If you want sustained weight loss, you cannot rely on food products that are ‘industrialized’ or processed – they contain too much sugar, wheat and vegetable oil. The best way to be sure that you are eating food that is good for you is to buy fresh ingredients and cook them. This is a very important point. Success will only come when you understand which foods to eat. And it will only be sustained if that food tastes great and if you look forward to eating it – and cooking is the best way to achieve this.
Remember: The Master Chef is You
Even if you have never tried cooking before, it is not too late to learn. It will enrich your life – weight loss with no hardship, just great food. If you can’t cook well you may want to consider taking lessons or learning from a friend or relative. Another possibility is to get free cooking lessons online – Jamie Oliver is always there with a load of fresh wholesome ingredients to teach you. Another option to improve your cooking skills is to try a food delivery company such as Gousto or HelloFresh. They will deliver a box of fresh ingredients right to your doorstep. The box also has simple instructions on how to cook the food – and you end up with a filling and nutritious restaurant-quality meal. If you have a family this can also be a social activity: you can take it in turns to choose your meal and cook it.
Cooking should be a pleasurable experience – remember, this is what made us human in the first place. Once you learn a variety of ways to cook, you may find that it becomes one of the highlights of your day – the actions and concentration that cooking requires will naturally relax you. After a while, cooking will have become a valuable part of your life, and maybe even something to pass on to the next generation.
To make your cooking experience great, in addition to having a standard set of pots, pan and dishes, I would advise investing in a new set of knives, an old-fashioned knife sharpener, a hefty chopping board and a food blender. You may need to clear out your fridge and start again to fill it (and the freezer) up with fresh food. Set up your radio or Wi-Fi speaker and enjoy the whole relaxing experience – your mind will be focused on your food (and the music) and all troubles and worries will fade away; you’ll also be able to show off your newfound skills to family and friends.
Away from Your Frying Pan
The other preparations to make before getting started are to your home environment – especially in the lounge and bedroom. Part of our plan will encourage you to sleep more, and in order to do this you need low lighting in the house for the hour or so before bed. See if you can change your bulbs to low wattage, invest in low table lamps or get dimmer switches. You may even want to choose a book to help with that relaxing time in bed.
Oh, and a final change in your home environment – please throw away your scales! The weight loss and health will come; don’t become stressed and obsessed by it and don’t be tempted to force it.
Reduce Family or Work Stress
We have learned that our environment can affect our weight set-point. External stresses and anxieties in our lives can also influence our cortisol levels. This will have an impact on where our bodies want our weight to be – how big a ‘fuel tank’ might be needed. If you are unduly stressed, then your metabolism acts like that of an injured animal – the cortisol message means you’re not going to let go of energy stores easily.
There may be factors in your life that are difficult to control, but that are causing you an undue amount of stress and therefore affecting your cortisol levels and your weight (cortisol ➞ raised set-point). Before you start the programme, you will need to take stock and consider what these factors could be. Are you in a job that is particularly stressful? Are there family, or relationship, issues that are causing stress at home? Is the commute to work too much? Are you incessantly worried about money? These factors are just as important as your diet. Unless you address these issues you may find your set-point more difficult to shift downwards. Remember, if all else fails, sleep, exercise, music, massage, dancing and laughter all help to lower cortisol levels.
Time to Start
You are nearly ready. You have realistic expectations that you are going to become much healthier and slimmer; you have read this book and understand how to regulate your weight and you have prepared your kitchen and home environment. The final, and perhaps the most important, ingredient is your time. To make lifestyle changes you will need to find the time to shop for good fresh foods and then the time to cook them, as well as finding time to be active and extra time for rest.
If you can make time to look after yourself, then everything will be easier. Remember that you are building a new body and a new life; your time investment is needed to do the job properly. If you are in a busy job or you have lots of family or other commitments, then you need to stand back and take stock of your life. Look to see how you can find this precious time. It may be that your current down-time is used mindlessly watching Netflix or scrolling through social media feeds. Think seriously about your lifestyle and your daily routine to find this time – only you can do it. I would estimate that you need to find one to two hours extra per day by dropping or curtailing current unproductive activities.
It Will Only Work If You Enjoy It
The crucial part of lowering your weight set-point is in the food and lifestyle changes that will be outlined in the next two chapters. If these changes improve your life, if they make you happier, then it is likely that you will continue with them – with the bonus that your weight will have reset, permanently. This is the opposite approach to the short-term diets in which the changes necessary for weight loss make you feel unfulfilled, unhappy and hungry – and are therefore not sustainable.
Prepare Your Mind
One of the essential changes that you must make to reduce your weight set-point is to normalize your insulin profile: this means no more sugar surges. We will discuss this in more detail in the next chapter. But you need to be mentally prepared for this change in your eating habits. As we have learned, sugar and highly refined carbohydrates (like flour) directly stimulate the reward pathways in your brain. This results in a surge of the brain hormone dopamine; it makes us feel good. It is naturally released after we consume foods containing sugar, and after sex. However, it uses the same pathway as drugs such as alcohol, nicotine, cocaine or even heroin. Because the reward is so powerful, we can get hooked on it and get addicted to the substance that triggers those feelings – whether it be drugs, sex … or sugar. You may have a sugar addiction, partial or full-blown. In either case, when you limit your exposure to sugar, you might find yourself going ‘cold turkey’. You may experience headaches, muscle aches, fatigue and poor sleep – until you can satisfy your extreme craving for sugar to stop the withdrawal symptoms and get another shot of dopamine.
You need to be mentally prepared for these short-term side effects of your change of diet. Just like the preparations you make in your home environment, you need to prepare your mind for the changes to come. You need to adapt to a healthier way of eating – but because of the dopamine surges that sugar gives us, and the addictive nature of these rewarding feelings, you may need extra help.
It is essential to have a clinical psychologist as part of any bariatric surgery team. Most patients with severe obesity will have developed an addiction to sugar and sugary foods, and as a result will also be suffering from a leptin deficiency, so that their brains will be receiving hunger signals constantly (as we covered in chapter 5). This is the reason most of these patients are compelled (by their hormones) to binge-eat, to eat to excess, usually in secret, while simultaneously experiencing a lack of control and feelings of guilt afterwards. Their problems are exacerbated because, by the very nature of binge-eating and the compulsion to consume as much energy-giving food as possible, it is highly likely that they will also become hooked on sugar. The psychologist plays an integral part in helping obese patients through the process of mentally readapting after bariatric surgery, when sugar is suddenly off the menu.
A Guide to Mindfulness and Mind
ful Eating
My friend and colleague Jackie Doyle, Lead Clinical Psychologist in my department at University College London Hospital (UCLH), has offered some useful advice on how to be mentally prepared for the changes in diet, and how these changes might affect you – as well as suggesting some practical coping strategies.
SECTION 1: MINDFUL MEDITATION
The best way I know to help manage stress is through mindfulness meditation. Numerous studies have shown that practising mindfulness improves emotional wellbeing and quality of life. There is also growing evidence that it can have a direct biological effect on stress hormones such as cortisol.
Mindfulness allows us to be fully present, aware of where we are, what we are doing and how we are feeling and thinking. It is in contrast to the state of being on autopilot, which will be familiar to all of us. This morning I was sitting at my desk and I realized that the drilling that was going on in the road outside had stopped. The sudden quiet was a real relief to me, which was strange because I hadn’t really been aware of the effects of this noise on my concentration levels. For all of us, sensations, emotions and thought processes can be occurring in the background without us really noticing, as we go about our daily lives. For example, have you ever had an experience where you suddenly become angry about something, but later feel you had over-reacted? Again, these ‘out of the blue’ reactions often occur because we have not been aware of the ‘back story’, a whole host of narratives, physical sensations and emotions occurring in the background of our experience. With mindfulness, we can become more aware of these background experiences and through this awareness learn to respond to difficulties in a skilful way, rather than reacting on autopilot.
Please don’t be alarmed: learning to meditate does not mean heading off into the hills of Tibet, and indeed you don’t even need to channel your inner Buddhist (unless of course you want to). There are many ways that people can learn mindfulness, through courses in person or online and through books or computer apps. Professor Mark Williams, recently retired Professor of Clinical Psychology at the University of Oxford, has developed a series of resources under the blanket title of ‘Finding Peace in a Frantic World’. More information on this can be found at https://franticworld.com.
SECTION 2: MINDFUL EATING
There are so many myths and misunderstandings about food and weight regulation. Often the people I meet have lost confidence in knowing how to eat, and what to eat. Research has shown that if babies are given access to a wide range of unprocessed food, they will eat a balanced diet over a period of about a week. However, for a variety of reasons we seem to have lost this natural intuition about eating.
Eating has become one of the things that we do very mindlessly. It is now very much a feature of Western culture to eat on the run, eat at our desks or in front of the TV. It has come to the point where many people say that they feel uncomfortable eating on their own if they are not also doing something else, e.g. checking their phones or reading. One of the downsides of this is that we miss valuable information about our eating habits.
In my clinical work, I run mindful-eating groups or seminars. At a certain point in proceedings, I hand out a small piece of chocolate for people to try. This is often greeted with laughter, surprise and fear. People are often shocked that I would encourage chocolate-eating, but go on to enjoy the ‘naughty’ element of this exercise. Some people, however, refuse to take the chocolate because they fear that it will open the floodgates to a full-on binge.
Below you’ll find a short exercise that you can try for yourselves. When trying this at home, I encourage people to choose a chocolate that they like, have eaten before and would often choose to eat. However, if it feels safer to choose a different food, this is also fine. The main thing is to try the experiment rather than just read about it.
MINDFUL EATING EXERCISE
Begin sitting down, ideally in a place where you are unlikely to be disturbed for five minutes. Have the chocolate unwrapped in front of you. Start off by really looking at the chocolate as if you have never seen it before. What do you notice; is it as you expected it to be? Now note what is going on in your body. Perhaps you are aware that your heart is starting to quicken or your mouth has begun to water?
Take the chocolate and smell it. What do you notice now? Does it smell as you expected it to? Does it smell different in one nostril compared to the other? Again, note what is going on in your body and perhaps any thoughts that you are having. Ask yourself, how much do I want this chocolate on a scale of 1–10 (10 = I very, very, very much want the chocolate!). Now take a small bite of the chocolate and rest it on your tongue, without chewing, and put the rest of the chocolate down for a moment. Slowly begin to chew, noticing all the sensations in your mouth, stomach and the rest of the body before you swallow. As you swallow, see if you can pay attention to the sensations as the chocolate goes down your throat into your stomach. Once the chocolate has gone, take note of what is happening in the rest of your body and any thoughts you are having. How satisfying was the chocolate on a scale of 1–10 (10 = extreme satisfaction)? How much do you want more of the chocolate on a scale of 1–10?
Now repeat this sequence. Take a small bite, rest it on your tongue, without chewing, and put the rest of the chocolate down for a moment. Slowly begin to chew, noticing all of the sensations in your mouth before you swallow. As you swallow, see if you can pay attention to the sensations as the chocolate goes down the throat into the stomach. Once the chocolate has gone, take note of what is happening in the rest of the body and any thoughts you are having. How satisfying was the chocolate this time on a scale of 1 to 10 (10 = extreme satisfaction). How much do you want more of the chocolate on a scale of 1–10?
Finally, repeat the sequence one last time. Once again take a small bite and rest it on your tongue without chewing, placing the rest of the chocolate down for a moment. Slowly begin to chew, noticing all of the sensations in your mouth before you swallow. As you swallow, see if you can pay attention to the sensations as the chocolate goes down the throat into the stomach. Once the chocolate has gone, take note of what is happening in the rest of the body and any thoughts you are having. How satisfying was the chocolate this time on a scale of 1 to 10 (10 = extreme satisfaction). How much do you want more of the chocolate on a scale of 1–10?
After you have completed this exercise, reflect on what you noticed. How might these discoveries help you take care of yourself?
This exercise is often a real eye-opener. Some people discover that they don’t actually enjoy the chocolate as much as they thought they did. It smelled funny or it tasted too sweet or they didn’t like the sensation at the back of the throat. Others say that the experience of eating slowly gave them as much satisfaction from three small bites as they would get from a whole bar of chocolate. This may sound crazy, but it is really worth testing it out. Others say that the exercise piques their desire to eat more chocolate, in which case I encourage them to do this, but again in this slow mindful manner, and see what they discover. Most people find that they are satisfied by much less than a typical portion size.
It would be a shame if readers were to embark upon this new adventure and miss the pleasures that food can bring or indeed miss the fact that food they once thought of as enjoyable actually isn’t. In the words of Jan Chozen Bays, American paediatrician and mindfulness expert, ‘Mindfulness is the best seasoning.’ For more on mindful eating, see the website (mindful eating, conscious living, https://me-cl.com).
SECTION 3: MANAGING CRAVINGS
Many people report that when they start to eat well, they experience fewer cravings. However, eating is not just in response to physical hunger or a result of hormonal changes in the body. There are times when certain foods seem to be calling us! The biscuits bought for the children or grandchildren appear to shout ‘come and get me’ from the cupboard. The chocolate in the fridge transmits thoughts such as ‘one won’t hurt’, ‘you deserve a treat, you have had a hard day.’
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br /> It is important not to underestimate the intensity of cravings. I often ask people to describe how their bodies feel when they are in the grip of an intense craving. They say that they feel edgy, agitated and restless; some say it is like being itchy all over. More importantly, in this state people say that it is very difficult to reason with themselves, to talk back to the chocolate or biscuits that are calling them. This is in fact an example of the autonomic stress response, when the body is charged, ready to act, and the capacity to think is reduced. This is an important physiological response in times of danger, but not so useful when this system is turned on in relation to food. If this is a regular experience, it is important to come up with a plan ahead of time, before the craving strikes, so that it can be implemented when it does. There are a variety of ways that I suggest people manage cravings.
Get moving – as mentioned above there is a lot of physical agitation associated with cravings. Moving can effectively ‘burn up’ this extra energy. Some of my clients turn the music up loud, dance, march on the spot or get involved in other intense physical activities. It is not simply about distraction; it is about directing this extra energy effectively.
Why We Eat (Too Much) Page 27