It’s not uncommon after a holiday break like the Thanksgiving one we just enjoyed for patients to mention to me that they gained five or six pounds thanks to hefty holiday meals. Indeed, New Year’s resolutions being just around the corner occupy a significant place in the American health psyche as people scramble to get back on track with regard to healthful food and exercise choices.
For the most part, I try to reassure patients that a single day’s worth of larger portions and scrumptious desserts is not a reason to abandon a dietary approach altogether. Even the most robust Thanksgiving meal, after all, is very unlikely in and of itself to lead to true weight gain in the range of pounds; conventional medical wisdom holds that a pound of weight gain is equivalent to around 3,500 calories. For comparison, that’s probably around the number of calories in an entire New York-style pizza or two whole packages of Oreos.
And that’s just to “gain” one single pound. Accordingly, while it’s probably not impossible to consume, say, 14,000 calories and gain four pounds in a single day, it seems extraordinarily unlikely.
That’s not to say that the scale may not show a weight gain of four or five pounds the day after big holiday meals. The high salt content of these meals could be the culprit. The human body’s response to a large salt intake is to hold onto more water due to the relationship between salt and water in the body. As a result, based largely on salt intake, the kidneys determine how much water to reabsorb and keep versus how much to urinate out.
Thankfully, after a few days during which salt intake presumably returns to a more typical level, the kidneys adjust and correct the salt-to-fluid ratio in the body and weight slowly comes back down as you urinate out the excess water.
This assumes a “normally” functioning heart, i.e., one that does not suffer from heart failure. For patients with heart failure, excess salt intake and the resulting increase in retained fluid can be dangerous and lead to an exacerbation of heart failure and so, generally, should be avoided.
Instead of focusing on these acute blips in the scale readings, most nutritionists and physicians advise patients to focus on the long-term trend of their weight and not fault themselves too much for a day of deviating from healthy eating choices. The important thing to remember in these situations is that a day or two of indulgence does not mean that all of the prior efforts toward being healthier have been wasted, and that the best course is to simply return to healthy habits in the days and weeks that follow.
All too often, we believe that healthful eating or exercise programs must be “all or nothing,” and that any deviation from this approach represents failure. This can lead some to say, “Well, I’ve already failed, so I might as well give up altogether!” This is a fallacy that I encourage my patients to avoid, as it is neither an accurate representation of nutritional physiology nor a helpful mental approach and can lead to feeling dejected. Instead, I tell patients the same things I tell myself the day after Thanksgiving: Remember the reasons why you started eating in a healthy fashion in the first place and be grateful for a day of enjoying yourself.
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Joshua Potter, D.O., a physician with Stony Brook Southampton Hospital’s Meeting House Lane Medical Practice, oversees the practice’s Shelter Island office. He specializes in family and neuromusculoskeletal medicine. Opinions expressed in this column are his personal and professional views and not necessarily those of his employer.
