July 21, 2013

How to Stop Eating Too Much, in Ten Moderately Difficult Steps

  1. Find out how much you normally eat. The only way to do this is to measure and record it. This is a little tedious, but it's really important and you just can't skip it. There are excellent tools out there that make it easier. I use myfitnesspal.com (I don't pay any attention to how much they tell you to eat – it's way too little – nor to how many calories they say exercise consumes – it's way too much. But it's free, and it makes recording your eating much easier.) Measure your waist and weigh yourself every day, too.

  2. Don't try to fix your eating yet. Don't try to eat less. Just find your present base line. Find out what you eat now. If you binge, don't beat yourself up about it: that's just part of the binge pathology. No need for beating up. Just write it down. For now, you're just gathering information. Just record it: all of it: for a whole month. That should be long enough for you to go through the whole range of your eating behaviors. I guarantee that if you do this faithfully, you will discover several startling things about how you eat. Mechanics say: you can't fix it if you can't see it. Your first job is to see it.

  3. Exercise. The CDC has an excellent recommendations: follow them. You can do this at the same time as you're recording, if you like. The exercise will not, of itself, make you lose weight: in fact, if you're starting from sedentary, you ought to pack on some pounds of muscle as you ramp up. This is fine. This is good. You want muscle. It will make you feel good to have muscle. Trust me. But we're not losing weight yet, okay? We're getting the body ready to be metabolically healthy. More important BY FAR than losing weight. If you never get farther than this step, you'll still be way ahead of the game. 

  4. Don't try to fix the eating yet, though. You're not ready. 

  5. Okay. You've faithfully recorded every single damn thing you eat for a month, and you're following the CDC guidelines for exercise, right? I know, it's hard. But if you haven't done these steps, don't do the next ones yet. Just start over and get the first ones down. Don't get discouraged: if it was easy, we'd all already be svelte, and we wouldn't be having this conversation. It's hard. But hang in there. Get these steps done. We'll wait for you.

  6. Now we're going to start fixing the eating. We're exercising, and we're tracking what we eat. The next step is to eat good food. You don't have to stop eating bad food. Not now, not ever, though you may have to eat less of it eventually (that's step 10.) There's lots of good food, and you're bound to like some of it. Basically, if it has no white flour, added sugar (including of course sugar's evil twin, corn syrup), processed oils, or preservatives in it, it's probably good food. Vegetables, fruit, nuts, meat, eggs, beans, tubers, minimally processed grains – all good stuff. But the tricky part is that we've learned to eat them in hyper-palatable forms. We eat potatoes – great! Wonderful food! – but we eat them drenched in salt, butter, and sour cream. We eat green salads – terrific! – but swimming in sugared, processed oils. We eat pork – a great meat! – but in the form of bacon, awash with nitrates and soaked in salt. Your job is to start eating these things fairly plain. Add some salt to your potatoes, sure. Dress your salad in cold-pressed olive oil & vinegar. Roast your fresh pork in the oven. They're great foods. (See Stephan Guyenet's blog posts on why people eat too much: Whole Health Source.)

  7. Don't stop eating bad food yet. Making these changes are hard enough: you're going to need your comfort foods to see you through them. This is the hardest part, and it's going to take a lot of work. If you're like most contemporary Americans, this part involves learning to cook, which is a big enterprise: learning to shop, learning to store food, learning to prepare food and keep a good, functional, ongoing kitchen. Learning to know when food has gone bad and needs to be thrown out. It means cleaning up after most meals, so that the kitchen is functional again for the next meal. All this stuff is hard. It's time-consuming and discouraging. If you learned to do it as a kid, thank your parents devoutly. (Really, call them up right now and thank them.) If you didn't – take a deep breath, lean in, and get going.

  8. So now, you're going to do some calculating, and figure out what your caloric needs at your goal weight are likely to be. I like this calorie calculator. Pick a sensible goal weight, not an extravagant one. If you don't have one in mind, I'd pick the highest round number that's considered to be in the “normal” range. Then use the calculator to find the number of calories you'll need to support that weight at your current activity levels.

  9. Now – you're still faithfully tracking your eating, right? I'm sorry, it's a bitch, but you've got to do it – now your aim is to eat that many calories every day in good plain food, the kind you learned to make and eat in step six. Eat as much bad food as you like, too! At this stage, that's important. Go ahead. Binge if you need to binge. Eat your treats. Reward yourself. You're making really difficult changes. You can eat anything you damn well please BUT – you have to eat your goal weight calorie requirements in good plain food as well.

  10. You've done this for a month? Excellent. Now, you're ready for the last step. You've been tracking for long enough now to see if the calculators were right, and make your adjustments accordingly. What has happened in your month of eating enough good plain food? If your weight and waist measurements have been going down – for many people they will be – then you're done. Just keep eating this way. But if you are not moving toward your goal weight and goal waist size, you're going to need to run a deliberate calorie deficit. Make it a modest deficit. A 500 calorie daily deficit is a whopping one: I'd go for 200 or 300 calories fewer per day, or maybe 1,500 or 2,000 fewer per week. (If you like more variation in how much you eat day by day, weekly totals may work better for you.) Don't cut out all your treats. Just eat mostly good plain food, and run enough of a deficit to lose at most a pound a week. If you're losing more than that you're probably just storing up trouble for yourself. It may take years to lose the weight. If it does, that's just fine. As long as you're eating mostly good food, and you're not gaining weight, you're playing the winning game: it's the long game, but it's the winning game.

There you have it: that's my advice. I want to stress that this doesn't describe my own journey: it's just how, looking back, after years and years of struggle, dead ends, and failures, it seems to me that it would have been easiest to do it, and it is how I do it now. I also want to stress that it's really hard. It's not hard because you're hungry and deprived: you're not. It's hard because it takes a lot of work and discipline to keep feeding yourself enough good plain food. That's what's hard. And there's no short cut, no quick and painless way around that. You have to learn to make it, eat it, clean up after it, and make it again. It sucks. But it works.

July 17, 2013

Moseley: Why Things Hurt

I often send this link to clients (and friends) who are experiencing chronic, apparently disproportionate pain. Partly I'm just stowing it here so I'll remember where it is.

A big obstacle in dealing with this kind of pain is that there's a widespread, fundamental misunderstanding about what pain is, and how it is created. It is not a direct perception of tissue damage. It's an alarm that's set off by one part of the brain (unconsciously) in order to get the full attention of the conscious part of the brain. How loud that alarm will be depends on a number of things, but it boils down to a unconscious assessment. The nervous system makes a preliminary judgement: just how bad is this thing that just happened? And it sends off a correspondingly loud alarm.

Here's the problem: it's really not very good at this. It takes some input, does a lightning quick check of fearsome things that can happen that might match that input, and if it finds something really scary, it blasts the siren. Better safe than sorry, is its motto. And remember, this happens before the conscious brain has any input. You don't get a chance to interrogate the nervous system. You don't get to say, "hmm, are these the sort of signals I might expect after overusing my back muscles, or are these the sort of signals I'd get from a spinal disk slipping out of place?" The first thing you -- meaning your conscious brain -- know, is a blast of intense and terrifying pain. It's completely real, as real as pain ever gets. But it may not mean there's anything particularly wrong.

Very unfortunately, though, the pain itself gets added to the database. And the next time your back muscles twinge, one of the fearsome things that show up in the unconscious brain's quick search is that this thing can REALLY hurt! Better intensify that alarm! Send up an even louder alarm than last time!

At this point, we're well on your way to what we commonly, and erroneously, call "a bad back." What we actually have is glitchy nervous system. Since there's nothing particularly wrong with the back, nothing we do to it is actually going to help very much (unless we inadvertently manage to reset the nervous system's responses.) If we don't understand that the nervous system can trip over itself like this, we're likely to undertake all kinds of things -- some of them drastic, such as fusing vertebrae -- in order to fix something that is not broken.