THE COMMON DIET TRAP
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Episode 277:
Show Notes
Dr Mary Barson and Dr Lucy Burns from Real Life Medicine discuss the harmful effects of all-or-nothing perfectionism in health and weight management, exploring how this mindset traps people in unhelpful patterns and offering practical strategies to overcome it.
All-or-Nothing Perfectionism Defined
Perfectionism in health and dieting is rooted in diet culture and represents the belief that actions must be performed perfectly or not at all. This mindset develops over years through accumulated messages such as "if you're going to do something, do it properly" and "practice won't make perfect unless you practice perfectly". The pattern affects particularly women and creates unrealistic expectations around health behaviors.
Harms of Perfectionism
Nobody can maintain perfection, and the attempt creates multiple problems. When slips occur, perfectionism triggers extreme responses: either complete loss of control with binge eating ("last supper" mentality) or total abandonment of efforts accompanied by guilt and failure. Perfectionism also prevents starting healthy habits because people wait for the "perfect time" with a "clear run" free of social events or challenges.
The Fluffy Analogy
Dr Lucy uses the "Fluffy" metaphor from Harry Potter—a three-headed dog that sleeps with music—to explain sugar cravings and food noise. When carbohydrate intake is low, the mental noise quiets down, but consuming sugar "wakes one head up". With proper emotional regulation skills and scaffolding, occasional sugar consumption doesn't lead to loss of control as it once did.
Strategies After Slips
The doctors recommend avoiding the diet culture response of restriction or fasting after overeating. Instead, they suggest ensuring adequate nutrition with protein, fat, and greens to prevent hunger, which triggers more cravings. Processing emotions through self-reflection with kindness and compassion helps identify triggers and choose different pathways in the future.
Celebrating Wins
When the brain offers unhelpful suggestions and they're rejected, it's essential to reward this positive choice with a "party in your head" or other non-food rewards like reading, dancing, or spending time with pets. This reinforces helpful neural pathways, especially important since brains tend to highlight failures more than successes.
Learning from Mistakes
The philosophy "you either win or you learn" transforms every experience into progress. Self-reflection with compassion allows analysis of situations without berating oneself, turning slips into learning opportunities. Pivoting doesn't require waiting until the end of the day—it can happen at any moment, as the body doesn't care about arbitrary time markers.
Episode 277:
Transcript
Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.
Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.
Both (0:16) And this is the Real Health and Weight Loss podcast!
Dr Mary Barson (0:21) Hello, lovely friend. Dr Mary here from Real Life Medicine joined by the truly fabulous colleague of mine, Dr Lucy Burns. Lucy, how's it going?
Dr Lucy Burns (00:34) Oh, good, good, good. I would love to say yay! Yippee! But you know, I'm a bit cranky for various reasons. So, you know, keeping it real at Real Life Medicine that no, you know, I don't always have a bit in sleep. I don't always wake up cheery. I am a tiny bit cranky. Just because I am.
Dr Mary Barson (00:52) Yeah, and you're allowed to be. Yep. Life isn't, it isn't all perfect, is it? In fact, it rarely is. Yes. You know, good segue for today as we continue our series on the stories in our head and the unhelpful stories that we may be carrying around unconsciously, not knowing what they are. And a really common story, actually it's a trap, but it's a very common story, is all-or-nothing perfectionism. The idea that you have to do it perfectly or you can't do it at all. It is particularly pernicious in the world of health and, a word that we don't like very much, dieting. Talk a bit about what perfectionism is, or this all-or-nothing and how it rears its ugly head.
Dr Lucy Burns (01:40) Yeah, so it's part of diet culture. It is for many, many women, particularly women my age and probably younger, everywhere. It's all around the idea that if you're going to do something, then you have to do it perfectly. And again, that's a story that we've been fed for decades, around everything we do. You know, you have to put your whole effort in. If you're going to do something, it's worth doing properly. There's all stories around that related to many, many things. You know, school homework, I remember that. Hearing, you know, if you're going to do something, do it properly. Don't half-ass it. My guitar teacher, God knows, obviously I didn't persist with guitar, he used to say practice will not make perfect unless you practice perfectly, which is rubbish. What a load of crap. Practice won't make perfect unless you practice perfectly. Oh, well then I'm not going to practice at all because I don't know how to practice perfectly. Like, honestly, so the thing about all of these stories is they build up. So it's never just one story. It's never something you hear once. It's years and years and years, decades and decades and decades of multiple little stories that all come together for our brain to then create a picture, if you like.
Dr Mary Barson (03:00) Yes, yes. And why is it harmful? Like, what are the potential harms of this perfectionism, aka all-or-nothing thinking? Why is it unhelpful?
Dr Lucy Burns (03:12) Because nobody can do it perfectly, and you don't actually need to. So, and if you're like me, your brain will be going, oh no, I can do it perfectly. I can. You might not be able to, but I can. So that was my story — it was always, I can do it because I can do something perfectly, whatever that is, prescriptively, if I'm invested. But the problem then happens is, well, what happens when you make a slip? Then, all of a sudden, it is like careering across the road to the other side, where you go out of control. And so again, thinking about various mindsets, because we've done perfect, and perfect often means hard. And particularly for dieting, it often meant calorie restriction. So not only was it restrictive because I was under-eating, it also meant when I wasn't doing it perfectly, I'd be out on a bender, having my last supper.
Dr Mary Barson (04:15) Yes. For me, this perfectionism could often go the other way. Like, I felt like, well, if I can't do it perfectly, then I can't do it at all. You know, one slip just leads to total guilt and a feeling of failure. Oh well, just obviously can't do it. Just throw the towel in. Also very unhelpful.
Dr Lucy Burns (04:35) Yeah, absolutely. So it certainly makes it all-or-nothing. So you're either doing it perfectly, or you're on a bender, or your brain goes — and this is part of the reason why we can't get back. Our all-terrain vehicle can't necessarily get back on track because it feels like I have to do it perfectly, and therefore that feels really hard. So, you know, why would the brain want to do something hard? But the other way perfectionism shows up, and this was really common for me, and I'm sure for people out there, was, well, I can't start because I've got a busy week, I would say. I've got book growth, we've got a morning tea at work, my husband's birthday, and, you know, we've got a wedding on the weekend. So, you know, I'm not going to start now. Like, it's the worst time to start.
Dr Mary Barson (05:18) It's got to wait till the perfect time. Yeah. Can't start till it's perfect.
Dr Lucy Burns (05:20) Yeah, yeah, yeah, till I've got a clear run. Yeah. So I'd be waiting for this kind of clear run, which I think is where, you know, sometimes in COVID, this is what people did. And a lot of people, COVID seemed to do two — people went one of two ways. They either, you know, put on COVID kilos because they were just at home making sourdough bread all day. You know, there was nothing to do, so food was the highlight of the day. Or they suddenly didn't have to navigate the world of morning teas and weddings and anything. And so they literally had a clear run. And so again, mindset is working out, well, life — there is life, and life has, you know, what you might find challenging. And you learn how to navigate these challenges. You can't just avoid them. Because basically, that means you're just going to sit in your bedroom all day for the rest of your life.
Dr Mary Barson (06:14) Which is not helpful. That's right. There's going to be ups and downs in life, there's going to be inevitable moments of imperfect, and they're going to keep happening. Because I'm imperfect, you're imperfect, the world is not perfect. Perfect is an impossible ideal. But beyond that, it's a trap. It's a perfect trap that will keep us trapped if we let it.
Dr Lucy Burns (06:38) Yeah. Because I always talked about my sugar addiction. You know, for me, sugar was life. I ate sugar whether I was happy, I ate sugar if I was sad, I ate sugar on the couch reading a book, I ate sugar at the movies, I ate, you know, at every barbecue. I didn't care about my friends, I just wanted to eat pavlova. The sugar was the main event. People go, so does that mean you never eat sugar anymore? And the answer is, actually I do now, but hardly ever. So the reason is that I've got skills around managing emotions without using food. And so when I do choose to have something — and it might be an ice cream, or it might be, I don't know, I'm trying to think of what it might be, it might be something — it's not an emotional response. It's intentional, which we talked a bit about last week. And then I can intentionally not have it the next day. A lovely analogy — lovely analogy, I don't know if it's lovely, anyway, a helpful analogy for me around sugar and the amount of sugar that we eat is around Fluffy. We haven't spoken about Fluffy for a little while. We're gonna have to introduce Fluffy from the beginning. Who's Fluffy? Lucy, tell me more. So for any Harry Potter fans, Fluffy was the three-headed dog, a Cerberus, so a mythical creature Cerberus, a three-headed dog that guarded, I think it was the Chamber of Secrets, or Chamber of something or other. And what would happen is that the dog would sleep with music. So the idea being that you keep Fluffy asleep, and the music played, and when the music stopped, one head woke up, and then two, then three. So for me, Fluffy stays asleep when my carbohydrate intake — particularly for me, sweet carbs, but for other people it might be savoury carbs — when that's low, or zero even. So all of a sudden, my mind is quiet. So the food noise is gone. And really, that's around dopamine receptors and, you know, physiological changes that happen in the brain. But the outcome is that the food noise is quiet. So I like that feeling because then I can spend my time thinking about other things, other than, you know, when am I getting my next hit of sugar. But these days, because I've got a whole heap of skills around emotional regulation and around soothing and all of that jazz, it means that if I have some sugar, yes, one head might wake up. But because I know myself very well, I don't let the second and third head wake up anymore. And I don't feel like I'm out of control. So when people are going, does that mean you never ever eat sugar again? Well, actually, no. I do eat sugar now, but it's like supported eating. So I've got a really good scaffolding around it. So I don't need to worry anymore. I don't fear it. I don't feel out of control. But that took some time. So you can't develop the scaffolding in a week.
Dr Mary Barson (09:42) Yeah, I would be interested what your advice would be for people who have woken Fluffy up but unintentionally. So perfectionism, a really common way that it rears its ugly head is that if you have a slip-up, like, you know, you eat ice cream because it's a summery day and your kids are getting some and you just do, or because you've had a terrible day at work, your boss is being an absolute adult and you buy some ice cream on the way home and eat it to help you feel better — like whatever reason — but it's unplanned. And now, you know, you've done this and you've got two things happening right now. You've got what's going on in your mind and what's going on in your body, the physiology and the psychology. So how would you help people with that?
Dr Lucy Burns (07:24) Yeah, so I think diet culture told us that if we overate, we had to then restrict the next day. You had to be good, you know, good. I've been bad. Now I have to be good. I have to make up for what I've done. And this isn't old culture either. There is tons of diet culture out there on the internet. There are gym bros out there banging on about calorie deficit morning, noon, and night. So our brain goes, right, well, I need to pay for what I've done. So the temptation is to fast. And again, fasting is not a tool. Fasting is not a punishment for overeating. Fasting is a completely separate thing, but that's what our brain might be tempted to offer. Whereas I actually go the other way. I go, right, well, I need to make sure that I am not hungry. So I'm filling up on protein with some fat. So, you know, I'm having my scrambled eggs, or I'm having my poached eggs, and I'm having lots of greens. And I am making sure that the next few days I have three meals, that I don't have any sniff of hunger, because that's when Fluffy will sort of swoop in, go, oh my God, you're hungry. You're hungry, quick, let's eat something. Whereas if you're not hungry, that can't help. So you've got that. The second thing, of course, is to think about your emotions and work out, well, what is it that you actually need? Are you lonely? Do you need to go and talk to a friend? Are you stressed? Are you angry? Do you need to process your emotions? You know, maybe you do. If you've got good skills, you might be able to do that by yourself. You might need help with it. So, yeah, I think those are really helpful. And then when your brain — so, you know, the waiter, as we call our brain, the waiter, because it offers suggestions, but just like the waiter, we don't necessarily eat all the specials that he's offered us. We don't have to take every bit of advice that our brain gives us. But when you decide not to take the sugary advice that it's giving you, you need to then reward your brain for that. Because there has been a part of your brain that has dug in deep and gone, no, this isn't going to be helpful to me. I'm not going to go down that path. I'm going to do this path. And then we go, yay, because we want to highlight when our brain does stuff that is helpful for us, because it sure as hell is really good at highlighting when it doesn't do helpful things.
Dr Mary Barson (12:18) Yeah. And how do you do that? Like, what is the actual practical advice you give people to take a moment and celebrate when you've done something helpful?
Dr Lucy Burns (12:57) Well, I call it a party in my head. So again, I don't necessarily talk out loud about this, but I might go, oh my God, Lucy, you are a legend. You're a legend. Look what you just did. You are awesome. Yay you. Awesome. This is fantastic. Good. Brilliant. So I might do that. And then my brain, of course, I'm like, oh, what are we having for a reward? Because, you know, we like rewards. Well, of course, in the olden days, my reward would be, you know, a Caramello Koala or something. Now it's right. Okay. Yes, you do deserve a reward. So what are we going to do? We might go and spend 20 minutes reading a book. It is something that is literally just for me. I might go and pat the dog — not because, well, the dog loves being patted, of course, but it is good for me. So that it is something that is just literally for me. What about you, Miss? What do you do?
Dr Mary Barson (13:47) I do that party in my head. I like to have a little dance, like a literal, literal dance. I don't dance well, but that's not the point. So, you know, I might just go Spotify, put on some celebration music, have a little moment to myself. If my kids are witnessing this, they will join in. We're used to this as a little dance party in the kitchen. It sounds over the top, but it is helpful, especially as I've alluded to this before. But my particular brain structure is such that I am very prone to harp on the things that I'm doing badly, to shine a spotlight on all of the ways in which I'm failing, all the little flaws, all the things that I'm doing wrong. My brain loves, loves to highlight that. So making a conscious effort to highlight when I just do something good and not brush it off — yeah, great, well done, but look at all these other ways in which you suck. No. Just, hey, I did this good thing and celebrate good times. Yeah, I'll do it. Yep. Daggy little moment like that. Dopamine hit. It works. Yep.
Dr Lucy Burns (14:46) Totally, totally. And I think, you know, part of perfectionism is the opposite side of that coin. So yes, definitely celebrating our wins. Recognising that we are all going to make mistakes. You know, I call it "welcome to normal." You are normal. If you make a mistake, that's okay. What we want to do, again, our brain is tempted just to not actually… sometimes again, your brain's going, oh, highlighting it all. It'll highlight potentially how terrible you are, or what a failure you are. It's not actually going to… what we want to do is actually look at just the situation at hand. So we can look at the situation and go, okay, so what happened here? And we do this with kindness and compassion so that we can analyse it, because it will happen again. So if you were at work, and you had an altercation or an interaction with somebody, and it made you feel bad about yourself, and so you snuck into the tea room and ate six biscuits, then that situation will happen again, unless we can kind of just tease it apart a bit and analyse it in a process we call self-reflection. So you reflect and go, okay, well, you know, what was I feeling? Why did this happen? You know, did I have any involvement in this? How could I think about this differently? And that's the learning part of it. And we're doing it with compassion, because without compassion, with just berating, we can't do it effectively. Because that way, we use our mistakes or our slips to help us choose different pathways in the future.
Dr Mary Barson (16:20) Yes, self-awareness, learning, self-compassion. And that is about creating that useful belief. And I love to say that, you know, you either win, or you learn. And learning is winning. So if you have set yourself, you know, some goals — my goals are to work on my health, to eat helpful food, to move my body — and you get to the end of the day, and you haven't done that, or you haven't worked in a way that is useful towards your goals, if you can just turn that into a moment of learning, with that self-reflection, and you know, that does initially suck a little bit, you have to sort of examine what didn't go well, tease out what you can learn from it, then you've won. Like that is an absolute win. And then you can celebrate that win. So you can actually always be winning. Even when you're not hitting your goals, quote, perfectly, unquote, you can still win, because learning is winning.
Dr Lucy Burns (17:19) Absolutely. And, you know, here's a little sneaky word that just popped in there. And you said, if you get to the end of the day, and you realise you haven't done whatever it is you wanted to do, you don't even have to wait till the end of the day. You can wait till the end of the minute, end of the hour. You can just decide halfway through a moment of whatever that you're pivoting, that you're turning, that you're switching. Our brain does like something we call the clean slate effect, which is another mindset. Maybe we'll talk about that next time. But you can make up your clean slate. The body literally doesn't care what day of the week, whether you've woken up in the morning. It's just going, righty-o, let's just sort ourselves out now.
Dr Mary Barson (18:00) That's right. Get out that metaphorical whiteboard marker, wipe it all off.
Dr Lucy Burns (18:05) Start right now.
Dr Mary Barson (18:07) Yeah, that's right.
Dr Lucy Burns (18:08) Yep. It's never too late. So my lovely friends, that's it for our mindset for this week about perfectionism. Be aware, you may not identify as a perfectionist if you're living in with a bit of mess, like Mary and I do. But if you're waiting for a clean run to get started, well then that is a kind of little bell signal that there's perfectionism sneaking in there.
Dr Mary Barson (18:33) Yes, indeed. See you later, beautiful ones. We'll see you next week. Indeed.
Dr Lucy Burns (18:36) Bye for now.
Dr Lucy Burns (18:41) The information shared on the Real Health and Weight Loss Podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
