Long Term Weight Loss
I was reviewing a lecture from a conference we attended in Charleston; the professor was reviewing the literature that points to why food behaves as an addictive substance. They have noted that food can act on the same pleasure receptors as other addictive substances. For instance, they have found that the pleasure receptors in the brain are low in obesity and addiction. Similarly, these receptors decrease with increased BMI. (It takes more food to obtain the same reward.) Also the brain's reward system is the same for food as for drugs. The area of the brain that controls this is in the prefrontal cortex, which is responsible for control of thoughts, feelings and actions. This area is disrupted both in addiction and obesity.
Thus, the satiety (fullness) signal gets longer and longer with increased BMI. You can fill the stomach but the craving area of the brain will still light up if stimulated with a thought or visual stimulus of certain foods.
For these reasons, it is important to realize that constantly trying to control cravings can be difficult. At this point we have no drugs to alter these centres of the brain. We need, therefore, to try and understand impulses and how we can best control them. Importantly, we must not feel guilty for indiscretions.
It is far more important for me to see people learning to accentuate behaviour successes and not just ‘weight' (loss). You must stop emphasizing pounds lost over a specific period of time. That's really trivial from a long-term standpoint. Instead, begin emphasizing behaviour. Ask yourself, "What changes in eating behaviour have I achieved?” Are you sitting down to eat now? Eating more slowly? Leaving just a little bit on your plate? Making eating a sole experience (not associated with other activities such as TV, reading or computer)? Pre-planning snacks as well as meals? Keeping food records and recording energy intake?
These are the elements of your weight control effort that really count.
If you have made some of these changes it is time to pat yourself on the back. Changing eating behaviours is what's important; not the number on the scale.
The difficulty with any lifestyle change, but especially with weight loss, is that we must have long term thinking. We must remind ourselves over and over again that food will always be available. Unfortunately, it is the most available ‘drug' to soothe any kind of emotion. So, a lapse in your diet is unimportant. What's important is learning to accept that lapse as normal, and return to portion control as quickly as possible.
Remember, weight loss for the long term is difficult, but you can do it. Don't ever stay discouraged; don't ever give up trying!
Dr. Doug