Long read: 2500 words

Last week I went along to another MNU Education Day up in Nottinham, this time with the renowned nutritionist James Krieger. This is the second education day I’ve been to with Mac Nutrition and it was fantastic.

As some of you will know, I’m half way through doing my 12-month nutrition course with MacNutritionUni and am absolutely loving it, so I obviously jumped at the chance to go to the education day and learn from one of the best in person. If you think you’d like to do the MNU course too, sign up using this link!

I’ve been thinking about what to share with you from his lectures and have decided to focus on adherence. As we (should) all know (by now), the biggest factor in whether or not someone achieves their goals is down to whether or not they’re sticking to the plan. Krieger said during his lecture that ‘most plateaus happen because people have stopped sticking to the diet’ rather than anything more complicated.

People want to blame all-sorts of factors for a plateaux, from hormones to metabolism to starvation mode; but nine times out of 10 it’s because the person has stopped being as strict with the rules as they used to be. Go on, be honest with yourself, and think about the times that you’ve plateaued.

Krieger says there are three factors to consider when it comes to adherence: physiological factors, psychological factors and an obesigenic environment. It’s not all about will power or laziness.

He says ‘the biggest challenge for anyone is keeping the weight off; most people can successfully lose weight’.

Physiological factors affecting weight loss

One of the main problems people face when it comes to keeping the weight off is the battle one faces with biological drivers. Formerly overweight people will just want to eat more food than naturally thin people of the same size. Research by Polidori et al published in Obesity in 2016 found that for every 1kg of weight loss, you have a biological drive to eat an extra 100 kcal a day. (You can read that paper here)

That translates to massive increases in hunger response. For example, if a person has lost 10kg, they’ll want to eat an extra 1000 kcal! No wonder it’s so hard for people to keep the weight off long term!

This essentially means the bigger you get, the bigger your appetite, and even once you’ve lost all the weight, you’ll always have a bigger appetite. This means if you want to keep the weight off, you have to make an active effort to continue to restrain your diet long term – and also practice eating at maintenance along the way. I’ll plan in diet breaks for clients to get them eating at a maintenance level, so they can practice not gaining weight when they’re not trying to lose it. This feeds into the psychological factors, which I’ll go into next.

Psychological factors affecting weight loss

Eating habits are harder to change than any other habit. This is for all sorts of reasons, but mostly because what we eat and how we eat are tied into who we are and how we feel. I can confirm, with my own n=1 story, that quitting smoking (which I successfully did) was a million times easier than quitting doughnuts (which I’ve never managed to do for long periods of time). Science, bro.

So why is it so hard to change our eating habits? We’ll I don’t really know, but I have a few theories. We’ve created these patterns of eating certain things when we feel certain things, which we’ve done so many times it’s all automatic. Undoing that takes a long time. It’s like when you first start learning how to run with proper form, and you realise you’ve been doing something else for 30 years. It feels weird and you can’t do it for long before you go back to doing what you were doing before. So you have to just keep practicing the new shape.

Practice the new eating habits, without getting mad at yourself when you revert to what you’ve always done. Just acknowledge that’s what’s happened and carry on practicing the new habits.

What happens a lot of the time is we feel so guilty or mad about ‘failing’ that we end up throwing in the towel and going to town. You can just start again on Monday, right? But why wait until Monday; why give yourself however many more days to revert back to old habits. Just let yourself have the meal or the snack or whatever and then get back to your regular practice. You don’t get better at anything without practicing it – and that includes eating a healthy diet.

Environmental factors affecting weight loss

We live in an obesigenic environment. This means we live in a society where we can get more calories than we need, in densely packed forms, with minimal effort. We used to have to work quite hard if we wanted to eat, but now we don’t even need to leave the house.

When you combine how easy it is to get calorie dense foods that taste delicious, with how much less everybody moves in general and how big portion sizes have become, it’s no wonder that obesity is on the rise.

There’s a show on the BBC at the moment which is blaming carbs for this increase in obesity, but statistics show that carb intake has actually declined since 2000, but obesity has continued to rise. Take a look at this startling graph prepared by American obesity researcher Stephan Guyenet (and see his original post here). Krieger actually recommended Guyenet’s book, The Hungry Brain, if you fancy learning more about why we over eat and how to stop.

carb intake over time x obesity

Now, the graph refers to the US, so figures in the UK will be a little different. But it’s still interesting to see. If carbs were in fact the culprit, we’d seen obesity decline as carb consumption declined.

So what’s the real culprit? Calorie dense foods that are too easy to eat. You could easily get over 1000 calories in one sitting at a fast food chain, which is nearly impossible to do if you’re just eating vegetables.

But how do you train yourself to eat more vegetables and less fast food?

Well, practice.

How to stick to the plan and reach your goals

The number one complaint I get from over-weight and obese clients when they first come to me is that they don’t like the taste of vegetables. So what do you do when you know you need to eat more vegetables and less KFC, but every time you try you don’t feel full and you don’t like the taste and it’s all a terrible disaster?

Step one, I’d say, is to cook your vegetables with some butter and salt. I mean, come on, what doesn’t taste better covered in butter and salt, amiright?

Step two would be to persevere. You can change somebody’s pallet over time, if they stick to the diet for long enough. You know you’ve got those friends that say they don’t even miss sweet things, then recoil if they have a treat saying it’s too sweet for them. Your tastes just changes according to what you eat the most of, so you have to get yourself used to eating more of the healthy things and less of the deep fried things.

These things take time.

Krieger mentioned a few techniques you could use to help appetite control, which I’m going to share with you.

weight loss adherence, low palatability - monika-grabkowska-646499-unsplash

Reducing food variety is a good way to reduce appetite. Photo by Monika Grabkowska

Low palatability means lower calorie intake

Your appetite will go down if you only eat foods that are bland. This means that sometimes having a limited range of foods that you eat can stop you from over eating. This means avoiding sauces and added sugar, for instance.

Your brain gets bored of certain tastes and leads to feelings of fullness. But when other tastes are available, there’s suddenly more space in your belly. Think about when you’re having dinner and you’re absolutely stuffed, but then someone brings out dessert and you’ve got room for a slice of cake. It’s because you’re brain isn’t full for cake, it’s full for the savoury stuff.

So when you limit food availability, thus limiting the taste availability, you help your brain regulate food intake better.

Increase physical activity to improve appetite regulation

Greater physical activity will reduce your brain response to food cues – i.e advertising etc. This will worked based on your activity level, and essentially means if you’re generally quite active and exercise and move around, you’ll be less susceptible to marketing campaigns telling you to eat all the things.

Increased physical activity is also a great marker of increased health and people who maintain increased physical activity after losing all the weight are more likely to keep the weight off than those who did not maintain regular physical activity.

Food substitutions

Swapping for low calorie, low fat versions of things is an easy way to lower calories without having to change too much. Diet Coke, for instance, is a great alternative for people drinking gallons of Coke every day. In terms of calories at least; it’s still not great for your teeth (but it’s not going to be worse…)

Reduce visibility of food

Krieger says you want to create ‘effort barriers to problem foods’. This means if you know there are things that you will over eat, you have to make it harder to do so.

Don’t have food on show, close it all in cupboards. Have only whole foods in the house, so if you want to eat a cake you have to make it yourself. Don’t buy the things you can’t control yourself around, so it’s not in the house in the first place. That way if you’re craving it, you’d have to go out to get it.

The more difficult it is for you to eat the calorie dense foods, the easier it will be to adhere to the plan. Especially if it’s really easy for you to eat the food in the plan.

Behavioural education trumps nutrition education

This one is more for the other fitness/nutrition pros reading this than the regular people looking to discover the secrets, but it’s a lesson that carries. You need to change behaviours if you want long-term success. This means learning how to do things differently, not just learning which foods are better and why. It means getting your clients (or yourself) to believe and understand the perceived benefits of certain changes and teaching them (yourself) how to cope with temporary lapses. It’s about getting out of that all-or-nothing mentality when it comes to dieting and learning how to avoid the big risk situations.

Dieters need to learn how to deal with difficult situations in a way that allows them to refrain from relapsing. Working through the plan and how the goals are associated with the plan, and coming back to the plan and the why is really helpful here. People need to believe in what they’re doing and a lot of the time simply wanting to lose weight is not enough. Motivation doesn’t really work and anyone who sits around waiting for it to strike before they put the work in will only ever put the work in sometimes.

You need a full proof plan that can still be followed even when people can’t be bothered. And you need some If-This-Then scenarios set up, so dieters can have a plan in their head for situations that might arise.

For instance: If you know you’re going to see your friend for cakes and coffee, then maybe swap a meal for a protein shake earlier in the day. This has two purposes: firstly, reducing your calories earlier in the day, so you can eat more later in the day, means you can eat the cake without going over your calories and feeling like you’ve done something bad; secondly, whey has been found to keep you feeling fuller, which will make it less likely that you over-eat the next time you eat something or that you won’t have a snack a couple of hours later.

Behavioural change takes time and is about establishing routines and habits. Some people are better if they change everything at once and some people need to go one or two habits at a time. You’re the only person who knows what will work better for you, so you’ll have to try and see for yourself.

If you’re under a lot of stress, it’s ok to have a diet break

Remember that life has to happen and if you’re stressed and you’re trying to lose weight, giving yourself a break is ok. Bring calories back up to maintenance for a bit and give yourself the breathing room to sort out whatever the life thing is. This will just give you practice at maintaining anyway, which we’ve already said is super important; but it’ll also give you loads more energy and then you can get back to trying to lose when you’re ready.

In conclusion

That was much longer than I’d anticipated, so apologies for such a long read and well done for making it this far! There was so much of Krieger’s lecture that I wanted to share with you and I obviously had to add my own thoughts on all the things he said.

There were actually loads more tips from Krieger on how to help a client adhere to a diet, so I’ll probably share the rest of those with you at some point.

The moral of the story really when it comes to adherence and weight loss is that you have to build new habits. You need exercise and diet to become part of your identity and not a thing you’re doing to lose some weight – otherwise you’ll just go back to doing what you were doing before and gain the weight you lost before you know it.

The easiest way to do that is to find an activity you love. Go often, make friends, build a community of your peers where you can hold each other up and cheer each other on. Being healthy in our current climate is a challenge and you need to make sure you have a proper support system in place.

Photo credit Martin MacDonald – that’s me in the Wonder Woman shirt at the front. Need to really work on them guns to fill it out lol. For more information on the incredible nutrition course I’m doing with MNU, follow this link; and for help with your own nutrition feel free to email me on pennievarvarides@gmail.com or drop me a DM on Twitter or Instagram @SuperPennie.