[Article updated on 19/09/2023]
As a private dietitian, trained by the G.R.O.S. (Reflection Group on Obesity and Overweight), I am sharing with you today an excerpt from a consultation that took place at the office. The patient (“P”) makes contact by telephone and says they are overweight, I (“T” for therapist) meet him/her for the first time.
Procedure of the meeting
– P: “Hello, I would like to lose around ten kilos. I have already tried to eat an apple a day, I did **** diets, I cut out sugar, fat, I ate steamed food, etc. Sometimes it works but usually after a while I gain all the weight back and then some. This time I want it to be durable and for that I bought a scale, I am ready to weigh everything, to be more strict, I will hold and not break, I will follow your advice to the letter, say me what to do.
– T: There is no doubt, you have an iron will and your motivation no longer needs to be proven. However, are you sure that the method is suitable? You yourself say that after a while, you return to your old habits and you are today at a weight higher than your starting point, without ever having stopped wanting to lose it…
– P: I agree but how to do it?
– T: What do you think stops you from losing weight in the long term?
– P: Sugar! I am addicted ! Impossible for me to do without it…
– T: What do you think then, of working first on the quantities of other foods, those which are not sweet. By eating them in smaller quantities, your weight will start to drop.
– P: Well it can’t work, it’s sugar that makes you gain weight !
– T: What do you think is more fattening: 100 calories of sugar or 100 calories of broccoli?
– P: It’s obvious, 100 calories of sugar will make me gain more weight. Sugar is stored and does not provide the same thing to the body as broccoli.
– T: Can you imagine that what makes you gain weight is exceeding the number of calories needed daily, regardless of the source of intake?
– P: It’s difficult, we’re not taught that.
– T: Has what you have learned so far allowed you to lose weight?
– P: No, I told you earlier, I gained weight…
– T: Is it possible for you then to try to see things differently?
– P: Yes, I can try.
– T: Do you agree that a kilo of feathers and a kilo of lead both weigh one kilo?
– P: I agree!
– T: So 100 calories of sugar and 100 calories of broccoli provide 100 calories to the body and have the same effect on weight?
– P: Yes…
– T: If my energy requirement is 2000 calories per day, when I eat 1000 calories per day of pastries, I lose weight, and when I eat 3000 calories of green beans, I gain weight…
– P: Seen like that….
– T: Very often, what prevents the patients I meet from losing weight is thinking that there are good and bad foods. They consume more of the so-called “good” foods than necessary and feel guilty when they eat the “bad” ones. This does not prevent them from no longer eating the “bad” ones, I would even say that once they have started, “damned for fucked up”, they eat more than they need.
– P: I recognize myself in what you say!
– T: If today you are overweight, it is because you have at times provided your body with more calories than it needed. We will then gradually readjust your intake in relation to your needs. This can start with reducing the portions of foods that are easier for you to part with. What do you think ?
– P: In this case, I will no longer eat vegetables and only biscuits. You can’t lose weight if you don’t eat a balanced diet, can you? In addition, I will have deficiencies…
– T: In your opinion, after months of breakfasts, lunches, and dinners made with sweets, pastries and chocolate biscuits, will you want a platter of sweets or a varied and diverse dish?
– P: I’m going to be disgusted with the sweets that I love so much. So, is that the secret? Disgust myself so I won’t be tempted anymore?
– T: Can we imagine instead allowing ourselves to eat it, taking pleasure in doing so, experiencing real satisfaction after tasting it, no longer being afraid of the consequences on weight, in order to naturally regulate the quantities, without restricting ourselves and systematically put yourself in a position of failure?
– P: You are talking to me about starting a reconciliation with sugar rather than continuing the struggle, is that right? Do you really think this will help me lose weight?
– T: I am convinced of it, and you?
– P: I still have to be able to stop at what I need!! But anyway, how do I know what my needs are? And how can I respect it?
– T: In your opinion, how can you know if you need to eat?
– P: My stomach, hunger!
– T: Absolutely!
– P: But it’s very hard to stop eating when you’re no longer hungry. I’m very greedy you know! Especially when around me, others are still eating or when I know there is cake left…
– T: Do you think that by forbidding yourself to eat each time, the problem will be solved?
– P: When I’m not in good spirits, it’s impossible. However, I know that you shouldn’t snack. It’s at these times that I crave sugar more.
– T: In these moments, does sugar make you feel better?
– P: At the time yes, but afterwards I feel guilty. I then promise myself not to do it again.
– T: And it works?
– P: No not really, it’s a vicious circle…
– T: Can you imagine then that the less these desires are satisfied, the more they will come back?
– P: Yes but still, satisfying them is dangerous…
– T: At the beginning yes, changing a habit is not that simple. That takes time. Is this your priority today?
– P: Yes, absolutely!
– T: Do you feel capable of it?
– P: Yes I think…”