Book Review and Recovery

I have been taking it easy since my surgery three days ago which has allowed me to catch up on some reading.  As a dietitian, I am often asked about the "best" diet, especially with regard to weight loss, so I was eager to read The Diet Fix, by Yoni Freedhoff, MD.

I've been following the pragmatic rantings of Dr. Freedhoff on his blog, Weighty Matters, for over a year now.  As a physician who specializes in bariatric medicine, he offers unique insight into the causes and treatment of obesity in North America.  He is not opposed to bariatric surgery in some cases, but his practice focuses on behavior change and education as the primary intervention for weight management.  Most importantly, he recognizes the dysfunctional food environment we all live in and has developed a program to help his patients manage their weight and live happily everafter in doing so.

Dr. Freedhoff acknowledges that there is no one perfect diet.  In fact, he concedes that there is more than one way to lose weight and keep it off.  The key, he argues, is setting realistic weight and health goals within a framework of compromises that an individual can live with without feeling hungry or deprived of their favorite foods.  He also readily admits that you cannot "outrun your fork".  Exercise is emphasized, but in whatever form you can stick with and incorporate into your daily routine, what he calls your "toothbrush level."  In other words, equating the importance of daily exercise with that of brushing your teeth.

The book is designed to be a 10-day plan to reset your habits into ones which you will hopefully carry with you to help you overcome what he calls post-traumatic dieting disorder.  While I'm not a fan of people making up new diagnoses willy-nilly, I think he hits this one right on the head!  I've seen so many people over the years who have such a dysfunctional and confused approach to eating that they no longer know what is normal and what is disordered.  Dr. Freedhoff outlines the steps necessary to undo years of dysfunctional dieting and recommends implementing each one day at a time.  They are as follows:

Day One: Gear Up
To learn to about appropriate serving sizes and calorie-content of your favorite foods, Freedhoff recommends you have some basic tools on-hand, such as a food scale, measuring cups and spoons, and some on-line reference tools.  He also asks that you have some shoes and comfortable clothes to wear to perform your choice of exercise.

Day Two: Diarize
Several studies have shown that this one habit alone can be responsible for promoting as much as three times more weight loss compared to dieters who do not keep a food diary.  With today's on-line tools and apps, we have a fantastic tool to better assess where extra calories are sneaking into our diet, giving us valuable information in which to make choices.

Day Three: Banish Hunger
I love this chapter!  Here, Dr. Freedhoff tells readers to eat and eat often.  Many-a-binge has been the result of under-eating until we can't take it anymore.  The psychology and physiology of dieting are explored in this chapter and strategies to undo years of disordered eating habits are addressed.

Day Four: Cook
This chapter offers basic organizational skills, teaching the reader how to plan and prepare simple meals.  He points out that to control our calorie intake, we really have to have control over the food we are eating.  Every time we eat out, we relinquish that control to a degree because in most cases we cannot be sure that the food we are served does not contain hidden calories we wouldn't even imagine are there.

Day Five: Think
Today, Dr. Freedhoff asks the reader to challenge their beliefs and identity as they relate to food and weight.  He offers a new perspective to many, one that revolves around setting realistic expectations.  He states, "If we're talking about weight and food, it means eating the smallest number of calories you need to honestly enjoy your day."  Regarding exercise, "it also means exercising only as much as you can honestly enjoy."  "Weight-wise, it means that rather than talking about your ideal weight, or some body mass index, or your body fat percentage, instead you're talking about your 'best' weight, where your best weight is whatever weight you reach when you're living the healthiest life that you can honestly and realistically enjoy."  Love this!

Day Six: Exercise
Here Dr. Freedhoff again focuses on reality and evidence.  The evidence is that exercise plays a relatively small role in losing weight, but is definitely correlated with keeping weight off.  An important point to consider when losing weight is that, as one loses pounds, the body requires fewer calories.  Eventually, if someone loses enough weight, they'd be forced to eat virtually nothing to keep losing.  Exercise helps to offset this phenomenon by building metabolically active lean body mass and burning a few extra calories, as well.  Exercise also offers a host of non-weight related benefits, such as stress management, cardiac health, and reducing the risk for developing certain types of cancer - all independent of body weight.

Day Seven: Indulge
Here is where Dr. Freedhoff's pragmatism takes off.  He has learned over the years that food indulgences are a normal part of life and to ban them sets people up for feelings of failure and loss of control.  Like the author, I am not a fan of saying any food should never cross your lips.  It's what you do most of the time that counts and incorporating indulgences in the normal course of life is, well, normal.

 Day Eight: Eat Out
See Day Seven.  Ok, there are strategies offered in this chapter to help the reader avoid overeating and how to make choices that are healthier without leaving you feeling deprived.

Day Nine: Set Goals
I've never been a big setter of goals.  Maybe that's a problem that I should work on.  I did find this chapter thoughtful and filled with some good tips on learning to set realistic goals.

Day Ten: Troubleshoot and Move Forward
Again, more thinking and reworking what is realistic for you and the lifestyle you want and can live with.

The final chapters of the book, Reset Any Diet, Live, Eat, Move, Think, Weigh, Heal, and Parent, delve deeper into the 10-day strategies and offer case studies based on patients Dr. Freedhoff has worked with over the years.

Ultimately, I really, really liked this book.  Not only will I be applying these strategies with some of my cancer patients, many who have a history of dysfunctional dieting now fueled on by fear of recurrence of their disease, but I will be experimenting on myself, as well.

Most of us with Meniere's have found that the disease has had an impact on how, or even if, we exercise, what we eat, and how we feel about certain foods.  While for most of us, dietary triggers are hit and miss, it certainly can't hurt to eat better and not use food as a comfort or to fear food unnecessarily.  I think this book offers some very easy, clear guidelines for just about anyone wanting to get away from strict diets and learn to enjoy food again in a way that promotes good health - whatever that might mean to you.