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ADHD: How Weight Gain and Weight Loss Failure, are Two Sides of the Same Coin

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Lance LevyBy Lance David Levy B.Sc., M.B., Ch.B., M.Sc., FRCP(C)Director of the Nutritional Disorders Clinic in Toronto, Ontario, Canada and author of Conquering Obesity. For more information, visit www.drlancelevy.com

Most days I see several new patients who were referred to me for the management of obesity. As obesity has become public health problem number one, everyone working in this field is trying to figure out why we have an ever increasing number of kids and adults who are overweight or obese, and as a consequence are facing serious health risks. Almost without exception, these individuals have tried all sorts of diets over the years and have not managed to lose weight and keep it off.

For many years it was felt that failure at weight loss was due to a lack of knowledge about diet, exercise and general lifestyle change. Often, seriously obese people were thought to be lazy or unmotivated. A research project I managed in 1985 showed that almost everyone with chronic obesity knew what they ought to do to lose weight; the problem was they could not sustain any method over a long enough time to be successful.

We also discovered that after failing at numerous diets, almost all with chronic weight problems felt defeated, and deep inside had no “drive for thinness” left in them. In other words they were highly sceptical they could lose weight and did not have the desire to devote more time to a “ project” that was doomed to failure. In short, they were turned off and angry if the word diet was raised in conversation. Well, we had to find a way around that scepticism, because it exerted such a negative influence and prevented a person from devoting both time and energy to a weight loss plan. The obvious way to determine why everyone felt so defeated was to discover why weight loss plans failed. It seemed clear that if roughly 98 % of people failed to maintain weight loss over a year, the problem was with the methods used and not with the people themselves.

After a number of experiments we determined that all diets end more or less the same way. Typically events occurred that were not planned for, and the effort and energy spent coping with, for example, an extra work load at ones’ job, financial worries, illness and so forth, meant that taking time to be mindful of what was being eaten, shopping adequately, and sleeping enough to be alert was not possible. Under the influence of unplanned energy and time sapping events, diet plans just fell by the wayside with predictable weight regain! Surely an individual could manage a diet and lifestyle change with a bit of planning and so stay on track.

Unfortunately our naive optimism was not borne out in fact. The fact is that people do well when they can, and if they can’t it is because they cannot, and not because they are lazy or uneducated. To find a reason for why keeping plans on track was so hard, we tried a variety of experiments on our patients. We found that as the degree of excess weight increased (higher BMI) the number of people with mood problems, daytime fatigue, chronic pain, digestive problems, and problems with impulse control increased in an exponential fashion.

In 1998, one patients’ story of weight loss failure was mystifying and caught my attention. I discussed him with Dr. John Fleming, a clinical psychologist I have collaborated closely with for 20 years. The patient in question was a man in his thirties. He was obese, with a BMI of 45, and ran a trucking business. He was brilliant at juggling all the truck routes and time schedules, affable, and good at dealing with emergencies, but terrible at self care. He simply could not follow the diet and lifestyle correcting plans I worked on with him; getting to bed on time, eating at regular intervals, grocery shopping, and taking a walk each day were totally beyond him. Convinced of his sincerity in trying to be compliant, we realized we were missing something. What we asked him to do was not “rocket science” yet it was impossible. In my next blog I will tell you what we found out and how it helped this man succeed in weight loss and in other ways as well.

May 10, 2011 Jimi

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12 Responses to “ADHD: How Weight Gain and Weight Loss Failure, are Two Sides of the Same Coin”

  1. gypsybelle says:

    Rick posted about making routines on May 13. that is really key for me but I veer off course time and time again. I make as much effort as I can to eat 3 meals, but they are not always as nutritious as I wish I would make them. that ties in to going shopping, which ties in to making sure I set aside and keep, in my budget, the money to do so. that ties in to having to take the bus, to get to a good supermarket, which ties in to being overwhelmed in a supermarket. Then there is the thing about only buying good food..as organic as possible….on and on. I am spending more time at smaller stores, closer to where I live, and I mean within 2 blocks. Is my problem motivation? or is my problem it is all just too overwhelming…….

  2. tdentay says:

    Right off the bat the word ‘diet’ is a self-defeating notion. It seems to connote that there’s a beginning (duh!) and -regrettably- an end when in fact there will never be an ‘end’.

    Much as in animal training, weight loss is not something that can be externally administered until the owner has been trained him or herself.

    I had the best of good fortune some years ago to read the Protein Power Lifeplan. Like any self-help book, you take out of it about 5% and leave the balance behind. I went from 190 (on 5’5″) to my current 158-160 which I’ve maintained for years with very little effort. And I didn’t go nuts nor have I become OCD about the whole issue.

    Just my thoughts.

  3. no_dopamine says:

    “He was brilliant at juggling all the truck routes and time schedules, affable, and good at dealing with emergencies, but terrible at self care. He simply could not follow the diet and lifestyle correcting plans I worked on with him; getting to bed on time, eating at regular intervals, grocery shopping, and taking a walk each day were totally beyond him.” That’s me, I can juggle a lot of balls in the air provided they aren’t too complicated, but like him, I can’t get to bed on time, I don’t prepare meals (my husband does), grocery shopping is when there’s nothing in the fridge to eat, and I haven’t got time to exercise. Waiting anxiously for part two!

  4. zsazsa says:

    A cliffhanger! How I hate those! Stopped by for a quick catch-up on things before heading to bed (at a decent time for once) and now I’ll be lying in bed awake all night wondering…
    Let’s see… the guy is ADHD and endlessly gnaws on his clothing the whole time he is out on the road driving. All the clothing he eats is ‘plugging’ him up and adding on weight (shouldn’t all the extra fibre clear him out??). Two shirt cuffs and sleeves along with one ribbed neckline = one extra pound a day!

  5. Rick says:

    Since the second part won’t be published for a while, I suggest, being ADD/ADHD individuals we each just make up our own stuff and imagine what Lance is going to say.
    Making routines is so key. I’ve found I only do it with a support system around me. To remind me, support me, and most of all, to help me stop and acknowledge the success and what’s I’ve accomplished so far. Cause all I see is what’s left.
    I also need a clear, measurable goal with lots of short milestones along the way.

  6. james@TADD says:

    Sorry to those of you who feel frustrated by the cliff hanger. The second part of this article will be published at the time of the next newsletter, in about ten days. Dr Levy will be discussing ADHD and Eating Problems in the Totally ADD webinar on May 25th at 8-9pm. You can sign up for an email reminder for this webinar at the bottom of the webinars page http://totallyadd.com/webinars

    If you have questions regarding ADHD and eating problems, please post them in the designated forum http://totallyadd.com/forum/topic.php?id=1388#post-11237. If the community cannot help, we’ll see if Dr Levy can answer them on the night.

  7. sunderwoodpug says:

    i hate cliff hangers. i am struggling with weight loss. i know what to do and get started but after about 3 weeks i fizzle and go back to my old routine. i need HELP

  8. Bill says:

    “Almost all with chronic weight problems FELT defeated.” I couldn’t agree with you more. Feelings / emotions have everything to do with effecting change. If you feel energetic and know the solution, implementing it becomes possible, whereas if you already feel defeated, how can you even get motivated to start?

    Mindfulness, guided visualization, Emotional Freedom Technique and hypnosis have all been shown to be effective in helping people overcome their emotional blocks, so they can apply what they know they need to do.

    Thanks for an excellent article!

    Bill

  9. memzak says:

    They guy must be ADD. Sounds like me when I was at a job I held for 10 years. I reached 450lbs because I had to be constantly snacking while i worked so i could concentrate. At times I would snack on things like mini shredded wheat instead of a second McDonalds sandwich I bought on the way to work. I lost 7 lbs that way but gained it back. Dry cereal loses its appeal after a while. I am very interested in what comes next. I’ve managed to lose 200 lbs and keep it off but it was not on purpose.

  10. Geoduck says:

    AGH!!! A cliffhanger?

    Hurry up and get the rest out! Looking forward to it.

  11. redriverbluesman says:

    Looking forward to the rest…this totally relates to me, as I’m always super busy and have a hard time keeping diets / lifestyle changes going.