Senior nutritionist Rose Carr talked to health professionals from around the country who are helping others to lose weight. And when she asked about some of the common problems their clients have and how they helped people overcome them, common themes emerged. Here are the experts’ rules for weight-loss success.
HFG nutritionist Claire Turnbull has a private practice, Mission Nutrition, based in Auckland.
Dietitian Nicky McCarthy of NutritionWorks is based in the Hawea and Lake Wanaka area.
Fiona Boyle is a dietitian and nutritionist with a private practice, Food Solutions, in Mt Maunganui.
Dietitian Amanda Johnson has a clinic, Kiwi Nutrition, in Johnsonville.
Rule # 1: Don’t assume you know what ‘healthy’ is
HFG nutritionist Claire Turnbull, says: “Nutrition knowledge can vary a lot… I always check people’s knowledge and habits around fats. It’s not uncommon to find people using lots of olive oil and eating lots of nuts because they know they’re healthy foods, but they don’t realise they’re so high in kilojoules.
“Often people will say ‘I eat a really healthy diet; I can’t understand why I’m not losing weight’. It can be because they are eating too much of those healthy foods. I compare the kilojoules in one cup of vegetables versus one cup of other foods. We talk about kilojoules and satiety; about the foods that will fill them up without so many kilojoules.
“For anyone not already using it, I ask them to change to low-fat dairy. It’s such an easy way to cut fat and kilojoules. Often people are not having nearly as many vegetables as they need for good health. Half a plate of vegetables at night is non-negotiable.”
Dietitian Nicky McCarthy says: “Many people don’t know how much sugar there is in drinks, even things like flavoured water. Even changing from a trim latté to a mocha adds lots of kilojoules from the choc powder. And some people can do well with their food and then undo it because they don’t realise the kilojoules in alcohol.”
Rule # 2: Don’t eat too little
We tend to think weight-loss is about restriction, whereas in many cases we actually need to start by eating more. Nicky McCarthy says: “People will think they are doing really well if they can eat small amounts at breakfast and lunch, but they get too hungry so it all falls apart at the end of the day. They end up blowing it, and think they will have to start again tomorrow. It’s important to spread your food intake out over the day. Your body needs a regular supply of fuel so don’t let yourself get too hungry.”
Dietitian Fiona Boyle agrees, and says the make-up of meals is important, too: “I encourage people to eat some carbs and protein foods at each meal so they are getting ‘staying power’ in the food they eat. I find that people who miss out on carbs are looking for something sweet in the evening; and people who don’t have protein during the day tend to find the wheels fall off in the afternoon.
“I always talk about fluids, too. Sometimes we get the message ‘I need something’ so we reach for food, when all the body needed was some water.”
Rule # 3: Be portion smart
“If you’re eating the right things, then it could be about how much you’re eating”, says dietitian Amanda Johnson. “We are exposed to huge portions all around us, which can give us a false idea of what’s normal, and stop us from tuning into our hunger.”
“Get an awareness of portions,” says Turnbull, who says this is another key to long-term weight- loss. “I ask people to start using measuring cups, tablespoons and teaspoons to help with this. They don’t have to do it forever but it helps develop that awareness of what they’re really eating.”
Boyle says: “Comparing your meat serves to the palm of your hand is a useful guide. We tend to serve the meat or carbohydrate portion first and then add the vegetables: try changing this around so the vegetables are served first – it’s easier to put a larger serve on when the plate is empty so this can help reduce meat and carbohydrate serves.
McCarthy agrees. “Try using smaller plates and cups. The only super-sized vessel should be your water glass. And compare the size of your hand to your partner’s hand and your children’s hands. These size differences should be reflected in the food you serve as well,” she says.
Rule # 4: Don’t stress if you plateau
“It’s very common to plateau”, says Johnson. “Things get hard. Life happens. We need strategies to get through the tough times. Sometimes we need to allow ourselves some slack. It may be that staying the same is OK for a while.”
McCarthy agrees. “Focus on other positive outcomes rather than just what the scales are telling you at that moment,” she says.
Boyle adds: “It’s important to reflect on your achievements so far; it’s easy to forget how much progress you’ve made. You may be feeling happier about your food choices, feeling better in your clothes, and have more energy.”
Rule # 5: Be mindful
“Some people feel they shouldn’t be allowed to enjoy food so they bolt it down without thinking,” says Boyle.
“Don’t eat while doing something else,” she says. “Give yourself permission to eat slowly and enjoy your food; don’t feel guilty about it. Always serve your food on a plate and take time to eat. When you are eating, focus on eating and enjoying your food. We need the mental satisfaction as well as physical satiety. Otherwise, it’s almost like the meal doesn’t count and it’s much easier to overeat.”
Rule # 6: Understand your food behaviour
If we don’t understand our own triggers and patterns of behaviour with food, it can make it difficult to change. Johnson says this is one of the reasons people regain weight once they’ve lost it.
“Many people lose weight and then put it on again because they haven’t changed their habits,” she says.” For some people it’s behavioural. Do they eat when they’re stressed or tired? If so, what strategies can we come up with to overcome that? For example activities other than eating or changing the availability of foods in the pantry.”
Turnbull says: “I talk to people a lot about the times they struggle: when was it hard to keep to healthy eating? We identify when and why they didn’t stick to it, and I help them come up with strategies to deal with those times. We need to be able to overcome those hurdles to make the long-term gains. For example, there can be a lot of social pressure around alcohol so plan strategies to cope: offer to be the sober driver; order water as you sit down at the restaurant; order a soda at the bar when you order an alcoholic drink. It’s about reducing your pace of drinking.”
Rule # 7: Don’t think of getting to ‘the end’
Making permanent, sustainable change is a constant theme with all of our experts.
“Getting healthy is not an end goal,” says Turnbull. “You don’t reach the goal and then you’re finished. Life isn’t like that. It’s about navigating the good times and the bad times. The goal is to know about food, make healthy choices and enjoy food.
“A ‘bad’ day is just part of the journey, nothing more than that. It’s about making healthy eating an interest: a part of who you are, your everyday life. It’s not something you want to switch on and then switch off again.
“Remember: it’s about what you do all the time, not about what you do sometimes.”
McCarthy agrees, and says: “Whatever you’re doing, make sure it works for you. The changes you make must fit into your life. That way they can be long-lasting.”
Boyle says: “It won’t happen overnight: focus on the long-term and be realistic. I had a client recently who came in and said, ‘I realise it could take three years to reach my goal weight’ and I thought, good on you. That’s being sensible.”
The Pleasure Principle – Appetite for Life
The six-week Appetite for Life programme, developed by Christchurch Public Health nutritionist (and HFG contributor) Bronwen King, has helped more than 2000 women around Canterbury. Bronwen King is a nutritionist at the Canterbury District Health Board in Christchurch.
HFG: What’s the focus of Appetite for Life?
BK: Weight-loss may be the draw card for participants but the focus is very much on health gain with weight-loss as a by-product of that. This is a very practical course about food and eating; our aim is to develop a love of good food. This is a surprise for many! We want to give them knowledge about what good food is and how good it tastes. At every session we spend half an hour tasting food.
HFG: What is involved?
BK: At our first session we talk about breakfast. We discuss what makes a healthy high-fibre breakfast and then we encourage our participants to eat a big breakfast – more than they might normally eat. We want them to eat until they are full (but not overfull) on healthy food. This can be psychologically very liberating, especially for people who expect to be hungry if they eat healthily.
HFG: What are some of the other topics you cover?
BK: We talk a lot about the eating process: why we eat, and the difference between hungry eating and non-hungry eating. Mindful eating is really important. We talk about how to adapt recipes to make them healthier. We show how to make healthy food that looks after their bodies.
We have a session on legumes. Participants absolutely love this session because it’s so different to what they expected. They are really excited when they know what to do with legumes and they realise legumes can be really tasty. We make lentil dhal and falafel patties and make things with cans of chilli beans and chickpeas. We make this ‘Bean Booster’… The recipe may sound hideous but it tastes great. The tasting sessions are what makes the course effective in terms of changing behaviours. People get excited about how good healthy food can taste.
HFG: And top weight-loss tips?
BK: Changing behaviours and getting healthier is a slow process. Give it time.
Getting active is not some miracle weight-loss solution, but it does help turn the body into one that’s better at burning fat. Physical activity can be hard. Perhaps reframe it as something with physical and mental benefits.
We encourage participants to read Healthy Food Guide to give them ongoing support. It’s very much in the same spirit of what we are teaching.