certain foods. Then we measure success by weighing ourselves obsessively, tracking to see if the diet is “working.”
It shouldn’t be like this, and in my opinion, this is the reason diets fail. First, our goals should not be focused on the scale. What really matters in your life: whether you can enjoy the life you want or whether your scale reads 15 lbs fewer? Health allows you to keep up with your children or grandchildren, take fewer medications, avoid illnesses and procedures and hospital stays. Being healthy means your body can do what you need it to do, whether it’s keeping you safe in an emergency situation or being able to live independently as you age. Eating a healthy diet and exercising has been shown to prevent (and in many cases, treat) many heath conditions, including cancer, diabetes, heart disease, stroke, and even dementia. Exercising and eating well has been shown in countless studies to improve energy levels, mood, sleep, and essentially all measures of well-being.
This is not to say that weight doesn’t matter - it absolutely does. For those who are overweight or obese, losing weight can mean curing or markedly improving diabetes, hypertension, high cholesterol, chronic back or knee pain, and sleep apnea. But I would argue by focusing on weight rather than the health of what we’re eating and the way we’re feeling, it ends up seeming more hopeless and frustrating. And if you’re someone who is healthy and just wants to weigh a little bit less - I would urge you to forget about the scale and instead take stock of your habits and energy level in assessing your health.
Sidenote: Teaching our Kids About Healthy Eating
As parents we have to be very careful about how we talk to our children about food. The focus should always be “this is healthy for our bodies” vs “this will make you get fat/weigh too much/etc.” The general rule for feeding kids is the parents choose what is available to eat, and the child gets to decide how much. When we force extra bites, we’re teaching them not to trust their body’s feedback mechanisms that tell them when they are not hungry. In addition, when we focus on weight vs health of food, we run the risk of our chid developing an unhealthy relationship with food, or worse, an eating disorder.
The alternative to “going on” a diet is what we should all be doing, and that’s following a heathy diet. All the time. Not prior to swimsuit season. Not after the holidays. It should become habit and second nature. The ideal diet is:
Balanced - mix of fruits, vegetables, proteins, fiber, healthy fats, and carbohydrates.
2. Minimally processed - the concept of processing will be discussed in a future blog post, but basically, you want to be eating food that resembles its original ingredients. We want to avoid things pictured below, where you can’t obviously tell what it’s made out of, and if you look at the ingredients, you understand what they are (unlike our example!)
3. Appropriately portioned - this is tougher to describe. Plate sizes, along with served portion sizes of almost all food and drinks have increased significantly in the last few decades. This is learned over time, but to start, planning how much food is available to eat prior to sitting down to eat is helpful to controlling portion size. (i.e. measure out a snack rather than eating directly from the bag)
4. Consumed when hungry - rather than when bored, anxious, or depressed. This is why underlying anxiety and depression should be treated prior to making major changes to the way we eat.
5. Sustainable - plan changes that you can continue to follow for the rest of your life. Don’t “give up” any foods you love. If you love chocolate, don’t forbid yourself from eating chocolate ever again. Choose less processed forms of chocolate like a chocolate bar whose ingredients you understand, rather than a pre-packaged brownie. Food is enjoyable; there’s no need to torture yourself by making things you love forbidden.
The American diet used to be like this, now it is the exception rather than the rule. This is due to many factors, including the invention of ultra-processed foods and ingredients like high fructose corn syrup that make it easier to consume more calories without feeling full. I also place blame on economic pressures like stagnant wages and the resulting pressure to work longer hours, work second jobs, and the resulting search for convenient food that can be eaten on the go.
But think about the kinds of diets Americans have been going on the past 20 years. Patients following the keto diet were adding butter to their coffee (and in my patients I often saw their cholesterol skyrocketing as a result!) For a long time low fat diets were in fashion, and instead people were eating more added sugar than ever. The caveman's diet was idealized, with no mention that the average life expectancy of a caveman was about 35 years. There was even a period when people believed you should follow a specific diet based on your blood type. Do any of those pass the common sense test for you?
I’m not going to lie to you, learning to follow a healthy diet for life is a lot harder than going on a diet for a period of time. Diets tend to spell things out simply: “eat as much of X as you want, but don’t eat any Y” or “only eat at this time of day,” etc. Often people substitute a meal with a processed smoothie or drink (try reading the ingredients on those!) because that is so much simpler than learning about food, which seems to become increasingly complicated. In future blog posts, I will delve into the components of a healthy diet in more detail. To start, just know that you can do it! Find a partner to help you on your journey, whether it’s your primary care doctor, a nutritionist, or a friend that practices healthy habits. Nothing worthwhile happens overnight, but by gradually learning and implementing changes, you will be able to reap the benefits for the rest of your life.
Sidenote: My Why
I’ve seen many patients whom I’ve yearned to work with to modify their diets, but I did not have the time working in the traditional medical system. Some I was seeing for medical problems like diabetes or high cholesterol, and some were just not eating well and were feeling the effects of an unhealthy diet. Unfortunately, during a typical physical appointment, I had to address so many other issues in such a short time: any concerns the patient may have, blood pressure, heart rate, lab work, medications, routine cancer screening…and then do a physical exam and address any abnormal findings. All of that usually takes place in 30-40 minutes, and there never any time left to discuss diet and exercise! I could send someone to nutrition for a consultation, but that was often a one-time visit that didn’t produce lasting change. I created Emerald Direct Primary Care so I can now spend as much time with my patients as they need, and meet as often as necessary to review questions, discuss progress, and celebrate lasting change. While there are plenty of great medications to treat chronic diseases, I would much rather prevent or treat a medical problem naturally with a healthy lifestyle. If you’re interested in making changes in your own habits, or are worried about medical problems lurking in your family history, please come see me! I am so excited to work with you to help you reach your goals!
Books to check out:
Food Rules: An Eater's Manual by Michael Pollan
Eat This, Not That: Thousands of Simple Food Swaps... by David Zinczenko