Wednesday, May 27, 2015

By Aiming at Weight, We Miss the Mark

I've never liked math, and I've never really been particularly good at it. Math was painful in school, so I had to be creative to get through it. I ended up assigning personalities to the different digits and putting them on teams--the answer to the equation meant a point for the particular team and whichever team had the most points at the end of the worksheet won. I had to make a game of it because it was so painfully boring.

But people love numbers, especially those relating to health. Numbers are neat and tidy, (or so it seems.) Doctors and journalists like to assess people's state of health according to the numbers--weight, body mass index (BMI), cholesterol, blood pressure, etc. Some of those numbers really are significant, like blood pressure. A BP too high or too low really does spell trouble, but those other numbers? Mmmm, maybe not so much.

Recently I read the book Secrets of the Eating Lab by psychologist Traci Mann of the University of Minnesota. Mann spends a good bit of time explaining why diets, that is, restrictive ways of eating that are meant to result in weight loss, are not effective.

Certainly, most people lose weight on diets, but apparently only 5% of dieters are able to maintain this weight loss over the long haul. 

Yes, 95% of people who lose weight through dieting gain back some, all or even more weight. And so they go back to dieting and repeat the process again. And again, and again. This lather, rinse, repeat action is called 'weight cycling,' or in common parlance, 'yo-yo dieting.' Some research suggests this is very not good for us, that remaining heavier is actually healthier than going up and down, over and over. Even if weight cycling were perfectly healthy physically, it has to be massively head-wrecking.

But what about that 5%, you might say?

A few months ago, I watched an HBO documentary called The Weight of the Nation. (It's on youtube, if you're interested, but I can't say I would necessarily recommend it.) One segment features two women who have both lost 100 or so pounds and kept it off for over a year. They're happier and healthier and feel great, and that's great!

But wow... maintaining their lower weights is like a full-time job. They speed-walk miles everyday. They were shown ordering lunch for takeout. Just deciding what they were going to eat involved calculator, pen and paper. It was like a meeting of the Congressional Budget Office. (Not that I've ever been to one, but you know what I mean.) "We could get this instead of that, ask them to cook it this way, take away the sauce and that saves us 200 calories!" For real. This is how these women live. And I respect them for it, but I suspect this kind of effort is why so many people gain back the weight. That's a lot of thinking and math involved in just ordering lunch... even for someone who likes math.

Of course, there are physiological reasons why weight regain happens, but I suspect a lot of it is that the behaviors required to lose the weight in the first place are just not sustainable. Draconian calorie restriction, tedious calorie counting, lengthy and/or unfun, grueling workouts. We just can't keep them up, and so we don't.

Mann recommends shooting for your 'leanest, livable weight,' meaning that number at which you can comfortably live without heroic effort. Research shows we all have a set weight range--a spectrum at which our bodies are most comfortable. We can influence this number to some degree through lifestyle choices, but it requires serious effort to lose--or even gain--a significant amount outside this range.

This sounds like good advice, but I'd really prefer to think of it as adopting habits. Excessive weight gain is sometimes just a symptom of bad habits. Focusing on the weight misses the mark. Shoot for healthy behaviors, tackle them one at a time, until they become (at least somewhat) effortless.

It might require a drastic change at first to break a habit--as I did in giving up sugar last year, but now not eating sugar is normal for me. It's effortless. I don't experience strong cravings or even enjoy very sweet stuff anymore. It didn't result in any significant weight loss--in fact, I've actually gained a little weight in the past year--but reducing my sugar consumption was an absolutely healthy habit. But focusing on the scale number wouldn't have helped me. Instead, I might have become discouraged and been tempted to give up an undoubtedly good habit.

I can appreciate why people like the numbers. They're quantifiable. You can pretty easily measure numbers, but the big picture--the important one--is more than just the math.