Most people reading this would love to lose weight, feel better and live longer. Doctors are a smart and motivated group of people. Unfortunately, that intellect and drive has not prevented us from avoiding an increasing incidence of obesity, diabetes, and hypertension identical to the general population. While this article may have started out sounding like an infomercial, I promise it will not end like one. With that in mind, here is what this article will not do: It will not tell you which is better the Mediterranean, Paleo, or Atkins diet. It will not tell you which foods are healthy and which are unhealthy. It will not tell you which is better: cardio or weight-training. When I think of what prevents doctors from achieving their health-related goals, two quotes come to mind: “Insanity: doing the same thing over and over again and expecting different results.” – Albert Einstein “If information was the answer, then we’d all be billionaires with perfect abs.” – Derek Sivers I’ll use these two quotes to address why people fail in achieving long-term health success. “Insanity: doing the same thing over and over again and expecting different results.” “Going on a diet” is fraught with so many tripwires, failure is almost guaranteed from the start. Here is the typical sequence of events that occurs: A person decides they want to lose weight (New Year’s Resolution or upcoming or upcoming beach vacation). They drastically alter their behaviors and include a combination of caloric restriction and increased physical activity. The person may occasionally reach their goal. As a benchmark though, only 8 percent of New Year’s Resolutions are achieved. Three months later, the person is right back where they started and occasionally worse off. Take the Biggest Loser contestants, for example, who regularly gain back most of the weight they fought so hard to shed. A person usually repeats this cycle many times over the course of their life. Each cycle has them exerting a large amount of effort, expense and time to find themselves exactly where they left off. This reversion to baseline is not due to a lack of willpower or discipline, but the result of inappropriate expectations and poor tactics. In the world of on-demand video and free two-day shipping, we are conditioned to expect near-instantaneous turnaround times. We apply this same expectation to weight-loss and fitness. We don’t just want to lose weight; we want to lose 15 pounds in five days. Resultantly, we apply extreme tactics to achieve these results, including completely overhauling our diet and exercise habits in a no-holds-barred-fashion. This, unfortunately, does not work and never will. Think of it this way: Mr. H is diagnosed with hypertension by Dr. Z, who prescribes him an antihypertensive. He gives him a three-month supply and asks him to return in three months. After three months, Mr. H returns to Dr. Z’s office. Before checking his blood pressure, Dr. Z asks Mr. H if he has been compliant with the antihypertensive. Mr. H admits he didn’t take a single pill for the first two and a half months. But over the last 15 days, he’s been taking six pills a day. I see little difference between Mr. H’s actions and the tactics employed by most people when making a New Year’s Resolution. What’s the solution then? For Mr. H it is taking one pill a day. For the rest of us, we can turn to the moral of “The Tortoise and the Hare”: slow and steady wins the race. “If information was the answer, then we’d all be billionaires with perfect abs.” The wonderful thing about being a physician is the ability to access, interpret, and apply information. Now replace “wonderful” with “worst,” and you have another reason we cannot seem to win with health-related goals. Doctors are excellent information searchers. Unfortunately, searching for the “best diet” or “best exercise” online or on PubMed gets us nowhere. The truth is the best diet or workout plan is the one you’ll actually do. It may turn out the Paleo diet has better health outcomes than the Mediterranean diet. But if a person could never sustain the Paleo diet but could sustain the Mediterranean diet — they should be on the Mediterranean diet. It’s that simple and worth repeating: the best [insert diet or exercise] is the one you’ll actually do. This means some amount of self-experimentation is necessary to find what works and what doesn’t. This is where the rubber hits the road and two rules should be followed: 1. Pick a goal and make it SMART (Specific, Measurable, Achievable, Relevant, Time-bound). When it comes to diet and fitness, make sure you spend extra time on the “Measurable” and “Achievable” aspects of the goal. 2. Make the smallest amount of change possible to progress towards your goal. This is usually counterintuitive to most people’s thinking. If some is good, more must be better, right? In diet and fitness, this is unfortunately not the case. Let’s use Dr. Z again as an example. He decides he wants to lose one pound per week to lose a total of 10 pounds over the next two-to-three months. He starts by writing down all of the food he consumes on a pad of paper. What he finds is this simple change results in decreased caloric intake and a loss of one pound at the end of the first week. This simple, cheap and sustainable change was all it took. At some point, he may have to institute another change, but until that time comes — less is more. It has taken us decades to gain the weight we have. There’s no reason to think we’ll be able to reverse that damage in a matter of days to weeks. Pick a reasonable goal and find the easiest way to work towards it. After two weeks if you’re moving closer to the goal, keep it up. If you’re not, it’s probably time to slightly change things up. Source
