Let’s Talk About the 5 Percent

5%I spend a lot of time focusing on the 95% failure rate of dieting just so people can be aware of what they are getting themselves into when they decide they want to lose weight. And inevitably, every few months someone on Twitter will say, “Of course long term weight loss is possible. People do it all the time.” Yes, many things are possible, even long-term weight loss. So I’m going to talk about them today, because I have some first-hand insight into the subject: I was one of those 5% that kept weight off longer than 5 years (16 years total).

But first, to recap: all of the available scientific literature on intentional weight loss efforts (and I’m going to avoid using the word “dieting” here just to save someone from piping up with, “Of course diets don’t work weight loss is about lifestyle changes…”) shows that somewhere in the very near vicinity of 95% of people who engage in them end up gaining most, all, or more of their weight back by five years. The best compilation of this science that I’ve read is Secrets from the Eating Lab by Dr. Traci Mann, so go ahead and check that out from your local library if you’re interested. There are many other books that reference the science of this failure listed here.

By contrast, there is compelling science in favor of the Health at Every Size® philosophy and weight neutral eating models such as Intuitive Eating, the Satter Eating Competence Model (check out the books Health at Every Size by Linda Bacon, Intuitive Eating by Tribole and Resch and any book by Ellyn Satter for the many studies regarding the efficacy of weight-neutral health interventions. You will be astounded).

But for now, let’s say you’re still not convinced, and you want to lose weight, and while you know that you have about a 95% chance of regaining all the weight you lose and maybe more, you still want to give it a chance and see if you can become one of these “lucky” few. Anything’s possible, right?! So let’s explore that slim possibility to see what your life will be like if you do grab manage to grab that brass ring.

When I originally started on my weight loss journey, my goal was not to live a miserable life of deprivation; in fact, I decided that if I couldn’t go and enjoy a McDonald’s meal at least once a week, I wasn’t going to continue on with it. And at that time in my young, never-dieted, frequently overeating body, I did lose weight quickly and easily without extreme deprivation. There are probably a lot of people out there with a similar, seductive experience.

But as time passed, the body remembered and frequently the number on the scale would start to creep upward. Food and calorie restriction had to happen more and more often in order to keep my weight in check. Eventually the maintenance tactics with how I ate when I first dieted (with my young, never-dieted, frequently overeating body) were no longer sufficient to maintain my older, thinner, always-dieting body. My solution to fix my upward-bobbing weight was to lose more weight, of course. I beat the odds, though, and was one of those magical 5% that had lost and maintained a significant amount of weight for more than 5 years. I WAS A UNICORN! Just kidding, unicorns don’t exist and I did. But seriously, I didn’t even know at the time how rare I was.

How did my reality match up to my original desire to be a thinner, normal eater who was relaxed around food? It never did. There was never a moment, even in the early “easy” days, that I did not worry about what or how much I was eating, even if I wasn’t having to eat restrictively at that moment. While my naturally thinner friends seemed to instinctively know when they had eaten enough and could stop when they were full and didn’t obsess over food all day long, I lived with the feeling that I would never be able to stop eating given half the chance and a full bag of Oreos. Instead of forever-after appreciating my thinner body, my dissatisfaction with it grew and grew until I was ready and willing to starve myself in the vain hope of perfection (which I could never reach because IT DOESN’T EXIST). During my most extreme restriction, I constantly denied my hunger, and then when the floodgates would inevitably burst, I blew well past full usually to the point of sickness. But I was not fat! So somehow that made me a winner.

Maybe I’m just a weirdo who couldn’t hold my 5 percenter* shit together. What of the rest of this segment of the population? Maybe they’re having a grand ol’ time. We could ask the National Weight Control Registry which is “the largest [10,000 members, so actually 0.003% of the US population] prospective investigation of long-term successful weight loss maintenance.” They study people who have managed to maintain their weight loss for at least one year. Let’s look past the fact that they define “long-term weight loss” as 1 year, and have a look at what they’ve found.

While the NWCR tell us that these people “maintain a low calorie, low fat diet” (around 1700 kcal for men and 1300 kcal for women), while doing “high levels of activity” (at least an hour a day, and we’re probably not talking brisk strolls in the park) and weigh themselves every day, they unfortunately don’t mention how people particularly enjoy their lifestyle, how relaxed and confident they feel around food, or if they spend the majority of their time thinking about their diets and weight. I know they don’t report on this information, because for a while, I was a participant in the NWCR, and in their surveys about what I ate and did to maintain my weight loss, they never once asked me about how happy I was about the whole damn thing (they may have asked me if I was happy being a not-fat person, but that’s not the same thing, is it?). Maybe they didn’t care; maybe they thought the means justified the skinny end and I shouldn’t have been so selfishly concerned with my happiness.

When the mental and physical toll of maintaining my weight loss eventually became too much to bear, and the unhappiness with myself no longer made any sense, I quit dieting cold turkey, regained every ounce of my lost weight and eventually quit the registry (and got happy with food, exercise, my body). As far as I can tell, they aren’t accounting for people like me – the dropouts, the weight-gainers – anywhere in their research. They didn’t bother to tell the rest of my story, where I decided that life sucked as a not-naturally-thin person, decided to start eating in a nourishing way, and gained weight.

If there are any 5 percenters out there living a free and easy life around food, I haven’t met or heard of them yet. I think most of them end up like Jillian Michaels, having to make a job – sometimes unpaid – out of maintaining their weight loss.

So if you are thinking about becoming one of the magical 5 percenters, know that your interests are pretty much only going to be food and exercise from here on out, and that there’s no guarantee you’re going to stay thin anyway. Want to be a foodie? Forget about it. Want to be like your naturally thin friends who seem to eat and not think all that much about it? Nuh-uh. Your new job will be that of a full-time former fatty, maintaining that weight loss with every ounce of mental and physical energy that you have. But you were looking for another full-time job anyway, right?

On the flip side, you can decide to make peace with food and your body, and develop some hobbies, which of course can be food and exercise, but can also include other things too. The choice is yours; just don’t say you haven’t been warned.

 

 *Can we have a call for #OCCUPYDIETSTREET or something? Wouldn’t that be totally fun?

Podcast!

Check out the latest Dietitians Unplugged podcast in which we discuss the misconception that intuitive eating is for weight loss.

Is Lean Cuisine Still a Diet Food Company?

dinner is served
Dinner is served.

Reader Nicole Geurin MPH, RD suggested today’s blog topic. She asked what I thought about how Lean Cuisine, long-time makers of low calorie, low fat frozen foods, has been retooling their brand to be less about weight and dieting. This video is one example.

 

I think the video is wonderful, so I checked out Lean Cuisine’s website to see what else they’re doing and they are clearly trying to rebrand themselves away from weight loss. They are even offering a filter for your browser that eliminates the word “diet” from your online searches (though if you don’t just search on the word “diet” that also works quite well). They have eliminated any reference to weight loss on their website, which is a pretty bold change. So for now let’s give Lean Cuisine the benefit of the doubt – they are no longer about dieting or perhaps even weight loss.

They also have a page on which they claim they are devoted to women’s wellness, although how that manifests itself in their products, I’m not really sure, and they aren’t specific. When it comes to food, women’s wellness isn’t all that different from general human wellness. I mean, there’s not some kind of menses milk that I’m aware of, or ovulation menu that we need to follow (Yes, some vitamin and mineral DRIs are slightly different between the sexes. That doesn’t usually translate to radically different diets for men and women). Unless they mean…wait, could it be? Might “women’s wellness” translate to our perceived need to eat less in order to weigh less? Which in some circles, is known as a diet. They’re definitely not saying it, so I don’t want to make any assumptions here. Maybe we just need to take a look at some of their products a little closer to see if they put their money where their (and our) mouths are…

Brief interlude: This is by no means an endorsement, but I actually like the taste of many Lean Cuisine meals. More on that in a minute.

…So I looked at the product list. I’m familiar with the Lean Cuisine products because they take up serious real estate in the supermarket freezer section, where I’m always looking for satisfying, filling, tasty and reasonably priced frozen meals without a ton of sodium in them (fun fact: these don’t exist). Looking at the images of the meals in their boxes on the website, they don’t seem to have changed significantly recently, though they do have a pretty wide selection of different “collections.” On the front of the box, they show a photo of a tasty and seemingly much larger meal than what is in the box, as well as little boxes showing the calories, fat, fiber, protein, sodium and carbohydrates. This information is required by law to be somewhere on the box in the nutrition panel so I’m not sure why it has to be displayed so prominently on the front, too — especially the calories. While it can be useful to know the amounts of certain nutrients in foods, especially for certain diseases, I always think the calorie count is useless and hasn’t done anyone a lick of good. Anyway…

Brief interlude part II: A few years ago when I was experiencing a lot of digestion problems from stress, I found it necessary to eat small, light meals more frequently. I thought Lean Cuisine would be perfect for this, and as I said, I actually found I enjoyed the taste. Lunch would come around and I’d eat one and…it wouldn’t even touch my hunger. So I decided to eat two at the same time in the hope of creating the satisfaction of a full meal. Well, it turns out 2 x 0 = 0, and even two left me craving more within an hour. After three days of that, I was ravenous and ready to eat the world. I had accidentally put myself on a diet eating those suckers!

…But here is the real problem as I see it. I looked at the nutrition facts, and the meals are roughly 250-350 calories, with most meals falling under 300 calories and one as low as 170 calories. Now, you know me, I’m not a dietitian to prescribe specific calorie targets for anyone (although clinical practice is quite different; in this setting we do actually calculate calories, protein and fluid requirements to make sure our patients are meeting their nutrition needs. But back in the not-sick, intuitive eating world…not so much), so if the meals satisfy you, by all means, enjoy them. They don’t satisfy me. Across any population, there is going to be a wide range of appetites. Some women eat less and will find the size and make-up of these meals satisfying; others, like me, need more. So here’s a lesson about women’s health and wellness: we are all a little different, with needs and appetites varying widely from person to person. Why isn’t Lean Cuisine addressing that aspect of our “wellness” by making different sizes of meals?

Brief interlude part III: I just told my significant other that I was writing about Lean Cuisine and their shift away from diet lingo and he said, “So are they finally naming them ‘Not Enough For Me Cuisine?'” Spot on, my dear, spot on. He once liked the grilled sandwiches (and I gotta admit, that microwave-grilling technology is impressive; if only they could use it for good instead of diet) but found that even two were not really enough for him. I know very few men who could tolerate eating so little at one meal, so it seems like they are targeting women after all…

What’s the bottom line, then? Yes, I think it’s wonderful that Lean Cuisine has moved away from diet lingo and has eliminated any reference to weight loss on their site. That’s a win. But for me, they’re still a no-go because they don’t meet my needs, even though I’m a woman and they profess to care about women’s wellness. It’s up to you to decide for yourself if, just because they say they aren’t diet foods, they aren’t diet foods.

For those of us that don’t want to give our hard-earned cash to diet companies this could be complicated. Because if a diet food company changes its branding but not much else, has anything changed at all? Does this represent a genuine move away from the pervasive culture of dieting and weight loss or just another example of co-opting of body positive, non-diet language to sell diet products?

Podcast!

Check out the latest Dietitians Unplugged podcast in which we discuss the misconception that intuitive eating is for weight loss.

Dietitians Unplugged Podcast – Episode 4: Will I Ever Lose Weight as an Intuitive Eater?

Cover2In Episode 4 of the Dietitians Unplugged podcast, Aaron and I discuss the common confusion around Intuitive Eating and the expectation of weight loss.

BONUS: a brief update on Oprah and her partnership with Weight Watchers that we discussed in Episode 3.

 

 

Listen on Libsyn or iTunes. Give us a review on iTunes if you like us — this helps to spread the non-diet love to more people.

 

 

 

 

 

 

Inside This Overweight Woman…

oprah_winfrey
Oprah, you are better than this.
I’m not the first (this was the first I saw and my inspiration for this post. And it’s awesome!), or anywhere near the last, person to be ticked off at Oprah Winfrey for her Weight Watchers ad in which she says, “Inside every overweight woman is a woman she knows she can be.” As though literally everything Oprah has already done in her life – hosted a long-running talk show, launched careers, empowered girls in Africa to go to school, become a media mogul with her own network all while probably dealing with racism, sexism and sizeism along the way – somehow isn’t totally awesome because she wasn’t thin while she was doing all those things.

But it’s Oprah’s choice. She can feel however she wants about herself, her career, her body. She can go ahead and diet for the millionth time, as though Weight Watchers were some well-kept secret that she just hadn’t caught wind of while she was busy failing at weight loss with her personal trainer and chef.

What I must completely object to, however, is Oprah’s insistence on speaking on behalf of “every” overweight woman. As an overweight – actually, obese, according to my BMI! – woman, I simply disagree that what is in me is a thinner woman whose life is better than my current fat one. I know because I already tried that.

When I discovered my thinner woman inside, I found she came with a deep insecurity about measuring up to others’ standards. I found a thinner woman who probably could have earned a PhD for all the time she spent adding up points and obsessing over food and weight. This woman may have had other interests outside of food, but she couldn’t fully cultivate them because there simply was no room left after food, exercise and worrying about how she looked.

Despite what Oprah said about looking in the mirror and not recognizing your own self because you’re buried under all that fat, this thinner woman, at her thinnest and hungriest, frequently looked into the mirror and didn’t recognize herself at all. She felt a strong sense of disconnection from herself, as though this was not in fact her own body but some borrowed, alien body with which she was not entirely familiar or comfortable. As though she knew the ephemeral quality of it already.

Oprah could not possibly know what is inside every fat woman. She only knows what’s inside herself and if she chooses to view all her amazing accomplishments as less than amazing simply because she was not thin, that’s her choice.

Because inside this fat woman is someone whose worth is not determined by her appearance, and knowing that, is just fine with the way she looks, and even more excited by the things she is. This fat woman dared to not diet, dares to take care of herself in a nourishing, not punishing, way, and dares to have her voice heard. She had the guts to start a blog and a podcast – things the thin woman never would have dared to do –  and to reject the anti-woman, anti-fat culture that is ever-present.

Oprah’s weight journey has been so public and I feel for her. She doesn’t know that her size really doesn’t matter to the amazing person she is. But, Oprah, please speak for yourself only. Because didn’t you hear? It’s okay for us to feel fine about ourselves without having to turn into something we’re really not. It’s okay for each of us to reach inside and see that the woman there is already the woman we want to be.

Podcast!

Have you checked out the Dietitians Unplugged Podcast yet? No?! Check it out here then!

Listen on Libsyn or iTunes. If you like us, leave us a review, as this helps to spread non-diet love to more people. Also check out our new Dietitians Unplugged Facebook page! More episodes coming very soon.

Diets Diets Everywhere

Pizza_(22)
Warning: this food not on any of these diets.

It’s the new year and we’re in the midst of a shit storm of diet ads and articles about which celebrity lost XX amount of pounds and how. Oh, and how YOU can do it too!

Googling the word “diet” feels, in the words of one of my friends, like having my soul pelted with bean bags. But I did it for you, my beloved readers, to save you the trouble of having to do it yourself. This is what I found:

There are diets that will make Dr. Oz rich, that will line the pockets of Nutrisystem and Weight Watchers and Jenny Craig CEOs and shareholders (I’m looking at you, Oprah). There are diets that will help you to “magically” shed pounds with mystery injections (while you simultaneously reduce your intake to less than 1000 calories a day and exercise two hours daily for 8 days a week). There are diets in which you can give up actual food and replace it with powdered “food” that you eat twice a day along with a “sensible” dinner (because everything else you do on this diet is “sensible,” right?). Diets that use the magic of ketones, either in raspberries or…in your body…or maybe both?…to make you lose weight because ketones, y’know?!

Diets that will have you tracking every single calorie, or Point, or fat/carb/protein gram that you put in your mouth, because somehow tracking food will make you less hungry (it won’t). There are diets that advise you to give up major macronutrients, like carbohydrates, in order to “shed” pounds, and which means you’ll never enjoy movie popcorn ever again, or a baguette with brie if you go to Paris. Diets that teach you how to ignore your hunger signals by tricking you into eating tasteless cardboard foods or drinking massive amounts of no-calorie liquid to fill the void.

There are diets that will convince you that you aren’t your truest, most awesome self until you more closely approximate the cultural “ideal” of beauty (you again, Oprah). Diets that tell you that you aren’t worthy of love or attention because you aren’t the thinnest possible version of yourself. Diets insisting that weight is a good barometer for health, even though you could lose weight just eating candy or dirt or styrofoam all day which wouldn’t be very healthy at all (I know at least one person who supplemented her eating disorder with a lot of candy and not much else). Diets that claim they “work” and then, because they are required by law to do so, add in the small print that, really, they don’t (results not typical translated at last).

There are hundreds, maybe even thousands, of diets out there. And they all claim that they work. But, sort of like that scene in The Social Network where Jessie Eisenberg as Mark Zuckerberg tells the Winklevii, “If you guys were the inventors of Facebook, you’d have invented Facebook,” if diets really worked, they would have worked. We’d all be thin because a significant number of people diet each year, and so at least a significant portion of that significant number would have lost a significant amount of weight and kept it off for a significant time. But they haven’t, as the science reliably shows again and again. And yet the diet companies continue to NOT have to prove they work, simply because we don’t demand real evidence. Yes, most people can lose at least some weight on any diet. And yes, most people gain that weight back within 3 to 5 years. And yes, the purveyors of diets will blame that failure on their clients.

So I implore you – at least know that you can choose something different this year because you don’t deserve to be tortured. Different how, you ask? Here are my suggestions:

Choose actual health, by deciding to honor your hunger and fullness cues and by choosing foods that feel nourishing to you.

Choose picking foods not for how thin or fit or healthy it makes you but for how much you enjoy it. Choose to expand your palette rather than restrict the kinds of foods you allow yourself to eat.

Choose learning to like and respect your body by rejecting the current cultural beauty ideal and deciding for yourself what you will find beautiful (hint: it should include your own badass* self).

Choose to understand that people come in all shapes and sizes, that body diversity is not only awesome but necessary to the survival of our species and that you will honor whatever size and shape your body decides to be when you’re treating it well.

Choose to move for the sheer joy of it. Not because someone told you to exercise to be healthy or thin because that’s not really any fun.

Choose to reject the dieting mentality that has put so many people on a weight roller coaster and left them hungry and unhealthier – both physically and mentally – than they started out.

Choose life over a fantasy that never seems to come true, because life is what you’ve got right now, and you don’t have forever.

If you need some inspiration for building your non-diet, body lovin’ 2016, check out my Resources  and Blogs I Love pages for some Health at Every Size goodness!

*Young people tell me this is a good thing!

Podcast!

Have you checked out the Dietitians Unplugged Podcast yet? No?! Check it out here then!

Download on Libsyn or iTunes. If you like us, leave us a review, as this helps to spread non-diet love to more people. Also check out our new Dietitians Unplugged Facebook page! More episodes coming soon.