Gary Foster - The Shift: 7 Powerful Mindset Changes for Lasting Weight Loss

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To my wife, Kathleen,
and our children, Katie, Ryan, and Kevin

The names and identifying details of some individuals mentioned in this book have been changed to protect their privacy.

The approaches and techniques described in this book are not meant to be a substitute for professional medical or psychiatric treatment.

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ILL LOSE WEIGHT
BY CHANGING THE WAY
I EAT THINK

This book is about losing weight and getting healthier, make no mistake. But its not about what to eat. Its not a diet book. There are no recipes, no sample weeks of meals, no food recommendations or restrictions, no claims about which foods will make you gain fat or shed it. Does that surprise you? When people are on a weight-loss journey, their first consideration is usually something like, What should I eat? What CAN I eat? Low-fat, high-fat, low-carb, high-protein, low-sodium, low-cal, high-fiber, Mediterranean, vegetarian, vegan, keto? Diet A or diet B? (Or diet CZ?) Ive seen this whether at WW (formerly Weight Watchers), where I speak to members face to face or virtually at workshops around the country and the world, or among the thousands of people I have treated in group or individual settings, or among those I have just met who learn what my profession is. Everyone is focused on what and how to eat. I get questions like, Can you really eat bacon and lose weight? Should I eat certain foods in combination? Whats better, avocado or kale? What foods start my metabolism in the morning? What are the top five foods for weight loss? I heard about [fill-in latest fad diet]what do you think? People often want to be told what to eat.

Yet most people dont need me, or anyone, to script a meticulous moment-by-moment, meal-by-meal eating plan for them. When given a food choice (eat this or eat that), people generally know which is healthier. This banana (big, small, whatever) or that banana split? Deep-fried or baked? More times than not, its clear. Sure, with a few foods, like dark chocolate or coconut oil, its not quite so obvious how beneficial or not they are for our health. For the most part, though, we know.

NAME THE HEALTHIER FOOD

1. (a) ground beef

2. (a) whole wheat pasta

3. (a) banana bread

4. (a) potato chips

5. (a) roasted potatoes

6. (a) grilled fish

7. (a) half and half

8. (a) oatmeal

(b) chicken breast

(b) white rice

(b) banana

(b) orange

(b) french fries

(b) fried fish

(b) 2 percent milk

(b) pancakes

Despite this awareness, when people want to lose weight they focus on food, assuming theres something they havent learned that an expert needs to tell them.

I get it. At the start of my career as a clinical health psychologist focused on obesity treatment, I assumed the same thingfood first, food last. But what I learned time and again through my work with my amazing patients was this: What you eat and how much, along with levels of activity, may seem to be all that count in weight loss, and they do count, of coursebut without another crucial component, they will not add up to long-term weight-loss success.

That component is your mindset. How you think.

Look at mindset as having two parts: how you think about yourself and how you think about the journey youre on.

The ideal way to think about yourself is to accept you as you are now; a great way to do that is to practice self-compassion (the subject of chapter 1). The ideal way to think about the journey is to think realistically, flexibly, and with the big picture in mind; one way to do that is by identifying and countering unhelpful thoughts (the subject of chapter 2).

Let me share how I became convinced that mindset is critical for any successful weight-loss journey, and why, without the proper mindset, any success will be fleeting.

After majoring in psychology in college, I wanted to head straight to graduate school to become a practicing psychologist, but I wasnt 100 percent sure of my path. My advisor suggested that I first learn about the field, by doing research with psychologists. I looked for jobs at the University of Pennsylvania, in Philadelphia, about forty-five minutes from my home, and two positions caught my interest. The first was helping a researcher in family dynamics to better understand how family interactions impacted medical conditions like asthma, diabetes, and others. Ive had type 1 diabetes since I was six years old, so the idea intrigued me. But the job involved watching and coding videotapes of family therapy sessions for eight hours a day. That didnt speak to me.

The second position was in the area of obesity: A research group at Penn was focused on better understanding its causes and treatments. The work caught my attention, as did the way it was being conducted. Still, when I was offered the position with the obesity research group, I felt it was largely serendipity to find myself in that world. I had no previous interest in or meaningful knowledge of weight loss or obesity. I myself hadnt struggled with those issues. My mom was overweight but not in a way that made a great impact on me or, as far as I could tell, on her. Back then, the prevalence of obesity in the United States was roughly 15 percent, not the 42 percent it is today. I confess with some shame that when I started in the field, I, like so many, held a simplistic, frankly prejudiced view of people who struggled with weight. Concepts like willpower and discipline were never far from mind. I wince to think I could ever have harbored such a misguided, hurtful, scientifically insupportable view.

Fortunately, it was knocked out of me in a hurry.

My early work at Penn involved doing weigh-ins, evaluations, and interviews. I asked people about their eating and activity patterns. Our patients were bravely taking part in studies that evaluated a variety of waysdiet, medication, surgery, behavioral methodsto improve short- and long-term weight loss, as well as manage the multiple medical conditions associated with excess weight. One study measured the benefit of a low-cal diet versus an extremely low-cal diet; another, the Atkins diet versus a lower-fat diet; another, the effect of behavior modification versus medication versus a combination of both; and so on. My interest and passion in the field grew profoundly. Why? I realized how much I enjoyed helping people who were struggling with their weight. I admired their persistence, courage, and openness to change. At that point in my career, I was hopeful that some mix of diet, a certain type of physical activity, and behavioral techniques like goal-setting and self-monitoring could improve success, in the short and long term.

My understanding of the field grew with my one-on-one work at Penn, as well as my extensive reading of giants in the field, several of whom were right there on our faculty, and whom I was fortunate to converse with and learn fromin particular, Tom Wadden, Kelly Brownell, and the late Albert Mickey Stunkard. Tom and Kelly are psychologists; Mickey was a psychiatrist. They helped me begin to understand that things were not as simple as they appeared. I was captivated by everything from the emerging science around genetics and fat cells to the potential benefits of surgery to advances in behavior therapy to the impact of school environments on childhood obesity. I grew increasingly aware of the pervasive, persistent, pernicious weight-based discrimination and stigma that so many people experience. The book that affected me most deeply, both personally and professionally, was Mickeys