dr.K's tiips

Some years ago, a colleague told me that he is embarking on a new weight loss program.  It was purportedly based on cutting edge metabolic concepts, thus, producing a high rate of success without really eating less. It is about “boosting the metabolism”: It was easy, it made you thin a long while – for life!

My colleague was very excited. The following week I saw him and asked how it was going.  He was crushed: “it’s a diet!…” he exclaimed with profound disappointment. He stopped dieting a few days later.

Therein lies a major problem for those who struggle for years with the desire for weight loss. We hope that we could lose weight without feeling hungry. We find the feeling of hunger intolerable – we must vanquish it before it even starts!  Our relationship with hunger has changed in modern times. What those of us in the society of plenty call hunger is very different from what people who don’t have enough food experience. In fact, our instinctive reliance on the assured availability of food – something that billions in the world cannot even fathom – has caused us to lose our tolerance for being hungry.

On the other hand, being overweight – a desirable trait once strictly the domain of the wealthy and powerful – became associated with possessing lower economic status, and being unhealthy and physically and aesthetically undesirable. Many overweight people are discriminated against, maligned by health professional and ridiculed and bullied as kids. The hip culture’s control over advertising, visual image, fashion, and social media vehemently denounces fat unless concentrated in the “right places” decided by “fat setters”. Whether for health reasons, social success, or self-image, the pressure to lose weight (or its more ruinous cousin – be skinny) is enormous.

The dilemma for those who want to lose weight is quiet clear – you cannot lose weight without being hungry – literally. Hunger, like thirst, is how your body notifies you it is getting too little nutrition to continue without using the reserves, which is exactly what we want when dieting. But our threshold for hunger is very low and our tolerance to it is even lower.

In fact, an entire diet industry is out there to convince you that there is a way around the feeling of hunger. Their promise: You can use your nutritional reserves (i.e., lose fat) without your body realizing it. “Unaware” of the caloric deprivation, your body would not sound the intolerable warning – hunger.

The failure to lose weight involves two types of lies. First, are the lies you tell yourself either by minimizing what you actually consume, or by repeatedly making yourself promises that you are unlikely to fulfill (“tomorrow I will really start dieting!”). Second, are the lies you tell your body hoping it would not notice the actual number of calories you consume (“I eat only healthy calories”, “everyone else had two deserts”, “I only ate half a doughnut”, etc. ). This particular “bargaining dialogue” with your body is unlikely to be successful as you and your body are at cross purposes: you want your body not to notice certain calories (“this is Carob not chocolate”). Your body, on the other hand, has evolved over millions of years where calories were scarce, hard to get and uncertain. It has the opposite mechanism you hope for: It knows how to use every calorie you consume, and those you don’t immediately need get stored in case the next meal would not be available for a while.

An attempt to convince your body that calories from Carob somehow don’t count, or that certain foods have different caloric meaning according to say, your blood type (!) and even weirder, anti-physiological “strategies”, is doomed to fail. The vast majority of overweight people who have normal caloric absorption in their intestines – are typically struggling for most of their lives with the pesky 15 to 30 pounds of unwanted weight. People who suffer from certain chronic medical conditions or from obesity are dealing with other physiological dimensions and require a different look into their weight gain or loss. But for the average overweight adult the following tenets should suffice to lose the weight they want to lose and even better, keep it off.

Effectively there are three types of diet:

1. Diet for weight gain
2. Diet for weight maintenance
3. Diet for weight loss

Accordingly, there are three clear rules:

If you want to gain weight eat more calories than what your body needs.

If you want to maintain your current weight eat more or less what your body needs.

If you want to lose weight eat less than what your body needs.

That’s it.

What your body needs should be determined individually but essentially, in order to lose a pound a week you need to eat 500 calories less than the number you need to maintain your weight. Remember: your body needs daily the same number of calories; if you eat less than it needs it would not “suffice” with what you give it – it would use the caloric reserves to reach the same number, i.e., it would start to consume your fat deposits.

Please consider that diet number 3 – for weight loss – entails dealing with the great intolerable – hunger.  You cannot give your body less than what it needs without feeling hungry.  We have different thresholds for feeling hungry, some get used to it and some cannot tolerate even the thought of it.  But a diet without the feeling of hunger is not going to succeed.

The good news is that in order to lose 10 pounds you need to diet for 10 weeks. That is 2 and a half months.  Some lose weight more slowly than others, and they may need more than 10 weeks to lose 10 pounds but the idea is that diet for weight loss is NOT a way of life.

I know that many diet consultants would have you believe that in order to lose weight you should adopt a new life style of eating a certain way and exercising. That is true but for weight maintenance and not for weight loss. The difficult psychological toll of a diet is the inner struggle against self-deprivation. Think about it:  you want to eat now, your body wants you to eat now, and yet you consciously deprive yourself of those immediate wishes for the sake of a non–immediate outcome. This is a very hard struggle; it is the major hurdle to maintaining and completing a weight loss diet. But the emphasis is on complete : a weight loss diet should have a finish line since you cannot afford to lose weight indefinitely!  A weight loss diet is not a life style – it is a temporary, unpleasant deprivation for a very clear goal.  Weight maintenance is a life style choice.  Staying around the amount of calories your body needs per day and restricting fluctuations to about 3 pounds up and down would make sure to maintain the weight at which you wish to remain. And an added bonus is that you would have a better quality of life, sleep better, have or develop less aches and pains and be more energetic. A weight loss diet is unpleasant but limited in time ( I remind you that we refer to the ubiquitous 15 pounds of weight many wish to lose and not to those who experience obesity.)  Weight maintenance means you eat what you need, and some days what you want, while being aware of your caloric intake and weight and in control of both.  This is a good, doable life choice that can eliminate the cycles of weight yo-yo with its great disruption of metabolic stability and health. Being in control of your intake and weight can halt once and for all the waves of guilt, self-recrimination and loathing and the sense of always being a bit out of control due to the unsuccessful struggle with your weight. What you need is a brief period of weight loss diet replaced by a long-term life choice to pursue a weight maintenance diet and avoid eating for weight gain. This is all you need to be rid of your S&M relationship with food.

I can imagine that at this point you are disappointed: where is the trick? Where is the secret to make weight loss diet pleasant, nonintrusive and lasting?  Perhaps some food combinations? Or foods that should not be mixed? Or hypoglycemic sugars? Or metabolic boosters? Something, anything that will promise us that diet is going to be painless, by tricking our body to use the fat reserves while inducing no hunger bells, i.e., still eating as much or more than we need – like stealing something without triggering the alarm.

The secret is that there is no trick.  The only way to trick your body is by interfering with the hunger and satiety mechanisms.  As we increase our understanding about leptin and ghrelin – the “appetite hormones” – we may soon able to tweak them. Within the next decade, some manipulations of the brain’s “appetite centers” may abolish the feeling of hunger even if we eat for weight loss.

But is it going to be the end of fear of dieting? Of course not. Most people (and other animals) in areas and periods of plenty, eat more than they need to function. Indeed, the brain rewards eating by releasing pleasure inducing substances. The ever presence of plentiful food, especially one deemed tasty, causes craving and addiction not unlike other pleasure principle substances or activities. We do not eat because we are hungry – hence controlling hunger would result only in partial reduction in failure (failure to lose weight, to maintain the new weight or failure in both).

In truth diet for weight loss stinks!

What about exercise and physical activity?

The vital importance and benefits of being physically active are beyond question. I suspect that many non-athletes are committing to exercise with the goal of losing weight. The logic goes as follows: “I burn calories when I am physically active: I cancel out my caloric intake by ‘burning calories’ through exercise – If I exercise vigorously enough, I would be able to lose weight without eating less.”

In reality, the connection between what we eat and how we burn it is for the most part out of our hands. Our metabolism is fortunately not under our conscious control much like our breathing isn’t, and for a good reason: Had our physiological activities (of which millions occur every second) been under our conscious control we would have died before completing our first breath! Sure, we have some latitude: we are in charge of the fuel and liquid intake, the environment where we choose to put ourselves into, the amount of physical activity we perform, how much we sleep, whether we consume substances that are deleterious to our health, in short most of the interactions between our body and its environment. The rest, whatever happens inside the body, our cells, their relationship to each other and the minute by minute homeostasis and balance, is left to the “automatic” control of the body. Our body and all of its functions are a “driverless” car, best left to its own.

But what about what we call our metabolism? Most of us are confused about what metabolism actually means. The simplest definition I could google is: “Metabolism is the chemical processes that occur within a living organism in order to maintain life.” This succinct statement encompasses virtually millions of complex activities that occur in the body at all times. The energy for the physiological activities is measured in calories. The body needs a certain supply of calories to maintain all life functions inside it. This happens whether we lie in bed or run 10 miles. Which is a good place to point out an evolutionary mechanism: We evolved to be active especially as it pertains to finding food, escaping predators and interacting with our environment.  What we now call exercise was once considered simply daily activities. Since it took such effort to find food, it made sense that the act of finding food would not cost a lot of energy – otherwise it defies the purpose. Therefore, physical activity, even strenuous exercise, does not cost a great deal of energy.  The body goes through the daily energetic requirements that are essential and mostly unchanged day to day. In other words, exercise burns a very small number of calories compared with the basic metabolic needs of the body.

The physical activity industry is extolling the virtues of exercise for weight loss by “burning calories”.  While these notions of “burning” and “calories” are nebulous and at best inaccurate, the problem is not merely semantic. Many people turn to exercise with the hope of losing weight. As it does not happen (certainly without a diet for weight loss) many become disappointed and drop out of physical activity. Some essential physical activities that are touted for weight loss – especially walking –are often neglected. Consequently, the majority of people who are not athletically inclined have an ebb and flow relationship with physical activity. Resolutions, new exercise fads, clothes that don’t fit, a special occasion, a medical scare, all ignite briefly an acute determination to exercise for weight loss, only to become disappointed by lack of change on the scale and of waist size. Discouraged, many descend back into the sedentary life so typical of  the American life style.

To reiterate, physical activity of any sort is essential to our health and wellbeing.  But it is not essential to weight loss, and certainly cannot make the body lose weight without dieting for weight loss – meaning consuming less calories than the basal physiological needs require.  Then and only then, would the body be forced to use its energy storage – our fat deposits.

As I mentioned above, dieting for weight loss sucks! Dieting for weight loss entails deprivation, feelings of hunger, and a great deal of discipline and self-control. The idea that diet can somehow be fun, care free activity, is an illusion promulgated by those who spare the overweight public the burden of an inconvenient truth. While many are set for failure due to misinformation and unrealistic expectations, the politics and financial interests behind the “eat more” society are making sure we eat more then we need and spend more time sedentarily absorbed in screens and hope for the best. (For a great discussion about the politics behind weight gain I highly recommend the book  “Why Calories Count – From Science to Politics” By Marion Nestle and Malden Nesheim – both professors of nutritional science. The authors discuss the politics and finance behind our “eat more” society and how it promotes the obesity problem that interferes with millions of lives in terms of quality, longevity and physical and emotional well being.)

I personally believe that since a successful diet, any kind of diet, is a function of adherence, and adherence is a function of personal choice it is important to state the basic tenets clearly and simply. If stated unadorned and practical, using the truth – even the inconvenient one – the potential dieter would be informed enough to make his or her own choices, understand the obstacles and embark on an open-eyed strategy.  Only when the expectations and the course of action are clear and a reasonable time limit is set, can a diet for weight loss succeed. The more rules, regulations, changes, steps, food combinations etc., the less successful the dieter would be. Also, the more complicated the diet, the greater is the chance that it hides beneath its ostensible “scientific” glint some inconvenient facts about weight loss and hunger and unsuccessful lies.

Here are my 10 tenets of weight loss:

1. You cannot “trick” your body. It would use the fat reserves only when not getting enough calories from your nutrition.
2. Everything digestible you eat, breaks down to the tiniest elements and gets absorbed into the body.
3. Metabolism is a process that happens in every cell of the body. You do not control your metabolism nor are you able to “manipulate” it
4. Most of the calories we consume go into routine life processes. Physical activity consumes less than 10 percent of the calories we eat. Unless you are an athlete, exercise does not contribute significantly to weight loss.
5. Most overweight people do not have hormonal reasons for becoming and staying overweight.
6. Successful weight loss diet is a daily commitment for a limited time. It is not a “life style” change.
7. Any time you eat more calories than what your body needs – you are eating for weight gain.
8. It is helpful to use an app for calories journaling provided you do not cheat and/or deduct calories “burned” by exercise.
9. It is helpful to weigh yourself frequently to make lying to yourself harder to do.
10. Every person can lose weight. In times of starvation there are no overweight people.

In short, the inescapable simple strategy for successfully losing weight is consuming less calories than one needs.

Diet is a difficult and unpleasant commitment. It is an act of continuous self-deprivation, it can put you in a bad mood, and cannot be sustained over long periods of time.  However, it is safe to say that no one can diet on your behalf. It is a decision that you need to make, a commitment that you need to keep, temptations that you need to resist, and deprivation you must impose on yourself.  Most overweight people would have preferred to lose some weight and had it been easy many would have succeeded. With the realities of our life, with plenty of calories to consume, many are unsuccessful.v

Science continues to break new frontiers and perhaps someday humans would lose weight without skimping on calories or food. Perhaps it would happen in your lifetime and you prefer to wait for that amazing breakthrough. It is of course up to you. Both weight loss and weight gain can be viewed as opposite ends of the same spectrum. With the years, we tend to gravitate closer to the weight gain side. It is no wonder: our body wants us to eat and rest. It evolved when hunger and strenuous physical activity were daily realities. We had to eat little and work hard and had very little leisure and very short life. So eating more and moving less is actually natural and aligned with our body and we get rewarded for that by our brain.  So it makes sense that most of us prefer to rest and eat more. In order to lose weight, you need to struggle with your body’s natural tendencies, hence give up certain pleasures and be miserable for a while. But this is also what makes losing weight so rewarding: not only are you going to feel lighter and better. You would enjoy the sense of satisfaction of having made a positive decision for your life and having accomplished it.  This is one of those wonderful accomplishments that you can claim all the credit for. And it is up to you.