PasseportSanté – Hélène Baribeau, you have been a nutritionist for several years now. What is your vision of diets to lose weight, whatever they are (low calorie, high protein, low in carbohydrates, etc.)?

In a diet, we must by definition impose restrictions, whether in terms of quantities or foods. The choice and quantity of food are only based on instructions, external factors. Dieting people have predefined portions of specific foods to eat at a particular time of day, so much so that they no longer eat because they are hungry, but because it is time and time to eat. that they were told to do so. In the short term, it can work, but in the long term, as we are no longer in tune with our real needs, we are likely to give up. On the one hand, there is the body which will end up asking for certain foods again: a diet low in carbohydrates, for example, induces a state of depression, fatigue, so the body will demand energy. There is also a psychological dimension: there are dishes and tastes that we will miss, and when we crack once, we have a lot of trouble stopping because we have been deprived for a long time, so we recover. weight.

Health Passport – You advocate a varied and balanced diet in the right proportions, but with a view to weight loss, this also means reviewing your eating habits and reducing the consumption of certain foods, in particular refined grains and sugars, and processed foods and prepared meals. On the other hand, you insist on the importance of listening to your desires and avoiding absolute restrictions. How do you listen to your desires while keeping a balanced diet?

It is about being aware of your desires and taking a step back from them. To do this, we should ask ourselves 4 questions: before eating, we should first ask ourselves if we are hungry. If the answer is no, we try to identify what makes us want to eat so as to take a step back from its immediate sensation: have we seen something or smelled a smell that made us want to eat ?. If the answer is yes, we wonder what we want to eat. You don’t necessarily want a particular food, you may want a particular flavor or texture, for example something cold, crunchy and salty. Then, this is where nutrition has a role to play: we teach the person to build a balanced plate based on their desires. If she wants pasta, we plan about a quarter of the plate in pasta, with a little sauce, a part of meat and a part of vegetables. The idea is not so much to make a plate to lose weight, but to give a guide of good proportions for health and to be full for a long time: if a person wants to eat pasta, we can direct his choice towards pasta to whole grains which are more filling than white pasta. If she wants to eat chicken, she must know that 30 grams will not be enough, that she learns to reach a certain minimum without having to weigh the food, therefore a rather visual estimate of the proportions. And if she craves fries and a hamburger, the idea is not to make her meal only of fries and a hamburger, to satisfy her craving by eating a reasonable portion of fries, half a hamburger, and a larger portion of vegetables or raw vegetables. Twenty minutes after starting to eat, when the signals of satiety arrive, it is finally a question of wondering if we are full, if we should leave it on our plate or refill. Most of my patients think that they will always want junk food, but in fact no, when you listen to your cravings and everything becomes permissible, the opposite happens: you will sometimes want sugar, but we will want it less often than when we forbid it, because in the latter case we are more likely to develop obsessions.

HealthPassport – You put a lot of emphasis on the importance of sticking to your hunger and fullness cues in order to lose weight, but it can be difficult to distinguish needs from cravings at the start of a change in diet, especially that we are subject to “sugar cravings”. What do you advise these people?

Most of my patients don’t feel or recognize their hunger and fullness signals well. I generally advise them to fill out a diary for a month, in which they write down at each moment of eating, mealtime, what they eat, with whom, the place, their mood, what they feel before eating. , how long they took to eat, how full they felt after eating, and a possible event that may have influenced their eating behavior, such as bad news, a stressful time, or a social activity. Keeping this journal allows people to relearn how to listen to themselves, it’s not even about weight, although most people tend to stagnate or even lose a little weight when they do.

Health Passport – One of the biggest criticisms made of diets is their propensity to gain weight in sometimes greater proportions than before the start of the scheme. Have you ever followed people prone to the yoyo effects of dieting?

When someone sees a nutritionist, it’s usually because he or she has tried several methods before, and it hasn’t worked, so yes, I’ve followed a lot of people who have been on yoyo diets. At that point, we try to change our approach: the first objective is to stop the bleeding from the weight gain. Secondly, we try to make the patient lose weight, but if he has already done too many diets for example, this is not always possible, his body is resistant to weight loss, in which case it is necessary to start a process of ‘acceptance.

PasseportSanté – What is your opinion on obesity? Do you think it is an incurable disease and that there are weight thresholds below which sick people can no longer descend?

Indeed, obesity is now recognized as a disease by the WHO because it is almost irreversible, especially in cases of advanced obesity, levels 2 and 3. When people have level 1 obesity and have no no health problem associated with their obesity, I think we can partially reverse the problem through lasting changes. They may never regain their initial weight but we can hope to make them lose 5 to 12% of their weight. In cases of advanced obesity, it’s not even a question of calories anymore, it’s much more complex than that, which is why some experts think that weight loss surgery is the only solution for these people. , and that diet and exercise will have very little effect. I have never met a patient with morbid obesity, rather I get people who are overweight or who are obesity level 1. But even for people who have mild obesity, it is not easy to lose weight.

PasseportSanté – What place does physical activity occupy in your recommendations?

Instead, I recommend basic physical activity for my patients: staying active during the day, standing as much as possible, gardening, for example. Walking is the activity that I offer the most because it is something that we already know, it does not require any equipment, and it is a moderate intensity activity that will promote fat capture. in obese people. Conversely, high intensity activities capture more carbohydrates than fat. If one of my patients takes 3 steps a day, for example, I will suggest that he climb to 000, then later to 5, and to walk almost every day. It is essential that the changes that we propose to patients are changes that they can make in the long term, that they can integrate into their daily life, otherwise it will not work. Usually when you start a diet, you know that you won’t be able to last your whole life by eating this way, so from the start, you fail.

Health Passport – The latest studies show that there are certain acquired factors that can strongly influence weight gain: bad intestinal flora transmitted by a mother herself affected by obesity, for example. If we add this to the many factors already known (genetic factors, food abundance, multiplication of processed foods, sedentary lifestyle, lack of time, depletion of resources) eating healthily while keeping a healthy weight does not become a real journey? of the fighter?

It is true that all industrial products with incredible marketing challenge us constantly. Despite all the willpower, persistence and knowledge one can have, junk food and its marketing are extremely powerful. In this sense yes, it is a struggle and a challenge every day, and under these conditions people who have a slow metabolism, unfavorable genetics, poor gut flora, are very likely to gain weight. To avoid temptation, we can limit the hours of TV not only to be less seated, but also to see less advertising. It is also about having good products at home, or buying gourmet products in smaller format. Ultimately, the cause of the obesity epidemic in the world is not the individual, it is really the food environment. This is why there are measures taken to reduce junk food, such as taxes, and why it is important to have a good nutritional education.

Return to the first page of the Great Inquiry

They don’t believe in diets

Jean-Michel Lecerf

Head of the nutrition department at the Institut Pasteur de Lille, author of the book “To each his own true weight”.

“Not every weight problem is a food problem”

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Helene Baribeau

Dietitian-nutritionist, author of the book “Eat better to be on top” published in 2014.

“You have to be in tune with your real needs”

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They have faith in their method

Jean-Michel Cohen

Nutritionist, author of the book “I decided to lose weight” published in 2015.

“Doing regular diet sequences can be interesting”

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Alain Delabos

Doctor, father of the concept of chrononutrition and author of numerous books.

“A diet that allows the body to manage its caloric potential on its own”

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