Q: I’ve done a lot of diets with strict rules but usually end up gaining the weight back. I don’t know how else to keep eating under control to get back to a healthier weight. What do you suggest?
A: It sounds like you are afraid that without a lot of rules, you will eat uncontrollably and excessively. I’ve worked with many patients over the years who voiced such fears. With so much high-calorie food available everywhere it can be easy to overeat, especially for those who are highly responsive to cues from the sight or smell of food. Although relying on an overly rigid set of rules to control eating can help weight loss in the short run, people often find they can’t continue long-term, and then their eating feels more out-of-control than ever.
Fortunately, there are alternative strategies. One, called “flexible restraint,” involves developing skills to make positive choices, rather than being held hostage by impulsive urges and old behavior patterns. It’s the sweet spot of knowing that you can balance having an overall healthy eating pattern with occasionally choosing high-calorie, less healthful foods in small amounts. Intervention studies that help people abandon rigid rules and develop this flexible restraint approach have shown improved long-term weight control and better psychological wellbeing.
This approach involves learnable skills, including listening to body cues of hunger and fullness, coping with emotions and impulses, and developing positive and accepting (rather than perfectionistic) patterns of thinking and self-talk. It’s about switching focus from a diet to a livable healthy lifestyle. This includes preparing healthy foods in ways that you truly savor, as well as developing habits for getting regular physical activity, dealing with stress and spending time with people you enjoy. Most registered dietitian nutritionists (RD/RDNs) are trained in helping people develop these skills, so I encourage you to seek their help. To locate an RD/RDN in your community, visit the website of the Academy of Nutrition and Dietetics (http://www.eatright.org) and enter your zip code to find one.