Wednesday, January 20, 2016

Diets Don't Work Healthy Lifestyles Do

Two things should be stated before I begin. First, when I discuss diets, I am NOT referencing diets that have been prescribed by a person’s medical doctor. These diets often save lives and DO work. If someone has a life-threatening illness or a severe food allergy, then following a doctor's orders is imperative. A person’s doctor knows his/her medical history, family history, food allergies and personal preferences. That is an entirely different scenario than someone buying a book or DVD on weight loss or better mental health through some arbitrary way of eating.* The second important point is that there is an enormous amount of hope in the data I’ve collected. However, to get to what works, what doesn’t work, and why, has to be covered. I don’t want anyone to lose hope in the beginning. Many people all over the world improve their mental/physical health and lose weight permanently. As I stated last week, I’ve lost nearly 100 pounds (7.14 stone or 45.4 kilograms), greatly improved my mental health and gotten into the best shape of my life by using the data from the next few week’s posts, so I know it is possible.

Some may be skeptical of the claim that dieting, and even dieting and exercise, rarely work because we have all been told so often that they are what allow us lose weight, regain health and become happy. Saying that diet and exercise are what lead to better health is an extraordinarily dangerous half-truth. I’m going to provide a small sample of the data that proves diet and exercise are only part of the combination to unlocking better mental and physical health. Remember, there is an enormous amount of hope, but before I could start working on a real solution, I had to know what the problem was. The first step in solving any problem is to admit there is a problem, and as anyone will be able to see, there is a big problem.

We have been sold the idea that diets and exercise will fix what’s wrong with us for so long that many have come to believe it without question. I have tried more diets than I care to recall. From Pritikin to Atkins to Paleo to Veganism and everything in between.  I knew I wasn’t lazy, self-indulgent or stupid. Despite following these diets as prescribed, I found myself obese, unhealthy and miserable. I knew something was wrong. Thankfully, researchers all over the world had been coming to the same conclusion I had come to--DIETS DON’T WORK! Here is a small sample of some of the data that I came across in my search for an answer.  

The United States Government decided to find the best diet for people on Medicare (their healthcare plan) in an attempt to save money. Obviously, individuals who aren’t overweight tend to be healthier and spend less in healthcare dollars, so the government thought it would be wise to find the best diet to help people lose weight. They hired six researchers at the University of California, Los Angeles. They were tasked with combing through all the data to find the best diet for the government to recommend. After a lengthy study, the researchers were forced to come back to their employer without the requested report. They were hired to do a job that they had to admit could not be done.  After researching all the data, they realized there was no “best” diet. All the diets failed miserably at producing any lasting effect. They stated:
These studies show that one-third to two-thirds of dieters regain more weight than they lost on their diets, and these studies likely underestimate the extent to which dieting is counterproductive because of several methodological problems, all of which bias the studies toward showing successful weight loss maintenance. In addition, the studies do not provide consistent evidence that dieting results in significant health improvements, regardless of weight change. In sum, there is little support for the notion that diets lead to lasting weight loss or health benefits.1
Since I’m already discussing my country, I’ll point out how incredibly hard we Americans have tried to lose weight. Last year alone, we spent over 60 billion dollars on diet books, DVDs and weight loss products.2 That’s more than some countries entire GDP. Obviously, with 60 billion dollars being spent, we are aware of the problem and are trying hard to make changes. If going on some sort of diet worked, Americans should be the slimmest, fittest and most vibrant people in the world. However, that is not the case. The reality is, depending on what variables are factored in, we are ranked in the top ten most obese countries in the world, every year. If 60 billion dollars is spent on a solution and the results are as abysmal as these, then obviously we need to focus on a better solution.

The researchers that the United States government hired to find the best diet are not alone in their analysis. It seems every day another study comes out with a conclusion that sounds eerily similar to what Garner and Wooley reported in Clinical Psychology Review back in 1991. Their conclusion stated:
There are two indisputable facts regarding dietary treatment of obesity. The first is that virtually all programs appear to be able to demonstrate moderate success in promoting at least some short-term weight loss. The second is that there is virtually no evidence that clinically significant weight loss can be maintained over the long-term by the vast majority of people.3

What do they mean by, “the vast majority of people?” Most studies show that the failure rate is around 95%, long term. Those numbers are generated from studies done on the general public. I would hate to see just how horrible the success rate is for those of us who have a mental illness. Throw the stress of a restrictive diet on top of the stress that already exists when someone deals with a mental illness, and I tremble to think of what the failure rates are.  

Enough with the doom and gloom. That is the problem, and it has been acknowledged. Now, why don’t diets work? I am going to oversimplify, to an absurd degree, the research of two neuroscientists who have thoroughly studied this question. If anyone would like to get deep into the details, I would highly suggest Dr. Robert Sapolsky’s book, Why Zebras Don’t Get Ulcers, Third Edition. Please understand before you spend your hard-earned money on his book that it is a science book. While he does make the data understandable, it is still a slightly technical science book. My wife is one of the most intelligent people I know, and she won’t get through the first chapter because she says it’s as dry as dirt. It isn’t about intelligence; it’s about whether you enjoy science books or not. I practically live in science books, so I find his work inspirational. But, that’s me. I love science.

Before I get to Dr. Sapolsky, I need to quickly go over Dr. Sandra Aamodt’s work because she covers why it is so difficult for people to maintain weight loss. Her work also shows why the majority of people end up gaining more weight than they lost on any diet. She can be a bit pessimistic. Who can blame her? Researching individuals who are trying their best to get healthy and lose weight, and ultimately failing, has to be a tough job. However, even she admits that better health and weight loss are possible if a person will stop dieting and focus on eating healthy foods, mindfully. 

Her research points out that while it’s true that our weight depends on how much we eat and how much energy we burn, the deciding factor of how much we eat and how much energy we burn is often outside our conscious mind’s control. Our hypothalamus is the part of the brain that regulates body weight, and it produces around 24 chemicals that tell our bodies to gain or lose weight. It is our body’s fat thermostat. It adjusts our hunger and metabolism in an effort to keep our weight stable. When we force weight loss, our hypothalamus works overtime to protect us from what it perceives to be a famine. Our minds/bodies don’t hate us; they are trying to protect us! Up until one hundred years ago famines and food scarcity were common things. 

Our bodies are programmed to save us during times of famine and distress by releasing chemicals to conserve energy and maximize fat storage. That's why when researchers go back and check on people who went on a diet, depending on how far back they look, 40-70% regained MORE weight than they had lost. These people’s bodies were preparing for the next famine by packing on more fat. Diets are a TRAP! Even the diets that don’t restrict calories are often complicated and overly restrictive of the foods one is “allowed” to eat. Our brains register that information, and it often causes stress. That leads us to the data that Dr. Sapolsky has spent his life collecting.

His work points to the fact that the number one predictor of mental and physical health (obesity, heart disease, blood pressure, mental illnesses, immune disorders, ulcers, diabetes, elevated cholesterol, anxiety, reduced brain functioning, etc.) is NOT what we eat. It’s our glucocorticoid levels. It’s what Psychology Today classified as “Public Enemy Number One.” It’s low-grade chronic STRESS. So, it’s not just what we’re eating, but what’s eating us. Chronic stress has been proved to cause an unbelievable number of health problems and is the leading contributor to weight gain. It causes hunger, fat storage, and sugar cravings. Reducing stress levels through wellness activities and by finding healthy foods and exercise that we love is the quickest and most assured way to improve mental and physical health, as well as the best way to lose weight. Please understand, as a man who does not accept anecdotal pseudoscience, I am shouting from the rooftops--THIS IS REAL! The research on stress and its effects on the body is hardcore, verifiable, reproducible, measurable science. {Please, note that no researcher is claiming people’s stress levels are the cause of mental illnesses. On the contrary, the little understanding that we do have shows that they are biological, genetic conditions. It just so happens that those genes tend to express themselves more frequently in people who have experienced chronic stress. It is not your fault if you have a mental illness, and there is NO scientific data to suggest it is.}

For anyone who would like to delve a little deeper into the subject of how stress affects the body, but who doesn’t want to read a science book, National Geographic did a one-hour special on Dr. Sapolsky's work. It also incorporates the groundbreaking research done in the Whitehall Study. It is an enlightening video. The only problem is it doesn’t get into solutions. However, many of the solutions that are posted on this site are from Dr. Sapolsky’s work. So, if you decide to watch it when you're done reading, don’t get discouraged. There are many solutions, and some of my favorites are already on this site.

The picture that I hope is becoming clearer is that, more often than not, the way to improve mental and physical health, and reduce weight, is not as simple as “diet and exercise.” Improving mental health, physical health and reducing weight is achieved through a healthy lifestyle, which consists of doing three things well (in conjunction with any medications one may be on). First, we have to reduce stress by participating in wellness activities that bring us joy. Notice, if you will, that of the listed topics on this site, wellness activities is the largest. There is a reason for that. Second, we need to find healthy foods that we’ll eat because we love them, not because we are forcing them down our throat due to some diet. I wrote about how I was able to drastically cut my sugar consumption and other junk foods, by adding in fruit and healthy foods that I love, in Healthy Eating With Mental Illnesses.4  I didn’t talk about eliminating foods. I talked about adding in as many healthy foods, that I love, as possible. I hope the philosophy behind that post is clearer now. Finally, we need to find types of exercise that bring us joy. The reason I wrote The Best Exercise for Mental Illnesses5 was to discuss how I became a fitness explorer, looking for the activities that I love. I never once discussed average calorie burns or muscle gains. I discussed having fun while exercising. Long term success stories of people who have achieved better mental and physical health contain some version of how they incorporated those three things. If we go about wellness activities, healthy foods and exercise with the mindset of finding ways to bring more joy into our lives, then they will make us healthier, happier, fitter and slimmer.

It should be more apparent as to why people are failing to achieve better mental and physical health through dieting, and why people write books that say if we simply cut out wheat or grains or carbs or fat or XYZ we will be thin and happy. It’s much easier than telling people they need to find ways to bring joy to their free time, to their healthy meals and their exercise routines. It is much simpler to say we should eliminate some subcategory of food. The average person wants a simple fix. The problem is, the “simple fix” has become a major part of the problem. I decided to find a way to rise out of the quagmire of average and do the right things, in the right way, to achieve better mental and physical health. I am so glad I did.

Next week will be packed with fantastic news! I’ll discuss how I was able to stop fearing food, and actually fall in love with it again. It is amazing how much that has helped my mental and physical health. I’ll also cover how I used the motto “take the best and leave the rest” to dissect many of the diets being sold today. I matched up what those diets prescribed with what the major population studies show and made notes of the correlations. In other words, I used the data on what the healthiest people on earth eat and matched it up with what these diets say we should eat. I was shocked at how little they had in common. So naturally, I also made notes on what was inconsistent with the best scientific data available. I use those notes to remind myself why I don’t want to go on each one of those diets, specifically. They help keep me strong if I am weak and tempted to jump onto one of them in hopes of getting a simpler fix. Next week will be about how I fell in love with food again to improve health, as well as what diets get right, and what diets get wrong. Hopefully, it will help.
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       As always, I wish you wonderful mental health and great successes eating healthy meals. If you, or someone you love, is severely depressed or anxious, please click the link to the right and you will be directed to the International Association for Suicide Prevention. It is a fantastic resource and is staffed by wonderful people.
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*If a person has found a diet that he/she truly loves then it will most likely work because the person doesn't feel deprived, starved or stressed by it. Those are the rare success stories that make up the 5%. People who found a diet that they loved and can actually stay on it forever. As the numbers show, that is extraordinarily rare, but it does happen.