Solicited Advice

Happy Thursday, everyone! Hope the week’s been treating you right.

I’m writing to you today from the comfort of my trusty computer chair. That’s right – I’m not in the gym! While I wish I could say that I have the day off again for good behavior, I must instead admit that I’m nursing an intermittent injury. I noticed some pain in what I thought was my left ankle last Friday. Further investigation led me to realize that the top of my foot was the issue; there was a stubborn, tight ridge running all the way down the top of the foot, from my big toe to my heel. I’m a bit used to stubborn, tight muscles at this point, so it wasn’t a major concern, and nothing was visibly wrong.

The pain cleared up over the weekend, so I chalked it up to “more soreness than I’m used to, but no problem” and went on about my business. I felt quite a bit better until halfway through my treadmill steps on Tuesday, when it came back with a vengeance. I was aware that I’d done a couple of TRX moves that probably irritated it, and decided to get in the bare minimum number of steps I needed before going home to relax. By the time my Wednesday trainer session happened, I could barely make it into the building from the parking lot without limping, let alone at the speed I’m used to traveling these days.

Erin was fantastic about this and modified my workout so that I could still get things done without putting extra strain on the foot. (This involved replacing my usual treadmill stuff with stationary bike stuff, and sticking to the basic weight machines instead of more strenuous options.) Her advice was to take it easy and then consider visiting physical therapy if it hadn’t improved by Friday. I was feeling a lot better after my workout… until I went to stretch out. I hobbled to lunch, counseling, and a few more minutes of biking (to replace my steps) before throwing in the towel and heading home.

Things are a little better today, but I’m still only about 60% improved, and my other muscles are also barking at me from leftover TRX stuff. I made time for the Pro Club hot tub last week after my class; I didn’t do that this week, and I’m now realizing the importance of it! I’ve also been doing some research to see if I can figure out what’s going on with my foot. I found something called an “abductor hallucis strain,” which sounds like the next big-budget zombie movie plot; it’s actually a sports injury caused by over-pronating (turning your feet inward when you walk) too much. I have insoles to help with this already, but they’re over-the-counter and not custom to my feet, so I’m guessing they’re not quite up to the task of handling my feet, my weight, or some combination of the two. They might also just need replacing, since 20/20 eats insoles and shoes for breakfast.

That said, the description of the injury is the only one that sounds like what I’m experiencing, so I’m 95% sure that I’ve found my culprit. The only advice I’ve gotten so far is to rest (and/or modify exercise the way Erin did,) ice it when I can, and consider taping the foot to help stabilize it against the kinds of things that hurt it – which I know a physical therapist can do. John had to see one for a shoulder injury early on, and he had that taped for a few weeks for much the same purpose.

So… I have a little extra time today, and I thought of something I’d like to spend it on. Quite a few of you have asked me what it’s like to be on this diet, and a few have asked for advice on their own diets if they want to lose weight. While I’m not comfortable telling folks what to do with their food, and while we did sign something before joining that asks us not to try to run our own 20/20 program by advising others, I can offer a few basic guidelines for anyone that’s curious.

First, a disclaimer: the thing to take away from this is that healthy diets are adjustable to each person’s needs, even on 20/20. John and I followed a linear and basic progression through each of the stages, but this isn’t mandatory; I’ve met people in group who went straight from Stage 1 to Stage 6 because they refused to avoid restricting things they knew were healthy for the sake of the stage progression, and others who skipped particular stages because they didn’t eat the things from that stage anyway. I’ve even met people who “messed up” and drank four glasses of wine when the program forbids alcohol; they lost weight anyway because their dietitian helped them balance the calories and discuss better strategies for coping next time. The exact stages are less important than what they represent; a brief period of resetting your body and expectations to baseline, followed by simplifying and categorizing the things you eat, while teaching you about the relationships between the kinds of things you eat.

Looking for hard “do this, don’t do that” rules in this program tends to land you a lot of very stern conversations from your dietitian and your therapist, which it took us a few weeks to understand – and explains why my advice won’t be in that format. They want you to learn balance, moderation, and portion control for the real world, as opposed to cutting out things from your diet forever. As my dietitian puts it, there are no “bad” foods, just foods that require more of an effort to balance – and foods that make it harder for you to maintain the goal of not being hungry on a proper diet. The more you learn and the more you know about nutrition over the course of this program, the easier this will come to you.

As a diabetic, I’ve had a huge advantage here; I’ve been seeing dietitians and diabetes educators for quite some time, both of whom focus a lot on these topics. Even if I was never able or willing to adhere to the rules, I did absorb the information. I’m often able to preempt my dietitian (and she lets me; it’s a good way to check my knowledge) when something I’m familiar with comes up. The number of times she’s confirmed something I’ve diagnosed as a possible issue in both my diet and John’s has surprised me. It feels good to know I’m at an advantage somewhere on this program, given how far I still have to go in other areas!

That said, many of us THINK we know what we’re doing, to our detriment. People have been selling snake oil for as long as humans have walked the earth, and there’s so much bad information out there from folks who are holding one or two pieces of the much larger puzzle. Even 20/20 recommendations have changed over time, and continue to do so. Our society contributes to the confusion as well by skewing our perception of what appropriate serving sizes are; in this country, we tend to prioritize the amount of food per dollar spent (and then avoid waste) rather than the amount we need to eat. The two things that you are asked to give up, once and for all, are the freedom to tolerate excess as normal, and the freedom to shove things in your mouth without thinking. Knowing what each food does, knowing your brain’s and your body’s reactions to them, and remembering that your brain cannot always be trusted to know what is good for it means that you can no longer afford to stay blind. You’re not losing the ability to live your life, but you are losing the ability to trust that a restaurant or a recipe will stop to consider your well-being before plating/cooking.*

*I’m going to stop on this subject for now. It’s a very deep rabbit hole that asks you to consider some difficult stuff about the world we live in, and I’ll be honest – until you’ve seen it with your own eyes, it sounds a little bit like paranoid hysteria. It’s the sort of thing I used to scoff at before I joined 20/20, and the program spends months trying to help you understand the issue (plus all the things that feed into it) because it’s a huge shift in the way we think about food, culture, and emotional issues. I was laughing and shaking my head right up until I felt my own body do the exact thing they were talking about, for the exact reason they talked about, and the experience was horrifying for someone that thought they had good willpower and control over their brain and their choices in life. It’s a realization I think we all need, but at the same time, I feel like it’s one of those things that fundamentally changes your life once you’ve seen it for yourself, and not everyone is ready for that. I’m not even sure most people get the strong reaction that I did. If anyone wants more information, I’m willing to discuss it on an individual basis, but it’s not necessary for the purposes of giving you guidelines on what to consider for balancing your diet well.

Again, as a final disclaimer: I’m not a doctor. I’m a student of the 20/20 Lifestyles school of thought that has helped me lose a bunch of weight and continue to do so. Exercise and things like stress always play a role in weight loss as well. Please don’t take my advice as the final word on anything you do (or don’t) eat. A proper doctor can help you to modify and change habits that aren’t working for you; let these guidelines inform that discussion, or simply treat them as experiments that may or may not work for you.




First off: how many calories should you aim for? This is based on a couple of factors. The first factor is a calorie deficit from the daily recommended amount (approximately 2,000 per day) that is required for your body to lose weight. This is the very definition of a diet: to lose weight, you must burn more calories than you take in. That said, restricting calories too much will cause your body to go into starvation mode, AND leave you hungry, thus halting weight loss and making you miserable at the same time. By the way, all that stress increases weight gain too. This is why you need a doctor to advise you on the amount of deficit you aim for. It’s easy to get overzealous and do more harm than good. Starvation is not a diet; well-planned and regular meals that help keep you full and balanced while still meeting your needs is the intended goal. Anything else is snake oil.

The second factor is your resting metabolic rate (or RMR.) This should not be confused with your actual metabolism, which relates to how your body burns ingested calories. Your RMR is the number of calories your body burns while not performing any type of formal exercise – in other words, just to function in the world. This number varies between people and changes over time. Things like previous diet changes (both good and bad,) stress, exercise, lifestyle, and heredity can affect the number. Athletes always have insane RMR numbers because of how active they are as a general rule; this is how Michael Phelps can eat what he does and still be an Olympic swimmer. 🙂 If you burn lots of calories in your general day-to-day, you might need to eat a little more than the average person (even while losing weight!) These people are more at risk for accidentally aiming too low on their calorie deficit.

Next: what amounts of other things should I aim for? Most diets are designed around specific features, such as low-carb, low-fat, etc. The 20/20 program takes a high-protein approach, which tends to keep people feeling fuller than other nutrients. The aim is to spend the highest percentage of your daily calories on lean proteins (chicken, lean beef, lean pork, protein powder mixed into things) or meat substitutes if you’re vegetarian or vegan (tofu). That said, fats are important for keeping you full too, and carbohydrates are necessary for providing the energy that you need to survive the physical challenges of the program. Small doses of healthy fats (nut butters, olive or canola oil, olives, avocados) are very much allowed, as are moderate amounts of carbohydrates. The diet does limit carbs, but calling it a low-carb diet is incorrect – we’re getting around 120-140 grams of carbohydrates per day, which is crazy low compared to most non-dieters, but crazy high compared to Atkins or other strict low-carb diets.

If there’s one recommendation I’d give people that are on a diet and struggling with hunger and cravings, it would be to consider making additional lean protein your first line of defense. I still can and do get hungry on days when I don’t balance this well. If you stick to relying on very lean proteins like white meat chicken, turkey, or lean ground beef, you can even eat extra of these sometimes without pushing your fat numbers off the charts. This is the major mistake I was still making on my “pregnant diabetic” diet, as I was still relying too much on cheese and other high-fat protein sources that added more calories to my diet than I could spare.

So what about sodium? Caffeine? Cholesterol? We do have to monitor these, sodium and caffeine in particular. (Recent information shows that a person’s cholesterol isn’t as affected by edible sources as we used to think, so they don’t harp on that unless your consumption is extreme.) Because John is on medication for high blood pressure, and I’ve been borderline-high for years, it’s more important than ever for us to watch our sodium. Sodium is found in almost EVERYTHING, and that’s even before you pick up the salt shaker. Most foods that are processed in any way contain a lot (check your canned beans, tomato sauce, or salsa labels for a nasty surprise,) and even some healthy things have sodium by nature. Swiss chard is one of those health-food darlings… and contains sodium, so you have to balance it right. Outside of medical issues, salt also tends to make people both hungrier and thirstier, and that’s another reason to consider limiting it – hunger is the enemy of dieters everywhere! We’ve had to learn to cook without salt for the most part, and I won’t lie: it’s an adjustment, coming from a world of constant salt in and on everything. If you do it, though, you’ll be shocked at just how unpalatable most other foods become within a week or two.

We also have to restrict alcohol. Alcohol contains a lot of calories and carbohydrates – this has been known for years. However, what we didn’t know prior to 20/20 is that consuming any alcohol at all can stop your weight loss cold in its tracks for up to two or three days, even if you balance it well in terms of calories. If you’re trying to lose weight, saying no to drinks may be a good place to start. Even if you’re doing the right thing with your diet, it might be stopping you from making the progress that you want to make. We learned that the program used to allow for one alcoholic drink per week, but they found that the clients who abstained lost weight at a much faster pace than those who drank, so they ended up removing it. This is not to say that you’ll never be able to drink again; it’s something you can do just fine in moderation, once you’ve lost the weight you want to lose.

So what do I actually eat?! I’m glad you asked. 🙂

The first and most important thing we eat is lean protein, as already discussed. This is the major thing that keeps us from being hungry all the time, and this diet would be so very  much harder without it. It’s the main reason Stage 1 starts you off with such a heavy emphasis on it. We use a canola oil spray to ensure that food doesn’t stick to our pans, and otherwise cook or grill as normal. We tend to avoid or limit sauces on meat because most contain a lot of fat, sugar, and/or salt, but we’ve eaten quite a few plan-appropriate versions at the gym, and we’ve created many of our own. (Ask John for his cottage cheese Alfredo and stroganoff recipes sometime!) We also eat a fair bit of tofu when we get tired of all the meat. I never used to like it until I moved to Washington and met all the delicious Asian preparations around here, so it might not be your thing. That’s OK.

The second thing that we eat a lot of is vegetables. The bulk of our meals have not varied from meat-and-veggies for months, and that’s by design. Note that this does NOT include starchy vegetables – corn, winter squash, peas, and sweet potatoes do not count here because of their natural sugar content, but almost everything else is fair game. We are allowed unlimited amounts of non-starchy vegetables, but we aim for at least 2-3 servings, twice a day. This keeps our fiber and nutrient levels up, gets us plenty of healthy carbohydrates, and provides additional bulk to keep us full. If you’re a veggie hater, this will take some adjustment. I recommend researching ways to cook vegetables that maintain their fresh, delicious qualities and don’t resort to burying them in oil, cheese, or bacon; overcooking is the problem behind 95% of those childhood nightmares that we all have! Salads are allowed for those that prefer their veggies raw, but we have to spend the calories and fats on the dressing instead of something more interesting.

Everything else falls into the nebulous category of the third thing we eat. If you envision the meat and veggies as the main entree at any meal, then our other choice is one additional carbohydrate of some variety. This can encompass fruits, beans, grains, starchy vegetables, bread, pasta, rice, or more – of which we only get ONE serving per meal. (When alcohol is allowed, it also fills this slot.) In short, if it’s not meat or a vegetable, it’s a choice as to which one we want the most for a given meal.

Learning to think this way is very easy, and very hard. On the one hand, it’s an easy rule because it’s one choice out of a list. On the other, when was the last time you ordered beans OR rice at a Mexican restaurant – and didn’t also order something with a tortilla and/or chips? If you ordered pasta at an Italian place, you’re forgoing the garlic bread. Salads sometimes have fruit AND croutons on them. If you have a sandwich, the only reasonable companion is salad or non-starchy veggies, because you don’t get to add chips or fries when you eat bread. If you want dessert (say, a piece of cake) then you’re putting it in that slot – and you’ll be balancing additional meals around it too, since a piece of cake contains more calories and fats than an apple or a piece of bread. If you have a mixed fruit tray in front of you, you have to figure out how many of each thing you can take to equal the approximate amount you’re supposed to eat. It’s complicated, and often frustrating, but it’s part of the balancing act that diets require.

Fats are also a struggle, since we only get one at a time. The only way to combine multiple sources of fat is to use less of each. For example, cheese and sour cream on a bowl of chili would require us to have tiny amounts of each, or we could forgo one in favor of more of the other. We could also eat both, if we consciously choose to eat less at a previous or future meal – but that could open us up to being hungry between meals. This works during times when neither of us are hungry enough to eat a full meal, but storing up calories with the intent to over-indulge later isn’t encouraged. It’s far better to balance out the amounts throughout the day so that you’re not running into trouble with hunger.

Also important to note is that these restrictions apply despite the fact that we’re eating only healthy fats. An entire avocado is about 40 grams of fat, which is a little less than the amount we shoot for in an entire day right now. While the fats aren’t the same kind as we’d get from eating a cheeseburger, that is still orders of magnitude beyond a normal person’s needs. For the curious, the actual recommended serving size for avocado is 1/8th of an avocado. I’m willing to bet you never knew or measured that. I didn’t.

If you’re exhausted at this point – well, so were we. We’ve had twelve weeks to ease into this process, and for me, it’s been even longer. I’m used to weird serving sizes on things when they affect my insulin, but I’m still learning as much as everyone else when it comes to non-carbohydrate balancing issues. Learning and mistakes are inevitable as time goes on.

The important thing is to react to your mistakes and learning opportunities well. If you eat something you’re not happy with, try to keep track of that and balance it out with a day or two of otherwise healthy eating and exercise. Don’t make the additional mistake of trying to starve yourself as punishment or to prevent additional calorie load. The occasional splurge is something that happens to everyone, and it’s only when it becomes a daily (or every meal) habit that red flags start to fly. If your diet is great and you just ate a cheeseburger, enjoy the heck out of it – and I’ll see you in the gym. 🙂 If it’s the second or third cheeseburger you’ve had today, that’s what the folks at 20/20 are there to help with. Mistakes that are normalized aren’t mistakes; they’re your new sense of normal, and it will take a lot more effort to get back on track.

The other key is not to beat yourself up. So many of us are harder on ourselves than we need to be about this stuff. Sad, angry, frustrated, and tired people all overeat and make poor choices, usually in an attempt to make themselves feel better. In the best case, this is unproductive and doesn’t change things; in the worst, it can provoke eating disorders like anorexia, bulimia, and binge eating. There is no such thing as a perfect person, or a perfect diet that people follow perfectly. This stuff isn’t easy. If it was, none of us would be struggling with our weight! Give yourself the grace to grow and change, and you’ll be surprised what you can learn.

If you’re struggling with the diet you are on, please, PLEASE do not hesitate to rely on your friends and your family. Supportive people in your life are there for this purpose, and they should welcome you with open arms. Having allies that know your restrictions and can help you stay within your limits, even on days when you’ve given up or just don’t care anymore are the best, but shoulders to cry on are great too. I don’t know where I’d be without our favorite bistro waitress and her penchant for making special shakes or meals for us when we’re bored, or all the folks I’ve traded recipes with over the last couple of months. We’ve taken their tactics of always thinking about new ways to make things we want to, while still sticking to the rules of the diet; it’s always a challenge, but it’s helped us improve our game as chefs. We haven’t eaten badly once since this started.

On the other hand… folks that want to act as the food police, or shame or berate you for having to say no to things that you used to love, are NOT there to help you. Consider spending less time with them. I’ve heard so many terrible things from group members that were told that they “weren’t fun anymore” by their hard-drinking friends, or people whose friends intentionally try to persuade them to go off-plan by eating pizza/fries/etc. right in front of them, or waving it in their faces. In my own family, I have an example of someone who ordered too much food for his wife because he was afraid she’d get skinny and leave him otherwise. Some folks have cultural issues as well; in some countries, refusing food or having leftovers is an insult, and in others, the amount of butter or oil you use in your cooking is a sign of how esteemed the guests are. I am so grateful that I don’t have to navigate this kind of backlash in my life! When I have to say no, I know that the people around me will understand, and that’s a huge weight off my shoulders.

My last pieces of advice are some that I’ve given to others before; I still swear by them every day, and both are 20/20 sanctioned! The first one is to start using smaller plates – serve dinner on salad plates or smaller dinner plates if you have them. If you don’t – get some! This is intended to trick your brain into believing that the smaller portions you’re eating look big and plentiful. You would not believe how effective this is. I think I’ve mentioned before that brains have no idea what is good for them; show them a full plate of food and they won’t think twice. Put that same exact food in the center of a huge, empty plate and you’ll feel like something is missing. If restaurants had chosen to do this instead of increasing the portion sizes (and then the plate sizes… and then the portion sizes again…) to compensate for more food, many of us might not be fighting our weight to this day.

The second piece of advice is to take the time and go the extra mile on plating. Most of us eating at home don’t bother with making sure plates are pretty and colorful. We don’t add garnishes or decoration like they do in restaurants, because who wants to buy extra stuff and then waste it? That said, if you’re on a diet, you’re probably eating 95% of your meals at home, and restaurants are a thing you struggle with. Take the time to bring that experience to you instead. Making a conscious effort to layer colorful veggies with bland chicken, or shaving your limited amount of Parmesan super-fine so that it appears to be more cheese than you should be eating, does wonders. I’ve gotten a few compliments from folks at salad bars because I try to arrange my salads in pretty ways. It helps to make you feel like you just got something special instead of another salad. (Note: please don’t do this if there’s a line. People will hate you.) The old adage is that we eat with our eyes first, and this is the difference between “diet food” and “gourmet spa meal that I’m fortunate to be eating right now.”

And with that… I put an end to this massive, massive blog update! I hope something in here has been useful, either in pursuit of your own dietary goals, or to help you understand the process that we go through when deciding our own meals every day. If not, it’s always good for me to try to explain what I’ve learned so far, if only so I can get used to saying the words. I’ve always struggled with being too shy or polite to ask people for things that I need, and learning to be honest when something does or doesn’t work for me is a big deal. I don’t ever want to be the kind of person that insists that everyone else do things the way I do, and I don’t ever want to judge those around me when they make different choices, but I do have to advocate for myself and my own needs now. If my knowledge and learning can help others as well as me, I will be even happier.

It’s a brave new world.


  1. Sophie Bruce

    Glad to see you all are handling your dietary changes so well!
    I was diagnosed this pregnancy with gestational diabetes, pretty close to the time you started on this 20/20 experience. So, for the past several months I’ve been on a diabetic diet and have learned so much about how food affects me and my body. I will admit, the inner scientist in me has kind of enjoyed testing my blood sugars so many times a day and getting to really see the cause and effect certain foods have.
    But I can also sympathize with the mental exhaustion that can take place because of the constant planning and analyzing required to stick to the diet. For me, the first month was very hard, but since then, it’s become easier and more habitual (Thank goodness!).
    I hope you both continue in your weight loss success and keep enjoying the process! 🙂

    • DterminD

      Thanks so much! I’m sorry to hear you’ve had to learn all of this so fast and unexpectedly, but it sounds like you’ve done a great job of rolling with the punches. Good information and a willingness to learn goes a long way toward reducing fear. I think most people would benefit from more education in this regard – it matters for everyone, not just the diabetics in the world! We’re looking forward to welcoming Baby Bruce #3 to the world sometime soon. 🙂

  2. Carolyn

    Thanks so much for sharing all of this helpful and sensible information, Amy. Your summary about healthy dieting is especially noteworthy to me, where you wrote: “…learn balance, moderation, and portion control for the real world, as opposed to cutting out things from your diet forever. As my dietitian puts it, there are no “bad” foods, just foods that require more of an effort to balance – and foods that make it harder for you to maintain the goal of not being hungry on a proper diet.” Thanks too for all of the information that follows that, explaining this further. I really appreciate it.

    I also really appreciate and am very thankful for how thorough the 20/20 program is, and I continue to be very impressed by how much you and John are learning and applying and progressing!

  3. Cara

    I hope your foot feels better! Hopefully you’ll get some good rehabilitation on it with new insoles, taking it easy on certain workout positions, and hot tub dips! 🙂 I think your advice on diet is spot on! Once you get the basics as you laid out, I find it’s helpful to manage macronutrient balance (fat to carb to protein ratios) and micronutrient targets. That always helps me lose weight more efficiently, and make sure that I’m getting enough vitamins and minerals in my diet through food variety. I use this app called Cronometer for tracking the nutrients in what I eat, but thats more for “advanced” nutrition. Still, it’s fun to see what’s going in to your body nutrient wise based on what you eat. I hope you have a good week and good luck with TRX today! 🙂

    • DterminD

      Oh, we definitely have to watch macronutrient ratios too, and there are specific thresholds we aim for on most of the major categories (fats, fiber, sugar, etc.) A lot of the targets get met by default because of the way you’re eating if you’re on plan, but learning how to balance it once you’re off plan is part of the program.

      So many people hate food tracking because they find it time consuming or frustrating, but you really DO need a way to know what you’re eating. There’s no SHAME in being over your limits once in awhile, but tracking things will help you know whether it’s becoming a habit. We’re asked to track all of our meals and then keep doing it for up to two years post-program – which is fine because I’ve been doing it for years already for diabetic purposes. 🙂 Doesn’t bother me! With all the good apps out there these days, it’s easier than ever to use what’s right for you. 20/20 has their own app that’s available for anyone to use, but to be quite honest, everyone I know uses MyFitnessPal. It’s a known fact that the 20/20 app needed updating a couple of years ago.

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