Guiding Principles for Healthy Eating
If you’ve struggled to lose weight and found it difficult to maintain it, you can blame it on evolution. The human body’s evolutionary response has evolved to tenaciously hold on to extra pounds. This bodily phenomenon makes weight loss challenging for many people and even more difficult to keep the weight off long-term. In this article, I will address a possible solution to this challenge by providing you with some guiding principles for healthy eating.
Over the past 40 years, despite numerous lifestyle changes and increased efforts to lose weight, the average person’s weight has continued to rise. Interestingly, a study in 2021 concluded that emphasizing weight loss as a solution may not be effective in improving overall health.
When Dieting is Harmful
Studies indicate that the cycle of losing and gaining weight, also known as weight cycling, might have more detrimental effects on health than simply carrying excess pounds. In a compilation of studies in 2021 weight cycling was found to be linked to an increased risk for diabetes. Furthermore, An earlier study from the same Chinese researchers revealed that weight cycling was associated with a 40% higher risk of death, particularly from cardiovascular disease. These findings highlight the potential risks of frequent weight fluctuations on health outcomes.
The US Food and Drug Administration (FDA) has approved five long-term medications for individuals with specific body mass index (BMI) criteria. (BMI; calculated as weight in kilograms divided by height in meters squared). These medications are orlistat, phentermine plus opiramate, naltrexone plus bupropion, liraglutide, and semaglutide. They are intended for use in individuals with a BMI of 30 or more (with no weight-related comorbidities) or a BMI of 27 or more (with weight-related comorbidities.). These drugs have been approved to aid in weight management for eligible individuals.
Based on three clinical trials, semaglutide (available under the brand names of Ozempic and Wegovy), has shown superior efficacy compared with placebo and other antidiabetic medications. These trials involving both injected and orally administered semaglutide demonstrated significant weight reduction results. As a result of these findings, the FDA approved Wegovy (semaglutide) as a medication for weight loss.
How Semaglutide Works
Semagludtide mimics a hormone in the body called glucagon-like peptide-1. It affects certain parts of the brain responsible for regulating appetite, increases insulin production, slows down digestion, and can contribute to feelings of satiety.
In various studies, semaglutide demonstrated improvements not only in diabetes management and body weight reduction but also in reducing the rate of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke in patients with diabetes mellitus type 2 at high risk of cardiovascular disease.
Too Good to be True?
Despite the popularity of these drugs, individuals must exercise caution before taking them. Especially for older adults using semaglutide to lose weight, there may be specific risks to take into account. For example, the American Society of Anesthesiologists issued a warning in late June about surgery risks for people who take semaglutide. In addition, an ongoing review in Europe is examining whether Wegovy and Ozempic, along with another weight-loss medication, Saxenda, may contribute to the increase of suicidal thoughts and self-injury.
Another study states, “The secondary condition can be high blood pressure, pre-diabetes, diabetes, sleep apnea, arthritis, hyperlipidemia, anxiety, and depression.” In another alarming study, experts say they are seeing more cases of gastroparesis, or stomach paralysis, in Ozempic users. This includes symptoms such as violent vomiting, nausea, stomach pain, and bloating. Gastroparesis, also known as delayed stomach emptying, is when food passes through the stomach slower than it should. Novo Nordisk, the maker of Ozempic and Wegovy, for comment. It told CNN: “Gastrointestinal (GI) events are well-known side effects of the GLP-1 class.”
Long-Term Effects of New Weight Loss Drugs
It remains uncertain whether the newer generation of weight loss drugs, which suppress appetite, will yield different long-term results compared to other weight loss approaches. A significant study, which lasted 68 weeks (about 16 months), revealed that weight loss plateaued and began to rise again by the end of the study, indicating that individuals may have become acclimated to the drugs.
The association between being overweight or obese is often linked to an elevated risk for health problems, and early death is well-established. However, an intriguing finding from a recent study is that being underweight can be considerably more hazardous than being obese. Both underweight and obesity, particularly higher levels of obesity, are linked to increased mortality compared to individuals with a normal weight category. Nevertheless, positive lifestyle habits are associated with a significant decrease in mortality regardless of baseline body mass index.,
Additionally,  A 2016 study spanning almost four decades and involving more than 100,000 adults in Denmark found that those with an ‘overweight’ body mass index (BMI) were more likely to live longer than those in the ‘healthy,’ ‘underweight,’ and ‘obese’ categories. These findings highlight that individuals who are overweight but in good physical shape may fare better in terms of health than those who have a normal weight but are out of shape.
Among three Danish cohorts, the BMI associated with the lowest all-cause mortality increased by 3.3 from cohorts enrolled from 1976-1978 through 2003-2013. Further investigation is needed to understand the reason for this change and its implications.
Work Toward Optimal Health, and a Healthy Weight Will Follow
The reality is that there is no simple, one-size-fits-all approach to weight loss. I believe that achieving optimal health is much more important than simply losing weight—and that when we focus on our health and well-being, the body naturally settles at a healthy weight.
The following blogs will give you a good understanding of my unique approach to weight loss:
2) How To Be Healthy and Happy Achieving Your Optimal Weight
3) Six Targets For Optimal Weight Using Botanicals
4) Adaptogens: Foundational Support for Weight Management
Donnie’s Health-Promoting Smoothie (Can be used as a meal replacement)
- Whole foods Super Green/Fruits: 1 scoop (I use N-Liven)
- Undenatured whey powder + Colostrum, Magnesium Creatine, Glutamine: 1 scoop (I use Beyond Whey)
- Fruit anthocyanins: 1 tsp.
- Yogurt (whole milk, sheep, goat, or organic coconut): 2/3 cup
- Coconut water: 2-3 oz.
- Frozen or fresh berries or mangos: 3 oz.
- Optional: sea vegetable blend: ½ tsp.
- Optional: ground flax seeds
- Optional: powdered herbal extract blends. I use Papaya Digest (nourishes stomach energy) and/or Thermo-fit (boosts metabolism).
Papaya Digest contains green papaya with ginger, orange peel, cardamon seed, and lotus root.
Thermo-fit contains guggul, coleus forskolii, green tea, cinnamon, and seaweed.
The Benefits of Intuitive Eating
Intuitive Eating is an evidenced-based, mind-body health approach comprised of 10 Principles and created in 1995 by two dietitians, Evelyn Tribole and Elyse Resch. It is a weight-neutral model with a validated assessment scale and over 180 studies to date. I find the research exciting and hopeful for the many people who struggle with weight issues.
Intuitive Eating is a dynamic integration between mind and body. Intuitive Eating is an adaptive approach conferring benefits beyond eating and is valuable for interventions that address social and structural barriers that impede Intuitive Eating.
The fundamental principles either cultivate or remove obstacles to body awareness, a process known as interoceptive awareness. Essentially, Intuitive Eating is a personal process of honoring health by listening and responding to the direct messages of the body in order to meet one’s physical and psychological needs.
Intuitive Eating interventions have consistently shown benefits for psychological well-being, and some have shown improvements in physical well-being, as well as in the relationship between Intuitive Eating and food intake.
The Principles of Intuitive Eating
1. Reject the Diet Mentality
Reject the diet books and magazine articles that falsely promise quick, easy, and permanent weight loss. Recognize the damaging effects of diet culture, which perpetuates unrealistic expectations and makes you feel like you are a failure every time a new diet inevitably fails to deliver long-term results and you gain the weight back. It is essential to let go of any lingering hope that a new and better diet or food plan might be lurking around the corner, preventing you from being free to rediscover Intuitive Eating.
2. Honor Your Hunger
Keep your body biologically fed with adequate energy and carbohydrates, otherwise, it may trigger a primal drive to overeat. Once you reach the moment of excessive hunger, all intentions of moderate, conscious eating are fleeting and irrelevant. Learning to honor your body’s natural cues will help rebuild trust in yourself and your relationship with food.
3. Make Peace with Food
It’s time to call a truce and put an end to the food fight! Allow yourself to eat without restrictions or feelings of guilt. When you deny yourself certain foods or label them as forbidden, it can lead to intense feelings of deprivation. This deprivation often results in uncontrollable cravings and, unfortunately, binge eating. Eventually, when you finally “give in” to your forbidden foods, it often leads to overeating akin to a “Last Supper” scenario and overwhelming guilt afterward. Embrace a healthier approach by giving yourself unconditional permission to enjoy food without judgment or unnecessary restriction.
4. Challenge the Food Police
Scream NO to thoughts in your head that label you “good” for eating minimal calories or “bad” for enjoying a piece of chocolate cake. These thoughts are the food police that monitor the unreasonable rules that diet culture has imposed on you. The food police station resides deep within your psyche, and its loudspeaker broadcasts negative comments, hopeless phrases, and guilt-inducing judgments. Chase the food police away and silence them. Regain your control over your relationship with food. This is a critical step in returning to Intuitive Eating.
5. Discover the Satisfaction Factor
The Japanese have a wise approach to healthy living and emphasizing the importance of pleasure is one of their goals. In our compulsion to comply with the diet culture, we tend to overlook one of life’s fundamental gifts—the pleasure and satisfaction that comes from the eating experience. When you eat what you truly desire, in an inviting environment, the pleasure you derive will be a powerful force in promoting feelings of satisfaction and contentment. By creating this enjoyable experience for yourself, you’ll naturally recognize when you’ve had enough to eat.
6. Feel Your Fullness
To honor your fullness, it’s crucial to trust yourself to give you the foods you desire. Listen for your body signals that your body sends when you are no longer hungry. Observe the signs that show that you’re comfortably full. During meals, take a moment to pause in the middle of eating and reflect on how the food tastes and assess your current hunger level.
7. Cope with Your Emotions with Kindness
Recognize that food restriction, both physically and mentally, can trigger a sense of loss of control, which may lead to emotional eating. Instead of turning to food to deal with emotions like anxiety, loneliness, boredom, and anger, find gentle ways to comfort, nurture, distract, and address the root causes of these feelings. While food may be a comfort for the short term, it can distract you from the pain, or even numb you. Food won’t solve the underlying emotional issues. In fact, eating to fill an emotional void may lead to making you feel worse in the long run. Ultimately, addressing the source of the emotion is essential for genuine emotional well-being.
8. Respect Your Body
Accepting your genetic blueprint is crucial in embracing a healthy body image. Just as someone with a shoe size of eight would not expect to realistically or comfortably squeeze into a size six, it is equally unrealistic and uncomfortable to have unattainable expectations about your body size. The key is to respect your body so you can appreciate your body and feel better about who you are. Rejecting the diet mentality is difficult if you are unrealistic and overly critical of your body size or shape. Everybody deserves dignity.
9. Movement—Feel the Difference
Militant exercise is not the solution to feeling better or achieving weight loss. Simply becoming active can positively shift your focus. The sense of fulfillment and satisfaction you gain and the energizing effect of physical activity can motivate you to get out of bed for a brisk morning walk instead of hitting the snooze alarm. It’s not about pushing yourself to extreme levels of exercise but rather finding joy and enjoyment in moving your body, which can lead to better overall well-being and a more sustainable approach to staying active.
10. Honor Your Health through Gentle Nutrition
When making food choices prioritize those that are good for your health and satisfying to your taste buds. Remember that you don’t have to eat perfectly to be healthy. Think of hormesis! A little bit of stress activates an adaptive response, which makes us healthier and stronger. This principle applies to all aspects of life, including food.
For instance, I am of Italian heritage and love indulging in really good pasta and other delicious Italian dishes. While focusing mostly on making homemade meals with organic and healthful ingredients, it’s also perfectly okay to occasionally go out and enjoy some great Italian food without being overly concerned about its organic status or nutrient density. The key is to cherish the pleasure of the meal and the company you’re sharing it with.
Ultimately, the consistency of your eating habits over time matters most. Pay attention not just to what you eat but also the reasons behind your eating, the timing of your meals, how you eat, who you eat with, and how much you enjoy your food. Cultivate a positive mindset by blessing everything you eat and savoring the pleasure of a good meal, as this sets the tone for a healthy and balanced relationship with food.
 Gaesser GA, Angadi SS. Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. iScience. 2021 Sep 20;24(10):102995. doi: 10.1016/j.isci.2021.102995. PMID: 34755078; PMCID: PMC8560549.
 Zou H, Yin P, Liu L, Duan W, Li P, Yang Y, Li W, Zong Q, Yu X. Association between weight cycling and risk of developing diabetes in adults: A systematic review and meta-analysis. J Diabetes Investig. 2021 Apr;12(4):625-632. doi: 10.1111/jdi.13380. Epub 2020 Aug 28. PMID: 32745374; PMCID: PMC8015818.
 Zou H, Yin P, Liu L, Liu W, Zhang Z, Yang Y, Li W, Zong Q, Yu X. Body-Weight Fluctuation Was Associated With Increased Risk for Cardiovascular Disease, All-Cause and Cardiovascular Mortality: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2019 Nov 8;10:728. doi: 10.3389/fendo.2019.00728. PMID: 31787929; PMCID: PMC6856014.
 Ghusn W, De la Rosa A, Sacoto D, Cifuentes L, Campos A, Feris F, Hurtado MD, Acosta A. Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. JAMA Netw Open. 2022 Sep 1;5(9):e2231982. doi: 10.1001/jamanetworkopen.2022.31982. PMID: 36121652; PMCID: PMC9486455.
 Singh G, Krauthamer M, Bjalme-Evans M. Wegovy (semaglutide): a new weight loss drug for chronic weight management. J Investig Med. 2022 Jan;70(1):5-13. doi: 10.1136/jim-2021-001952. Epub 2021 Oct 27. PMID: 34706925; PMCID: PMC8717485.
 Shamus, Kristen Jordan, What you need to know about surgery risks with weight-loss drugs Ozempic, Wegovy, July 24th 2023, https://www.freep.com/story/news/health/2023/07/24/weight-loss-drugs-wegovy-ozempic-surgery-risks/70385317007/
 Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005 Apr 20;293(15):1861-7. doi: 10.1001/jama.293.15.1861. PMID: 15840860.
 Matheson EM, King DE, Everett CJ. Healthy lifestyle habits and mortality in overweight and obese individuals. J Am Board Fam Med. 2012 Jan-Feb;25(1):9-15. doi: 10.3122/jabfm.2012.01.110164. PMID: 22218619.
 Pedro L Valenzuela, Alejandro Santos-Lozano, Alberto Torres Barrán, Pablo Fernández-Navarro, Adrián Castillo-García, Luis M Ruilope, David Ríos Insua, José M Ordovas, Victoria Ley, Alejandro Lucia, Joint association of physical activity and body mass index with cardiovascular risk: a nationwide population-based cross-sectional study, European Journal of Preventive Cardiology, Volume 29, Issue 2, January 2022, Pages e50–e52, https://doi.org/10.1093/eurjpc/zwaa151
 Burnette CB, Hazzard VM, Larson N, Hahn SA, Eisenberg ME, Neumark-Sztainer D. Is intuitive eating a privileged approach? Cross-sectional and longitudinal associations between food insecurity and intuitive eating. Public Health Nutr. 2023 Mar 10:1-10. doi: 10.1017/S1368980023000460. Epub ahead of print. PMID: 36896622.
 Evelyn Tribole, MS, RDN, CEDRD-S, What is Intuitive Eating? https://www.intuitiveeating.org/what-is-intuitive-eating-tribole/
 Horwath C, Hagmann D, Hartmann C. Intuitive eating and food intake in men and women: Results from the Swiss food panel study. Appetite. 2019 Apr 1;135:61-71. doi: 10.1016/j.appet.2018.12.036. Epub 2018 Dec 22. PMID: 30584896.