Updated: Jul 1
“No other area of national health probably is as abused by deception and misinformation as nutrition. Many travesties cheat the public of enormous sums of money, and of good health as well.”
~ White House Conference on Food, Nutrition, and Health
I have lost count of how many times my friends and family members have told me that they are doing so many things to correct their diet and lifestyle so they can get fit or reverse their chronic health conditions, but they are not seeing results. Or that they saw some great gains in a few weeks but then, the weight came back, and the waist size went back to the previous tape measure. This is frustrating and demotivating.
Whether you are morbidly obese, just overweight like most adults these days or at your ideal weight and body composition and want to keep it that way, this article will hopefully give you pointers to build the best possible control mechanism for you. We have based it on primary literature as much as possible to keep it free of bias instead of relying on other people’s opinions. This article tries to answer the question What does the best available balance of evidence say at this moment about optimizing your weight and metabolic health in general?
Weight loss sustainably is important because 10kg lower weight over 22 BMI can improve life expectancy by 3 years. This health and longevity benefit works through multiple mechanisms such as improved cardiovascular health through higher insulin sensitivity and lower blood pressure, lower cancer risks through lower inflammation and oxidative stress, and lower neurodegenerative risks. But more important than weight loss is losing inches from around your waist which is a more accurate indicator of metabolic health.
Yet, 90% of people trying to lose weight don’t succeed. Below are 10 reasons why they don’t succeed at all or even if they do in the first instance, that weight loss doesn’t last:
Too much misinformation out there which doesn’t let people make the right decisions. An article in The New England Journal of Medicine on obesity concluded that “false and scientifically unsupported beliefs about obesity are pervasive” in medical journals as well.
Too many contradicting theories out there which also don’t let people make the right decisions. Doctors tell us to eat less and move more. We join the gym and the fitness trainer wants us to increase our protein intake and asks us to drink whey protein twice a day. Online gurus tell us to adopt fad diets that work for 2 months and then we give up
We all have our own biases and want to believe theories and influencers who say what we want to hear not what the right thing is to do.
Weight loss is a multivariate function. It’s not just what we eat. It also needs us to manage our sleep, physical activity, and stress, mostly in that order of influence. But, different professionals only ask us to work on only one dimension which is their area, such as fitness or diet
We ignore the effects of lifestyle factors such as alcohol and smoking. These factors also make us unhealthy and add more body fat. They also work on our neural dopaminergic circuits causing us to feel depressed when we are not drinking or smoking and urging us to eat more unhealthy junk.
Calorie counting does not work. 100 calories from a sugar-sweetened carbonated beverage will make us fat but the same from almonds or peanuts or fruits will not. Yet, most health coaching on weight loss still over-rotates around calorie counting. Creating a caloric deficit is important for losing weight but the way to achieve that is by eating the right foods and making our body achieve its internal biofeedback controls.
Macro-counting does not work. Again, 100 grams of carbohydrates from white bread will make you fat and unhealthy whereas 100 grams of steel-cut oats or chick peas will do wonders to your health. There are good proteins and bad proteins. There are good fats and bad fats. Eating the right, whole foods is important
Context matters! We look at our lab test reports and tend to analyze them as static images of health. This is often wrong. Let’s look at a lab report showing high LDL cholesterol levels. Without the full context, this lab report may look scary to the point where the doctor might start statins. But, if the person has been losing weight because of his diet changes and increased physical activity, then a rise in cholesterol levels is expected because his body is burning fat which is being pulled out of adipose tissue and transported by blood. So, the full context matters
It takes 17 years for research to get incorporated into day-to-day practice. Findings from research today will be taught to our doctors 10 years from now and will become part of common practice in another 10 years. This delay means our practices today still don’t incorporate the science that we know today.
A lot of what is being propagated can be harmful. For example, did you know that doing headstands or shoulder stands or even downward dog poses in yoga can cause strokes and should be avoided if you have hypertension? Given 40% of Indian adults have hypertension and over 60% don’t even know yet, that means we all need to be careful about what online video we start following from tomorrow morning.
5 things you should do instead:
Go back to the basics. There are some common-sense truths that we have known since we were kids – eat your vegetables and whole grains, don’t eat outside food too much, eat fruits and nuts, drink lots of water throughout the day, sleep properly and on time, quit smoking, drink alcohol occasionally and responsibly and go out there and do some exercise. These are all true and we need to follow all of these.
Work with expert coaches. Find out coaches who are empathetic and are trained in the latest health science curriculum. Understand their credentials and don’t just go by a few anecdotes and success stories. They should be able to explain the how and why of their recommendations and they should not ask you to start eating completely new foods that you are not used to
Set your identity. Identify yourself as the fitness guy or the healthy eating guy or the yoga guy. What you identify yourself as is what you will ultimately become. Your identity will make sure you feel uncomfortable when you don’t do what you have decided to become
Make systems not goals. Don’t just stop at setting up your health goal. Create the system to achieve your goals. Start with understanding your health baseline. Then set milestones. Then set the actions to achieve those milestones. Then turn those actions into your daily schedule and then set calendar alerts.
Be patient. Sustainable weight loss doesn’t happen overnight. It takes many months. If it happens very fast, it can cause severe risks such as hormonal imbalance, gallbladder stones, etc. So, don’t get too caught up with weight loss targets within set timeframes. Be aware that if you are on a healthy path, whether you lose weight in 6 weeks or 6 months, you will always be better off in the long run.