‘The first principle is that you must not fool yourself – and you are the easiest person to fool.’
Richard Feynman1
WHEN IT COMES to losing weight and ensuring it stays lost, there is good news and bad news.
In the two previous chapters we focused on the bad news, drawing attention to the fact that while restricting or removing macronutrients leads to weight loss, this weight rarely stays off for more than a few weeks, which can lead to an unhealthy binge/purge cycle.
Now for the good news! Losing weight and sustaining that loss is achievable, provided some lifestyle changes are made. These involve the kind of strategies mentioned in previous chapters, such as learning how to control stress and manage negative emotions, having at least seven hours’ sleep each night and taking regular exercise, as well as regulating both what is eaten and how much. In this chapter we will consider these last two factors since, in our experience, they present the greatest challenges.
It’s something of a common-sense statement, but the key here is to avoid foods that, while rich in calories, are poor in nutrients. By choosing instead foodstuffs that are nourishing and which also enhance feelings of fullness (See Table 1), the likelihood of persisting with a health-promoting new eating plan is greatly increased. Research has shown that diets high in lean protein, fibre and complex carbohydrates have the greatest success in ensuring sustainable weight loss.2 Ingredients that fulfil these criteria include chicken, fish, soya, nuts, green vegetables, fruits and whole grains such as porridge.
While there can be very little room for cakes, biscuits and sweets in a diet designed to reduce weight and enhance lean body mass, they should not be entirely excluded. Banishing every such food from your diet whilst simultaneously reducing the number of calories consumed increases the risk of succumbing to an eating binge. Food deprivation is often a precursor to binge eating as it makes that food more rewarding upon consumption.
‘Don’t overeat’ may sound like a simple enough instruction, but in fact even the most determined dieters can be nudged off course and eat more than they intend. The reasons this happens can be very subtle; here are ten ways in which overeating can occur, together with practical strategies for avoiding this.
When it comes to the amount of food we serve ourselves, perception is everything. If we are using a large plate it takes more food to make us decide that we have a suitable portion than if we are using a small plate. This issue of size applies to both the crockery the food is served from and the utensils it’s served with – the larger they are, the more we tend to serve ourselves.3 Even if it’s only the serving dish that is bigger, the portion of food served from it can increase by as much as 57%.4 But to flip this around into a positive, a smaller portion on a smaller plate will look as satisfying to us as a larger quantity on a bigger plate. Therefore monitoring the size of the crockery and utensils you use can really help to reduce overeating.
The same is true of how we serve ourselves drinks. When asked to pour an exact measure, without the use of a measuring device, even professional bar staff have been found to pour up to 30% more into wide glasses than into thin ones. This is known as the horizontal–vertical illusion; we focus on the height of the liquid in the glass while ignoring the width, thus deceiving ourselves about the true amount. In a study we conducted, those given a wide tumbler poured almost twice as much as those with a narrow glass (397 ml vs. 796 ml).5 Giant bottles of cola have been shown to increase the amount people serve and consume by up to 45%.6 The lesson to be learnt from this is that using a tall, narrow glass rather than a short wide one will minimize the number of liquid calories consumed.
A lack of colour contrast between the plate and the food can also make a substantial difference to the amount served. When the two are similar, larger portions are usually taken, since it becomes harder to gauge the amount of food on the plate. We put this to the test in an experiment where participants self-served pasta in tomato sauce onto either white or red plates. When pasta in tomato sauce was dished up onto red plates, 22% more food was taken than when white plates were used.
One of our messiest pieces of research involved hundreds of chicken wings in barbecue sauce. While a tasty food when hot and fresh, they quickly become sticky and thoroughly unappetising when cold and partly eaten. Our purpose was to investigate whether having evidence of the number of chicken wings already consumed left on the plate would result in people eating less of them.
The participants in this study were an audience attending a comedy show in a London pub. They were provided with an unlimited supply of barbecue chicken wings to munch. Before the show began, the audience had been divided into two groups (though they were unaware of this). One group had their leftover chicken wings left on the plates as they were served with more. The other had their dirty plates swiftly replaced with clean ones by the serving staff. The group that could see the chicken bones piling up on their plates consumed an average of seven each, while those whose dirty plates were replaced averaged eleven wings per person.
A chicken wing with the skin contains 62 calories and the barbeque sauce adds another 20 calories, making 82 calories per wing. This meant that every member of the ‘clean plate’ group ate just over 900 calories, while those who kept their leftovers consumed 574 calories.
Similar findings have been reported by other researchers across a variety of situations; without some kind of reminder, most people struggle to remember how much they have consumed.7 One study found that only five minutes after eating a meal at an Italian restaurant, around a third of diners (31%) were unable to recall how much bread they had eaten.8
By keeping the evidence before your eyes you can constantly monitor how much you have consumed and avoid mindlessly overeating.
In a study we developed for the television programme Secret Eaters, amateur artists were invited to a life-drawing class, on the pretext that we were filming a documentary about painting. During a break they were offered three types of cake as an afternoon snack: banana cake, carrot cake and brownies. Two separate serving tables were set up and the artists were randomly directed to one of them. While the same cakes were available on both tables, they were described in very different ways by signs on each one.
The cakes on one table were said to be lower in fat, with an accompanying photograph depicting images of health. On the second table the cakes were described as indulgent and ‘devilishly’ good, with pictures implying they were delicious but not very good for you.
The number of cakes taken from each table was counted and any uneaten cake portions carefully weighed. The results were striking: those eating what they believed to be the ‘low-fat’ variety consumed just over 1,000 calories more on average than those offered the ‘nice but naughty’ option.
The danger here is obvious; the perceived health halo of a ‘safe’ low-fat food can tempt consumers into guilt-free overconsumption. Shoppers often take such claims at face value without bothering to check, or even consider, the extent to which such products can really be described as low fat, or the fact that even a product which really is low fat can cause you to put on weight if eaten in sufficient quantity.
When we conducted a study into how people read labels, using eye-tracking technology, we found the majority only looked at the caloric information, not the fat content or macronutrient distribution, even though it was usually printed in big, bold, easily read text on the front of the packet, bag or bottle.
We’re all likely to eat more of a food we believe to be ‘low fat’ or ‘reduced fat’, and to significantly overestimate the extent of the reduction involved. While reduced-fat foods are, on average, around 11% lower in calories, many consumers believe them to be up to 40% lower.9 This in turn can lead them to consuming up to 50% more food at a sitting.
‘For normal-weight people, low-fat labelling increases consumption the most, particularly with foods that are believed to be relatively healthy,’ say Brian Wansink, an established expert in eating behaviour from Cornell University, and Pierre Chandon from the world-renowned INSEAD institute in Paris; ‘for overweight people, low-fat labelling increases their consumption of all foods.’10
Also, while we may view hamburgers to be less healthy than a sandwich containing fresh vegetables, this is a somewhat oversimplified view. For example, an advertisement depicting a foot-long Subway Sweet Onion Chicken Teriyaki sandwich claimed that it contained ‘only 10 grams of fat’ and compared it to a Big Mac which ‘contains 33 grams of fat’. The advertising copy quoted Jared Fogle, a Subway spokesperson, as saying that this meant: ‘You can eat another and another over the course of three different meals and still not equal the fat content of one Big Mac.’
He’s absolutely right.
‘Yet,’ as Wansink and Chandon point out, ‘the advertisement fails to mention that the . . . foot-long sub contains more calories (740 versus 600 calories) and more cholesterol (100 versus 85 milligrams) than the Big Mac. Thus, eating three Subway subs would provide 1620 more calories and 215 more milligrams of cholesterol than eating one Big Mac.’11 Suddenly it doesn’t sound like such a healthy option.
A pause point is simply something that obliges you to stop eating for a moment, during which time you can reflect on whether you have eaten enough. When snacking, for example, a pause point might be unwrapping a sweet, opening a new tube of Pringles or reaching for another bag of nuts. During a meal it might be created by having to get up from the table and go into another room, or to a different place in the same room, to serve yourself with further food.
In one study, every seventh Pringle in the tube offered to participants was dyed bright red to make them stop and think when they reached it. Under these conditions, 48% fewer Pringles were eaten in a single sitting, saving 250 calories.12
And in a study we conducted ourselves, we provided two groups of medical students taking part in a netball contest with bags of crisps as a mid-game snack. While they all received an identical amount, one group were given their crisps in a single, jumbo-sized bag while the others were given them in six smaller bags. Based on previous studies, we hypothesised that players given the jumbo bag would consume significantly more crisps than those obliged to open a fresh bag each time they finished one. This was indeed what happened. Students with the jumbo bag ate around 60% more than those given the separate ones.
Pause points are just as helpful when it comes to main meals. Research has shown that diners are likely to eat 20% more if the serving dish is left on the table while the meal is eaten.13 (See also ‘Make eating more of an effort’.)
To put this to the test, during filming of an episode of Secret Eaters, two groups of friends were offered a free roast chicken lunch at a fashionable London restaurant. One group ate with the chicken, potatoes and other types of vegetables in large serving dishes in the centre of the table. The second group enjoyed the same menu but served themselves from a counter in a different room. This ‘pause point’ meant they ate up to 50% less than those who merely had to reach across the table and help themselves to whatever they fancied.
The ‘free chicken lunch’ experiment mentioned in the previous section also illustrates what is termed the Principle of Least Resistance, first proposed by the French philosopher Guillaume Ferrerò in 1894 and later developed by the American psychologist Edward Chace Tolmen during the 20th century.14
Simply put, it states that people prefer to do short and simple tasks rather than lengthy or difficult ones. While this might appear to be little more than common sense, its implications when it comes to weight control are considerable.
In 2011, food psychologist Paul Rozin and his team from the University of Pennsylvania explored the subtle factors that lead to overconsumption in a cafeteria setting. The focus of their investigation was the university’s refectory, which served around a thousand people each day. Their aim was to discover if diners could be influenced to eat more or less without realising this was being done.
In the experiment, eight ingredients – broccoli, grated cheese, chicken, cucumber, hard-boiled eggs, mushrooms, olives and tomatoes – were placed in various different locations on the self-service counters. In one configuration, a particular item was placed on a single large tray in the middle row of the serving counter. This meant it took very slightly longer to reach that food than those at either end. By switching around the location of high-calorie (e.g. eggs, chicken, cheese and olives) and low-calorie items (e.g. broccoli, cucumbers and tomatoes), the team found they were able to covertly manipulate diners’ food choices, and therefore the number of calories consumed. For someone eating at the cafeteria five days a week during term time, the difference amounted to 3,527 calories more or less over the course of a year.
‘This would translate into a 1.01 pound (0.46 kg) body weight difference,’ comments Paul Rozin. ‘Bearing in mind that the average annual weight gain for an adult American is in the range of 0.9 to 2.5 pounds a year, these manipulations would diminish weight gain to an extent that could have an impact on public health.’15
When it comes to snacks, keep them hidden from view and harder to access immediately. A study we conducted found that when a bowl of chocolates is placed on an office worker’s desk, he or she will eat around nine a day; when they are placed in a desk drawer the number drops to six; and when located in sight but placed six feet away, to just four.
Night-time eating poses a problem for many people who struggle with their weight. Part of the issue with eating at night is that ‘satiety responsiveness’, which describes the body’s ability to detect hunger, is lower at night than during the day. This significantly increases the risk of overeating.16
Some people, perhaps aware of this problem from personal experience, resort to the habit of ‘grazing’ throughout the day in the hope this will reduce after-dark hunger. It is an approach to eating that, until recently, many dieticians and food writers actively promoted. Unfortunately, because this type of eating can confuse ghrelin signalling (See Chapter 6), which is essential in diminishing the desire to eat, it tends to increase calorie consumption. For this reason, the shift to eating three square meals a day is becoming fashionable again.17
In her 1950s book, Let’s Eat Right to Keep Fit, American nutritionist Adelle Davis advised readers to ‘eat breakfast like a king, lunch like a prince and dine like a pauper.’18 Half a century on and this advice still holds good, even though these days most people ignore it. They do so for a variety of reasons, the two most common being they ‘aren’t hungry’ or they ‘don’t have the time’.
This is a mistake that those seeking to control their weight should avoid. Because skipping breakfast increases the desire to snack, it is strongly associated with overeating, weight gain and obesity. Adolescents who skip breakfast typically snack on more desserts, high-fat salty foods and fizzy drinks compared to those who consume breakfast.19
Researchers have found that doubling the protein content of your diet to between 20% and 30%, from the normal 10% to 15%, can result in an immediate loss of body weight.20 It also helps to control calorie intake over the remainder of the day in four key ways:
Increasing protein may be the first step in a series of changes that lead to achieving a healthy body weight. This is not to say that we advocate the kind of fad diets which emphasise protein to the exclusion of many other foods, but taking advantage of its satiating effects, particularly earlier in the day, will give you the best chance of developing a healthy relationship with foods of all kinds.
We demonstrated the importance of this advice ourselves, in an experiment involving sixteen young men and women. They participated in what they believed to be a study about teamwork. After being divided into two groups of eight they were kept busy, in different rooms, from early morning until early afternoon. One group was given only water while the second was supplied with snacks of fruits and nuts, each person’s bag containing 370 calories. By lunchtime this meant that the first group was famished while the second, although hungry, felt much less urgency to eat. Each person was then given £10 and sent off to a nearby supermarket to buy whatever they wanted for lunch. Every item they selected was unobtrusively noted and the calorie and fat content recorded.
While we expected there to be a difference in food choice between the groups, we had not expected just how big a difference it would be. The total calories consumed at lunch by the group that had been provided with snacks amounted to an average of 700 per person. Individuals in the ‘hungry’ group, by contrast, ate an average of 2,500 each and also selected foods such as chocolate bars and crisps that were 400% higher in fat overall.22
It’s clear from this that hunger can have a very significant effect on the kinds of foods we prefer at a given time.
The tendency to consume more when eating in company is so predictable it is almost mathematical.23 When eating with one other person we tend to eat around a third (35%) more than if alone. When dining with three others this increases to about 75% more, and as part of a group of seven or more up to 96% extra.24
Not only does eating with others cause overeating as a result of being distracted by the conversation, but diners tend to copy both the amount of food eaten by others and the speed of eating. In one study, confederates of the researchers acted as ‘pacesetters’ and ate at varying speeds with different groups of diners. The more food the pacesetters ate, the more the other diners also consumed. People also drink more alcohol in company than on their own. This not only increases the number of calories consumed (depending on the vintage, a glass of wine can contain up to 175 calories), but it also reduces awareness of how much has been eaten.25
The ambience of the place in which food is eaten, its lighting, odour and noise, can also influence the amount people consume and cause diners to overeat. Researchers have found, for example, that while bright lighting decreases the length of time people spend over their meal, soft or warm lighting (including candlelight) generally causes people to linger longer and enjoy an unplanned dessert or an extra bottle of wine. This is why fast-food restaurants, where the desire is to move customers out of the premises as soon as possible, are typically very brightly lit, while exclusive eateries have dimmer lighting to encourage longer stays.26
Yet it might be surprising to learn that a relaxing environment actually inhibits eating overall. As an experiment, we converted two different floors of a large restaurant into an upmarket eatery and a fast-food diner respectively. The former had soft lighting, waitress service and played classical menu. The latter was brightly lit and played loud pop music. We found that although those dining in the relaxed atmosphere stayed for longer, they actually consumed fewer calories, an average of 749 per person, than those in the fast-food restaurant at around 949 each. This was most likely because by eating rapidly and mindlessly, the brain failed to respond in time to signals from the digestive system that sufficient food had been consumed. By encouraging a more leisurely approach to dining, the relaxed environment allowed feelings of fullness to be noticed earlier and more easily.
As well as being more mindful of what and how you eat, there are four further steps one can take to encourage sustainable weight loss.
There has been significant controversy about whether it is a good idea to monitor one’s weight regularly. Arguments against doing so include the fact that if the reading is higher than expected it may lead to depression and so encourage comfort binge eating. Some people also worry that ‘obsessing’ about their weight makes it harder to achieve a healthy relationship with their body.
However, if you have a tendency to put on weight (and don’t we all?), you must keep scales in your bathroom. No matter how painful it may be at first, weekly weight monitoring plays an important role in both losing weight and ensuring that it stays lost.
Researchers studied the behaviour of a cohort of successful dieters who had lost at least 30 kg, and maintained the loss for 2–5 years, from a sample obtained from the National Weight Control Registry. The five trends which emerged are not all that surprising. They are: maintaining at least 1 hour of physical activity per day, following a diet that is low calorie and low fat, consistency in eating habits between the weekends and weekdays and, finally, regular weekly weigh-ins.27
Lack of sleep has been associated with a higher incidence of obesity, hypertension, and higher total cholesterol and triglycerides levels. As we explained in Chapter 8, having insufficient sleep can lead to weight gain in a number of ways, not least by reducing self-control, leaving one vulnerable to impulsive eating.
In recent years the number of hours of undisturbed sleep the average person gets has fallen dramatically, in both the developed and developing world. To compound the problem, many people now work night shifts or, more damagingly still, split shifts, which disturbs their natural bodily rhythms.
During our waking hours our body temperature rises and falls; we warm up during the day, which makes us more alert, before cooling down in the evening, which causes us to feel sleepy. In most people, body temperature peaks around 6–7 p.m., and this is therefore when they naturally have the most energy. There is a small drop in body temperature around 3 p.m., which is when some people like to take an afternoon siesta, and then a large drop around 2–3 a.m. These are also times when snacking is most likely to occur.
Whilst we do not have the space to provide an extensive plan for improving one’s sleep, here are some basic principles to follow. On our website (www.thefatplanet.com) you will find more detailed advice on improving your sleep.
We are all frequently told of the benefits of exercise for our hearts and for our bodies in general; there is no need to repeat much of that information here. There is also a small amount of truth in the idea that if a person wants to lose weight the best thing they can do is ‘move more’. However, the reason for this may not necessarily be the one you might expect.
It is certainly the case that exercise burns calories and, as we have seen, in the end it is excess calories that are the cause of weight gain. Having said this, the amount of exercise which most people feel able to take is unlikely to have a large direct impact on their weight because of this. Rather, it is the positive effect that exercise can have on mental health which can be particularly beneficial.
Exercise elicits the release of beta endorphins in the body – hormones which activate opiate receptors and thereby produce feelings of wellbeing. Similar receptors are actually activated when we eat foods high in sugar and fat. Exercise can therefore prevent us from seeking the comforting high of unhealthy food because it provides a similar lift in mood itself.
We should also mention the results of a large population study published in the European Journal of Preventive Cardiology, which demonstrated that by taking regular exercise, maintaining a healthy diet, drinking alcohol only in moderation, and not smoking, people could reduce their risk of fatal and non-fatal cardiovascular disease by more than 57% and their risk of a fatal attack by 67%. When seven or more hours’ sleep each night was added to these lifestyle factors, the overall protective benefit increased even further. Now there was a 65% lower risk of fatal and non-fatal cardiovascular disease and an 83% lower risk of fatal events.28
It may be something that you’ve heard a thousand times before, but if you find the time to take regular exercise you won’t regret it – you’ll feel better, both mentally and physically, which will go a long way to helping you maintain a healthy weight.
Sustainable weight loss must be regarded as a long-term project rather than a quick fix. It takes up to two years for new and healthier eating habits to become established and for the appetite threshold to be reset. To expect to achieve this over any shorter period risks descending into what are, for many, all too familiar patterns of weight cycling and yo-yo dieting.
‘In order to lose weight, you need to be motivated, and the best way to do that is through understanding what you’re for, and how to change,’ says writer James Fell. ‘Not just your body, but your mind, your schedule and your reason for being. It’s not just about the exercises you engage in and the diet you consume; it’s about changing who you are. It’s not a list of actions. It’s someone you become. Don’t just do this; be this.’29
In this part of our book we have focused on ways in which individuals can take ownership of and responsibility for their own body. Yet, external factors have no less important a role in encouraging overconsumption. In the final chapter, we examine the extent to which outside agencies such as NGOs, national governments, food companies and regulators need to become involved in combating the obesity pandemic.