In this season of New Year's resolutions, Amy Tuttle wants you to reconsider traditional dieting.
"Dieting is inherently difficult," said Tuttle, a nutrition therapist in Chestnut Hill who helps clients assess their relationship with their bodies, food, and dieting.
"It's externally guided rather than internally. It doesn't let you listen to your body or your food preferences, but sets up rules and asks you to be obedient. That's a setup – and it's human nature to rebel."
A meta-analysis by the Journal of the American Medical Association supports this vision, showing that while patients managed to lose weight on diets, victory can be short-lived. Over six months, the most successful diet, the Atkins diet, resulted in the highest weight loss (22.3 pounds), but after one year, participants had regained eight of the pounds that they had lost.
"Whether it's your first or 15th year of dieting, there you are, further away from being able to trust your body or yourself," said Tuttle.
According to Marketdata Enterprises Inc., an independent market research publisher, the number of active dieters fell 10 percent since 2015 to 97 million in 2017, due to a "growing size acceptance movement and dieter fatigue." The latest Centers for Disease Control and Prevention statistics show that the nation is getting fatter, not thinner, yet the dieting industry continues to grow, reaching $66.3 billion in 2016.
If you're above your natural healthy weight, first you have to figure out why, Tuttle says. Reasons could include mindless eating, mindless not eating (when you get too busy to eat and come home starving), mindful not eating (dieting), or emotional eating. To help clients understand where they are, Tuttle employs mindfulness training, asking questions to help them understand their eating patterns, and develop an honest assessment of what their healthy weight might be.
Participants are then counseled to find their way back to this natural weight – which may not match the recommended weight charts – by eating like a baby.
"Babies eat until they're comfortably full, then they turn away from the spoon," she says. "They eat foods that their bodies like and that they like."
Which doesn't mean nourishment goes out the window.
"If we feed babies and kids a variety of foods – good, bad, healthy or unhealthy – they choose foods that give them a healthy intake. Only when we get older do we move to 'all or nothing' thinking," she says. "As a mindfulness teacher I support people to find a middle way, asking them to ask themselves, what do I like and need, and how much will be enough?"
Tuttle advises that people feed their bodies several times a day with foods that combine carbohydrates, protein and fat. That includes classic dieting no-no's like pizza and trail mix. The trick is to eat when you're hungry and stop when you're full, which can be difficult and scary for those used to deprivation eating.
"I don't want people to eat wimpy food, low-calorie or low-fat foods," she says. "Real foods have enough carbs or fat so you won't get so hungry sooner."
Emily Rubin, the main dietitian at Jefferson's Celiac Center, Fatty Liver Center, and Weight Management Center, finds that such lifestyle modifications are the best approach to weight loss.
"Mindful eating is definitely healthier and can lead to better long-term results," said Rubin. "By eating when you're hungry you aren't always thinking of your next meal."
But Kelly Allison, director of the Penn Center for Weight and Eating Disorders, cautions that there's no weight-loss magic in mindfulness.
"It's appealing to think a mindfulness approach could help us with long-term weight management, but it depends on what your goal is – if you want to maintain weight, it helps you slow things down and be more in touch when you're full. But there are no good long-term studies that show that mindfulness can help you lose weight and keep it off long term better than caloric restriction can."
For Janice Platt, 62, formerly of Cherry Hill, the mindfulness approach to weight loss was difficult, but welcomed. As a binge eater who had once gained 90 pounds, she realized that she was using food to blunt her emotions.
"I learned a long time ago that diets weren't going to do it for me," she said. Having been on diets since she was a teenager, she knew that no matter what the plan, "it worked for awhile and then it didn't."
Working with Tuttle and a support group, Platt said, she learned how to eat, how to enjoy foods, and how to pay attention to what she is chewing and tasting.
"I'm still in the process of learning," said Platt. "Food is still an issue; there are lots of emotions involved, particularly with comfort foods. But if I want to eat cookies or cake, I don't have the self-hatred. I feel like I can eat like a normal person now."
Tuttle guides her patients to think about their internal sense of their weight and emotional issues by asking themselves questions such as these: