EXPERT WITNESS: A psychologically sound diet

By Michael G. Brock One hears a lot of talk about a medically sound eating program, or a medically sound diet or weight loss plan, but I don't think I have ever heard of a psychologically sound diet. I find this curious because overeating really is not a medical problem in most cases. That is to say, rarely are people obese because of medical reasons. We can complain that our metabolism slows down as we age, and that we burn fewer calories unless we have a rigorous exercise plan, but the bottom line is that we are taking in more calories than we are burning. The medical solution to the problem is simple; cut down your calorie intake until you are burning what you take in. The fact that most of us can't or don't do that is an indication that we eat for other reasons than physical need, and those reasons are in the domain of the human psyche. This isn't news to anyone; eating is pleasurable, and often substitutes for other kinds of pleasure. Like other pleasures it can become a dependency. It often becomes so important that we are willing to sacrifice our quality of life, our health, and even our mobility and the length of our lives because we are so addicted to the pleasure of eating. Granted, some of this has to do with the kind of food we eat. I don't know how many people actually cook meals anymore and sit down with what's left of the nuclear family for a dinner including balanced portions of protein, vegetables and starches, but I would think not too many. Not that everything in those meals was all that nutritious; I think a lot of the nutrition in the vegetables I ate as a child went down the drain with the water in which they were overcooked and bleached out. Still, I did eat some vegetables, and other foods that were not as high in fats and starches as the average contemporary American diet. When necessary, however, I find that I can usually get a fairly nutritious meal at restaurants not typically frequented by health and fitness fanatics. Heck, even a quarter-pounder without cheese or fries and with a diet coke can stave off starvation without adding too many unnecessary calories. Moving up a notch, most restaurants serve a salad, and they'll put chicken or fish on it if you ask. But I'm getting ahead of myself. The point is that the reason Americans are all fat is not just that bad food is cheap and plentiful; it's that we eat too much of everything. And once that pattern has been developed, it is hard to break; to the point that as a last resort we are having a "medically-sound" procedure performed to shrink our stomachs because we are unable to change our behavior. As a kid my family had pretty good eating habits, without a lot of junk, sweets or snacks. Truth be known, I could have eaten more as a kid, given the size of my frame, but I stayed skinny well into my 30s. However, a sedentary life, long hours and gradually worsening eating habits resulted in my putting on an extra 50 lbs by the time I was in my 50s. Somehow I realized about six years ago that I could cut out a lot of calories if I just stopped consuming drinks with sugar in them. I quickly dropped 20 lbs, but still had an extra 30 lbs that stayed for a couple more years. Noticing that a friend of mine who was the same age had lost weight and was looking really trim, I asked her how she did it. She said she had gone to Weight Watchers. I had been there once myself and it worked, but I put the weight back on when I quit going. Moreover, I didn't want to take the time to attend the self-help meetings that are part of the program. I began to analyze what it is about Weight Watchers that works. I decided that it was a psychologically sound program: It is behaviorally specific. You eat a certain amount of specific foods and keep track of what you're eating; and you are accountable for your progress, having to get on the scale at meetings. There is peer group pressure to succeed, and perhaps a desire to please the leaders of the group and get their approval. (I believe the leaders are also former or current members of Weight Watchers.) And it is sustainable as long as you continue to eat according to the plan, which is a little looser after the goal weight has been achieved. Beyond that there is the obvious fact that thinning down raises one's self-esteem and, to some extent, the esteem of others. I began to ask myself how I could design a behaviorally specific program that would work for me. I had already begun gravitating back to fruits and vegetables, eating whole grain bread, avoiding fried foods, and eating more chicken and fish, but I was still overweight. The first thing I decided to do was to set a goal. I looked at what the charts said I should weigh and decided at what weight I would look and feel the best. As previously stated, that goal was about 30 pounds away. It was important to set the goal because, as the title of a book I once read explained, "If you don't know where you're going, you'll probably wind up someplace else." Secondly, I decided to get on the scale every day. Accountability is an important principle for behavioral change, and it is no less true that we have to be accountable to ourselves than that we have to be accountable to our families, clients, employers and the IRS. Former Piston basketball player Rashid Wallace used to like to say that, "The ball don't lie." It is equally true to say that, "The scale don't lie." Yes, one scale may differ a pound or two from another, but if you get on the same scale the first thing every morning you have a pretty good idea where you are. Four years later I still get on the scale every day first thing. If the scale says I ate too much yesterday I have to make up for it today. If it says I'm too thin, then I know it's my duty to have an ice cream. The next thing was to have a specific plan with regard to what I would eat. I tend to like healthy food and have found a way to eat healthy without spending hours over the stove, but I do admit it is more costly to eat a lot of fresh food. I don't care. My car runs, I don't need a new one every year, or lots of space I don't live in. I do need good food. My particular plan is two healthy meals a day and a yogurt parfait (plain yogurt, granola and fruit). I also like to use Splenda or a facsimile thereof, which is close enough to sugar for me. I used to eat the parfait at night, but from a health standpoint breakfast is probably the worst food we eat, so I have begun to eat the parfait for breakfast and have the other meals later. I don't eat many carbs, preferring to fill up with protein and vegetables. I especially like salads, Greek, or spinach with strawberries, shaved almonds and blue cheese. Sometimes I just throw in whatever I have. No bread before the meal when eating out is a good habit. And usually I don't eat desert, unless I'm too thin and in danger of wasting away. This diet/eating plan is sustainable; I eat essentially the same things today as I ate when I started four years ago. I get on the scale every day too, and my goal weight is the same. The only part of it I change is the occasional indulgence I allow myself in ice cream or desert, depending on what the scale says. I didn't start this diet with the idea of going back to being fat after I bought a lot of new clothes. The changes were intended to be, and are permanent. Any diet or eating plan one starts with the intention of that change being temporary will have a temporary result. Why put yourself through that? I don't get it. A friend of mine likes to say that nothing tastes as good as being thin feels. I know that's true for me. I may have a few more lines than when I was heavier, but I have more energy, and often feel like the minor league baseball player I used to be. I sometimes I go out with other in shape old people and rock and roll at night (thanks, Bill Callahan, for introducing me to that group back when you were single!) Others have noticed the change, but initially most expressed concern, given my age. "Are you all right?" One rumor had me dying of cancer...hmmm. Needless to say, those reports and the news of my subsequent demise were somewhat exaggerated. What was it Paul McCartney said, "I think I'm still alive, but if I were dead I'm sure I'd be the last to know." So that's it, two meals a day and a yogurt parfait. Sometimes I throw in a smoothie. Specific, behavioral, measurable, sustainable; good, sound psychological principles. Use it if you like; just don't write a book based on this or you'll be hearing from my lawyer. ---------- Michael G. Brock, MA, LLP, LMSW, is a forensic mental health professional in private practice at Counseling and Evaluation Services in Wyandotte, Michigan. He has worked in the mental health field since 1974, and has been in full-time private practice since 1985. The majority of his practice in recent years relates to driver license restoration and substance abuse evaluation. He may be contacted at Michael G. Brock, Counseling and Evaluation Services, 2514 Biddle, Wyandotte, 48192; (313) 802-0863, fax/phone (734) 692-1082; e-mail: michaelgbrock@ comcast.net. Published: Wed, Aug 15, 2012