"Eat well, live better" class vs. MFP

history_grrrl
history_grrrl Posts: 216 Member
edited September 2023 in Health and Weight Loss
Last week, I had a phone appointment with a dietician (a few months ago, I asked my GP to refer me). It was fruitful, and conveniently my GP's clinic was just starting a four-week Zoom class on healthy eating, etc. The first session was this morning, and it was fascinating.

I just read an interesting recent thread about dieticians, but started a new one because of the earlier one's title: https://community.myfitnesspal.com/en/discussion/10896027/dieticians-are-awful/p1

Here are some things the dietician running the session told us (fyi, when the participants introduced ourselves, I did mention using MFP):
  • She cautioned against weighing and measuring because it's too diet-focused and "we can't ever truly know" what calories are in our food (? - something about the calories it takes to digest certain foods).
  • Calories in, calories out is oversimplified.
  • "Tracking calories is difficult and most often inaccurate."
  • Instead of counting calories and macros, we should use the plate method and hand portion guide.
  • Our bodies want us to be a certain weight so we can survive famine (paraphrased); she did say this was a theory, but didn't say if she subscribed to it or not - so repeating it multiple times in response to questions suggested she does. (Personally, I find this type of evolutionary biology claim not useful because it doesn't reflect the actual conditions in which we live now - but maybe there's more to it.)
  • On multiple occasions, she suggested we look into Health at Every Size.
My personal pet peeves: Saying "right?" after almost every clause, a lot of uptalk, and exercise suggestions that paid zero attention to the possibility that some people have physical limitations.

I did say I've been eating "rigidly" and "according to rules" (her terms) - which is precisely why I am not currently stuffing myself with giant pieces of cake and pints of ice cream and why, in fact, those things are not in my house - and that the process is educating me about calories and portion size as well as pushing me to eat more mindfully. She agreed that this can be beneficial temporarily for informational purposes, but clearly wants us to follow an approach that is more holistically focused on overall health and well-being.

I don't disagree that the "diet mentality" is problematic, but I found the disjuncture between her approach and MFP's really interesting.

I'm not going to stop tracking, but I will do the "homework" and see how it goes.
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Replies

  • claireychn074
    claireychn074 Posts: 1,604 Member
    The only thing I’d agree about is that weighing every morsel and counting calories for ever may not be seen as mentally healthy ie my interpretation of her point about being “too diet focused”. But, here’s the rub: the plate method doesn’t work for everyone. If everyone could self-moderate their food intake we wouldn’t have a multi-billion £ industry. And I have a naturally obsessive personality. I record all my food and I’m fine with that. We all differ, and what works for one won’t work for all.

    Attend the classes but decide what works for you. For some it’s MFP, others it’s Noom, WW or IF 🤷‍♂️
  • snowflake954
    snowflake954 Posts: 8,399 Member
    Well, between tracking calories and using "My Plate" I'd have to say her method isn't exactly accurate either.

    Is there some good information buried in there? Perhaps. You'll have to decide what works best for you. It's important to rein in overeating and get your portions down. I find MFP to be very helpful and liberating.
  • history_grrrl
    history_grrrl Posts: 216 Member
    @snowflake954 Yes, there is some good information, and I also like that it’s a small group, just six of us, and others have good questions and comments. There’s one guy who lost 60 pounds in preparation for hip surgeries, and I hope he’ll share more about his strategies.

    I did like the concept of weight loss as an outcome of healthy eating, exercise, etc., as opposed to the goal itself, but that’s probably just semantics. I also appreciated the facilitator’s critique of BMI, which I share. (I happen to have a connective tissue disorder, and BMI is meaningless for anyone who has it.)

    But there’s no way I’m deciding portions by the size of my fist or palm or whatever. Deck of cards? Also not happening.
  • herringboxes
    herringboxes Posts: 259 Member
    I think different things work for different people.

    Physics is physics, but there are people for whom counting calories is a dark path due to their backgrounds.

    I don’t have that background, but I use the plate method (without realizing it was a method) just due to vision loss making building my calorie log just too exhausting.

    That worked for me, but would not work for others. Some can’t be intuitive, they need hard numbers and need to weigh every morsel. Still others need to track but eyeballing it is enough.

    The other dietician sounded like a total quack. But this one might be useful for certain people.

    What I don’t like are the hard conclusions like “calorie counting is too rigid” (it can be too rigid for some people is much better).

    CICO is not oversimplified - but indeed there is more to it in the sense that some foods feel more filling, and other factors. CICO still applies.

    I don’t worry about what other people choose to do or what works for them.
  • ddsb1111
    ddsb1111 Posts: 871 Member
    edited September 2023
    Instead of counting calories and macros, we should use the plate method and hand portion guide.

    When I got married my husband did all the cooking. In less than 6 months I gained over 10lbs, using this plate method. I ate at the same times, used IF, did the same work, and had the same routine. The only thing that changed was I didn’t track my food. Over the next 3 years I proceeded to gain another 10lbs, using her method, but added more activity. I couldn’t fit my clothes and generally felt horrible. I even got a personal trainer and gained an additional 4 lbs.

    What changed from then to now, 4 years later? I basically stopped the (IMO) insanity of not taking control of what I ate and how many calories I consumed. I started to weigh and track again until I could get a handle on my calories and started losing. I didn’t feel obsessed and it didn’t change much of my routine but a few extra minutes. I started losing weight immediately tracking *as accurately as I possibly could and following the data that was presented to me with that tracking*. I made small tweaks that I noticed either effected me in a good or less than ideal way.

    That being said, some people can use this plate method and it works out great. But I guarantee that my husbands ribeye steak, mushroom gravy, mashed potatoes, and buttery veggies won’t be the same calories as someone else’s salmon and veggie dinner, using the same plate method. I thought and hoped it would work but no. What would her advice be to me then? Cut back my portions? Then it wouldn’t be the plate method. Cut out the calories in the food? Well, that’s controlling calories, right? Besides, I did none of the cooking and had recommended that before and it didn’t work.

    Our bodies want us to be a certain size? I don’t know about that. Then my body wants to be 300 lbs+ on my small frame. Food availability is part of why we want to keep eating. I don’t think our bodies are saying it wants to be that size though. There may be some homeostasis but I have yet to find it without (comfortably) controlling my intake and tracking in order to be satisfied with what I get.

    Part of why her advice drives me bananas is that it is so far from a reality that works for me. I suppose if eyeballing our food worked she wouldn’t have a job. Some may lose weight, but I wonder how many of them are their “ideal” weight. Just so many red flags to me.

    ** in response to this: She cautioned against weighing and measuring because it's too diet-focused and "we can't ever truly know" what calories are in our food (? - something about the calories it takes to digest certain foods).

    I really really enjoyed reading your post. Thanks so much for sharing your experience. If there’s anything I do like about what you’re doing is that talking about it can make us more mindful. That’s why I come here. It helps me focus on my goals and why I’m doing them. I’m crossing my fingers you find useful tools from this experience and success on your path to health and wellness.
  • history_grrrl
    history_grrrl Posts: 216 Member
    Oh, I forgot to mention: she shared a picture of the Canadian food guide but also mentioned the “Mediterranean diet” multiple times and showed a graphic of that. I have a feeling this is what she’ll be promoting, so I’ll share more info when we get to that.

    I’ll also list some of the resources and worksheets later on, and can provide links if people are interested.
  • snowflake954
    snowflake954 Posts: 8,399 Member
    history_grrrl wrote: »
    Oh, I forgot to mention: she shared a picture of the Canadian food guide but also mentioned the “Mediterranean diet” multiple times and showed a graphic of that. I have a feeling this is what she’ll be promoting, so I’ll share more info when we get to that.

    I’ll also list some of the resources and worksheets later on, and can provide links if people are interested.

    Oh---please tell us what she says about the Med diet. I live in Italy and that's our way of eating. I find that a lot of "experts" are actually clueless about what it really is.
  • AnnPT77
    AnnPT77 Posts: 34,204 Member
    edited September 2023
    Interesting post, thank you. AARP (retiree organization in the US) has recently come out with a book and some eating guidelines that seem to take a similar approach, though with perhaps a stronger emphasis on adequate protein in every meal because many seniors don't get enough (more by taste-preference than poverty, I think, though there's some of both of course).

    I'm going to selectively snip a few things from your OP to comment.

    As a generality: What that dietitian is saying seems to be becoming more common as mainstream advice, I think because of a perception that calorie-counting focus has not worked (at the population level), has triggered some backlash, and it's now time to try a different approach.
    history_grrrl wrote: »
    * She cautioned against weighing and measuring because it's too diet-focused and "we can't ever truly know" what calories are in our food (? - something about the calories it takes to digest certain foods).

    Yes, certain foods do have a higher TEF (thermic effect of food), i.e., require more calories to be burned in order to metabolize them. I think that most of us have a consistent enough way of eating that this isn't a big deal, if we adjust our calorie goal based on 4-6 weeks of logging and weight change results.

    * Calories in, calories out is oversimplified.

    Sure, in a practical sense.

    To me, calories are the foundation. If calories aren't in line, weight management isn't happening.

    But things like satiation, energy level, personal taste preferences, possible emotional/psychological factors, and more are part of the practical side of weight management . . . but that's true of most any method of managing eating/activity more intentionally, I think?

    Isn't the plate method oversimplified in that sense, too?

    ETA: I've seen some critiques of calorie counting that call it oversimplified or similar because it ignores the value of good nutrition. I think that's just silly: There's nothing inherent in counting that requires us to ignore nutrition. If anything, a tool like MFP specifically makes good nutrition easier for me, because I can see how I'm doing over time with major nutrients.
    * "Tracking calories is difficult and most often inaccurate."

    Research suggests that that's true. But personal preferences matter here. I don't find it particularly difficult, and "close enough" is OK with me - i.e., if I'm getting the results I want, that's accurate enough.
    * Instead of counting calories and macros, we should use the plate method and hand portion guide.
    * Our bodies want us to be a certain weight so we can survive famine (paraphrased); she did say this was a theory, but didn't say if she subscribed to it or not - so repeating it multiple times in response to questions suggested she does. (Personally, I find this type of evolutionary biology claim not useful because it doesn't reflect the actual conditions in which we live now - but maybe there's more to it.)

    The plate/hand thing isn't appealing to me at all. I eat in quite non-average ways. I'm vegetarian, which is part of that, but also my meals are mostly combinations of things. What part of my plate should my bean tostadas with avocado, tomato, and yogurt topping take up? That's confusing to me.
    [*] On multiple occasions, she suggested we look into Health at Every Size.

    Ugh. I agree that health is a key goal, of course. But there's a bunch of nonsense in the blogosphere labeled HAES, too.

    I don't disagree that the "diet mentality" is problematic, but I found the disjuncture between her approach and MFP's really interesting.

    The thing is, a "mentality" is an interior state. The same external actions can correlate with different mental states in different people.

    I 100% agree that calorie counting, for some, can result in obsessive thoughts and dysfunctional behavior (like refusing to participate in social events involving food). It doesn't have that effect on everyone.

    (more snipping from quote below)
    history_grrrl wrote: »

    But there’s no way I’m deciding portions by the size of my fist or palm or whatever. Deck of cards? Also not happening.

    Yes. That's "no way" for me, too. Partly it's the things I mentioned above. Beyond that, as someone who's a data geek and a hedonist, I think it would make me more anxious/compulsive and unhappy rather than less. One of the things I like about calorie counting is that I can eat every delicious calorie I burn, with very little worry about either over-eating and regaining, or under-eating and missing out on some pleasurable eating.

    I'd enjoy it if you'd add to this thread as you get more information from the class. It's interesting.
  • springlering62
    springlering62 Posts: 8,437 Member
    edited September 2023
    Calories in/Calories out oversimplified?

    I think that’s why it works so well for me.

    It may not be perfect, but simple enough that I know immediately if one or the other is out of kilter, and I see results as long as I K.I.S.S.

    Why demonize simplicity? 😶

    Your mission is to cull the best of both -or make a decision to choose one- and make it work for you.
  • zebasschick
    zebasschick Posts: 1,067 Member
    i've lost 98 pounds using calories in/calories out. suggestions like these from a previous doctor's dietician were useless to me. my calorie tracking, btw, turns out to be MUCH more useful than any other method, and it's pretty accurate. has she not heard of the FDA and manufacturer calorie listings?
  • herringboxes
    herringboxes Posts: 259 Member
    jessalittlemore wrote: »
    I'm not an expert in anything and I'm not going to knock someone's whole career I haven't had any personal experience with...

    That said, I kind of chuckled that the dietician poo-poos the accuracy of calorie counting and calls CICO "oversimplified" and in the same breath tells you to use the "hand portion" method. 'Cause THAT'S scientific and not arbitrary at all!

    I wonder if the logic is that both methods are imperfect, so the one that is probably easier (and possibly less triggering for some people) is recommended?

    I dunno, I’d be more of a fan if it was phrased as an option rather than dismissing CICO and selling this as the only solution.
  • kshama2001
    kshama2001 Posts: 28,052 Member
    herringboxes wrote: »
    jessalittlemore wrote: »
    I'm not an expert in anything and I'm not going to knock someone's whole career I haven't had any personal experience with...

    That said, I kind of chuckled that the dietician poo-poos the accuracy of calorie counting and calls CICO "oversimplified" and in the same breath tells you to use the "hand portion" method. 'Cause THAT'S scientific and not arbitrary at all!

    I wonder if the logic is that both methods are imperfect, so the one that is probably easier (and possibly less triggering for some people) is recommended?

    I dunno, I’d be more of a fan if it was phrased as an option rather than dismissing CICO and selling this as the only solution.

    Could be.

    I recently did the VA MOVE program and multiple methods, including hand portion and calorie counting on MFP, were included.

    This was good, as only a few of us, perhaps just me, were willing to do MFP.

    Our leader was a nurse, not a dietitian, who did mention quite a few food myths as fact, and repeatedly said, "It's hard," so not a great program either.

    I just sat through it because it was the only way I could get Contrave prescribed. I'm having too many side effects to go to the full dose though and have been at 1/4 strength for a month :disappointed: Told this to the pharmacist and am waiting to hear back from the doctor.
  • history_grrrl
    history_grrrl Posts: 216 Member
    edited September 2023
    Just popping in to say I’m glad to know this report-back will be interesting and useful to some, and also to lament: can’t believe I misspelled “dietitian”! (I am known, in my circles, as something of a spelling maven.) Yikes.

    Also, I’m really enjoying everyone’s thoughtful responses. So much insight here; I especially appreciate the points about logical inconsistencies, such as the inexact nature of such things as “palm size.” As some others have said, as a details person who appreciates precision (math major for a while in university until history stole my heart), I find it pretty easy to weigh and log and vastly prefer it to muddled guesswork. I plan to gently bring up these points, including mentioning the legacy USDA site.

    Back soon to post some of the resources from Week 1.
  • lynn_glenmont
    lynn_glenmont Posts: 10,092 Member
    kshama2001 wrote: »
    lynn_glenmont wrote: »
    She cautioned against weighing and measuring because it's too diet-focused and "we can't ever truly know" what calories are in our food (? - something about the calories it takes to digest certain foods).
    Calories in, calories out is oversimplified.
    "Tracking calories is difficult and most often inaccurate."


    The fact that we can't get a guaranteed accurate calorie number from weighing and measure is a bad reason to advocate the plate measure and hand portion guide. If weighing is bad because it's not perfectly accurate, that means she thinks accuracy is a good thing. Eyeballing stuff is pretty much guaranteed to be less accurate than weighing.

    I wouldn't hire an accountant who told me not to keep records and just give them a spitball estimate of what I spent on various things.

    I wouldn't hire a doctor who thought that instead of sending a sample of my blood to a lab, they'll just lance my finger, squeeze out a bit, and decide what was wrong with me by looking at it with the naked eye.

    I wouldn't hire an engineer or architect who instead of calculating the weight various materials will bear, just shrugged and said "use 2X2s and throw in some rebar where you think you need it."

    I love your accountant example! I'm not at all disagreeing with it; this is what it made me think of:

    At one point in my life, I had to carefully monitor my bank balance. One pay period, I literally had $1 left before pay day. These days, I have a cushion, and don't have to keep track that closely.

    Similarly, there have been times in my life when I lost weight by making some food and lifestyle changes, and did not have to track calories. Not so these days.

    Absolutely -- specific changes that work for you instead of tracking is perfectly fine, if that works. I just think the person running the class in the OP is saying "weighing is an inaccurate to track calorie. Here, try this even less accurate way of tracking calories."
  • sollyn23l2
    sollyn23l2 Posts: 1,755 Member
    zebasschick wrote: »
    on the other hand, almost every woman i know whose doctors (mostly male) put them on an 800 calorie per day diet. that's low for me at 5'4", it's super low for someone like my friend, who's 6 fee tall. i am sure there must be doctors, nurses and dieticians out there who know more than the average bear about nutrition, but no one i know has ever met one in person.

    I've never heard of any doctor putting someone on an 800 calorie diet. 1000, maybe. If they're super morbidly obese and facing imminent death if they don't lose weight.
  • AnnPT77
    AnnPT77 Posts: 34,204 Member
    sollyn23l2 wrote: »
    zebasschick wrote: »
    on the other hand, almost every woman i know whose doctors (mostly male) put them on an 800 calorie per day diet. that's low for me at 5'4", it's super low for someone like my friend, who's 6 fee tall. i am sure there must be doctors, nurses and dieticians out there who know more than the average bear about nutrition, but no one i know has ever met one in person.

    I've never heard of any doctor putting someone on an 800 calorie diet. 1000, maybe. If they're super morbidly obese and facing imminent death if they don't lose weight.

    There seems to be an idea getting going that goes to 800 for a short time at first, maybe a couple weeks. I think it maybe started in the UK, and I think some doctors are recommending it.

    https://thefast800.com/the-very-fast-800/

    Personally, I wouldn't want to do it. 🤷‍♀️
  • kshama2001
    kshama2001 Posts: 28,052 Member
    AnnPT77 wrote: »
    sollyn23l2 wrote: »
    zebasschick wrote: »
    on the other hand, almost every woman i know whose doctors (mostly male) put them on an 800 calorie per day diet. that's low for me at 5'4", it's super low for someone like my friend, who's 6 fee tall. i am sure there must be doctors, nurses and dieticians out there who know more than the average bear about nutrition, but no one i know has ever met one in person.

    I've never heard of any doctor putting someone on an 800 calorie diet. 1000, maybe. If they're super morbidly obese and facing imminent death if they don't lose weight.

    There seems to be an idea getting going that goes to 800 for a short time at first, maybe a couple weeks. I think it maybe started in the UK, and I think some doctors are recommending it.

    https://thefast800.com/the-very-fast-800/

    Personally, I wouldn't want to do it. 🤷‍♀️

    Yes, the NHS and Diabetes UK have an 800 calorie programme for eligible Type 2 Diabetics. I doubt the US doctors recommending this are using the same eligibility requirements and providing the same level of support and monitoring.

    https://www.england.nhs.uk/diabetes/treatment-care/diabetes-remission/
  • history_grrrl
    history_grrrl Posts: 216 Member
    edited September 2023
    As promised, here are some links/citations for resources that aren't password-protected from the first session of the class:

    Week 1

    Mindless Eating: Brian Wansink, Mindless Eating - Note: I just looked this book up and found this interesting Guardian article: https://www.theguardian.com/science/head-quarters/2018/feb/16/mindless-eating-brian-wansink-is-there-something-rotten-behind-the-research

    Am I Hungry: https://amihungry.com/

    Canadian Food Guide: https://food-guide.canada.ca/en/

    Mediterranean Diet Pyramid: https://oldwayspt.org/resources/oldways-mediterranean-diet-pyramid

    Mediterranean Diet Scoring Tool: https://www.hamiltonfht.ca/en/resourcesGeneral/Documents/Medi-Diet-Scoring-Tool.pdf

    Canadian 24-Hour Movement Guidelines: https://csepguidelines.ca/

    What Are You Really Hungry For?: https://barriefht.ca/wp-content/uploads/2019/10/9.-What-Are-You-Hungry-For.pdf

    24-Hour Fitness: https://www.youtube.com/watch?v=3F5Sly9JQao

    Healthy You Journal: http://niagaranorthfht.ca/wp-content/uploads/2023/01/Screen-Shot-2023-01-23-at-10.48.03-AM.png
  • history_grrrl
    history_grrrl Posts: 216 Member
    @snowflake954, I just posted above some of the "Mediterranean diet" material. Somewhere else, I saw a discussion saying this originated with some guy in the 1950s observing eating patterns of people in southern Italy, but now I can't seem to find it.
  • AnnPT77
    AnnPT77 Posts: 34,204 Member
    One of the thing to aim for according to the Mediterranean scoring tool is 480 calories of olive oil every day? I'm not going to do that, period. :D (They apparently would want that to be in addition to the fatty fish and nuts, besides. Yikes.)

    Overall, looking at the whole scoring tool, I get it, but there are some not very nuanced points in there IMO if one is pursuing overall healthy eating, a maybe broader thing than just "eat Mediterranean". (Don't interpret that as a diss to Mediterranean; even as described there, it looks like a reasonably healthy approach, even though I'm not gonna spend that many calories on any oil daily. (Personal goal is 50g/450 calorie fat minimum, prioritizing MUFA/PUFA and enough O-3s for balance.)

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