May 2011 - Weight or health - which motivate you?
I have yet to meet any woman who likes being told she is too fat. Most men feel the same way, although some will argue (wrongly) that their solid ‘beer gut’ is ‘muscle’.
Most of us will feel uncomfortable if anyone, including a doctor, tells us we are too fat. Worse, if you already know you are too fat and you’ve tried lots of diets over the years, being told you are too fat may produce feelings of resentment, depression or defiance.
Some doctors, often conscious of their own size, don’t like to mention excess weight to a patient. It’s easier to write a prescription for a drug to reduce blood sugar or blood pressure than to tackle the real cause – which is often excess fat.
There may be a way to get round our fat problems.
A program in the United States compared two groups of overweight women selected to be as similar as possible. One group was asked to follow a well-balanced prescribed diet that would help them lose weight. They were weighed regularly.
The other group was told not to worry about their weight, but just to aim for ‘health at any size’. Rather than considering whether foods were fattening, they were to think about whether the food was healthy. If it was, they should enjoy it. If it wasn’t, they were to consider it as unworthy and look for something better.
After six months, the two groups returned to their doctors. The dieting group had lost much more weight than the ‘health at any size’ group’. But by 12 months, the dieters had regained most of their initial weight loss and were feeling pretty miserable about the whole thing. The second group had actually continued to lose weight slowly and steadily and were now doing better than the others. They felt happier and healthier.
I suspect that the big difference between the two groups came from who was in charge. The dieters were trying to do what someone else had decided for them. The second group had been given responsibility for their own choices with the aim of keeping their bodies healthy.
‘Health’ won over ‘weight’ in this study and I think it gives us a clue as to what may make for successful weight loss. Choosing foods that are good for health is empowering. Eating what someone else decides for you is not.
Some years ago, a group of women in Sydney who were trying to lose weight discovered they all loved chocolate cake, but felt guilty about eating it. Most said they wolfed down cake and other ‘bad’ foods to minimise the time they felt guilty. This meant that eating foods they loved did not make them happy and none felt satisfied by the experience.
They were set an exercise. Once a fortnight, they and a friend were to go to Chatswood shopping centre, have a coffee and share a piece of chocolate cake. There was one condition: before making their choice, they had to check out at least two, and preferably three, cakes that were displayed in glass cases in cafes. From these, they were to decide on the most luscious looking cake, then they were to eat it slowly and enjoy every mouthful. Having searched for real quality, and because they were sharing the cake (and the indulgence), they had no need to feel guilty.
The women agreed that when they were given permission to eat the cake, it tasted much better. And knowing they could repeat the exercise in two weeks, they were happy to forget about chocolate cake until then. After the second occasion, some said that they actually didn’t think any of the cakes on offer were really all that good and thought they’d wait and try another shopping mall another time. These women had been empowered to be in charge of chocolate cake rather than having chocolate cake control them. Their overall intake of cake decreased and their satisfaction increased dramatically.
Dr Rick Kausman, a Melbourne GP who teaches overweight women to like themselves – now, rather than when and if they become thin – offers similar ideas in his book, titled ‘If not dieting, then what’. It’s a great read and has helped many people to change their perspective on weight. Local libraries usually have a copy.
Dr Kausman’s message is that we need to respect our bodies – whatever their size or shape. By thinking well of ourselves, we’re more likely to take care of our bodies.
When I had a private practice, I didn’t weigh my patients. They and I knew they needed to lose some excess fat. I had seen too many people wearing light clothes in cold weather, removing their jewellery or skipping their morning cup of tea so they would weigh less – for me.
How crazy! It was their health that mattered, not my approval. If they really wanted to know their weight, I suggested they weigh themselves in the privacy of their own bathroom before breakfast on the first day of each month, and record the figure. How well their clothes fitted would be an even better indication of progress.
Too often, people focus on weight when they should be considering health. You can be fat and fit – although it makes it much harder to get fit if you have excess fat to carry around. But if you achieve it, it’s healthier to be fat and fit than thin and unfit. ☼