by Barbara Berkeley, MD
The debate continues and probably always will. Is regain inevitable after weight loss? Does our body inevitably sabotage efforts to keep weight stable? Is the only way to avoid this "fat fate" a jaw clenching, moment to moment fixation on every habit and morsel? Are all maintainers clinging to a cliff by their fingernails ready to plunge as the result of a single tremor, a momentary gust of wind?
Dr. Rudolph Leibel of Columbia University is perhaps the major bearer of bad news in this regard. His research over many years suggests that the body mounts a relentless campaign to regain weight once we've lost it. At a recent obesity conference, Leibel discussed this evidence. Obesity doctors (like Yoni Freedhoff whose comments are linked within the article I've referenced) and successful maintainers responded. All of us have seen successful maintenance and we know that it is possible. Regain is certainly not inevitable.
However it would be foolish to assert that maintenance is not difficult. Virtually every successful maintainer I know, including those who respond to this blog, are highly controlled in their eating habits. This is a necessity when we live in a world which surrounds us with opportunities to eat badly. In a world where anything is possible and everything is offered, a strong moral compass must guide our behavior. We've created a similar situation in the food environment and navigating that environment requires a clear sense of course and direction.
But it is my observation that those who succeed in maintenance long term are the ones who have learned to relax into the practice. Most of us start out with the "white knuckle", teeth gritting approach. We try so hard, feel so challenged, and often have the sense that we are continually dodging a bullet. White knuckling through something can get you over the hump in the short term (like public speaking, or running the last half mile in a race), but it is unlikely to provide a long term success. And when you do let yourself slip, all that built up tension is likely to lead to a monumental fall.
The best outcome is one in which your maintenance behaviors become second nature and preferable, not forced. How to get there?
1. Accept the fact that learning maintenance takes time. Be patient. What you are looking for is habit building. So each day, think of working on ways to make yourself happy within the diet and fitness framework you've chosen. Do NOT try to adopt behaviors that you truly don't enjoy. Work on finding substitutions for the fat-promoting things you used to eat and do. Be flexible and try many different solutions. When you notice that you are going back to the same newly created behavior repeatedly, it's because you've formed a habit and you are enjoying it. Continue with that behavior and look for others that need changing.
2. Develop a touchstone. Have some mantra, or something about yourself that re-aligns you each day, reminds you of how far you've come and inspires you to keep going. This should be something that makes you feel very good. This can be a set of before and after pictures that you keep someplace you can see them each morning. Maybe you couldn't wear shorts or a certain favorite type of clothing prior to weight loss. It might be good to keep that clothing on the outside of your closet to remind you that you now can. You might develop a brief self-affirmation...but make it something positive rather than an assignment. So instead of exhorting yourself to stay healthy or stay on track, for example, perhaps you might thank yourself daily for the great sense of relief you feel each day when you are are healthier and are remaining at a manageable weight.
3. Become an expert in you. Weight issues suffer from the input of too many "experts" including me and people like me. You can learn from others, but don't take any of it as gospel. Your task throughout a life of maintenance and health will be to sift through the "stuff" and extract the gold. The formula that works for you will have similarities to those adopted by others, but won't be the same. Don't be pushed around by those vociferous voices on the internet or the meaningless blather in women's magazines. No one can know more about your particular responses to food and weight gain than you do. So start collecting data on yourself. Figure out in detail what foods you are susceptible to and which trigger appetite and/or disable your resolve to eat better. Weigh yourself daily during maintenance so that you get to the point where you can accurately predict what you will weigh each morning before you ever step on the scale. In a short time, you will learn what factors boost weight for you. They may include eating after 8 pm, drinking alcohol with meals, eating salty things, or slight increases in carb consumption (like adding back some grains, potatoes, rice or bread). You will also learn what factors decrease weight. They may include eating most of your food at lunch and just having a small bite at dinner, decreasing a particular source of extra carbs (I gain weight from grapes in certain seasons for example), or exercising in the evening.
4. Stop thinking about dieting and start thinking more about the creative process of working on your individual food choices. If you keep moving forward, you will be adding new pieces and discarding some old ones. You will be learning new things and storing away that knowledge for the future. You will be observing the things that trip up others and seeing the potholes before you fall into them. But one thing you will NOT be, is perfect all the time. Think more about enjoying your growing expertise and less about the times you mess up.
5. Stop being so serious. Laugh at yourself more and criticize yourself less.
6. Applaud yourself. The vast majority of dieters never, ever become maintainers. If you are struggling with maintenance it's because you are one of the rare number who has actually managed to lose weight successfully. It's true that the real challenge begins with the end of weight loss, but you are ready for the learning process and strong enough to negotiate the bumps along the way. Trust in your own smarts!
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