I want to explain, once again, my arguments on the question of weight, obesity, diet and dieting. I’d like to make some suggestions as well, if only to counter the impression some readers got that I did not realize how difficult many find it to change their diet, and also the impression that I would not give any advice. I do wonder how much advice is necessary, when the main factor is clear, but here goes anyway.
When food eaten and activity undertaken are in balance, few people are fat, though there is some variation around the major factor causing weight gain, which is food eaten. As far as we know, being lean was the norm until recent times for all but the richest people, who could afford to live off the fat of the land. Previously, food was scarce and work was hard. Now, food is plentiful and most work is sedentary.
If physical labour decreases, perhaps because of automation and increased leisure, and food is cheaply and readily available, people, on average, get fatter. They eat more than their bodies need. There is still variation between one person and another. This increased average weight seems to be the pattern in the world since 1950. Pacific islanders top the list, then some Caribbean ones, Arab countries, then in 17th place the US, for which the weight gain has been startling: by 2014 the average BMI was 28.9 This is very high. Americans have gotten fatter, very fast. The UK is in 40th place at 27.3 and this is high and also a relatively recent phenomenon.
Here is an illustrative list: https://en.wikipedia.org/wiki/List_of_countries_by_body_mass_index
Although people vary, they varied in ancient times and they vary now, but the average weight has gone up. This is so recent it cannot be due to generational changes, though some people may be more prone to putting on weight than others, within some narrow limits depending on amount of food eaten. The general increase in weight over the last 5 decades cannot primarily be due to genetics. Eating too much is the strongest hypothesis. We should exclude that before seeking other explanations.
By the way, the general screening indicator of body mass index has to be refined by racial differences: black, Asian and Pacific groups are more at risk, and should probably aim for BMI 22 or lower. The National Institute for Clinical Excellence says: “Limited evidence suggests that a BMI threshold of 23kg/m2 in black and Chinese populations may be approximately equivalent to an overweight cut-off point of 25kg/m2 in white European populations.” That is to say, to reduce their risk of diabetes, these populations probably have to be thinner than the European healthy target.
Either people have to eat less or to exercise very much more. If anyone thinks to the contrary, all they have to do is to show that weight is not linked to calorific intake and energy expenditure in controlled circumstances. Settings in which access to food is carefully controlled reveal the basic relationship: eating too much makes you fatter. Self-report only reveals the capacity for self-deception. Meals are reported, snacks forgotten.
I see this as a practical issue, rather than a moral one. If you are fatter than you want to be, eat less. In most ways this is up to you. You are free to be any weight you like. The broader social impact depends on externalities: taking up more space in public seating and consuming more resources in public health systems. In a community which shares the costs of any excesses, then anything which makes you unwell and unproductive has a negative impact on your neighbours. If you can afford it, it is your business how fat you are. If you can’t, your slimmer neighbours are carrying you. In the UK about 90% of type 2 diabetes is estimated to be due to overeating. This is a heavy burden.
How does one eat less? Really, this should not need any further explanation, but here are some practical suggestions, for those who felt I had none to offer. All diets work, and start working immediately. Inconsistently applied and quickly abandoned diets don’t have a chance to work. Saying that diets don’t work is like saying that computer backups don’t work. If you can discipline yourself to do them, they work very well.
There is no point in going on a diet to lose some weight, if going on a diet is considered to be something which will last a few weeks, to be replaced by the habitual level of eating, because then there will eventually be a return to habitual weight. Diets have to be maintained long term and will consist of a wide variety of good food, so that it can be enjoyed and accepted as normal. It will no longer be seen as a diet once you have trained yourself to eat well. It will not be dieting, but a sustained change in how much is eaten. Not a 12 week diet but a permanent change towards enjoying healthier delicious food.
At this stage you might be seeking a justification for starting to diet. The main function of any diet is to interrupt and restrain eating more than necessary. Diets impose artificial restraints, and if they have any effects they are due to calorie reduction. There is simply no way round the fact that if you eat more fuel than your body needs your weight will increase. The laws of thermodynamics apply to you even if you do not believe in them.
If you want details, see citric acid cycle link: https://en.wikipedia.org/wiki/Citric_acid_cycle
All food is converted more or less easily to glucose, but fat has more calories per gram. There is little benefit in restricting yourself to one or the other food category, but remember that high fat like butter, cream, and oils produces far more glucose. There are guidelines about the balance of those three, and twice as much carbohydrates as protein seems to be a sustainable plan for weight loss. I leave these blends to you. Nutritionists advise a balanced diet, and can give you their interpretations as to what that means. The percentages of carbohydrates and proteins required tend to be given with rather wide estimates.
You may have a view about the slimming effects of particular mix of fat, protein and carbohydrates. Consider a man eating 2500 calories per day or a woman eating 2000 calories who want to take in an extra calorie of food. Whatever blend of fat, protein and carbohydrate they choose, these will still be digested down to glucose, and they will gain in weight. Better not to have the extra calorie.
How can people motivate themselves to make such a change?
Often a health problem triggers a change, or some event which makes a person note and regret their weight. Without some pressing reason it is unlikely there can be any change in eating habits.
A digression. Some people think that you cannot judge advice about diet unless you know the writer’s personal experience, so here is an irrelevant brief personal history: I have been reasonably thin all my life: skinny as a child, slightly less so in my 20s and 30s. At roughly age 30, though still thin and never above BMI 25, I made some changes to stop gaining further weight: no longer having any sugar in hot drinks and not drinking lots of milk. Things carried on as before. In March 2015 I was at my standard BMI of 24 to 24.5 but found that my blood pressure had been high for six months and decided to drop my weight. University of Cambridge researchers had suggested that the really healthy BMI was 22 or below, but they reluctantly declared 25 as being OK simply because they were advised that the public would not do anything to mitigate their weight if they were set apparently impossible targets.
So, this made me look at my diet again, with the very simple focus of getting to a BMI of 22. By the way, if you feel that the body mass index does not apply to you, congratulations for being in the < 1% of the population with well-developed muscle mass. For the rest of us, BMI is a good enough measure. Yes, you should also measure your waist, and you can get calipers out to measure fat, but those are refinements within the general factor of BMI which works as a useful metric for most people.
The decision has to be taken, and a simple plan made prior to implementing the new regime, which will be permanent. You cannot hope to lose weight unless you change your habits, including how you shop for food. It is difficult to change any engrained behaviour: habits are useful because they minimize the cost of new learning. Repeating a habit is easier than making changes which may lead to future benefits. This is a slow-life-history decision. Your change has to begin with your shopping trolley. If you buy it because it looks tempting, you will eat it.
Although they may be hard to follow, here are some steps you can take.
1 Something has to motivate you to lose weight. Recovering your desired body shape or improving your health or regaining years of life lost to being overweight might be motivators.
2 Anyone you live with must know that you are on a permanent diet, and ideally share in that diet.
3 Learn the rough categories of food types by calories, say to the common metric of calories per 100g. There are many available lists, and also pictures of common foods. Foods with high calorific density should be avoided totally or eaten very sparingly.
4 Foods which are not required for the new diet should no longer be bought, and those already in your house should be given away. Your food shopping must be planned in advance, and you should have alternatives if a particular food is not available. It is a good idea to just buy for 4/5 meals in advance so you do not have too much in store. No impulsive food purchases.
5 If you don’t already have one, buy a good quality weighing machine. It should be precise enough to show small changes. I suggest it should be set on a linear scale: lbs or kilos rather than stones and lbs. Record your weight first thing in the morning, which will give you the most flattering estimate. You can regard it as the true estimate, because it is not exaggerated by the transitory effects of the weight of food and water you will carry in you most of the day. You should also take a measurement of your waist and, as a reality check, note the main mark on your actual belts so as to reveal which notch you find comfortable, and measure that as well.
6 Since your target is to control your weight, from now on measure it every morning. You will soon find out the error range, and begin to note changes week by week. Behaviour can change if you have feedback: your weight is the feedback you need if you wish to lose weight.
7 Since your key route to success is to control calorie input, use a kitchen weighing machine for portion control, again preferably set on a linear scale such as grams. A few weeks should be enough to let you learn the weight and calorific value of your portions. You don’t have to measure every calorie or every bit of food. You should simply keep an eye on the weight of food you are eating, and know what it means in terms of approximate calories.
One simple approach to a new diet is to look carefully at what you like to eat, and simply reduce the portions and cut out the highest calorie ingredients. Although logical, this can be hard to achieve. It feels too much like eating as usual, and good intentions tend to lapse unless you make a change which indicates a new start.
Other approaches are fasting and meal skipping. Most people find fasting hard to do. There are too many temptations in ordinary life. Meal skipping is somewhat easier, particularly if you have had a larger meal than usual earlier in the day. Personally, I think meal skipping is a useful counter-balancing technique after over-eating, rather than a regular target.
Another approach is to make a conscious and well-signaled change in what you eat. This will be your diet, so personalize it. Here are some general guidelines to follow or ignore. Avoid processed foods in the sense of ‘ready’ meals. There is nothing particularly wrong with them other than that they are designed to make you want to eat them again, and you will not know the full list of ingredients, and may come to regard them as the basic core to which you add further things, which will make your total intake go up.
Some foods like pasta are pre-prepared and none the worse for it, but that is OK because you can decide what, if anything, you add as a sauce. Other things to avoid or to eat sparingly are calorie dense foods like sugar, butter, cheese, chocolate, ice cream, cheesecake, nuts, fatty meat, pate, salad dressing oils, cakes and biscuits and sweets. (All these things are good foods in moderation, but it is hard to be moderate when they are readily available in your house).
One behavioural change is to cook from basic ingredients yourself. This gives you absolute control over ingredients, and probably makes you feel far more in control of your eating. It establishes a new ritual.
You can still go out to restaurants but choose sensibly, picking courses as close to your diet as possible. If the dishes are all very tempting, just follow the two-course rule, and decide which option you like best.
The first two weeks of a new diet are difficult. Breaking habits is hard. You need something to fill up your stomach until it adapts to the new, reduced calorie regime. One way is to eat raw carrots and celery and fruit at all times of hunger, before, during or after meals. I never want to see celery again, but carrots are a useful standby. By the way, there is nothing special about carrots and celery. Any other vegetables or fruits will do, according to availability and your preferences.
Another behavioural change is to take particular care of what you eat for your standard breakfast, because if you get that under control then the rest of the day will be easier. It should be good enough to have a fair chance of keeping you satisfied until lunchtime. The following is too specific, but is intended just as an illustration:
For example 40g of cereals, or porridge oats in winter, together with milk and some low fat yoghurt with some fruit; plus some bread, toast or pastries and coffee or tea without sugar should meet the bill. It does not have to be that, just something which you like, can stick to, and provides about 450 calories. That still gives you plenty of leeway for another two meals.
Lunch and dinner can be anything you like, so long as portions are controlled in terms of size and therefore calories: ham, chicken, fish, lamb, pork, steak with salad, vegetables or rice. Rice is a very useful ingredient.
Dessert: always fruit such as raspberries, blackberries or other berries, melon, nectarine, plums, Kiwi fruit, pear, apples, nectarine or other fruit in plain low-fat yoghurt.
Inviting guests home: Give them a light starter; then one of your set meals; and then a very big desert of fruit and berries, with a choice of yoghurt or, for them, some cream or ice cream to go with it. It is up to you whether, and at what stage, you tell them you are on this particular diet which they have just eaten. Alcohol is highly calorific, so if you drink it something else has to go if you want to keep within your limits.
Inviting guests out to eat: Don’t mention the diet. As you look at the menu, say that if they want a starter that’s fine, but that unless you can find something light you will probably skip it. For the main course chose something from the menu which, on balance, is likely to be low on calories. Conversely, skip starter and desert and go for the main meal you most enjoy.
Although not strictly necessary, it might help to do about half an hour of exercise a day. The calories burned up will be very low, less than 200 calories, but it might have benefits for your circulation. Do whatever exercise you enjoy, and that you can fit into your day so that it becomes a regular habit. Since bi-pedalism is one of our greatest achievements, it might be walking. Swimming is also a good idea, if you can easily find a place to do it, because it has very low impact on joints, and involves your whole body. However, even 700 metres of crawl over 22 minutes is unlikely to burn off more that 190 calories, which you can replace with 50 grams of cheddar cheese in about 20 seconds. Short of digging ditches in winter to protect Moscow from invasion, exercise is not a direct weight loser.
The ingredients in your diet are of minor consequence, other than tending towards smaller portions and lower calorie density foods. You can eat all food types at some stages of the week or year, just in smaller quantities, and high calorie density foods very sparingly.
Most people’s weight will go up when their controlled feeding pattern is disrupted. Holidays are good example of losing control. Outside of holidays, parties are difficult because it is easy to lose track of how much food you have eaten, particularly when snacks are available and starters are served on trays. The only hope is to compensate later by reducing your intake on subsequent days.
Will the diet boost your IQ? Probably not, though by keeping healthy you may avoid the effects of ill health on cognitive abilities, particularly so if being over-weight leads to surgery and anaesthetics for long operations. By some calculations you will gain 5 years of life by avoiding being overweight, but since these years, by definition, are at the end of your life, you may wish to discount them.