Have you ever heard the term “Harm Reduction?” It is a concept that encourages better health habits without total abstinence. For example, if you are a mental health worker and one of your clients drinks a six-pack every night, encouraging her to drink one or two beers would be harm reduction. We’re not looking for perfection in harm reduction, just for some improvement.

Can we apply the harm reduction concept to health habits? Certainly! Every extra step, every vegetable consumed, and every cookie avoided has positive health consequences. Moreover, harm reduction is in line with the Stop Losing and Win principle of just doing your best each day and not beating yourself up when you stray from your plan.

We are making the assumption that you have a plan for eating and physical activity, and if you don’t, we encourage you to set some flexible goals. Set easy ones to start such as “I will take 2000 steps today” or “I’ll eat fruits and vegetables three times today.” And as we’ve said before, be gentle to yourself, using harm reduction rather than strict rules as your guide. The human mind resists rules, so roll with harm reduction!

As we get closer to our publication date, Karen is reviewing some of the most significant texts that we read over the past few years. In Stop Losing and Win, we discuss Intuitive Eating, a concept (and excellent book) by Tribole and Resch, both registered dieticians. The authors teach their readers how to tune into body sensations of hunger and fullness, recommending that they do not restrict food or diet, but that they reach detente with food by learning to eat more naturally.

We love Intuitive Eating and have learned a great deal from the book. However, our plan includes both tuning into the body AND controlling the environment, something that Tribole and Resch would not necessarily recommend.

Food shopping, preparation, and storage are rather mundane daily tasks that most of us give little conscious attention to, but a little extra care in executing these tasks can really pay off when it comes to weight management. Here are a few things I do to make it so much easier to get the nutrients I need (but not more than I need):

1.       I grocery shop around the periphery of the store, concentrating on fresh foods that are bursting with good nutrition. As I shop, I consider snacks as well as main meals.

2.       I make sure my fridge and pantry contain foods I can grab and go such as prepared fruits and vegetables, cheese sticks, hummus, olives, and leftovers. I can always find something nutritious and delicious whenever I need to eat.

When I am surrounded by excellent choices, my task of eating a high-quality diet is made much more straightforward. As I assess my current situation, I see that I can do two important things. One is to listen to my body. The other is to control my environment. Environmental controls are key to managing not just my weight over time, but my health as well.

My physical therapist was here this week and she mentioned that she had gained 10 pounds during the COVID-19 crisis. I did a quick calculation: “Goodness! I gained 20!” I’m not sure why I was so surprised–I know exactly how I did it. I have always been an emotional eater, and I am perennially happy and at home in the kitchen. That turned out to be a toxic combination when trying to maintain my weight during a pandemic. I dedicated lots of extra hours to cooking and baking and expended my nervous energy through nibbling. Gaining 20 pounds was easy.

In any planning process, it’s good to assess where you are at the beginning of the plan. I can easily identify several strong assets.

·       I have the habit of getting regular exercise in the form of walking and strength training.

·       My eating habits are surprisingly good: Now that I’m not scared to death, I eat moderate amounts.

·       My love of the kitchen has become a real advantage as I whip up nutritious meals that are heavy on produce and light in fat and carbs.

·       I can say “no” to sweets and goodies. I have them on occasion so that I never feel deprived.

·       I get on the scale and record my weight each week. And I write the number down, no matter what it says.

In Stop Losing and Win (which we hope to publish this summer), Karen and I provide just one chapter on dieting. Through research and experience, we learned that dieting is a pernicious process that has severe consequences for the mind and body. We recommend to our readers that they diet for no more than six months, going back to maintenance in order to fully recover from diet deprivation. I will consider our own advice in my planning. I have not even decided whether to diet again or not, knowing how fraught that process can be. Check-in with me next week when we will grapple with the big question: “To diet or not to diet?

Having major surgery has put much of my life out of control. I can’t move the way I always have. Pain is intrusive. Time doesn’t even behave itself, foreshortening and stretching out in strange ways. In situations like this, I find that I need a plan for self-care more than ever. This plan doesn’t have to be a big, formal production, but rather a set of intentions that promote health and get me through a sometimes-difficult time. Healthy habits such as drinking plenty of fluids; eating nutrient-dense, calorie-light foods; reinforcing emotions such as gratitude and self-love; sleeping well; and moving my body for the joy of it all fall into this broad category that I’m calling “self-care.”

Today my plan contains several short walks, some tasty and nutritious meals, a series of exercises, and recovery from the activity in the form of icing, elevating, and massaging the surgical leg. My plan also includes visits with friends and neighbors, reading and writing, calls, emails, and texts with people I love, and distractions provided by puzzles, television, books, and magazines. And resting. These baby steps are all that fit in my post-op world right now. As I get better, the scope of my world will expand and my self-care activities will get bigger with them.

I set my self-care intentions as little goals I can achieve throughout the day. The stakes are low: I’m only accountable to myself, and anyone who knows me also knows that I am a notoriously lenient boss. Nonetheless, having small goals lends structure to my recovery, reminding me that, even when some aspects of my life are out of my control, ultimately, I am the author.

Both regular exercise and eating right feel really good. What is it, then, that has me dragging my feet when it comes time for the daily walk or exercise class? What attracts me to junky food, like a moth to the flame? What, pray tell, is that lethargy, thick as maple syrup, that sticks me to my bed in the morning when I really need to get up and work my legs?

I wish I had the answers—if I did I’d be rich! Instead, all I can humanly do at this point in my life is to examine the role inertia has played in my health-related activities. I have noticed that both eating outside my “plan” and hanging out when I should be moving my body will trigger the response that I don’t want: more of those behaviors. Conversely, eating well and moving often encourage more of those behaviors. However, the energy that gathers around the “bad” health behaviors gains momentum and power much more quickly than the impulse to be healthy. Although I can’t explain it adequately, it is this asymmetry that should be cause for concern.

As you know, we are building a book that should be a good resource for people who, like us, want to stay fit all of our lives. One thing we have noticed is that people tend to “fall off the wagon” after losing pounds, returning to their original weight, often in record time. This eventuality is stated as a given in most of our resources. Could bone-deep inertia be the cause? If so, what can we do about it?

Understanding and guarding against the gradual (and not inevitable) slide back into bad habits is a great start. For me, just recognizing my impulse to nibble mindlessly or sit endlessly prompts me to check those behaviors. Good habits need to be constantly reinforced. Even five years into my journey, I find that inertia can stick me to almost any surface!

It is strange and new to have the scale telling me I have gained weight—and still feel good about myself. As a matter of fact, I am not absolutely sure why I feel so good in my skin. But one reason, I’m guessing, has been a real commitment to fitness that was spurred by my knee replacement surgery. My body is probably thanking me for the long walks and the strength training.

Like most people, I generally feel bad about myself when weight is in an upward trajectory. However, this week I just can’t muster the self-loathing required to be a regular woman in America in 2023. Karen and I have been talking about the phenomenon of feeling good about ourselves when society doesn’t concur. It’s a radical act, one that we definitely DO recommend.

I am guessing that weight gain can have a wide variety of social meanings, one of them being that I don’t give a **** about what is expected of me. Oh, ho! Dig down a little and you’ll see how untrue that statement is. I really do care, but not enough to put myself through something as draconian as a diet.

In a couple of weeks, I’m scheduled for knee replacement #2. Recovery from that will require my full attention for a few months, so no dieting yet. Coming into this second surgery strong is probably the best favor I could have done for myself. And I will keep the exercise going, especially now that I can lunge, squat, step up stairs, and get up off the floor with the best of them. Just wait to see what I can do with two fully functional knees!

This is the time of year when hundreds of millions of people resolve to live better in the coming year. At
the top of the list is losing the Christmas cookie weight plus a few additional pounds. Fitness is another
oft-made goal, as you swear to Gods of the New Year that you will work out at the gym and take up
running. We have a different, easier resolution for you this year: Eat more fruits and vegetables.
I re-read the blogs we posted over the year and found a thread that I just need to tug at one more time:
Eating plants does you a world of good. When you eat fruits and veggies, the capacity of plants to grow
and heal and reproduce is transferred to you through their phytochemicals. We don’t think the TV dried-
up fruits and vegetables in capsules necessarily maintain this magic. So, resolve to eat the real thing.
Fruit is easy—it’s the original “fast food.” But veggies are best when prepared well. Our gift to you this
season is our recipe for roast veggies.
Set your oven to 375 degrees. Cut your favorite veggies into bit-sized chunks (zucchini, summer
squash, peppers, eggplants, carrots, green beans, Brussels sprouts, etc.). Put them on a baking
sheet, spray with a little olive or avocado oil, sprinkle with salt or your favorite seasoning. Bake
for 15-40 minutes, giving them a spin after 10 minutes, and testing them with a fork. Carrots
naturally will take longer—the tender guys like zukes will be done quick.
Roasting brings out the natural sweetness in vegetables. Even if you never really enjoyed eating them
before, we think you’ll keep coming back all year long to these roasty little nuggets. Happy New Year!

Believe you me, I know the feelings that bubble up when the scale is not cooperating! It’s as if all of your
goodness, your many achievements, and your value as a human being simply disappear the moment
that dreaded number shows up. However, it’s important to note that this is but an illusion. You are fully
intact: intelligent, successful, compassionate, and powerful. The scale doesn’t get to tell you otherwise.
I like to think of weight management as an intellectual rather than an emotional endeavor. This is a
problem that is solved though thinking and planning. For example, I have plans for maintenance such as
grocery shopping regularly, fixing foods that are light in fat, sugar, and calories, getting plenty of
exercise, and listening to my body’s signals of hunger, thirst, and satiety. I have a plan for dieting when I
feel I need to, doing all of my maintenance tasks plus cutting back on daily calories and tracking exercise
and activity. All of these weight management tasks can be done with a calm mental attitude and without
angst and misery.
We all know that society treats our body weight as a moral issue: We should weigh such-and-such and
should immediately address any pounds that others might find to be excessive. I contend that it’s this
moral stance that, paradoxically, triggers overeating. Afterall, what is the most natural reaction in the
world to stress? And didn’t we all learn to self-soothe at our mother’s breast (real or metaphorical)?
May I suggest that you begin to think about managing your weight as a game of skill? In this game, your
strategies are going to determine your outcomes. Do you have the right foods on hand? Are you getting
plenty of exercise? Are you tuning in to how your body feels as you eat? Sticking with the skills and
strategies while avoiding the hysteria will keep your goal of managing your weight in the mental rather
than the emotional realm. In other words, manage your weight without going on a head trip.

It’s strange. I feel exposed and vulnerable since I put on 15 pounds. Here I am, a weight maintenance guru, failing to follow her most basic guidelines. Nonetheless, I have done it, and now I’m doing that thing we say never to do unless it’s a real emergency: dieting. I started a week ago when I scared myself by hopping on the scale. Yikes! Double yikes! Several days in a row.

As you know, I had a knee replacement in September. The weight management went on the back burner as I focused on physical therapy, walking, pain management, and, well, living in an altered body. I allowed myself seconds and homemade cookies during my recovery. Eating without a plan was fun but was not without consequences.

One thing we talk about in our book, Stop Losing and Win (which will probably be out in the summer), is how flimsy willpower is. For that reason, I was glad to have a plan and an alternate set of habits that allows me to eat a highly nutritious diet and leave off the junk. WW rewards you for eating lots of fruits, veggies, and lean proteins by making them zero-point foods. I’m not eating everything anymore, but my choices are delicious. Speaking of habits, using the WW tracker gives me instant feedback and assures that I will continue to lose weight as long as I use it. It’s good to have a plan.

All that PT and walking? They have paid off. I now have the strongest legs I have had since I was a teenager (and didn’t have to work at it). The new knee is remarkable and, after over 10 years of incapacitation, I’m amazed at what it can do. I’ll have the second knee replaced in January, but this time, I won’t go way off my plan, wandering in the wilderness months. Let’s just see if I can pat my head and rub my tummy at the same time.

In a nutshell, no, it is not. According to registered dietician Ashley Jordan Ferira (2022), there are several metrics that are more meaningful when it comes to your overall health such as blood sugar, blood lipids, and inflammation levels. Even waist circumference and blood pressure are better measures of health than BMI which fails to calculate many factors such as your racial background and body composition. Don’t let that one little number, your BMI, do a number on your self-esteem.

That leads us to the crux of this blog: Whereas you care about your health and fitness level, you can’t let society’s standards-du-jour (as illustrated by hundreds of “influencers”) dictate how you feel about yourself. If you are like most people, you will carry a little more adipose tissue at some stages of life and a little more muscle at others. The BMI doesn’t distinguish between the two, even though your metabolic health might be dramatically different when you are leaner or fatter.

And, yes, we recognize the fact that a number like the BMI can have an inordinate amount of power over you, evoking guilt, shame, self-loathing, and a panoply of other negative emotions. For now, just let the BMI go. Focus on the ways you can contribute to your own good health, eating lean proteins, fruits, and vegetables, and getting regular physical activity. Moving and eating well are two favors you can do yourself at every phase of life, that and good mental health. When you feel good, you look good!