The support of others, though, often spells the difference between losing weight and not, between keeping it off and not.  Studies throughout the past decade have reached this conclusion.  And while Judith Beck, Ph.D. talked extensively about using a “diet coach” in her 2007 book, a new book by Miriam Nelson and Jennifer Ackerman builds an entire weight loss plan around supportive relationships.   To cement the idea even more firmly in our public conscience, Dr. Oz (in his Real Age newsletter) recently headlined “Lose Weight With the Buddy System”.

You may well breathe a sigh of relief on hearing that you’re not to blame for those lone struggles with food.  All you needed was a teammate to succeed.  On the other hand, it’s not always clear what using relationships for weight loss really means.  Or how it actually helps.  How can you best make these social prescriptions work for you?

First of all, the social prescriptions aren’t so new as recent reports suggest.  Weight Watchers and other organizations, notably 12-step groups like Overeaters Anonymous, have long capitalized on the power of group influence and support.  Newer is the confirmation that who we socialize with can influence our weight.  Hang around with slim people and you’re statistically more likely to eat less, and vice versa.  Newer, too, is the discovery that even phone check-ins with a doctor or diet coach can make impressive differences in weight loss and maintenance.

Relationships exert a powerful influence on our goal achievements in a number of ways.  Having another to call on, we gain strength against cravings, fatigue, discouragement, confusion.   We’re less likely to mess up when we know we’ll be reporting to someone else.  We’re more likely to do what’s good for us with the encouragement and problem-solving help of another.  We find inspiration in knowing that mentors have succeeded against similar odds.

Likewise, a variety of social support structures offer promise.  A “buddy system”can involve two people, relatives or friends, working toward shared goals.   A “coach” doesn’t necessarily have to be a clinician or professional, though research does suggest that these relationships make a significant difference.  People who’ve struggled for a long time, whose weight and eating issues have been strongly resistant to change over the years, may even do best with a “team”—perhaps some combination of doctor, coach, nutritionist, support group, buddy.

To assess your own social support standing, think of who in your life can or could support your goals.  First think of friends and family.  Who might you talk to?  Who might you want to spend more time with, simply because they are supportive, or because they themselves behave in ways you aspire to.  Consider whether an organized group or class might bolster your efforts and resolve.  Think of whether or not checking in with a coach, doctor, nutritionist, or trainer might help you stay on track.

Knowing that our social connections can help us care for ourselves, our weight and health offers a wide world of possibilities.  We’re surrounded by many obstacles to eating well, but we’re also surrounded by a lot of other people.

Also see the 10/15/10 blog, “Diet Buddies:  When Two is Best”, and “Research Shows Coaching Works!” at the www.eatsanely.com homepage.

Recently, I’ve blogged about abstinence vs. moderation.  In other words, do you try to cut down, learn to “eat just one”, or is cutting completely the ideal response?  For most of us, reducing sugar’s presence in our households and on our plates makes a sensible and solid first step.

As you begin this process, let “practice, not perfect,” guide you.  Try to treat the “not perfect” gently—beating yourself up for imperfections won’t help, and might even hurt.  If you start now, you’ll get to a better place in time.   I list here some beginning ideas.

1.)    check labels on any foods you eat regularly that come in cans, jars, or boxes.  If any contain unexpected sugar, look for a similar type or another brand that doesn’t.  Or, eliminate the food if practical.
2.)    check labels on store-bought or take-out sweets (for example, cereals, doughnuts).  See if you can find other items that you like that contain fewer grams per serving (for cereals, aim for under 5g per serving).
3.)  think about all the times you eat sweets during the week.  Try eliminating one.
4.)  again think of your weekly sweets intake.  Are there any that aren’t particularly special to you?  Could you let those go?
5.)  if you drink soda or other sweetened beverages, experiment with replacements.  Diet drinks aren’t nutritious, but they do cut sugar intake.  If you don’t like those sweetened with Aspartame, try one with Splenda.    Beyond diet sodas, lemonades, and iced teas, think of water, seltzer, vitamin water, herb tea, seltzer with a splash of juice.  Any of these substitutions can radically reduce your overall sugar intake.
6.)  if sweets in the house lead to grazing or binging, try buying fewer, or even none at all (in other words, you’ve got to go out to get the stuff).  It may be helpful to make a family decision to do this.  You don’t really need multiple packages of cookies, candy, and ice cream.
7.)  keeps lots of good fruits and berries on hand.  Use these for snacks and desserts more often.   You’re likely to develop more desire for them as you enjoy them more.

Give yourself plenty of time to get used to these reductions and replacements.  You will get used to them.  New habits take some weeks to stick, though.  Once new habits have truly replaced the old, you will certainly feel better for it—that’s the reward for your efforts.

As the bad news on sugar grows ever more grim, we may find ourselves overwhelmed—worried, yes, but not sure just what to do.   Solid science now labels sugar a toxin, an addictive agent, and the key culprit in metabolic syndrome (high blood pressure, high cholesterol, high blood sugar), obesity and related disease.  So, what to do with this worrisome news?  Are we really to stop eating sugar completely?

The reports may well scare you into trying to do so.  It almost goes without saying, though, that this is easier said than done.   Sugar flavor-boosts many grocery and take-out items, even those that don’t taste sweet.  Also, there’s that “addictive agent” part—and this prevents many people from stopping, despite their best efforts.  The flavor-boosters work to make us crave more and more, and some among us are particularly susceptible.  Few foods challenge us more than sweets when it comes to choosing and shopping well.  And few foods challenge us more when it comes to “eating just one”.

Recently, Psychology Today blogger Alexis Conason Psy.D. addressed this issue from the point of view of avoiding the deprivation-diet mentality.  This makes good sense.  If we can relax and stay reasonable about it, we can reduce without triggering binges, and without completely losing a source of occasional pleasure.  For some, though, this kind of moderation seems impossible.  And a lot of misery attends the trying.

In our current world, we all need to find ways of coping, of staying healthy and sane, in the midst of the near-constant call of too much fattening food.   Several of the paths that offer their followers solid dietary footing  rely on sugar abstinence.  These include not only 12-step, addiction focused groups like Overeaters Anonymous, but also some of the reliable weight loss plans, such as the South Beach Diet.  With these regimes you aim for no sugar at all.  You pick yourself up and plant yourself back on the path if you slip.

Many people who worry about weight, though, and over-attraction to sweets, do learn how to pick and choose, to eat just one, to relegate sweets to the occasional “treat” category—in other words to eat them in moderation.   This does require a shift in how sweets are conceived.  Clearly, as Dr. Conason noted, their lure proves too powerful as “forbidden fruits”.    Moderation tends to backfire, too, when thoughts of fairness (“Everyone else can eat them…why can’t I?!”) or of deserving (“I’ve had a tough week, I deserve this!”) go unchallenged.

Noting that people do learn to eat sweets in moderation does not mean that it comes easily or immediately.  In fact, people of all sizes usually find that learning to resist the call for “more” takes effort and practice.  I provide a link here to an earlier blog with ideas on how to get started:  Eating Sanely With a Sweet Tooth http://www.eatsanely.com/blog

Learn more on the recent science:

60 Minutes, CBS, 4/1/12 segment,  “Is Sugar Toxic?”

“Is Sugar Toxic”, by Gary Taubes, New York Times Magazine, 4/17/11, http://nytimes.com

Nutrition Action’s April issue focuses on sugar and belly fat and metabolic syndrome.  Available in print, upcoming online http://www.cspsinet.org

Sweets top the food pyramid—they sit on that tiny “eat sparingly” point.  We know “eat sparingly” is easier said than done.  Sugary foods fill way too much of the average person’s diet these days.  It’s hidden in foods we buy, we love it, and it’s hard to stop after any amount that could be called “sparing”.

As promised in June 25’s [2010] blog, I continue here the discussion of how to stick to those small amounts.  I started with a few ideas about buying less, switching to items containing less, and eliminating sugared beverages.  Now we turn to the sweets we eat because we want to—whether that’s candy, cookies, pie, or cake.  How do you start to say “No, thanks, I’ve had enough” after one piece?

It doesn’t make sense for anyone—skinny, fat, or in-between—to eat sugar in large quantities.   So what’s reasonable for you?  A small serving per day?  Two per week?  Three?  This is what you can set as your “working to get to” goal.  (What’s reasonable if you have a lot of weight to lose will be on the lower end–not only because of the calorie content, but also because of how the sweets may affect your metabolism.)   Often people will target something like “one chocolate after dinner each night”, or “dessert on weekend nights”.

Aim for this goal amount.  Know that as you begin, you’ll probably want more after you’ve had that amount.  Think of how you’ll deal with the desire for more.  I’ll describe a couple of possible strategies here.  First, giving yourself a time limit before you head back to the cookie plate sometimes works.  This kind of scenario might evolve like this:

You’ve decided that what’s reasonable for you is to allow for dessert on weekends, but not on week nights.  You don’t buy packaged cookies or ice cream to keep in the house.  You go ahead and bake brownies on Friday afternoon to have on hand.  After dinner, you get out the plates and whipped cream.  You put a decent-sized brownie on the plate (not tiny, not gigantic).  You sit down to eat it with a fork.  You try not to gobble and rush.  You savor it.  (Note that here you’re employing some strategies to help reduce the tendency to overeat:  setting a plate, eating more slowly.)  When you’ve finished, you definitely would like  to keep going.  However, knowing that you’re trying to learn moderation, you’ve helped yourself out in advance by not keeping the serving platter in view.  In fact, the brownie container is already closed and put away.  You tell yourself, I’m not going to have another for at least 20 minutes.  Then you make some coffee or tea.  In 20 minutes you rate your desire for the second brownie.  It’s definitely reduced.  You decide to wait another 20 minutes.  By then, you’re busy doing something else and stopping for a brownie seems irrelevant.

As successful episodes like this accumulate, your ability to stop after one serving will increase.  If an episode is not successful, analyze what went wrong.  Ask yourself what might have helped.  Then try again another time.

A second strategy calls for substituting lower-sugar items and giving yourself some time to get used to those.  Here is an example.  Peggy learned that her daily blended coffee drink contained 49 grams of sugar.  A friend pointed out that this was equivalent to more than three bowls of Froot Loops.  Appalled, she nevertheless grew anxious considering a change in the years-old routine that she liked very much.

Peggy began by telling herself that every other day she’d order something else.  She thought it would help her to be able to look forward to her favored drink at least every other day.  Because it seemed similar, she began to order iced coffee with milk and Splenda.  She found that she actually liked this more than she thought she would, though she missed the thicker, more frappe-like consistency of the other.  She experimented—iced latte, iced decaf, one Splenda, two Splenda, milk, cream.  She returned to the original iced coffee, though, because she liked it well enough.  She especially liked that she saved 150 calories and 49 grams of sugar each time.  That really made her feel good.  In less than a month, her blended drink had become a once-a-week treat.  She’d found herself opting more and more often for her new drink, even on the “off” days.  It had become her new habit.

The ease of this change surprised Peggy.  And while not all transitions will go this smoothly, experimenting, starting again and again where necessary, will usually lead to a new routine.   This is all part of finding a place for sugar in your overall diet and life.  It’s hard to eliminate it completely, and many don’t even want to.  But minimizing sugar’s unhealthy presence, feeling more comfortable with much less, is a goal worth working toward.

To read more about the effects of sugar, go to www.cspinet.org/new/sugar.

First, setting out to change one small thing in your overall routine does not rule out making bigger changes if you wish.  The small change by itself, though, has more power than you might think.  You’re more likely to succeed in making and sticking with that small change, for starters.  And that builds your confidence and reinforces your belief in yourself, however subtly.

Also, the change itself will have some benefits that count.  It’s better to walk to the mailbox than stay put at your desk, for example, even if this doesn’t equal an hour at the gym.   Further, once a change becomes a habit, adding another small change, and then maybe another, becomes easier.  Before you know it, you might have trouble even remembering your older ways.  If you’ve ever switched from whole milk to lowfat, to take one example, you may note how your tastes did indeed change over time.

What kinds of small changes might you try?  Here are a few of hundreds of possibilities:

*add two servings of cooked greens to your weekly diet
*add 30 minutes extra exercise to your week (or 15 mins)
*make dinner at home one additional evening per week
*bring your lunch to work 1 (or more) days per week
*switch to reduced or low fat dairy products
*add three extra vegetable servings to your weekly diet
*switch to whole grain bread or pasta
*reduce your daily calorie intake by 100
*do floor exercises at home one or two times per week
*join an exercise class and commit to it for one class cycle
*reduce the number of unhealthy snack foods you keep at home by half
*if you eat out at lot, eliminate one time per week
*meditate or  do relaxation exercises twice per week
*put a cap on butter or mayonnaise in your diet—
  say no more than a pat or small spoonful per day
*initiate a family walk after dinner once a week

Once you target that one change, give it a week, or ideally two or three, before you decide if you can live with it.  If you don’t think you can, choose another.  If it’s going well enough, keep it up another week or two or three and then reevaluate.  If you mess up a day or a week, simply restart.  At some point, you’ll find you’ve got a new habit or routine in place.  Remember, it can take weeks or even months for some changes to feel natural and automatic.  Allow yourself that time to adjust.  Then you’ve got a new “normal”.

Recent research supports the “one small thing” strategy as a door-opener to bigger change.   The strategy by itself, for those who need to lose weight especially,  won’t necessarily lead directly to melted pounds.  This is particularly true if you’ve carried extra weight for a while.  For many, dieting has caused the metabolism to slow down and actually conserve weight.  This is discouraging, and points to the need for much more radical habit change for weight to budge.

But the one small change can prepare the body and mind for more and bigger changes in time.  If you start skipping a dessert, say, or bringing your lunches to work more often, or substituting eggs for breakfast donuts, the value may not necessarily lie in immediate pounds lost.  Getting used to these ways, though, will make the next change, and the next, easier to do and more likely to happen.  The same holds true with exercise.   Start with that one day’s walk, and you’re more likely to add other activity in time.

This is good news.  We may be hard-wired to overeat certain foods or to hang onto unhealthy weight.  But we have some ability to forge new habit pathways in our brains—and that leads to better choices and better self-care in the end.  So:  if you need drastic changes, prepare yourself.  Get help in weathering the hard transitions.   But if you’re not ready or able to do so….definitely start with that one small thing. 

 Move more, eat better:  these goals top any weight watcher’s goal list.  In fact, they top anyone’s health improvement list, no matter their size or weight.   While lifestyle advice churns out wherever we look, it seems, some new books offer fresh insights and help that don’t require dropping whole food groups or changing your personality.

If regular exercise eludes you, for instance, Gretchen Reynolds’ new book The First 20 Minutes:  The Myth-Busting Science That Shows How We Can Walk Farther, Run Faster, and Live Longer may have you thinking differently about the importance of movement.   Reynolds, who writes on exercise science for The New York Times, looks at why, how, and how much exercise helps.  What she uncovers may surprise you.  Some of this will certainly interest those whose routines flag because weight stays stuck.   Or because the routines themselves seem daunting. 

The most recent science, in fact, suggests that exercise helps weight in a less direct manner than we typically think.  One of its most important roles, for example, may be as a “gateway” behavior to other health habit changes.  Further, different benefits accrue for exercise routines of different types and different durations, including those 20-minute ones of the title.  And any movement at all, anything but sitting , in other words, burns calories and boosts health.

How do you get yourself to move more, even if you target the small change?  Diet and exercise habits notoriously challenge people in their change efforts.   Last year, Willpower: Rediscovering the Greatest Human Strength, by Roy F. Baumeister and John Tierney, renewed attention to willpower building.  Excerpts from their, and others’, work continue to appear in women’s and health-oriented magazines.  This focus on “the self-control muscle” can aid our efforts tremendously.  But Miriam Nelson and Jennifer Ackerman’s The Social Network Diet renews attention, instead, to the ways our social environment—from close relationships on out—help us.  Self-control needn’t always be completely self-generated, in other words.

The research on social support and weight loss probes the family meal (eating with your kids correlates with better weight) to phone coaching (you’re likely to lose more and keep more off with this) to friendship networks (hang out with better eaters, and your weight will improve, too).   Nelson and Ackerman bring all these widespread studies together under their spotlight.  Together a clear picture emerges.   Whether close or distant, in the background or in our face, our relationships and social contacts affect our health and weight.  Their book focuses on how they can influence them positively.

 If you fall in the challenged category when it comes to exercise or diet improvements, you may indeed need to strengthen self-control muscles.  You may find motivation in heartening new information, such as in Reynolds’ new book.  However, it may be that help from a personal or professional other will spell the big difference for you.  In any case, health advice often assumes you’re on your own.  In fact, your relationships always operate to help or hinder you, and checking in on them makes a lot of sense.

Notes/Related Reading
Willpower:  Rediscovering the Greatest Human Strength, by Roy F. Baumeister and John Tierney, The Penguin Press, 2011
The Social Network Diet, by Miriam Nelson and Jennifer Ackerman, Fast Pencil Premiere, 2011
The First 20 Minutes:  The Myth-Busting Science  That Shows How We Can Walk Farther, Run Faster, and Live Longer, by Gretchen Reynolds,  Hudson Street, 2012 (out later this month)
Eat Sanely:  Get Off the Diet Roller Coaster for Good, by Terese Weinstein Katz, www.eatsanely.com workbook and ebook edition.
www.eatsanely.com/blog see these related entries:  “If Self-Control is a Muscle, Why Can’t I Exercise It?” (9/9/11); “Diet Buddies:  When Two Is Best” (10/15/10); “Eating Sanely Means Moving, Too” (7/28/10); “Stand Up to Keep Weight Down” (6/4/10); “Change One Small Thing” (3/5/10)
www.eatsanely.com/evidence-for-coaching-it-helps More facts and statistics on the social environment and weight loss.

To read more on this important topic, see also the 12/16/12 blog,  “Talking to Kids About Weight”, below.

We’ve known for a long time that calorie-cutting can spur binging.   A strong diet-binge link first caught national attention in 1985, when psychologists Polivy and Herman demonstrated the connection in their laboratory.  Further studies consistently confirmed that “dietary abandon follows dietary restraint”–so reliably, in fact, that eating disorder experts usually consider the link a given.   Recent headlines, though, highlight research supporting deep calorie cuts, and even breakfast skipping, as potentially effective weight loss aids.  In other words, in these studies eaters did not necessarily “rebound” eat after restriction, and thus weight loss continued.  All this will surely confuse the binge-prone overeater, who may have worked hard to not skip meals or cut calories too deeply.   What’s there to learn here?

One study at Cornell, for instance, found that subjects indeed did not “rebound” eat when they followed extremely low calorie (500 cal) regimes two days per week for six months.  Their weight loss, in fact, matched that of a comparison group who reduced on a more traditional regime.  The New York Times summarized the study as “A Low Calorie Meal is Shown to Pay Off”.   The study’s lead author, David Levitsky, found “no evidence of any compensation” in the dieters.

As for breakfast-skipping, the long-held notion that successful losers must eat this meal has met challenges as well.  Nutrition Action, a publication of the Center for Science in the Public Interest, recently summarized the controversies in their “Breakfast Debate”.  It seems that often breakfast does help people lose, though a sizable group appears capable of skipping the meal without later overeating.

At issue in both lines of study, of course, is whether or not cutting back, or “depriving” must necessarily lead to overeating that then undermines weight management.  In the first case, where extreme low-calorie days (including “meal replacement” foods) aided the weight loss, researchers admit that results may not apply to the obese.   Subjects were, after all, not from high body mass index categories.  Neither were they screened for pre-existing binge tendencies.  The focus of the research, in any event, was not on binging.  It asked instead whether or not a biological “set point” might drive the appetite to make up for missed food.

Summing up the breakfast debate, David Schlundt of Vanderbilt University suggests that all things considered, breakfast probably most often helps the weight loss cause.  Both metabolic and appetite management factors would back this idea.  However, that’s still not a straightforward recommendation for everyone.  Changing one’s routine, in fact, whether that means adding or skipping the meal, proved the key weight loss factor in one study.   Other studies have similarly shown complicated results, with meal skippers not always and necessarily “making up for it later”.

For those with a history of binging, such severe calorie-cutting, or meal skipping, may well lead to greater overeating for reasons ignored in this current news.  Indeed, Cornell’s Levitsky speculates that subjects cognitively labelled the study’s “meal replacement” bars as “meals”.  This certainly could have reduced a perception of deprivation.  The perception of deprivation, and not the biological fact, may be the strongest factor in that drive for binging, after all.  Cognitive, emotional, and psychological reasons may indeed propel “rebound” eating with no help needed from biological set-point drives.Schlundt, of the breakfast research, wisely concludes that, after all, “you need to personalize a diet”.  Personalizing a diet, however, especially considering the well-proven tendency for calorie-cutting to backfire, goes beyond the question of how and when you eat your meals.  How you think about your eating, and how you manage related feelings also matter.  It’s important, of course, to arrange meals and meal times to avoid becoming ravenous and confusing the appetite.   But to avoid “rebound” or “compensation” eating, you’ll probably need to do more than that.  Perceiving food changes as choices, not forced deprivations, helps.  Perceiving yourself as one who can choose, and not one whose diet is dictated by others—doctors, spouses, the culture—helps a lot, too.  Extremely important, too, for anyone making dietary changes:  separating out hunger that calms frayed nerves from hunger that signals bodily need.

In the end, in our confusing (and fattening) food environment we all end up needing to personalize how we eat and deal with food.  Very few of us have bodies that can eat whatever, whenever, and stay healthy.  Those trying to lose weight, as well as those seeking control over binging, need to find what works—eating less, yes, but in what way can this occur without binging or otherwise undermining the process?   One way to read the recent news is as a support for diverse approaches, where even age-old prescriptions are questioned when it comes to figuring out what’s going to work for you, and your body.

            *know what you’re up against
            *make the habit changes you can
            *exercise
            *be kind to yourself
            *address emotional overeating
           *do all you can to keep it up
 

  These ingredients have also formed my working definition of sane eating for the past several years.  You’ll find this in the Eat Sanely workbook’s first pages:

We must find a way to eat that maintains a healthy enough weight,
 without worry or guilt,
  that we can more or less stick with forever,
 not just for the course of a diet.

            And the steps then outlined for eating more sanely:

1.      Know This Problem is Overdetermined (it’s not just you)
2.      Start With an Understanding of How You Change
3.      Know What Kind of Eating Plan Works for You (what’s to eat?)
4.      Obstacles Will Occur and Must be Understood and Resolved
5.      Movement Has to Happen
6.      Keep it Up and Get Help Where Needed The components this definition and plan mesh with the “what can you do about it” conclusions.  It may well prove, for example, that many overweight and chronic dieters will lose weight only slowly and with difficulty.  Realistic weight loss goals, though, improve chances of success.   Focus on what’s achievable, and you’re more likely to relax and feel good about progress.  You’ll less likely give up in frustration.  You’ll be building the kind of consistency that leads to change that can finally last.

Being kind to yourself, too, weaves into the sane eating definition.  Easing the worry and guilt, while hard, now proves essential to the whole business of change (see the 4/11/11 blog for more on this).   In other words, you’re less able to exercise self-control and stick with new plans when you’re beating yourself up and wearing yourself down psychologically.   Reducing emotional overeating, a key goal as well, goes hand-in-hand.  While we overeat in many different emotional situations, worry often tops the list.   And guilt often lurks undetected in any emotion-fueled binge.

Sticking with it, of course, forms part of sane eating, and part of long-term weight maintenance.  It’s never going to be easy, and the vast quantities of junk food around us won’t vanish any time soon.  We acknowledge how hard it is to keep weight down and healthy habits in place.   It’s got to be a forever effort, then, or it simply isn’t going to work.  The weight will return, plus some, and so will the bad feelings.  This, in fact, is part of what the newest research cited in “The Fat Trap” impresses upon us.  So part of the prescription is to find ways to pick ourselves up when we slip, and to keep strong supports in place.

 I’m closing today with another related workbook excerpt.  Here are the introduction’s last words:

            If this sounds like a lot, it is.  Eating sanely, for a lifetime, can transform you.  If you need to lose weight or stop binging, you will feel encouraged and gratified in reaching those goals.  They can be extremely important goals in themselves.  But beyond that, know that feeding yourself well and carefully, day after day, year after year, allows for even more.  Your physical health will certainly benefit.  Your mood and emotional life may feel more stable.  And, you’ll have built a foundation of self-care and self-respect that in time can permeate all parts of life.