Dear DOCTOR Owen:

Fair Game

Dear “Game”:

Yours is the same story I hear day after day. Most people who feel the way you do have someone to compare against. It always comes down to two things: the environment or genetics.

This subject has been studied extensively. Below, I discuss two articles that report what most obesity experts know—people’s metabolic rates can differ from one another, but not nearly as much as most believe. What most people do not realize is how small metabolic differences, over time, end up with substantial weight differences.

In The New England Journal of Medicine, Vol. 327, 1893–1898, and The American Journal of Clinical Nutrition, Vol. 35, 727–732, researchers measured resting metabolic rates, food diaries, exercise diaries, body composition, and psychological testing. They compared test subjects (Group I) who believed that they were diet-resistant (genetically fat) with test subjects (Group II) who did not think that were diet-resistant. Both groups were equal in weight, percent fat, and food choices.

Group 1, which believed that they were genetically fat, underestimated their food intake by 47% and overestimated their exercise calories by 51%. The subjects in Group II were much closer to their actual caloric intake and exercise expenditure. A second study showed almost exactly the same results in a different population and city.

At my clinic, we diet and health counselors constantly see individuals who just seem to have amnesia about their caloric intake. I suppose that—psychologically—this is some kind of protection mechanism for them. For example, we see patients, sometimes for years, who keep food records but never “come to grip” with the arithmetic before their very eyes. And, sometimes patients simply do not understand calorie balance. I had a patient weighing more than 500 pounds who said that he “just doesn’t eat anything.” It turns out he didn’t—instead, he drank more than 3 gallons of milk/day, which amounted to more than 5000 calories! But he never ate anything.

A person  needs about 5000 calories/day to maintain 500 pounds.

There are literally hundreds of articles that reveal similar findings. No matter what your metabolic rate, there is a level below which you will lose weight—period. When in Rome, we eat like the Italians. Newlyweds almost always gain weight during their first year of marriage. They adopt each other’s eating habits—always toward the higher calories. Friends who party together eat similarly when they are out. It is natural to perceive others’ habits through one’s own eyes.

For someone in your situation, the only way to gauge intake is learn exactly what you eat and exactly how many calories are in that food:

Life is neither fair nor equal. However unfair you may judge it now, it is possible for anyone to lose weight. While the perceived effort you may have to exert may seem uncomfortable, it may not be nearly as uncomfortable as the effort someone else has made or will make. Each of us has a unique tolerance to pain and discomfort, and avoiding food can be absolutely uncomfortable. Exercising is uncomfortable. Not having as much—whatever—as the next person obviously makes many of us uncomfortable.

Only bitterness and resentment will come from wishing to be like others. My advice: Don’t wish. Instead, know!