A Penn doctor on how being kind to herself — and keeping lists — helped her shed 30 pounds
I tell people now that I eat what I want, but I changed the concept of what I want. What I want more than the cheeseburger or the chocolate is to feel good physically and emotionally.
How’s that diet going that you resolved to follow during the new year?
A lot of people have lapsed by now. But it doesn’t have to be that way, as University of Pennsylvania gynecologist and obstetrician Janice Asher found out. Six years ago, she lost 30 pounds and has kept it off.
She and a former student, Jordi Rivera Prince, who lost even more weight and kept it off, have written a book to help the rest of us, The Permanent Weight Loss Plan: A 10-Step Approach to Ending Yo-Yo Dieting. Prince, who writes under the pen name Jae Rivera, and Asher maintain that weight loss is as much about attitude and being kind to yourself as it is about food.
On Jan. 21, Asher will discuss her book at the University of Pennsylvania Bookstore, 3601 Walnut St., from 6 to 7 p.m.
She spoke to us recently about dieting.
Please share some of your personal story.
I never had a weight problem until I was 40 years old, although, like most American women, I never thought of myself as having a great body. But I was a size 6 prior to that second pregnancy.
After the birth of my second child, I started gaining weight. I knew what I should eat. I knew what I should be doing. Everything would work but only for a while. Then I would gain the weight back and be angry and frustrated and disgusted with myself. I would turn, as people often do, to food. When you want to comfort yourself, your comfort food is not celery.
One day, I finally appreciated that hating oneself is not going to lead to weight loss. Not in a sustainable way. So I reframed it as wanting to take care of my body, physically and emotionally. It included eating in a healthy way and moving in a healthy way and not playing that self-deprecating tape that was on rewind in my head all the time. Once I made that commitment, I lost 30 pounds. It’s now been six years and I haven’t gained back the weight.
You write not about “wanting to lose weight,” but “wanting to take care of myself.” Your goal is “vibrancy,” not “thinness.” Why was that a game-changer?
People can get thin. People can lose weight by eating two cupcakes and a diet soda every day. But they will feel like crap. They will probably look like crap. And they won’t be able to sustain it. I thought in terms of what I was doing to make my body stronger and fitter and healthier. And when you eat in that way, the result is weight loss. But the goal was to be good to myself.
When I would go out with friends and they would say, “Let’s have a cheeseburger,” I would really want a cheeseburger. But I would want something else more. That’s what every choice became. I tell people now that I eat what I want, but I changed the concept of what I want. What I want more than the cheeseburger or the chocolate is to feel good physically and emotionally.
You discuss “comfort” vs. “deprivation.” Tell us more about that.
We are all hard-wired from an evolutionary point of view to want to avoid deprivation because it’s dangerous for us. That’s why people who lose weight by feeling that they’re depriving themselves not only gain back the weight, they usually gain back more than they lost. So it’s really important to think about what comfort and deprivation mean. In the book, I talk about the comfort food circle of hell. It goes like this: I want a cookie. I have a cookie. Feeling like a shark tasting blood, I want three more. I have an argument with myself about it. Eventually, I probably succumb and have several more cookies, after which I’m disgusted with myself, after which I feel sorry for myself, after which I want to comfort myself. So I have a cookie.
Now, I have reframed the concept of comfort and deprivation. Physiologically, when we eat sugary, fatty, salty, processed foods, it makes our brain happy. Those are comfort foods. But only for a few minutes. Then we start to feel dull, sleepy, maybe irritable and anxious. That comfort is so short-lived. So now I think of deprivation as being that which deprives me of good health and feeling good about myself. I just changed the paradigm. I want a comfort that is more long-lasting and healthier.
A lot of your success seems to be linked to customizing your diet by getting to know yourself — writing lists about what you want to do, why you want to do it, how you’re going to do it.
It’s not customizing the diet. The diet is very simple. The book has 27 chapters. Only one or two are about what to eat. What to eat is basically this: a lot of plant-based food, very little meat, more fish.
The customized part has to do with strategies, and that’s why I like lists. If I say that I want to lose weight so that my mother will stop nagging me, how long do you think it will be before I say, “To hell with what my mother thinks”? I want reasons that matter to me — so that my diabetes will be better controlled, so my knees won’t hurt so much, so I can fit into the beautiful blue dress I bought last year. Write them all down. It’s motivating to look at the list.
And then make lists of strategies — what works, what doesn’t, what you might want to try next. So much of unhealthy eating has to do with habits. You come home from work. You’re tired. You’re hungry. You see some chips in the pantry. You grab some and turn on Netflix. How about changing the habit? I come into the house. I’ve gotten rid of the chips. I grab an apple. I put on my sneakers and go out for a half-hour walk. I have made my den a no-eating zone unless it‘s a fruit or a vegetable.
This brings me to my third list, which is probably the most important: a list of successes. Every time you make a good decision, write it down. It gives you something to build on and be proud of yourself about. If you ordered a salad instead of the cheeseburger, give yourself credit. If you didn’t feel like going to the gym that day but you did anyway, give yourself credit. It gives me incentive to keep going and to not feel deprived.
Finally, although dieting a la Janice Asher isn’t really about quick tips, how about a few anyway?
These are tips that have helped me and many of my patients.
Don’t wait until you lose weight to respect and take care of your body.
At mealtime, eat all your vegetables first. When you do that, you’re eating the healthiest, least-calorie-dense food first. You’re also giving your stomach and your brain time to register fullness.
Plan ahead. I am never ambushed by food. Let’s say it’s Thanksgiving. I don’t want to be sitting in a corner munching on a celery stick. But I also don’t want it to be a food orgy after which I’ll feel awful. So I plan ahead. If I plan to have a piece of pumpkin pie, fine. If I plan to have three pieces because what the heck, it’s Thanksgiving, fine. But I don’t have this back-and-forth discussion about what I will and won’t eat.
Get support, whether that takes the form of a running buddy or explaining to your family why there’s not going to be ice cream in the house anymore. Part B is, don’t accept shaming as a form of support. If someone says something to you like, “I thought you said you weren’t going to eat that,” you have a right to say, ”Ouch, that hurts, it doesn’t feel like support at all.” Don’t go back into the self-blame and shame space.