“You need to help me lose weight,” she said, gesturing angrily at her body, “I’ve tried every diet out there, and I keep failing. What am I doing wrong?”
I have heard variations of this refrain thousands of times over the course of my career. The people who I see in my practice are refugees of what we call “Diet Culture.” They are usually women who, at some point in their lives, were told that their bodies weren’t okay the way they were, despite the fact that they were perfectly healthy. They started their first diet sometime in their younger years and now they are 16, 22, 35, 47, 63. They have been on the front lines, fought, lost, fought, lost again, and have finally realized that they were only at war with themselves. They have come to the conclusion that the only way to win is to not play, and this is what we do—learn how not to play. We learn how to eat normally.
Almost all weight loss attempts fail, when measured over five years.
Despite the fact that most of us can’t think of any of our friends, family members, or coworkers who have successfully lost weight and kept it off, most people find the high weight-loss failure rate hard to accept. Although most people can lose weight in the short term, 95 percent of people gain it back within five years. Worse, two-thirds of those who regain lost weight end up at a higher weight than where they began.
Over the course of years, most people are consistently gaining weight due to trying to lose weight. Why? Restricting calories causes metabolic changes that make losing weight difficult, and once fat cells are created, they are impossible to lose unless surgically removed.
Our bodies are designed to survive in the face of starvation, not starve when food is abundant. Being hungry when there is plenty of food around usually causes eventual overeating. It’s pretty easy to hold off on overeating at the beginning of a diet, but as time goes on it is nearly impossible to resist breaking the diet.
To add insult to injury, since foods that are high in sugar and fat are calorically dense, these are the foods that we tend to want, and lots of them, when we are undernourished. When the diet eventually ends, we feel that we have failed. In a few months, after the body has binged back up to at least the original weight, the cycle usually begins again with a new diet. This kind of weight-cycling, or “yo-yo dieting” as it is commonly called, is extremely stressful to the body. It can lead to diabetes, cardiovascular disease, certain cancers, eating disorders, depression, and anxiety. Staying at a higher weight is actually better for you than weight-cycling.
Health at Every Size™ (HAES™) is a philosophy that acknowledges that well-being and healthy habits (going to the doctor, having social supports, being physically active, good nutrition) are more important than weight. The eating part of the HAES philosophy is called Intuitive Eating. It is the practice of listening to the body’s cues about what to eat, when to eat, and how much to eat. In short, it is just eating normally. It is how you ate before you thought your body was nothing other than a vehicle to move you around. It is not the “eat whatever you want whenever you want to” diet. It is not a diet at all. It is accepting your body just as it is and making it as healthy as you want it to be.
The foundation of intuitive eating is “legalizing” all food. Nothing is off-limits. We learn to listen to hunger cues and learn the difference between eating for physical hunger and eating for emotional hunger. Usually there is a lot less “emotional eating” than people think, once they stop dieting and their eating regulates. We also learn to listen to what our bodies are asking for. Does it want something hot or cold, crunchy or smooth, savory or sweet, spicy or bland, and how much? How is that food going to feel in your body?
In my 20-year career, I have never once come across someone who only wanted to eat candy or chips all day for weeks, which of course in what most people fear. Built into our DNA is a desire for variety of different foods, so that we get all of the nutrients that our bodies need. If one has been withholding certain foods and calories repeatedly however, it usually takes some time for their body to get back to a normal eating pattern.
The most challenging element of intuitive eating is learning to not beat oneself up for “mistakes” in eating, not in a touchy-feely kind of way, but simply because it doesn’t help. It is a gathering of eating experiences, looking at them, moving on, and getting closer to acceptance, and therefore peace, with food. None of us will ever be perfect at eating, and no one will ever have a perfect body. Those realizations are liberation.