Small changes, big difference

Today's New York Times had an eye-opening article on small changes in diet and exercise and obesity. The hallmark of some of the most recent anti-obesity initiatives seem to be small changes. How many times have you heard that if you cut just 100 calories a day, you can lose 10 pounds in one year? I don't have enough fingers and toes to count how many times--and perhaps even more annoyingly, it's flat-out wrong.

The secret to weight loss, we are told, is that you have to burn more calories than you consume. Which is technically true, it's just that the body's metabolism doesn't use the kind of straightforward arithmetic that we learned in elementary school and that you'll find in calorie counters and on pedometers everywhere. It's more like ultra-advanced calculus, where there are numerous factors that go into how many calories we consume and how many we use.

From today's article by Tara Parker-Pope:

A person’s weight remains stable as long as the number of calories consumed doesn’t exceed the amount of calories the body spends, both on exercise and to maintain basic body functions. As the balance between calories going in and calories going out changes, we gain or lose weight.

But bodies don’t gain or lose weight indefinitely. Eventually, a cascade of biological changes kicks in to help the body maintain a new weight. As the JAMA article explains, a person who eats an extra cookie a day will gain some weight, but over time, an increasing proportion of the cookie’s calories also goes to taking care of the extra body weight. Eventually, the body adjusts and stops gaining weight, even if the person continues to eat the cookie.

Similar factors come into play when we skip the extra cookie. We may lose a little weight at first, but soon the body adjusts to the new weight and requires fewer calories.

That's not to say that doing small things is useless--they can have profound impacts on our health even if our weight doesn't budge one bit.

Writes Parker-Pope:

“There is a much bigger picture than parsing out the cookie a day or the Coke a day,” said Dr. Jeffrey M. Friedman, head of Rockefeller University’s molecular genetics lab, which first identified leptin, a hormonal signal made by the body’s fat cells that regulates food intake and energy expenditure...“I’m not saying throw up your hands and forget about it,” Dr. Friedman said. “Instead of focusing on weight or appearance, focus on people’s health. There are things people can do to improve their health significantly that don’t require normalizing your weight.”

Which pretty much hits the nail on the head. Weight is not a behavior we can change at will. I'm all for kids playing outside more and watching TV less, for them to eat wholesome foods and a variety of treats and sweets. Maybe no one's weight will change as a result of this, and that's just fine.

I've found small changes to be some of the hardest--and therefore most worthwhile--changes I've made in my recovery. Small things, such as getting rid of "low-fat" foods and working to get to bed at a reasonable hour, haven't budged my weight but have had a noticeable impact on my recovery.

What small change have you made that's helped (or hindered) your recovery?

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Anonymous said...

I keep re-falling in love with this blog. This post is so true, the same flaw in basic maths has always irritated me, and yet I can't help but think it's still the answer.

Kim said...

Small changes are what it's all about, in my opinion. I feel like lots of people cling to this idea of a "grand moment of epiphany" in recovery, when an orange is traded in for a pile of pancakes and there is no turning back. For me, it's been so many small changes. Like you said, getting rid of all low fat, nonfat, diet, light foods was a big small step :) Skipping a day here and there of going for a walk. I doubt the 20 minute walk was affecting my weight much, but it was part of an obsessive mentality. Being consistent with snacks is a daily small step I take. These are always hardest for me. Three square meals? No big deal. Snacks? SO easy to "forget." There are lots of other small steps -- not getting on the scale, not doing specific body checks, going on medication, adding extra toppings to my oatmeal, not measuring things I used to measure (like cereal), not counting (this involves crossing one thing off the list at a time. I don't count protein grams or sugar or fat anymore. Still working on calories. Those numbers appear in my head sometimes). It's all about little steps.

More and more, I think about weight like height. It's a somewhat fixed thing. There are drastic measures we can take to change these things, but genes are pretty powerful things. We don't all obsess about being shorter or taller, and it's really just as absurd to obsess about being lighter or heavier. I get irritated with all that math about eating 100 calories less a day to lose 10 lbs. It's not that simple. The body is much more clever than that.

Flannery said...

For me, it was giving up diet soda. I was so addicted to it, and 'wasting' my calories on liquids was just too scary. But over Thanksgiving, I drank too much diet coke and really, really felt the effects it had on my body and my response to food, and suddenly I just couldn't do it anymore. Now, everytime ED starts in on the virtues of calorie-free drinks, I remind myself of how they really feel and pick the real one instead.

Amy said...

I don't have things that are reduced or rid of fat by means of extraction. It's just not worth it. (Exception: skim milk 'cause it's all I've ever drank, and the texture of whole/2% has squigged me out ever since I was little.) I've never been able to tolerate sugar-substitute foods (they give me terrific headaches), which I think has saved me a lot of grief.

Abby said...

I'm still working on this, obviously, but it's all about the little steps. The other day I left my tennis shoes at home, knowing that by not having them with me (and wearing boot), I wouldn't stop by the gym on my way home.

For me, it's a matter of not enabling myself. If I have only "safe" foods at home, that's what I will always choose. If I have a variety and really no other choice, I will branch out and be OK with that. If I have my shoes, I will walk to much, etc.

Every step is small, there is no great "enlightenment," but I have to trust that these small steps will help me move forward.

Cathy (UK) said...

Given that I had anorexia nervosa for nearly 30 yrs, I tried many recovery srategies... I was never sure whether it was best to just 'go cold turkey' - i.e. to make drastic changes to my lifestyle/behaviour, or to take 'baby steps'.

Eventually what worked was make drastic changes. I didn't have much choice in the matter because I was in heart failure and chronically fatigued. Exercise was impossible. So, I thought, 'Cathy, Just Do It'.

The problems came when I started to introduce physical activity back into my life again, and had the opportunity to eat what I wanted to eat. It is so difficult for me to eat or exercise flexibly. If I eat less than usual it's hard to eat more again. If I exercise in a setting such as a gym/leisure centre I 'have' to do more and more.

The main thing that drove my anorexia nervosa - and drives my behaviours in general is my rigid, self-made rules. If I break my rules, my anxiety levels escalate exponentially...

Kate said...

I wrote a post about this very thing yesterday! Baby steps! One of my most significant has been to stop reading magazines at the gym. Fitness or otherwise. They make me feel worse instead of better when I get off the elliptical!

Anonymous said...

I have just entered recovery (again) and I'm following intuitive eating. Our bodies are pretty great. They tell us what we need if we listen :)

Anonymous said...

I have to say, Tara Parker-Pope is someone whose blog I find more frequently annoying than informative. Once in a while she'll post something that makes sense, such as what you are quoting today - but that's probably just because of the study she recently read. If she reads a poorly done study that draws totally nonsensical conclusions, she'll be agreeing with THAT, and praising the work and seemingly advocate living by the conclusion.

However, I agree with everything YOU said and today, I even agree with what TPP is quoting or paraphrasing. And probably, today, agreeing with wholeheartedly.

Carrie Arnold said...

Thanks, everyone, for sharing!


I agree with you about TPP's Well blog. It's not on my list of must-reads, but this article was published in the regular NYT Health section (ie, hard copy) which I *do* read, so that's how I found it. I'm glad I did!

Anonymous said...

I think the original article is wrong for making small changes seem so insignificant. Making small changes are what lead to larger ones. Most people don't start off taking a huge leap into a new lifestyle, they take small steps to ease the process. I think small steps DO make a big difference, even if it is not visible right away.

My recovery process has been full of little steps that are inching me closer to my goal. Admitting that I relapsed, going back to therapy, eating more, saying "no" to the scale...all of these are steps I have taken towards my recovery. I may not have magically transformed into a healthier, ED-free person over night because of them, but I have already seen major differences in my life because of them.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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