Dear DOCTOR Owen:

I have been on a weight-loss program and lost 75 pounds this year. I am terrified of the upcoming Thanksgiving holiday and Christmas season because I know that most people gain weight at this time. We will be going to several parties, and have family coming over for both holidays. Help!

Stuffed Turkey

Dear “Turkey”:

You are not alone! The average weight gain for the holidays is 7–15 pounds. Through the years, we have seen a number of contributing factors:

• People eat more food.
• Food is eaten in a social context. The food intake in social eating is always higher in calories because it is prepared with fat to improve the taste. People eat more when they feel happy and loved.
• Exercise schedules get interrupted, so people quit working out (“already ‘blew’ it”). Then, too, people travel and, most importantly, abandon their “stay focused” attitudes.
• But these things do not have to occur if you maintain focus.

Researchers at the Illinois Institute of Technology’s Center for Behavioral Medicine divided obesity patients attending weekly classes into two groups during the holidays: One group of dieters was told to “self-monitor” their programs and report after the holidays; the second group received outside support in the form of phone calls and daily mailings reminding them to record what they ate and drank. The second group, which was given the extra support, gained no extra weight; the first group “packed on” pounds.

Most seriously obese people need support and structure for long-term success. While education is important, personal accountability is vital. Study after study of very sick, obese individuals demonstrates the value of personal contact.

My clinic uses a slightly different approach. We diet and health counselors provide the time and place to call, but place the responsibility on the patient. Instead of referring to our program, we say:

This is your program. It is not our health. It is your health. Our job is to bring the problem to focus for daily confrontation. The problem will not go away. Ignoring the problem only deepens the need to avoid it. Our job is to track your progress and advise accordingly. Your job is to report and ask advice.

Throughout the last 15 years, patients at the clinic have been very successful in keeping off their weight during the Thanksgiving and Christmas holiday periods. But Mardi Gras, Memorial Day, and Labor Day can be “the pits” because they have achieved the notoriety of Thanksgiving and Christmas; 20 years ago, these three events were not even considered “holidays.” Therefore, the average Joe does not plan for the onslaught of food and fun at these celebrations and gets “nailed.”

Now, every day is a holiday for eating in America—especially here in the New Orleans area—so accountability needs to be more stringent than ever. “Paying back” over-eaten calories via diet or exercise is more often and takes longer. Indeed, you may spend the week before a holiday or a weekend “saving up” for it or do “payback” time post-holiday or post-weekend.

It is hard to fathom how good we have it in America. But, sooner or later we must “pay the piper.” Pay now or pay later?