I disagreed with Dr. Freedhoff's column today, in a minor way. Of course, being a person prone to fattening most of my life, my point of view is different from his, as a practicing physician.
He deals with people with a WIDE variety of problems and personalities, i'm sure. As a result, he has to approach each new problem in a what-works-for-the-mean fashion, and then refine the treatment depending upon the reaction of the patient. I COULD be right in the middle of the pack and respond typically, but i rather suspect i'd be more of an outlier, and in that case, the "right" approach/treatment would be all wrong. This goes for the psychology of dietary change as well as the physical aspects of it.
In his posting, Freedhoff says, "my issue is whether or not blind restriction is a sustainable long term strategy. My experience says that it isn't, and that blind restriction, the belief that if you're trying to manage weight or live healthfully you simply can't (or don't) eat nutritionally bereft but hedonically wonderful foods, is one of the reasons so many dieters ultimately fail."
My point is, when most people change their eating habits in order to lose weight, they're not thinking "i'm going to eat like this for the rest of my life" (even if they ought to). They're living life in a day-to-day manner, wondering if they can hang in there, wondering if they'll actually take off a significant amount of fat THIS time, and dealing with all kinds of derailing surprises, pleasant and unpleasant. The last thing in the world they need to think about is, am i going to be content doing without foodstuffofchoice when i'm 70?
When people are dealing with food restrictions TODAY, they need tools that will help get them THROUGH today without undue hunger and stress, in such a way that the diet isn't ruined. Tools like ... foods that are pleasant and satiating enough though "innocent," until their bodies unlearn the bad habits that got them to this point in the first place. Tools like ... tested ways to beat stress. Tools like sleep and metabolic-flexibility-promoting exercise and truly useful supplements. Tools like mental habits that encourage one to take the dietary high road.
In that vein "i don't" eat grains, or sugars, or a lot of other things. This is not to say i NEVER have them these days, or that i never will again. I just DON'T, as a generality; it makes things easier. Like what i said before about stubbornness=willpower. My choice. Eating the Italian bread on the table while waiting for the saltimbocca to come? I don't eat bread -- no decision necessary.
So if you're in the doc's position, you may need to strategise like a general planning a campaign -- looking down the road and thinking "we must not allow the troops to feel hopeless, even though it doesn't look very encouraging." Those troops in the trenches though -- eating their k-rations and worrying about going over the top later -- need to be able to say, "today, 'i don't' eat cake ... but i will when i go on leave."