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Why we shouldn't compare losing weight to quitting smoking

In any discussion of the possible solutions to the obesity epidemic, sooner or later someone is guaranteed to bring up tobacco. They will propose we use the same strategies that helped people stop smoking to help people lose weight.

These proponents miss one fundamental difference between smoking cessation and losing weight – while the former is a behaviour, the latter is not.

When I quit smoking, I change a behaviour. I stop doing something, namely putting a cigarette in my mouth, lighting it up and inhaling its smoke.

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In contrast, losing weight is something that happens – not something I do. Yes, there are behaviours that may (or may not) lead to weight loss, but the relationship between these behaviours and what happens to those numbers on the scale is far from straightforward.

When I stop putting cigarettes in my mouth, I have successfully stopped smoking. But when I start eating breakfast, going to the gym everyday, counting calories and cutting carbs, there is absolutely no guarantee that those numbers on the scale will budge. Indeed, more often than not, they will remain exactly the same or even go up.

While we don't know how a person's weight will react to such changes in lifestyle, we do know this: Someone who eats better, increases their physical activity and gets more sleep will see health improvements – irrespective of what happens to weight.

This reality has important consequences for anyone trying to slim down. All you really have control over are your behaviours. When you decide to start eating breakfast and eventually are eating breakfast every day, you will have successfully changed your behaviour. Hopefully, this will translate into more energy and better control of your eating for the rest of the day. However, there is absolutely no guarantee anything will happen to your weight.

In fact, even when you decide to cut your daily calories and somehow manage to do so – you will have successfully changed your behaviour (to eating fewer calories). But again, there is no way to predict what will happen to your weight. This is because your body will very rapidly adapt to living off fewer calories and will find ways to sustain your body weight even on fewer calories than before. This is the frustrating physiology behind the dreaded "weight-loss plateau."

All of this is why in behavioural interventions we focus on behaviours and only set behavioural goals – never weight goals. While I can guarantee that eating more nutritiously and being more active will make you healthier, I have no idea whether or not these behaviours will lead to weight loss, let alone how little or how much.

Unfortunately, many people state (often unachievable and, more often, unsustainable) weight-loss goals and this is the source of endless frustration. "I'm doing everything right but I am still not losing weight." This, indeed, is the rule rather than the exception.

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Thus, I regularly tell my patients, "If you work on your health behaviours, your health will improve – no matter what happens to those numbers on your scale. You just do what you do and those numbers will do what they do (or not)."

When frustration sets in, just remind yourself – smoking is a behaviour, losing weight is not.

Health Advisor contributors share their knowledge in fields ranging from fitness to psychology, pediatrics to aging.

Dr. Arya M. Sharma is professor and chair in obesity research and management at the University of Alberta. In 2005, he spearheaded the launch of the Canadian Obesity Network. He is also past-president of the Canadian Association of Bariatric Physicians and Surgeons. Sharma maintains a widely read blog on obesity prevention and management. You can follow him on Twitter @DrSharma

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