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Although you cannot change your genetic makeup, you do have some manner of control over energy intake and expenditure. Many people get hung up on trying to achieve the perfect combination of carbohydrate, fat, and protein and neglect the basic tenet of calorie balance. In a comprehensive review of literature, however, researchers concluded that energy restriction (lowering calorie intake) was the only variable that correlated with weight loss (J Am
Diet Assoc. 2001; 101:411–420).
It seems so straightforward on paper, doesn’t it? In reality, things may not be so simple. In other studies in which subjects voluntarily consume far more calories than they would under normal conditions they do gain weight but not nearly as much as the numbers indicate. In other words, their bodies adjust to the higher calorie intake and begin burning calories like it’s going out of style! In much the same way, when people restrict calories to a level dramatically lower than usual (as they commonly do when trying to lose weight), their bodies adjust by burning calories more slowly. Do they lose weight? Yes, but probably not as much as a straight numbers analysis would predict. The bottom line is that your body will go to great lengths to remain at a stable weight, regardless of your actual calorie intake. So what’s the take-home message? If you want to change your weight and your life for good, focus on the habits, attitudes, and situations that influence the calories you consume and burn instead of on the calories themselves. It certainly doesn’t hurt to be aware of the calorie content of the foods you commonly eat, especially those you consume outside the home, but don’t get caught in a numbers game.
There are ways of measuring energy expenditure directly, but most are costly and time consuming. You can get a rough estimate of your daily calorie needs by walking through the following steps instead. The total calories you burn each day can be broken into three main compartments—basal calorie needs, calories for physical activity, and calories for the thermic effect of food. Basal calories cover your energy needs at rest and keep vital organs such as your brain, heart, lungs, kidneys, and liver functioning. The majority (about 60%) of your total daily calorie needs fulfill your basal energy requirements. You can estimate your basal calorie needs by multiplying your healthy body weight in pounds by 10:
Healthy body weight (lbs.) ??10 = Basal calorie needs
Example:
Sandra currently weighs 175 lbs. and has determined that her comfortable, healthy weight is around 160 lbs. She walks for 30 minutes two to three times a week and has a sedentary job:
160 lbs ??10 = 1,600 calories for basal needs
Most people also need calories for daily activity—if not for exercise, then for showering, getting dressed, taking care of children, or going to work. If you are sedentary or only minimally active, the calories you need for physical activity compose about 30% or less of your total daily needs. Very active individuals may spend up to 50% or more of their total daily calories on physical activity! Add calories for physical activity to your total daily needs by multiplying your basal calories by one of the following factors:
? 1.2 if you are sedentary
? 1.3 if you are lightly active (easy walking, swimming, or biking a few times a week; or your job involves light activity)
? 1.4 if you are moderately active (planned exercise most days of the week at a fairly challenging intensity)
? 1.5 or more if you are very active (intense exercise most days of the week or a physically demanding job—for example, construction worker)
Basal calorie needs ??activity factor = basal calories + calories for physical
activity
Example, continued:
1,600 calories X 1.3 = 2,080 calories for basal needs and physical activity
The final compartment of energy expenditure is the thermic effect of food. These are the calories your body uses to process the food you eat. This forms only a small percentage (10 or less) of your total daily calorie needs. Add thermic effect of food calories to the total by multiplying your answer from earlier by 1.1:
(Basal calories + calories for physical activity) X 1.1 = Total Daily Calorie
Needs
Example, continued:
2,080 calories X 1.1 = 2,288 calories per day for weight maintenance
If Sandra wanted to lose weight gradually and healthfully, she could increase her physical activity and reduce her calorie intake to around 2,000 calories per day.
Are you tired of math? Don’t sweat it. As you learned early in this section, it is counterproductive to focus exclusively on calories while improving your lifestyle. Your body does an amazing job of balancing the energy it burns with the amount you consume through food. Focus instead on improving the nutritional value of the calories you consume, and that will leave plenty of room for enjoying some foods purely for pleasure!

Carbohydrates are composed of units of carbon, hydrogen, and oxygen (commonly referred to as units of sugar) and are the body’s principle source of energy, providing about four calories per gram. Most carbohydrates are eventually converted to glucose or glycogen in your body. Your central nervous system, including your brain, relies almost exclusively on glucose for fuel, and your muscles are powered primarily by glycogen during activity—two compelling reasons to make carbohydrate-rich foods a staple of your diet! In fact, 45% to 65% of your total calories should come from carbohydrates (in general, the more active you are, the more carbohydrate calories you require). This macronutrient comes in two forms—simple and complex. Simple carbohydrates are those that consist of just one or two units of sugar. They are found naturally in fruit, fruit juices, and milk—all of which contain other important nutrients—and are added to many foods in processing. Table sugar, honey, syrups, candy, cookies, ice cream, fruit-flavored beverages, and colas are all examples of foods high in simple carbohydrates that provide calories but few additional nutrients. Complex carbohydrates consist of many units of sugar and are often referred to as starches. Grain and plant foods such as cereals, pastas, rice, bread, crackers, potatoes, corn, and beans are all rich in complex carbohydrates as well as vitamins, minerals, water, and dietary fiber. Most of these foods are also naturally low in fat. You can estimate your daily need for grams of carbohydrates by multiplying your total daily calorie needs by your desired percentage of calories from carbohydrates (45% to 65%—less if you’re sedentary; more if you’re active) and dividing that number by four (there are four calories per gram of carbohydrate):
Total daily calories X ____% = Calories from carbohydrate
Calories from carbohydrate ÷ 4 calories per gram = Grams of carbohydrate needed per day
Example (continuing with Sandra from earlier example):
2,000 calories per day X 0.50 (50%) = 1,000 calories from carbohydrate
1,000 calories ÷ 4 calories per gram = 250 grams of carbohydrate per day

One of nine children growing up on a farm, Gail recalls childhood meals full of fried foods and unlimited desserts. Though body weight was “part of my family’s consciousness,” neither Gail nor any of her family members were seriously overweight, due in part to working the farm and plenty of bicycling on country roads. Throughout her high school years, however, Gail began to struggle more and more with her body image, self-confidence, and eating patterns. “I don’t remember having very much fun in high school. A couple of my older sisters had gotten into trouble, so I tried to be the perfect student. I got a job, dated a little, and went to night school, and that was the first time I can remember dieting. I know now that I was bulimic, but we didn’t call it that at the time. I remember stopping eating for six days at one point; I was thin, but I was totally out of control.” Fortunately, Gail recognized how unhealthy she had become and gradually stopped her purging behaviors, going on to marry and move to Indianapolis. The move proved stressful, and she again turned to eating to manage her emotions. At 36, Gail was diagnosed with osteoarthritis and placed on medications, while her work environment and one particular supervisor were driving her back to destructive eating patterns.
“It was a horrible situation, and I started eating to deal with my unhappiness. I probably gained 50 pounds that year.”
After discontinuing her arthritis medications during pregnancy, Gail decided she didn’t want to start them up again after she’d delivered her son, so she joined the NIFS Fitness Center in 1996.
“I knew it needed to be convenient and supportive, and it was, but I was really disappointed that I didn’t lose weight quickly at first. I yo-yo’d up and down for about seven years before I finally decided I had had enough. On December 4, 2002, I had just gotten to the point where I was feeling really horrible. I had watched a TV program that encouraged people to seek out a support system and develop goals, so that night, I drew up my own personal timeline. My goal was to lose 40 pounds, one pound per week.”
Gail still struggled with emotional eating and with finding a time for her workouts, but she had an “a-ha” moment with both issues. First, she decided to keep track of every situation or emotion that seemed to trigger negative eating patterns. She wrote each situation on an index card, and on the reverse side, developed a list of “eating alternatives” for that particular situation.
I carried those cards with me wherever I went—in the car, at work, in my purse.
They were always there to remind me what to do if I was struggling.” As for finding time for her workouts, Gail decided to juggle her schedule a bit to move exercise to her lunch “hour.”
“It just came to me. I asked my boss if I could come in a little earlier and stay a little later, and take a long lunch for my midday workouts. I’m still coming to NIFS almost every day during the week to exercise. I know how important it is for stress relief, and it’s almost like I have two days within a day now. I get to shower and go back to work in the afternoon more refreshed.”
Gail firmly believes in personal responsibility for changing your habits while finding support and accountability to help you accomplish your goals. “You have to find that place or that group or that person to support you—something to provide the consistency and accountability. It’s tough to get out of the destructive cycles; I know I couldn’t have done it without my husband. But you have to make the decision. No one else can do it for you. I know my body so much better now. I know how I feel when I eat too much, and, because I’m much more tuned in to my body, I just don’t think I’ll ever go back to the kind of patterns I had before.”

Hunger is one of the most primal drives that humans experience, but it certainly
isn’t the only need to which you must attend. Far too many people attempt to use
food to meet these other needs, often to the detriment of their overall health and
well-being. Part of leading a balanced lifestyle includes being able to identify and
satisfy some basic needs in an appropriate manner. These needs include, but are not
limited to

• Adequate, quality sleep
• Physical activity
• Appropriate medical care
• Connecting with other people (emotionally, physically, spiritually, intellectually, and socially)
• Expressing emotions and thoughts
• Respect
• Rewards
• Pleasure
• Relaxation

How about you? Do you look to food to manage these needs? Do you eat when you are tired? Stressed? Bored? Lonely? Anxious? Do you reward yourself with food? Do you feel like you haven’t taken a legitimate break from work unless you’ve had something to eat? Is food your primary sensual pleasure? If you’ve answered yes to some or most of these questions, it’s time to take a serious look at your behaviors and evaluate how you can begin meeting these needs in a healthier way. It never hurts to talk to someone you trust or to seek out a qualified counselor to help you identify and develop ways of satisfying your legitimate needs as a human being. The following story shows how one of my clients learned how to meet her own needs and break an emotional eating pattern.

Mindfulness, or paying attention, is a technique inherent in the natural eater. It sounds so simple, doesn’t it? But in a world that pushes convenience, speed, and efficiency, paying attention to what, how much, when, and why you eat can be daunting. The following concepts can help you work toward a more mindful eating experience.

Know That You Can Eat Again
If you believe that this is the last time you will enjoy steak and potatoes (at least for a while), you create a mindset that lends itself to overeating. As you recall from the study on human starvation, deprivation usually promotes binging when food becomes available again. Overeating is not a sign of a defect in character; rather, it often points to prior restriction of food or particular types of food. This is why diets that place certain foods on “to be avoided” lists almost never work in the long haul.

Make Eating a Priority
It’s difficult to be mindful when you’re trying to eat, talk on a cell phone, and navigate the morning rush hour. Even if you have only five minutes to devote to a meal, sit down, take a deep breath, and enjoy it as much as possible. If your food options are limited, make the best of the situation and focus on whatever is sitting in front of you.

Create a Positive Eating Atmosphere
Many people find it helpful to go out of their way to create a positive, relaxed atmosphere when they eat. You’ve probably heard it before, but this time act on it! Go ahead—get out the candles, put on good music, use real flatware, turn off the TV, and don’t answer the phone (or email or voice mail). This particular concept takes many different forms depending on your needs and preferences. Some people find cleanup after meals to be such a burden that they occasionally use disposable plates and utensils to feel more relaxed while they’re eating. These aren’t rules, merely suggestions. Do whatever you can do to eat in a positive environment.

Honor Your Taste Buds
Have you ever eaten a food strictly for its health-promoting qualities? I’ve worked with many clients who consistently order a salad for lunch, dutifully munch through a plate that sometimes contains far more calories than they realize, and get absolutely no satisfaction from that meal. What happens in the afternoons? They raid the vending machine or a colleague’s candy dish for food that tastes good to them. By respecting your unique food preferences and choosing to eat a variety of foods that you truly enjoy at mealtime, you will be less likely to go on food raids at other times of the day.

Check In with Your Body During the Meal
This is especially helpful if you have little control over the portions served, as in restaurant meals. As soon as you are served, mentally or physically separate the meal into two or more portions. When you’ve finished one portion, pause for a moment to evaluate how you feel, how the food tastes, and if you really want the rest. If you’re eating at home, you can accomplish this “body check-in” by starting with smaller servings, eating what’s on your plate, pausing for a short break, and then deciding whether to get another helping. Sometimes you may choose to keep eating, even if you know that you have had enough to satisfy your physiological hunger. Special meals or celebrations and traveling to places that offer new foods are common and legitimate reasons to eat more than usual. The key is to recognize that your body and appetite will adjust for these decisions, and your next hunger signals may not appear as soon as they usually do!
As you become a more mindful eater, it may become clear that you are or have been using food to meet legitimate, nonhunger needs.

One of the most concrete steps you can take to uncover your natural eater is also one of the most basic—respond to your unique body’s signals that ask for nourishment. People who have ignored these signals for much of their adult lives often report that their appetites resemble insatiable beasts instead of the gifts that they truly are. This can be a direct result of past dieting or attempts at severe calorie restriction. In a classic study on the implications of starvation, Ancel Keys and his colleagues made intriguing observations of men who voluntarily restricted calorie intake to half their typical levels (Biology of Human Starvation, University of Minnesota Press, 1950). Among other disturbing characteristics, the subjects enrolled in the study displayed

• Food obsession—These men spent most of their waking hours contemplating food, recipes, eating, meals, snacks, and calories. They talked about food, collected recipes, and fantasized about elaborate meals that included their favorite foods.
• Compulsive eating behavior—They hoarded food, pushed food around on their plates to prolong meals, and binged when they were allowed free access to food during the “re-feeding” period of the study.

• Depressed cognitive function—Subjects were apathetic, despondent, tired, and uninterested in sexual activity. They could no longer think creatively. Does any of this sound eerily familiar?

Normal, everyday people can exhibit the same characteristics when they consciously restrict calories to a level that is inadequate for daily activities and functions. Learn to work with, not against, your body’s physiological hunger signals to optimize your health and quality of life.
0—absolutely famished
1—extremely hungry
2—very hungry
3—hungry
4—just beginning to feel hungry
5—neither hungry nor satisfied
6—just beginning to feel satisfied
7—comfortably satisfied
8—full
9—extremely full
10—stuffed or nauseous

If this is the first time you’ve made an effort to identify your body’s hunger signals, don’t worry about doing it “correctly.” Each person experiences hunger and fullness a little differently, and there are no rules about how often and how much you should eat. Some people prefer to allow themselves to get fairly hungry in between meal times; they tend toward the traditional “three squares” a day. Others don’t like getting that hungry and would rather eat smaller amounts more frequently; they are often called grazers. Both styles of eaters are legitimately honoring their bodies’ signals. It will be up to you to determine the best way to incorporate responding to your hunger in your particular lifestyle.
For now, just concentrate on making eating a priority when you become hungry. If you’re thinking “What kind of plan is this? Eat when I’m hungry?! What if I can’t stop? I need concrete rules!” take a deep breath (or 10 or 20) and relax. It’s taken a long time to get where you are today, and it may take a long time to become comfortable with the natural eating process. Expect it to be a learning experience, complete with mistakes, blunders, and a healthy dose of humility. As you’re learning to respond to your body’s hunger signals, you’ll also want to start tuning in to your body’s satiety, or fullness, signals. Varying levels of satiety correspond with numbers 6 through 10 on the Hunger-Fullness Scale. To respond to these signals, you will need to become more mindful during the eating process.

Natural eaters are the embodiment of the age-old nutrition tenets of variety, balance, and moderation. Natural eaters come in all shapes and sizes. Some are tall, lean, and lanky; others are round and soft; still others are muscular and solidly built. The common thread among natural eaters is that food is simply not an issue. They rarely think about food apart from designated meal and snack times and are able to eat a wide variety of foods—including so-called “junk foods”—without experiencing a moral dilemma. This often prompts their dieting acquaintances to remark “How can you finish that whole slice of cheesecake?! I’d feel so guilty!” or “How can you eat whatever you want and never gain an ounce?” or “What do you mean, ‘you don’t want a brownie right now’?”
Do you know people who seem to be natural eaters? Spend time with them, observe their behavior, and listen to their conversations. You won’t hear them talking about the latest, greatest fad diet or discussing the calorie, fat, or carbohydrate content of the foods being served as if that were the most fascinating topic of the day. Natural eaters have a knack for listening to their bodies, honoring what they know about nutrition, and respecting their own and others’ food preferences. Sound appealing? There’s a natural eater inside each and every person waiting to be discovered. Resolve here and now never to tread the dieting path again; life has so much more to offer!

The emotional eater turns to food to lessen the intensity of negative emotions and enhance the enjoyment of positive emotions. He is usually sensitive to others’ needs, opinions, and attitudes. Criticism can send him in search of a candy bar, potato chips, and soda. Common emotional triggers for eating in the absence of physiological hunger are anxiety, depression, boredom, loneliness, fear, stress, excitement, joy, happiness, and many others. Food is the emotional eater’s drug of choice, and instead of turning to less acceptable methods (such as drinking, gambling, or smoking) of dealing with life’s curveballs, he heads for the freezer. All people, dieters at the top of the list, can fall quickly into emotional eating patterns, especially if they are overworked, deprived of quality sleep, or faced with more than they feel capable of handling.

The chaotic eater runs at full throttle day in and day out. She may juggle a full-time job with family and community responsibilities and often works long hours, stealing time from exercise and/or sleep to please as many people as possible. The chaotic eater frequently uses convenience foods and rarely sits down at a table to eat. She might eat in the car, on the bus, at her desk, during meetings, or while talking on the phone or answering emails. Her life is fast, and so is her food. She knows she should feed herself more nutritiously, but life is simply too hectic to make it a top priority.
Chaotic eaters spend a lot of time at the extremes of hunger and fullness. They may go many hours or most of the day with nothing more than coffee and a vending machine snack, and then gorge themselves at night when they finally have the opportunity.
Other chaotic eaters simply don’t want to be bothered with planning nutritious meals and
snacks. They believe that tedious task is reserved for health nuts and nutrition professionals. Dieting veterans can be chaotic eaters when they are “off” their diets; they reason that they’ll get back on the bandwagon when life slows down a bit and they can muster a little more willpower.

The restrained eater often appears to be the picture of health. He may work out religiously, scrutinize his food choices, and keep close tabs on his body weight. Below the surface, however, the restrained eater agonizes over food choices and may miss out on social events due to erratic eating and exercise patterns. He spends an inordinate amount of time thinking about food, planning what to eat or avoid, and/or exercising to “make up” for indulgences. The restrained eater may look like the textbook definition of health, but he is far from achieving a balanced lifestyle or peace of mind. Many dieters fall into this category when they religiously count calories, points, or grams of carbohydrate, fat, or protein. For some restrained eaters, food is the one thing over which they exert full control, so eating becomes their method of coping with an otherwise unpredictable life.