"It's not our fault diets don't work"—an expert explains how to lose weight sustainably

Do you find yourself starting new diets with resolve and enthusiasm, achieving results for a bit but eventually sliding back into old habits? This is a pattern that many people experience and it can take its toll on your self-esteem.

I chatted to Dr Aileen Alexander, a women's health and weight-loss expert, medical doctor and TEDx speaker about why traditional weight-loss diets can seem doomed to fail, and what we can do differently if we want to lose weight and keep it off.

Why traditional diets don't always work | Aileen Alexander | TEDxAberdeen - YouTube

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"The traditional approach to weight loss is dieting and dieting is synonymous with restriction," says Alexander. "Diets usually focus solely on food, types of food or calorific content, but not enough on why people eat. When people come to me, they can usually tell me five or 10 things they should be doing differently, and then they feel really guilty because they're not doing those things. My job is to help them understand why they aren't. I’m talking about busy lifestyles, stress, boundaries in the workplace, work-life balance, relationships, lack of sleep, maybe there are hormonal imbalances related to perimenopause or menopause—all these things can drive us towards certain foods."

Traditional diets usually involve a lot of rules and breaking rules comes with guilt. "Take fasting for example, that's eating within certain times, or keto is cutting out carbs, and macro counting means weighing everything we eat," says Alexander. " I think these approaches are simplistic, idealistic and restrictive. There are all these rules, instead of people learning how to intuitively live life on their own terms."

"Diets don't teach people how to listen to their body's hunger signals or respond to what their body needs. In fact, they teach us to ignore these signals. Diets like this are really difficult to stick to. When [people] can't stick to the diet, they blame themselves and it erodes their self-esteem. And that process often harms our relationship with food."

How do you lose weight sustainably?

"The first thing is we need to have a whole-person approach," says Alexander. "We need to look at the whole person and not just the food they eat, but try to understand why they eat. We need to understand what's driving the behaviors." Think about the areas in your life causing stress and how you can address them.

"The approach needs to be simple and stepwise, where we're doing one thing at a time instead of all of the things," says Alexander. If you try to make too many changes at once, for example, deciding to prep all your meals, exercise every day, reduce your intake of processed foods and so on, it's too much and it becomes unsustainable.

"It also needs to be enjoyable. It needs to be an approach that adds value to somebody's life rather than restricting them," says Alexander. Aiming to eat more varied, healthy meals for example, rather than cutting out foods, can make life feel more enjoyable as well as help you lose weight.

Sleep also plays a big part in weight loss. "When we've slept well, we produce more of a hormone called leptin, which makes us feel full and we produce less ghrelin—the hormone that makes us hungry—so we're less likely to overeat," says Alexander. Lack of sleep affects us in all sorts of ways. "If you've not had a full night's sleep, you're less likely to exercise, and are more likely to make poorer food choices.

"We need to make sure that we're also not demonizing certain foods. We're still able to eat out, we still get to have ice cream, we still get to have chocolate in our diet if we want it because we enjoy it rather than turning to it in times of stress.”

"Ultimately, I think we need to support individuals in feeling empowered to make healthy choices and also help them understand why they're not making the best choices without making them feel bad about it," says Alexander.