By Dr. Karen Reznik Dolins
“I know what I need to do to lose weight,” Patti says during our first nutrition counseling session. “Just tell me what to eat, and I’ll be fine.” After a bit of discussion, Patti admits that rigidly following a meal plan allows her to lose weight for a brief period of time, but that eventually she becomes bored, the daily stresses of life get to her, or lagging energy causes her to look for foods not on her plan. The result is a regain of the weight she has lost, and often a few additional pounds to boot. Perhaps more problematic, each attempt leaves her feeling more and more discouraged and hopeless about ever managing her weight forever.
Ellen had been struggling with her weight since high school. Her mom was constantly dieting, and was always after her to control her eating. When we met, Ellen said she would like to feel as though she had a normal relationship with food. She wanted to feel that she could eat when she felt hungry, and stop when she was satisfied. A mom with 2 young children, she often felt so stressed out about how to put together a healthy meal that she would buy take-out food for her family when her husband was traveling.
Bob found that he was putting on weight every year. At his last checkup with his doctor, his blood cholesterol and blood pressure were elevated. He tried to be aware of eating healthfully, but his work schedule allowed him little time for exercise and he tended to eat whatever was available without much thought over the impact his food choices were making on his health. He would eat a bagel for breakfast because it was quick, but avoided sandwiches at lunch because the bread was “fattening.”
All of these people came for guidance after years of trying to manage their weight by following what they thought were the rules. Often, my first task is to explain the differences between the myths and realities of weight loss.
Carbohydrates make you fat – Busting the Myth
This recycled myth has come and gone a number of times. It has seen resurgence thanks to Dr. Atkins and Dr. Agiston of South Beach Diet fame. In fact, an overwhelming body of research has shown that calories make you fat, regardless of where they come from.
Public health messages in the 1980′s and 1990′s focused on reducing fat in the diet. Saturated fats and trans fatty acids are known to have detrimental effects on health, while all fats are calorically dense. A teaspoon of oil, for example, has almost three times the amount of calories as a teaspoon of sugar (45 vs. 16). Unfortunately, lowering the fat content of foods doesn’t necessarily lower calories. This was made clear when commercial bakers responded to market demand by making fat free cakes and cookies, adding more sugar to make up for the decreased palatability of the lost fat. Calories in these products were similar to their full-fat counterparts. Many found that they had a tendency to overeat them, and most users of these products did not lose weight.
Carbohydrates are an essential part of the diet as all of our cells use the sugars we get from them for energy. Eating carbohydrates in their natural form, or at least minimally processed, ensures more vitamins, minerals and fiber, and less added fats, salt, and sugar. Research has shown that eating fruits, vegetables and whole grains helps with weight management as the fiber and water in these foods makes them satisfying. Eating one bagel with nothing on it, for example, can have as many calories as 2 slices whole grain bread, 2 oranges, and 1 cup of non-fat yogurt.
Rather than avoiding “carbs,” consider the level of processing in the carb-containing foods you are eating. A baked potato, for example, is full of nutrients and fiber, and satisfies the appetite. A bag of potato chips, though, keeps you hoping for more.