Doomed If You Diet, Doomed If You Don’t
Episode one! 24-year-old co-host Juna Gjata says restrictive eating has made her miserable her entire adult life, but she’s sure if she stops she’ll "literally gain 20 pounds on gingerbread lattes and peppermint mochas."
Enter Dr. Eddie Phillips, founder of the Institute of Lifestyle Medicine and a seasoned doctor, who aims to help Juna get to a happier, healthier place with food.
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Dr. James Hill is Chairman of the Department of Nutrition and Director of the Nutrition Obesity Research Center at the University of Alabama at Birmingham. His research focuses on the causes, consequences and treatment of obesity. In this episode, Dr. Hill weighs in on whether or not diets are actually effective.
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Sal DiStefano is a personal trainer and fitness podcaster for the show Mind Pump. Instead of seeing physical appearance as a main goal of fitness, Mind Pump cultivates self love and promotes holistic health through quality information and education.
Bio | Mind Pump Podcast | Mind Pump Instagram | -
Speaker 1 [00:00:01]Ad . [15.8s]
Speaker 2 [00:00:20]Produced by the iLab at WBUR, Boston. [3.1s]
Juna: If you're listening to this podcast, chances are you've probably had the goal before of trying to lose weight or go on a diet.
Dieters [00:00:36]Gosh. [0.0s]
Dieters [00:00:36]Uh, yeah. [1.4s]
Dieters [00:00:39]Multiple years. Yes, multiple years. [1.6s]
Dieters [00:00:42]Yeah. [0.0s]
Dieters [00:00:43]Yes, I did one. [1.6s]
Juna: When I was growing up, everybody I knew was on a diet -- girls smaller than me, girls bigger than me. They were all like, "Oh my god, I'm getting so fat. Oh my God, please tell me my thighs don't look that bad." Even more importantly than that, though, all adult women in my life were also trying to lose weight. So when we go out to lunch, go out to coffee with teachers, with my family friends, it's like everybody was getting "a salad, please. Um, and I would like the dressing on the side." They were getting coffee. "Can I get a tall, skinny mocha with like no whip?" And eating rice cakes. And I was always like, how can people like rice cakes better than chips? But whatever. No one was losing weight. As soon as I got to college and I didn't have the vulturous eyes of my parents watching over me, I was free to do whatever I want, and what that meant to me was extremely restrictive dieting. So basically, I spent my freshman year eating all salads, no dressing, no croutons, you know, going to the gym like twice a day, just living the #RabbitLife 24/7. And for the first time in my life, I gained 15 pounds. Food, we need to talk. That's the name of this podcast from WBUR. I'm Juna Gjata.
Eddie: And I'm Dr. Eddie Phillips. In another WBUR podcast called The Magic Pill, we focus on moving exercise from a chore to a gift. From something that you have to do to something that you really look forward to doing. What if we did the same thing with food? What if we talk about food as something that you really enjoy, that you look forward to enjoying?
Juna: Eddie, that sounds like a bit of a foreign concept.
Eddie: Well, we're going to deal with a lot of different pieces of this, everything from the psychology of food to exactly what you need to eat and what a healthy weight might be. And in the end, we're going to look forward to moving into what you might call a weightless state.
Juna: Elevator pitch. Okay. My name is Juna. Me and my family came here from Albania when I was five. I didn't speak any English. I worked hard and graduated college last year.
Eddie: From?
[Graduation music plays]
Juna: From Harvard. Eddie, you're embarrassing. And my major was cognitive neuroscience and evolutionary psychology.
Eddie: Woah.
Juna: And my secondary was in music because I wanted to be a concert pianist.
Eddie: How did the concert piano work out?
Juna: I mean, I did get to play at Carnegie Hall.
[piano music plays]
Eddie: Wait, wait, wait. So I get to ask the age-old question. How do you get to Carnegie Hall?
Juna: With practice and a lot of it!
Eddie: So practice, practice, practice, so you made it.
Juna: I made it for like a hot second, but whatever. Even after all that time with scales and arpeggios Eddie, and all that memorizing of the dorsolateral prefrontal junction of the parietal blah, blah blah. To this day, the hardest thing I've ever had to do has been dealing with issues around food, body image, etcetera etcetera.
Eddie: And the self-image thing I think is critical. So how do you describe yourself, then?
Juna: I don't know. I always think I'm so overweight. And then when I talked to Hannah, my best friend, like, she's always like, "I don't think anyone's ever thought themselves, 'wow Juna is fat.'" But I've thought that to myself every day of my life, every time I see myself in the mirror. I want to be 20 percent body fat. But I think for a lot of people, that would be an extremely low body fat percentage.
Eddie: But that's what you're looking for.
Juna: That's what I want.
Eddie: So, what I'm hearing is that you've got a discipline muscle bigger than everyone else on the planet. You practiced enough to get to Carnegie Hall. You're smart enough to get through Harvard with a cognitive neuroscience, yada yada. And I have to add, if you don't mind that you did all of this with a serious visual impairment.
Juna: Yeah, I'm actually legally blind, which basically means everything is really, really, really blurry.
Eddie: Well, from what I can see, you overcame all of these challenges with flying colors. And yet, food is your nemesis.
Juna: It is the hardest thing I've ever had to do in my life.
Eddie: So intellect and discipline is maybe not the full answer here.
Juna: Clearly, it's not. Like I have still not figured it out.
Eddie: So Juna, I'm going to do my best to help you figure out -- if it's not discipline and it's not just knowing what to eat -- what is going to get you to a happier place with food.
Juna Okay, Eddie, I'm super glad about that because I mean, you do have some street cred. You are an assistant professor at Harvard Med, and you're the founder of the Institute of Lifestyle Medicine and you practice at the VA Boston. So, I mean, I guess you may have some knowledge about this stuff, right?
Eddie: Well, this is where I say that first off, I'm not an eating disorder specialist. So if you think that you have an eating disorder or someone that you know has one, maybe press stop right now and call your doctor. But Juna, most Americans are struggling with their weight. The Standard American Diet, which we call SAD, is leading to hundreds of thousands of premature deaths a year. I've heard these questions you're bringing up from thousands of patients over the years and all the people that we've trained all of their experiences, which are coming to the table with, is universal.
Juna: I mean, I can totally see that. Recently, I took a trip down to a department where I spent a considerable amount of time as an undergrad. Hello.
Kay [00:06:26]Hey Juna. [0.1s]
Juna Hi, Kay. And I just went through the building asking people some questions. So, among the people you know, how many would you say are on a diet?
Co-Workers [00:06:39]A serious diet? Maybe two. [0.0s]
Co-Workers [00:06:39]25, 30 percent of women. [1.3s]
Co-Workers [00:06:41]At least 75 percent. [1.0s]
Co-Workers [00:06:42]99 percent.[0.0s]
Juna: Yeah. I mean, doesn't it seem like there's a new diet literally every week? It's like, what's in vogue? Is it vegan? Is it keto, low carb, high carb, low fat, high fat, Atkinson. And, oh, is it Atkins? Oh my god. South Beach, North Beach, West Beach, Southeast Beach. Probably? Who knows?
Co-Workers [00:07:02]Gosh, there was one, what was it? That you had grapefruit in the morning and toast. [2.4s]
Co-Workers [00:07:05]I did a 30-day dietary reset. [2.4s]
Co-Workers [00:07:09]You would just eat one particular thing each day, like one day my friend and I were at a staff meeting, eating a huge chicken and we were grossing everybody out. And then we just ate lamb one day. [12.3s]
Juna Did it do anything?
Co-Workers [00:07:23]I don't remember. Probably not. [0.4s]
Co-Workers [00:07:26]If there were an actual miracle diet out, we would have heard about it by now. [3.6s]
Juna Yeah, I mean, that is kind of the point of all this. If there were a miracle diet, why do none of us know what it is? I thought I would ask Dr. James Hill. I don't know what his title is.
Dr. Hill: You want the new title?
Juna Sure.
Dr. Hill: Chairman of the Department of Nutrition and Director of the Nutrition Obesity Research Center at the University of Alabama at Birmingham.
Juna: OK. Dr. James Hill.
Dr. Hill: I see surveys that over half the population is trying to lose weight. I don't know that there are good data there, but my guess is there are rare middle-aged women that aren't concerned about weight.
Juna: But do we know what percentage of diets actually work?
Dr. Hill: Yeah, we actually published a paper a few years ago, and what we found is if you define success as maintaining at least a 10 percent weight loss, which we know improves health, about 20 percent of the people trying to diet were achieving that. I think we can conclude that a lot of people are successful to get the weight off, and very few people are successful at keeping that weight off over the long term.
Juna So if diets really don't work, why do people still go on them? Why are they so tempting?
Dr. Hill: A food restricted diet works extremely well to get the weight off. It works extremely poorly to keep the weight off. And I think we have decades of research showing that.
Juna: Diets work in the short term. They fail in the long term. OK, great. We can just tell everybody. And problem solved, right? Well, not so fast. It turns out that everybody I talked to knew the buzzword of “lifestyle change”. That's what everybody kept saying like, "Oh yeah, diets don't work. You have to make a lifestyle change.".
Co-Workers [00:09:19]Diets should be viewed as a lifestyle change. [2.8s]
Co-Workers [00:09:23]Ones who lose the weight, basically are changing their whole lifestyle. [2.4s]
Co-Workers [00:09:27]You know, like actual lifestyle change, like the people who have lost a significant amount of weight and then kept it off. [5.5s]
Juna: Wow, the media has done a fantastic job of drilling into our skulls the words "lifestyle change." Like what is lifestyle change, first of all? But like, second of all, why is it so hard to implement? Sounds to me like we could use a little help. I thought I would ask Eddie.
Eddie: Yes. Yes, Juna. OK, I'll give you the kind of a big answer first, and then maybe we'll make it real personal really quickly.
Juna: Ok, Sounds good.
Eddie: Most of the diseases that are out there are the result of lifestyle choices that we make. So what you eat and how much you eat and how active you are and whether you get sleep, whether you smoke. Those things are responsible for like 80 percent of the diseases, they are responsible for most of us dying prematurely. And it's also responsible for most of the money that could be saved because all of these diseases, like diabetes and high blood pressure and all this are largely preventable. Or you could treat them by changing your diet or your exercise or your sleep or not smoking. So what’s actually kind of cool is if you go to a survey of nurses and you ask them, I mean, they know you shouldn't smoke, you should not eat too much, you should sleep enough, you should get some exercise. What percent do you think actually do those behaviors?
Juna: Like 60 percent?
Eddie: How about like three or four percent? But I really appreciate your youthful optimism.
Juna: Oh no, that's not good. [laughs]
Eddie: We all have something to work on. So let's start there.
Juna Why is food such an issue? Because we all kind of know, like in general, yeah, probably should eat vegetables, blah blah blah. Lean meat, blah blah blah blah blah. What's the deal with food?
Eddie There's so many choices that I think we're trying to make sense of them. You go to the supermarket and there's what, thousands of things that you could buy and how do you decide which brand and what you're going to cook or not cook. So I'm overwhelmed, and I'm the one that's supposed to be giving advice.
Juna: Eddie, if you're overwhelmed, what is the hope for the rest of us, please?
Eddie Oh, there's plenty of hope. I think we just have to kind of figure out and maybe start at like a more basic level, OK, which is --.
Juna: I can do basic.
Eddie: OK, so, you know, rather than kind of focusing right on the action right away, like I’ve got to go on a diet and I’ve got to lose weight.
Juna: Mm-Hmm.
Eddie: I'll ask you the question that I'm asking my patients now. So when I first went to medical school, I only went there once, but when I went there, I learned to ask that question like, "what's the matter with you?" You know, "why are you here today?" Now I'm going to ask you this question, "what matters to you?"
Juna: Oh, wow. Honestly, what has mattered to me for the past five years has literally been being a size four. That was the driving factor of all the quote "lifestyle changes" I made.
Eddie: Is there anything that matters more to you or a little deeper than that?
Juna: Yes, I wanted to feel happy in my body, like in my life. I guess?
Eddie: Yes. And would you rather be happy or a size four? Or maybe both?
Juna: I'd probably be, you know, if I had to choose, I'd rather be both. But, I guess if I were happy, then I'd probably be OK either way.
Eddie: So happiness is good, you know, especially as people get older. Often they say, I really I just want my health if I have my health and I've got a thousand wishes. Of course, you know, I don't have my health. I got one wish. So what matters to you is… say it again.
Juna: Being happy and healthy.
Eddie: OK. And what does healthy mean to you?
Juna: It means it's like kind of effortless. Like, I want to feel good about what I'm eating, how I'm moving and going about my tasks like I don't have to fight my own body on things.
Eddie: So you want to be free?
Juna: Right.
Eddie: That's kind of cool.
Juna: I guess that is kind of cool. I never thought about it that way.
Eddie: What would you do to get there?
Juna: I mean, I've already done like the worst of all, which is Keto, so probably anything.
Eddie: What if the next thing you did was something that actually supported what you said?
Juna: I would totally do that.
Eddie: And what if that meant kind of enjoying your food?
Juna: Woah, stop right there. Enjoying food? What kind of crazy idea is that?
Eddie: I mean, what if we got past like the guilt that we're hearing about?
Juna: Dude, I would be down because let me tell you, I was starving.
Eddie: Did you enjoy starving?
Juna I'm not very fond of it, you know? But as they say, you're doomed if you diet, doomed if you don't. As in, you know, if I am not dieting, like, I'm literally going to gain 20 pounds on gingerbread lattes and like peppermint mochas. And if I do diet, then I'm just like watching everybody else drink their peppermint mochas and like, I want one, too. Hello!
Eddie: Juna, you just put a lot on the table.
Juna: I know, right? Maybe this is the perfect time for a brief message to our listeners.
Eddie: Kind of like a palate cleanser.
Juna: Exactly.
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Juna: OK, I'm back at the table. So, Eddie, could you just give me like a little taste of what a real lifestyle change would look like for people?
Eddie: I think the first thing, Juna, it's not just about bullying your way through, and it's not just about discipline. Because, well, our discipline just kind of runs out. But the people that actually know why they want to make a change, they're like a ship and they're just redirecting their course. You change your course by two degrees and through the months, through the years, you're going to be in a different place. In other words, like the changes that you're going to make are the ones that you're comfortable with sticking with for the rest of your life. And then maybe it's not a diet anymore. Maybe it's just the way you eat.
Juna: Wow. OK. See, that is a little bit mind-blowing, because let me tell you, there is no way that I could be eating the way I am on a diet for the rest of my life.
Eddie: That's why it's going to fail.
Juna Right? Here is one of my all-time favorite fitness podcasters, Sal DiStefano of the podcast Mind Pump.
[Mind Pump Intro Music plays] : With Your Hosts, Sal DiStefano.
Sal DiStefano: Juna, Yes. I don't know, I was about to ask you, how do I say your name?
Juna: I have never been so excited in my whole entire life. After freaking out for 2.5 hours that he agreed to an interview, I asked him, what separates your successful clients from your non-successful clients?
Sal DiStefano: Clients that come in that have the "I want to get in shape tomorrow" mentality and "I want the most strict diet. Just tell me what to eat. Tell me what to do." Those people never last. The people who come in who say, "My diet's not great, but I want to work on it, but I want to take my time. I want to learn." They're OK with the fact that the scale isn't moving yet. When I hear talk like that, I know I’m gonna be working with someone who understands that they're in it for the long haul. They're cool with it.
Juna: I mean, it really makes sense that it would take a long time, as Sal says, because lifestyle change, like a real substantial change for the rest of your life, is super difficult.
Sal DiStefano: Let's say you have the same boyfriend or girlfriend for 15 years, you know, change that. That's a very difficult thing to do. Maybe you like to sleep a particular way. Change that. And fundamentally, that's a difficult thing to do. How we eat is such an integral part of who we are, that to change that, fundamentally, it's going to be very difficult and it takes a lot of time and people don't understand that fully. If they really appreciated it, understood it that way, they would take a much slower approach.
Juna: Oh, see, I always have this mentality of like, I'm going to do this for 10 weeks. Like, I'm always like 10 weeks away, 10 weeks away.
Eddie: And you always will be.
Juna: The 10 weeks keep moving up.
Eddie: It's like when you're stuck in traffic and you're still 20 minutes away from where you want to be.
Juna: Oh, good grief. I'm done being 10 weeks away. It's no fun.
Eddie: But Juna, what if we took the next 10 weeks together to unpack all of these things you brought to the table?
Juna: That sounds like something that will probably take us at least 10 episodes, right, Eddie?
Eddie: That sounds just about right. So maybe this is kind of the last 10 week period that you're going to need. And, you know, maybe over the course of that, we'll have you sort of dig into actual nutrition. We're going to probably go back and talk about exercise.
Juna: Right, my favorite.
Eddie I got the right person here to talk about psychology.
Juna: Neuroscience.
Eddie: I think guilt’s going to pop its ugly head up in here.
Juna: I mean, it's only when I spend 99 percent of my time. OK, sounds like a great plan. And Eddie also like, I don't want to make things awkward, but --
Eddie: I can do awkward well.
Juna: OK. You're doing great. I was just going to say that it hasn't really escaped my notice that most of the people that I've played the tape of, like the the regular peeps out there have been women, whereas the experts I've been citing have been male. And that is something I definitely want to talk about with you.
Eddie: I don't have any easy answers on this, and I'm really looking forward to digging into it a little bit with you.
Juna: Well, I am looking forward to it and hopefully, I'll be able to have a peppermint mocha this season. Maybe.
Eddie: I think you're going to have one and you're going to enjoy it.
Juna: Wohoo.
Juna: We want to say thank you so much to our guests, James Hill and Sal DeStefano. And if you want to learn more about this podcast and the stuff we're talking about, go to our website, WBUR.org/foodtalk.
Eddie: In the next episode of Food, We Need to Talk we're taking a deep dive into the fallacy that some foods are good and some foods are bad.
Ep 2 Promo [00:19:32]We are completely obsessed over these labels that we're putting on food, but our body is just not confused at all. It will use whatever you put into it, which is, I think, a big disconnect. [9.2s]
Juna: We want to connect with you. So if you haven't already head on over to Apple Podcasts or wherever you get your podcasts and subscribe to Food, We Need to Talk. And if you like what you're hearing, please leave us a review.
Eddie: Food, We Need to Talk is a production of WBUR.
Juna: Our amazing editor and producer is George Hicks.
Eddie: Our executive producer is the inimitable Carrie Goldberg.
Juna: I'm Juna Gjata.
Eddie: And I'm Dr. Eddie Phillips. See you next time.
Juna: Eddie, you know I don't see that well.
