In our house, there are no pictures of my wife and me that are more than a few years old.
When I was a medical resident, nearly two decades ago, I didn’t take very good care of myself. I was a pediatrician, and I counseled patients and parents all the time about how to eat right and get enough exercise. But I couldn’t seem to figure that out for myself. I gained a lot of weight, and so did my wife, Aimee.
After our second child was born, Aimee decided she needed to make a change. She told me she was going to try Weight Watchers. Since it seemed silly for us to prepare two meals at a time, I decided to join her.
It worked. Weight Watchers then was mostly focused on fat reduction, calorie counting and increased fiber. We both lost weight. I didn’t lose all that I wanted to, but it was certainly an improvement. Unfortunately, it was hard to keep sticking to the program. There were too many days I was hungry. I became too obsessed with “low fat,” as fat seemed to be how “points” were calculated. (Today, Weight Watchers points focus on calories, sugar, fat and protein.)
Years later, when I decided to try to lose weight again, I focused on exercise. I made it through the torments of P90X, P90X3 and Insanity. Each workout regimen had its own diet plan, with a list of foods to avoid. I stuck to none of them for more than four or five months. They were too hard, and after initial success, my weight loss stalled.
Most recently, I tried to go “low-carb.” I became convinced, by reading books and studies, that carbohydrates were the true danger, not fats. I eliminated sugar from my diet almost completely. Once again, my weight dropped, but it eventually stopped falling.
My experience is not abnormal. Studies of diets show that many of them succeed at first. But results slow, and often reverse over time. No one diet substantially outperforms another. The evidence does not favor any one greatly over any other.
That has not slowed experts from declaring otherwise. Doctors, weight-loss gurus, personal trainers and bloggers all push radically different opinions about what we should be eating, and why. We should eat the way cave men did. We should avoid gluten completely. We should eat only organic. No dairy. No fats. No meat. These different waves of advice push us in one direction, then another. More often than not, we end up right where we started, but with thinner wallets and thicker waistlines.
I’m a physician and researcher with a particular interest in analyzing dietary health research, and even I get dizzy with the different perspectives on something as seemingly simple as the benefits of brown rice or the dangers of red meat. This is one reason I’ve decided to focus much of my writing on dietary health. I want to be able to advise my patients about what healthful eating looks like, and eat that way myself.
These conflicting opinions about nutrition have one thing in common: the belief that some foods will kill you — or, at least, that those foods are why you’re not at the weight you’d like to be. This is an attitude about food that actually has its roots in an earlier and opposite idea — that some foods can keep us from dying (think of sailors avoiding scurvy by eating citrus). Indeed, some of the earliest “expert” advice about food was predicated on the notion that some foods can save us.
When many more Americans were malnourished than are today, making sure they got more of foods containing things like vitamin B and C made sense. Today, the vast majority of people in the United States are not suffering from vitamin or nutritional deficiencies. Advice is usually delivered in terms of deprivation, not supplementation.
Much of this advice comes in the form of moralizing. But by making so much of our focus on what we’re doing “wrong,” we’ve removed much of the joy from eating and cooking. I made sure to avoid negative tones a couple of years ago when I drew up a manifesto/road guide we called simple rules for healthy eating. They include the idea that you aren’t going to avoid all processed foods, but you might try to limit them. The one I felt most passionately about was No. 7 — “Eat with other people, especially people you care about, as often as possible.” But lately, I’ve been thinking that No. 2 — “Eat as much home-cooked food as possible” — may be the most important.
I’ve recently been learning more about cooking theory — not so much following recipes, but understanding why those recipes work. A favorite guide in this quest is “Salt, Fat, Acid, Heat” by Samin Nosrat. Right there in the title are two “forbidden” elements. They’re also some of the main reasons good food tastes good.
The home-cooked food rule probably did more than any other to help Aimee and me get down to reasonable weights. Today, we’re much happier with how we look and feel. There are pictures of us looking happy in recent years around the house. Thanksgiving has reclaimed its mantle as my favorite holiday, because it’s so centered on food and family.
And yet. While I’ve adopted a much healthier attitude toward food in general, I sometimes find myself slipping into old habits. These last few months, I’ve been trying to lose weight again. I’m not obese, and I’m healthy. But my weight and height place me in the “overweight” category, and I think I could be thinner. As before, I tried going low-carb. I lost weight initially, then hit a plateau. I’ve been getting frustrated.
I was complaining of this to Aimee last week when my oldest child, Jacob, asked me why I was dieting. He couldn’t understand the point. I had no answer. I don’t think it will make me healthier or make me live longer. It won’t improve my quality of life. I won’t be in better shape. My clothes would fit the same. I’m not even sure anyone would see a difference.
I’m still too liable to think that being thin is the same thing as being healthy. I’m still too inclined to think that dieting is the same as healthful eating. Neither are true. Too often I’m chasing some imagined ideal that has no real-world consequences. My other son, Noah, has my physique and may someday find it all too easy to put on pounds. What message am I sending to him when I obsess over the number on the scale?
Jacob’s wiser than me. I’m still learning. One theme of my Upshot articles is that we should weigh the benefits and the harms in any health decision. When it comes to food, too often we focus only on the latter. When my daughter, Sydney, made cupcakes last night and asked me to try one, I did. The joy it brought her, and me, was worth it.
Aaron E. Carroll is a professor of pediatrics at Indiana University School of Medicine who blogs on health research and policy at The Incidental Economist and makes videos at Healthcare Triage. Follow him on Twitter at @aaronecarroll. He is the author of “The Bad Food Bible: How and Why to Eat Sinfully,” from which parts of this article were adapted.
Aaron E. Carroll is a professor of pediatrics at Indiana University School of Medicine and the author of “The Bad Food Bible.” @aaronecarroll
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