Weight loss and the Biggest Loser: What you really need to know about the NY Times article

Patients, Facebook friends, and friends of friends contacted me in horror after reading the NY Times article on the Biggest Loser. Weight re-gain is inevitable. Most if not all of it.  And metabolic rate is screwed too. The control you believed you had? Doomed to dissolve. The hope you were given that you'd finally made it to your goal size or weight—or were getting closer—shattered. Overweight, obese, underweight or average size—the feelings knew no size boundaries. Fear. Anxiety. Hopelessness. Panic.

The pain of regain extended well beyond the 14 Biggest Loser contestants studied and their loved ones. It was felt by those of you who shared their struggle and their joy and sought inspiration from this outrageous, extremist show. 

The NY Times summarized the research: by 6 years after the show’s end, all but one participant studied had either regained some weight or gained beyond their starting weight; 4 contestants are now heavier than before they tortured themselves with this unsettling weight loss regime.

I know how you're feeling.

Nearly all have slower metabolisms now than at program’s start—over 600 calories less on average— with the biggest loser, Cahill at a loss of 800 calories burned per day; he now has to eat 800 calories less per day to maintain the same weight compared to at the start of the program. Many reduced their weights enough to improve their health, but the struggle to maintain the loss was constant and painful—physically and psychologically.

Where’s our anger at this abuse?

Four to 6 hours daily exercise was commonplace, with Cahill reporting 7 hours/day while on the show. Two or more hours included intense cardio workouts. And their intake? 1000-1200 calories was not unusual—an outrageous restriction even if the obese individuals were sedentary. That’s right. Just breathing or being at rest they would lose weight at that calorie level given average heights and starting weights. The degree of starvation was shameful and irresponsible. A set up for failure for sure. And did I mention there are now reports by participants of taking stimulants (provided to them by the program) to accelerate the weight loss—like ephedra and Adderall? 

It is simply abusive to lose weight the way they were directed to for the public’s entertainment. The extreme calorie deprivation resulted in a hormonally induced hunger and subsequent binge eating. No doubt, great shame and embarrassment resulted from their regain as they blamed themselves for their “failure”. Unfortunately, people replicate this self-abuse with crazy diets all the time, believing they can just jump-start their weight loss and then sustain it. Wrong, wrong wrong. 

What can you learn from this Biggest Loser study?

Yes, metabolic rate does slow with weight loss. This is not news. You knew it. You knew that when you were dieting and the weight loss you’d hope would continue simply didn’t happen. Your weight would plateau even though you were doing just what you were doing before. Even though you were “being good”. And so you made an adjustment. You’d eat a little less or exercise a little more or use behaviors like purging. And what resulted? More frustration, less “success” with weight loss. 

It may be time to be more realistic.

And for many if not most of you, rebound overeating or binge eating occurred. Because you’re a failure? Surely not! Because it wasn’t sustainable. Because you felt deprived—hungry, unsatisfied, fatigued, unfocused, vulnerable. Because hormone levels fought against you, as leptin levels—which helps us feel satiated—dropped with weight loss.

While the number of study participants—a mere 14 individuals—was small—the results were enormous. All but one regained significant weight. Yet the big news from this piece was the extent of the metabolic rate drop and the duration that it was sustained—observed when last checked 6 years after the end of the show! Now that’s scary.

What does this really mean for you?

While we don’t have all the answers, it appears that the degree of restriction impacts the outcome. Meaning, more rapid loss, more rapid gain. The “biggest loser”, Danny Cahill, had the greatest drop in metabolic rate—down 800 calories/day. He also regained the fastest, based on the NY Times graph accompanying the article. Deny your body and it’s gonna do what it needs to preserve yourself—it’ll try to slow the engine down, to conserve, to save some fuel for another day, to burn fewer calories. Yes, it does appear proportional. More moderate reductions in rate of weight loss, less drop in metabolic rate. 

Is my metabolism ruined forever?

The degree and duration of metabolic drop reported in the Biggest Loser research is simply not seen in other studies—a drop of 3-5% is more common. And most studies show that this drop reverses with increased food intake. 

Living with anorexia? 

Fear not—you have not permanently messed things up. The famous Minnesota Starvation Experiment demonstrated what those who treat eating disorders know from practice—that metabolic rate rapidly increases with re-feeding. (But continue to starve yourself and yes, your metabolic rate will be suppressed.) It requires a lot more calories than we’d expect for underfed individuals to restore weight. Ask any parent who is helping to renourish their child with anorexia. 

So please don’t be too quick to assume your fate. How do we know metabolic rate increases in this population? In addition to the Starvation Experiment and inpatient studies using indirect calorimetry—a  measure of resting metabolic rate or calories burned at rest, we also can see it indirectly—from increases in heart rate, body temperature and hormone levels.

I don’t have anorexia. I just diet to lose weight.  What does this mean for me?

“Just dieting” still lowers metabolic rate. If you are as extreme as the contestants, you may need to acknowledge your fate. If you are expecting rapid loss to be maintainable, think again. Torturing your body with hours of exercise each day as many of them did (or any amount, quite frankly, that leaves you starving) and/or restricting your eating and denying your hunger will fail you. 

Banning these? Time to change your approach
 to weight management.

Feeling deprived by omitting foods that satisfy you will lead you nowhere. Besides the reduced metabolic rate, the resulting deprivation leads to binge eating. And binge eating contributes to significant excess in calories and weight regain. Hopelessness follows, leads to the “what the heck effect” and eating recklessly. It all adds up to significant weight regain. And with chronic restricting, there’s also a loss of muscle mass which further reduces metabolic rate.

So now what?

Using more sensible, less extreme, more behavioral approaches to take charge of eating may seem less sexy, but has my vote. An 8 year study on lifestyle change resulted in long term weight loss (in 73% of overweight participants)— but not to the degree you might be hoping for. A 5-10% drop in weight was maintainable without losing sanity, and improved health. 

While the Biggest Loser participants tortured themselves dropping huge amounts of weight, and suffered as it rapidly increased, those with practical lifestyle changes lost less to start and after some initial regain, stabilized for years, suggesting better long term outcomes. The Biggest Losers? The study ended at 6 years, but based on the charts most seem to be likely to continue their weight gain trend.

So what can you do?

• Accept more realistic weight goals.  Modest paced weight loss (assuming weight loss is truly needed) may be most sustainable. 
• A 5-10% weight loss is enough to have a signifiant impact on your health—on blood pressure, blood sugar blood, cholesterol, fitness level and overall well being. 
• Focus on fitness goals. Regardless of your weight, find ways to move more, setting realistic goals.
• Address the quality of your intake for health. Include plenty of whole foods including grains, fruits, vegetables, nuts and lean protein sources—as well as fatty fish. But allow room for other foods you enjoy—yes, that includes cupcakes.
• Work on your eating behaviors, as I’ve addressed throughout this blog (see posts labeled mindful eating and binge eating)
• Cover your ears when your doctor says you must drop to the average BMI if you haven’t seen that place in decades, or ever. Clearly more harm than good will be done.
• Oh, and stop blaming yourself. Take charge of what you can control without physical or mental distress. And take some steps to love yourself as you are.

Thanks for reading. And sorry it's taken so long for a blogpost. Please take the time to share your thoughts--and share this piece with others.

Recovery from an eating disorder is still possible. Even after all these years.

Against all odds

She's not someone you'd expect to recovery. Decades living with an eating disorder, endless barriers to jump over.  But seeing the progress that my patient (I'll refer to as) Amy has made should provide hope to anyone who has long given up. Yes, recovery is possible. Not easy. Not quick. But possible. Please read through the end and share your thoughts with "Amy". 

In the last 50+ years, I cannot remember a time in which I was satisfied (even slightly) with my body.  As a matter of fact, I view it as disgusting and embarrassing.  Even at my sickest state, I was convinced I was the fattest one in the room.   In this point of my recovery, I deem it important to reflect on how far I’ve come.  Below is my life’s journey thus far.

It is uncertain to me why I have suffered from Eating Disorders for most of my life.   However, in my past, could lay the meaning for all of this.  My mom had EDs always.  My ED could be attributed to nature vs. nurture.  In other words, it was perhaps either a learned behavior or maybe it was genetically passed down to me.   It seemed important to my Mom that I should watch what I eat.  She was always suggesting that I should not have seconds at meals.  I remember my Dad taking us for ice cream when we were kids.  My mom would always get a diet soda so it seemed appropriate to me to follow her lead. When I was 8 years old I experienced a terrible trauma.  Even all these years later, I cannot reveal the details of this trauma.   All of these childhood memories are what, I believe, set the course for this ever-lasting emotional rollercoaster that is my life.

As I was preparing to graduate from high school, my ED became quite severe.  I was passing out on a daily basis.  My pediatrician told me that I was being “ridiculous”; I did not need to lose any weight and to just “eat more”.  It was at this time that I realized that if I ate just enough, it would not raise suspicions. It was also in my teen years that I started to self-harm.  I did this to the point of being certain it would kill me.  I didn’t care.  These behaviors even led into my adult life.

At the age of 23, I was married and eventually had 3 kids.  During this time, my behaviors somewhat subsided until my husband began drinking heavily.  This not only effected him, but it also effected me and our children.  What at first seemed like a “silver lining” was actually the calm before the storm.  I became engrossed in my ED once again.  All my behaviors emerged all at once.  I was unable to sit with my family at the kitchen table during dinners.  I would make my own “safe” foods and eat at the counter while doing chores while I ate.  Even as an adult, I was still following my Mom’s lead.

After 20+ years of marriage I finally somehow found the strength to separate from my husband.  As I began trying to pay our bills, it quickly became apparent that there was no money left in our joint accounts.  I had to begin again.  This stress increased the frequency of my ED behaviors.  I became quite sick again.  I refused to admit it.  My foggy brain kept me from the reality of my life.  Even when close friends and family claimed I needed help, I thought they were just trying to make me fat.  Kathy, my therapist, challenged me to attend an intake interview at an ED treatment center.  She even called them for me.  I went in order to prove my point – I do not need help!

Getting help--no quick fix

What I thought would be one hour out of my day, turned out to be four years of my life.  Since that day, I have been in residential 3 times, and PHP and IOP too many times to count.  After each stay, I felt like a failure.  I’m not sure if I felt this way because I couldn’t be cured from my ED or because I was letting my treatment team talk me into eating. Insurance was not a great help.  They would only approve 2 weeks max in resi for my first 2 stays. I would be discharged from residential and immediately make excuses for using just 1 or 2 behaviors.  “That’s better than all of them”, I would assure myself.  My outpatient treatment team were instrumental in convincing my insurance company to extend my treatment in my last resi stay to 6 weeks.  Upon discharge, I thought I was cured.  I felt great for a few weeks before the ED got into my head again.  I relapsed.

I overcame that relapse thanks to the support of my RD, Lori and the rest of my treatment team.  She could see through the ED lies.  She knew I was relapsing even before I did.  Yet I've turned it and I’ve had many accomplishments in the last few months:

I dug myself out of financial debt.

I eat my meal plan consistently

I’ve attempted to move away from “safe” foods.

I haven’t used ED behaviors in 3 weeks.

I’ve enrolled myself into a 16-week DBT group.

These are all accomplishments that I would not have believed possible even 3 months ago.  I will strive to add to this list within the next 3 months.  I feel more peace and contentment in my life now than I have ever before.

The journey isn't over. But recovery is in site

Even though I reached so many incredible accomplishments, that is only the beginning of the end of my recovery. Today, there a different challenges to face. Being closer to recovery than ever before, I am now terrified of losing my ED.  It’s been my stress control, my safety net, my numbing against my life.  How do I let go of it when I may need it again?  What if I can’t get it back? Even though I know that it is in my best interest to continue to move forward with my recovery, part of me does not want to let go of my ED forever.   My goal going forward will be to use my “wise” mind to conquer these thoughts.  I want to be able to look in the mirror and think, “I am who I am; I’ve done the best I could, given my circumstances, and I am proud of what I’ve accomplished”.  I WILL continue to fight and learn to love myself, whoever that may be, “Against All Odds”

Here's another recovery story you might like:

http://dropitandeat.blogspot.com/2014/03/theres-no-gift-like-recovery-and.html

From eating disorder recovery & advocacy, to losing weight, to bread baking?

Got 30 minutes? Check out this podcast I was interviewed on yesterday on Heritage Radio's Feast Yr Ears. http://heritageradionetwork.org/podcast/lori-lieberman/



Topics discussed include:

• Why I love working with people with eating disorders--the most challenging of all my patients
• More nutrition pet peeves, what simple step pediatricians can take to catch an eating disorder
• What to say and not say to someone who has lost weight
• The me and Cate story of Food to Eat and Drop the Diet aka why I adore Cate Sangster
• My major food obsession. You mean you don't already know?

If you like it, please share it.

And thanks for your recent comments which I promise to respond to!

So you think you're recovered from an eating disorder? Take this quiz to find out.

1) Recovery is about weight gain. Period.

The simple answer? 

It just might not be going the way you planned. 

False. Now don't let your eating disorder get all excited, saying "See! I told you so!"

Weight restoration is surely a must for those who have fallen from their usual weight or in the case of kids, their weight for age and BMI curves. That is, their expected pattern of gain based on their age and their weight history. For kids, falling off their usual growth curve suggests a problem. It shouldn't be praised or rewarded, but evaluated. (Pediatricians, did you read that?!) But if someone's weight was high due to unhealthy behaviors such as binging, emotional overeating, or general disregard for satiety, and weight dropped with improved eating and coping, weight gain is likely unnecessary.

Simply reaching a healthy range based on the charts also isn't enough. Perhaps your restrictive eating and suppressed weight began as a young teen, and you've lived for years with eating disordered behaviors. Did you rely on cigarette smoking or other substances? Was your appetite suppressed by ADHD meds? As you recover, weight gain may be essential regardless of what the BMI charts say. Focusing on the weight is misguided!

Your weight may be technically in the normal range, but your behaviors may indicate a problem. You know, like restricting, binging, purging, laxative abuse, compulsive exercise.

Weight is just one component of eating disorder recovery.

2) If I get a period (and I'm not a guy) then my body is healthy.

False

Surely losing your period when you're of age and sex to be getting a period is cause for concern. But getting your period is not evidence that all is well and you have recovered. You may get what seems like a period when you're on the pill, or start to get periods back without all the hormones being back to normal. Or maybe like one adult patient I used to see, in spite of her struggle with anorexia, she managed to conceive and deliver 5 children, never missing a cycle. Similarly, weight may be restored to the appropriate place, but it may take several months for menses to resume. For guys, low testosterone level is a more silent red flag that things are amiss; is resolves with adequate eating.

3) If I can take in enough calories, then I've recovered.

False

Can you eat foods you used to enjoy?

Sure, you will need enough calories to get your body bad to normal function--with a healthy heart rate and blood pressure, without major drops in pressure when you go from lying down to sitting or standing; with normal body temperature and energy level; with better sleep and mood. But full recovery means eating a range of foods and nutrients. It requires eating enough carbohydrates and fats-- not just protein. Recovery, true recovery, demands you include foods that seem scary, foods that you used to love, so that you aren't controlled by them. Like eating some pizza or an ice cream if the spirit moves you.  It means eating bread that may be whole wheat, or white, sourdough or french, without relying on ‘sandwich rounds’ or high fiber, low calorie flatbreads, or “Ezekiel” bread. If you’re truly recovered you can eat foods even if you can't justify them for their nutritional value, even if you don't think of them as "good for you".

4) I've stopped using laxatives, vomiting, and I'm eating better. I'm healthy now that I'm exercising every single day. So surely I'm recovered.

False. Replacing one behavior with another-- in this case, having to exercise to allow yourself to eat-- is also not healthy. Be careful that you aren't just swapping one behavior with another-- even a 'socially acceptable' behavior like exercise. If you feel you can't eat if you don't exercise you have work to do!

Ok. So I am doing fine with all that. But I need to be the one preparing the food. I'm still recovered, right?

I know. This is a scary idea. I will
settle for nourishing you
with words.

Not quite. Full recovery includes some flexibility and acceptance of what you can't control.

It means eating meals out without having to look up the calories before hand, and without having to modify the entire meal according to ED (that said, being vocal about your preferences doesn't have to be disordered. While Sally didn’t have an eating disorder in "When Harry Met Sally" this scene is worth viewing for some comic relief. Recovery is being able to eat a meal without watching the food be prepared, fearing the secret addition of ‘toxic’ ingredients.

Recovery acknowledges that people you know diet or overexercise or are losing weight, and it is what it is. (see husband triggering) And that you stay the course with eating and avoiding behaviors because it simply has to be; because you can be a great dieter-- but it didn't serve you very well being in that place before. And because you simply deserve to feel better.

Not as far along as you hoped? 

Then move your frustration to action. If you've just started on this path, hooray for improving your intake and taking steps toward recovery! Perhaps you're finding other ways to cope, so you're freeing yourself from unhealthy disordered behavior. Maybe reading this post helps you realize that more recovery pieces are in place than when you started. Progress! The point of this piece is to raise your awareness to help you keep going and reach fuller recovery. And to shake up some denial that stands in your way.

Yes, there's hope. See some of the links below.

Any changes to your thinking or eating you still need to make? Perhaps the post below will help to motivate.

Please share your thoughts!

And thanks for reading.

http://dropitandeat.blogspot.com/2011/09/beyond-calories-learning-to-embrace.html

http://dropitandeat.blogspot.com/2012/09/lessons-from-my-final-day.html

http://dropitandeat.blogspot.com/2013/05/do-you-believe-recovery-just-isnt.html

http://dropitandeat.blogspot.com/2012/03/normalizing-eating-and-hiking.html

Spouses, partners, parents of loved ones with eating disorders--I need you to keep reading. Really.

You may have no idea how they're suffering. Your wife, or mother, or partner or son. It's about shame. And fear. That's why they can't tell you. That's why it's so hard for her to ask for help. I'm not placing blame, but I'm asking you to start to listen like you never have before. Because it's hard for those living with anorexia, bulimia and binge eating disorder to say what needs to be said.

Don't be fooled by his size or his weight. People with eating disorders come in all sizes. And don't be fooled by how well she had been doing. Slips happen. That's normal. But recovery requires acknowledgement that things are amiss, and that support is available. Right there. In person. Not just virtually through this blog, or a virtual support group or a friend across the world.

Yes, they need to know that you are there for them, unconditionally. Even if you really don't understand. Even though you wish they'd just 'get over it'. Struggling with an eating disorder is something they simply did not choose.

She may not discuss it with you, seeming as if all is well. And he may deny that he's restricting or over exercising. Besides. It's so much easier to see what we'd like to see.

So if you suspect that there's something not quite right, please start a discussion. And use open ended questions, ones that can't be dead-ended with a simple yes or no response.

You just might have your blinders on to
what's really going on--right before your eyes.

Do you know how trapped she's feeling?
Like there's no way out of her misery?

Sometimes we're a bit too close to the situation to
see the whole picture.

FB and your diet, weight, fitness & happiness: A cautionary post about comparing.

Everyone is so happy. And doing so well, always having a great time. They’re all eating amazing food and managing their weight. They all look so healthy, too. And their kids are always smiling—they have the perfect families. Everyone else is so good at exercising—Map My Ride/Run and other apps prove they’re doing so much better than you running and cycling and walking. Yes, by comparison you hardly rate.

Hardly his happiest or his best mug shot.
Posted with permission.

Or so it seems.

It was quite timely that my patient whom I’ll call Beth, described her frustration having spent too many hours on Facebook. (Imagine that. Spending too much time on social media.)  She saw far too many ‘friends’’ photos displaying beach-bound bodies with a confidence she doesn’t possess. Like those ‘before and afters’ from diet ads from Diet Center and Weight Watchers (where the print too small to read confesses that these images are of rarely occurring weight loss that normal people don’t usually experience nor maintain in the real world) they showed what everyone else was capable of—except for her. These photos of Beth’s friends and acquaintance were beautiful—looking slimmer, happier and more fit than her for sure. 

Or so it seemed.

These pictures of friends struggling
 hardly get seen.

Ok. Raise your hands if you post pictures of yourself that you'd rather destroy. Right. We only post our best shots, the ones that get the ‘likes’, right? And we surely don’t see people throughout the day, at all times, when they may be looking their worst—like we see ourselves. No early morning “I-just-rolled-out-of-bed” shots posted on FB.  And did you know that some ‘friends’ even use apps which photoshop their pictures, like they do in magazines with airbrushing? Yes, it’s even possible that some pictures you’re thinking are real have been touched up. 

Comparison is a tricky business. You only see a small slice of a person’s life, of what’s really going on. The rest, no doubt, is projection. They ‘seem’ happy, or healthy, or content. But maybe it’s just how it appears. Their exercise level may be awesome, or excessive or a rare event advertised to their Facebook friends.

No, these imperfections don't make
it to FB.

Your friend who’s lost all that weight may have cancer, or may be struggling with anxiety and depression, causing her to feel anything but happy. Or fit. Or relaxed. The bikini clad acquaintance may be so preoccupied with what she believes she can and can’t eat that she hardly enjoys herself at the beach, or when she dines out, or even when at home deciding what she could possible have for lunch.

Yet another recent study showed that using social media can have a negative impact on our eating behaviors including binging, purging and using diet-pills. “Both online physical appearance comparison and online fat talk were associated with greater disordered eating” the study by Dr. Bulik and colleagues showed. Without the comparing, however, greater Facebook use was associated with decreased disordered eating behavior. So it’s all how you use it. "Comparison is the thief of joy"--I can't agree more with this quote attributed to Theodore Roosevelt.

Looking neither happy, nor energized.
I was actually quite miserable here.

Maybe it’s time to challenge your Facebook and social media friends. Are they capable of posting a picture where they don’t look so awesome? Can they post the ride or run where their speed was less than impressive?  I doubt that most can bring themselves to do so—but wouldn’t that change things?

I’d love to hear what you think. So please leave a comment! And thanks for reading.

The very low sugar, low fat healthy diet—an oxymoron.

Kristen knew to avoid fats—except for those in nuts (which she included in very limited amounts) and certainly those in dairy and oils. Fats are bad. Period. She loves fat free yogurts, but those she omits because of the sugar. Same with milk, which she truly used to enjoy. Now she uses fortified water aka lite almond milk. Seasonal fruits, even the organic stuff—completely stricken from her diet, you know, because of the sugar.  Whole grains—well those have those god-awful carbs so those are out too. Yup, that leaves… lean poultry and fish and non starchy vegetables.

No wonder meal planning is a challenge.

No wonder she struggles to not binge following a day of deprivation.

No wonder her energy level is low, and her thoughts are preoccupied with food and eating.

Why can’t I decide what to eat?

If you're like Kristen, you get so over-focused on what you shouldn't eat that you're challenged to figure out what to eat.  Your endless food rules about nutrition, weight and health leave few foods to eat—and enjoy. 

I've lost count of how many patients came into my office these last weeks, stating: "I have no idea what to eat anymore. I just can't decide." These are patients of all sizes and conditions—patients with anorexia, and those with binge eating disorder and bulimia; and those struggling with their climbing weight and obesity in spite of their attempts to eat healthy. And they’re all ruled by unnecessary food rules.

Wrong, wrong, wrong about fats!

Like Kristen you too may be fat phobic, in spite of the updated newest guidelines for Americans 2015, which have removed the notion that total fat should be avoided. Got that? There is no evidence to support a recommendation that total fat should be restricted—neither for weight management nor for health and disease prevention. 

Really? How can this be?

At the 2015 Scientific Sessions of the American Diabetes Association (ADA) there was a wealth of research showing that diets rich in fats from plants sources—with nutrients like mono unsaturated fats (think avocado, peanuts and olive oil)—and in omega 3s (think salmon, sword and tuna in addition to walnuts and flax) help reduce abdominal fat distribution which is the greater health concern than obesity.

And, wrong about carbs and weight gain!

Also at the ADA, extensive research was presented concluding that macronutrients—the protein, fat and carbohydrate balance of your diet—ultimately have no impact on your weight. That's right. Numerous large studies including a well-done Harvard study confirm this.

I know, I know, it’s hard to believe when you’ve already been sucked into the misinformation of carb and sugar toxic diets and fat phobia.

You’ve lost sight of the bigger picture. In spite of eating a diet full of healthy foods including protein sources, fruits and vegetables, grains and fats—your calorie intake can become reduced to the point of providing inadequate calories for your day to day need. You get fuzzy headed, feel fatigued and decision-making about food becomes challenging. Rules and restrictions consume you, so you're at a loss to figure out what you can eat. I mean if you know you can’t eat gluten or that carbs are toxic or fats will make you fat and sugar is poison than what's left? How can you choose what to eat when there's so little that allowed?

Remember when you used to simply eat?

Move from micromanaging your foods.

How can you loosen the reins? Start to shift your thinking from micromanaging your diet. Rather than hyper focusing on each individual food item, on every nutrient or component of your intake, consider the bigger picture.

Consider OJ.

I walk through the supermarket noting the orange juice selection. Remember orange juice, the juice of oranges naturally high in vitamin C (and lesser known for its high potassium and folic acid content)? Only now it’s available calcium fortified. And get it with pulp—it’ll make you think you’re getting more fiber, when in truth there’s no difference. Add omega 3s while you’re at it—just get it with fish oils (quite a disgusting thought, personally). My point? Why are we thinking that one food has to be everything to our diet? Can't oranges or orange juice just provide us with the nutrients it's known for?

Must our pasta be whole wheat and protein fortified or be banned from our diet? What if you started with white pasta—yup, no fiber, all carbs, delicious pasta? You don't need to have the whole 16 oz. of it. By itself it's hardly a balanced meal. But surely you can find a solution to that, right?

Yes, you can add vegetables—for vitamins, for volume and texture, for fiber and satiety. Feel the need for protein at that meal? Add a glass of milk, some cheese, some shrimp or chicken or smoked salmon.  See where I’m going? 

Maybe think even bigger picture. Perhaps some meals are higher carbohydrate, but your protein is met from other meals or snacks?  Maybe you had a Greek yogurt high in protein or some nuts, for instance.

It's time to aim for balanced meals and a balanced day of eating, rather than hyper focusing on some 'perfect', ideal foods and eating style. Imagine even including a baked good simply because you enjoy it, as a snack when you’re hungry—contributing to your energy needs for the day, in addition to the wholesome foods you strive to limit yourself to.

Now that’s healthy eating.

Thoughts? Questions? Does this resonate for you? Are you out there reading? Please share with anyone who might needs some reality checking! Thanks!