"Do As I Do?"

by Becca Krukowski

During a recent session at the gym, I noticed that Self magazine was promoting a blog titled “Eat Like Me.”  I was intrigued, so I decided to check it out.  In this blog, a registered dietitian in Boston describes all of her meals and usually includes a picture of each meal as well as details about servings of various food groups.  In addition, she sometimes includes recipes, so that the reader can replicate her meals.  I don’t know how many people follow her blog, but it’s an interesting concept. Readers are able to see “first-hand” the challenges of someone who is trying to maintain a healthy lifestyle, and they are able to see the portion sizes that she is consuming. They see her eat healthy food, and they see her eat dessert.  And the blogger is of normal weight. So, it’s a “do as I do” philosophy, rather than “do as I say”.

The “Eat Like Me” blog reminds me of a research article that I read recently: Weight maintenance and relapse in obesity: A qualitative study by Byrne and colleagues. In this qualitative study, health behaviors are compared between three groups of women: maintainers of a weight loss, regainers of a weight loss, and those who have always been in a healthy weight category. The punch line of the study is that the maintainers and the healthy weight women were very similar in terms of weighing themselves regularly, adhering to a low-fat diet, exercising and not eating to regulate mood.  The regainers were quite different—they were much more likely to exhibit unhealthy behaviors.  So, do we have something to learn from healthy weight individuals?  Or, given different genetic predispositions to obesity, are healthy weight individuals just frustrating to overweight individuals?

Given my occupation, I am often asked by my patients, as well as family and friends, “what do you eat?”  Just a few minutes ago, I was heating up my veggie burger in the staff kitchen, and one of my colleagues inquired about my lunch and then responded that she will have to try some veggie burgers because she wants to be “thin like me”.  I don’t know how I feel about this focus on how “thin people” do it. On one hand, I know I try hard to eat in a healthy manner and exercise regularly, but on the other hand, I know that one size doesn’t fit all when it comes to diet and exercise.  As a mostly vegetarian who is used to eating with the cost efficiency of a graduate student, I can’t imagine that most people would be happy to “do as I do”. But I also wonder, does “do as I do” give more credence to weight control advice?

Comments

[Mara]

I looked at some of the meals on that blog. I think she eats very little (no snacks, and the breakfasts and lunches, in particular, look like they'd leave me hungry) - whereas someone else might think she eats a lot. The question is: must a person eat this amount to either lose or maintain weight? Must a person, a woman, especially (who is said to need less calories than most men) be "trained" in eating this way and in weighing and constantly monitoring her self, diet and weight to be thin? Does thin always = healthier? I think it's a cultural norm for women to eat very small amounts of food. I also think we, as a culture, swing back and forth between over - and under - indulgence with food.

[B.Jones]

If what you want naturally does not work for you, then the answer is yes. You have to "train." Thin doesn't equal healthy. I eat plenty, but have learned how to eat smarter, fresher and better. Processed foods are awful and not satisfying at most levels. I also have completely overhauled my activity level, and that is the difference between having to live on nothing and eating to be active and enjoying your food.

I have my only theory that isn't that original but it's the "Warrior/Farmer" theory that we all used to be one or the other in America/Asia/Europe, and that was how we were able to eat dense foods and maintain a normal weight. We worked ourselves very hard to survive. If we mimic that life or portions of it, we would all be better off. Our overindulgent, convienience-obsessed American society just won't revert back to that ideology.

[Mara]

Well, to each their own. What works is whatever one can do for the rest of their life that supports health.

[april]

I think it is quite instructive to study those who tend to be fat if they eat the Standard American Diet, but maintain a healthy weight through other means. I mean, most of us weren't born with the genetics of Julia Roberts, and frankly, I'm glad I wasn't. The rodent studies seem to show that we naturally fat girl mice, when fed calorie-restricted high nutrient diets, outlive those naturally skinny folks! But we have to exercise some self-discipline, and we have to fight like hell to maintain a healthy diet in an obesogenic food environment. Not easy... but it can be done. And for those who are interested in maintaining healthy weight loss, adopting a diet that hits all the nutritional bases can be the key to success. I mean, shouldn't it be obvious? If you're malnourished, you're going to be hungry. If you get the nutrition you need from foods that are lower in calories, you're going to be thinner, and healthier. How much effort people want to put into this is clearly up to them, but I think that moving the focus from numbers on the scale to numbers of RDA percentages that you get from your food is a step in the right direction. No one should lose weight fast, but when you focus on weight, you tend to see a drop in the scale number, no matter what it's cause, as a victory. That can lead to a whole host of unhealthy behaviors. When you define a victory instead as getting 100% of your RDAs from food, and cutting back on unnecessary calories, you can experience success on day one. The feeling of succeeding just builds on itself, leading to further success, and an eventual drop in those numbers on the scale.

Nutrition first, the weight loss will follow.

a

April writes: "If you're malnourished, you're going to be hungry. If you get the nutrition you need from foods that are lower in calories, you're going to be thinner, and healthier." This make sense (although excellent nutritional value can come from foods quite high in calories, as well). What I question (about the "Eat As I Do" blog, and with all diet books and eating plans) is that everyone has the same type of hunger and amount of hunger. I think even if a person eats foods of high nutritional value, there is still considerable variation in people's degree of real hunger. For people with obesity, (who might almost always feel hungry - and actually Be hungry) I think it's even more confusing. Bottom line: if people are hungry, they will probably break whatever diet or eating plan they try to adhere to.

[Mara]

(comment after April's was from me).

[Shefaly]

I think I have to agree with Mara.

Weight is such an individually-manifest thing that one-size-fits-all does not work. Else what is the need for dietitians writing individual plans for people?

Also eating is determined very culturally. Although cosmopolitan people, with a foodie interest, have to learn about many kinds of cuisines to accommodate their differences while eating healthily.

I took a look at the blog entries. Now I am not big, nor am I a big eater, but I exercise hard so I need proteins and I do not have a sweet tooth. With these specific personal quirks, I think she appears to eat very little, many of the things in her entries such as granola bar/ pizza slice/ trail mix (a very American concept which took me some getting used to, while hiking in the NE some years ago) etc will never figure in my shopping lists, my fridge, my plate or my palate.

Interesting but 'do as I say' in this case IS the better approach.