The usual conversation between a provider and a patient ends with encouragement to “eat healthier and come back and see me next time.”
But it’s pretty unlikely much will change by the next visit. As we discussed in Your Guide to Understanding Weight Management, our bodies are programmed to crave sweet, fatty, and salty foods and are easily influenced by an unhealthy food environment. If we’re going to improve our eating, we need to have a plan and take specific steps. We need some guidelines to help us decide what to eat and what to avoid in this 24/7 eating buffet that most of us live in.
What’s Holding You Back?
One of the things that makes weight management so challenging is that everyone is different. Two siblings may eat the exact same diet and portions, yet one is slim and the other isn’t. Or you and your husband may both go on an eating plan like paleo or Atkins, and one of you adapts easily and drops pounds while the other one struggles. (Remember: thin on the outside doesn’t mean healthy on the inside.) And we all have different ways that we get derailed from eating healthfully on a consistent basis.
Here are some of the diet pitfalls I see in my patients; do any of them apply to you?
“I don’t know what to eat.”
Some people truly never learned how to make their own nutritious and balanced meals. Some grew up in families that relied on lots of frozen and packaged foods, rather than cooking from scratch. They’re influenced by advertising and media messages on what to eat. If this sounds like you, a simple book about healthy eating, such as Michael Pollan’s In Defense of Food or Food Rules: An Eater’s Manual can be helpful. A nutrition class or a visit to a dietitian can also help you learn what to eat.
“I know what to eat, I’m just not motivated to change.”
For all the reasons above, it’s hard to get motivated to make any changes. If you’re one of these people, it might be good to have an honest discussion with your provider. We can help you think about what might motivate you and where to start with some small changes.
“I don’t know how to cook.”
How much you cook at home is a good predictor of how healthfully you’re eating. Despite all the food delivery services out there, you’re much more likely to eat well if you know how to cook real food at home. Cooking doesn’t have to be complicated, but you do need some basic skills, such as chopping an onion, cooking rice and pasta, sautéeing vegetables and properly cooking fish and meat. (They used to teach these in school.) Try enrolling in a cooking class or finding a YouTube channel, website or magazine that you enjoy. Be careful of getting hooked on the Food Network, as that might just promote more sitting and less cooking!
“I know how to cook, but I don’t have time.”
Somehow we find time for work, checking email multiple times a day, and social media. Yet we cannot find time to cook. Cooking is a necessary habit for a healthy life. So if you’re motivated to be healthy, you need to find some time to cook. (It might even be more important than going to the gym.) Can someone else cook for you? Yes. As long as you know what the cook is putting in your food. But with few people being able to afford a personal chef, you’re better off carving out time to cook. A key strategy is sitting down once a week, planning out your meals, and when you will cook them. For many people, devoting a weeknight after work or a weekend morning to cooking works. Or you can make cooking social by doing it with a friend or in a family meal prep class. Make bigger batches so you can eat the leftovers through the week.
“I eat healthy meals, but I’m snacking all the time.”
This is a common scenario. In many cultures, people only eat at mealtimes. But, most Americans eat throughout the day. First, look at the places where you’re snacking. If it’s the candy jar at work, kindly ask it to be removed. If the problem is at home, create a safer environment by ridding your house of snack foods such as chips, pretzels, candy, cookies, and ice cream. Make a pact that you’ll only eat them when you’re out of the house or when you make them yourself. Many people go into the kitchen when they’re bored and start munching. But if there’s no junk food there, or you only have nutritious snacks like fruit and nuts, you’ll find another way to relieve your boredom. And if you do keep a few snacks in the house, tuck them away on high shelves in cupboards or the back of the refrigerator. Brian Wansink and researchers at Cornell University’s Food and Brand Lab found that you’re most likely to snack on whatever you see on the counter or in the front of the refrigerator. For a healthier kitchen, they recommend placing fresh fruit in these prime places.
“I’m addicted to carbs.”
It’s important to differentiate between different types of “carbs,” as “carbs” are not a food. Carbohydrates are essential nutrients. They’re in vegetables such as kale and lettuce, but few people are addicted to those. The issue is refined carbohydrates, like sugar and processed corn/wheat. Did you know these foods actually can stimulate the same parts of the brain as other addictive substances, such as cocaine and heroin?
That’s why once you start the day with a sweet coffee drink and a pastry, you may find yourself reaching for more starchy foods such as pizza, pasta, a sandwich or cookies through the rest of the day. If this describes you, it may be helpful to treat the food like an addiction. Some people break the cycle by totally eliminating refined carbs, at least for a little while. Used to a bagel in the morning? A soda in the afternoon? Try eliminating them for a couple of weeks to wean yourself off of these foods and then only eat these foods as an occasional treat.
“I haven’t found the perfect diet app yet.”
Apps that promise weight loss abound. But scientific research hasn’t shown that most weight loss apps are effective on their own. Many of them focus too much on calories in/calories out. But apps can help you stay on course if you use them as part of a well-organized eating program. They can be useful for tracking how you’re eating, and you can share this info with your provider. If you’re someone who responds to apps monitoring your behavior, look for ones that assess food quality (rather than just calories), let you track a specific behavior (like how many vegetables you eat a day), or use social pressure to keep you on track. Some examples are Fooducate, Nudge, stickK, and Rise, an iPhone personal nutrition-coaching app owned by One Medical.
What are some healthy habits to help me start eating better?
Eating to prevent disease is important, and so is enjoying life. You can still be healthy and enjoy your favorite foods. (Remember the definition of food.) Overly restricting yourself will lead to failure and feeling bad about yourself. This state of mind often leads to more unhealthy eating. Remember, there are other things you can do to keep healthy: don’t smoke, limit alcohol use, be physically active, get adequate sleep, and do some form of mindfulness/meditation. If you’re doing all of these things, but eat the occasional serving of chips, cookies or ice cream, you’re still healthier than most Americans.
So what should I eat?
Forget all the fad diets, and celebrity eating plans and what works for your friends. Despite all the studies out there, most people can develop healthy habits by just relying on Michael Pollan’s simple food rules: “Eat Food. Not too much. Mostly Plants.” First, only eat food, not food-like substances, such as Cheez-it crackers and Kool-Aid. A good rule: If your great-great grandmother wouldn’t recognize it, you probably shouldn’t eat it because it’s a highly processed food. It’s probably not food at all, so stay away. Second, don’t eat too much. This is a harder one to grapple with, but keep in mind that portion sizes have expanded over the past 20 years and many Americans eat double what they really need. Try to stop eating when you’re feeling 75 percent full.
Finally, eat mostly plants. Forget about which diet is best. All healthy diets have one thing in common: they’re are mostly made of plant foods. Look at every plate you eat: If 70 to 75 percent of it is filled with foods that are grown from the earth and sold at the farmer’s market (except for white potatoes), you’re probably on the right track.
How can my provider support me in managing my weight?
Your provider can be a coach and consultant on your way to better health. He or she can discuss your weight and how it might impact your health, after looking at your other risk factors. Your provider can also help you figure out what kind of eater you are and what resources may help you.
With a few simple steps, you’ll be on your way to healthy eating, a habit that can help you avoid many chronic diseases.
The One Medical blog is published by One Medical, an innovative primary care practice with offices in Boston, Chicago, Los Angeles, New York, Phoenix, Portland, the San Francisco Bay Area, Seattle, and Washington, DC.
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