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Mindfulness:
Making Conscious Choices
Mindfulness means paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.
The best, and most sustainable, action starts with the mind, not the body. That’s why I devote this chapter to helping you use your mind in a way that will make the rest of my program more logical and actionable.
What does the word “diet” bring to your mind? Most likely …
•Hunger
•Deprivation
•Fatigue
•Calories
•Dessert (none)
•Loneliness
•Alcohol (none)
•Punishment
•Exhaustion
•Embarrassment
•Failure
•Nuisance
Most of us feel we have neither the physical nor the mental energy to go on a strict diet, and we secretly resent the time it takes to think about food. We like to eat for pleasure as well as to satisfy our hunger. Having to plan our meals with forethought is punishment for most of us.
All these negative feelings jeopardize the likelihood that we will achieve permanent weight loss. It doesn’t have to be that way. Let me introduce you to a new way of thinking about eating and dieting that shouldn’t summon all these nasty associations. It hinges on being mindful, making healthy choices, and budgeting your portions as you do your money.
Patient Story: Feeling More Alive
Geoff is a sixty-nine-year-old who has had type 2 diabetes for the past twelve years. He needed to lose 50 to 60 pounds, as he was tired of carrying around so much weight and wanted to better control his diabetes with a lifestyle change. He hoped to decrease some of the medication he was on and didn’t want to take insulin. “I just decided that I needed to take charge of my health,” he says.
Geoff has now lost 46 pounds on the Health First program and has been able to stop one of his diabetes medications as his blood sugar is in much better control. As he puts it:
I feel so much more alive with all this weight off. I sleep so much better now, and I believe the cardio exercise that I’m doing four days a week has also helped my sleep. I like the concept of choosing healthy options instead of thinking about restricting what I can eat. The other day I had to carry something that weighed 40 pounds – I could not believe that I used to carry that much weight around all the time. I know I will reach my goal weight and keep it off. Choosing smaller portions, staying focused, being physically active daily, and exercising are the keys. I’m now much less fearful of developing kidney failure as a result of my diabetes, as my blood sugar is so much better since I have lost all this weight. This program really does work.
Mindfulness: Concentrate on What You’re Eating
Eating is something we all have to do. We just do too much of it, often without even being aware of what we’re doing. We scarcely notice the bowl of potato chips eaten while watching a movie. Or the bag of corn chips that vanishes in a few minutes.
Patients who have successfully lost weight on my program tell me that the single most important thing they learned was to be fully focused on what they were doing with food. They learned to focus on what they were eating, when they were eating, and why they were eating at a particular time. Being mindful of food, and your relationship to it, is an extremely valuable tool in losing weight.
Be mindful of what you’re eating. Focus your attention on the portion you’ve taken, the health value of your selections, and the appropriateness of your choice in relation to your long-term health goals.
Bring your full attention to food whenever you’re around it – whether you’re preparing food, ordering food, opening the cupboard or fridge, going out for dinner, or visiting friends and family.
After a very short time, this mindfulness will become second nature to you. It isn’t all that difficult. Those with peanut or shellfish allergies must be aware of food as a matter of life and death. For those who simply want to lose weight, what first seems like a task easily becomes second nature.
The more attention you pay to what you’re eating, the healthier your choices become.
Q. You have a potentially fatal shellfish allergy. You’re at a buffet. How will you eat?
A. By focusing on every food choice.
Most of us eat too quickly and without much thought as to what we’re putting in our mouths. A critical component of the Health First program is learning to become focused on what you eat. When you pay more attention to your food, you’ll eat less, make healthier choices, eat smaller portions, and lose weight.
There’s no doubt that we’re living in a society that contributes to becoming overweight or obese. Everywhere we turn, there is an abundance of easily available food poised to make us unhealthy and increase our risk of lifestyle diseases. For example, many of us have unhealthy foods in our cupboards, co-workers may bring sweets to share at work, convenience stores are filled with a huge variety of unhealthy snack foods, and fast food restaurants are busier than ever, serving foods high in saturated fats and sugars in portions that continue to grow. Food surrounds us, and rarely is convenient food good for us.
These trends may seem impossible to resist, but you are capable of fighting back, losing weight, and becoming healthier. Always think before you eat: Is there a healthier choice?
Think Before You Eat
Preventing mindless eating and staying focused around food will get you a long way toward reaching your weight-loss goals. Later, I’ll provide you with some tips on managing at restaurants and social functions.
Contemporary Portions Are Gigantic
Portion creep is a major cause of obesity around the world. Food portions are double those common in the 1950s and, in some cases, even three times as large. You can see how the portion size on the left (1950s) compares to present day portion sizes on the right.
The National Heart, Lung, and Blood Institute has assembled these portion creep facts in a video called Portion Distortion.
| Portion Size | ||
| Twenty Years Ago | Today | |
| Bagel | 3 inches | 6 inches |
| Cheeseburger | 333 calories | 590 calories |
| Spaghetti | 1 cup of pasta | 2 cups of pasta |
| Fries | 2.4 ounces | 6.9 ounces |
| Turkey sandwich | 320 calories | 820 calories |
| Soda | 7 fluid ounces | 20 fluid ounces |
Making Choices
I want you to think about food as something you have a choice about. Instead of feeling deprived of food because you’re on a “diet,” think of food as a tool to health and as something about which you always have a choice. You can choose a cookie, or you can choose an apple. You’re not “giving up” the cookie. Instead, you’re choosing to have a more wholesome snack that will advance your goal of having a healthy mind and body. You can have that cookie or saturated-fat-laden hamburger any time you want. You’re simply choosing to make a healthier selection, one you won’t regret the next time you have your cholesterol checked.
On the Health First program, you don’t have to give up all that much of anything; you just budget your portions and make health-conscious selections. You’ll gain empowerment over food by simply making better choices.
Tonight you may have a choice between cheesecake for dessert or fresh strawberries. You know the cheesecake is loaded with saturated fats and sugar, both of which will increase your risk of diabetes, heart disease, breast cancer, and colon cancer. Does this mean you can never have a piece of cheesecake again? Of course not. Once you reach your weight goal, you’ll be able to choose a dessert once a week. It’s also likely that you’re not going to want to choose foods that are high in sugar and saturated fats very often. Your new “culture of health,” as I call it, learned through a focus on mindfulness, will set you free from bad eating habits. (We’ll talk more about this later, and how you can maintain your weight loss.)
Budgeting
Just as you budget your personal finances or your expense account, you can budget your portions of certain foods. Don’t worry, there aren’t many food groups to remember. I’ve made the Health First program very simple to follow. For each of the food groups, you’ll be able to eat a certain number of portions per day or per week. Think of it as a budget that you can spend but not exceed. The details are explained in chapter 3; meanwhile, here’s an example of what I mean.
For meats (beef, veal, lamb, and all pork products), you can have three portions per week. A meat portion is defined as 6 ounces (or 170 grams). As a rough guide, a 6-ounce meat portion (170 grams) is about the size of the palm of your hand. For example, you could have a 6-ounce steak on Monday night and have two portions left for the rest of the week. You could have 6 ounces of roast beef on Saturday night for dinner, and then have a 6-ounce lean burger on Sunday, and still be within your budget of three meat portions per week. The budget is three portions, any time during the week – but no more than 18 ounces (510 grams) of meat a week.
For many, this may be a real challenge; however, you may be comforted to know that poultry (chicken and turkey)* and vegetables are completely unlimited in this program. You are also allowed three fish portions per week. By following this simple program, you won’t be hungry and you will feel great.
As you get further into the diet part of the program, don’t forget to keep moving. Exercise and physical activity are every bit as important as diet for your overall health. (See chapter 7, “The Power of Moving.”)
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* Except if you have kidney disease.
Use Physical Activity as a Diversion
If you have a habit of eating while watching TV, try walking on a treadmill instead of snacking. Some of my patients now enjoy their shows this way. If you still want to snack while watching your favorite show, then choose a healthy snack like vegetables dipped in hummus, a piece of fruit, a handful of almonds or seeds, or plain yogurt (1% fat or less) with your own fresh fruit added to it.
Instead of eating mindlessly, try going for a walk, taking the dog out, throwing a ball with the kids, doing some yard work, or picking up the vacuum cleaner – anything active that will keep your hands busy, your mind distracted, and your body healthy.
Emotional Eating
Food is also tied to our emotions. Many of us eat in response to emotional states. Sometimes we eat out of boredom, depression, frustration, worry, disappointment, or anger. In my experience, for some patients, emotional eating is one of the biggest obstacles to overcome in trying to lose weight. Emotional eating often results in binging on unhealthy foods. Here are some techniques to try when the urge to comfort yourself with food comes upon you.
Be Mindful of Your Emotions
Recognize the emotion that’s driving you to eat and confront it. Acknowledge it, give yourself permission to feel the way you do, but don’t give yourself permission to let that negative emotion dictate bad eating habits. Don’t use food to cope with emotions. Call a friend or do something to distract yourself from your emotional state. For those who snack on unhealthy foods out of boredom, or want to reward themselves for a hard day or a job well done, you could grab some baby carrots, cherry tomatoes, wedges of orange, red or yellow peppers, or a piece of fruit instead. These are much healthier choices, and they also taste great.
Be Prepared Inside and Outside the House
When it comes to food, preparation is almost as good as prevention. If you have a tendency toward emotional binge eating, make sure you always have lots of prepared vegetables in your refrigerator ready to eat. Keep some no-fat or 1% plain yogurt or hummus for dipping. Think of these as supplies that must be readily at hand. Without them, you’re likely to turn to crackers, cookies, and other foods that are immediately available but will not help you reach your goals.
Plan to take a healthy snack with you whenever you’re going to work or when you’re shopping or going to a movie.
A Trick That Always Works
On your way home from work or on your way to a restaurant, eat a piece of fruit or a small container of plain yogurt or handful of almonds. Fruit or yogurt consumed twenty minutes to a half hour before you eat will cut your appetite. Taking the edge off your hunger will make you far less likely to grab the first thing that comes to hand at home or to overeat at a restaurant. No fruit or yogurt with you? A bottle of water fifteen minutes before a meal will also moderate your hunger.
A New Meaning to “Bring Your Own”
Do big family meals create a huge temptation to splurge? One of my patients participating in the Health First program made a point of bringing a plate of cut-up vegetables and fruit to family gatherings so she could enjoy healthy snacking before and after the big meal. (She has lost 29 pounds and has kept them off.)
Creating mindfulness by following these simple steps will provide you with insights into your eating behaviors. This is the first important step to achieving a healthy lifestyle.
Patient Story: Feeling Great – and Safe
Mary is a fifty-eight-year-old with a BMI of 34 and a waist circumference of 38.6 inches (98cm). She was pre-diabetic. A year later, she was diagnosed with colon cancer. After her surgery, she was determined to lose weight to avoid developing diabetes and to help reduce her risk for a recurrence of colon cancer.
She embraced the Health First program and lost 20 pounds (10kg) over three months. Her blood sugar is now normal and, to date, her colon cancer has not returned. As she writes:
I feel great and I’m so proud of myself. So many of my friends in our community have type 2 diabetes, and I now feel totally confident that I have prevented getting it myself by losing 20 pounds and making exercise part of my lifestyle. I also feel very strongly that my new way of living will prevent my colon cancer from coming back.