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."
Two points. First, I've found it's actually easier to cut out certain foods than to cut back on them. You don't revisit the decision every time there's cake around (for example), and your tastes change. After awhile, junk food tastes like junk. As Phinney & Volek point out in The Art and Science of Low Carbohydrate Living, people in studies don't make their peace with a permanent LC diet. All they have to do is wait until the study is over (or until nobody's watching).
ReplyDeleteSecond, the Hartwigs make a good point in the book It Starts with Food: Imagine you're allergic to cats. Now imagine you go from living with 20 cats to one cat. You're still going to have allergy symptoms. If your problem is food sensitivity, you have to try total elimination for a time.
The reason some people may have trouble sticking to an elimination diet is because they're not really on an elimination diet--it's just a cutting-back-a-little diet.
that's why it's my opinion that WW and other such programs don't "really" work. people may lose some weight on them, but they don't train their bodies not to run on glucose, and the whole yoyo thing happens.
ReplyDeletei too find it easier to be "perfect" than "moderate"! :-) however, at this stage of MY game, anyhow, the fortnightly cheat day seems to help rather than hinder. not entirely sure why that is, but "shaking up" my body with an out-of-the-ordinary meal SEEMS to put it on its mettle somehow.
I dont understand the comment in the article about never enjoying food again. One of the wondrous things about the ketogenic diet for me is that just like a normally wired human being I can "enjoy" my diet, but only when Im truly needing food. On SAD I never really enjoy food because I never get full. Its a nightmare. I completely love eating my steak, until Ive had enough, then the idea of steak makes me sick. How many times have I watched a friend put down thier fork with pasta still on thier plate in awe and wonder at their strength. Its like an alcoholic cant have wine with dinner, a nonalcoholic cant. Thats problem with so many bunching diet advice, theories, all together for everyone. -------- I dont eat carbs (except when I give in every few weeks.
ReplyDelete[nodding] i think people whose APPETITES (not bodies or metabolisms in this case) are THAT broken desperately need to normalize themselves. reset themselves. the SAD may be "yummy" but compared with a steak when you're hungry, it's far from satisfying. i thoroughly enjoy everything i eat, even though some people would consider it pretty spartan.
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