An Industry Ripe with Failure
Most folks who try to lose body fat struggle and ultimately fail to achieve their goals. This is not their fault and neither was becoming obese in the first place. The fault lies within the "system". Without sounding conspiratorial, "the system" represents the advice of working within the constraints of the Standard American Diet and Standard American Exercise Recommendations as the basis for weight loss. The truth of the matter is that trying to cure obesity and all its related co-morbid conditions within the current "system" is like trying to quit smoking by switching light cigarettes.
I can't remember who said "All diets work, all diets fail" but it is the absolute truth in the management of obesity. After treating hundreds of obese individuals, I can tell you that most encounters start with the following questions:
- What medication can I take to lose weight?
- What diet should I try?
- What supplement works the best?
- Which exercise program works the best?
What do all these questions have in common? They are simply the wrong ones to ask and usually tip me off that the patient is in the wrong mindset for a successful attempt at fat loss. They suggest that curing obesity is a matter of discovering the right fat loss tool which can be adopted into our current way of living that will allow us to enjoy the Standard American Diet (SAD) yet see the weight magically come off.
Before weight loss tools are even discussed, it is critical to understand obesity is a multi-factorial disease process in which hormonal regulation, stress, sleep patterns, dietary patterns (both what and when people eat) and most importantly behavioral patterns are all equally to blame. Obesity is caused by an astronomically complicated group of interrelated physiological processes which have fallen into disarray as a result of the processed "foods" (I prefer to call them "edible food-like substances") which have become commonplace in the SAD. Our bodies become overwhelmed with the task of dealing with this highly-processed-garbage deficient in any basic nutrients. Our primary metabolic functions, including cell repair and energy regulation (stored energy versus burned energy), become so dysfunctional that the result is obesity and all its related co-morbidities (diabetes, heart disease, cancer). So, recommending a specific workout routine, supplement, diet, or medication doesn't address the underlying issue. It's akin to turning on the heat in the summer because the air conditioner is set too cold.
But I Know Someone Who Lost Weight by Drinking "Supplement" Shakes!
I'm often asked, "If convention doesn't work, why do I know people who have lost weight using conventional approaches?" By conventional approaches, I assume you are talking about anything you've seen on TV or heard around the water bubbler at work. Think Adkins, South Beach, BCG, meal replacement plans, point system plans, etc. Typically, all methods will work initially due to multiple variables including the fact that most weight loss regimens require users to reduce "sweets" and cut processed carbohydrates. The problem is that dieters typically cut all foods, the bad and the good, across the board, because they erroneously think weight loss is about reducing your caloric intake and increasing your exercise output. If this were the indeed the case, the record number of Americans adhering to the government's diet and exercise recommendations would be stifling obesity rates yet the numbers are skyrocketing! The truth is, conventional weight loss recommendations (eat-less/move-more) simply do not work and it has been proven time and time again. Why? Humans have overcome adversity (droughts, famines, fires, ice) over the past 200,000 years because our bodies compensate. We mimic these historical adversities by reducing our caloric intake and increasing our exercise. In return, our bodies compensate to keep us alive by slowing our metabolisms.
Here is an oversimplified rundown of the typical weight loss attempt:
Your body needs a certain amount of energy to run its functions throughout the day (breathing, pumping blood, repairing cells, growing hair, etc.). Let's say it is 2000 calories. You have excess fat to lose so you decide to only consume 1200 calories a day. In theory, you should be left with a caloric deficit (meaning your burning more calories than you are eating) and have to tap into your energy stores (your fat) to make up the difference. And this is true, temporarily at least. There are a lot of things going on which will actually cause your daily caloric expenditure to fluctuate by several hundred calories a day (but that is for another post). When we deprive our bodies of the required caloric intake, it responds by saying "Hey?! What the hell is going on here?! Eat something dummy!" These cues (hunger & cravings) are hormonal and cause the familiar gnawing hunger of a calorie-reduced diet. But, because you're determined to lose weight before summer, you ignore these hunger cues and continue your caloric deficit for... say... 3 months (in my experience, that is the average). At first, the weight comes off fast, then it slows, reaches a plateau and ultimately starts to come back on! But why?! The answer is simple: you purposely denied your body nutrition and this freaked it out. The human body worked hard during the caveman days to keep us alive through the good times and the bad times. During the bad times, the body slows down various processes to conserve energy. This is why when you're dieting you often feel fatigued and cranky, your immune system dysfunctions, sometimes your hair will thin, your sex drive decreases (a starving person is not a good candidate for reproduction) and the weight comes back on despite the fact that you're still denying your body the calories that it is pleading for. Think of this like using power saving mode on your cell phone. You can't do any of the fun stuff with it until it's recharged. You can argue with me all day about the validity of this process but ultimately, nature and evolution are right.
The Reward Cycle
The current system is built on triggering your evolutionary program to eat foods that give you reward. I was there, I know. I would go to bed looking forward to breakfast. Breakfast made me feel good because it was a reward. Who doesn't like a tall stack of pancakes with syrup? Then I would look forward to my mid-morning snack - trail mix or a granola bar: reward. Then lunch - a sandwich and some kind of chips/crackers: reward. Dinner was the same. Fridays were the best because it was pizza night: BIG REWARD! It's no wonder we crave the food we crave because they are full of rewards and this genetically programmed reward system kept us hunting for foods that were high in energy for eons.
Curing obesity is both exquisitely simple as it is infinitely difficult! A key point is the need to work within the confines our physiology and genetics rather than against these processes with drugs and unsustainable diets. This current paradigm forces the individual to approach their weight goals through the act of constant DEPRIVATION. This runs in contrast to our genetic programming to seek out rewards to ensure survival. For instance, we decide we are going to deprive ourselves of ice cream, beer, sugar, carbs, pizza. etc. This becomes a lifestyle of negativity and of constant reminders of what you cannot eat and certain foods become taboo. The "aha!" moment comes when you realize that losing weight is not about making a list of foods that you have to avoid and restrict. It doesn't mean taking three months off these taboo foods only to have a cheat day or to return to them after bikini season. The point I am trying to make is that a successful weight loss inducing diet is not about restricting things from the Standard American Diet but about shirking the Standard American Diet altogether.
Food is Sacred
I encourage patients to think outside the box and remove themselves from the current nutrition paradigm. Their relationship changes from being controlled by cravings and struggling to limit the processed foods to one where foods are worthy of their consumption. You can get to a place where you ask not "when can I eat a piece of cake" but "why would I even want to eat that piece of cake?" I encourage patients to ask themselves "what will the food do for me?" Is the self-ridicule, the feeling of cheating yourself or the feeling of defeat worth three minutes of "yum"? Once a patient realizes their body is sacred and the food which fuels it is sacred as well, they reach a zen-type level of understanding nutrition. When the paradigm shifts from RESTRICTING certain foods from the SAD framework to eliminating the framework altogether there comes the realization that you are not restricting anything! You CAN teach your taste buds to enjoy the endless combinations of flavor available from nature rather than allow chemical cocktails to hijack your evolutionary responses and make you crave the unnatural.
Our grandparents (and generations before them) understood this principle and is why they had the skills and knowledge to bake and cook from whole foods scratch to grow and can foods for storage, and that some foods were indeed a reward and reserved for special occasions (once, maybe twice a year). Once you "see the light" and recognize real food, you simply ignore the junk and trust me... YOU NO LONGER CRAVE IT! You are not depriving yourself of cakes, sugar and processed carbs, you are deciding that those food-like-substances are not part of your ecosystem. And yes, you'll get looks at holiday dinners and birthday parties when you push away the pastries but you have to realize that it is their issue, not yours. If they want to tease you because you won't eat a piece of chemically generated sugar filled, trans fat laden cake for little Johnny's 3rd birthday party, let them.
So you may ask, "What program is healthy and how do I start it?" I am a HUGE proponent of the Paleo lifestyle (follow the link for a brief description). YES, Paleo people can be as annoying as vegans (not really) and I understand that no program is one size fits all. The biggest takeaway from Paleo is to just stick with natural whole foods. That's it. You can adjust your macros if you want, you can try "going keto" knock yourself out; if you want to try vegetarian (and miss out on essential nutrients from a balanced diet which includes meat) then hey, it's a free country. If you're frustrated and confused the BECOME AN EXPERT YOURSELF! Here is a partial list of books that completely changed my way of thinking about nutrition: Paleo/Whole Foods Resources.