by Barbara Berkeley, MD
Some years ago I wrote about the fact that weight maintainers have to live on a sort-of island. While everyone around them is splashing in a sea of fat, sugar and chocolate (and a great many are drowning in it), those who live by their own eating rules are up on dry land watching the proceedings in a state of relative isolation. It can be downright lonely on the island.
This is especially true over the holidays when eating and unhealthy behaviors reach their absolute peak. It's always difficult to say no to the candy at the check-out and the super-sized taco on the menu, but it becomes nearly impossible when eating becomes bound up with family, with joy and thanksgiving, with memories of the past, and---at least in my neck of the woods--- with cold, snowy days that beg for hot chocolate and mashed potatoes.
Data from a JAMA study by Danziger in 2005 looked at America's most popular diets and was able to show that they mostly fail because of low compliance. Those who were able to follow diet rules assiduously did well, regardless of the type of diet they chose. I believe that exactly the same conclusion can be reached about successful maintainers. It is knowing your rules and following them exactly that leads to long term weight control. And that means 365 days a year...with no holiday exceptions.
Now this does not mean that your rules have to exclude all modern eating. That would be frankly impossible. What it does mean however, is that you must clearly, CLEARLY know which foods you have to completely avoid in order to prevent relapse. You must also know exactly how much and what types of foods will preserve your current weight and you must have a plan for small gains that you are willing to institute right away when the scale climbs up. Does this sound like "defensive eating?" It is! We are forced to take a defensive posture to ward off an onslaught of excessive consumption and addictive substances. Remember too that we are likely more susceptible to these foods now then we used to be. Whether this has occurred because of environmental factors, gut bacteria or some other cause is unknown...but the fact remains that we must protect ourselves more now than we had to in the past.
During the holidays, you will need to work your plan so that it allows you to continue following the rules. Over the many years I have been eating as a 90% Primarian, I've found that by far the easiest strategy is to simply do the same thing over the holidays that I do the rest of the year. This seems difficult at first, but many successful maintainers employ this strategy and have found that it gets easier as time goes by. I challenge those of you who are new maintainers to try getting through the rest of this year without going off your base eating plan. Keep track of how you feel after attending holiday events and see whether avoiding sugars and starches substantially changes your experience or enjoyment. You might be surprised!
Exercise usually suffers during this period as well. Over the past two months, my own exercise regimen took a hit as I went out of town for a conference and, following that, my mother got ill and needed hospitalization. While cutting back on aerobics and tennis created many more hours in the day, the change quickly began to impact me. I have been frankly stunned at the degree to which being sedentary, even for a few weeks, can have a direct negative consequence. If you are just beginning to devote yourself to physical activity, you won't notice this. But if you are someone who has been an exerciser for a long while, it will be obvious. Within a short time, I simply started to feel like another person and, without going into the details, it wasn't a person I enjoyed being.
Today's Well blog in the NY Times has a good article on exercise as potent medicine. A meta analysis of studies concluded that exercise can often be as effective as medication for many of our modern illnesses. I doubt that there is an exerciser in this readership who would dispute the fact that exercise works like a drug for them. Hippocrates famously said, "Let food be thy medicine and medicine be thy food". In his day, it was impossible to be sedentary. No doubt this wisest of physicians would have said the same of exercise had he known that we would all devolve into couch potatoes.
Here's what I say to my patients during the holidays.
Remember that eating in a way that protects and defends your weight and body, keeping yourself strong through exercise, sleeping 7-8 hours a night, and taking time to relax and de-stress are all part of the most important gift you can give yourself this season. For every year that you get through the holidays having given yourself this gift, you add more holidays to your life, more opportunities to live without pills, dementia, and excess risk.
Remain joyful this holiday season by preserving, protecting and strenghtening the greatest gift you have ever been given: your body and mind.