Dear DOCTOR Owen:

I have a very difficult time in re-starting my diet—over and over again. I know that it is necessary for me to prevent a re-gain of all my lost weight again and to stop the recurrence of my medical conditions. I wanted to go back to my previous program, but it was closed. Do you have any good ideas?

Push Me

Dear “Push”:

Every patient I have ever seen has the same problem: re-focus and re-motivation. We have begun a program called P.U.S.H. (Personal Understanding and Strategies for Health) at my clinic, which has become very popular. Some patients call it “Shove,” “Kick,” “Boot,” or “Pull.” So far, it has been very beneficial in helping patients get—and stay—focused on their original and present goals.

P.U.S.H. is modeled on the following two premises:

• You must have a personal understanding of yourself (your needs, your limitations, your “quirks,” etc.) when considering the possibility (or even the likelihood) of “intentional food deprivation.” Why would anyone seek discomfort? Plus, obviously, you want the secondary gain—better health, better acceptance, a better life. Why seek discomfort when you are relatively comfortable? Whatever past pain you went through to lose weight and gain control of your health was likely well worth it and has become resolved. The pain that forced you to seek the help you initially needed is gone.
• You must have certain strategies for health in order to maintain motivation. You can be motivated all you want, but success will follow once you have methods in place to keep that motivation in focus. This is true of any endeavor. P.U.S.H. requires that you maintain the following records in order to stay on track: choose a diet plan(s); set goals and make sure you are meeting them on a regular basis; report results; be accountable via attendance (and participation in) at meetings; set up a strong support system (via phone calls).

Our P.U.S.H. program lasts eight weeks—long enough for patients to see results and gain control of their health, yet not become bored or distracted. And, this is just the right time period for methods to become habit-forming and a natural part of daily living.

Losing weight and keeping it off are lifelong processes. The health benefits of a diet are as long- lived as the diet itself. I see many people who lose considerable weight and control their disease—but experience a relapse of their diseases after a mild re-gain of weight—that is, they back to their old eating habits.

Weight is not the problem; the diet is the problem. However, re-focusing and re-dieting will quickly re-gain control of the medical condition. Therefore, the “diet” must last forever. The type of strategies incorporated in P.U.S.H., and similar types of programs, will be necessary forever.

I have found that the people who join P.U.S.H. three or four times a year rarely lose touch with what best works for them because eight weeks are enough for them to maintain their weight and have control over their obesity-related diseases. At the clinic, P.U.S.H. sessions are regularly held between major annual events—winter holidays, summer, start of school, and so on. It is at those times of year when many people travel and become distracted in their eating.

Prior to any endeavor, setting specific goals is “fundamental.” If you do not know where you are going, then how will you get there? Therefore, initially, all P.U.S.H. participants write down their eight-week goals, their one-year goals, their five-year goals, and their 20-year goals. Then they list the obstacles (by name) to meeting those goals, as well as the names of the people whose cooperation is vital to their success.

Find someone—but not necessarily an expert—who will help you with your accountability: your spouse or partner, a local athletic coach, a dietitian, a friend, even a clergy person or spiritual leader. (I have found that spiritual leaders are terrific “support systems” because they are accustomed to seeing that members of their “flocks” regularly attend behavior modification class and follow P.U.S.H. principles.)

So, tie your goals into the “big picture” and your “weight” will suddenly become only a “health” issue—the only real value in life, as good health is essential for sharing love with your family and friends.