Anyway, not my point here. Regardless of how anyone gets that overweight, our approach to weight loss is so backassward, I don't know where to begin.
Before a person can get weight-loss surgery, they typically have to prove they can stick to a diet, otherwise the surgery will be for naught. However, this particular doctor in this program is so out of it, so unempathetic, I wonder how he stays in business.
First, most of these people eat in excess of 10,000 calories a day. His first order? Cut down to 1500 calories. Um, what?! The poor patient has been eating crap and calories for so long, her body won't even register 1500 calories as being a full day's supply! Maybe a snack, but not enough to satisfy over the course of a day. He obviously doesn't know anything about how hunger and satiety work.
While I understand sometimes drastic measures must be taken, as in these cases with the morbidly obese, we need to catch these people before they are in a life-or-death situation. Before they reach 300, 400, 500 pounds someone can intervene and stop the enablers and show how to live and eat properly.
Okay, so we're all fat (last stats show 67% of Americans are overweight or obese), now what? Get out those measuring cups and measure out 1/2 cup of veggies, a slice of meat no bigger than a deck of playing cards, 1/2 a muffin, 1 egg ... etc. Yeah, we all know we eat more than what the serving size says. Really, 6 serving in a pint of ice cream? Suuuurrrreee.
Say you're used to eating a whole box of mac and cheese, whole can of veggies, 7-8 fish sticks, followed by a large soda by yourself for a meal. Now you're supposed to cut that back by 80% and feel full?? Sorry, ain't happening. You might stick to your new 'diet' for a few weeks, but never really feel full and the moment you plateau, you're back to your old habits.
Let's equate this with smoking. For most long-time smokers, going cold turkey isn't feasible (not that it hasn't been done, it's just not very effective). We offer nicotine patches and a step-down program. Makes sense, no? Still offer the nicotine 'fix' but lower the dosage over time until the cravings cease.
So why don't we do this with weight loss? Why not offer a step-down program? Have the patient track his/her eating habits for a week, noting exactly how much he/she eats, then design a step-down system for them that keeps the cravings more at bay. Now, I know there won't be much weight loss using this system, but the patient won't be miserable and constantly craving food (and especially foods that aren't good for them). Instead of that whole box of mac and cheese, start off by eating only 3/4 of it. Drop the fish sticks from 7-8 to 4-5. Try to replace the large soda with tea with a no-calorie sweetener (or at least juice, which yes, still has sugar, but at least has nutrients in it).
Small changes can make a big difference. After a couple of weeks, the 3/4-box of mac and cheese may seem too much. Down to 1/2-box, and finally, the recommended serving of 1/4-box. It's not going to happen overnight, and may take months to re-train the satiety center of the brain, but it can be done. Once the portions are under control, we can then concentrate on the actual foods and hopefully, add a bit of exercise in.
Yes, it's a slow and arduous process, but I believe it can be successful in the long term. And note, this is not a diet. I don't believe in diets. I believe in changing eating habits and permanent lifestyle changes.
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