I have tried all types of “Diets” and none of them keep the weight off. What diet do you recommend?

February 3rd, 2012

Diet is often misconceived as a temporary solution to weight loss. I feel this has given the word “diet” the wrong connotation for most people. Diet should refer to good healthy eating throughout each day. I try not to make too many changes in my patient’s diets too quickly.

Humans are creatures of habit. We do not like drastic changes. I had a patient once who ate McDonald’s every day for lunch. When I told him his cholesterol was very high, he got scared. He asked me what he should eat. I told him whole grains, plenty of fruits and vegetables, less red meat, and absolutely no fast food. He missed his follow-up appointment and did not show up in my office until 6 months later. He recounted that he changed his diet completely for 2 weeks, eating nothing but oat meal, brown rice, steamed fish and vegetables. However, he went back to his “Big Mac” ways shortly after and said he felt like a failure. This is not healthy for both doctor and patient. The doctor gets frustrated that the patient didn’t adhere to the diet. The patient feels like he “failed” in his attempt. One can say there’s nothing wrong with unsuccessful attempts, but I disagree.

Take the example of the “slot jockey” at any casino. These men and women will play at a machine, putting in tons of quarters for hours on end. But if a machine does not pay out after 10 or 20 times, they will move on, perhaps mumbling, “it’s an unlucky machine.”  The same is true with diet, and smoking for that matter. If you fail multiple times, the chances of success on the next attempt are going to be much less. It becomes a self-fullfilling prophecy.

I often tell my patients to change one single item in their diet each week. For example, change the daily can of Coke to Diet Coke. That one small change will save you 140 calories per day. The next week, they can change the fried egg sandwich on a roll each morning to a fried egg sandwich with whole wheat toast. So this is a gradual, but more effective and lasting way of changing diet. It’s not feasible for someone to go from eating burgers and fries to eating something that looks like twigs, hay, and birdfood.

I once had a lovely Italian lady as a patient. I diagnosed her with type 2 diabetes. She didn’t mind taking medications but she was devastated about the dietary changes she would have to make, “How can I have my pasta?!” I taught her how to check her sugars and she was religious about checking before and after meals. She came back a few months later with a grin on her face. She said she “cheated” a few times and had lasagna and found the sugars to be high. However, a friend told her to try whole wheat pasta. After she had the same size portion, which she knew should be no bigger than a fist, she checked her sugars and found them to be good! Since then, she has been much happier. She learned on her own how to adapt her diet. As I mentioned previously, we humans don’t do well with drastic changes.