You are not a before picture

I was incredibly privileged to have contributed to the Sunday Times bestseller ‘You are not a before picture’ which was released in June. It was authored by a patient of mine, Alex Light, who describes her journey of recovery from a long-standing eating disorder and how she improved her relationship with food and her body and found true food freedom as a result. The book is an inspirational guide to help tackle diet culture, find self-acceptance and make peace with one’s body.

An image of the front cover of You Are Not a Before Picture by Alex Light. Image from Harper Collins.

Hundreds of patients have walked through my clinic door with a diagnosed eating disorder that was triggered by a history of dieting. So I wanted to write my first blog post on the importance of ditching the diets - this is fundamental in improving one's relationship with food for many reasons.

Most diets are attractive because they promise rapid and dramatic weight loss, usually of more than 2 lbs of fat loss a week. Typically, when one starts a diet one sees weight loss right away, especially if one is motivated to stick to it. However, the initial weight loss is usually dramatic because most of it is merely water loss due to reduced/eliminated carbohydrate consumption which forces the body to use up its stored fuel (known as glycogen). Therefore although one sees a smaller number on the scale it is mostly dehydration, not fat loss.   

In order for fat loss to occur, the diet has to provide fewer calories than before to create a calorie deficit.  To create that calorie deficit, diets often forbid certain foods or even whole food groups or replace actual food with unsatisfying shakes or even recommend eating non-food items like cotton wool.

When the human body is deprived of calories it ramps up one’s hunger hormones in an effort to get the fuel it needs to function, making it difficult to comply with the diet. One also feels deprived psychologically of one’s usual tasty and satisfying meals. Over time this physiological and psychological deprivation inevitably leads to someone ‘falling off the wagon’ and abandoning the diet altogether. So, fad diets do work in that they do result in weight loss but the problem is that they are not sustainable in the long term making it near impossible to keep the weight off.

When one does ‘fall off the wagon’ the floodgates of previously forbidden food open. Hundreds of patients in my private practice have told me they had their first binge after dieting. This can result in people eating more calories, possibly even more than they did prior to going on the diet which can result in them regaining all of the weight and possibly more. According to the Council on Size and Weight Discrimination, 95% of dieters regain their lost weight within one to five years. This isn’t because 95% of dieters aren’t trying hard enough, the problem is that diets don’t work. What this suggests is that people who are interested in losing weight and maintaining it need a more sustainable plan than simply going on a diet.

If one eats too few calories for a sustained period of time, the body adapts by slowing down its metabolism, which is just a physiological response to starvation. I have seen patients eat as little as 800 calories a day and not lose weight because their metabolism has slowed down so much. They then panic as they believe they need to eat even less than this to lose weight and deprive themselves of nutrients putting them at risk of all sorts of health problems like fatigue, light headedness, poor concentration, hair loss, weakened bones, loss of periods and reduced fertility. It can also result in low mood, mood fluctuations and emotional instability. I have seen hundreds of patients where a history of dieting has led to a full-blown eating disorder and the diet has contributed to not only a fear of foods but also physical and mental health problems.  

From a psychological perspective, diets promise beauty, acceptance, self-esteem and a life free of problems. To someone who has struggled with weight issues all their life or an eating disorder they promise control in their out-of-control world and they make decisions for someone who is overwhelmed by decisions. They provide the illusion that there are simple answers for complicated problems. The language of dieting uses words like "good,'' "bad." "cheat'' and "guilt" which reinforces the narrow thinking the individual may already have developed.

Diets have an extremely low success rate, yet advertisements for diets promise quick fixes and magic results, and when they fail the consumer is blamed for a lack of willpower. This can then exacerbate depression and low self-esteem and for someone who is already feeling powerless, a diet reinforces those feelings.

It is possible for everyone to develop a healthy relationship with food even those who have been stuck in the diet cycle for many years or someone with a diagnosed eating disorder. My top 3 steps to take to kick-start the process of improving one’s relationship with food are:

Step 1: Ditch the diet  

Step 2: Establish a regular eating pattern. This helps prevent one from becoming overly hungry which risks overeating or bingeing. Regular eating also helps one’s hunger and satiety cues to become more reliable again after a period of dieting or being underweight.

Step 3: Acknowledge that all food groups play a role in the body and include each one in the correct portion and proportions.

I have seen hundreds of patients in my private practice who have switched to this way of eating which has helped them to recover from disordered eating/an eating disorder and to feel more satisfied after meals, in control of their eating and where necessary also helped with a healthy weight loss which they have been able to keep off in the long term.

If you want to fix your relationship with food like Alex did, subscribe to my newsletter to get free tips and advice by clicking here.