An Alternative to Willpower for Losing Weight

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Photo: flossyflotsam

A common belief, even among doctors, is that almost no one succeeds in losing weight in the long term. And for almost two decades, I’ve counted myself among the skeptics, being able to tally on the fingers of one hand the number of my patients who’ve managed to do it—literally less than five out of multiple hundreds, if not a few thousand.

When I stumbled across the ideas put forth in the slow-carb diet though (“slow” in contrast to “low” because one cheat day a week is allowed), I became excited—and not just for my patients. Though I’ve never had much of a weight problem myself, after nine years of marriage, four years of fatherhood, and a consequent 50% reduction in the time I have available for exercise, I found I’d put on nearly twenty extra pounds. So when my wife noticed me noticing several inches of my abdomen hanging over the sides of my belt one day, she suggested I try the slow-carb diet myself. I did and shed the extra weight in just two months.

Because I found the diet both easy and effective, and because a number of studies have suggested that an excess of carbohydrate is likely a major contributor to the epidemic of obesity in North America, I began recommending the slow-carb diet to a number of my patients. And they started losing weight.

But not all of them. Some just couldn’t wrap their minds around the idea of giving up carbohydrates (including a cardiologist!) and didn’t even want to try it. Some tried it, but didn’t like it. And some liked it, but couldn’t stay on it.

This last group was the one that frustrated me the most. Here was an approach to weight loss that didn’t require calorie counting, knowledge of food groups, or portion control. They only needed to follow one simple rule to make it work: don’t eat carbohydrates six out of every seven days. Not to mention that almost all of them told me they didn’t actually miss the carbohydrates! So why did they fail?

“Weak willpower,” they said.

When I heard that, though, I became excited all over again, because the reason they gave me for their failure was wrong. A lack of willpower wasn’t what did them in. What did them in was their decision to use willpower in the first place.

THE PROBLEM WITH WILLPOWER

Willpower is not only among the weakest of mental forces, but in most people it actually fatigues with continued use. Some have suggested this is part of the reason the cheat day helps people stay on the diet: it gives their weary wills a much-needed chance to recover enough to resist the subsequent week’s temptations. The problem, though, is that the time horizon over which willpower fails isn’t days—it’s hours (not that the cheat day isn’t crucial—just not, in my view, for recharging the will).

This almost certainly explains why most of my patients who gave up the diet told me that when they would come across a tempting carb during the week, too often their wills weren’t strong enough to resist it. When they found themselves confronted with a piece of pie, a brownie, or a bagel—especially if it was near the end of the day—they’d end up eating it almost as often as they’d pass it by. It didn’t take too many weeks of failing this way for them to become discouraged and give up.

But the reason they failed wasn’t because the slow-carb diet doesn’t work. The reason they failed was because they were relying the wrong strategy to implement it. The key to resisting the temptation isn’t willpower. It’s distraction, avoidance, and acceptance. What follows below, then, is the 7-point plan I gave them for beating temptation without relying on willpower.

THE 7-POINT PLAN

1. Distraction is more effective than willpower. In 1970 psychologist Walter Mischel famously placed a cookie in front of a group of children and gave them a choice: they could eat the cookie immediately, or they could wait until he returned from a brief errand and then be rewarded with a second. If they didn’t wait, however, they’d be allowed to eat only the first one. Not surprisingly, once he left the room, many children ate the cookie almost immediately. A few, though, resisted eating the first cookie long enough to receive the second. Mischel termed these children high-delay children.

How did they succeed? “Instead of focusing prolonged attention on the object for which they were waiting,” Mischel writes, “they avoided looking at it. Some covered their eyes with their hands, rested their heads on their arms, and found other similar techniques for averting their eyes from the reward objects.” In other words, Mischel concluded, distraction is superior to willpower for delaying gratification.

To resist a tempting pleasure, then, you have to find a way not to resist it but to distract yourself from it. How? With the most distracting thing there is: another pleasure.

2. The most effective way to distract yourself from one pleasure is with another pleasure. In a second study, Mischel placed two marshmallows side by side in front of a different group of children to whom he explained, as in the previous study, that eating the first before he returned to the room would mean they couldn’t eat the second. He then instructed one group of them to imagine when he stepped out of the room how much marshmallows are like clouds: round, white, and puffy. (He instructed a control group, in contrast, to imagine how sweet and chewy and soft they were.) A third group he instructed to visualize the crunchiness and saltiness of pretzels. Perhaps not surprisingly, the children who visualized the qualities of the marshmallows that were unrelated to eating them (that is, the way in which they were similar to clouds) waited almost three times longer than children who were instructed to visualize how delicious the marshmallows would taste.

Most intriguing, however, was that picturing the pleasure of eating pretzels produced the longest delay in gratification of all. Apparently, imagining the pleasure they’d feel from indulging in an unavailable temptation distracted the children even more than cognitively restructuring the way they thought about the temptation before them.

So when you want to avoid something tempting, read an engrossing book instead. Or watch a movie. Or listen to music. Something you find genuinely pleasurable. Or if for some reason you can’t engage in an alternative pleasure—or shouldn’t for some reason—think about doing it instead. For example, when you see a pizza, think about eating ice cream. As vividly as possible, imagine the specific sensations your tongue will experience as your favorite flavor of ice cream drips languorously down your throat and into your stomach. (On the other hand, thinking about one food when you’re trying to avoid eating another food may be too viscerally activating. Some people may need to turn their thoughts to a different kind of pleasure than the one they’re trying to avoid to make this strategy work for them.)

Or, alternatively, turn your focus to a problem you’re trying to solve. Whether a math problem, a brain teaser, a relationship issue, or a philosophical question, problem-solving is intrinsically engaging, and engagement is the key to distraction.

But not just any kind of engagement, it turns out. Emotionally arousing engagement. Turning to something you find merely intellectually interesting is often not enough, especially when you’re viscerally activated by hunger (or sexual attraction, or nicotine cravings, or whatever). You need to find something to distract you that makes you feel good. It could be thinking about an upcoming date or vacation, or an expected pay raise and all the things you’re going to buy with it, or that really awesome movie you’re going to be seeing later that day. But whatever it is…

3. Plan out your distraction ahead of time. Studies show that making decisions–even simple ones–also depletes willpower. If you’re constantly deciding what alternative pleasures to think about or pursue each time you face a temptation, you become progressively less likely to be able to make the strategy of distraction work. Which is when rationalizations gain the power to convince you it’s okay to do what you’re trying so hard not to. The key is having your response ready. To make using it a rule instead of an on-the-spot decision. Something that doesn’t require conscious thought. That way, when you’re abruptly confronted with a display of cookies at the office Christmas party, you don’t have to fumble for an effective distraction. You already have it ready to pull up automatically, without even thinking about it.

4. Use willpower to create habits. In point of fact, I urge everyone on the slow-carb diet to leverage the power of habit when making all their food choices. That is, figure out what you’re going to have for your regular meals every day before you enter the cafeteria or the restaurant or wherever you eat your meals on a regular basis, and simply make eating it an automatic rule. That way, you don’t even have to call on the power of distraction to make sure you stay on the diet (much less the strategy of willpower). This is why, for example, I have scrambled eggs for breakfast and a chicken Caesar salad for lunch every weekday.

Research shows we’re most likely to succeed in maintaining any behavior (whether flipping off a light switch when we leave a room, avoiding carbs at lunch, or exercising after work) when we make it a habit. Not that getting ourselves to engage in a behavior consistently enough to turn it into a habit is easy. For one thing, the time required to establish a new habit varies tremendously, in one study taking anywhere from 18 to 254 days. For another, and not surprisingly, the more complex the desired behavior, the longer turning it into a habit seems to take, decreasing the likelihood that we can turn it into a habit at all. Finally, when confronted with the need to choose between competing behaviors, we tend to follow the path of least resistance, the path that requires the least amount of energy, which isn’t necessarily the path along which our desired behavior lies.

Here, however, is where the creative use of willpower can help us: not to resist temptation directly, but to lower the energy required to initiate a desired behavior (for example, exercising) while raising the energy required to initiate competing, undesired behaviors (for example, watching television). In this way, we decrease the effort required for us to act in the way we want and increase the effort required for us to act in a way we’d rather not. We might, for instance, choose to move our treadmill up from the basement into the living room where we spend more of our time while simultaneously removing the batteries from the television remote control and placing them in an inconvenient location. By placing the desired behavior along the path of least resistance, we turn it into the behavior we’re most likely to repeat. And the more we repeat it, the more likely it is to become a habit, and the less and less we need it to lie along the path of least resistance. The key lies in recognizing that the energy required to initiate a desired behavior often needs to be even lower than we expect. Which is why the reason moving a treadmill from the basement to the living room may mean the difference between using it and not. Despite our believing it shouldn’t, having to walk that small extra distance to the basement often requires a level of energy that’s beyond us, especially when other habits, like television, beckon within easier reach.

5. Avoid habituation to distraction by inventing new distractions. Though turning to an emotionally engaging distraction is a powerful way to avoid succumbing to temptation, the more often we turn to it, the less effective it becomes. We get used to—or habituate, as the psychologists like to say—to everything. Think about it: when is the enjoyment you get from your material possessions (a smartphone, a sports car, a boat) at its greatest? When you first buy it. Just like the flavor of gum is most intense when you first start chewing it but then quickly fades, the enjoyment you get from your possessions diminishes the longer you have them and the more you experience them. Unfortunately, our possessions aren’t the only thing to which we habituate. We also habituate to our thoughts. That is, the more you think about something, the less your thinking about it arouses emotion (this isn’t all bad: habituation is also what helps people overcome phobias). But what this means is that the more you turn to your preplanned distractions, the less they’ll actually distract you.

The solution? You have to continually find and plan alternative distractions. Once you find your go-to distraction no longer works, don’t keep turning to it. Recognize it as a signal that you need to find a new one. That way, you’ll always have an effective means for dealing with unexpected temptations when they appear.

6. Avoidance is even more effective than distraction. Recognize, however, that distraction is most effectively used as a bridge—a bridge to the most effective strategy of all: avoidance.

In another part of his first study, Mischel also tempted children with a cookie, but this time took it away from half of them when he left the room (telling the children from whom he took it that they could signal their desire to eat it immediately by ringing a bell). What he found was that the effect of removing the temptation was even more striking than visualizing an unavailable pleasure: six out of eight children who couldn’t view the cookie waited a full fifteen minutes before signaling their desire to eat it; those who could view it, on the other hand, waited on average less than a minute.

The lesson? If you want to stop eating carbs, stop buying them. Avoid the shelves in grocery stores that stock the ones that tempt you. Avoid restaurants that sell your favorite desserts or offer mostly carbs (Italian restaurants, especially—unless it’s Saturday!). The best way to avoid eating carbs, in other words, is to minimize the likelihood that they’ll cross your path in the first place.

This may sound obvious, but how many of us actually plan our days—actually alter our schedules—based on this principle? If you’re serious about meeting your weight-loss goals but find your ability to resist carbs is poor, you can’t just have a plan in place for distracting yourself when you meet with temptation. You have to design your days to minimize the likelihood of encountering temptation at all.

This redesign needn’t be dramatic. Sometimes you only need to walk down an alternative hallway at work—the one that bypasses the candy machines, for example—to make effective use of the principle of avoidance, even if it means going a little out of your way. Or maybe take a different route home (the one that bypasses McDonald’s). Or make sure to shop when you’re not hungry so you don’t bring home carb-containing foods to tempt you when you are hungry. Often, the sum of a series of small interventions that have been carefully planned adds up to a result that’s greater than the sum of its parts. When it comes to losing weight, small, carefully designed and consistently executed interventions are in general far more effective than one or two large ones that require tremendous amounts of willpower.

7. Acceptance of pain will reduce its influence on your behavior. We’ve been built by evolution to avoid pain, signaling as it does danger, injury, and even the possibility of death. But studies suggest we sometimes put ourselves at risk for even greater suffering when we try to avoid pain than when we allow ourselves to feel it. More harm often results from excessive drinking and drug use, for example, than from the anxiety they’re often used to anesthetize. And the willful suppression of hunger (which is, essentially, pain) is associated with an increase in food cravings and binge eating.

In contrast, accepting pain, being willing to experience it without attempting to control it, has actually been found paradoxically to decrease pain. In one study of patients with anxiety, for example, subjects who were taught to accept their anxiety reported substantial reductions in worry, reductions that persisted even beyond the duration of the study.

But such a decrease is only a happy byproduct, for the true purpose of acceptance isn’t to diminish pain but rather to become more comfortable feeling it. In fact, aiming to diminish pain purposely via acceptance is functionally no different than trying to suppress it, and as a result typically backfires. For acceptance isn’t about feeling better so much as it is about doing better, about preventing anxiety from causing us to socially isolate ourselves—or preventing hunger from causing us to overeat. And indeed, at least one study showed that accepting food cravings—rather than resisting them—reduces eating.

So when you’re hungry and all there is to eat is carbohydrate, in addition to turning to a distraction and trying to remove yourself, or the carbs, from the area, consciously recognize and accept the fact that you’re feeling hungry—and move on. For accepting hunger rather than resisting it is what will make it far more likely that you’ll be able to uncouple your hunger from the action to which it usually leads—eating.

FINAL THOUGHTS

Of the twenty or so patients of mine who abandoned the slow carb diet, fourteen agreed to try it again once I introduced them to my 7-point plan. I was careful to warn them—as I would warn you—that as straightforward as these steps seem in principle, they take consistent practice to implement effectively. But if you do practice them consistently, you’ll have the same chance at success as my patients—all of whom, as of this writing, are still on the slow-carb diet and  have lost in aggregate approximately 750 pounds. So no longer do I count myself among physicians who believe that only the smallest subset of people can achieve and maintain weight loss in the long-term. Now I know that when it comes to the slow-carb diet—to dieting in general—judicious use of the principles of distraction, avoidance, and acceptance will dramatically increase your chances of success.

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All the ideas in this post are drawn from my book, The Undefeated Mind: On the Science of Constructing an Indestructible Self, every page of which contains innovative strategies—all based on rigorous scientific studies—to increase your ability to handle adversity and resist discouragement. Check it out. Resilience really can be learned.

Next Week: How To Remember Things, Redux

21 comments to An Alternative to Willpower for Losing Weight

  • Sheryl

    I completely believe all that you have written will work because some of the principles I have incorporated into my life naturally (without being taught). Another way I have avoided certain things, like McDonald’s, is to teach myself how disgusting they are and make them UNpleasurable.

    I am, by nature, a very picky eater and I have found that I have consumed many foods in quantity thinking of them as treats. Then, at some point, I will eat it and realize I am eating out of habit and not because I really like it anymore.

    My stumbling block to following this plan is that I cannot think of what to eat if I did not eat carbs. As I said, I am a very picky eater. For instance, I eat a certain cereal for breakfast every day, even when donuts are available. I know my cereal will keep me satisfied longer so I stick with it. But, it is a carb. With what would I replace it?

    I do not like eggs and eat them maybe three times a year. I do not like meat, in general, especially not in the morning.

    Dinner is already difficult with me not liking 90% of what we put on the table. I eat a little and then have yogurt later in the evening, but yogurt has carbs, so it, too would be out.

    I have struggled with this for a long time and have found no good alternatives. But this is only my odd issue.

    You have outlined a terrific behavioral model that can be easily put in to place and would actually be fun to practice. I hope many more take advantage of your insight and experience!

  • Ellen

    I have found that the time horizon over which willpower fails is actually minutes, not hours. A few minutes of distraction does the trick. In addition to accepting hunger, one should also accept that this is not a “diet” that ends when the weight-loss goal is achieved, but a lifelong change in eating habits. It’s not necessarily easy at first, but it gets easier over time, and it’s well worth the effort.

  • This is FANTASTIC advice that I can use for every vice I have!!! Just at the right time—thank you for sharing!!!!

  • Rose Kreher

    Your tips do work, but please, please define what you mean by carbohydrates! There are only three sources of nutrition: fats, protein, carbohydrates. The Romaine lettuce in your salad is a carbohydrate. Carrots are carbs, as are every other fruit and vegetable. Perhaps come up with a new word to define the harmful carbs?

    Thanks,
    Rose

    PS—Knowing the difference has been one of the ways I’ve been able to keep off 15 extra pounds for as many years.

  • I’m with Rose. It’s CRUCIAL to define “carbs” for your readers. If you are eating salad or vegetables of any kind, you’re eating carbs. And unless you’re making it yourself, your Caesar salad dressing probably has carbohydrates in it as well.

    Correct me if I’m wrong, but what I think you are telling your readers is to avoid starchy carbohydrates, like bread, pasta, and potatoes, and sugary carbohydrates like candy, cookies, cakes, and even excessive amounts of fruit.

    As Rose says, there are three macronutrients in your food. Protein, fat, and carbohydrate. Meat and eggs are primarily protein and fat, though they do have trace amounts of carbohydrate in them. Fruits and vegetables are primarily carbohydrate and generally low in fat, though there are a few high fat fruits (avocado and olives, for example).

    In my 14+ years of (mostly) low-carb living, dozens of people have told me that they tried a low-carb diet and it didn’t work, but when I dug deeper, I found that their version of “low-carb” was basically “all the meat I can eat.” When I explained that what they were doing was not a “low-carb” protocol, they’d get mad at me. But if you read ANY of the reputable low-carb diet books out there—Atkins, Protein Power, Carb Addict’s, Whole30—they will tell you that eating your veggies is extremely important. Atkins, for example, requires 2 cups of salad daily, even on the strictest part of his diet plan.

    Once people understand that it’s starches and sugars that they need to avoid, they usually find a regular low-carb protocol to be quite livable. After all, what’s not to like about a diet that allows you to eat bacon-wrapped filet, asparagus hollandaise, and pate de foie gras on a bed of wilted spinach? (Okay, yes, I miss chocolate mousse.)

    Wendy: Yes, you basically have it right.

    Alex

  • Alex,

    I’m glad you are becoming a believer in the effect diet can have (and that it can be followed by some of your patients).

    I agree with Rose that one needs to be clearer about what is meant by “slow carbs.” I can guess, but don’t want to add any confusion to your comment board.

    Personally, and to help Sheryl, the best rule for me was to conclude that I wanted to put only healthful food in my body. That quickly pushed us to fresh fruits and vegetables, whole grains, beans, legumes, etc. (all organic where possible). What I no longer eat is “processed food” which had come to make up much of my diet in my youth. Basically, if it comes in a box, and has a long shelf life, I no longer want to eat it, and so we don’t buy that. In fact, we purged our pantry and cupboards of such food and gave it all away.

    In this way, we also find no need to count calories, points, or other “diet” strategies. This is not a diet … it is a lifestyle. We just eat healthy, wholesome, made-from-scratch food at each meal (or via leftovers). Not as hard as one might think. And really nutritious, delicious, and so enjoyable.

    I have come to conclude, without a doubt, that food is medicine. And even healthy food is a bargain compared to the much more costly medical and pharmaceutical interventions that would otherwise become necessary if we continued to eat the Standard American Diet.

    And one more point: while I don’t think weight loss is the primary objective of healthy eating (but rather, properly fueling your body), in case anyone was wondering how my lifestyle affected my weight—I’ve dropped 30 lbs (almost 20% of my bodyweight) and am the lightest and fittest I’ve been since college.

    So I’ve come to believe that eating healthy (and I believe the healthiest diet is a plant-based diet) will yield weight loss of its own accord. Like a fringe benefit. And who among us couldn’t stand to lose a few pounds “for free”?

  • Greg Doyle

    Hey guys, the doctor did not make up the diet; he is providing behavioral advice. Go do some research and look up the slow-carb diet if you really want help. Carrots have carbs yeah, but the diet is not called the NO CARBS diet. Sheesh. Yogurt has some carbs; get the Greek yogurt and eat it with some fruit.

    Just cut out all processed carbs. Breads pasta, anything in a package, etc.

    Great stuff btw, Alex. Studied health behavior science in college and it’s great to see the effective weight loss strategies being promoted by doctors. I’m going to buy your book.

    Greg Doyle

  • andrea

    Alex,
    I have to say I am a bit disappointed by this entry. The behavioral advice sounds good (with the caveat that you often quote one single study, which is a questionable practice), but your insistence on low-carb diet is misleading. The study you link to is NOT about carbs and weight gain, rather it is about “Intake of sugar-sweetened beverages and weight gain.” The problem we seem to face is more the fact that we are eating too much fructose (contained in sugar and sweetener) rather than too many carbs, as the hugely popular video by Dr. Lustig (http://www.youtube.com/watch?v=dBnniua6-oM) and his books show. Literally billions of people in history have had carbs as the main staple in their diet, and obesity was not a problem until recently (see Dr. McDougall at TED conferences http://www.youtube.com/watch?v=d5wfMNNr3ak), and even in paleolithic times we were eating high carbs plants (See Dr. Warinner on “Debunking the paleo diet” at TED: http://www.youtube.com/watch?v=BMOjVYgYaG8). This does not mean we shouldn’t be eating less refined carbs; it means, however, that things are not as simple and black and white as you put them. Did you do some serious double blind study on your recommended diet? Did it occur to you that it may work on you and your patients/friends just because on adopting it people eliminate sugar and start controlling their food intake, rather than because they eat fewer carbs in general? Without a proper methodological study (regressive analysis, etc.), you can’t exclude that and other possibilities, and I think there may be more “magical thinking” than science in your suggestion. Full disclosure: I am Italian, and didn’t like your singling out Italian restaurants as BAD FOOD. I don’t know what Italian or pseudo-Italian food you eat in America, but you can check the latest data to discover that Italians have one of the highest life expectancy in the world, and are much healthier, on average, than Americans, in spite of having a host of bad habits and economic troubles. More than science, your statements about carbs and Italian restaurants sound like schmience. I am using words that sound a bit harsh on purpose, as I am an habitual reader of your blog, and I am used to much better entries than this one. By the way, the healthiest of them all, according to the latest data, are, as usual, the Japanese. I have been living in Japan for 18 years, and I can tell you people here are way much skinnier than Americans, but they eat a lot of carbs, mainly in the form of white rice, but also bread, pizzas, etc. They are eating much less sugar though, especially in the form of sweetened soft drinks, as many youngsters still prefer unsweetened Japanese tea to sweet sodas.

    To sum it up, I don’t doubt your diet works, but I strongly object to your extrapolation about why it works, and the way you recommend it. Although there are many people who recommend low-carb diets out there, and it is becoming the latest fad, there is no scientific consensus on it. Many scientists would actually tell you that there is no single diet plan that works best for humans, and to recommend a silver bullet to cure everything is more like a magical spell than a scientific formula.

    Anyway, I’ll keep reading your blog, confident that you will continue producing many excellent entries.

    Best regards

    Andrea: My apologies for singling out Italian restaurants in a negative way. I don’t claim to know with certainty the mechanism(s) behind why setting out to limit one’s carb intake has produced the results in my patients that it has. I strongly suspect (as you suggest), though, that it’s because, as many others have argued and some studies have shown, it cuts down on overall calorie intake and possibly reduces levels of insulin (which is, among other things, a hormone that promotes fat storage). I recommend the diet not because a randomized trial diet suggests I should (unfortunately in medicine we often don’t have such trials to guide us but must still use whatever data exists to make recommendations—though here is one), but because it’s so simple: it doesn’t involve calorie counting, deliberate food portioning, or any of the other practices that so many of my patients complain are too difficult to continue long-term. By focusing on one easily identifiable objective, it seems to produce eating habits that result in weight loss. To your point that it doesn’t work for everyone, I absolutely agree (and made that very point myself in the post). But it’s worked more consistently than any other dietary advice I’ve given.

    No one knows for sure why North America is experiencing an epidemic of obesity, quite true. I linked to the article as one example of many. But your point (and the point of several commenters above) is well-taken that not all carbs are proven equal and that the over consumption of fructose may be the more specific problem (really, I see it as over consumption of food in general; it’s just that carbs, and perhaps fructose specifically, are so often what we choose to over consume). But even if that’s not the cause, focusing on the limiting of starches and refined sugar does seem to be extremely effective in helping many people (though admittedly not all) lose weight.

  • Poor Dr. Alex … promoting a good, healthful diet and he gets blasted from all sides.

    I’d like to offer some thoughts on why the lower-carb diets work so well for controlling weight. There’s a hormone called cholecystokinin (CCK) that your body produces in response to eating fats and, to a lesser degree, proteins. CCK is the hormone that tells your brain “I’m full; stop eating now.” Interestingly, it takes about 20 minutes from the triggering of this hormone for its message to get to your brain. (Remember what mom always said?)

    CCK release is not triggered by carbohydrate. Which is one reason that you can stuff yourself until your stomach aches with fried rice, but you will feel hungry just a couple of hours later. If you eat a portion of meat, a generous salad with oil-based dressing, and a serving of broccoli with a bit of butter, you won’t be hungry for about 4 hours. It’s the fat content, triggering your CCK release, and telling your brain “all full, no more fuel needed.”

    Studies done to test the glycemic loads of different foods revealed that combining them with fats lowered their glycemic impact. Al dente pasta with alfredo sauce had less impact than a softer pasta with a lower-fat sauce. Bread dipped in olive oil or spread with whole butter had less impact than plain bread.

    It was when I learned this little secret … start my meal with some healthful fats so that I feel full sooner and stay satiated longer … that my weight began to drop. And as long as I maintain that habit, I can manage my weight issues nicely.

  • B.L.

    I find it easier to completely give up carbs, sugars, or starches than it is for me to allow myself a cheat day. I tried the slow carb diet and often found that since I would allow myself one cheat day, I would often move the day if I was presented with something. I would also pull a cheat weekend with the thought that I can use cheat days from back to back weeks next to each other.

    I just avoid those foods and the ugly withdrawals all together.

  • Raymond W.

    Hi Alex,

    Wonderful post as always! Wendy Anderson’s post above made a great point, in that eating fat helps one to feel full. Have you heard about the low-carb, high-fat diet? Please see this video and spread the message if you find it helpful: http://www.youtube.com/watch?v=FSeSTq-N4U4 This video really converted me to low-carb, high-fat diet. I eat fewer carbs and more fat than before I started this diet, feel less hungry, eat less in general, and lost 11 pounds so far in three month’s time! No willpower required!

  • Natalie

    I think this is a great article concerning staying on a healthy diet. However, significant scientific and medical research has been done to illustrate that a low or slow carb diet is not good or natural for the body. The human body is designed to eat complex carbohydrates as a primary source of calories. The primary issue with the standard American diet is most of the carbohydrates are processed and refined. The body does not get enough fiber and the body does not process our food properly leading to weight gain. You will loose weight on a low carb diet, but it is not a long term solution and stresses the liver and body’s organs in other ways (this is likely why a cardiologist would not recommend a low carb diet). People in many countries outside the US have much lower obesity rates, yet eat a diet much higher in carbohydrates than Americans. A much more effective solution would be to change the type of carbohydrates consumed. No processed sugars or refined flours, etc. Eat primarily whole grains (rice, barely, beans, etc.) and whole vegetables, lots of leafy greens. There are many trendy diets, such as a low/slow carb diet, paleo diet, etc. However, simply eating more unprocessed foods is the healthiest way to loose weight for your body. It is simple to say, but can take more effort because highly processed foods is more readily available in our society. However, habits can be made and changed. Also, identifying how hungry you really are is key. Many of us are in the habit of over eating or comfort eating.

  • Wow you are getting wordy. I vote for #4 and being cheap. I can’t remember the last time I bought cookies, cake, pie or ice cream and I never fill my plate up. Over the years I have lost my taste for sugar and really don’t care for candy etc that people try to force on you during all the holidays. From my point of view there are a lot of sugar holidays too. Eventually even things like potato chips became to sweet and I quit them. Now if I could just exercise more I might loose the 4 or 5 pounds I would like to loose.

    I also rarely eat out as they feed way to much in most restaurants and I prefer my own cooking.

  • Bravo! What I especially love about this post is that Alex made the tweaks that helped him drop those unwanted twenty pounds. Considering how much stress many doctors experience, it’s especially effective role modeling. Seeing a doctor who can prioritize balanced mind WITH body is worth celebrating. From my perspective, this enhances his authority and leadership position in health care. Here’s a column I wrote, “How Do You Stay So Thin?” that offers a bit of levity with an effective weight loss tool:

    http://gisellemassi.com/columns/how-do-you-stay-so-thin

    Giselle
    http://www.gisellemassi.com

  • Catherine Heath

    I complete agree. I always feel that your posts have great insight into the human mind and the strange ways in which we work. I find it comforting to read such about practical ways to improve my life, one small step at a time.

    I think one of the key points of this post is distracting oneself from obsessing over food. Once you break that link and focus on something else, the sometimes overwhelming desire to consume fades away.

    Another key point is your discussion of exactly when to use willpower—not in the sticky moment when you’re reaching for the fridge, but in your moments when you have the option to form habits.

    This all supports my suspicion that you cannot control your brain, but merely suggest good behaviors to yourself. The way to master yourself is to arrive at goals from the side, looking askance at what you really want to achieve. Then you bypass the exhausting cycle of trying to force your mind/body to do what you want, because as you say, willpower is one of the weakest tactics for doing anything. Habitual practice actually works.

  • I am quite late responding to your post Alex but here goes…..(perfect timing btw).

    WHY WE GAIN WEIGHT:
    There are convenience stores on every corner, TV commercials promoting the latest tempting food fad, easily-used debit cards (impulse buying of chips, pop, cookies, etc.), driving instead of walking, that blasted TV on every evening & well into the night (so easy to eat when watching TV for hours or on the computer), major effort to plan to bring your lunch/dinner to work every day (when many either skip a meal or eat out), this darn business of “super-sizing” and finally boredom.

    Alex, your #1 genius idea is distraction. Pperfect.

    My idea is that keeping a bowl of apples in a highly visible place will distract me from searching for a carb fix. But, why do I need a carb fix? My solution is to eat small amounts of protein/fiber every 2-3 hours. If I don’t get too hungry I have fewer cravings.

    TV watching at night and using the computer are the instigators in my personal battle. Nightshift is my nightmare. At home keeping busy by knitting is good. I have also noticed that “sleep eating” is intense after taking sedation but not yet going to bed. There is no mindfulness when partially sedated. Perhaps patients could be given a heads-up that this twilight zone can (& probably will) cause weigh gain.

    Stop parking so close to where you shop. Walk, walk, walk.

    Many days if I crave chocolate/chips etc. I will actually go to the store, walk up and down the isle and use taste imaginary. In my mind I eat every carb I crave. I become full and satisfied and leave the store with not one item bought! Am trying to perfect this at home.

    Rituals, habits, distractions and getting enough sleep help keep me resistant to cravings. Hard work for sure!

  • Michael

    I’ve never met a heavy person who wasn’t malnourished. The “juicing” fad is astonishingly effective at allowing people to quickly catch up on nutrition and begin to address their weight in a very different way.

  • I devised a method of losing weight that focuses solely on turning off the fat switch. And that’s how I lost my weight and that’s how everyone else who is following The Gabriel Method is losing weight too.

    The Gabriel Method shows you how to lose weight easily and naturally, WITHOUT DIETING, by working with your body’s natural genetic programming, rather than against it.

  • [...] addicts were addicts because they were weak-willed, lazy, and hedonistic. But now we know just how ineffective willpower is in helping people resist temptation, especially people whose brain chemistry has been altered by chronic substance abuse. We [...]

  • Elise Bodtke

    I found good advice here for tackling behavior change. This year I started on weight loss in the spring, intending to lose 46 pounds, and I’m more than half-way there. I took advantage of not being particularly hungry after open-heart surgery to begin forming an eating-less habit. For me it was useful to concentrate on when I was actually hungry and blocking attention to appetite, hunger being something fairly easily satisfied while appetite is potentially infinite. After trying different approaches, I settled on my final successful strategy: understand what is required nutritionally and make a plan for how can I eat the fewest calories and still be nutritionally adequate; eat that core set of foods and as little as possible that day (which varies from day to day); eat tasty but basically the same thing every day from a list of foods I’ve agreed with myself are nutritious along with some little treats like a little bit of chocolate. Since I am old by common definition of what that is, it was important to include a lot more protein than I would have imagined to be nutritionally adequate but I found an ideal-for-me protein source for much of my day: Greek yoghurt (Fage) which checks in at 130 calories for 23 grams of protein in a cup, quite a deal. I don’t count calories; I keep a chart on what my weight is each day when I get up. If I’m losing I’m doing it right, if I’m not or I’m gaining weight (over several days, not daily) I need to modify what I’m eating toward the less caloric—but always keeping that nutritional core to sustain me. Works for me but we all have to figure out what makes psychological sense to us. Now! On to some of my other “challenges.” This set of approaches will be useful.

    Elise: Planning ahead as you describe is key. Good luck with reaching your goal!

    Alex

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