Tuesday, March 2, 2010

Is it more effective to make radical or incremental lifestyle changes to improve your health?

There was an article in yesterday's New York Times that has brought this question to the forefront of my mind. In Obesity Epidemic, What’s One Cookie? 

Harvard psychologist Deirdre Barrett, the author of Waistland, advocates that radical changes are necessary and, fortunately, are biologically easier than small or gradual changes in diet. She says it's a basic physiology of substance addiction that your hormones will readjust and your cravings will diminish after you get through an initial withdrawal period. 

In Change or Die, Alan Deutschman talks about Dean Ornish who also advocates for radical change. In part, because people can actually see improvements over the course of a month that reinforce the positive lifestyle changes that they've made. It makes the healthier choices worth making. This makes me think of a quote I've seen attributed to Kate Moss. "Nothing tastes as good as skinny feels."

We have some people in our Biggest Loser program that have taken a radical approach. I know one person lost 18 pounds in six weeks. She has clearly done more than switch to diet soda. Another participant went from playing some golf when the weather was nice to taking an exercise class five mornings a week and then doing some cardio on his own in the afternoons. They are both in it to win it.

Other people have chosen to make some modest changes, adding one more hour of exercise a week or trying to cut back the calories they consume by ordering dressing on the side. These folks are not seeing big results and some of them are getting discouraged. Why bother making the sacrifice if you're still wearing the same size jeans?

Are the modest changes easier to sustain over time?  The article in the New York Times points out that, "Cutting out or burning just 100 extra calories a day — by replacing soda with water, say, or walking to school — can lead to significant weight loss over time: a pound every 35 days, or more than 10 pounds a year." Maybe this is a good approach if your goal is to lose 10 pounds and you are patient enough to spend a year doing it. If your goal is to lose significantly more than that though, a radical overhaul to your diet and level of activity will yield must faster results. This may make the sacrifices seem worthwhile and encourage you to keep going.

Have you made and sustained a significant lifestyle change? If so, tell me how you did it and I'll share your experience with our Biggest Losers.


Maggie said...

As far as I'm concerned, exercise is more important than what you eat. I've lost 50+ pounds twice and both times the thing that worked was exercising, not dieting. Telling yourself you can never have something just makes you crave it. My advice for losing weight:

1. Try to be good during the week but relax some on the weekends. Knowing you can eat what you want on the weekends makes it easier to stick to eating healthy during the week.

2. Watch portion sizes. Don't eat out of the box or bag--put food on a plate or in a bowl. Pay attention to serving sizes suggested on packages and stick to them.

3. Walking is exercise. Don't feel that if you're not sweating like a pig it doesn't count. Also, if something hurts, don't do it. For instance, running hurts my knees and ankles so I don't do it. I'd rather be able to walk and do other forms of exercise than be forced to do nothing because of an injury.

4. Don't weigh yourself. Go by the way your clothes fit. Obsessing over numbers doesn't do anyone any good.

jmcnichol said...

Maggie, it sounds like you read French Women Don't Get Fat. I'm about halfway through it and the everything in moderation approach definitely suites me.