I became a #Noomer on the 28th December as I embarked on a 14 day free trial. I was intrigued; I had seen adverts everywhere with one clear message: Stop Dieting. Get Life-long results.
It lures me in – ‘There’s a reason diets don’t work… find out how long it will take to reach your goal weight…’
What exactly is Noom?
It describes itself as an award-winning weight-loss programme.
The app uses a combination of psychology, technology and human coaches to help people build sustainable habits and meet their personal health and wellness goals.
The founders were driven to create Noom because they were dissatisfied with how the American healthcare system focused on sick care instead of healthcare. They wanted to create a digital product that helped people take control of their health.
Already I’m confused.
Is Noom a diet or not?
It justifies its non-diet status by saying no foods are forbidden. Mmmm, ok.
I provide some personal details and stats and tell it I want to lose a stone. I deliberately kept the starting weight and goal weight both within a ‘healthy’ BMI range to see if this would flag anything but it doesn’t.
The Harris Benedict equation calculated my BMR, they use my answers to estimate my activity level, before then hacking out 500 calories to create an energy deficit to achieve the equivalent of 0.5kg weight loss a week. I spent much of my NHS career in weight management clinics using the same principles.
They point out calories shouldn’t go lower than 1200 for women or 1400 for men ‘to make sure your body is getting all the other nutrients it needs’ and I am assigned a calorie budget of 1200 calories.
All good though, because remember this is not a diet, it’s going to help me create sustainable habits and take control of my health, or so they say.
Next, they tell me how to divvy up my budget. They introduce me to the concept of red, yellow and green foods. Their main point is not calories (although they do list them against every food I log), but calorie density. Foods with a higher water content, for example have a low-calorie density and will fill me up.
- Green foods are the least calorie dense and/or contain the highest concentration of healthy nutrients.
- Yellow foods have more calories and/or less healthy nutrients per serving than green foods.
- Red foods are the most calorie dense and/or have the least healthy nutrients.
They are quick to point out though that ‘red doesn’t mean ‘bad’ and green doesn’t mean ‘good’’
I’m told to log my food and weigh myself daily. I can track my activity too.
It certainly raises awareness – as you log your meals a colour code appears down the side, so you can see at a glance how much of your day is proportionally red, yellow or green. The user can reflect on their choices and guidance is offered on how to make better, less energy dense ones.
For some #noomers, I’m sure this is really enlightening and helpful and facilitates choices that are higher in fibre etc. Whilst I’m not supposed to start judging foods based on their colour code, its difficult not to. I love a hot chocolate every day and it supports me to meet my calcium requirements as I don’t otherwise drink any milk. It’s red though. Yellow is better but I still need to be careful of these foods – so that’s things like eggs, avocado, some fish, quinoa (but not other wholegrains) and all pulses.
And other red foods I should limit include nuts, seeds and full fat dairy. In general protein doesn’t seem to fair as well and when we know the role it actually plays in creating satiety, I think that’s confusing.
Is this teaching the user to have a balanced relationship with food that is non-judgemental?
Meanwhile, should I focus on changing my behaviour, losing weight or both?
This is where Noom really can’t decide. It acknowledges there are many factors which impact weight, but reassures me it only takes 3 things to be done consistently in order for me to be successful:
- Weighing myself
- Logging food
- Reading the articles
I’m told weighing in everyday creates self-awareness and helps make healthy choices, but the SMART goals they advocate do focus on all aspects of wellbeing.
It shares data on the benefits of physical activity for cardiovascular health, but I also read I can earn more to put in my calorie budget the more exercise I do and I’m reminded not to cheat the system. They tell me they’re ‘a bit tight with their calories’ and they’ll give me back only half of what I burn to make sure I stay in a deficit.
Wowzers, I think I need some psychology to help me here.
The psychological parts of Noom are supposedly what sets it apart from all other weight loss programmes so let’s look at those.
The Psychology of weight loss (according to Noom)
Here we see some useful behavioural science principles, for example temptation bundling to aid motivation and behaviour chains to understand triggers for our actions.
Trigger –> Thought –> Action –> Consequence.
I’m reminded there are many consequences to my actions. This leads to the CBT aspect of the programme.
I’m encouraged to think through what triggers behaviour and the thoughts that are attached to that, with the knowledge of course, that it is our thoughts that we have the power to change. Some examples are given of ‘evil thoughts’.
Different types of thought distortions, many of which I’m familiar with and come across with clients all the time. For example, all or nothing thinking where we make big sweeping statements that aren’t very accurate. They also describe delusional thinking in which ‘You convince yourself of something you don’t really believe to justify a decision’ They give the following example,
‘This wafer-thin slice of cake doesn’t count’ – they back this up with the statement ‘But it does. Oh yes, it does’
After the thought distortions article apparently, I now knew ‘all the ways my sneaky little mind could fool me’
Then we have the ‘inner elephant’ – who apparently represents my impulsive, irrational, emotional side. I shouldn’t trust her because she is trying to derail me. It’s a useful delve into the psychology of food choice, but I’m not sure I like the subtle undertones. I think it’s time for a reality check.
The nuance of weight loss (and Noom)
Calculating energy requirements
They like to point out this is just maths and science. This assume energy balance and regulation of body weight are completely within our control and make no allowance for the metabolic impacts of repeated dieting on the body. Equations can only ever be an estimate and do not know the workings of our inner physiology, and yet we rely on them heavily to dictate our path.
Research shows that dieting itself has been shown to be the strongest predictor of weight gain over time. Funny how Noom don’t choose to share this evidence.
Tying exercise to weight loss
If guilt is used as a motivator for exercise, research shows it it more likely to be linked to emotional eating. Those who are motivated to exercise by things other than the ‘calorie burn’ have been shown to do this more consistently. Being physically active is one of the 4 key behaviours that are associated with living longer, irrespective of what you weigh.
The hidden impacts of food logging and weighing daily
Studies may show food diaries and weighing frequently yields better weight loss results, but what are the impacts behind the scenes that aren’t documented? Most weight loss studies don’t look at psychological state. My clinics are filled with people that have done just this and they now carry with them more weight, disordered eating and food obsession. Was that weight loss achieved sustained or was it yet another cycle? That #noomer’s previous dieting history is key and there were no questions asked about that.
Repeated dieting has been shown to increase food related anxiety, body dissatisfaction, uncontrolled eating and weight gain over time. Eating more intuitively on the other hand, actually has the opposite effect. Noom describes scale anxiety actually diminishing the more you do it. I struggle to get on board with that concept, based on my clinical experience.
In reality, when linking everything back to weight, judgement tends to take over innocent reflections. This is especially true when despite being urged to look at other measures of progress, there will come a point where the scale is unlikely to reflect perceived effort or sacrifices being made. For example, I’m not allowed to go out for dinner very much, and could choose broth-based soups as a starter. Er, no thanks.
I’m asked if I’m having doubts and am reassured this is normal. I’m also told not to give up and that ‘if you are going to doubt something, doubt your limits’.
So, as far as Noom is concerned I am my only limitation – so if my body is not responding, it is me who needs to exert more will power or effort. This reinforces the likelihood we will judge ourselves and take personal blame.
I’m not sure physiology is something that responds to big picture thinking and motivational quotes. Weight regulation isn’t a mind over matter thing, it’s rooted in primal survival mechanisms and there are many reasons why weight regain occurs.
No one can argue that there are very clear lifestyle behaviours that are associated with improved health, and for those trying Noom as their first experience of a not a diet diet, it could well provide the stimulus and support they need to make beneficial changes. Some people really get on board with the tracking and learning about foods and the app provides a focal point for exploring all aspects of our food behaviours.
However, for the thousands who have dieted for many years, the idea that this isn’t a diet will lure them in and has the potential in my opinion, to further erode their food relationship and with it their physical and emotional health. It is also for these reasons, that I now no longer provide portion plans and calorie deficits and why we have so much evidence that a non-diet approach can improve physical and mental health.
As I was about to cancel after my free trial, I’m handed the carrot of a group coach. This will see me through the ups and downs of my ‘weight loss’ journey says the non-diet app.
I check out the other people in the group…
Ellen is 72. She tells the group she is tired of yoyo dieting. This, she says, after many different diets, is hopefully the right one for me.
Oh Ellen, I wish I could give you a hug, but I’m off.
If you’d like to understand more of the science behind dieting, please do contact me and I’d be happy to chat!