Your Brain on a Diet
Trigger warning: Discussion of diets and weight loss.
Sandra Aamodt is a neuroscientist. The video below is her TED Talk about our brains on weight loss and, in particular, about mindful eating.
She has a very, very pessimistic view of weight loss. Far more pessimistic than Linda Bacon in Health at Every Size. Bacon wrote:
…the best way to win the war against fat is to give up the fight. Turn over control to your body and you will settle at a healthy weight. And regardless of whether you do lose weight, your health and well-being will markedly improve. You will find that biology is much more powerful than willpower.
Aamodt’s advice is to learn to eat mindfully — eating when you’re hungry, stopping when you’re full — in an effort to mitigate eating disorders and stop gaining weight. Your best bet, she says, is avoiding diets because they will, in almost every case, cause you to get fatter. She explains how the body’s systems for controlling weight are like a home thermostat. You can open a window in the winter and cool things down, but the thermostat is still set where it’s set and it works to regulate the temperature of the home. Similarly, you can do drastic things to lower your weight, but your internal thermostat is still set where it’s set and your body will still work to regulate your weight back to it’s set point. Often it overshoots and you wind up fatter.
So, is my thermostat stuck in the 350-pound range? I have this on my mind, because I’ve lost a little bit of weight (about 15 pounds over the course of three or four months). I have no idea if eating mindfully, which for me means making sure that I’m eating between my body’s base metabolic rate and total daily energy expenditure (the number of calories my body needs for organ function and to maintain my weight), will continue to cause slow weight loss. I don’t know if Aamodt is right, and my body’s thermostat is set so that I’ll probably not be able permanently lose much more weight or if Bacon is right and, if I give my body what it needs, it’ll take care of coming to my “healthy weight” on its own.
I know that if I’ve learned one thing from a lifetime of trying to manipulate my weight, for me personally, dieting is a recipe for failure. I wish I could go back to my 20-year-old self and take Aamodt’s advice about mindful eating and not gaining weight. I don’t believe that I would have gone from 180 to 360 pounds in the 22 intervening years if I hadn’t cycled through diet after diet, fostering disordered eating along the way.
In Aamodt’s talk, she uses one chart. It looks at four healthy behaviors: improving nutrition, increasing exercise, not smoking, and drinking in moderation. While people with normal weights show an increase in health with each of these behaviors that they adopt, it’s obese people who show the biggest increase when just one behavior is adopted. When people who are of normal weight and people who are obese adopt all four, the difference in their levels of health nearly disappears.
If you look at the chart, you can easily see that it implies that having a BMI of more than 30 is a significant health risk for someone who doesn’t eat well, doesn’t exercise, who smokes, and who drinks a lot of alcohol. Adding in just one healthy behavior doesn’t make much difference for those with BMIs below 30, but does for those with higher BMIs. By the time you get to all four behaviors, it’s a pretty even playing field.
It’s hard to ignore the fact that for the vast majority of humanity, very low calorie diets are impossible to sustain. There are some people who are able to lose significant weight and keep it off for the long run, but they are outliers. I think some of them design their lives around making sure that they can put a lot of their attention and willpower toward keeping the weight off. Some of them, perhaps, weren’t fat for long enough to reset their thermostat to a higher level. Maybe they gained weight after an illness or a pregnancy, for instance, and lost it within a year or two.
One thing I’ve noticed about the Body Acceptance and HAES community is that while there is a lot of talk about weight loss and how possible or impossible it is, there is very little discussion about gaining weight. So little discussion, in fact, that when I think about it now, I’m not even sure how to wrap my head around it. I almost never think about gaining weight. I don’t think about someday weighing 370 pounds or 380 or 400. I assume that what I weigh now is the most I will weigh. My weight has been stable since I started practicing HAES, but before that I had gained ten pounds a year for the six years since my youngest child was born. I have no idea when that would have stopped, or if it would have at all.
I’m not sure if I’ll keep losing weight, but I am pretty confident that I will never be thin, and I’m at peace with that. I am positive that I have control over how active I am, how strong I am, how well I feed myself. I’ve never been a drinker or a smoker, but it’s interesting to me that when the other two of the four healthy behaviors — eating and exercise — fell apart during a recent time of stress, I fell apart, too. I felt like crap. Bringing them back in line has had nearly miraculous results despite only a very, very modest weight loss.
I think maybe putting the focus on the things we can control, like adopting healthy behaviors, maintaining weight, improving health, is one of the most important things we can do for ourselves. Whether Aamodt is right, and weight is not something we can control beyond a narrow range, or Bacon is right and mindful eating and joyful exercise will allow our body’s to reach a natural, healthy weight, we know that letting go of the fight to be smaller is maybe the path to reduced stress, increased happiness, and improved health.
Here’s the thing: HAES stands for HEALTH at Every Size, not HEALTHY at Every Size. It doesn’t imply (I find it strange to think that anyone thinks it does, but a recent foray into reddit-land has taught me that there are people who do) that everyone on Earth is already healthy. Improved health is the goal of HAES, and I truly believe that’s an attainable goal that can have sustainable results.
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