It has been a little while since I last wrote. I apologize for this absence. Thanks to those that have encouraged me to keep writing. I plan to write much more over the next few months.
As you may or may not know I have a few weight loss programs at my practice. I love working with patients on diet and weight loss. I would also say that there seems to be few things more satisfying for patients than when they lose a lot of weight and start feeling great. It doesn't take long for patients to notice increased energy, vigor, and improved stamina. This process is soon accompanied by an increase in confidence and hope for the future. The long term transformations can be simply life altering.
I have been occasionally blown away by what dedicated patients are able to accomplish. I have had some patients who have been on multiple diabetes medications for years who have been able to get off all their medicines in periods as short as a month. Truly radical changes are possible. In my experience we often underestimate what is possible especially with sustained and consistent effort.
When I was heavier I used to suffer from sleep apnea, low energy, depression, lethargy, poor cognitive performance, decreased impulse control, joint pain, inability to take care of household tasks, and much more. I could go on and on. After losing weight these symptoms disappeared. Unfortunately, despite the great benefit I observed I slowly gained all the weight back and had to struggle to lose it all again. This story is not uncommon.
Interestingly, one of the reasons that obese people tend to struggle with weight may be in part related to a propensity to seek immediate gratification (at least in terms of food) at the expense of long term benefit. Why people do this can be for many reasons including emotional eating, responses to stress, accessibility, and many other reasons. To some degree it is also biological because our hunter-gatherer ancestors didn't have much reason to focus on the long-term effects of weight or diet as they were mostly concerned with eating as much as possible of the food they encountered as soon as possible. They also preferred foods that provided as much caloric density as possible such as foods high in sugar and fat. This explains to a large degree why our brains are hard wired to prefer foods like ice cream or pizza which are high in calories, fat, and sugar. Basically, when we eat these foods we are following the pattern of our ancient ancestors to take advantage of the availability of calorie dense foods.
The problem is that in modern society our biological preference to favor high calorie dense foods with high amounts of sugar and fat can now become detrimental to our health especially as we generally lack periods of scarcity and have an abundance of these foods available to us at all times. This contributes to obesity.
So how do we combat this natural and biological tendency?
The answer lies in part due to something called "time preferences."
In theory, our modern stable society-where we can expect to have a reasonably long life expectancy and some semblance of stability-should permit us to make decisions that favor our long term success or the success of our future selves.
However, most of us still prefer to do things that have short time preferences meaning that they provide more immediate rewards and consequently favor our present selves at expense of our future selves. This explains why illicit drugs and fast food are so prevalent as they favor this time preference. It also explains why people people eat pizza and ice cream so readily.
However, is this time preference really what will provide us with more meaning, satisfaction, personal pride, dignity, and the ability to love and serve others?
When most of think of the drug addict we can easily see how favoring the short term drug high is seriously detrimental. But when we overeat or indulge in any other unhealthy habitual behavior we are doing the same thing. It is just not as socially stigmatizing.
One of the greatest insights I have come across is how many of our ancient stories such as those contained in the Bible focus on the idea of sacrifice or time preference. One of the lessons of the stories of Cain and Abel and Abraham and Isaac is the idea of how the willingness to produce a correct and worthy sacrifice of the most prized immediate possessions will provide long term success, meaning, and prosperity. When you think about it this a truly astounding insight and not shared by any other animal species. Many of the bible stories reveal how much better our lives can become over the long term if we sacrifice short term gratification, pleasure, and evil. The ultimate example of this came in the form of Jesus who willingly sacrificed his life for the long term benefit of humanity.
This bring me to a technique that some researchers call "Episodic future thinking". This technique relies on our innate human ability to vividly imagine the future and has been shown in many studies to help people lose weight and make better food choices in the moment. This is a technique that I practice. At a basic level it means that prior to eating any food you take a few moments to imagine positive future events that you like to have happen. These events don't necessarily have to involve eating. They could involve imagining running on a beach or attending your children's wedding. Focusing on future potential positive events that you would like to have happen can help overcome the urge to satisfy short term urges and put you in a future favoring position.
I personally find it even more powerful to vividly imagine the worst possible results of making the wrong decision repeatedly and contrast that with outcome of making the right decision repeatedly. I tell patients to run away from their own nightmare scenario and toward their own ideal future. I do this practice immediately before I go to eat food. I generally can be fairly certain that I am making the right decision if I can be proud about that decision one hour, one day, one month, one year, and even ten years from now. Both the present and future have to be prioritized.
One other visualization strategy that I picked up in a podcast from health guru Ben Greenfield is to imagine that you are the protagonist in a movie and that the crowd in the theater is watching your behavior and rooting for your success. It can be useful to visualize how they will react to a potential good choice versus a bad choice. I have also found it useful to visualize taking advice from my future self who is the person that faces the ultimate consequence of my current actions.
I encourage you to try these techniques as much as possible when you are tempted to satisfy any unhealthy habit including eating behaviors. As I mentioned earlier I have many weight loss programs and would be happy to help you in your weight loss journey. Stayed tuned for future posts on weight loss and weight loss strategies.
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