What’s Really Causing the Obesity Crisis?

There has been much discussion of a new law passed in 2010 requiring restaurants with 20 or more locations to inform consumers of calorie counts for menu items. A study by the Stanford Graduate School of Business examined behavior before and after calorie counts were posted, and found that Starbucks customers ordered food with an average 6 percent fewer calories as a result of posted calories. This led some to speculate that “This country’s obesity epidemic can be explained by a mere 100 extra calories a day for each person,” or about the equivalent of one small cookie. This is not a new speculation and it’s a oft-touted message that 100 extra calories a day equals 10 pounds a year gained.

Other articles have come out disputing this assessment, noting that obesity is a multifactorial disease, and cannot merely be explained by an extra 100 calories per day. We agree that obesity (and weight gain in general) is more complex than simply consuming an extra cookie a day, in large part because we have found that 100 extra calories doesn’t stay at 100 extra calories for long – it accelerates.  Once dieters start doing something they know they shouldn’t (like having an extra cookie after dinner), it turns into more and more giving-in over time.

We work hard with our dieters to overcome thoughts like, “It’s okay to give in just this one time,” or “Just this one time won’t matter.” We teach dieters that every time, and every decision matters because it all has consequences for the next time. If you’re familiar with our work, you know that we say that every person has two psychological muscles: the giving-in muscle and the resistance muscle. The giving-in muscle is the muscle that allows dieters to give in and make eating/drinking decisions that run contrary to their weight loss goals. The resistance muscle is the muscle that enable dieters to resist doing something they know they shouldn’t, and to make decisions that support their weight loss goals.

Recently, I was working with a dieter on the skill of eating everything sitting down. She told me that she did well with the skill except she continued to eat fruit standing up because, “It didn’t have that many calories.” I reminded her that the skill was to eat everything sitting down, not everything with more than 20 calories, or everything bigger than a quarter. When she ate standing up, whether it was a blueberry or a brownie, she was reinforcing the idea, “I don’t have to do what I said I would do if I don’t feel like it.” By eating standing up, no matter what the food was, she was exercising her giving-in muscle. And the problem is that it’s not one giving-in muscle that allows her to eat standing up, and one that allows her to skip reading her response cards, and one that allows her to eat extra at dinner, and one that allows her to throw her dessert plan out the window. They are all connected, and once she starts giving in in one area, she makes it far more likely she’ll start giving in in other areas, too. By the same token, she makes it harder to resist giving in because she’s weakened her resistance muscle.

Another dieter I worked with made a plan to have two glasses of wine at a party. She ended up having three, and said to me, “But that was at least better than the four or five I could have had.” In some ways she was right; in terms of calories consumed and possible hangover effects, three glasses of wine are better than more. But in terms of the psychological effect, three was similar to four or five because she was still sending herself the message, “It’s okay not to stick to my plan.” This means that the next time she’s tempted to not stick to her food and drink plan, it will be harder for her to overcome the temptation because she strengthened her giving-in muscle.

A third dieter was recently on vacation and ended up not eating what she had planned for breakfast because another option looked better in that moment. She had the thought, “Just this one time won’t matter.” I asked her how the rest of the day went and she acknowledged that she got off track at lunch and dinner.  This was a great reminder that one time is never just one time! Giving in begets giving in, and once dieters start giving in, that’s the mode they tend to continue in. By the same token, resisting and making on-track decisions makes it easier and more likely that they’ll continue to stay on track.

So whether or not it’s an extra 100 calories a day, if dieters start buying into thoughts like, “Just this one time” or “Once won’t matter” or “Just this little bit” or “It could have been so much more,” pretty soon it will be much more than 100 extra calories.

Upcoming Workshop

CBT for Weight Loss and Maintenance

October 22-23, 2018