Never and Can’t

“I can’t have pasta anymore?”   

“You aren’t going to let me have soda any more?”  

I hear questions like this every day. 

I hate them for two reasons:   

First, as an Obesity Medicine doctor, I don’t make absolute rules about what my patients can and cannot have when they leave my office.  My job is to give sound medical advice.  I explain to my patients what changes will help them lose weight. However, I don’t put myself in a controlling parent role and I hope my patients don’t see me as that kind of figure in their life.  In reality, all of us grownups can pretty much eat whatever we want. We have that right.  We typically have to accept the consequences of those decisions (good or bad), but we can eat whatever we want.

Rather than a strict parent, I think of myself kind of like Yoda; a teacher – helper – a guide – someone that gives wisdom and advice without doling out punishment or consequences.  The teacher’s job is to provide the information and the student’s job is to take that information and process it, study it, and apply it.  I can (and do) say things like, “drinking soda is not going to help you lose weight and/or get healthier” but it’s not my place to say, “you can’t have soda anymore”.  

The second reason I hate these types of questions is that they assume that we can classify foods as either good or bad.  If you are a patient in my office, you have likely heard me say, “if it’s a carb and it’s white, it’s not right”.  I think it’s a pretty decent statement – I don’t think simple white carbohydrates have much of a role during weight loss, but I don’t refer to them as “bad”.  

If you have followed my writing over the years, you probably know that I have a big weakness for donuts.  I don’t eat them often – although my mouth and the reward center in my brain both love those things, my body and my gut feel differently about them!  I don’t consider them “good” or “bad” – they are just donuts.  They certainly aren’t going to help during active weight loss and they can’t play a huge role in my life now that I’m successfully keeping the weight off, but they aren’t terrible evil things that are out to destroy me.  When I occasionally have one or two, I don’t beat myself up for having them nor do I fall into a spiral of negative thinking for doing something “wrong.”  

We often refer to foods as “not right” during active weight loss.  This doesn’t mean that our patients can NEVER have them.  Rather, it means that they will not be helpful RIGHT NOW.  

These are two radically different time periods.  

Never is extreme.  Never typically results in a feeling of deprivation and obsession about the food.  Never means that you will spend a lot of time thinking about how much worse your life is now that something you like has been taken away.  

Not right now means you are willing to place something aside in pursuit of something more important.  Not right now means that you understand that the treatment of a problem typically involves change.  We talk about this all the time in the office – that treating a problem is different than preventing it.  If you have metabolic diseases (including excess weight) – almost all of which are caused by what we eat – those same foods are not going to be a big part of the treatment of the diseases. The time to indulge in them is NOT RIGHT NOW. 

Keep trying – keep learning – keep growing

this is hard stuff!

Courtney Younglove, M.D.