If we keep fat intake low, estrogen stays at a more modest level throughout the month. It won’t ever climb too high—and there will be no big drop at the end of the month. That helps tame PMS, cramps—and cravings.9
Step 4:
Break Craving Cycles
Seductions occur on a cycle. Passionate tangos start late at night, not at 9 A.M., and fireside cuddles happen in January, not August. Food cravings have their cycles, too. Some hit every twenty-four hours or so, usually in the evening. Others, especially chocolate cravings, arrive on a monthly hormonal cycle. There are powerful yearly cycles, too. The keys for breaking out of these patterns may surprise you. Willpower plays virtually no role at all, while timing and biology matter a lot. Let’s start with a look at the daily binge.
Breaking Out of a Daily Cycle
Eric was a forty-five-year-old man whose weight had gradually inched upward over the past fifteen years or so. His mother was Korean and had been quite slim all her life. However, Eric took after Dad, who was from Wisconsin and had a classic “apple” shape, with a fair amount of extra weight around his middle, most of which came on in midlife. Eric had been quite athletic as a teenager, participating in baseball and track, and had no problem burning up whatever he ate until he hit about thirty. Since then, his midsection had gradually expanded over and beyond his belt. He came to our offices for help.
I asked about his current diet, and he described a fairly normal Midwestern menu. I then asked him to note down everything he ate—and when he ate it—for the next three days, using a food scale and the diet record form you’ll see in chapter 14. A few days later he came back to the office with the form dutifully filled out.
Looking at his diet record, there were clearly some ways to improve what he was eating. But what was even more noticeable was when he ate. In fact, his eating schedule was a classic pattern seen in people battling weight problems: everything was shifted toward evening. He ate surprisingly little in the morning, and considerably more later in the day. People who maintain healthy weight tend to space their meals out fairly evenly throughout the day, but overweight people very often skew everything toward nighttime.1
I asked Eric about this pattern. He took a deep breath and said, “Well, I knew it. I didn’t want to admit it, but—well, I’m fine during the day. You’d be proud of me; I eat almost nothing.” He took another deep breath. “At night it’s a different story. It seems like I basically have no control.” The truth is, he was actually not a lot different from other people, but he then proceeded to beat himself up with a protracted dietary confession.
He called himself a foodaholic. He got home from work about 6:30 and nibbled on cheese as he made dinner. By the time his meal was ready, he had already gone through so much cheese that he had almost no appetite left—but he ate his normal dinner anyway. Afterward he ate various snacks, including chocolate ice cream, a rolled-up piece of bologna, or a bowl of cereal. But it was always in the evening. He ate very little breakfast and had no great excesses during the day at work. But as soon as he arrived home the binge seemed to kick in. It made no difference how full he was from dinner. The evening hours called him back to the refrigerator. He found himself inventing reasons to go to the store—he needed a lightbulb or a newspaper or some tape—when what he was really there for was a chocolate bar, some potato chips, or a soda. As he gained weight over the years, he saw no way out of the habits that seemed to have him locked in.
Many people fall into similar patterns. Evening is the most frequent binge time. But some people are hit by the bagel tray or candy machine as soon as they arrive at work. For others, it’s a late-morning snack to knock out the hunger caused by an overly rushed breakfast. Some people lapse into binges in the midafternoon.
Maybe something like this has happened to you. You get home and have a reasonable dinner, but then you want something sweet. And, a bit later on, you want another snack that you know you don’t really need. The next day the same thing happens again . . . and the next day, and the next. And eventually you start to plan for a binge, one that arrives predictably, day after day.
These habits are not cued by hunger, but by time and by our surroundings. In large measure, they are learned in the same way that walking into a movie theater triggers a desire for popcorn, or that early morning makes you want a glass of orange juice.
Breaking Your Schedule
As Eric told his story, he looked at me as if I were a priest taking confession. But, as I told him, it pays to set aside guilt. Instead, we aimed to look at his problem as a physical cycle repeating on a biological clock.
We first looked at having a more ample breakfast and keeping his blood sugar stable during the day, as you’ve seen in the previous chapters. But we went a step further, focusing not on the food, but on time.
I asked Eric to break up his evening schedule every night for three weeks to the extent he could, and we plotted out a plan to do that. First, he aimed to get home a bit earlier each day, so he wasn’t so hungry. He was then going to change his clothes and leave the house. He might go for a jog with a friend and then to dinner at an inexpensive restaurant. Or he could go to a bookstore or lecture. The idea was just to break the routine, get him out of the rut he was in, limit the time he had at home, and focus his attention on something other than the refrigerator.
When he knew he would be eating at home, he prepared dinner in advance, so that it would require only a quick reheating, and he made sure to go to bed at a reasonable hour, rather than staying up watching television. He also cleared the contraband out of his refrigerator and took advantage of the other tips you’ll read about in chapter 14 and elsewhere in this book.
Eric found what most other people find: breaking a habit can be a very quick process. In a few weeks, a new habit can solidly displace an old one, and he found he quite easily drifted away from his old routine. His thoughts about cheese and other snacks didn’t entirely disappear during this time, but they were toned down and were replaced by something that he wanted more: As he lost weight he felt more and more fit, and he even developed a taste for healthier foods. He very much liked the way he felt.
After three weeks he stopped planning so many evening activities but still found it fairly easy to stay on his new, healthier path. The bad news, as he discovered several weeks later, is that the rut you were in waits patiently for your return. It is perilously easy to slip back in. This is especially true if the habit you’ve fallen into also involves drinking, since alcohol dissolves willpower. In Eric’s case, though, if he did find himself sliding back into Snackville, he simply broke his schedule up again and made sure that he had plenty of healthy things on hand ready to eat. It also helped him to remember why he was doing this. He taped a hand-written note to his refrigerator that read, “Losing fifty pounds will taste so much better than junk food.”
In fact, over time he actually did lose a bit more than fifty pounds, and the key, he felt, was being able to break his craving cycle. Here are tips for breaking out of your own:
• First, be sure to eat a healthy breakfast, make sure your meals are keeping your blood sugar steady—and eat an adequate amount of food, especially early in the day, using the guidelines in the previous chapters.
• Change the people and places in your life that tend to trigger your binges. If you’re alone, arrange to be with someone else at the time binges would normally arrive. It doesn’t have to be a close relationship—being at a lecture, a library, a religious service, or even walking on a busy street still counts. If binges hit you at home, be somewhere—anywhere—else.
• Break your schedule. You need a new pattern, not just with food, but with time. If you stay in the same schedule, your internal clock will wake up cravings, right on schedule. It does not matter how firm your resolve is at other times of day. You have to break out of your time of vulnerability.
• Plan for competing activities.
• Go to bed an hour earlier. Fatigue fuels cravings. Rest shores up resolve. And get regular exercise, so you sleep soundly and wake refreshed. More on this in chapter 10.
• Don’t seduce yourself. If you’re leaving little presents of the very foods you’d like to get away from lying around in your cupboards, that’s a sign that you have not made up your mind for a change.
As you’ve seen, the main focus is not on food, but on time. If you plan for your time of vulnerability and break up the cues that lead to bingeing, you’ve got the best possible control over the problem.
Monthly Cycles and Hormone Swings
If you are a young woman in the week before your period, cravings can go through the ceiling. You have probably heard the common observation that women seem to love chocolate more than men do. Well, it is entirely explained by the amount of chocolate they consume in that week alone.
Those cravings aren’t always so helpful, needless to say. Every chocolate bar that floats into your life brings another 200 calories that leap out as soon as you tear open the wrapper. Once in a while you can get away with it. But if it’s a couple of chocolate hits a day, and it lasts a week or more out of every single month, you’re talking serious calories.
The culprit in all of this is estrogen, the female sex hormone.* Men have a little estrogen, but not very much. Women prior to the age of menopause have quite a lot of it, and what seems to cause premenstrual cravings is a sudden drop in the amount of estrogen coursing through your bloodstream.
Let me give you the details at the risk of being slightly technical: During the first week or so after your last period has ended, your body starts making extra estrogen to prepare anew for the possibility that you might become pregnant. It starts to make a fresh inner lining of your uterus, just in case a tiny new baby might come drifting down a fallopian tube.
But pretty soon your body senses that you did not get pregnant this month after all. So, during the week before your period the amount of estrogen in your bloodstream quickly falls, the lining of the uterus is shed in menstrual flow, and the whole process starts over again the next month. Now, in that last week of your cycle, this sudden drop of estrogen triggers all manner of symptoms. You might feel bloated, your mood can change, and, of course, chocolate will sing out to you in a way unlike that at any other time of the month. You don’t want it, you need it.
Using Foods To Control Estrogen
You can tame estrogen with rather simple diet changes, as my colleagues and I demonstrated in a recent research study.
One of our research participants, Valerie, joined the study because she had terrible PMS and menstrual cramps every single month. In the week before her period her mood went south, and food cravings flooded in. And as her period was about to start, cramps kicked in so badly that she needed heroic doses of ibuprofen just to get through the day at work. She had put up with these symptoms ever since adolescence, but they seemed to worsen in her late twenties.
Previous researchers had found that women who follow very low-fat diets have much lower levels of estrogen in their blood, compared to women who eat fattier foods. This observation was important because it explained, at least partly, why breast cancer is very rare in countries such as Japan, where diets are much lower in fat. In countries where fattier foods are the order of the day, women have higher levels of estrogen in their blood, and, in turn, that means a higher risk of cancer. Of course there are other contributors to cancer, but the fat-estrogen connection has intrigued researchers looking for ways to prevent it.
The key point here is that trimming the fat from our diets can reduce estrogen. I reasoned that we could use this fact not just to reduce cancer risk, but also to reduce the menstrual symptoms that hit every single month. That is, if we keep fat intake low, so that estrogen remains at a more modest level throughout the month, it won’t ever climb too high and there will be no big drop at the end of the month. We ought to be able to reduce PMS, cramps—and cravings.
If we keep fat intake low, estrogen stays at a more modest level throughout the month. It won’t ever climb too high—and there will be no big drop at the end of the month. That helps tame PMS, cramps—and cravings.
Thirty-three women joined our study investigating what diet could do for menstrual symptoms. In order to really reduce fat we eliminated animal products entirely, which, of course, eliminates all animal fat. We also asked participants to keep vegetable oils to an absolute minimum. The diet took a little getting used to, but within a week or two everyone found recipes they liked and had figured out what to order at restaurants.
Valerie was not especially hopeful that the diet would work, but medication didn’t seem a good enough answer, and it didn’t do a thing for her mood or her cravings. In the study she didn’t have to count calories or fat grams, but she did have to choose lighter options: pasta marinara instead of meat sauce, a hummus sandwich instead of grilled cheese, bean chili instead of meat chili, and grilled vegetables instead of french fries. Her diet records showed that her fat intake dropped to about 10 percent of her calories, or about 20 fat grams per day, while her fiber intake shot up to about 50 grams.
Even though there was no limit on portions, she lost about ten pounds over the eight-week study.
But what really counted was the change in how she felt. As her period approached she had no mood changes at all, virtually no noticeable cravings, and, as she put it later, her period “just sort of sneaked up on me. Instead of my usual, really bad cramps on the first day, it just happened, with basically no pain at all.”
The change was dramatic for many other participants, too. We reported our results in the journal Obstetrics & Gynecology in 2000.2 The average duration of menstrual cramps dropped from four days to about two and a half. PMS symptoms, like water retention, bloating, and difficulty concentrating, improved—and many participants reported that cravings dropped, too.
That drop in cravings can be a wonderful gift. If you have felt like biology has simply taken over and you are powerless to control what you eat, you’ll find that you really can tame hormone-driven cravings to a great degree.
Using Foods to Block Hormone Swings
There are actually two ways diet influences how much estrogen is in your blood. First, as we’ve seen, fat increases the amount of estrogen your body produces. When you cut the excess fat from your diet more or less completely, the amount of estrogen in your blood stays at a lower level all month long. And since it is apparently the sudden estrogen plunges from peaks to valleys that trigger cravings and other PMS symptoms, smoothing out the terrain makes a big difference.
Second, fiber helps reduce estrogen, too. Here’s how: Your liver filters your blood every minute of the day. As it does so, it not only removes waste products, toxins of various kinds, and whatever else might be floating along in your bloodstream, it also removes excess estrogens, sending them through a tiny tube, called the bile duct, into the intestinal tract. There, fiber soaks up this waste estrogen, just like a sponge soaking up water, and carries it out of the body.
If you have plenty of fiber in your diet, this estrogen-disposal system works pretty well. But, as you know by now, meats, dairy products, and eggs have no fiber at all. If you had eggs and bacon for breakfast, and yogurt and chicken breast for lunch, your body does not have enough fiber to do the job. So, the estrogen that your liver has carefully removed from your blood and sent into your intestinal tract actually ends up passing back into your bloodstream. The answer is to bring the vegetables, fruits, beans, and grains into your diet so their fiber can trap estrogen in the digestive tract and carry it away with the wastes.
The effect of a low-fat, plant-based diet is really quite profound, cutting estrogen levels nearly in half within a few weeks. There is still more than enough estrogen for fertility and for a normal cycle, but not so much so as to cause problems.
But getting this benefit requires making changes in your diet. Our research participants reported that the benefits of a low-fat, vegan diet were partially lost if they brought cheese or fried foods back onto the menu even occasionally. It also does not work if you change your diet for just the last week or so before your period. You have to follow the low-fat diet throughout the whole month. The idea is to stop estrogen from rising too high early in the month, so that it doesn’t have so far to fall at the end of the month.
To try this, follow these steps:
• Begin the diet change on the first day of your monthly cycle (the first day of your period) and follow these guidelines through the entire month.
• Eliminate animal products and added vegetable oils. Use the recipes in this book, choosing those with the least fat.
• Be sure to go high-fiber, using the Quick Fiber Check here to help you.
• During the last week of the month pay attention to your cravings, PMS symptoms, and cramps. You will likely notice the benefits in the very first month, and you may also find that the effects become more and more pronounced with each new cycle.
You’ll also probably lose weight. Valerie did—more than a pound per week—and that can be a big motivator for sticking with it.
Breaking Annual Cycles
Many people are locked into a yearly cycle. You’ll start to notice it in the fall. Under the influence of holiday parties and cooler weather your appetite control begins to erode. You might feel a bit like a squirrel filling your cheeks for the cold days ahead.
Researchers at the National Institutes of Health in Bethesda, Maryland, nailed down the pattern exactly. They put 195 people on the scale at intervals throughout the year and found that virtually all the weight people gain over the year occurs in the second half, especially from October through December As summer draws to a close our appetites increase and our weight ratchets upward.
Suddenly, at the stroke of midnight on New Year’s Eve, we resolve to stop all this reveling and get back into shape. During the next few months we diet, start exercising, and manage to lose a little bit of the weight we’ve gained. Unfortunately, the overall trend is steadily upward. The NIH researchers found that the average person gained 1.7 pounds as the year drew to a close, and lost 0.2 pounds in the spring, for an annual increase of about a pound and a half. And when fall arrives again, the whole cycle starts over.3
This had happened to Eric, the man we met at the beginning of this chapter. He had a daily cycle that we helped him break, as we saw earlier. But he had a yearly cycle, too. It did not seem to relate much to parties, and he didn’t actually start any new bad habits. It just seemed that his appetite was stronger in the fall. His portions always grew, and he found himself driven back for seconds. “Every fall I start to notice that my clothes feel tighter,” he said. “I can see my appetite is bigger.” As the years went by, his weight gain was clearly strongest in the autumn and early winter.
The good news is that, if you can beat the autumnal weight gain, you’ve more or less got the whole year licked. So, what should you do?
First of all, don’t slack off when it comes to exercise. Cooler weather often means that we’re indoors, perilously close to the refrigerator, and far from bike trails, golf courses, the beach, or anywhere else where we might get a bit of physical activity. In the NIH study, those who were the most physically active in the fall were least likely to gain weight. This does not mean you have to sweat off the pounds; exercise also works simply by getting you away from food.
It also helps to be aware that holiday weight gain is essentially permanent, which puts snack trays in a whole different light. That cheese-on-a-toothpick or butter cookie is going to become part of you essentially forever. Maintaining normal eating habits during the holidays blocks that end-of-year weight spike. And if you actually improve your eating habits you can bend your weight graph into a whole new shape.
In a recent research study, we put a group of women on a low-fat, vegan diet in early January, when they were strongly motivated to knock off the pounds they had gained earlier. Needless to say, they lost weight in the ensuing months—about a pound per week over the first three months or so. But what was even more impressive was that those who stuck with the diet after this study period and through the following holiday season were completely protected from holiday weight gain. In fact, they continued to lose weight through the fall and into the following year.
Eric followed the diet recommendations you’ll read about in chapter 13. He did not rush to take the weight off, and he had one fairly major slip while on vacation, and regained a few pounds. But he resolved not to let that happen again and, in fact, did not. As I mentioned above, he kept more than fifty pounds off with virtually no difficulty. He had beaten not only his daily cycle but his yearly one, too.
How to Beat Seasonal Depression
Winter brings another craving booster. As the days become shorter and shorter, low light levels can trigger depression, along with cravings that are muted during the warmer times of year. It is called Seasonal Affective Disorder (SAD), or winter depression. At the same time, you’ll lose your normal energy and will have trouble getting out of bed. The pattern of increased appetite and increased sleep is different from what can happen in more typical cases of depression, in which people lose their appetites and suffer with insomnia. Seasonal depression hits most frequently in young women living at northern latitudes.
Those who stuck with the diet through the holiday season were completely protected from holiday weight gain.
When the cravings hit you won’t start looking for pickles or Belgian endive. What you’ll crave are sweet or starchy foods. The reason is that high-carbohydrate foods naturally cause the brain to produce serotonin, a mood-controlling neurotransmitter, as we saw in chapter 2. This is the same brain chemical that is elevated by Prozac, Zoloft, and other common antidepressants. So, although some people feel more on edge with sugary or starchy foods, people with winter depression find that these foods cause a natural mood boost and make them feel better.
Now, there is nothing wrong with using foods to cope with winter blues. But you’ll want to be careful about which ones you choose. Cookies, cakes, and chocolate contain plenty of carbohydrate (which is not likely to cause much weight gain all by itself), but they also have enough butter, shortening, or other fats to add a lot of calories. In contrast, whole-grain bread, brown rice or rice cakes, pasta, and fruit provide healthful carbohydrate, which increases your natural serotonin production with very little fat—as long as you don’t add it in the kitchen.
If you suffer from this problem there is another treatment you should be aware of. Winter depression—and the overeating that comes along with it—responds beautifully to daylight, especially if you can get a generous amount of it early in the morning. One of our study participants, Jean, tended to really dig into cookies and starchy foods during the late fall and winter months. Come spring, she could not lose the pounds she had gained during the preceding months, and her weight ratcheted up higher and higher. I suggested that she try a simple form of “light treatment,” by taking a twenty-minute walk outdoors in the first morning light. This step alone cut her cravings dramatically and boosted her mood and energy level, in addition to burning off a few extra calories.
For more refractory cases, psychiatrists use special lights that provide what nature has neglected. Used daily, they set a new light cycle and gently bring mood, sleep, and appetite back to normal. Some lamp models can be set to a timer, gradually waking you in the morning and setting a healthy diurnal cycle. Although they are quite safe, they should be used under the supervision of an experienced psychiatrist, because light treatments at the wrong time of day can actually reset your biological clock in the wrong direction and worsen insomnia.
So, if you find yourself in an annual cycle of autumn weight gain that you can’t quite lose in the spring, you’ll want to follow these recommendations:
• Focus first on the type of food you eat, in order to insulate yourself from the foods that cause the problem. Low-fat, fiber-rich, vegan foods always are best for weight loss. Check the recipe section for plenty of healthy choices.
• Be sure to maintain your exercise routine, despite cooler weather and holiday schedules.
• If you’re using sweet or starchy foods to cope with winter blues, you’ll want to be very careful about their fat content.
• If you suspect winter depression, by all means consult a specialist, who may recommend light treatments or other therapies that can knock out the mood and appetite problems.
Getting Off the Merry-Go-Round
If a daily binge cycle has you in its grip, you’ll want to use all the other steps in part II, but break up your schedule, too. If you’re on a monthly cycle, you’ll want to use foods to tame hormone ups-and-downs. And, if the problem is a yearly ratcheting up of your weight as your appetite grows in the fall and winter, you can tackle the problem by focusing mainly on the type of food you’re eating, rather than the amount, by staying active, and by looking for signs of winter depression.
We have seen many, many people from all walks of life who feel absolutely stuck in a self-defeating cycle, and yet they easily get on the path to breaking free. You can, too.
*The term estrogen actually refers to a group of related compounds, including estradiol, estrone, and others. For simplicity, I will refer to them all as estrogen.