The Advice Show: How to Lose Weight and Limit Your Sugar Intake

Managing our sugar intake, says Dr. Julie Friedman, is like managing an addiction.

“When you have access to that addictive substance all the time, that is where the psychology comes in,” says Friedman, an assistant professor at Northwestern University Medical School and director of weight management programs at Insight Behavioral Health Centers.

In this episode of “The Advice Show,” Friedman talks weight-loss strategies, what her pantry looks like and how a personal medical emergency impacted her choice of her field of expertise.

Below is an excerpt of our talk, but the entire conversation can be downloaded via SoundCloud and iTunes or streamed via YouTube. “The Advice Show” is part of the Sun-Times Media Local Podcast Network.

Q: I am your perfect patient because I would love nothing more than for obesity to be a disease, and that way it is not my fault. So convince me, because I am perpetually 20 lbs. overweight.

Friedman: First of all, I do personally believe that obesity is a medical disease. In order to look at why I would believe that, we have to define disease first. Disease is typically something that impairs functioning across a lot of different organ systems or body systems. So from that standpoint, obesity would definitely meet criteria for a disease.

And when you say, “I would love to be told it is not my fault,” I will tell you it is about 60% not your fault in the sense that we inherit genes that dictate our weight somewhat.

So if you inherit a certain weight range, it is then your behavior that determines where you are on that range.

But certainly many people eat well and exercise and still struggle with their weight. So some of it is also having to accept what weight range and what genes you have inherited, which is hard to do, especially in this culture where fat is so bad.

Q: Fad diets seem to change every year, but what does the most damage?

Friedman: The single biggest inflammatory food that you can eat is definitely sugar, and that is linked to weight. Now as for the psychology of it, life is too short to go without sugar entirely. And so we have to really teach people. It is really like managing an addiction. When you have access to that addictive substance all the time, that is where the psychology comes in.

I think that is where you find the middle ground, in terms of saying, “How do we get them consuming less sugar?” I have kids, too. They are going to be subjected to sugar everywhere they go. We have to teach them what to do around it. Something as simple as saying, “You can have dessert every night. But you don’t have dessert after breakfast, and you don’t have dessert after lunch.”

Things like that really work because they give people the structure of “moderation.” Because moderation is really a myth. It is very difficult as human beings. We can’t moderate our behavior, especially around sugar.

Q: I need a sugar exorcism.

Friedman: We crave what we eat. If you keep eating sugar, you are going to crave more of it. So then moderation goes out the window, because physiologically, we’re just not able to moderate our food intake.

And we know that. There is really new research that shows that actually the higher consumption we have of refined carbohydrates, the worse our signaling is in our brain to signal our stomach to produce fullness and hunger cues.

Q: This is “The Advice Show,” so give our audience advice about how to moderate weight.

Friedman: First of all I love the idea of a sugar exorcism and I would say go ahead and do that, but do it very temporarily. So the less you are eating it, the less you will crave it. And then we work it into your diet, but we keep it out of your home environment. Have it, plan for it, make it deliberate, but go out and get it, because the minute it is in your home environment, it will haunt you.

Q: So what does your pantry look like?

Friedman: I have an 8-year-old and a 4-year-old, one of whom is also sugar obsessed, so we do keep a pretty clean pantry. But yet, we certainly have sugar. Right now you would probably find cookies, crackers, all the things that we tell our patients to limit the quantity of, but you would find a reduced variety of it. So I think that is our negotiation. My husband loves variety. He would love to have seven different kinds of cookies in the house. We have one, because I know if we put seven in there, my kids will be in there all the time. I really, truly believe life is way too short to go without sugar.

Q: What advice do you have the hardest time following at home for you and your family?

Friedman: That’s a great question and I know the answer right off the bat. And it is only eating while eating. So we always talk about just eating while you’re eating, not in the car, not eating in front of the TV, not reading while you eat. I can’t remember the last time that I only ate while eating.

Q: You have a very personal reason for going into this line of work. Can you tell me that story?

Friedman: I was attracted to health psychology, largely because I had a medical crisis. I was getting a PhD in clinical psychology, and I had been having pain and I was right in the middle of finals. It turned out that this was a large ovarian cyst that had actually caused my ovary to twist.

I was admitted to a hospital to the emergency room, and while they were doing the surgery, my right external iliac artery was cut.

My parents were told, “Listen, we had to save her life. She’s probably going to lose her leg, but we’re not going to know that until she wakes up from surgery and stabilizes a little bit.”

And about three days later, everybody was sort of watching and I hopped out of bed and bounced around the room like I always had — which was nothing short of a miracle.

Q: How did that change your trajectory then?

Friedman: What saved me, essentially, was the fact that I had been exercising before the surgery. And so it brought me to this point of really understanding for myself how important it is to take good physical care of yourself.

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