A note about exercise: Do it! By boosting mood, it will make this Nine Step Program easier. And don’t worry that exercise will make you even hungrier; the calories you’re burning more than compensate for the extra calories consumed as a result of any increase in hunger. And besides, I’ve noticed that when people start exercising more, their cravings diminish and they gravitate more toward healthier food. (Sushi or a salad is more appealing after a workout than a heavy, fatty meal.) Plus, exercise can help you get back in touch with your appetite signals, which is part of the plan.
Many of these nine steps will be easier to tackle with some support. For instance, a phone call to a level-headed friend can avert a binge; an after-dinner walk with a neighbor can help break your evening ice-cream-and-television habit; going out to eat with your spouse or friend who enjoys healthy food will make it easier to choose well at restaurants. In chapter 2, Ann offers great tips for building a support system.
Step 1: Address Emotional Eating
Feeling out of control around certain foods isn’t necessarily an emotional eating problem, but it might be. If you’re using food to cope with stress and emotions—both good and bad—you’re going to have to work on conquering that problem. People who are able to maintain weight loss report very low levels of emotional eating, according to studies, while people who gain back the weight have a high prevalence of emotional eating. The message is clear: If you don’t conquer emotional eating, you’ll never lose weight or keep it off. In the previous chapter, Ann helped you tackle the problem from all sides. It’s a good idea to simultaneously use the exercises in that chapter and this treatment plan together. They reinforce each other.
Step 2: Keep a Food Record
You need to know the full scope of your challenge: what you’re eating and drinking, how much, when, and in reaction to what triggers. This invaluable information will help you in many other stages of this treatment program. The only way to get this information is to log it. If you’re a veteran food logger, and it helped you, you understand how powerful this tool is. If it didn’t, you may be thinking, “Not again!” But I’m going to challenge you to try again; if your food log wasn’t helpful in the past, it’s probably because you weren’t ready to accept what it told you. Your Lifestyle Log is in appendix 1. (You can print out extra copies at www.thebestlife.com/motivation; you don’t have to be a member to get access to the log.) Ideally, you’d log every day for the next month. If you can’t, then log as many days a week as you can, with a minimum of four, including two of your days off. Don’t worry, you don’t have to do it for life! This program requires some intense work up front for results, but it does get easier. And remember, even after you regain control over your diet, your log is always there for you when you need a reality check or a motivation booster.
Step 3: Make an Eating Schedule and Stick to It
People who have a good diet and who are in control around food can be more flexible about when and what they eat. Guided by hunger and fullness signals, they can tell, for instance, that they’re still a little full from a bigger-than-usual breakfast and will have lunch an hour later than normal. But when you’re giving in to cravings and overeating, your hunger and fullness signals get out of whack. To reset them, you’ll have to impose an eating schedule and strictly adhere to it. This is a strategy I picked up from Christopher Fairburn, MD, who heads Oxford University’s Centre for Research on Eating Disorders. His book Overcoming Binge Eating was published in 1995, and a 2010 study from the Kaiser Permanente health care system supports its effectiveness. Even if you’re not bingeing— but instead eating throughout the day—this strategy will help you bring back balance.
Here’s what to do: Set up times to have breakfast, lunch, dinner, and one or two snacks. If you’ve lost touch with your hunger and fullness cues, then eat the meals and snack(s) whether you’re hungry or not—eventually your body will adjust to your new eating schedule and the signals will kick back in so that you’ll find yourself hungry at mealtimes. If you are already in touch with your hunger and fullness cues and you’re not hungry at mealtimes, then eliminate a snack or two and/or make your meals a little lower in calories. If you find that you’re not hungry because you’ve been giving in to cravings between meals or you doled out too much food at the previous meal, then stick with the schedule and, at meals, try to avoid eating to the point of feeling stuffed. In the Lifestyle Log, there’s a column to track your hunger using a 1-to-10 Hunger Scale, explained on page 230. You’ll refer to this column to determine how often you eat in response to hunger (if you even feel the sensation). You know you’re getting better when you start seeing more 3s and 4s before mealtimes—those numbers correspond with feeling hungry but not starving.
Eat enough; don’t diet. Yes, you want to lose weight, but this isn’t the time to start significantly cutting calories. At this point, you have a much bigger problem than your excess weight—your food addiction—so it’s best to focus on this first. After all, not eating enough only makes you more vulnerable to your addictive foods. So make sure your meals are satisfying and that you’re taking in enough calories. Landing the right calorie level involves a little trial and error; you know you’re in the right zone when, except for just before mealtimes, you’re not physically hungry (which, I know, is a sensation some of you need to regain) and you have enough energy to exercise. For most women, that means not going below 1,700 calories; for men, at this exercise level, no lower than 1,900 calories. I realize that these calorie levels may seem high if weight loss has been your focus, but, again, your focus shouldn’t be on weight loss right now. So use these numbers as a starting point and work up from there if necessary. (To see what balanced days look like at these and other calorie levels, check out the meal plans in any of the three Best Life books or visit www.thebestlife.com, where you’ll also find hundreds of recipes, each complete with its own nutritional analysis, and discount coupons for Best Life products.)
Still, you don’t want to overeat; that just reinforces the bad eating habits we’re trying to break. So be sure to get the most filling and appetite-quelling meals for the calories. Check out the “Keep It Satisfying” box on the next page.
Write down your schedule on the following page. Eat as close to the assigned times as possible—ideally, within thirty minutes. Have at least one healthy snack, such as a tablespoon of peanut butter or a slice of reduced-fat cheese on a few whole grain crackers, or a piece of fruit and a few tablespoons of nuts, or a slice of turkey on a small piece of whole grain bread spread with reduced-fat mayonnaise. If two or three snacks prove an even better deterrent to caving in to the addictive foods than one snack, then have more snacks and eat a little less at mealtimes.
MEAL TIME OF DAY (MEALS SHOULD BE NO MORE THAN FOUR HOURS APART)
Breakfast ________________
Snack * ________________
Lunch ________________
Snack * ________________
Dinner ________________
Snack * ________________
* Have at least one healthy snack; more if helpful.
KEEP IT SATISFYING
It’s easier to quell a craving when you’re not hungry. So, along with sticking to an eating schedule (step 3), eating “high-satiety” meals—meaning those that satisfy hunger long after you’ve left the table—can also help take a bite out of hunger.
High satiety does not have to mean high calorie. In fact, many high-satiety foods actually help you lose weight. While your body requires a certain number of calories every day to keep you satisfied and minimize hunger, it’s also looking for that satiating sensation of a full (but not overstuffed) stomach. When the stomach stretches to accommodate a meal, nerves relay a “full” signal up to the brain; that usually takes about 20 minutes from when you start eating. That’s where the volume (how much space a food takes up) and the weight of a meal or snack come into play. It turns out that you eat about the same weight of food every day (the actual weight differs from person to pers
on). So if you hit that weight with lower-calorie foods, you’ll be just as satisfied as if you filled up on high-calorie foods, given, of course, that you’re meeting your basic calorie needs. For instance, have a cheese Danish and a cup of whole milk for breakfast, and you’ve consumed about 11 ounces of food (approximately 2½ cups) for 411 calories. But for that exact same number of calories, you could have had 1 cup of cooked oatmeal topped with 2 tablespoons of chopped walnuts and 1 teaspoon of maple syrup, served with 1 cup of strawberries and 1 cup of fat-free milk—for double the weight, 22 total ounces. The second breakfast weighs twice as much as the first, and if you were to measure it in cups, it’s about a third larger. Clearly, the latter breakfast will be more satiating for the calories.
Wondering how the weightier breakfast contains the same number of calories as the lighter one? The answer is simple: It contains more water. Water is heavy, and watery foods are bulky and help make a meal satiating. Strawberries are 91 percent water, similar to most other fruits and vegetables. Fat-free milk is 90 percent water, and even the oatmeal is 83 percent water. A cheese Danish, on the other hand, is just 31 percent water, and while the whole milk is 88 percent water, it has nearly double the calories of fat-free milk because of all the fat.
So here are the ingredients you’ll need to create satiating—but calorie-controlled— meals and snacks:
Water-rich foods such as fruits, vegetables, and low-calorie (broth-based or vegetable puree) soups. About half your plate should be fruit and/or vegetables at each meal. And starting off with 100 calories of a low-calorie soup can make it easier to stick to a reasonable calorie count for the entire meal.
Fiber-filled foods such as (again) fruits and vegetables, whole grains, bran-based cereals, high-fiber crackers (such as Wasa crispbread) and wraps (such as whole wheat tortillas and Flatout Flatbread), and beans (legumes). The fiber component of these foods is calorie free and expands in the gut, creating a sense of fullness. If you struggle to meet your daily fiber goal (at least 25 grams for women and 38 grams for men), and need a boost, you can try a fiber supplement, like Benefiber.
Protein is particularly satiating, and keeping it lean helps you cut down on calories and artery-clogging saturated fat. You don’t need much: just 2 to 4 ounces per meal. Eggs and liquid egg whites (such as Better’n Eggs and All Whites), fish, skinless poultry, pork tenderloin, and tofu are good choices. Because red meat is linked to certain types of cancer, limit even lean cuts of red meat to once a week. Milk and soy milk are rich in protein, so they cover your protein needs for breakfast. And if you’re looking for nutritious vegetarian sources of protein, you can go for tofu, lentils, legumes (such as black beans and pinto beans), or one of the many Best Life approved gardein products.
Low-glycemic-index carbohydrates can help suppress hunger. The glycemic index (GI) is a 1-to-100 ranking of the extent to which a set amount of carbohydrates raises blood sugar. Foods with a low glycemic index (55 and under) elicit the slowest and smallest rise in blood sugar, followed by medium GI foods (56–69) and high glycemic index foods (70–100). So, ideally, most of your carbs will fall into the low or medium levels. Most fruits and vegetables are low GI. Milk and yogurt are as well, because protein slows the journey of the digested food to the gut. But it varies when it comes to grains; here are some lower-GI grain choices:
Barley
Bulgur wheat (cracked wheat)
Oatmeal (the thicker the cut, the lower the GI; steel-cut oats are best)
Pasta (including regular pasta, whole grain pasta, and pasta enriched with fiber and/or protein such as Barilla Plus)
Wheat berries
In The Best Life Guide to Managing Diabetes and Pre-Diabetes, you’ll find the glycemic index of many more foods, because a low-glycemic-index diet helps manage these conditions. You can also look up the GI of foods on www.glycemicindex.com, a website maintained by the University of Sydney’s Human Nutrition Unit, School of Molecular Bioscience.
Fat boosts satiety by helping slow the passage of food from the stomach to the intestines. Make the healthy fats listed on page 94 your staples. About two fat servings at each meal should do the trick; a serving is about 45 calories, such as 1 teaspoon of oil or 2 teaspoons spread such as Best Life Buttery Spread, or 1 tablespoon of light mayonnaise or nuts.
Step 4: Change Your Inner Dialogue
To overcome food’s strong pull and to start rewiring your brain, you’re going to have to change some long-held views and ways that you talk and reason with yourself. Instead of telling yourself that you’re weak, out of control, and need food, here are new approaches.
Rethink deprivation. You’re going to be cutting back on fattening fare, which has become a big part of your life. Your challenge is to do this without feeling so deprived that you focus even more on the foods and go rushing back to them. Just as turning to these foods became a habit you learned, turning away from them is also a learned habit. “Like any good habit, the more you do it, and the more rewards it brings, the more ingrained and natural it will become,” says Adrian Brown, MD, a psychiatrist specializing in eating disorders and an associate clinical professor at Georgetown University Medical Center in Washington, DC. “At first, people don’t see how cutting back on foods can be rewarding, but if they’re persistent, they soon understand. The sense of pride, control, and accomplishment—and usually weight loss—become worth the temporary discomfort of not devouring a doughnut. However, it takes a while to make that switch.”
Agree to handle a little discomfort. While the rewards of passing up high-calorie foods eventually trump whatever difficulties you may experience, how do you deal with the initial discomfort, which can be very agitating? “It’s a fine line,” says Dr. Brown. “You don’t want to set food rules so rigid that you panic or rebel, but you also don’t want to completely let yourself off the hook so you’re able to continue your behavior. Make an agreement with yourself that you’ll accept some discomfort. Go for the easiest sacrifices first, such as not trying out the new ice cream–topped French toast concoction advertised at the pancake house. Or ordering a small serving of fries rather than a larger one. Adjust to these changes first, then tackle the harder, more ingrained habits, like that latte and cookie you have every day at eleven in the morning,” suggests Dr. Brown.
Give addictive foods a mental makeover. Contemplate one of the foods that holds such sway for you. Let’s say it’s a German chocolate cupcake. What are your immediate associations? Yummy, comforting, exciting, scary, powerful, fattening, loss of control—both good and bad associations might come to mind. Your goal is to break, or severely weaken those associations, so that the cupcake becomes a much more neutral object that no longer has a grip on you. Try looking at it through the eyes of a space alien: It’s a dark brown and light brown mound composed of mainly sugar, flour, and butter. It can raise blood sugar and cholesterol, induce guilt and disappointment, and, if eaten when you’re not hungry, can make you uncomfortably full. By looking at your problem foods with fresh eyes, they might not look so great anymore. For me, it’s Buffalo chicken wings; I view them as little hunks of skin and fat dipped in even more fat!
Imagine the problem food is not always available. Usually your craving reaches fever pitch only when you know the food’s available. You’re walking on a boardwalk and start craving fries because there’s a French fry stand every few yards. Every afternoon the bell in your head goes off at three o’clock for a candy bar from the vending machine just one floor down from your office. When you’re lying in bed, you might be thinking about the cookies in the cupboard, but you’re probably not having an overwhelming craving for the bacon-stuffed potato skins at the T.G.I. Friday’s fifteen miles away. So your mental trick is to tell yourself that foods that are physically within your reach are simply not available, or at least not all the time. It’s like going to a museum: The objects are there, but you can’t pick them up and take them home. The museum idea has not only helped me say no to unhealthy foods but has also saved me a
heap of money I might have spent on clothing or furniture I didn’t need.
Remind yourself that you’ll never regret it. “We’ve all regretted ordering that triple-chocolate mousse cake dessert when we’re already stuffed, but rarely does anyone who skipped it say the next day, ‘Geez, I wish I’d ordered it,’” Dr. Brown points out. “Quite the opposite: You feel elated that you dodged the calorie bullet. As you’re experiencing the craving, give yourself a few moments to imagine the regret you’re going to feel if you eat it and how good you’ll feel if you pass it up.”
When you do indulge, eat mindfully and enjoy. You may have heard the term mindful eating, which is basically the act of focusing on your food when you eat. You’ll get a lot more satisfaction from eating 100 calories of a food you really enjoy (in my case, dark chocolate) if you savor it without distractions than if you scarfed down 500 calories of chocolate or other treats while you were trying to break up a fight between your kids or racing to get to a meeting on time. Some people purposefully distract themselves while they’re eating problem foods because they feel guilty about it, so they try not to focus on what they’re doing. According to therapist Angela Taylor, “A lot of my clients have benefited tremendously from mindful awareness exercises. For instance, I recommend a ‘first-bite meditation’: Before taking the first bite of food, take a deep breath in and out. Then take a good look at the food before eating it, smell it, and as it hits your tongue, concentrate on its tastes, flavors, and textures.”
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