Lose Weight Without Dieting

February 24, 2008

Michelle May, MDAnti-Aging Psychologist, Dr. Michael Brickey








Host: Anti-Aging Psychologist Dr. Michael Brickey

Expert Guest:  Michelle May, MD

Broadcast: 1-19-08 on webtalkradio.net where the latest shows are broadcast and posted as podcasts

Dr. May knows how to get people off the yoyo diet treadmill and losing weight for good. She is a Board Certified Family Physician and author of Am I Hungry? What to Do When Diets Don’t Work, and the CD Stop Dieting, Start Living.  Her website is http://www.amihungry.com/  

TRANSCRIPT ©Michael Brickey–excerpts permitted with attribution

MB: This is Dr. Michael Brickey with the Ageless Lifestyles Program, cutting edge thinking on being youthful at every age. Today’s show: Lose Weight Without Dieting, with the Am I Hungry? physician, Dr. Michelle May. Dr. May knows how to get people off the yo-yo diet treadmill and lose weight for good. She is a board-certified family physician and author of Am I Hungry? and What to Do When Diets Don’t Work. So Dr. May, how do diets often end up making us fat?

MM: Well, it’s ironic. But you know, if diets were the answer, we would not have an obesity problem in America, because almost everybody that I know who’s overweight has been on at least one, if not dozens, of diets. The thing is that we know that diets aren’t just doomed to fail, they’re doomed to backfire, because what happens is we have these primitive survival mechanisms in place, and so when our body is chronically under-fueled, it begins to set up adaptive mechanisms that will prevent it from starving to death. It somehow doesn’t realize we’re doing it on purpose. So when people lose weight, they begin to lose hopefully a little bit of fat. They certainly lose a lot of water, especially at the beginning of a diet, and they also lose muscle. Unfortunately, when people gain their weight back, they get back just their water and their fat. They don’t get the muscle back that they lost. So a lot of people, after many years of dieting off and on, will actually have a higher body fat percentage and a lower metabolism because they’ve given up some of their muscle mass over the years. So that, on one physical level, causes diets to fail. And I think you’ve probably seen this with people you’ve talked to. But diets also fail psychologically and socially. It’s very difficult for people to maintain the level of energy and time that it takes to weigh and measure and count and write everything down. And when we deprive ourselves of certain foods, we actually begin to crave those foods, we think about them more, we give them special value, so we want them more than we did even before the diet. And then when we give in and have them, it’s hard for us to stop because we feel like, “Gosh, I’ve already blown it. I might as well just keep eating it. I’ll get rid of it and then I won’t have to deal with it tomorrow and I’ll start over again.” So ultimately this yo-yo thing that we see so often is really an expected outcome of deprivation, restriction, and under-fueling our bodies.

MB: So we both have a physiological program that says, “Hey, this is an emergency,” and compensates for it, and psychologically we have a tough time with diets.

MM: Absolutely.

MB: One of the things that you emphasize is how oftentimes we eat for emotional reasons. How does that play into dieting and weight loss?

MM: The thing is, is that most of us have learned to use food to cope or to distract ourselves or to feel better. In fact, food actually has some physical chemical properties that make us feel a little better temporarily. Now, of course, the operative word there is temporarily, because when we use food to, for example, entertain us when we’re bored or comfort us when we’re sad or keep us company when we’re lonely, we do feel better for a short period of time. And that’s what drives us back to it again and again. But food really doesn’t meet those needs very well, so those triggers, those stressors, those emotional reasons that we eat come back again and again and again, so people begin to feel somewhat powerless around food. Now, it is important to say, though, that not everybody who struggles with their weight or struggles with their eating has deep, dark psychological issues. Most of us don’t. I mean, I personally had a lot of emotional type links to eating, but it was really more about trying to deal with stress, trying to deal with being very busy – you know, maybe some perfectionism, some of those kinds of things that are very common. And really, all I needed was some new skills, some new ways of taking care of myself.

MB: How much would you say the emotional needs are dealing with stress, and how much of it is “I’m depressed,” “I’m lonely,” “I’m anxious,” and those kinds of emotional needs?

MM: Well, it’s different for different people, and that’s one of the keys to solving weight issues is to really start to figure out what it is for you specifically. So those of us who work in this area, our job is really to help give you the realm of possibilities and some ideas and some tools and some skills to help you deal with those, once you establish exactly what it is for you. And in fact it’s interesting because, for some of the people I work with, it’s really not so much emotional but it’s environmental – it’s a lot of this “learned” behavior. So for example, in our culture, we’re fortunate – we live in an abundant food culture. We have more than we need. And so consequently, people who sell food – restaurants and packaged goods, and even sometimes grandmothers and mothers – try to sell it to us by promoting it as something that will make us feel better or something that we deserve or something that’s interesting or that it’s a good value. And so a lot of people that I work with, they’re not just emotionally attached to food, but they’ve learned to use food in a way that it really gets to excess, where they eat much more than they need because that’s what they’ve been taught.

MB: So you’ve gone from being a physician to being a detective and you teach other people how to be a detective, as well?

MM: Yes. I like the way that you put that, Dr. Brickey. In fact, it’s really about teaching people to become their own expert. A lot of the diets that are out there now, some expert or some diet or some guideline tells you what you should and shouldn’t do. But the truth is that we were all born experts in our own bodies. When we’re born, we’re born with the ability to indicate to our parents when we need to be fed. We cry, we fuss, and then when they feed us, we stop eating, even if there’s food left in the bottle. When we’re done, we’re done. But over time, we unlearn that ability. So a lot of the process that I teach is about helping people recognize their own inner expert, their own ability to recognize when they need food and when they don’t, and to use those other triggers, that so-called head hunger or emotional hunger, to help them figure out what else they need, so that they can take care of those needs better.

MB: Are there are a lot of people that are just so out of touch that that’s really not a good way to try to lose weight again?

MM: You know, that’s a great question. I think a lot of people are very disconnected from their bodies. I think that this is true not just in terms of weight, but in all sorts of ways we’re very disconnected from ourselves. And so this process is amazing because it not only helps people manage their weight more effectively, but it helps them recognize their other true needs. So definitely people who struggle with their weight are likely to say things like, “But Dr. May, I’m hungry all the time!” Well, a person that’s very overweight probably isn’t truly hungry all the time, but they’re confusing physical hunger with other reasons that they feel like eating. I’ll sometimes have people that’ll say, “But Dr. May, I’m never hungry!” And what they’re telling me is that they’re eating for so many other reasons that their body never needs to give them the cue to eat. So I don’t think that there’s anybody that’s so disconnected that they can’t relearn this. In fact, in my work – we teach workshops, and by the second week people are coming back, just amazed at how easy it is to reestablish those hunger cues and to really get in touch with their body again. The harder part, of course, is not eating even though you know you’re not hungry. That’s really the hard part for most of us.

MB: When you work with people, is it more getting them to take their own histories and figure it out for themselves? Or is it more clipboard and the doctor’s taking the history and coming up with the diagnosis?

MM: No, it’s very much about skill-building. It’s much more of what I would call a coaching model. So I am only the expert in asking the right questions. The real expert is the patient or the participant in the workshop. And so what I do is I teach them how to ask themselves a series of questions so that they’ll come up with the right answer. Unfortunately, a lot of people that struggle with their weight, they are moving through their lives on autopilot. They feel like eating; they put food in their mouth. They see something that looks yummy; they’re eating it before they realize it. They sit down to dinner, flip on the TV, the plate is clean before the first commercial, and they don’t realize it. So what I really want to do is help people become conscious or mindful or wake them up to the decisions that they’re making. So it’s not about being bad or good. It’s about being aware of what it is that you’re doing and why.

MB: Are you pairing this with relaxation training or some kind of meditation or something that slows them down in getting them living in the here and now? Or is it more focusing on just understanding their eating patterns better?

MM: No, those are great skills. For example, one of the tools that we use is called a mind/body scan. And you would probably recognize it from mindfulness training or maybe meditation training. But in essence, we’ll – one of the very first steps that we take is to help people learn to slow themselves down, take a couple of really deep breaths to reconnect with their body, close their eyes, shut out the external environment, and then scan their body from head to toe: “Do I feel discomfort? Do I feel hunger? Am I tired? Is there pain? Is there a concern, a medical concern that my attention is drawn to?” And then to begin to scan their thoughts and feelings: “What am I thinking about? What am I feeling?” Not with judgment, not with the idea of, “Oh, I shouldn’t eat this,” or “Oh, I’m terrible for wanting to eat this.” But really just seeking to understand and see what’s there. So this mindfulness, this slowing down, this relaxation is a very important part of it. And it serves double-duty because, as you’re well aware, a lot of the triggers for many different problems – medical problems, psychological problems – really are this inability to slow down and relax and relieve stress effectively. So it sort of serves those to help connect people so they understand why they want to eat. And at the same time it also serves as a way of calming themselves to maybe deal with some of those triggers in the first place.

MB: Is there an ideal diet or an ideal way to eat, or is it very individualized?

MM: We use an all foods fit approach, and in fact that’s the approach that the American Dietetic Association takes, as well. So I’m very adamant that there are no good foods or bad foods. In the context of an overall diet, even something as empty as a Twinkie may have a place, you know-

MB: Even a dry Twinkie?

MM: Exactly. As long as people are practicing the basic principles of balance, variety, and moderation. So we want to balance our macronutrients. We want to balance our eating for pleasure with eating for health. We want to eat a variety of foods, across the food groups and even within a single food group. And we want to practice moderation in all things, not just those things like saturated fats and sugary foods, but also moderation in our exercise, in the way that we approach any food that we eat, because ultimately we can undo any specific decision by how we balance and moderate the remainder of the food that we eat that day or the next couple of days.

MB: Yeah, kind of the flipside of moderation is any time you take something to an extreme, you tend to get into problems with it.

MM: That’s right, that’s right. And I think that’s kind of what I’ve been seeing going on in our culture over the last several decades. We have one extreme of overeating, eating mindlessly, eating too much, valuing quantity over quality. And then we have the supposed answer for that, which is the other extreme, which is counting and weighing and obsessing and depriving and feeling guilty. Those two extremes don’t work for people. And people naturally seek balance and they seek moderation. So the moderation part will cause them to – or the balance part will cause them to swing from one direction to the other. And really, all I’m offering people is a way to find that middle ground, a way to balance eating for health with eating for pleasure, a way to understand your hunger cues so you eat what you want, but you eat it in order to meet your physiologic needs, a way to recognize what your emotional needs are, so that you have an opportunity to really meet them, instead of trying to stuff them down with chocolate cake.

MB: You talk about a lot of myths of dieting. One of them is it’s a good idea to eat every three or four hours.

MM: Well, here’s the thing. That myth is a myth because it’s based on observation that people who don’t struggle with their weight tend to eat frequent small meals. But they don’t do it by checking their watch. They do it by eating when they’re hungry and stopping when they’re satisfied. Well, it turns out that your stomach is really only about the size of your fist, so it comfortably holds about a handful of food. So if you eat when you’re hungry, when your stomach is empty, and you fill it with just about a handful of food, that’s not going to last very long. So a person will get hungry again in maybe two hours, four hours, six hours, depending on how much they ate, what they ate, and how active they are. So when we take an observation about something that people do naturally and we make a rule out of it – “You have to eat every three hours” – we’re not teaching people to reconnect with their own ability to do that. So what’ll happen is people will come in to me, to a workshop, for example, and they’ll say, “Well, I heard that I’m supposed to eat every three hours. But should I do, because I’m just not hungry at 3:00 in the afternoon? Should I eat?” Well, no. And then the flipside of that is people will say – on these diets, they’ll say, “Well, whatever you do, don’t let yourself get hungry.” And I think what they’re talking about is this problem that some people get into where they don’t eat for way too long and then they’re too hungry. That’s not a good place to be because when we’re too hungry, we’re not likely to think through our choices. We’re likely to eat too fast. We’re not likely to feel satisfied right away and so we’ll polish off more food than we really need and then we’ll feel stuffed. So I think really a better rule of thumb would be to check your watch, and if it’s been three hours since you’ve eaten, stop what you’re doing for a minute and look for hunger signals. See if you’re hungry. If you’re not, remind yourself to check in again in a half-hour or so. But don’t automatically eat just because the clock says to.

MB: Well, it’s fascinating the way you’re teaching people to learn to trust their bodies. What about the advice to never eat after dinner or after 7:00 pm?

MM: That’s another really good one, and very, very common. And I think that that rule, that “Don’t eat after 7:00” is, again, based on a logical observation. What we know is that a lot of people who struggle with their weight tend to eat late in the evening. But they’re not doing it because they’re hungry. They’re doing it because they’re sitting in front of the TV or they’re bored or they’re lonely or they’re stressed, or this is maybe the first time all day that they’ve had to reward themselves – they’ve finally got the kids in bed, the ironing done. And so people eat after 7:00 for reasons that have nothing to do with hunger. But your metabolism doesn’t shut off at 7:01, so if you were hungry at 9:00 because you ate your dinner at 4:30 or 5:00, then there would be no reason that you couldn’t have a little snack. On the other hand, if you feel like eating at 9:00 and you’re not hungry at all and you know you just ate dinner a couple of hours ago, then there’s a pretty good chance that that desire to eat is coming from something else, and that’s the kind of eating that causes the problem. So I just encourage people, rather than setting these arbitrary rules, try to figure out what your triggers are. What is it that’s causing you to feel like eating, even though you know you don’t really need the food right then?

MB: So if somebody found that one of their triggers is automatically eating while they’re watching television, would you set up a rule that – no eating while watching TV?

MM: Well, now, that’s a really great question. I would never personally tell somebody they shouldn’t eat after 7:00 or you should never eat in front of the TV. But certainly people can set guidelines for themselves that work for them. So let’s say that a person was consistently asking themselves if they were hungry in order to try to resolve their weight problem, and they realized that whenever they sat down in front of the TV at 8:00 to watch their show, they want to have that bag of chips right next to them, because that’s what they’ve always done. They’ve created a habit. They’ve built a trigger for themselves. So they might say, “You know what? This habit isn’t serving me very well, and instead of trying to fight it, let me see if I can change into a new habit.” So, for example, I had one patient; he said that he had sat in the same place on his couch for so many years that he actually had a butt-shaped divot in the cushion. So he said he moved from that couch, where he always used to have plenty of space to lay out all of his goodies and snacks, into a recliner chair next to the couch, and he said immediately he created a new habit. There was no trigger associated with that particular new chair; in fact, for him it was symbolic of moving on and moving to a new place. So again, if a person felt that there was a particular problem for them and they wanted to create some structure or some guidelines that would help them manage that, that’s perfectly appropriate. But it’s not appropriate for me to tell them what to do, because then it’s my rule, not theirs, and they don’t own it.

MB: My math teacher would be thrilled with all the calorie-counting and point systems and how that’s helping people’s math skills. What do you think of it in terms of weight loss?

MM: Well, I think you’ve hit on a good point. A lot of us don’t love math that much, and we don’t have that much energy to be counting and weighing and measuring anyway. Calorie counting is an artificial external means of controlling intake. Now, don’t get me wrong – weight loss is about calories in and calories out. There’s no question about it. But most of us don’t need to count calories. Again, we were given the gift of a natural ability to know how much our bodies need. Babies don’t count calories, toddlers don’t count calories, children don’t count calories. And many of the thin people that you know – spouses or friends who’ve never struggled with their weight – don’t count calories. If we can tap in again to our intuitive or instinctive ability to know how much we need, we don’t need artificial means like that.

MB: What about the people that just say, “Hey, weight loss is a matter of willpower. I just need more willpower.”

MM: Don’t we all? And you know what? You do need a lot of willpower to follow a diet. It takes a lot of energy. It takes a lot of time. In fact, many people say it’s really about “won’t power” – what I won’t do. And here’s the thing. I want to make changes that are going to last forever. I want to help people learn to do something because it feels good, not because they’re being good. So let me give you an example of this. A lot of people struggle with overeating. Whether they’re hungry or not, when they sit down to eat, they eat more food than they need. And one of the things that we do, and one of the things that the book talks about, is helping people recognize that when you eat that much food, you feel very uncomfortable. So I’ll have people visualize a balloon. So as you’re thinking about this, visualize yourself blowing up a balloon. And as you first blow it up, it’s very easy to blow up. You get to sort of a little stage where it kind of reaches that little tension. That’s how full your stomach is when you’ve eaten about the right amount of food. But in order to blow it up big, you have to take a big deep breath and force that air in. That’s what happens when you fill your stomach with more food than it needs. The walls of your stomach begin to stretch, so you being to feel uncomfortable. And then visualize that full balloon pressing on your belt buckle, pressing up on your diaphragm, pressing on your intestines, making you uncomfortable, maybe hard to breathe, maybe a little bit of heartburn. Well, what about any of that sounds good? Not very much of it. Most of us would say, “Oh, my goodness! That’s not a very comfortable feeling.” I remember that old antacid commercial: “I can’t believe I ate the whole thing!” Well, that’s a miserable way to feel. So what I teach people is, rather than trying to be good, try to feel good. Stop eating when you’re totally comfortable still, when you’re energetic, when you don’t feel drowsy and like you need a nap, when you don’t have to unbuckle your belt, when you don’t feel regretful. And then remember – remind yourself that you’ll eat again when you’re hungry. So if the food’s tasting good and you really want to have a few more biters, put it away in a container, and in a few hours when you’re hungry again, pull it back out, because it’s going to taste great. It doesn’t taste that great at the end of eating it. At that point, you’re really just eating the memory of what it tasted like at the beginning.

MB: So, noticing how you’re stomach feels is just one more aspect of listening to your body and heeding what your body is telling you.

MM: Exactly.

MB: I hear a lot of people say, “Well, if I just exercise enough, the problem would be solved. I can just continue eating the way I’m eating.”

MM: Well, and you know, the problem with that is that a lot of people have learned to associate exercise with punishment for eating. So they eat and then they punish themselves with the treadmill. Or they overeat, and so now they have to pay penance by going to the gym. And here it is, is this negative relationship with exercise: “I do it because I was bad.” Well, nobody likes to do anything because they were bad. We want exercise to be something that makes you feel good, that you do because it gives you more energy, it helps you sleep better, it makes sex better. You certainly are more fit and more active and more vibrant and more flexible and stronger and more functioning in your life. It’s not about weight. It’s about how you feel. And so I really urge people to ignore those calorie-counting charts. I want people to really focus on how great it feels when I move my body, how great I feel when I eat the right amount of food, and not use exercise as a way to earn the right to eat.

MB: Is part of that having an image of what you look like and feel like when you are the weight that you want to be?

MM: I think that’s true, but again, when you talk about – earlier you mentioned this idea of mindfulness and being in the present. When we are always striving for what we looked like in high school or on our wedding day, or when we’re putting off living our life until we lose that 10 or 20 pounds, or 50 pounds, or 100 pounds, we’re not living in the moment. And you know, honestly, this moment that we have right now is the only moment we have guarantee of. The rest of it’s gone and we don’t know what’s going to happen in the future. So when people live in the past or postpone living their life until the future, it’s going to actually make it harder for them to manage their weight. I think when people really go out and live their full live that they deserve and they’re intended to, then ultimately food becomes a way of fueling that life. It doesn’t become the whole reason for living that life.

MB: That’s a fascinating distinction, because so much of the achievement and success literature is about, “Well, set your goal and imagine how great you’re going to feel when you’re a millionaire” or whatever the goal is. And this is a very different philosophy of being in the present and being very aware of what’s happening. In case readers are tempted to think that, “Well, it’s easy for Dr. May to say this stuff. She doesn’t know what it feels like.”

MM: You know, any time somebody is really passionate about something – and I hope that you’re hearing my passion in my voice-

MB: Yes.

MM: When somebody is really passionate about something, it usually is because they have some personal connection, and that’s certainly true for me. I struggled with yo-yo dieting from really about age 11 or 12 into my early 30s. I really – I even remember during medical school – I had just finished medical school, I was in the first all-night call of my residency at the hospital. And I remember standing in the salad bar line, filling up my plate, debating everything I was putting on there: “Should I have cheese? Dressing on the side, no sunflower seeds. Okay, more tomatoes, more cucumbers, more lettuce.” And then I remember seeing the malted milk balls over in the corner. And I remember, for the first time, realizing that I could actually hear them calling my name. And at that moment I thought, you know, I am connected to food in a way that I didn’t realize that other people felt. And I continued to struggle with that food. I continued to struggle with overeating and dieting and all of that for many, many years. And in my practice, I saw people over and over again, people with very serious diseases – heart disease and diabetes and cancers and other things – who really wanted to make changes in the way that they ate, but they would swing back and forth from that overeating to dieting to overeating to dieting. And I just knew that it wasn’t just me that was struggling with this. The whole paradigm doesn’t make sense. And in fact, there’s very few things in medicine that we recommend, even though we know that they’re going to fail most of the time, and there’s hardly anything that we recommend that we know it’s going to fail and then we blame the patient when it does. Diets don’t work. We know they don’t work. And it’s about time for people to say, “Well, what does?” What does is learning how to use food appropriately, learning that it can be enjoyable, it should be enjoyable – we should love the food that we eat, we should love eating with other people. But we shouldn’t have to obsess and think about it every hour of every day in between. So ultimately, the reason I’m so passionate about this is because it gave me a sense of freedom. It gave me an ability to enjoy food. I didn’t mention this earlier, but my husband is a professional chef. My parents own restaurants. I love to eat, and I don’t like having to weigh and measure and count and punish myself for it. But I also don’t like overeating – I don’t like how I feel. And I want to have the energy to live my life and do the other things that I enjoy in addition to eating.

MB: So it was your triumph and joy over your own eating problems that motivated you to specialize in helping others with these problems?

MM: Absolutely, absolutely. It’s been such amazing work, because when people learn to slow down and listen to themselves, and when they learn that food cannot take care of all their needs, but there are other things that can, they begin to just blossom right before your very eyes. Now all the sudden food isn’t controlling them. In fact, I say to people, “It’s not really about being in control at all. It’s about being in charge, which means making choices.” And sometimes the choice is to have a couple of chocolate chip cookies – done, it’s wonderful. Sometimes the choice is to say, “You know what? I need to call a friend.” And whatever that choice you make, it’s not about being perfect; it’s about choosing to be intentional about taking care of yourself.

MB: Let me take a break here. This is America’s Anti-Aging Psychologist, Dr. Michael Brickey, with the Ageless Lifestyles Radio Program. Today’s guest is Lose Weight Without Dieting physician, Dr. Michelle May. You can learn about her books, workshops, and coaching programs at http://www.amihungry.com/. And her flag ship book, not surprisingly, is Am I Hungry? Information about Anti-Aging Psychology is at DrBrickey.com, or you can just go to NotAging.com and that will transfer you to DrBrickey.com. Dr. May, there are a lot of diet experts that advocate to just keep your blood sugar levels stable and everything else will fall into place. How important are blood sugar levels?

MM: Well, blood sugars are really important, because we’ve been talking – we’ve been kind of talking around this concept of hunger, so maybe this is a good time to stop for a minute and talk about what hunger really is. Hunger is your body’s physical way of telling you that you need fuel, and predominantly caused by two things. It’s caused by an empty stomach, so when your stomach is empty it might grumble or growl or you might get hunger pangs or it might feel empty. I almost get like a hollow feeling right in the center of my belly. On the other hand, a falling blood sugar will also give signals of hunger. And when your blood sugar is dropping, you don’t have blood glucose molecules or sugar molecules for your brain and your muscles and your red blood cells to function properly, so you might begin to feel a little foggy-headed. It might be hard to make decisions. A lot of us feel irritable and kind of cranky. It might be hard at that point to think of anything but eating. In addition, people might feel a little shaky or low energy because their red blood cells are running out of glucose. So this idea that we need to keep our glucose level is right on the mark. But we can’t do that unless we’re connected with the symptoms that our body gives us to tell us that we need to add more fuel to our system. So just like on our car, we have this little fuel gauge, and if we’re smart, we keep on eye on it so we don’t run out of gas. Same thing with your body. You’ve got to check in with your fuel gauge periodically and see how you’re feeling. When it starts to get low, you want to tank up a little bit before it hits empty. What people are doing right now, Dr. Brickey, is they’re driving down the road and stopping at every gas station they see, regardless of whether their body actually needs fuel or not. So we just have to think about how we really function our best.

MB: You know, one of my pet peeves is you go to a restaurant and they bring out the bread, and they do that because it distracts them and people don’t get so irritable waiting for their meal to arrive, and because you eat the bread and it gives you a spike in blood sugar and it feels good. When we’re talking about blood sugar levels – I know you normally don’t like rules, but do you encourage people to eat the proteins or fats first, or…?

MM: I don’t – I really don’t like rules and I don’t like to teach people things like that. However, you’re pointing out something that’s really important. And you know, we often hear that people should write down everything that they eat. Well, I don’t like to do that from a counting-weighing-measuring perspective, but I think it can be really helpful for somebody who’s trying to figure out what’s going on and how their body functions best. So let’s say, for example, that I’ve decided that I want to take charge of my eating. I don’t like the way that I feel, I don’t like the way that my clothes are fitting, and I want to have more energy and I want to be healthier and improve my blood sugars. So if I decide that and I begin to log what I eat – not every calorie, not weighing and measuring, but just generally: “Okay, I ate a handful of crackers, I ate an apple, I ate a couple of pieces of hard candy” – whatever, just keep writing it down. And then I happen to notice that on that day that I went out to lunch with my friends and I ate that big, huge platter of pasta that they brought out, and then by 2:00 I was nodding off at the bridge table – very embarrassing. And I note this to my self and I realize that when I overeat these refined carbohydrates like pasta, I feel sleepy. I get this big spike. If I happen to have diabetes and I’m logging my blood sugars, too, I notice my blood sugar went way up and out of control during that time. Well, now I can say, “Look what happened when I did this.” I wasn’t bad. I just have now a little bit of new information that I can use to help me make decisions in the future. So the next time I go to that restaurant, I’m going to order maybe some whole wheat pasta in a half-serving, or I’m going to share it with somebody, or maybe I’m going to choose the chicken breast with the veggies and just a little side order of pasta instead. And then when I do that and I notice that I was more energetic and I felt better and my blood sugar was more level, now I say, “Ah, that worked better for me, and in the future I’m going to choose that.” So again, it’s not about me telling a person what to do; it’s about helping them figure out what works best for them so that they can make those decisions long-term. Because, you know, I’m not going to be with you on your cruise or at your daughter’s wedding, and so ultimately you have to be able to make those decisions on your own, without having to think of what I would say.

MB: So you want the primary information coming from our bodies, but it doesn’t hurt to get a second opinion from sometimes logging what you eat or taking a look at some of the rules.

MM: Well, exactly. And nutrition information, and so many of us have resources and sources available to people to help educate them about the effects of food. But nutrition information should be a tool, not a weapon. We want to ultimately use that information to help us make decisions, but we don’t want to beat ourselves over the head. We don’t want to tell ourselves that “I can’t have this,” and “I can’t have that,” and “This is bad,” and “If I eat that, I’m bad,” because ultimately that only results in rebellion. These feelings of deprivation are so powerful that they will actually begin to create cravings that drive us back to eating the very thing that we didn’t want to eat in the first place. So again, it’s not so much about controlling ourselves around certain foods, but it’s about being in charge of how we feel and how we want to feel.

MB: Being in charge is a great feeling. You say that eating right can be fun, and that’s probably for a lot of people to believe. How can it be fun?

MM: It’s true. People have such a love/hate relationship with food. But one of the things that I love to do – I do a lot of speaking at professional organizations and associations and corporations – and one of the things I love to do with them if I have the opportunity is a mindful eating meal. And essentially I teach them about just some of the things that we’ve talked about here and a lot more. And I sit down with them and we eat together, and I show them when they aren’t distracted by the television or reading the newspaper, when they really smell their food and see their food and give thanks for their food, and when they choose their every single bite and they chew it carefully and notice every taste, every aroma, every seasoning as it’s going down, and then choose the next bite just as carefully, noticing how their body is feeling, noticing when they’re becoming satisfied and when the food isn’t as flavorful anymore, which is a signal that they’re not hungry, those kinds of little things will bring such an amazing sense of pleasure. One of the ways that I compare it is if you have a young grandchild and that grandchild came over to visit you and you were working on the internet and you had your back to that child and you said, “How was your day? So good to see you,” and you kept typing along and not paying any attention to that child, that child wouldn’t feel very loved, and you certainly wouldn’t feel very connected and wouldn’t enjoy that relationship. Well, food is very much the same. We need to pay full attention to get every morsel of enjoyment out of it, instead of shoveling it down while we’re driving or talking on the phone or watching TV. So ultimately this idea that food can be joyful and wonderful and we can have fun and cook with other people and eat with our fingers and talk and enjoy it – that’s really that healthy relationship with food. We don’t want to be sitting our dinner talking about how many calories are in it or how bad we’re being or how many minutes we’re going to have to spend on the treadmill tomorrow, which just takes all the joy out of it, doesn’t it?

MB: So you’re into getting people to be very sensual about their food.

MM: That’s a great word. I love that word. Maybe I’ll call my next book Sensual Eating.

MB: I like it.

MM: It’s a good feeling and I think food should be that way. It’s intended that way, and I think it’s really our current culture that has turned it into such a battle. I don’t think it needs to be that way.

MB: When people are clearly obese and they say to you, “It’s got to be genetic. My body just doesn’t work the way everybody else’s body works,” what do you say to them?

MM: Well, I think there is genetic variation. Even before we had McDonald’s and such readily available food and so much automation and mechanical society, there still were overweight people way back in history. So I think there is genetic variation that makes some people more prone to that. But we’ve seen such an epidemic that we know that there’s no way that there’s been a genetic drift in the last 20 or 30 years, and that’s just not possible. And so clearly what’s happening is we’ve taken people who might have a propensity for gaining weight and put them in a really abundant food environment, and then allowed them or taught them or helped them become disconnected from their eating. So I think that, rather than saying, “This is just the way I am, it’s never going to change,” I think a person can be in charge and say, “I might be heavier than the average person, and in fact, for now, I’m not even going to focus on my weight as the issue. I’m going to focus on eating in a way that feels better to me. I’m going to focus on eating in a way where I can really enjoy my food. I want to eat in a way that doesn’t leave me feeling stuffed and uncomfortable and regretful. And I want to move my body in a way that I can function fully in my life and run with my grandchildren and go get into an airplane seat if I want to.” Those are very real, tangible, exciting, fun things to think about. It’s not about a number on the scale. It’s about how I’m living my life right now and how I’m feeling with every decision that I make.

MB: I’m sure you have a lot of pet peeves about some of the popular diets. Which ones would you say are the worst?

MM: I’m reluctant to point fingers because, in fact, any time anybody teaches you “This is the way you must eat,” it has a tendency to backfire. So even for example, what I’ve been talking about with hunger, some people that are listening to this are saying, “Okay, so the rule is I can only eat when I’m hungry.” Well, as soon as they make that the rule, they’re going to rebel against what I’m saying, too. I never said that. What I said was: Ask yourself if you’re hungry when you feel like eating. Connect with your body and then make a choice. So ultimately, any time some outside expert tells you what you should do, it’s very likely that there will eventually come a time when you stop doing that. So I often tell people, if what you’re considering doing isn’t something that you can imagine doing every single day for the rest of your life, no matter what else is going on, then don’t bother doing it for a day, because as soon as you go back to what you were doing before, you will gain the weight back. That’s what we’ve been seeing. And unfortunately, a lot of people gain back more. So I don’t think one diet is worse than another one. Some of the worst ones medically or physiologically, they’re so hard for people to stay on, they can’t really be on them long enough to injure themselves, you know. They just can’t stick to it because it’s so hard, so…

MB: The “Am I Hungry?” Program is certainly one of the most comprehensive. Are there prices of some of the popular diets that get it right?

MM: Yeah, I think you’re starting to see more people talking about hunger as a cue. I think a lot of even popular diets – for example, I’ve noticed that Weight Watchers, their big New Years push this year has been, “Stop dieting, start living.” And I just have to laugh because that’s actually the tagline on my website and on all my materials. So it’s funny that even some of the very popular diets are using phrases about not dieting. The truth of the matter is that even Weight Watchers is a way of weighing and measuring and counting in order to come up with a point value. So I don’t think that just because we call it a lifestyle change means that it’s not restrictive in nature. But a lot of people can learn really good information about nutrition. A lot of the people that I’ve worked with, including myself, who’ve been on Weight Watchers lots of times, we have a lot of information about nutrition. And so I think there’s something to be gained from that. It’s the restriction part of it that gets people into trouble. It’s the, you know, “Okay, so this food has a lot of sugar in it, therefore you have to exercise X-amount more minutes if you want to eat it,” or “If you eat it, you have to eat less of something else.” I mean, those kinds of things, in the long run, tend to backfire.

MB: For people that want to use physical fitness to help them become healthier and lose weight, are there some physical activities that are more helpful than others?

MM: I think really, for most of us, where we see the most benefit is when we increase from where we are to that next level. So what I mean by that is that if a person is very sedentary and not doing anything at all, and now they choose to get up and go get their own mail, maybe walk their dog around one single block, they’re going to see remarkable improvements in their energy level and how they feel. So I often tell people that the place to start is exactly where you are. Instead of, again, focusing off into the future of, “Oh, I should exercise 30 to 60 minutes every day, like the government says,” how about, “Look, I’m doing nothing right now. I’m going to exercise for five minutes every day this week.” Well, you know what, that may not seem like very much, but it’s huge. It’s a 500% increase over what you were doing before. And that little door opener helps you see that it is possible to be more active. And then next week it might be seven minutes, and the week after that it might be ten. And who knows, by the end of the year maybe it is realistic to do 30 minutes. So I encourage people to start wherever they are. Now if they’re really physically active and they’re enjoying it and all they’re doing is walking, they’re going to get huge benefits by adding strength training. If people are doing walking and strength training and they’re not taking the time to stretch afterwards, they’re going to notice a huge improvement when they begin to take a yoga class or a stretching class. So there’s always more that we can do, but the point is that you start exactly where you are and not avoid it because it’s too hard or the goal is too far off in the future.

MB: I love the way your philosophy just all fits together and it’s so consistent. There is a rule I want to ask you about – the business about drinking eight glasses of water a day. I’ve also had some very bright physicians tell me that that’s not necessarily so. Is that important?

MM: You know, that’s a great question, too. When we wrote Am I Hungry? I also had a dietician and a psychologist that worked on the book with me, and we didn’t put anything in that book that we couldn’t find researched evidence for. We looked everywhere for data and studies that showed that that was the right amount of water, and we couldn’t find it. And so the truth is, is that that’s been some dogma that’s been passed down from year to year to year, diet to diet to diet. There really is no apparent physiologic reason to drink eight exact glasses of day. And in fact, what we know is that people who are overweight actually need more water. I live in Arizona; people who live out here need more water. People who are exercising or ill need more water, or on certain medications. So here’s what I tell people. Instead of following an arbitrarily rule about how much water you should drink – any more than following an arbitrary rule about how many calories you should eat – try to connect with your body. And here’s how you do it with water. Whenever you pee, stand up and look into the bowl and see what the urine looks like. If it’s very dark, that usually means that your body is concentrating the fluids in your body. It means it’s not getting enough fluid. When you start increasing the amount of water you drink, your urine will look lighter and more dilute. Now, the exception to that, of course, is certain medications and certain vitamins. But for people who aren’t on those vitamins, that’s a really handy cue for how well they’re doing water-wise.

MB: So again, it’s listening to your body and noticing your body instead of following arbitrary rules.

MM: Exactly.

MB: People who go on your program or other programs – I’m sure even your people sometimes blow the – what they were supposed to do, and maybe are embarrassed and just want to give up on the whole thing. What do you say to them at that point?

MM: You know, I think that every mistake that we make is a learning opportunity. Every time I screw something up – and I do it myself and I’ve been eating this way for a dozen years now – every time I screw something up, I learn something about myself. I learn a little bit more about what would work better for me. What got in the way? What happened today that I ate so much more than I meant to? And when I approach any situation, particularly around learning to eat healthier and be more physically active, with a sense not of judgment and failure, but a sense of learning and openness to this journey, then I can improve, I can get better. That’s why earlier when we were talking about how much people eat, you didn’t hear me say that I would feel guilty when I ate too much. I said you would feel regretful. Because guilt means you were bad; you did something that you shouldn’t have. But regret means that you did something that you wish you hadn’t. And because of that, you can take that information and learn from it and choose a different path next time. That’s how we learn. That’s how children learn. If children felt guilty and gave up every time they fell down as they were learning to walk, we’d all still be crawling on all fours. But we get back up, we learn from our mistakes, we brush ourselves off, and we try it again until we get it right.

MB: I like that. Now, you have CDs, you have books, you have workshops. How does a person know what is the best fit for them, or whether a book or CD would sufficient, or whether they need the whole treatment of a workshop?

MM: Oh, that’s a great question. You know, we have lots of formats because, as you know, people learn differently. They learn at different paces. So somebody who’s just trying to get an idea whether this is right for them might not want to spend a single dime. On our website we have a little quiz that they can take. They can actually download the first chapter of the book for free, just clicking on the links in our shopping cart. So, you know, we want people to have the information. And so I would first encourage anybody who’s thinking to themselves, “You know, this makes sense for me. I’ve done a lot of dieting. It hasn’t worked. I’ve always believed there could be another way.” I would encourage them to just roam around on AmIHungry.com, read a few articles, download the first free chapter – don’t spend a penny, just spend a little bit of your time. And if it feels right, pick up the book or maybe click on one of our workshop links. We have facilitators all over the country and we have facilitators that teach by telephone for people that don’t have a facilitator near them or don’t like to travel or don’t like to go out of their house. And so they can take a workshop by telephone if they wanted to. So I ultimately think, just like the approach of managing your weight, just as different things work for different people, so can we learn this approach in different ways – listening, talking, reading, whatever works for you.

MB: You are so individualized about everything you do. Is there any last piece of advice or comments you’d like to share with us?

MM: Yes. I would say that you are never too old to take care of what’s happening in your life. If something hasn’t been working for decades and decades, that’s all the more reason to try something different. Don’t try the same old thing over and over again, expecting it to turn out different. It’s time to really say, “Is it possible that I could go back to learning how to eat instinctively again? Can I learn how to take care of my body and listen to my body and trust what it’s telling me? And can I restore a joyful relationship with food and physical activity that serves me well?” I think it’s possible. I’ve seen it happen hundreds and hundreds of times. And I hope that your listeners are learners and people that want to make changes, because ultimately it’s only when we do the same thing over and over again that we get stuck.

MB: Dr. Michelle May, you are a jewel. The program you developed is just so beautifully consistent and common sense and is just such a great philosophy – as a matter of fact, a philosophy that could spill over into a lot of other aspects of life.

MM: Oh, I agree with you completely. That’s the joy of it. You see it showing up all over the place.

MB: This is America’s Anti-Aging Psychologist, Dr. Michael Brickey, with the Ageless Lifestyles Radio Program, and today’s guest is Am I Hungry? doctor, Dr. Michelle May, and you can learn about her books, workshops, and coaching programs at http://www.amihungry.com/. Her flagship book is Am I Hungry? And information on Anti-Aging Psychology is at DrBricky.com, or you can just go to www.NotAging.com.