Smart People Don't Diet

Praise for Smart People Don't Diet

"Since all of the data indicate that diets don't work, Dr. Markey proposes a reasonable path to good health in easy, doable steps. Dr. Markey gives insights into why we eat the foods we eat, and how we can change our inclinations so that we pick healthier choices. She suggests ways to change habits, and there are many easy-to-read tables throughout that give alternative food options. And most importantly, Dr. Markey writes about how positive feelings about our body shape and characteristics can spur us to strive for health."

—Joseph Dixon, PhD, Department of Nutritional Sciences, Rutgers University

Copyright © 2014 by Charlotte Markey

Cartoons on pages 1, 19, 37, 63, 83, 113, 137, 161, 183, and 203 copyright © Randy Glasbergen

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Printed in the United States of America. For information, address Da Capo Press, 44 Farnsworth Street, 3rd Floor, Boston, MA 02210.

Designed by Brent Wilcox

Set in 11.75 point Adobe Garamond Pro by the Perseus Books Group

Library of Congress Cataloging-in-Publication Data

Markey, Charlotte N., author.

Smart people don't diet : how psychology, common sense, and the latest science can help you lose weight permanently / by Charlotte N. Markey, PhD. — First Da Capo Press edition.

pages cm

Includes bibliographical references and index.

ISBN 978-0-7382-1771-0 (paperback) — ISBN 978-0-7382-1772-7 (e-book) 1. Weight loss. 2. Weight loss—Psychological aspects. 3. Self-care, Health. I. Title.

RM222.2.M3577 2014

613.2'5—dc23

2014031432

Published by Da Capo Press

A Member of the Perseus Books Group

www.dacapopress.com

Note: The information in this book is true and complete to the best of our knowledge. This book is intended only as an informative guide for those wishing to know more about health issues. In no way is this book intended to replace, countermand, or conflict with the advice given to you by your own physician. The ultimate decision concerning care should be made between you and your doctor. We strongly recommend you follow his or her advice. Information in this book is general and is offered with no guarantees on the part of the author or Da Capo Press. The author and publisher disclaim all liability in connection with the use of this book. The names and identifying details of some individuals in this book have been changed.

Da Capo Press books are available at special discounts for bulk purchases in the US by corporations, institutions, and other organizations. For more information, please contact the Special Markets Department at the Perseus Books Group, 2300 Chestnut Street, Suite 200, Philadelphia, PA 19103, or call (800) 810-4145, ext. 5000, or e-mail special.markets@perseusbooks.com.

10 9 8 7 6 5 4 3 2 1

For Charlie and Grace
The best reasons I can think of
to keep eating my vegetables

Contents

Introduction I Wasn't Always Smart

1 Just Don't Do It

2 Why Diets Don't Work

3 Phase One: Honestly Weigh In

4 Love Yourself Naked

5 Phase Two: Bite by Bite

6 Get Moving

7 Phase Three: Eat Smarter

8 Restart Smart

9 Share Your Success and Encourage Others

10 The Big Picture

About the Author

Acknowledgments

Notes

Index

Introduction

I Wasn't Always Smart

I've been obsessed with food for as long as I can remember. As a young girl, I was convinced I would one day be a ballerina. Of course, most little girls want to be ballerinas, but I really was going to be a prima ballerina. A decade in the dance world inevitably resulted in a lot of scrutiny about what I ate and what I weighed. By the age of twelve, I knew quite a bit about dieting, but that was expected as a girl auditioning to be a part of San Francisco Ballet. During the audition, I was told that I would not be admitted into the company. In fact, I was told that I would not ever make it as a dancer because I "simply did not have a dancer's body." At the time, I was crushed; today, this memory serves only to confuse me. I don't remember what I weighed back then, but I know I was nowhere near overweight. Unfortunately, my preadolescent self just assumed I was fat, and I reluctantly left ballet for more typical teenage pursuits: sports, cheerleading, boys.

Watching my weight wasn't reinforced only on the dance floor but also at home, where someone was always on a diet. I learned how to count calories before I hit puberty. And, I learned a lesson that the dance world had first introduced: watching what you ate was a normal part of life. Adolescent insecurities ramped up my interest in dieting, and it wasn't long before my obsession with food led to a dark chapter of my life. By the middle of high school, my weight was hovering below a hundred pounds and I had already achieved my adult height of five feet five inches. Fortunately, there were people who noticed when I lost weight. A high school math teacher (an intimidating man who also happened to be the school's football coach) sat me down, expressed uncharacteristic empathy, shared his own struggles with his weight, and offered sound nutritional advice. My swim coach encouraged me to be proud of my "strong legs," and a school counselor never failed to just ask me how I was doing when he saw me. My family worried, my friends provided support and encouragement, and doctors assured everyone that there was no medical explanation for my weight loss.

There was no dramatic turning point or epiphany that led me to eat more, take better care of myself, and return to a healthy weight. I became older and more mature, and I suppose I gradually came to terms with the fact that I was not being smart, I was potentially compromising my health to be thin. My story is not one of a magical moment of redemption; it's a story of a typical, insecure teenage girl who gradually learned what healthy eating entailed with some help from a nutritionist, good social support, and the pursuit of a degree in psychology.

When I began my undergraduate education at Santa Clara University, I did not plan to major in psychology. But, after taking a few classes, I was hooked. I loved that a scientific, methodical approach was available to help me understand my world better. I began to do research during my senior year of college, and—not surprising, I suppose—my initial focus was on children's eating attitudes. I applied to graduate school because I loved psychology and wanted to continue doing this research. By that time, I had moved beyond trying to merely understand myself to wanting to understand all the children, adolescents, and adults who struggle with poor body image and engage in maladaptive eating behaviors. I was lucky to receive incredible training at the Healthy Families Project (University of California, Riverside), the Children's Eating Lab (Pennsylvania State University), and the Longevity Project (University of California, Riverside) while I completed my PhD in health and developmental psychology.

In 2002, I joined the faculty at Rutgers University and developed a course called the Psychology of Eating. Many years later, I still love teaching this class, and my research at Rutgers focuses on issues ranging from romantic partners' influences on eating behaviors to parents' concerns about their children's obesity risk. For some, thinking about food, doing research about food, and teaching about food (never mind the need to eat food!) for this many years would be unappetizing, but I've never tired of the subject and don't expect that I will any time soon.

I began to think about writing this book several years ago when I was teaching my Psychology of Eating course. In the class, I spend a considerable amount of time trying to debunk myths about food, dieting, and body image for my students. Most semesters, I ask students to bring in popular diet books, and we discuss them in relation to the scientific facts about weight loss; most books don't fare well once we start digging for evidence to support their claims. It turns out, for example, that there's no scientific support for a ten-day, seventeen-day, or twenty-one-day weight loss plan, regardless of what some books claim. I've been encouraged by my students, who tell me that what they learn in my class is life changing and that they wish that they had known this information years ago. Time and time again, students report giving up on fad diets in favor of the gradual, sustainable, healthy approach to weight loss and weight management I offer in this book. In addition to my students, I continue to be inspired by the latest science and research, which contradicts the avalanche of inaccurate information out there and offers sound information about eating, weight, and body image.

Outside the classroom, when I tell people that I am a health psychologist who studies eating behaviors and body image, they often have a lot of questions for me. Surprisingly often (at least I'm always surprised), they start to tell me about a new diet they are trying. Favorites among people I've encountered lately seem to be the Paleo diets, Mediterranean diets, and low-carb approaches (that trend just doesn't want to die, apparently!). I'm always a bit stumped as to what to say to people when they want to talk about these diets. There are thousands of diet books and diet plans available at any given time, and many of these plans offer some reasonable advice about weight loss. Unfortunately, as my students and I have spent considerable time exploring, the vast majority of them also offer some really terrible advice.

This is not a subjective statement. Other diet plans often offer advice that is not supported by science. In fact, their advice often contradicts scientific evidence. Sometimes, their claims are so egregious, I wonder how they are even legal. As it turns out, there isn't a "book police" or a "diet plan investigative team" out there somewhere in the world evaluating the claims made by other folks who offer advice about weight loss. In fact, in the process of working on this book, I was even warned that no one really cares about science; people just want to lose weight fast.

If only fast worked.

Unfortunately, fast weight loss often results in fast weight gain. It's unfair but true. Many scientists, doctors, nutritionists, and psychologists understand that dieting often makes dieters gain weight rather than lose it, because nothing done for only a few days or weeks can have a long-term effect. Not only that—being on a diet is a miserable experience for most people.

So, What Does Work?

The approach to weight management that I prescribe in this book is not a typical diet. I won't be telling you exactly what, when, or how much to eat. It's not that restrictive, and it's not a quick fix. But here's the thing—it works. All of the information is supported by psychology, common sense, or science—and in most cases all three. You probably already know a lot about the advice that I will offer. For example, you know that eating less will help you to lose weight. But, do you know how to do this in a way that is sustainable? As a health psychologist, I can tell you there is nothing you can do for only a few days or weeks that will have any effect on your long-term weight loss or health.

So if this isn't a diet book, what is it? This book presents a different approach: a way to think about and change your eating and activity habits for the rest of your life. Based on what I've learned personally, studied scientifically, and teach my students, I've created a plan that addresses the psychology of weight gain and offers proven, smart strategies for healthful, sustainable weight loss and management, with specific advice about eating well, losing weight, and keeping it off for the rest of your life.

This book provides a 3-phase plan that offers you:

• • A psychological approach to weight loss and maintenance that will not make you miserable.
• • A commonsense approach to sustaining weight loss for the long term, including the tools you need to be an educated consumer and make good decisions regarding your eating and activity habits.
• • The information you need to evaluate your own habits and a week-by-week plan to make gradual, sustainable lifestyle changes.
• • Positive advice for getting "back on the wagon" without guilt, should you ever find yourself succumbing to unhealthy habits in the future.
• • A scientifically proven way to feel your best at a healthy and attractive weight.

My ultimate goal is to change the way you think about food forever. The title says it all—smart people don't diet. What you hold in your hands is a diet book only in that when you finish it, I hope you don't ever think of going on a diet ever again.

Note: This book was written with all people in mind—those who want to lose five pounds, those who want to lose fifty-five pounds, and those who just want to eat better and improve their health. However, before beginning any dietary or physical activity regimen, it is recommended that you confer with your primary care physician. Further, if you are morbidly obese, need to lose a great deal of weight, and time is not on your side, this book can help you, but it is especially important for you to be under the supervision of a physician, and you should consider consulting a nutritionist as well.

Just Don't Do It

When it comes to weight loss, there's no lack of fad diets promising fast results. But such diets limit your nutritional intake, can be unhealthy, and tend to fail in the long run.

Centers for Disease Control and Prevention

As I finished teaching my Psychology of Eating class this semester, one of my students wrote,

As an on-the-go college student who wishes she had the time to lose a few pounds and be fit, a promise like "Lose 20 lbs in 2 weeks!" sounds so enticing. Just this past winter I considered doing a detox diet. This class was my first exposure to the psychological aspects of dieting, and I can honestly say that I will never consider a short-term type diet again, especially if it makes bogus promises to change my life. There's no way of getting around the fact that we need healthy lifestyles in order to have healthy bodies and minds.

It is feedback like this that led me to write Smart People Don't Diet.

We aren't necessarily born smart when it comes to dieting, but we can become smart. And I'm certainly not suggesting that because you have gone on a diet that you lack brainpower. If that were the case, then I just succeed in insulting the majority of adults (including me), who have dieted to lose weight at some point in their lives. If you are one of these individuals, let me guess the outcome of your diet. You lost a few pounds at the start, but then within a year you gained all of the weight back. Within a year of the failed diet, you probably tried another, which also failed. I don't know this about you because I'm a psychic; I know this because I've been there and I'm a scientist who studies dieting. Dieting is actually one of the worst things you can do if you are trying to lose weight. You will soon learn that smart people don't diet when they want to achieve long-term weight loss.

Men and women all over the world go on diets all the time. In fact, about 90 percent of women and upward of 70 percent of men in the US report dieting. Why do so many people diet? Obviously, they want to lose weight, and dieting seems like the solution. However, it is questionable how well these diets actually work. Given the rising rates of global obesity, it seems pretty clear that these diets are not causing people to get any thinner. Did you ever think that maybe there is another way?

This book presents a different approach: a way for you to think about and change your eating and physical activity habits for the rest of your life. However, this book is as much about what you should do as it is about what you shouldn't. This is important because what most people do to lose weight doesn't work—at least not in the long term. My goal is for you to think about weight management as a long-term endeavor. I'll admit that probably sounds daunting. However, I will lay out 3 phases for revamping your eating and activity habits. My goal is to change the way you think about food and weight management forever. I want to empower you to make smart choices that enable you to enjoy food and maintain a healthy weight.

Before reading any further, it is important that you think about why you picked up this book in the first place. I'm guessing that you aren't happy with your current weight. Most likely, you want to lose weight, get in shape, or improve your health. Maybe you want to achieve all three of these goals. It's possible that you have a pair of jeans that you wish you could still fit into (and still be able to breathe) or you have an upcoming wedding or school reunion for which you'd like to look your best. Perhaps, as you start to feel the effects of aging, you realize the necessity of taking care of your body more than you used to—especially if you want to be around to see your children and grandchildren reach particular milestones. Although some of these goals may be more meaningful to you than others, there is really no bad reason to want to maintain an optimal weight and improve your overall health. But it is important to keep these goals in mind. Remind yourself regularly why you care about losing weight or maintaining a healthy weight. Reread sections of this book that especially motivate you. Talk with your family and friends about this new approach to weight loss and weight management. Make it a part of your life, not something that you do temporarily in preparation for swimsuit season.

The approach to weight loss and weight management that I prescribe in this book is not a diet. In fact, my entire approach implores you to just don't do it—don't diet! In this book, there are no gimmicks and no fads. I offer information that is supported by science. I've also incorporated common sense, anecdotes, interviews with experts, and other forms of wisdom to support the claims I make. My goal is to teach you how to be smart about these issues by understanding what researchers such as me know about healthy weight management (tip: fasting to fit into a pair of jeans is not supported by any research!).

Why Evidence-Based Advice Is Important

Everybody eats, so everybody thinks they are experts on eating. We may all have "gut instincts" as to the best way to lose weight, but it is important to consider what science has to say about the topic. The healthiest approach to eating is not a matter of opinion. Psychologists like me have been doing research about eating and weight loss for over a hundred years, and thousands of studies about these issues have been published. Scientists in related fields such as nutrition, medicine, and community health have also been studying and publishing about these issues for a very long time. And yet it seems that the most marketable and even outlandish ideas are what get the most attention when it comes to weight loss—not necessarily the ideas that are really going to work! Just because you would like to lose twenty pounds in two weeks does not mean that this is realistic. However, people sell outrageous ideas like this in various diet books and plans because that is what people want to buy.

In this book, I will summarize what is known from decades of research in an accessible and easy-to-read format. I'll talk about the evidence that supports what I advise so that you can become a smart consumer of all of the information you may encounter about dieting and weight loss from today forward. Advertisements and the media make a lot of enticing claims; I want you to be critical of this media information so that you no longer find yourself struggling to eat well. My goal is to empower you to maintain a healthy weight for the rest of your life. I will explain why diets don't work, why it is often difficult to lose weight, and what you can do that will work. This isn't my opinion; this is a fact echoed by researchers, doctors, and even the Centers for Disease Control and Prevention (CDC), which warns that weight loss isn't about dieting but about "an ongoing lifestyle that includes long-term changes in daily eating and exercise habits."1

What Is Weight Management?

You may be starting to notice that I tend to refer to my approach as "weight loss and weight management." How is this different from dieting? I use the term "weight management" because my approach provides you with a means to not only lose weight but maintain a weight you are happy with for the rest of your life. Literally, I mean how you will manage your weight. I realize that the word "manage" may sound a bit like I'm proposing that you approach eating and physical activity behaviors as a "job" you must do, that we all must do. Just like we have various jobs and activities we perform each day, we should take care of ourselves by eating well and being active every day (okay, most days). This will make us healthier, happier, and better able to contribute to our communities (as opposed to "costing" society resources; more on this point in Chapter 10). Despite the connotations of the term "job," you will not find that a smart approach to weight management ultimately results in changes to your life that feel like a lot of work.