Breaking Free from the Diet Cycle: A Lifestyle Medicine Approach to Lasting Weight Loss

I've always joked that I've lost over 100 pounds—the same 5 pounds over and over again! This isn't a complaint unique to just a few people. In fact, in my practice and even in my circle of friends, I often hear the same woes: "I lose a few pounds, then gain it again, then lose it again..." And that's just for those who feel fortunate enough to even be able to lose the pounds at all. There are many people who feel quite stuck at their weight.

I struggled with this same problem. After having 3 babies, I had over 40 pounds to lose. It wasn't an easy task. I tried them all—Weight Watchers, keto, intermittent fasting, low fat...you name it. Yet, it wasn't until I actually changed to a slower, more sustainable “lifestyle” approach that the pounds finally came off...and stayed off! In my nearly 3 year journey of getting to my goal weight, I learned firsthand—not only through my own experience—but also through intensive study of lifestyle medicine, that weight loss (and really overall health) is a complex and affected by many different factors.

Nutrition: The Foundation

When we moved last summer, I was sorting through a box of cookbooks and came across several of the different "fad" diets I'd tried. I had flashbacks to severe calorie restricting, adding points on apps, scanning every barcode, counting macros, and watching everyone else eat while I nearly starved myself—only to see slow and often non-sustained results on the scale. When I think of those years, raising babies and trying to get my body back, I think of being HUNGRY!

That's just the problem with many of these "diets." They're short-lived, extreme, and almost always unsustainable. Sure, keto worked great, but after a few months of preparing drastically different foods than my family ate, and making sure I didn't throw everything off by eating too big of a piece of fruit, I finally had to give it up. Not to mention the physical and mental disaster that ensued shortly after (more on this in another post)—turns out your brain needs carbs to make serotonin, one of the happy neurotransmitters!

While it's mostly true that eating fewer calories than we burn will lead to pounds shed, this isn't so black and white. Yes, if you compare the standard American diet to "diets" such as keto, paleo, or Mediterranean, you likely will lose weight simply because you're paying more attention and overall your excess calorie intake will decrease. However, this doesn't always mean better health.

What's more important than counting calories is focusing on overall food quality. When we begin to see nutrition as a long-term, life-sustaining way to nourish our bodies, rather than focusing on the calorie count at the end of the week, we move from a "get rich quick" mindset to something much more sustainable and rewarding. In 2019, I transitioned from over 30 years of eating just about anything, to adopting more of a whole food, plant-based approach. That was the first step in the weight not only coming off, but also not coming back.

Movement as Medicine

I remember in high school "working out" to those DVDs where a woman wearing tight clothing swung a light dumbbell back and forth while stepping around to music, thinking that would keep me in shape and help me tone up. Sure, there was nothing wrong with that because, hey, every movement counts, right? I'm sure that worked fine for my teenage self, but I can tell you that now, into my mid 30's, it takes a lot more than that alone to move the scale if we are talking about weight loss.

Luckily, exercise isn't the only piece to the weight-loss puzzle. While the benefits of exercise are countless from a mental, physical, and social-emotional standpoint, we can't depend on exercise alone to help us lose weight. Yes, if you're training for a marathon and not replacing calories burned by eating like a starving teenager, you'll lose weight. But most of us are juggling family, career, health conditions, fatigue, and just life in general while trying to stay healthy. Many of us don't have 10-15 hours a week for intense exercise. In fact, the general recommendation for overall health is about 150 minutes of moderate exercise a week—that's really only half an hour, 5 days a week.

I always tell my patients that health is like a pie with many pieces. It's not JUST diet or JUST exercise. It's actually the entire lifestyle that creates good health—nutrition, movement, stress management, good sleep, healthy relationships, etc. That's why we need to find balance in everything we do.

My advice when it comes to exercise and weight loss? Start with where you are, and with what you have. Want to get a fitness trainer and a new gym membership? AWESOME! Can't afford it or don't have time? No problem. Take a brisk walk around the block after dinner while the kids follow you on bikes! It all adds up. I generally recommend 30 minutes of moderate exercise such as brisk walking each day, which can be broken up into 10-15 minute chunks if you're busy. Try to get in weight training at least 3 days a week, too, because your metabolism (and your bones) will thank you!

Stress, Sleep and Your Weight

I am not one of those people who lose weight when I'm stressed. In fact, it's the opposite...and it's generally attributed to late night stress eating (toast is my favorite, how about you?). While stress eating is common, there's more to stress and weight gain than just sneaking those extra snacks. Stress can cause our bodies to create more cortisol. Not only does this make our appetites grow, but it can also raise blood sugar, slow down metabolism, and make us store fat naturally—and typically in places like our mid-section which is a big risk factor for many chronic diseases.

While I can't tell you to just quit that stressful job (let's be honest, you've already thought about it), I can tell you that finding a solid, healthy way to cope makes a huge difference. Maybe try putting your stress into a healthy outlet such as walking or jogging (I love trail running for this reason...it's hard to be upset when you're enjoying nature). Weight lifting is also an effective frustration-buster. Or find a good friend or counselor. Start journaling.

And you know what else is super important? Getting a good night's sleep! Sleep might actually be one of the most important functions for our bodies to heal and flourish. Have you ever tried to get up early and exercise when you've had only 4 hours of sleep? And let me tell you about my (lack of) ability to manage stress after working a week of 12-hour night shifts... Allowing our bodies to rest by getting 7-8 hours of solid sleep per night can do wonders for our metabolic health and ability to lose weight.

Relationships and Support

If you've ever joined a weight loss challenge, watched a weight loss show, or been part of a weight loss group, you can see why having social support (and sometimes even some healthy competition) can be so motivating. Having others around you who support your goals or maybe even are doing them with you can be the key to success. And the opposite can be true—watching others around you indulge in foods you know you shouldn't have can be frustrating.

This is why it's important to have a group of supporters. Maybe it's your family or close friends. Maybe you have a little contest going with your co-workers or with those at the local gym. Great! Also, sometimes you need the help of a medical professional or health coach to give you the boost you need. On the flip side, be sure to create healthy boundaries and avoid toxic relationships that will only sabotage your wellness and health goals.

Your Action Plan

Remember, start where you are. Keep your goals manageable. It's ok to start small and build up gradually as you feel better and get stronger. Form a solid support group. Set weekly goals, but make them attainable (1-2 pounds a week is a great goal! Don't be disappointed at this rate of weight loss!) If you think you have an underlying medical condition such as thyroid problems, insulin resistance, hormone imbalances etc., then make sure to be evaluated by a medical professional.

And most importantly, keep the long term goal in mind. This isn't a "diet", it's a lifestyle. Your body (and your mind) will thank you for taking the time to do it right.