Reasons my patients want to make healthy lifestyle changes

• so I can be around to play with my grandchildren
• to lower my risk of a heart attack
• to improve my blood sugar
• so I can have an easier time climbing up the stairs
• to have more energy
• to improve my mood
• to have less nausea
• to have less bloating
• so I don't eat until I am uncomfortably overfull
• to feel better
• so I can walk further without getting out of breath
• to improve my blood lipid levels
• to feel stronger
• to feel good
• so I can take care of myself
• because only I can do this for myself

I want to lose weight!

     "I want to lose weight!" This is the most common goal of people who I speak to for a nutrition consult. If there is one thing I have learned through my years of being a dietitian, it is that I can't guarantee weight loss. My patients can tell you better than I can tell you that weight loss is really hard to achieve and even harder to maintain. Generally, in the best case scenario, diet alone will lead to 5-10% weight loss, which is often not enough to meet the patient's goal. Fortunately, nutrition changes, even with no weight loss, can lead to real improvements in health and health risk reduction. 

Fear of deprivation

     One of concerns that my patients have is that once they change their eating habits, certain foods will become forbidden, and they will constantly feel deprived of these foods. This fear leads to the "last supper" phenomenon that precedes a diet. The thought is, "I will never be allowed to eat donuts again, so I better get them all in now before they become banned in my next diet." In reality, the idea of prohibited foods is a concept we create ourselves. The extension of that thought, that deprivation is inevitable, is also self-created. 

    I would like to point out the fallacies in both statements. First, we do not have to outlaw foods. I am not even talking about promoting the "everything in moderation" theory. I am simply talking about the black and white/all or nothing thinking that goes into banning foods. The "never again" mindset. Regarding the fear feeling deprived, there are a few other possibilities. Some of that fear stems from the fact we decide foods are forbidden. It is human nature to want what is not allowed. Easing up on the rules can help us avoid the feeling of deprivation. Additionally, there are other helpful and more accurate thoughts we can have. Perhaps a more accurate thought might be, "Let's see what happens if I have oatmeal for breakfast today instead of a donut. I don't need to make plans for the rest of my life right now. I am just deciding about right now" Or the thought could be, "I want to eat a donut when I can really enjoy it, like on a relaxed Sunday morning when I can sit down and savor the taste. Now I am rushing to work and will scarf it down and barely taste it." Or the thought can be, "I would like to sit down and enjoy a donut now. Not because I earned it or because I was good. But because right now I am choosing to eat and enjoy a donut." 

    Remember, knowing these ideas does not immediately translate into feeling and living these ideas. It takes a lot of effort, practice, and reminding ourselves of the perspective we prefer to have. Bumps in the road towards this are just moments to notice what happened. Each new moment is a new opportunity that does not have to depend on the past. 

Non-hunger reasons we eat

• tiredness
• boredom
• anxiety
• restlessness
• pleasure-seeking desires
• habit
• social setting that encourages eating
• location
• eating customs
• "last supper" mentality
• rebound from food restriction

    Which of these have you experienced recently?