Nevertheless, the more I read, the more I'm convinced that excessive food reward and/or palatability is the elephant in the room when it comes to obesity and metabolic dysfunction. We live our lives surrounded by foods that are professionally crafted to satisfy our basest gustatory desires-- to drive us to eat more, against the wisdom that our bodies have accumulated over millions of years. They do this by exploiting the hard-wired preferences that guided us toward healthy food in the natural environment.
Obesity is not always going to be 100 percent reversible. I know no one wants to hear that, but I'm not in the business of selling snake oil. Some people can reverse it completely; others won't lose any fat at all; the majority can probably lose a substantial amount of fat but not all of it. Highly controlled diet studies in rodents show that obesity due to eating highly rewarding/palatable refined food is mostly reversible when they are placed back on low-palatability whole food, but they don't usually lose all of the excess fat, and the longer they've been obese, the less fat they lose (1, 2, 3). The capacity for the fat mass "setpoint" to re-establish at a lower level may diminish over time, varies between individuals, and probably also depends on other factors that no one currently understands. I think it's important to be kind to yourself, and not set unreasonable expectations.
I can't guarantee that what I'll present here will help everyone, but it is unlikely to do harm. As always, these are simply ideas for you to consider. You are fully responsible for your own implementation of them, and your own outcomes.
I've organized this weight loss strategy into five different "levels" based on the desired outcome. Some people may want to use this strategy in a preventive manner, or to address metabolic disorders other than overweight that are related to excess energy intake (insulin resistance, fatty liver, etc.), in which case they would probably want to stick to levels 1-3. Levels 4 and 5 are primarily for people who are not losing weight at the lower levels, and would like to further reduce food reward and the body fat setpoint.
The goal is to adopt a diet that allows fat mass to return to a healthy level, while eating nutritious food to fullness. You may initially feel deprived, but you should become more satisfied by simple food over time.
The low-hanging fruit:
- Avoid the highest reward foods: candy, sweetened chocolate, ice cream, cake, cookies, other sweet baked goods, fast food, pizza, and other foods that you know are particularly problematic for you. Don't put yourself in a position to be tempted by these if you can avoid it.
- Minimize liquid calories, particularly sweetened beverages, beer and sweet cocktails. Modest quantities of milk, wine, and unsweetened spirits are fine.
- Don't snack. In France and many other countries with strong food traditions, snacks are for children. Adults eat at mealtime, in a deliberate manner.
In addition to everything in level 1:
- Avoid industrially processed food in general, particularly packaged food with many ingredients. Minimize restaurant food. Cook your own food from single ingredients to the extent that you're able.
- Avoid adding sweeteners to food and drinks-- including artificial sweeteners. The sweet flavor itself is a reward factor.
- Avoid seed oils (corn, soybean, sunflower and safflower in particular).
- Include a regular source of omega-3 in your diet. This can come from some mixture of wild-caught fish, flax seed/oil, pastured meat/dairy/eggs and green vegetables.
In addition to everything in levels 1 and 2:
- Reduce the overall energy density of your food (calories per volume) while keeping it nutritious, but don't go overboard. This can be accomplished by adding extra vegetables to the meal, and using potatoes and sweet potatoes as the main source of starch (rather than bread, pasta, rice, etc.). Microwaving is a fast and effective way to cook potatoes and sweet potatoes for those who are short on time.
- Focus on minimally processed foods.
- Don't add fat to your food. That doesn't mean don't eat fat, it just means keep it separate from your cooking. If you want to eat butter, eat it separately rather than mixing it in with your dish.
This level is about simplicity. Here, we are approximating the reward value of certain non-industrial diets. In addition to everything in levels 1-3:
- Eat only single ingredients with no flavorings added. No spices, herbs, salt, added sweeteners, added fats, etc. If you eat a potato, eat it plain. If you eat a piece of chicken, eat it plain. It can be in the same meal as other foods, but don't mix anything together. If you would like to keep salt in your diet, dissolve it in water and drink it separately.
- Cook foods gently. Minimize grilling, sauteing, broiling, frying, and particularly deep frying. Add a bit of water to the pan, rather than oil, when cooking meat or vegetables, and cook gently with the lid on.
- Minimize all liquid calories.
- Only eat foods that taste good when you're hungry; avoid foods that you'd be inclined to snack on even when not hungry. A lot of foods move from the latter category to the former when they're completely unseasoned.
- Some people will benefit from avoiding wheat. Your mileage may vary on this.
This level reduces variety, which is another reward factor (4). This is something that you attempt at your own risk, as there may be downsides to eating the same foods every day. I think the risk is small if you choose your three foods carefully. I wouldn't recommend doing this indefinitely, but rather as a short-term strategy to lose fat, followed by a more relaxed maintenance phase.
- Pick three foods, and eat nothing else. Try to pick foods that will provide a relatively balanced diet. A starch, a meat and a green vegetable is one possibility. For example: potatoes, broccoli and beef. Again, cook everything gently and add no seasonings to your food whatsoever, including salt.
Some people have lost fat simply by avoiding carbohydrate or fat. I've heard people say that a low-carbohydrate diet in particular curbs their cravings and allow them to have a healthy relationship with food again (although others have developed strong cravings on low-carbohydrate diets). I believe this is partially driven by the fact that carbohydrate and fat are major reward factors.
I believe that all things being equal, it's best not to restrict any macronutrient to an extreme degree (there may be some exceptions, such as diabetes). That being said, as carbohydrate and fat are major reward factors, they are additional tools in the toolbox that you can use to further reduce reward if you choose.
Don't be a Drill Sergeant
Ultimately, for any diet to work, it needs to be sustainable. It's probably a good idea to allow yourself a meal or two a week that you really enjoy. Just don't indulge in the worst offenders-- foods that will stay on your mind, and reinforce your cravings for days or weeks. You know what your own trigger foods are. Don't even put yourself in the vicinity of those foods if you can avoid it. If your diet is balanced and nutritious, your cravings should subside over time, and you will become more satisfied by simple food.
An Alternative Strategy
In his book The Shangri-La Diet, psychology researcher Dr. Seth Roberts outlines a simple strategy that he claims can lower the body fat setpoint without significantly altering the diet. The technique involves taking flavorless calorie-containing foods between meals, which lowers overall energy intake by suppressing appetite (according to him, by lowering the setpoint). I'm not going to steal his thunder, so you can read his book, or visit his website or forum if you want more information about how to implement it.
I tried Dr. Roberts' strategy for a week out of curiosity, and it did suppress my appetite somewhat. According to the theory, the more excess fat mass you begin with, the more your appetite should be suppressed. I didn't have much fat to lose, but I noticed a modest effect on my appetite nevertheless. I have a few reservations about the technique. I don't know much about its long-term effectiveness or safety, and neither does Dr. Roberts, according to our communications. It doesn't strike me as having the potential to be very dangerous, but as our ancestors didn't sip refined olive oil between meals, the precautionary principle applies. Still, it's an interesting technique that I'll be keeping my eye on in the upcoming years.