As dietitians, we often talk to weight loss patients about “watching what [they] eat.” However, a growing body of evidence tells us that the formula for success may be less about watching and more about something else: Writing.
Specifically, writing down food intake in a daily journal. Here’s a closer look at five ways in which keeping a food journal can help bariatric patients with weight loss adherence in order to reach their weight loss goals.
Weight gain is a gradual and sometimes insidious process. When the pounds creep on, many people find themselves wondering how they gained the weight. Food journaling turns weight loss and weight management into a proactive preventative measure.
When people track what they’re eating in food journals, they become more aware of what they’re eating. This leads to increased accountability and awareness of the relationship between what weight loss patients eat and their weight loss successes and failures.
Making a bad food choice is one thing when no one is looking. However, when patients know they’re going to write it down and account for it later they’re less likely to slip up in the first place.
But weight loss journals can also be a useful tool when used before eating. By writing down what they plan to eat, pre-op and post-op bariatric patients can lay the groundwork for a day of healthy choices.
Sure, keeping a food journal can help patients understand exactly how many calories and macronutrients they’re eating each day. In doing so, however, food journaling also serves the higher purpose of making patients more aware of their food choices along with the factors influencing those choices.
Food journalism is also an effective defense against emotional eating. As Jeanne Goldberg, professor of nutrition at the Friedman School of Nutrition, Science and Policy at Tufts University in Boston, told the Wall Street Journal: “The idea is to raise our consciousness. Is it lunchtime and you were hungry? Or is it just that you were bored and you were home, so you went to the kitchen and got something to eat?”
Different weight loss patients have different levels of knowledge pertaining to food and nutrition. Some may think they’re making bariatric-friendly choices and yet still find themselves struggling to lose weight. Even worse: They’re unlikely to be accurate when attempting to remember and relay what they’re eating to dietitians.
Enter food journaling. This written record gives dietitians the opportunity to review what patients are eating in order to determine areas for positive change. Reviewing a patient’s weight loss journal can also help dietitians ensure that patients are meeting other targets, such as protein intake.
All of this begs the question: Given that food journaling is fairly labor intensive, is it worth it? The answer is a resounding yes. In fact, research from Kaiser Permanente’s Center for Health Research indicates that not only did 70 percent of people lose enough weight to lower their health risks through food journaling, but study participants who kept food diaries doubled their weight loss.
The conclusion, according to Jack Hollis PhD, a researcher at KPCHR and lead author of the study: “It seems that the simply act of writing down what you eat encourages people to consume fewer calories,” Hollis said.
Adds Kaiser Permanente internist and weight management specialist Keith Bachman, MD: “Every day I hear patients say they can’t lose weight. This study shows that most people can lose weight if they have the right tools and support. Keeping a food diary doesn’t have to be a formal thing. Just the act of scribbling down what you eat on a Post-It note, sending yourself e-mails tallying each meal, or sending yourself a text message will suffice. It’s the process of reflecting on what we eat that helps us become aware of our habits, and hopefully change our behavior.”
And that’s one of the most exciting things about food journaling in the 21st century. Thanks to technological advancements, today’s weight loss patients have more options than ever when it comes to finding a food journaling method that best suits their needs and preferences.
Keep in mind, though, that not all food journals are created equal. In order to help your patients make the most of theirs, advise them to note — in addition to foods consumed — time, location, mood and satiety in their journals. This can help them identify negative habits, patterns and triggers in order to avoid them. Additionally, it’s also important to log all foods eaten — including beverages and condiments -— as these calories add up and yet are often underreported.
There is a caveat, however, when it comes to the role of food journaling: It only works for the long-term if sustained over the long-term. Many patients who successfully lose weight through food journaling only to stop keeping track of what they eat end up regaining the weight.
The takeaway for dietitians: Reinforcing to patients the importance of continuing to food journal is also critical to weight loss adherence.