WHAT YOU NEED TO KNOW ABOUT DIETS: A PSYCHOLOGIST’S PERSPECTIVE

Atkin’s, Paleo, South Beach, the Zone, Mediterranean . . . Each diet claims to have found the holy grail of weight loss. Just follow these easy steps and the fat will melt away. Wrong! In this article, I’ll discuss the evidence about the effectiveness of diets and provide honest advice about what it really requires to be successful.

The Effectiveness of Dieting

A recent review of 48 dieting studies, published in the Journal of the American Medical Association (JAMA), found that low carbohydrate (e.g., Atkin’s) and low fat diets (e.g., American Heart Association) were about equally effective ( about 17 lbs of weight loss at 6 months). From the authors:

“although there are statistically significant differences between some of the named diets, these differences are small and likely to be unimportant to many seeking to lose weight.”

In plane English, one diet was not more effective than another. But before jumping onto a diet consider this warning:

“Similar to previous reviews, we found that weight loss decreased at 6-month follow-up,and began to regress to the baseline mean at 12-month follow-up. . .”

In English, dieters started to gain back all their weight at 1 year. In another review of weight loss studies, the most commonly cited reason for regaining weight was failure to stick to the diet. I’m not a fan of diets. Or more precisely, I’m not a fan of how we choose to diet. Just up and change your eating habits, the way you’ve been eating your entire life, is a recipe for failure.

Weight Loss can Equal Weight Gain

Dropping 10 lbs on a new diet in the first two weeks is tempting but most diets result in increased weight gain. In a study authored by Traci Mann, Professor of Psychology now at University of Minnesota, dieting doesn’t work. She and her team reviewed 31 long-term studies of dieting that followed dieters for two to five years. People typically lose 5 to 10% of their body weight on just about any diet in the first six months. That may not sound like much but consider that if you weigh 200 lbs that could be 10 to 20 lbs. That’ll change your wardrobe but in a surprising way. About 1/3 to 2/3 of dieters gain more weight than they lost.

What I advocate is a modest and long-term approach to weight loss, one that takes into account the investment of changing eating habits and addresses the many factors that influence eating.

The Stages of Change Model

It’s rare that we start a new habit and follow through committedly the first time. It may seem like we master new habits in a once-and-done fashion, but really we fail to recognize the many gradual and progressive steps required for lasting change. For example, most smokers have made dozens of attempts to quit before finally staying quit. On top of this smokers may think over the consequences of smoking and the benefits off and on for months or even years. All of this eventually builds a drive that reaches a point where the person has the motivation to stay quit.

The stages of change model recognizes that people are at different levels of readiness to change their behavior. The model has several stages:

  • Precontemplation. Some people aren’t ready for change. They are don’t see the importance of changing or they want to change but see it as hopeless to try.
  • Contemplation. These people recognize the importance and benefits of change but feel conflicted about acting on it. Contemplators know they should lose weight because of high blood pressure and potential diabetes but they can’t just seem to get enough motivation to act on it.
  • Planning – These people are gathering information about how to change and are on the verge of taking action but haven’t quit yet. Planners are studying various diets and will start in the near future.
  • Action – These people have actually started to change their behaviors. It could be a small or a large change.
  • Maintenance – These people have been doing the behavior for 6 months or more.

You can ask which stage fits you best. As you do this, you might notice that in some ways you are in action (e.g., drinking plenty of water, avoiding candy) but in other ways you may be in contemplation (e.g., turning down a pizza when your friends invite you out to eat). When it comes to something as complicated as dieting, the stages of change oversimplifies the process of losing weight. Dieting isn’t a single behavior but many related behaviors. Below I explain this more.

Dieting is Many Related Behaviors

People vary in their readiness to change, just like in the stages of change. But all our behaviors/habits are connected to other habits as well as other influences. To change your diet requires changing many other behaviors: how much and how often you eat, the kinds of foods you put in the fridge, your willingness to stop buying junk food when shopping, your assertiveness in turning down offers of junk foods from family and friends, and so on.

Think about dieting (or any behavior) as moving soldiers to an objective. You don’t have to get every soldier to an objective to win the war, just enough to the tip the scales in your favor. If you want to stick to a diet you have to change many behaviors not just what you put in your mouth.

Dieting (or eating) is also complicated because it is also connected to emotions, family traditions, friendships, and culture. When you diet, you are really reorganizing your life in numerous domains. Food is a central part of many cultures, whether it’s Cuban rice and beans or the meat and potatoes of Southern cooking. Family and friends may see your change of eating, not just as a health strategy, but as a rejection of cherished tradition. You may also feel some loss as well. Would you be sad if at Thanksgiving or Christmas dinner you had to pass up all the meat to stick to your vegan diet?

Do This Before You Diet

Before you go on any diet, try these basic steps that can help weight loss. Why struggle through a diet, if there are much simpler steps you could take first.

  • Cut down on fried foods, junk foods, and high sugar snacks.
  • Drink more water (we sometimes eat because we’re under-hydrated)
  • Eat smaller portions (don’t starve yourself. Just stop before you feel bloated after a meal)
  • Eat healthy snacks
  • Eat more slowly and enjoy your food.

Steps to Successful Dieting

If you appreciate the investment that a diet requires, then you can be more successful. Given that a diet requires changing on many fronts, you can more honestly assess your readiness to adopt a lifestyle that will support healthy eating. Below is a discussion of some of the lifestyle changes that dieting requires. This is a preliminary list to get you started. Think about others areas that you will have to change as well.

  • Pick a Diet that Appeals to Your Palate in the Long Term and ignore any glorified claims. As we discussed earlier, there is little difference in the effectiveness of diets. So ignore all the hype and think about whether a steady diet of this kind of food, day after day, years after year, is in your power. It’s not necessary to stick to the diet 100% but years into the future you should be able to eat the majority of your meals following the guidelines. Also consider whether you can afford the time and money to prepare the meals for this plan. Starting a diet is like getting married, you need to commit for the long term; otherwise, make the simple changes I recommended above.
  • Make Changes Slowly. The bigger the change in your eating, the harder the diet. I don’t suggest starting a new diet all of a sudden. Give yourself time to get used to eating and preparing your new foods as well as cutting out or restricting forbidden foods. Add or eliminate a few foods each week and see how it goes. How easy or difficult is it? If you’re struggling, then give yourself more time. You may take several months to fully start a new diet.
  • At First, Limit, but Don’t Stop, Your Indulgences. Are you a Twinkies addict, a chocoholic, or a bacon aficionado? If your diet restricts those foods, how hard is it going to give them up or limit them? A first step might be to limit how often you eat them rather than just stopping them cold turkey. Buy fewer of these foods on your next shopping trip will help.
  • Get Used to Feeling a Little Hungry. Another requirement of many diets is limiting food intake. But we all differ in how full we like to feel after eating. For the longest time, I wanted to feel completely satisfied after eating. But I often ended up overeating because it takes time for the sensation of fullness in your stomach to reach your brain and release hormones that shut down the hunger response. I was a fast eater, so by the time the signals got to my brain, I had already eaten too much. To change this, I had to learn to get more comfortable with being a little hungry at the end of a meal. It took months for me to overcome the urge to eat until I was no longer hungry. The hardest situation is always leaving some of a favorite food, like Tikka Masala. OK, I’m still struggling with this.
  • Prepare Your Own Meals. The more you can control your meals the easier it is to stick to a diet. This is easy if you are an avid and skilled cook but if you’re not, then this is going to be a challenge. You may want to buy a cookbook, study recipe websites, or ask your more talent friends for advice. If you frequently dine out or buy frozen meals, then buy an apron and get some practice. You’ll also have to figure out how much time you want to invest in cooking. Over time, you can get more skilled and efficient if cooking isn’t a labor of love.
  • Get Others to Join You. One of the best ways to stay consistent with a diet is to have others in your immediate circle join in, most importantly those who live with you. The best way to do this is to collaboratively select a diet together – instead of just picking one and trying to convince your partner and family to get on-board. If they’re not willing to join you then you’ll have to consider how difficult it will be to cook separate meals.
  • Expect Some Resistance to Your New Eating Habits. “Oh come on. Just have a few bites of this sausage,” I can hear others chiding you. This was my experience when I cut out red meat. I still eat other meats, so it’s not that big of a change, but I still get some raised eyebrows if I turn down a steak.
    Preparing Your Social Network. Changing your eating means changing the way you spend time with others. When it comes to eating out, you may have to pick different places to eat, depending on how restrictive your diet is. Discuss this with family and friends.
  • Replace Emotional Eating with Other Coping Strategies. At times, we’ve all used eating to cope with uncomfortable emotions: stress, boredom, anxiety, depression. Pay attention to how much you eat (especially indulgent foods) when you feel this way. You may be an emotional eater. You’ll need to cut down on this tendency. Develop good emotion management habits (meditation, deep breathing, calming walks) as alternatives to eating.

The Final Outlook

Just jumping into a diet suddenly is like starting a marathon by sprinting. This is a long and gradual process. Diets can make significant change in your weight quickly but in the long-term most people fail. The quick fixes often backfire and lead to weight gain. Think about dieting as a lifestyle change in which you have to reorganize your life to reward your new eating habits in a sensible way. If you want to eat healthier you have to do more than just change your eating. You have to change your life.

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Jason Drwal

Jason Drwal

I am a writer, blogger, clinical psychologist, parent, devoted spouse, coffee snob, runner, and connoisseur of exotic foods.

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