Eating in the Slow Lane

A year ago Dixie Evatt would have described herself as a classic lifetime dieter—and not a very good one at that. Speaking in a soft drawl that betrays her Texas roots, Evatt says she tried everything under the sun. “I had gone away to spas, spent two or three weeks in intensive sessions, and done liquid protein, Weight Watchers, and Atkins. You name it, I tried it,” she says. “I was often a successful dieter—but only for a while. Within a year or two the weight always came back.”

Evatt, a recently retired writing teacher at Syracuse University, says she’d usually top out at about 230 pounds on her five-feet-five-inch frame. “Then I’d panic and try another diet. The one thing about me,” Evatt says with a soft chuckle, “is that I never give up.” When she reached her mid-fifties and began having a harder time getting around, her doctors suggested something she’d never heard of before: mindful eating. “It sounded interesting,” says Evatt. “I’d never tried anything that tapped into my mind.”

So off she went to take a series of classes at the State University of New York’s (SUNY) medical center in Syracuse. The experience was unlike any of her other attempts. “I was used to weight-loss programs where you run out and sweat or measure your food on a little scale, and there are all these rules,” she says. But in this class, everyone was simply encouraged to sit quietly and then to eat one thing—a sliver of crunchy celery, for instance—with complete and rapt attention.

“At first I thought, surely there’s more to it than this,” says Evatt with a laugh. “But here was a program where you got really quiet and turned inward—and that turned out to be enough.” She went home with some meditation tapes, instructions to practice eating at least one meal slowly and consciously, and a renewed sense of hope.

She got a chance to test her newfound approach when she visited a local restaurant shortly thereafter, and ordered her favorite dish, blackened snapper with rice. But this time, instead of pulling out her book and burying herself in it while she ate, she concentrated on the meal. “I was smelling, tasting, enjoying that fish, and I ate only half and was fully satisfied,” she says. “It was a powerful moment because I realized that this technique could work for me.”

And so she kept at it, going to class, meditating, and eating mindfully for at least one meal a day. When Evatt stepped onto her scale nine months later, she found she’d lost 21 pounds. “In the other weight management programs I’d experienced, the programs were always controlling me: ‘This is how you exercise,’ ‘These are the no-no foods,’” says Evatt. “This strategy put me in charge.”

The program Dixie Evatt attended was founded at SUNY by physician Lisa Kaufmann after she began to despair of finding any conventional methods that could help her patients lose weight. Like many practitioners, she had seen too many patients try the standard dieting approaches, do okay for a while, and then gain back all the weight they’d lost.

“For most people,” says Kaufmann, “the underlying emotional and behavioral issues are not addressed by conventional diets. So eventually they start eating again and regain everything, plus another five or ten pounds.”

Kaufmann got the idea for her program several years ago when she was attending a meditation retreat and noticed that no one in the room was overweight. “I realized that as people gain awareness, they are less likely to have compulsive habits,” she says. It made her wonder whether people who wanted to lose weight would be more successful if they simply learned how to pay close attention to what they were eating.

In creating her four-year-old program, Kaufmann drew on the Buddhist techniques that inspired it, which aim to cultivate a be-here-now attentiveness to everything we do, including the act of eating. The program teaches becoming aware of many things that we do automatically—which clearly runs against the grain of current American dietary habits. Surrounded as we are by fast food, quick snacks, and accelerating time pressures, we as a nation are eating faster, eating more, and gaining weight at an unprecedented pace.

But the very thing that makes mindful eating so alien to so many Americans—that is, deliberately slowing the pace of eating—helps explain why it’s gaining adherents. “A big reason so many Americans are so fat is because we’ve lost touch with the ceremony of eating,” says Deborah Kesten, a nutritionist who teaches mindful eating and wrote The Healing Secrets of Food and Feeding the Body, Nourishing the Soul. Some of the growing number of other books that make mindful eating an element of weight loss include Eat More, Weigh Less, by cardiologist Dean Ornish, The Zen of Eating, Art of the Inner Meal, Eating Mindfully, and the aptly titled When You Eat at the Refrigerator, Pull Up a Chair.

Kesten has done a study comparing people who follow her program and concentrate on the pleasure of eating to those who multitask during meals. “We’ve found that people who eat mindfully—with gratitude and positive feelings—are more likely to be normal weight.” In Kaufmann’s class, students meet once a week for ten weeks. The lesson plan is pretty simple. “People can eat anything they want,” she says, “but they have to eat it with complete awareness. No television, no radio, no newspaper.” If you know you can eat all you want, she adds, you tend not to eat as much—there’s always tomorrow.

Mindful weight-loss programs like Kaufmann’s, which are based at a medical institution, are rare. Most are offered through independent therapists and private organizations. What links the various programs is an emphasis on helping people reconnect with the body’s natural ability to signal when we are hungry and when we are full—signals that have become scrambled in today’s fast food nation. “Studies show that if you draw out the meal, build in pauses, and allow your satiety signals to come into play, you will eat less,” says Judith S. Stern, vice president of the American Obesity Association, noting that it takes about 20 minutes for the mind to get the message that the stomach is full. “If you eat too fast, you outpace your body’s natural signaling system.”

Kaufmann likens the progress she sees in her patients to a healthy regression. “Participants learn to eat like toddlers,” she says. “Watch a toddler eating something new—he’ll look at it, hold it, smell it, and eat it. That’s what we tell our students to do.”

But it’s not just mindful eating Kaufmann teaches: She encourages students to slow down the rest of their lives, as well, to relieve some of the stress and tension that can contribute to overeating. “Many people with eating problems have a real problem with self-hatred and a sense of unworthiness,” says Kaufmann. So in her classes students also meditate or perform body scans, which means sitting very still and developing an awareness of every part of the body. The practice helps people realize that excess isn’t that rewarding. “Eating a whole bag of chips with complete attention isn’t much fun,” she says. “You reach the end and think, yuck.”

Although Kaufmann hasn’t done any studies on the success rate of her approach, she knows it’s worked well for a number of the 300 people who’ve taken her classes. “Many end up approaching a healthy weight by the end of the class,” she says. “People who practice eating mindfully get pretty good at it.”

Still, she admits, the take-it-slow approach isn’t for everyone. The factors contributing to weight gain are many and complicated, ranging from metabolic disorders to deeply ingrained eating disorders. Also, for some people, it just takes too long to get results. Others resist doing so altogether. “One woman told me she doesn’t want to slow down and feel her feelings,” says Kaufmann. “She actually wants to be numb.” The program can also be hard to stick with in a world where more and more people eat at their desks or in their cars or in front of the television.

To see whether you’re a good candidate for this strategy, says Stern, ask yourself the following questions: When you go out to eat, do you tend to finish before everyone else? Are you done before anyone else is even halfway through the meal? If so, mindful eating could be worth trying.

Dixie Evatt is the first to admit that slowing down takes practice. “This is a technique, not a magic bullet,” she says. “It’s up to me to make the change.” But she’s so happy with the results thus far that she’s decided to make it a lifelong practice.

In the end, Evatt says, she likes eating mindfully because there’s no sense of deprivation. “I find myself having little epiphanies along the way,” says Evatt. Before she began focusing attention on what she eats, for instance, green food all tasted pretty much the same. Now when she eats a mixed salad, she notices the subtle differences between the bitter, sweet, and fruity tastes of the leaves, and enjoys the variety.

Another recent insight makes her fairly confident she’ll keep off the weight for good. “I’ve learned that when you slow down and really taste fast food chicken,” she says, “you may realize you don’t actually like it!”

Ode to chocolate

What’s it like to eat mindfully? Consider this little exercise, inspired by workshops on building positive relationships with food.

Break off a small piece of chocolate, then sit down, take a few deep breaths, and look at it closely. Turn it over in your fingers and smell it. Then close your eyes and take a tiny bite—make it last as long as possible. Block out all the distractions around you and concentrate completely on the chocolate. Notice how it feels on your tongue, at the back of your mouth, how it tastes when you suck it. Enjoy it, savor it, until it’s completely gone. Then take another tiny bite and do the same thing. Pause every time you take a bite to think about the taste. Eaten this way, any food can go a long way, and you won’t have to eat as much of it.

Losing weight: what really works?

Countless experts have opinions about how best to lose weight. But the sad fact is that up to 90 percent of all diets fail. So we decided to talk to the experts who’ve studied the other 10 percent. The National Weight Control Registry has examined the habits of more than 4,000 people who have lost at least 30 pounds and kept them off for a year or longer. Physician Vincent Pera, director of the weight management program at Miriam Hospital-Brown University, works with registry researchers and describes the leading strategies for successful long-term weight loss.

• Get help setting a reasonable goal. Most people set themselves up to fail
by picking an unrealistically low goal weight. This generally ends one of two ways, says Pera: Either they don’t reach their goal, get discouraged, and give up, or they reach it but can’t sustain the extremely low-calorie diet it takes to keep them there. Pera advises working with a health practitioner to set a goal weight that’s both attainable and healthy. For instance, a good weight may be higher than what’s indicated on the insurance company charts, but enough of a loss to generate health improvements.

• Calculate calories. The standard recommendation is to lose weight at a rate of 1 to 2 pounds per week. To do this, you’ll need to burn 500 to 1,000 more calories more per day than you take in. To figure out approximately how many calories you spend, multiply your weight by 10. Then aim to create a calorie deficit. For instance, an inactive 250-pound person burns about 2,500 calories per day. To lose a pound a week, you will need to shave off 500 calories every day. You could limit your intake to 2,250 calories daily, for instance, and burn off another 250 calories with 30 minutes of brisk walking.

• Don’t skimp on exercise. “Our studies have shown that exercise is the most important variable to predicting long-term success in weight loss,” says Pera. You needn’t run a weekly marathon to reap its benefits. Thirty to 45 minutes of moderate-intensity exercise, five days a week, will do as much for your waistline as a higher-intensity regime. And keep in mind that there’s no need to do those 45 minutes straight; three 15-minute sessions are just as effective. For most people, moderate-intensity exercise, such as a brisk hike or a jog, should keep heart rates in the desired 100-to-130 beats per minute range.

• Drink plenty of water. Pera has noticed that his well-hydrated patients shed more pounds. How water aids weight loss isn’t known; it may have something to do with water’s role in the breakdown of foods in the body, or it may just be that water helps dieters eat less by making them feel full. Whatever the reason, Pera says, the link is clear, and he recommends drinking 64 ounces or more of calorie-free beverages a day.

• Use substitutions to curb cravings. Replacing high-calorie foods with low-calorie ones helps in two ways: You can continue to eat the same volume of food, which will make you feel full, and you can satisfy cravings, so you won’t feel deprived. For instance, says Pera, if you’re dying for a scone, have an English muffin with sugar-free jam instead. “The sacrifice doesn’t feel severe, but you’re saving about 500 calories,” says Pera. “Eating food that has some appeal to you will help you stay on the diet long term.”

• Make sure your calories are high quality. If your nutrition suffers, you may actually sabotage your diet. “If the body senses starvation or deficiency of nutrients, it will try to conserve energy in the only way it can—by slowing down metabolism,” says Pera. Consult a nutritionist if you need help figuring out where you might be falling short.

• Find other forms of comfort. If stress, loneliness, or other emotional problems send you straight to the refrigerator, you need to come up with a plan ahead of time for dealing with your emotions. Often the best option is to get out and exercise. Other possibilities include keeping a list of chores or things to do around the house, or calling a friend when you feel blue. Chances are your hunger will be gone by the time you finish.

• Don’t stop short. “Studies show that people who reach their goal weight maintain their loss better in the long run than people who don’t,” says Pera. For instance, if two people need to lose 50 pounds, and one loses 30 and the other loses the full 50, the person who reached the goal weight is more likely to still be there years later. “People do better when they can focus on one thing,” says Pera. “Once someone has attained their goal weight, they can shift their focus from losing weight to keeping it off.”

Diet pills: too good to be true?

If you think all those pills claiming to help you lose weight “the fast and easy way” sound too good to be true, you’re right to be suspicious. The first generation of weight loss supplements—and the ones that tend to be the most aggressively marketed—are stimulants, which work by artificially speeding metabolism, so you lose weight quickly, but as soon as you stop taking them you gain it right back.

But other types of supplements can be useful. The most promising work not by offering a quick fix, but by helping your body achieve a proper balance so that your efforts won’t be undermined by an unnaturally sluggish metabolism or any nutritional deficiencies. “The idea is not to ‘cause’ weight loss per se, but to use judiciously selected supplements to fill in any gaps left by diet to support optimal metabolism,” say David Katz, director of
the Yale University Prevention Research Center.

A bit more research is needed on some of these supplements to determine their effectiveness; others have done well in trials and are considered safe. Here’s a rundown of the leading contenders.

Worth Considering

Calcium Everyone knows that calcium is good for your bones, but it also plays a role in maintaining a healthy weight. When calcium levels are low, you tend to put more calories into fat tissue than into lean muscle tissue, making it very hard to lose weight. “If your doctor has ruled out any underlying medical problems and you’re doing everything else right—going to the gym and dieting—and still not losing weight, this may be one thing that can help,” says Roger Clemens, a nutritionist at the University of Southern California.
• How much: “The best results have come from eating low-fat dairy foods,” says Clemens. He says to aim for a total of 1,200 mg of calcium a day, which you can get from 3 to 4 servings, or a mix of food and supplements. (Split the pills into a morning and evening dose for better absorption).

Chromium Taking this mineral may help quash Syndrome X, a common factor in obesity in which chronically high insulin levels interfere with metabolism and increase hunger. How do you know if you have Syndrome X? A tendency to gain weight around the middle coupled with high blood pressure are two good indicators.
• How much: Katz recommends one or two 400-microgram supplements a day of chromium picolinate.

CLA (conjugated linoleic acid) A fatty acid that occurs naturally in meat and dairy, CLA in supplement form appears to be of some help in making sure that dieters lose body fat instead of muscle. But the benefits are not likely to be dramatic—in a recent Scandinavian study, volunteers lost up to 9 percent of body fat, but body weight stayed about the same or dropped only slightly (though one of the treatment groups showed a small but significant weight loss).
• How much: Take 3,400 mg a day. Look for “9-cis,11-trans type” on the label, the one for which there has been the best data, says Clemens.

Green tea supplements Some research has shown that green tea capsules may suppress appetite and help people burn calories faster, but the effect didn’t necessarily translate to weight loss.
• How much: The many documented health benefits of drinking green tea certainly make it worth sipping, or taking in supplement form.

Long Shots

5-H T P Some practitioners prescribe 5-HTP, a derivative of the amino acid L-tryptophan, because it can increase levels of the neurotransmitter serotonin; low levels can contribute to obesity by causing hunger and cravings. But while studies suggest that 5-HTP may lift depression, its role in weight management hasn’t been well studied. Practitioners report good results from combining it with amino acids, but this tactic hasn’t been the subject of much research yet, either. For now, it’s probably best to stay tuned until more studies can be done.

Pyruvate Your body produces this compound naturally, and researchers have also looked into using supplements to help reduce fat mass. So far studies have shown that the effect is only slightly better than what you get with a placebo. It’s considered pretty safe, but unless further research finds a way to boost effects, it’s probably not worth trying.

Bitter orange Derived from citrus peels, this weight-loss supplement is widely touted as a safer “ephedra-free” alternative. But beware. Though bitter orange doesn’t contain ephedrine, it does contain synephrine, a stimulant that’s chemically very similar. Other herbal stimulants, like yerba maté, kola nut, and guarana, should be avoided, too.

Garcinia cambogia Though some earlier lab studies suggested this Ayurvedic herb may be able to suppress appetite and possibly speed up metabolism, recent human studies have not shown it to be of much help in weight loss. A peson’s will to eat seems to overcome any appetite controls, says Clemens.