Diets and Obesity

Just my personal story:

I’m 6’2" tall. At age 52, I weighed 267 pounds, up from 183 pounds in high school. BP was controlled by medication and I was in otherwise reasonably good health. I decided I needed to lose at least 40 pounds.

Diet: I started eating primarily frozen diet dinners, not because they were particularly healthy, but because I could track my caloric intake more easily. (Also, I tend to cook “fat” when I cook my own meals.) I supplemented with fresh fruits. My target was 1000 - 1200 calories (OK…Kcal) per day. This usually translated to 3 or 4 frozen dinners each day. I had only coffee for breakfast, then one frozen dinner for lunch. I never ate out or got fast food. I would have two frozen dinners for dinner.

Exercise: I started fast walking. I walked at least 3 miles twice a day (morning and evening). After a week or two, I ramped up to 4.5 miles.

It took me 3.5 months to get down to 224 pounds. I’m now about 228 pounds. The biggest change I made to maintain my weight was to minimize food as an aspect of my daily life. I stopped going out with people to eat lunch simply because they said, “Everybody has to eat lunch!” I stopped thinking of food as a treat or a reward. While I still enjoy a good meal, I don’t think, “What’s the biggest sandwich I can get for the money? Does Costco have those great subs on sale? Who has the best layer cake?”

I think that my 16% weight loss was significant and a decent goal. I still think about the weight loss and dieting on a regular basis, but it doesn’t rule my life. However, I frequently find myself in a situation where somebody offers me some treat like ice cream. I will refuse it UNLESS it’s chocolate chip. When they seem puzzled, I explain that if I’m going to consume a couple hundred unnecessary calories, I’m only going to do it if it is my absolute favorite ice cream. Same with cookies, pies, etc. I know it’s just an artificial POV, but it helps me to avoid the social pressure to consume (especially around my very overweight in-laws).

One thing I would like to point out is the way to end an addictive behavior is to quit cold turkey. Obviously, you cannot quit eating. But you can–and I did–stop snacking. And that change was basically the only change I made to lose 27% of my body weight and keep it off.

When I was in college I had a friend who was a grad student in a lab and couldn’t go home for holidays. One Christmas season his mother sent him a box of home-made cookies. For the next few weeks, he snacked every night around 9 on a glass of milk and a few cookies. Then the cookies were finished. For the next few nights, come 9 and he felt a hunger pang. The point of this story is that snacking is its own habit and you can quit cold turkey. It is hard, but can be done. And once you break that habit, you are home.

Four years later and I’ve been fairly stable in the 209 to 212 range.

One thing that I believe is an issue for a lot of people is a failure to accurately assess distance and effort. I’ve often seen people talk about places being “miles” away when the place may only be a km away, at most.

This sounds horrible! Was it worth it? I love food. I love fresh food, and freshly cooked whole foods (a steak, a roasted yam, a fried egg).

I briefly tried counting calories, and it was way too much work. (I just picked over the chicken carcass from last night’s roast. How should i record that?) And i talked to a lot of people who were doing it, and they were basically all relying on packaged food with nutrition labels.

I’m 5’6". I weigh 180. I weighed more before the pandemic, but cutting out “social eating” meant i ate less. I’m sure it would be better for my knees and feet if i weighed less. (My blood sugar, cholesterol, etc. Are all pretty good, though, so I’m really not worried about metabolic issues.) But when i think about what it would take to significantly reduce my weight, it just doesn’t seem worthwhile.

Wasn’t horrible at all. They don’t really taste that bad. I’ll admit that it wouldn’t suit everyone, but I had come to realize that I needed to change my eating habits and that treating meals as simply necessary, rather than making them a focal point or eating as part of social interactions, was one way to go.

I lost the weight and resumed a more normal eating pattern. Haven’t eaten a frozen dinner in over 15 years and the weight stayed off. It kind of bothers my wife a bit, since she has a constant struggle against putting on weight. I hardly eat anything at all during the day (maybe a small pastry mid-morning) and then we have a relatively light dinner in the evening (salmon, green beans, and a salad). She snacks all during the day, though they are generally healthful snacks at intervals of a couple hours. She doesn’t understand how I can go almost 24 hours eating only a croissant. It’s now a deeply ingrained habit.

I vastly prefer “real food” too, and I eat a lot more of it than of the processed stuff with convenient nutrition labels. Didn’t stop me successfully losing weight, I’m thankful to say.

With a calorie-counter app and a basic awareness of “how much is an ounce”, “how much is a half-cup”, etc., it isn’t even that much work once you get used to it. Calorie intake reduction is a matter of averages, not unfailingly precise measurements. Once you are aware of, and tracking, approximately how much you’re consuming, then you can make significant cutbacks pretty easily.

What I would do in the case of picking over a poultry carcass would be to throw all the bits in a container while picking, and then eat however much of the accumulated scraps I wanted. Still just as good and fresh food, not particularly burdensome in terms of consumption tracking, but provides a reasonable metric for understanding how much you’re eating.

(Another thing I did early on was to dump a cup of water into each of the bowls I use a lot for meals, just to get a visual sense of “how much volume is a cup”.)

I wish I could do this easily. I get nauseated when I don’t eat between meals. I am on a medication with a side effect of appetite suppressant so I have to force myself to eat, especially in the middle of the day. What ends up happening is that I don’t feel hungry enough to eat lunch so I snack my way through lunch and then get very hungry later in the day. I’m having an issue right now where because of my son’s feeding problems (which are fairly severe and for which he is in occupational therapy) I have to keep a wide variety of his snacks in the house at all times, and so I have constant temptation.

The upshot is because of my healthy home cooked meals, I’m not gaining weight. But because of the snacking, I’m not losing it either.

Without being too extreme, I think there’s some room for categorical/cold turkey approaches. I had a soda addiction causing me all sorts of trouble from my teeth to my stomach. I quit soda cold turkey in February. I would maybe not recommend quitting caffeine cold turkey because the withdrawal sucks, however after that first hellish month, my IBS has improved a hundredfold since I stopped drinking soda, my sleep improved and I haven’t had any more cavities.

Unfortunately I backslid last week when I had the flu and started drinking a ton of Sprite, then I realized my stomach has been feeling messed up and knocked it off. For me with this issue, there isn’t any room for exceptions, they will soon prove the rule because soda is just a tremendously triggering food for me to ingest - difficult to stop, exacerbating a number of health problems, and serving as a gateway to more junk food.

I figure after a year of successfully eliminating this one thing, I can set my sights on something else.

Re caffeine, i strongly recommend tapering, and not dropping it child turkey. I fast on Yom Kippur, and i prepare for that by reducing my caffeine intake. The last two years i weighed my dry tea on Rosh Hashanah, and cut down approximately linearly until i had none the day before Yom Kippur. And that was nearly painless, unlike other methods I’ve tried.

(And this year, i went about a month before deciding to take up my daily pot of tea again. If I’d had a good reason to stay away from it, i could have.)

I don’t know if tapering is the way to go with food, but it certainly works for some addictions.

I’ll suggest that for mostly physical addictions, you need to taper to avoid problematic withdrawal symptoms that may be aversive enough or dangerous enough to put you right back on your poison.

OTOH, for mostly psychological addictions (SDMB I’ma lookin at you!), cold turkey is probably the best way to break the habit. Especially if you can substitute an alternate less-harmful habit into the same mental “slot”.

Yeah, in retrospect I would have tapered. I had just finished reading Dopamine Nation (which is a pretty good book and not nearly as predictable as I expected) and the author had this regimented way of testing the removal of substance/stimulus so I was trying to follow that.

I guess I was trying to speak less to cold turkey and more about categorical bans on certain food items. I’ve been through the rounds of therapy about food and have been discouraged from labeling certain foods “good” and “bad” but I kind of think that’s untrue. There are objectively bad foods from a nutritional standpoint. The trick is you have to come up with rules you can live with forever, and not everyone can or should live with categorical food bans forever.

But here we have the tension between effective treatment for disordered eating and the vast amounts of rationalization that many fat people (myself included) will use to justify eating crap food. I do think there is something to the notion that restricted eating of any kind usually leads to restriction/binge cycles. I was very skeptical of that until I saw it happen in my own life. When large categories of food are off the table for a period of time, they will be sought in excess the second one’s guard drops. In fact, the reason I stopped drinking soda is because I stopped restricting my eating and was actually starting to check in with myself about what I really wanted to eat in that moment. At first I was like, “Wee, I can drink all the soda I want!” and I did, and didn’t feel guilty about it. But after a few months of this, I began to see the connection between soda and feeling like crap. Sometimes we eat things out of habit or for that hit of dopamine but when we tune into what happens after the immediate effect, we learn that we actually would have preferred something with a different effect. When soda ceases to be an exciting treat/cheat, it’s just there to be evaluated on its own merits like any other kind of food.

Therapists are right to help clients move out of the shame and negative self-talk spiral and to take the value judgments out of food. But I’m not sure we have to stop there. I think that’s a good foundation to start making healthier choices. And I think many therapists, including my own former therapist, would say, "Well be careful about labeling certain foods “healthy” or “unhealthy” but no, there are objectively unhealthy foods. “Everything in moderation” isn’t really an effective rule of thumb because our culture’s perception of what “moderation” means is so skewed toward excess.**

**I would not encourage this mindset for someone with a serious eating disorder like anorexia, but in my case I was just caught in a moderate restrictive eating/binge cycle that was making me fatter. I am close to someone who used to be bulimic and now has binge eating disorder and severe body dysmorphic disorder, so I know how much worse it can be, and that’s not really what I’m talking about.

If any of this sounds contradictory, well, it’s a complex issue.

Yeah. It was probably wise of them to call the badge “devotee” instead of “addict” or “sucker”. :wink: