You: On a Diet

and

Collins Gem Calorie Counter

Contents

Cover

Title Page

You: On A Diet

Collins GEM Calorie Counter

Copyright

About the Publisher

The Insider’s Guide to Easy and Permanent Weight Loss

MICHAEL F. ROIZEN, MD

MEHMET C. OZ, MD

Authors of the million-copy bestselling You: The Owners Manual

With Ted Spiker, Lisa Oz, and Craig Wynett

Illustrations by Gary Hallgren

Disclaimer

This publication contains the opinions and ideas of its authors. It is intended to provide helpful and informative material on the subjects addressed in the publication. It is sold with the understanding that the authors and publisher are not engaged in rendering medical, health, or any other kind of personal professional services in the book. The reader should consult his or her medical, health, or other competent professional before adopting any of the suggestions in this book or drawing inferences from it.

The authors and publisher specifically disclaim all responsibility for any liability, loss, or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this book.

Dedication

To the millions who have dieted hard,

so they can learn to diet smart

Part 1

Introduction
YOU: On a Diet
Work Smarter, Not Harder

Most diets promise commonsense solutions to tight-pants problems: Eat less, and you’ll weigh less. Keep your mouth closed, and you’ll keep the pounds off. Sweat like a sauna-dwelling sumo wrestler, and you’ll wind up skinnier than a sheet of paper. Straightforward enough. But if it really worked that way, our bodies wouldn’t be large enough to be spotted by Google Earth. If it really worked that way, then most diets wouldn’t fail. If it really worked that way, then we all must be a bunch of rebellious hellions with mayo-covered lips and belt-busting bellies who don’t feel like following a few simple instructions.

Or it could be that most diets have it all wrong.

We believe it’s the latter.

You know why? Because most diets instruct you to take on the corn chips, meatball specials, and dessert trays with brute force. It’s you versus food in a lifetime heavyweight fight. But in that scenario, the fight is always fixed—and not in your favor. That’s because the battle against extra pounds isn’t won with force, with sweat, with trying to diet. It’s won with elegance, with smarts, and with healthy choices that become as automatic as a Simon Cowell barb.

When it comes to dieting, trying to whip fat with our weapon of willpower is the food equivalent to holding your breath under water. You can do it for a while, but no matter how psyched up you get, at some point your body—your biology—forces you to the surface gasping for air. And with most diets, your body forces you to gasp (or gulp) for food. No matter how hard you try not to eat, some hidden force deep inside is always prying your mouth back open, making it impossible for willpower to win. Instead of sparring with your waistline, it’s time you made your body an ally in the fight against fat.

Our process is to look at our overweight bodies the way scientists would: Identify the underlying biology of the problem, then find the cures. Why? Because we’re lucky enough to be in the right place at the right time—a time when the scientific world has just now started to unlock the biological mysteries that have caused us to store fat and gain weight. For the first time in our history, the scientific community is uncovering the medical evidence about food, appetite, and satiety that will allow you to tackle weight problems with the real weapon against fat: knowledge. By making this knowledge simple and accessible, we’re going to give you tools and actions to crack the code of true and lifelong waist management. In fact, our plan will help you avoid the dangerous yo-yo cycle of weight gain and weight loss. We’re going to help you reprogram your body so that you can keep off the weight you lose forever.

Through the years, many of us have been led to believe that our weight problem is about two things: calorie counting and mental toughness. While some of us may say that the weight problem is too much of the twelve-cheese lasagna, the real problem is that most of us have as much of a clue about how our bodies work as we have about how our cars do. Sure, we know the major parts and generally what they’re supposed to do. The real danger of thinking we have most of the answers is that we stop asking the questions. If we look under our hood, do we really understand the systems that make our bodies accelerate to a life of fat and the ones that slam the brake on the dangerous cookie-and-cake collisions that take place every day? Probably not, and that’s what we’re here to help you learn.

Above all, we’re going to teach you that when it comes to dieting, you need to work smart, not hard.

Following our plan, you can expect to drop up to two inches from your waist (or a dress size) within two weeks and see results steadily after that. While the end goal is what many of us look for, we believe that the path you choose to get there is what really dictates whether you make it or not. Our path looks like this:

Part 1: What a Waist! Starting here, we’ll talk about our major principles for how the body is designed to work and how our program is geared toward those functions. And we’ll also give you the biological ideals of the human body—how our bodies originally looked and functioned. We’ll also give you some self-assessment tools for figuring out your own body’s ideals. Once you know where you’re going, you’ll have a better idea of how to get there.

Part 2: The Biology of Fat. Here you’ll follow morsels of food from the pantry to the porcelain bowl and everywhere in between. We’ll start by exploring the physiology of appetite, and then we’ll dive into the science of fat—how we store it, how we burn it, how we fight it. You’ll learn what a truly amazing system your body is when you steer it in the right direction through wise nutritional and activity choices.

Part 3: The Science of the Mind. When it comes to overeating, most of us put more emphasis on what we’re noshing than on what we’re thinking. But you can’t discuss weight issues without exploring the scientific and chemical (and even spiritual) reasons why your brain hormones and your emotions drive you to the eight-enchilada special. More important, we’ll show you the strategies for making your emotions and the chemicals that drive them work for, not against, your waistline.

Part 4: The YOU Diet and Activity Plan. After you read and learn about the intricacies of your body, you’ll find the eating and activity plan that will teach your body to eat and work smart. Your body will become your gym as you gain sleek strength in your body’s foundation muscles—all without using weights. And you’ll learn to make the right decisions in the supermarket aisle and at the fast-food window. The fourteen-day plan outlines recipes, exercises, and actions you can take to live leaner and healthier.

(In our appendices, we’ll explore the medical options for dealing with weight issues—for times when you may plateau, and for those people whose weight problems have led to major medical problems.)

Now, with all the diet information that’s circulating today, sometimes it’s hard to know what’s right, and sometimes it’s hard to remember what to do even if it is. That’s why we feel that while the program is important, how you learn it—how you ingrain it as part of your lifestyle—is just as vital. As we travel through the four parts of the book, you’ll notice various ways you’ll learn about your body and how to change it. These are the five main elements we’ll use along the way:

YOU-REKA IMP

YOU-reka Moments! Like Einstein suddenly realizing that E = mc² you’ll develop deep insights that challenge your preconceptions about diets, about fat, and about your body. In the margin, you’ll see our YOU-reka imp—the signal that we’re about to come upon a moment of enlightenment by busting a myth or explaining something to you about diets that may seem 180 degrees from what you believe is true.

YOUR Body: In parts 2 and 3, as we explore the biology of your body, we’ll start each chapter by giving quick biology lessons about what really happens inside your body. We ask that you put on your metaphorical scrubs and gloves as you whiz through your arteries, travel through your intestines, and hang out in your stomach. We’ll get up close to your fat so we can see how your body handles it and how it manipulates your body. We believe that by learning about how the inside of your body works, you’ll develop the smarts you need to change how the outside looks.

YOU Tests. Through interactive quizzes and measurements, you’ll establish baselines for such vital statistics as your ideal body size and your eating personality. And you’ll also be able to test for the secret things that could be contributing to a weight problem (get a load of our tongue test on page 70). You can start in a few pages by taking the Fat Facts Test on page 17.

YOU Tips: After we explore the biology of your body to show you what bad things can happen if you make the wrong choice or have cross-wired genetics, we’ll immediately give you actions that can help turn your body around. At the end of each chapter, we’ll outline intelligent strategies—big and small—for living, eating, and moving in a more healthful way.

The YOU Diet and Activity Plan: In Part 4 (on page 191) we’ll detail the specific and simple strategies, recipes, and exercises that will lead you to the body you want—for the rest of your life. The fourteen-day YOU Diet (it’s actually so easy that we crafted a seven-day plan that you do twice) and the no-weights-required YOU Workout provide all the tools and instructions you’ll need. Best of all, they don’t take a lot of time, and they’re so easy that you can incorporate them into your life today.

So where do we start? With our first YOU-reka! moment: Your body naturally wants to take you to your optimum weight, as long as you don’t get in its way.

That’s right. For almost everyone, no matter what your genetics, the systems, organs, and processes of your body all want you to function at an ideal weight and size. With the following few principles that we’ll develop throughout the book, we’re going to teach you how you can make that happen without having to bludgeon yourself in frustration with a butter knife. These are our major principles of achieving your very best and very healthiest body.

YOU Will Choose Elegance over Force

Most dieters try to defeat their Oreo/Cheeze Doodle/custard pie infatuations with will, with deprivation, with sweat, with a “my-brain-is-stronger-than-your-crust” attitude. But trying to beat your body with mind power alone may be more painful than passing a melon-size kidney stone. Instead, you have to learn about the systems and actions that influence hunger, satiety, fat storing, and fat burning to fine-tune your corporeal vehicle so it runs on autopilot and takes you to your ultimate destination: a healthy, ideal body. (For those who want to skip ahead, you’ve probably already peeked at Part 4; however, getting to know the nuances of your body is what will help you achieve and maintain a truly healthy-size body.)

FACTOID

When you lose weight without exercise, you lose both muscle and fat, but when you gain weight without exercise, you gain only fat. It’s much easier to gain fat weight than it is to gain muscle weight which is one of the reasons why yo-yo dieting fails so miserably: When you continually gain and lose and gain and lose, you end up gaining proportionally even more fat, because of the muscle loss that takes place every time you lose.

YOU Will Learn How Your Body Thinks

True body improvement is about science. It’s about making the leap from witchcraft to hard data, from alchemy to chemistry, from speculation about what works for your body to explanations of how your body actually works. The only way you’ll understand the way calories and fat travel from that 2,000-calorie onion loaf to the back of your arm is by bringing alive the physiology of hormones, blood, organs, and muscles—by explaining the processes of digestion, starvation, fat storage, and muscle movements. When you understand the magic of physiology and the fun of biology, you’ll know what actions to take—and why you’re taking them—to reboot your body back to where it wants to be. Just as when you’re trying to help a tantruming toddler or kick-start a frozen computer, you can’t fix it unless you know what’s wrong. Know the why, and it’s much easier to handle the how—when you need to. Let’s face it, we’re not going to be sitting next to you at 10:30 p.m. when you’re pilfering a Pop-Tart. So you need to be equipped with knowledge of how your body works and reacts to that Pop-Tart so that you can defend against the little sugar-coated bugger.

YOU Will Challenge Your Beliefs about Diets

Throughout our lives, we’ve been conditioned to believe that if one thing is good for us, then more of it must be better. If you eliminate 100 calories from your daily diet, then eliminating 400 must qualify you for size 2. If you walk to lose weight, then running a marathon must nuke the fat right off your body. Well, neither idea is true. Worse, not only aren’t they true, but many of the diet myths perpetuated today actually hurt our bodies. Food deprivation, for example, drops your metabolism and makes your body want to store fat. Many of the rules, ideas, and principles you may believe about dieting—that you assume work when dieting—simply aren’t true and can very well contribute to weight issues because they keep the vicious cycle of fat loss and fat gain revolving faster than Lance Armstrong’s front wheel.

FACTOID

In men, the supplement L-carnitine-at a dose of 3 grams a day-helps muscles use carbohydrates, but it is also good for blood vessel function in both men and women.

In a way, we live on the two extremes of a pendulum. Either we swing all the way in one direction (strict, tedious dieting with a draconian low daily calorie intake), or we swing all the way in the other direction (popping cream-cheese-smothered bagels like grapes). We have to stop swinging so much and start living in the middle of that pendulum by striking a balance and avoiding the periods of extreme “ons” and “offs.”

One of the reasons why most so-called diets fail is because of a psychological and behavioral flaw that many dieters have. We desperately want to believe the simple, comforting promises that diets make—that doing A always gets us B. Because once we see that A (eating wheat germ 24–7) doesn’t always equal B (the cover of Vogue), then we get frustrated and angry, and give in to the gods of cream-filled baked goods.

Unfortunately, your body and your fat do not have a linear, two-step relationship. Instead, think of your body as an orchestra. All of its systems, organs, muscles, cells, fluids, hormones, and chemicals play different instruments, make different sounds (your intestines have dibs on first-chair tuba), and produce different results depending on how you use them. They work independently, but only when they’re played together can you appreciate the magnificent symphony of your own biology. As the conductor of your biological orchestra, you control how the instruments interact and what the final result will be.

YOU Will Make Dieting Automatic

While we want you to “not think” about eating good foods, we also know that “not thinking” may be how you got into this pants-stretching mess in the first place. When you don’t think about the consequences of ordering football-size cal-zones, you wind up with such pleasantries as high LDL (lousy type of) cholesterol, low HDL (healthy type of) cholesterol, inflammation in your arteries, and a higher risk of aging arteries that cause memory loss, heart disease, even wrinkles, as well as a steady stream of coupon offers from the large men’s department. We want your body to guide you to the right choices—without thinking about them—so that they’ll lead to the results you want. It will take some effort at the start to retrain your habits, palate, and muscles, but this program will serve as a lifelong eating, activity, and behavior plan that will become as routine as going to the bathroom before bed.

Unless you’re the rare kind of person who responds to dietary drill sergeants, you won’t find long-term solutions using traditional weight-loss methods: willpower, deprivation, fads, phases, or dead-bolting the lid of the butter pecan. Instead, using this plan, you will train yourself to never think about how much you’re eating, never think about getting on a diet or worry about coming off one, and never have to figure out formulas, zones, or, for the love of (fill in the deity of your choice), place a chicken breast on a food scale.

YOU Will Focus on Waist Management

Our society seems almost as obsessed with pounds as it is with celebrity breakups, but it’s time to shift your thinking: Studies have shown that waist circumference, not overall weight, is the most important indicator of mortality related to being overweight. Of course you’ll lose pounds on this plan, but we want you to switch your focus from a number that measures your weight to one that measures your waist. Because of its proximity to your organs, your belly fat is the most dangerous fat you can carry.

YOU Test

Take Out the Tape

Some people haven’t stepped on a scale since Laverne & Shirley played prime time. And that’s a good thing. For our purposes, you don’t need to know how much you weigh (but if you want to check your progress on this program, then go ahead and peek). All you need is a tape measure. Measure the circumference of your waist at the point of your belly button, and record the score here. (Depending on how your weight is distributed, you may need to make an adjustment to where you place the tape. If you’re obese, keep the tape measure parallel to the floor during measurement.)

YOUR SIZE:

For optimum health, the ideal waist size for women is 32½ inches; once you hit 37 inches, the dangers to your health increase. For men, the ideal is 35 inches, and the dangers to your health increase once you hit 40 inches.

While we’re going to emphasize waist over weight in this book, we also know that many of you won’t be able to resist the siren of the scale. When it comes to actual weight, you do need to stop thinking about one specific number. (“I want to get down to one hundred thirty.”) All of us have an ideal playing weight-not a weight for running marathons or making All Pro linebacker or posing for an airbrushed-anyway centerfold. This ideal playing weight is a range in which you live lean and healthy, and one in which you significantly reduce the risks of aging diseases associated with being overweight (more on all of this in Part 2).

In addition to helping you shrink your waist through diet, well also teach you the exercises that will help you achieve and maintain a healthy waist size. Now, we don’t want you to think that exercise must involve sweating like a waterfall and panting like an obscene caller, because it doesn’t. But you do need to start thinking about your body as a dartboard: it’s all about what’s in the center. You’ll be focusing on the physical activities that will help control your waist size—specifically walking and foundation-muscle training of your entire body (without growing igloo-size muscles). Well teach you simple moves that will develop all of your foundation muscles, and well teach you how to tighten your belly, improve your posture, and develop the muscles that will make you fit into your clothes better. That translates into a shapelier waist, which, studies show, makes you more attractive to others.

But let’s not overlook the management part of the waist management equation. We all know how good managers work: they plan ahead and create systems that play to people’s strengths, they set realistic goals, they measure progress, and they don’t force their employees down roads that are designed to give them a pack-your-things meeting with HR. You need to train yourself to be a good waist manager by following a plan that’s designed to help you become the CEO of your body.

You Will Focus on YOU, but Not Rely on YOU

It doesn’t matter whether you look at presidents (Lincoln or Taft), musicians (Usher or Heavy D), or tennis players (Sharapova or Serena), it’s clear that we all have different builds, just as we all have different genetics, metabolic rates, and chemical interactions. Still, there are some fundamental biological facts that are true whether you’re built like a branch or a stump. As a species, we’re programmed to gain and preserve the right amount of weight. That’s simply what our bodies are designed to do (more on that coming up). The trick is to figure out your factory settings. Then, we’ll give you the all-important lock-setting tools that will help you to reboot those factory settings so that your body maintains its ideal size and shape.

While this is a very individual challenge, it doesn’t have to be a lonely one. Life is a team game; you’ve got sports teams and surgical teams, restaurant staffs and office staffs, hip-hop clubs and calculator clubs. And of course you have the ultimate team: your family. The most successful teams all work the same way: Everybody plays a different role and contributes in his or her own way. You may have a Shaq, Kobe, or LeBron on your team, but the team can’t win the title unless everybody, not just the stars, works for the team goal.

Somehow, though, when it comes to weight control, you believe that you’re solely responsible for dropping your excess pounds and changing your habits. To make it worse, when you’re gaining weight, even the fans are chipping in on your side; the world around us wants us to gain weight in the form of big portions, drive-throughs, and family dinners that could feed a small municipality. Then when you’re trying to lose weight, it’s as if everyone’s against you; they bring junk food into the home, suggest that everyone goes out for ice cream, and feast on pork fat while you’re trying to gnaw on cauliflower.

You have to stop thinking that this game is you versus a stadium full of rib-loving opponents. Sure, you need to be the quarterback of your waist control team, but you won’t achieve success without a team that can block for you, high-five you when you’re doing well, and give you an encouraging smack on the butt when you’re not. Your starting lineup should include your doctor, maybe a nutritionist, maybe a personal trainer, and certainly scads and scads of fans like your family and friends (online or in person) who can push you, support you, and yank the bowl of candy corn away from you. But you shouldn’t be the only one relying on other people; you should use this opportunity to find a support partner who needs you as much as you need her. After all, the best kinds of satisfaction shouldn’t come from the sixth spoonful of cake batter, but from sharing knowledge and support, and helping others lose inches.

YOU Will Stop Blaming Yourself

The classic psychology of fat is this: If you’re thin, then you believe that fat people must be doing something wrong to make them fat. But if you’re fat, then you blame the environment, or your genetics, or anything else. Well, we’re going to try to eliminate that blame and use medical insights to explain the epic saga of weight-related problems. We want to move dieting past a guilt-driven and blame-ridden system, and make it a science-based system.

Of course, not everyone can look like a Cameron Diaz or a Brad Pitt. To get an idea of what your healthy weight, waist, and shape should be, you’ll need to take into account such things as bone structure, muscle mass, genetics, and risk factors associated with your weight. Here’s a fact that goes virtually unmentioned: There are clinically obese people who live with no risk of health problems, and there are CD-thin people whose risk of dying prematurely is more than a chuteless sky-diver’s. Our goal is to get you to the point where you strip away inches, you strip away the risks of being overweight, and you strip away the guilt associated with the process of always trying to do so.

YOU Will Never Be Hungry

We know exactly how you’ve felt when you’ve dieted in the past. Hungry. Famished. Three seconds away from steamrolling through a triple-dip cone with sprinkles. That recipe for dieting is one you can tear up. In fact, the only place hunger ever got you was a pair of pants that could double as curtains. To eat and work smart, your goal is never to be hungry and never to be in a state of dietary angst, where your only salvation is the 99¢ menu at the drive-through window. By keeping your hunger (and internal chemicals) in check, you’ll avoid the impetuous behaviors that send fat on an express ride to your belly.

YOU Will Make Mistakes

Look, we don’t care how motivated you are, how willing you are, how inspired you are by Eva Longoria’s body. Someday, and someday soon, a volleyball-size muffin is going to get the best of you and nudge, bribe, or cajole its way into your stomach. That’s OK. Hear that? That’s OK. You’re going to have moments when your eyes, body, and curious fingers won’t be able to turn radar lock off of the queso dip. You have to get past the concept that diets have side effects—that is, unexpected negative consequences. Instead, realize that eating plans have effects—offshoot actions, behaviors, and emotions that are simply part of everyday living. One of those effects is that you will occasionally eat things that are nutritional cigarettes; while one may not hurt you, it can get you addicted to some bad behaviors. Because of that, waist management is about developing contingency plans—plans that allow you to make mistakes and then get back on the right road. We’re going to teach you how to make a YOU-Turn when you do make mistakes with Twinkies or Tootsie Rolls or any bad-for-your-waist foods. That way, your dietary fender benders won’t turn into 100-car Autobahn pileups.

YOU Will Be Flexible—and Have Fun

Most of us want our diets to be a little like having the remote control; we want the power to make lots of choices, depending on everything from our mood to the time of day. It’s clear from research that the most successful eating plans are low-maintenance: You can follow them with your family, and you won’t feel overwhelmed by cravings. If you can do that, you’ll get results. But try to stay on a diet where you feel more isolated than a Yankees fan at Fenway Park, then chances are that the result will feel like the box-office numbers of a B-level horror flick—a miserable failure.

Eating right shouldn’t be about feeling bad. It should be about feeling strong, increasing energy, living better, feeling healthier, and having more fun than a front-row rock fan. It should be about eating without thinking and without obsessing about every forkful. Of course, we all have reasons for overeating or eating the wrong kinds of food (stress, boredom, comfort, five-cent wing specials). But our goal isn’t just for you to make by-the-book food substitutions or come to grips with your Devil Dog demons. You should be grinning—not grimacing, grunting, and growling—as the inches melt away from your waist, and laughing as your lipid profile improves. You’ll understand how, after we show you how the mind-stomach connection works by explaining how brain and belly chemicals control what the mind thinks, how the fork acts in your bodily orchestra, and how this relationship can become a cacophony in the wrong hands.

So now that we’re about to begin, you’re probably asking, What are we going to do, and how are we going to do it? Well, we’re going to give you everything you need to make a body change—through a series of elegant and effective changes based on hard science—that will stick with you for your life. Simply, this book will serve as your lifelong waist management, body-changing plan.

Best of all, when you put it all together and integrate automatic actions into your life, you’ll live by the principles you’ll need to stay fit and healthy, so that you can achieve and maintain exactly what you’re striving for:

Your ideal body.

The Fat Facts Test

What Do You Really Know about Fat, Diets, and Other Weight-loss Solutions?

To help you determine your level of dietary knowledge, take this Fat Facts Test. In less time than it takes to listen to an American Idol off-key clunker, you may just learn more about your body and belly than you’ve ever known before.

1 What is the first historical event that we can point to as contributing to the rise in excess pounds?The development of agriculture.The development of whipped cream in coffee.The development of more office jobs.The development of fast food.

2 What is the reason most diets fail?They’re designed so that they’re impossible to stick to long-term.They’re so complicated that you need a math degree to follow them.There are only so many carrot sticks and celery stalks a person can take.Mozzarella sticks. Mmm!

3 Which of the following strategies is most recommended for people trying to lose weight?Weighing yourself once a week.Eating two to three small meals a day.Eating nuts every day.Ex-Lax smoothies for everyone!

4 What’s the most important number for determining whether an increased waist size is putting you at risk for health problems?Bra size.Blood pressure.Cholesterol.Heart rate.

5 What is ghrelin?The name of a Harry Potter character.A hormone that makes you want to eat more.The name of fat cells in your belly.The chemical in your brain that makes you feel good.

6 What is leptin?The name of the dude on the Lucky Charms cereal box.The muscle-building protein that helps burn fat.The nutrient in fruit that works in conjunction with fiber.A chemical from fat that tells your brain you are full.

7 Which spice has been shown to be helpful for controlling weight?Cinnamon.Thyme.Oregano.The one married to David Beckham; Posh, is it?

8 Complete this sentence with the most accurate response. Fructose .Is responsible for decreasing the number of calories in many foods.Tricks your mind so you stay hungry longer.Is responsible for increasing the amount of bad-for-you trans fat in foods.Sure makes my Trix taste darn good.

9 What does your body most want to do in periods of extreme stress?Stay away from food.Gorge on food.Seek crunchy foods.Crumple up into a pile of jelly and retreat to a warm bath.

10 Which choice is most recommended to cut your appetite?Whole-grain foods.Whole aisles of fruit.Whole lot of a diet soda.Whole boxes of Girl Scout cookies.

11 Of the following choices, which is least dangerous to a long-term waist management strategy?A 1,000-calorie-a-day diet.Higher than usual colonics ro remove all fat.Training for a marathon.Playing video games.

12 Which organ is most responsible for metabolism?Heart.Stomach.Liver.Kidneys.

13 Which condition is responsible for weight gain in about 10 to 20 percent of younger women?Vulvodynia.Hyperthyroidism.Polycystic Ovary Syndrome (PCOS).I’ve had six kids, so cut me a break, would ya?

14 Calorie for calorie, what fills you up for the longest amount of time?Fat.Fiber.Fructose.French fries.

15 At least how much must you walk daily for optimum waist control?Thirty minutes.Two hours.Any time you can spare.Any, as long as it’s not traveling to and from the fridge.

16 What is the main purpose of liposuction?To help people lose weight.To target problem body parts.To keep some Hollywood docs in business.To ensure another season of successful reality TV.

17 What is your omentum?A badly misspelled word.The part of your brain that’s stimulated to store fat.A chemical that controls hunger.A fat-storing tissue.

18 Health-wise, what is the optimal waist size for a woman?As little as possible.32½ inches.Under 35 inches.Whatever slides into that little black dress, honey.

19 Which part of your body that plays a role in weight gain works most like your brain?Your stomach.Your heart.Your small intestine.Your unmentionables.

20 What is CCK?The former Soviet Union.A hormone that regulates insulin levels by changing your blood sugar level.Colonic Creations by Katherine.Cholecystokinin, a chemical that tells your brain to stop eating the waffle.

21 Of the following items, what contributes most to weight gain?Periods of low levels of willpower.Short periods of high-intensity stress.Long periods of low-intensity stress.Periods of high-intensity dessert trays.

22 What is a duodenal switch?An effective surgical technique for losing weight.An intestinal transplant.The hot new band from Seattle.A program for cleansing your colon of toxins.

23 Which of the following can be an effective medical option for weight loss?Aspirin.Beta-blockers.Statins.Antidepressants.

24 Which activity is most helpful for waist control?Crunches.Cardiovascular training like running.Resistance training like weight lifting.Naked salsa dancing every other Tuesday.

25 What’s the worst side effect of losing weight?Increased risk of chocolate withdrawal.Increased risk of muscular and joint aches.Increased risk of yo-yo dieting.Increased risk of astronomical tailor bill.

Answers

1 a. The development of agriculture meant that we could now have foods we wanted, not needed. And that’s what provided the foundation for indulgence.

2 a. Most diets don’t reprogram you to think and eat automatically, so that eventually you’ll go off the diet just as surely as you went on it.

3 c. Eating a handful of nuts has been shown to help you stay full, while skipping meals can be detrimental because your body will go into a fat-storing, starvation mode when it doesn’t have enough calories.

4 b. Of these risks, blood pressure is the greatest indicator of health risks associated with being overweight.

5 b. Ghrelin makes you want to eat more.

6 d. Leptin keeps you full.

7 a. Cinnamon increases insulin sensitivity, which helps enhance the satiety center in your brain (and also reduces blood sugar levels as well as cholesterol levels).

8 b. Fructose, as in high-fructose corn syrup, doesn’t appear to turn off your hunger chemicals, so you do not feel full; thus you eat more.

9 a. Extreme stress (as in the case of a car accident, or even exercise) turns off your hunger. Chronic stress (like a long line of looming deadlines or family problems) can make you crave feel-good carbohydrates.

10 a. Whole-grain foods are loaded with filling fiber.

11 d. Playing video games works because it keeps your hands busy, so you can’t eat. (Training for a marathon is actually destructive to your body because of the risk to your joints, and for most people, 1,000 calories is a dangerously low daily caloric intake. Do we really need to explain colonics?)

12 c. Your liver is responsible for most metabolic functions.

13 c. PCOS is responsible for weight gain in at least 10 percent of women under age fifty. It’s now clinically called androgen excess; androgen refers to the male hormone.

14 b. Fiber fills you. A cup of oatmeal in the morning has been shown to prevent you from afternoon gorging.

15 a. Walk at least thirty minutes-at once or in intervals-every day.

16 b. Liposuction should be used to sculpt problem areas, not to remove a lot of fat.

17 d. Located next to your stomach, your omentum is fat that can cause damage to surrounding organs.

18 b. While 32½ inches or less is ideal, 37 inches is when women start seeing a greatly increased risk of weight-related disorders.

19 c. Your small intestine-with 100 million neurons-has anatomy similar to your brain.

20 d. CCK is a chemical that directly and indirectly sends a message to your brain from your guts that you’re full.

21 c. Chronic stress makes your body store more fat.

22 a. A duodenal switch is one of several surgical options for people with morbid obesity.

23 d. Bupropion, an antidepressant, has been shown to help control cravings and lead to about a 7 percent weight loss. Other antidepressants, such as tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs), can often be associated with weight gain.

24 c. Adding a little muscle through resistance training helps your body burn more fat throughout the day.

25 c. Yo-yo dieting not only has physiological effects, because you end up gaining more weight after you’ve lost it, but it also has psychological effects.

Scoring

You get one point for each correct answer.

20 and above: Congratulations, doc. You’re an anatomical expert.

11–19: You’re average, but then again, the average person is overweight, so maybe this isn’t so good. Maybe you’d better read on.

10 and below: Don’t worry, you’re about to enroll in the ultimate course in the biology, history, and anatomy of fat-which is the best way to change your body.

Chapter 1
The Ideal Body
What Your Body Is Supposed to Look Like

Diet Myths

 Your body doesn’t need any fat.

 Fast food is responsible for most of our fat problems.

 Dieting has to be hard.

The most common question heard among overweight people isn’t “Can I have more sour cream?” It’s “Why can’t I lose weight?” While you may think you know the answer (severe pancake addiction), the real reason is biological: We’re actually hardwired to store some fat.

Our bodies have more systems that allow us to gain weight than to lose it. Historically, as we’ll see in a moment, that served us well. Today, though, we’ve poisoned the systems that help us lose weight and empowered the ones that allow us to gain it—botching up our anatomy and turning our bodies into fat-storing machines. One of your goals will be to reprogram your body so that your internal systems can work the way they did when the greatest enemy we faced was a charging wildebeest, not a cheese-drowned pork roll.

Our ancestors survived by gaining and storing weight to survive periodic famines. That has left our bodies prone to storing fat and gaining weight, tendencies that willpower alone can rarely overcome. To see how our bodies have morphed from rock-hard to sponge-soft, let’s look inside the bodies of early man and woman. They looked like stereotypical super-heroes: strong, lean, muscular, able to jump snorting mammals in a single bound.

As we evolved, we created systems and behaviors to survive when droughts and poor eyesight made picking and hunting less than successful. We learned to thrive, and we learned to eat. In early times, our diets consisted of fruits, nuts, vegetables, tubers, and wild meat—foods that were, for the most part, low in calories. That’s not to say our ancestors didn’t enjoy their foods. They consumed their sugars through fruit, and they even splurged when they came across the Paleolithic Cinnabon—a honeycomb. The difference between their splurges and ours? They came across the sweet treats only rarely; it’s not as if they popped in for a 900-calorie sugar bomb every time they went shopping for a new buffalo hide. Add that to the fact that their definition of “searching for food” included walking, stalking, and chasing, not sliding the milk carton out of the way to find the pudding pack. It was a lot of work to get food, so they naturally burned many of the calories they consumed through the physical activity of hunting and gathering.

The Heavyweight Fight: Genetics Versus Environment

It’s easy to argue that lifestyle choices and lack of willpower are responsible for weight problems (it’s the argument that lean people tend to make). But it doesn’t explain the 95 percent failure rate after two years of people who have lost fifty pounds or more; they had plenty of willpower to lose but regained the weight nonetheless. Researchers argue that obesity is more genetically linked than any other trait except height-and at least 50 percent of obesity cases clearly have genetic components. Our take: The waist control game requires two players-environment and genetics. Even if your genes have made you predestined for a life of taking up two seats, that doesn’t mean you should abdicate control over your body. When you make the right behavioral and biological changes that we outline, you’ll be able to stay healthy and avoid the bad side effects of excess weight, like diabetes, high blood pressure (hypertension), and arterial inflammation. While 10 percent of the obese population has genetic challenges that may make a supermodel contract impossible, the bigger risk with these genes is not in the weight itself but in the predispositions for risks associated with obesity. For example, one genetic problem associated with being overweight is called leptin deficiency (leptin is a hormone associated with satiety, which we’ll discuss in the next chapter). Folks who either don’t produce leptin or block its signals usually become morbidly obese, and the problem is surely genetic.

While some people have these abnormalities, they tend to be the minority of the population. If you need to worry about losing twenty-five, thirty-five, even fifty pounds, your problem is not likely to be genetic. Only when your excess weight exceeds one hundred pounds would most doctors consider testing for genetic abnormalities. Still, the example of leptin is only the tip of the scientific iceberg as far as genetics and obesity are concerned. As the fight against obesity continues, we’ll see more and more drug companies target genetic reasons for weight gain-that is, drugs that attack the genetic biochemical problems that may be contributing to your weight problem. That said, the onus of waist management still falls on you, to improve your environment and your behaviors so that your genetics can work for you, not against you.

Because salt and sugar were scarce, our ancestors mostly feasted on grains, vegetables, and meats—for good reason. The meat provided the protein, vitamins, minerals, and fatty acids that helped them grow taller and develop larger brains, while the other foods gave them nutrients such as glucose, a simple sugar found in fruit and the complex carbohydrates of plants, that they needed to grow and develop, and for energy to move. And, of course, food was always fresh, as there was no canning or refrigeration to store up food for Super Bowl parties, or to sneak in an 11 p.m. bowl of sugar-coated oats.

FACTOID

The difference between obese people and thin people isn’t the number of fat cells, it’s the size of these cells. You don’t make more fat cells the fatter you get; you have the same number of fat cells you had as an adolescent. The only difference is that the fat globules within each cell increase as you store more fat. By the way, muscles work the same way: you don’t make more muscle cells; the muscle cells get larger.

Another difference was that the meat our ancestors ate wasn’t like the meat we know today. Theirs was low in fat and high in protein; ours often comes in the form of corn-fed cows pumped up to make fattier, tastier cuts. Even today’s buffalo burger is corn-fed. Truly wild game has about 4 percent fat, while now most commercially available beef has nine times that amount. (The theory behind protein-heavy diets like Atkins is that protein reduces overall food intake and could reduce calories as well. The flaw is that eating proteins dripping in saturated fat, like bacon, isn’t exactly the same as eating the leaner, healthier forms of protein like chicken and fish.)

The result: Your tribal forefathers and foremothers could eat anytime they could harvest or catch something, and still not put on excess weight.

The lesson: Our ancestors never thought about a diet in the way we do—and their bodies had the approximate density of granite. Us? We obsess about diet more than red-carpet reporters obsess about designer dresses, and our bodies have the consistency of yogurt.

Still, we can’t blame the advent of fast food and waffle cones for all of our weight issues. The downfall started in the pre-GA. (pre-Golden Arches) era—over 10,000 years or so ago, when agriculture first appeared. Agriculture allowed us to make more advances than a seventeen-year-old boy in a movie theater, but we paid a price for them. Besides Myth Buster sparing the lives of countless mammoths, the rise of agriculture ensured that we’d always have a steady supply of food—an advantage during times of famine, a disadvantage at the $6.99 Mama’s Kitchen Eat-Everything Buffet. With a constant source of food, people became less nomadic, and communities grew closer together. While the average life span increased (thanks to the elimination of the extreme sport of tiger chasing, with, perhaps, some help from sanitation and immunization), agriculture also brought its share of downsides: more bacterial infections, shorter stature, and rotting teeth that comes from eating refined sugar and less nutritious farm-raised food (overused soil depletes food of its nutrients). Our ancestors’ diets shifted from vegetables and meat to grains from the farms, essentially hindering them from getting the diverse mix of protein and micronutrients needed for brain development.

FACTOID

During the Muslim holiday of Ramadan, people eat only after sunset so they consume all their calories at night. Should they lose weight? Anecdotal evidence, gathered by doctors watching residents working all-night shifts, indicates that people who eat all their 2,000 daily calories in one meal gain more weight than those who space those calories over three meals. Why? Because the one-timers are kicking in their starvation mode, making their bodies want to store fat rather than burn it.

The advent of agriculture essentially started the sociological shift that altered the way we lived—and the way we eat—up until this day. We could now produce food, so we could now produce what we wanted, not necessarily what we needed. Instead of making foods that could both complement our bodies and appeal to our taste buds, we started making ones that were kinder to our tongues and pocketbooks than they were to our waists.

We’re not in the business of trying to make you live like cavemen, or help you score a blue-jeans billboard, or help you become thin enough to escape between two jail bars. What we should acknowledge is that we live in a world with free will, with temptations, and with more eating options than the Mall of America. Biologically, our bodies want us to eat right. But in today’s society (cavemen didn’t have bad bosses or deadlines for annual reports), our biological drive to be the right weight and to eat right can be overcome by stress or temptation. And that has shifted many dietary decisions from biological necessities to psychological reactions. What we’re going to do is teach you how to reprogram your body to work the way it’s supposed to work—so that you eat to satisfy and to fuel rather than to console or excite. Controlling your fat isn’t about being banished with a life sentence of broccoli florets. It’s about teaching your body a little bit about the way our ancestors ate. Naturally and automatically.

YOU TIPS!

Automate Your Eating. If your waist management plan is going to work-as in, really work, for your whole life-then eating right has to become as automatic as it was for our ancestors. That’s not as insurmountable as it seems. Just look at one study from the Journal of the American Medical Association. Two groups were assigned two different diets. One went on a diet rich with good-for-you foods like whole grains, fruits, vegetables, nuts, and olive oil, foods found in the typical Mediterranean diet. The other group was not given any specific direction in terms of foods to eat but was instructed to consume specific percentages of fat, carbohydrates, and protein daily. In short, they had to think a lot about preparing foods and dividing amounts, while the first group only had general guidelines about foods to eat.

The groups weren’t given guidelines about how much to eat; they let their hunger levels dictate their hunger patterns. And when they did that, what happened? Without trying, the first group ate fewer calories, lost inches, and dropped pounds.

YOU-reka! The point: The people in the good-foods group ate the foods that naturally kept them satiated so their bodies could seek their playing weights.

 The “good-for-YOU-foods group” ate significantly more fiber than the control group (32 grams versus 17 grams).

 The “good-for-YOU-foods group” ate higher amounts of good-for-you omega-3 fats in the form of olives, fish, and nuts (especially walnuts). Those fats help increase the level of chemicals that make you feel satiated.

 The “good-for-YOU-foods group” more than doubled their consumption of fruits and vegetables.

The “good-for-YOU-foods-group” ate the foods we recommend in the YOU Diet, didn’t obsess about calories, and enabled their bodies to do what they’re supposed to do: regulate the chemicals that are responsible for hunger and for satiety (more on this in Chapter 2).

Don’t Undereat. When our ancestors couldn’t find food and went for long periods of time without it, their bodies acted like a life preserver, storing fat in anticipation of the inevitable periods of famine. The same system works today. YOU-reka! When you try to “diet” by going for long periods of time without eating or by eating way too few calories, your brain senses the starvation and sends an SOS signal through your body to store fat because famine is on its way. That’s why people who go on extreme fasts and extremely low-calorie diets don’t lose the expected weight. They store fat as a natural protective mechanism. To lose weight you have to keep your body from switching into starvation mode. The only way to do it: Eat often, in the form of frequent healthy meals, and snacks.

Plan Your Meals. Start every day knowing when and what you’re going to eat. That way, you’ll avert the 180-degree shift between starving and gorging that occurs when you skip meals. Our fourteen-day diet (in Chapter 12) will show you how to plan your meals so that you feed your body regularly to avoid extreme periods of overeating and undereating that can lead to a gain in weight and inches.

YOU Test

Remember Your Ancestry

Some people say their family has big bones or big cells. Some say their family has big appetites. Some say their family just has big beer coolers. If you gained weight as an adult you can get a relatively accurate picture of what your ideal size should be by thinking about what you looked like when you were eighteen (for women) or twenty-one (for men); a time when you were at your metabolically most efficient and when you weren’t stapled to an office chair for sixty hours a week. Most people gain their weight between the ages of twenty-one and sixty, so by looking at your size at eighteen or twenty-one, you’ll have a good, though not quite scientific, idea of your factory settings. It’s not perfect, but it’s a thumbnail sketch of where you want to be. You can record your waist size (or closest guess) from when you were eighteen, but, more important, think about your shape. Ask your parents about their body sizes-or find pictures of them-when they were eighteen, to help give you a good idea of what you’re supposed to look like.

YOU Test

Stand in Front of the Mirror.

Naked. Without Sucking in Your Belly.

For some of you, this assignment may feel natural, but for most the exercise is as uncomfortable as a coach-class airline seat. We’re having you do this not to benefit the neighborhood peepers, but for two other reasons. First, we want you to realize that we’re emphasizing healthy weight. Not fashion-magazine weight, not featherweight, but healthy weight. And we think that means you have to start getting comfortable with the fact that every woman isn’t as light as a kite, and every man won’t have the body of Matthew McCanoughey. Where you want to be may not be exactly where your body wants you to be. We’re not saying you need to accept a belly that looks like four gallons of melted ice cream, but we want you to get closer to your ideal health-and that means physically and emotionally.

Second, we want you to look at your body. Now draw an outline of your body shape (both from the side and front views). Ask a partner or close friend to look at the shape you drew and tell you-honestly-if that’s approximately what your body looks like. (Your clothes can be back on at this point.) This is just a quality-control check to make sure you have an accurate self body image. (Those with eating disorders have very distorted body images, making it an obstacle for getting back to a healthy weight.) This might be the first time you’ve ever had to articulate things about what your body looks like-and that’s good.

Part 2

Chapter 2
Can’t Get No Satisfaction
The Science of Appetite

Diet Myths

 Hunger is primarily dictated by what’s happening in your stomach.

 The biggest battle in dieting involves willpower.

 As long as a food is low-fat it’s not going to make you fat.

As much as an iPod bud in the ear, fat has become a regular part of our landscape. We see it everywhere. We see it tethered to a hunk of prime rib. We see it masquerading as a Nutter Butter. We see it crammed into evening gowns or cascading over belt buckles. We’ve seen paparazzi-haunted celebrities gain it and lose it, lose it and gain it. And, if we can bear a confidence-crushing six seconds of nudity in front of a mirror, most of us have seen our own share of flesh that droops, sags, or jiggles. So, reason would tell you that we should know as much about fat as we know about Angelina Jolie’s private life. But we don’t.

Sure, we know what it looks like, what it feels like, and that it can be as bad for our health as a steak knife lodged in our hand. But few of us really know how fat works biologically—how the Twinkie morphs from a wonderfully yellow spongy cake to the flab that conjoins our inner thighs, or how our skinny-as-a-straw friend can wolf down a meat-lover’s supreme while we feel bloated if we as much as sniff four carrots.

Starting in this chapter and continuing throughout the rest of part 2, we’ll show you the way that food travels—from the time your body wants you to eat it, to the time it exercises squatter’s rights on your hips, to the time you fry it into oblivion. The best place to start? With your appetite. Appetite really comes in two forms: physiological signals that make you hungry and emotional coaxes that lure you to food.

In this chapter, we’ll explore those physiological signals, because understanding and controlling your hunger and satiety signals will help you adopt a healthy eating plan. (We’ll explore the psychological and emotional aspects in part 3.) Once you know that those mechanisms have much more powerful control over how you eat than do your taste buds, then you can make the behavioral, attitudinal, and biological adjustments you need to live at your healthy weight.

Above all, there’s one sign that will clue you in to whether you’ve become an effective processor of food. It’s the sign that you, not a bag of gummy bears, are in control of your weight. It’s the sign that you, without having to work at it, have been promoted to captain of your waist management vessel. And it’s the sign that you’ve ultimately reprogrammed your biology so that your body uses food as a medicine to make you stay healthier so that you live long enough to see how Lost ends.

Fat’s Bad Rap

Sure, nobody likes body fat especially when it beats you through the door by five or six seconds. But despite potentially serious consequences, fat, by nature, is good. (That’s not a typo.) Besides helping Santa hopefuls land December jobs, it also helps your cells function and provides insulation. Most of your fat is stored in a reservoir throughout your body. You have drums and drums of it sitting passively, just waiting to be burned. But you have another kind of fat, too. It’s called brown fat and is usually found on the back of your neck and around your arteries (and has absolutely nothing to do with how much chocolate you eat). This increases in outdoor workers during cold spells to protect them from the weather; it insulates our vital organs. Though you have a fairly small percentage of brown fat as an adult about one-third of fat in babies is brown fat and it’s used primarily to keep them warm. What makes brown fat different? YOU-reka! Brown fat is alive. It has nerve fibers, like any organ, and it also has leptin receptors. When the level of this hormone goes up, it turns on energy consumption in the brown fat and burns it. This is important because it shows that the right leptin levels can signal you to immediately get rid of this fat. And it’s also symbolic of the inherent goodness of body fat-when it’s found in the right amounts.

That sign? Satisfaction.

As you change from always thinking about diet to never thinking about it, you will be reprogramming your body so that it’s not your eyes, tongue, or overzealous utensils that will guide you.

YOU-reka! Instead, it will be the chemicals in your brain and body.

By tuning in to your body’s signals, you’ll allow your anatomy to work the way it’s supposed to: so that you’ll never be famished, you’ll never pop a button at the table, and you’ll never bounce between hunger extremes. Instead, you’ll get a little hungry, you’ll eat, you’ll stop. Satisfied.

The Anatomy of Appetite

You’d think that the first place we’d start to talk about how appetite influences fat would be the spot that’s covered by an XXXXL shirt. But to understand appetite, you have to navigate farther north—to the place that may hold the least fat. In your brain, you’ll find the hypothalamus, a key command center for your body. Among the biological functions it controls are your temperature, your metabolism, and your sex drive. Located in the center of your brain, the hypothalamus (see Figure 2.1) also coordinates your behaviors that involve appetite—not just for food but also for thirst and even for sex. So while it may appear that call-to-duty signals come from your stomach growling or your loins tingling like a static shock, it’s actually your brain that’s sending out the signals that you crave either a quiche or a quickie. (At least one person we know helped curb an eating problem by having regular, monogamous, healthy sex. When the appetite function for sex was satisfied, the appetite function for food was diverted.)

FACTOID

As you get older, you have fewer leptin receptors in your hypothalamus-meaning that you have fewer satiety signals, which makes you more prone to gaining weight.

Hidden in your hypothalamus, you have a satiety center that regulates your appetite. It is controlled by two counterbalancing chemicals that are located side by side (see Figure 2.2).

 The satiety chemicals led by CART (the C stands for cocaine and the A for amphetamine, since these drugs put this chemical into overdrive). CART stimulates the surrounding hypothalamus to increase metabolism, reduce appetite, and increase insulin to deliver energy to muscle cells rather than be stored as fat.

 The eating chemicals driven by NPY (a protein called neuropeptide Y). NPY has the opposite effect on the hypothalamus; it decreases metabolism and increases appetite.

Think of these two command chemicals as any game or sport that involves offense and defense, like soccer, checkers, or even dating. The offense is always trying to make advances, trying to score points, and trying to attack, while the defense protects its territory.

Your eating chemicals play offense. They want as many points as possible, so they fire off those signals for your body to score: eat, eat, eat, calories, calories, calories, chimichanga, chimichanga, chimichanga. The biological message: Prevent starvation by eating. Meanwhile, your satiety chemicals play defense, like a goalkeeper, the back row of checkers, or a protective parent. They send the messages to your brain that you’re full, to shield you from steadily pumping bacon-wrapped scallops down your gullet. How do we know these centers work this way? For one, by looking at extremes and seeing what happens when the feeding system is turned completely on or off. When we study animal models, we see that if a rat’s eating center is destroyed, for instance, it forever forgets to eat. The resulting severe anorexia starves the body of all energy and nutrients so that it withers away to the approximate width of an envelope. In rats whose eating center is overstimulated, though, food is always on the radar screen. And those rats eat themselves to death—literally—by increasing their fat-induced diseases like diabetes, hypertension, and arthritis.

Figure 2.1 Food Fight In your hypothalamus, you have hunger and satiety chemicals. The hormone leptin goes to the satiety center to make you feel full and satisfied, while the signal from the hormone ghrelin makes you want to eat gorge, and slobber over your every feast.

Figure 2.2 Chemical Reaction If we look closely at the hypothalamus, we see that a small nucleus at the bottom houses NPY and CART, which fight the yin-yang battle to control the brain biochemistry of hunger. Each chemical readily travels to other nuclei in the hypothalamus. NPY causes our temperature to drop and our metabolism to decrease as we feel hungry. CART stimulates the opposite influence. The nearby mammillary body (literally shaped like a nipple) is part of our limbic system, where we store memories and emotions—just the right combination to create a craving for a favorite food. The thalamus is the body’s relay station and rapidly transmits orders throughout the brain based on the desires of the eating center.

FACTOID

CART (cocaine-amphetamine-regulatory transcript for those scoring at home) is the reason why cocaine addicts don’t gain weight. Cocaine and amphetamine stimulate this chemical, giving you a double brain bat to help you control appetite and increase metabolism. It’s unclear whether CART will be the basis for effective weight-loss treatments, but researchers are studying the neurological effects these drugs have on appetite to see if they could lead to long-term pharmaceutical solutions to weight loss (without of course, the dangerous side effects of illicit drugs). Marijuana, by the way, has its own receptors that overwhelm leptin, which is one big reason why pot smokers get the munchies. It’s also an area that’s a promising new approach to weight-loss drugs. By figuring out how the drug turns off the gene that produces leptin, we’ll be able to figure out how to flick it on-to keep leptin (and thus satiety levels) high. The prototype drug has done great in trials and symbolizes a new generation of smart weight-loss medications that work hormonally.

In a perfect system, your offense and defense complement each other; you get the foods you need and stop when you’ve had enough. Unfortunately for everyone except elastic-waistband manufacturers, a lot of things can mess up those systems (many of which we’ll discuss in a moment). But these obstacles aren’t insurmountable. You can take comfort (and find motivation) in the fact that your body wants you to reach your goals. Your body doesn’t want to be bigger than it should be. Your body doesn’t want lots of excess fat. Take the case of rats made obese by force-feeding. When they’re allowed to eat freely, they go back to their control weight. They eat what they should eat, without thinking. Same goes for starving rats. When allowed to eat again, they don’t gorge. They naturally go back to their control weight. And we know from years and years of research that what rats do is a pretty fair indication of what humans will do under the same circumstances. (Humans, of course, will do what rats do when they’re motivated only by biology. A rat isn’t upset by stress at home or work, which is why controlling the emotional aspect of eating plays such a big role in effective waist management, as we’ll discuss in Part 3.)

YOU-reka! If you can allow your body and brain to subconsciously do the work of controlling your eating, you’ll naturally gravitate toward your ideal playing weight. You do it by developing a well-trained defense that naturally balances the offense. When you do, you’ll win the diet game every time, whether you have willpower or not. Though it may not always be the case in football or Scrabble, when you pit offense against defense in your body, the offense in your body typically attacks more aggressively. It’s simply easier to scoop up bean dip than it is to leave it for others.

The Hunger On and Off Switches

Duct tape over your mouth isn’t how your body regulates food intake. Your body does it naturally through the communication of substances controlled by your brain. Although there are many hunger- and obesity-related hormones waiting to be discovered, there’s enough evidence to suggest that two hormones have as much influence for dictating our hunger and satiety levels as a head coach does on offense and defense—hour to hour and year to year.

Lovin’ Leptin: The Hormone of Satisfaction

In sumo champions, a little extra fat can produce good results. But we also think that fat has an unfair knock against it. Fat is treated a little like an accused suspect; it sometimes gets a bum rap. Fat produces a chemical signal in your blood that tells you to stop eating. Left to its own devices, fat is self-regulating; the problem occurs when we override our internal monitoring system and continue to stuff ourselves long after we’re no longer hungry. Your body knows when it’s had enough, and it prevents you from wanting any more food on top of that. How does fat curb appetite? Through one of the most important chemicals in the weight-reduction process: leptin, a protein secreted by stored fat. In fact, if leptin is working the way it should, it gives you a double whammy in the fight against fat. The stimulation of leptin (the word comes from the Greek word for “thin”) shuts off your hunger and stimulates you to burn more calories—by stimulating CART.

FACTOID

Neuropeptide Y is a stress hormone that increases with severe or prolonged stress. This may be why some people in chronically stressful situations tend to gain weight. Testosterone, the male sex hormone, seems to stimulate NPY secretion, while the female sex hormone, estrogen, seems to have a varying effect depending on the stage of a woman’s cycle.

But our bodies aren’t always perfect, and leptin doesn’t always work the way it’s supposed to. In some research, when leptin was given to mice, their appetites decreased, as expected. When it was given to people, they initially got thin, but then something strange happened: They overcame the surge of leptin and stopped losing weight. This indicates that our bodies have the ability to override leptin’s message that our tank is full. How? When leptin tells your defense—the satiety chemicals—to kick in and protect you against stray bonbons, the pleasure center in your brain says, “Uh, yeah, three more this-a-way” That surge from the pleasure center, which we’ll discuss in more detail in part 3, can overrule leptin’s messages that you’re full. That’s called leptin resistance (there’s another form of leptin resistance as well, which happens when cells stop accepting leptin’s messages). Most obese people, by the way, have high leptin levels; it’s just that their bodies have the second form of leptin resistance—they don’t receive and respond to leptin signals.

That doesn’t mean leptin is always on the losing end of this chemical battle. YOU-reka! The challenge is to let leptin do its job so that the brain demands less food. One way to do it: Walk thirty minutes a day and build a little muscle (that’s part of our activity plan in part 4). When you lose some weight, your cells become more sensitive and responsive to leptin.

FACTOID

Scientists found how ghrelin works accidentally: in gastric bypass surgery, doctors cut out the part of the stomach that secretes ghrelin. They soon realized that it wasn’t just the smaller stomach but the reduced ghrelin production that helped surgery patients eat less food. The eat-everything signal was shut off, clearing the way for the satiety center to take care of its business.

Ghrelin Is the Gremlin: The Hormone of Hunger

Your stomach and intestines do more than hold food and produce Richter-worthy belches. When your stomach’s empty, they release a feisty little chemical called ghrelin. When your stomach’s growling, it’s this gremlin of a hormone that’s controlling your body’s offense; it sends desperate messages that you need more points, you need to score, you need to FedEx the chili dogs to the GI tract immediately. Ghrelin makes you want to eat—by stimulating NPY. YOU-reka! To make things worse, when you diet through deprivation, the increased ghrelin secretion sends even more signals to eat, overriding your willpower and causing chemical reactions that give you little choice but to line your tongue with bits of beef jerky.

Ghrelin also promotes eating by increasing the secretion of growth hormone (ghre is the Indo-European root word for “growth”). So when you increase ghrelin levels, you stimulate that growth hormone to kick in, and growth hormone builds you not only up but out as well.

Your stomach secretes ghrelin in pulses every half hour, sending subtle chemical impulses to your brain—almost like subliminal biological messages (carrot cake, carrot cake, carrot cake). When you’re really hungry or dieting, those messages come fast—every twenty minutes or so—and they’re also amplified. So you get more signals and stronger signals that your body wants food. After long periods, your body can’t ignore those messages. That’s why sugar cookies usually trump willpower, and that’s why deprivation dieting can never work: YOU-reka! It’s impossible to fight the biology of your body. The chemical vicious cycle stops when you eat; when your stomach fills is when you reduce your ghrelin levels, thus reducing your appetite. So if you think your job is to resist biology, you’re going to lose that battle time after time. But if you can re-program your body so that you keep those ghrelin gremlins from making too much noise, then you’ve got a chance to keep your tank feeling like it’s always topped off.

Food Fight: The Ghrelin Versus Leptin Grudge Match

So now let’s get back to that offense and defense. The natural state is for you to have a give-and-take relationship between your eating and satiety chemicals—between your ghrelin and leptin levels—to influence NPY and CART, respectively. It’s the relationship between the impulse that says, “I’ll take a large pepperoni with extra cheese,” and the one that says, “No more passengers, this belly is full.”

This battle over eating isn’t between your willpower and the Belgian waffles; it’s between your brain chemicals. The NPY is the villain—encouraging you to buffets, driving you to the pantry, pointing its chemical finger to the convenience foods, while CART is your dietary guardian angel, which encourages a cascade of allies to keep you full and satisfied and in no way interested in creamed anything. Think of the two substances—NPY and CART—competing for the same parking space, the one that will ultimately determine whether or not you eat (see Figure 2.3). They both arrive at the same time and want that space. Either more NPY or more CART sneaks into the spot, thus sending the all-important go or stop signal to your brain to influence the hormones that make you feel full or hungry.

Here’s how they all work together: Ghrelin works in the short term, sending out those hunger signals twice an hour. Leptin, on the other hand, works in the long term, so if you can get your leptin levels high, you’ll have a greater ability to keep your hunger and appetite in check. Isn’t that great? Leptin can outrank ghrelin—to keep you from feeling like feasting on anything short of fingernails every few minutes. If you focus on ways to influence your leptin levels, and, more important, leptin effects (through leptin sensitivity), your brain (through CART) will help control your hunger.

Sometimes, it may seem like we don’t have much control over the chemical reactions taking place within our arteries or inside our brains. But just as you can control things like cholesterol and blood pressure by changing the foods you eat or altering your behaviors, you can also control the satiety center of your brain. How? Through your choice of foods.

Figure 2.3 In a Jam The satiety center is waiting to be turned off by NPY or stimulated by CART. Whichever fills up the receptor docks first is what controls whether you want to eat more or not. In turn, these two proteins are influenced by lack of water, sleep, and even sex. They’re also influenced by ghrelin coming from your stomach, which stimulates NPY so you get hungry, and leptin from your fat, which is further stimulated by a chemical called CCK, released from your intestines after a meal.

At least as far as your body is concerned, foods are drugs; they’re foreign substances that come in and switch around all those natural chemical processes going about their business within your body. When your body receives foods, different chemical reactions take place, and messages get sent throughout your system—turning on some things, turning off others. While your body internally gives orders, you set the tone and direction of those orders through the food you’re feeding it. Eat the right foods (like nuts), and your hormones will keep you feeling satisfied. But eat the wrong foods (like simple sugars), and you’ll cause your body to go haywire hormonally, and that ends up with one result: the next notch in your belt.

A major gang leader against your body is fructose, found in high-fructose corn syrup (HFCS), a sweetener in many processed foods. Here’s how it works: YOU-reka! When you eat calories from healthy sources, they turn off your desire to eat by inhibiting production of NPY or by producing more CART. But fructose in the HFCS, which sweetens our soft drinks and salad dressings, isn’t seen by your brain as a regular food.

Because your brain doesn’t see any of the fructose in the thousands of HFCS-containing foods as excess calories or as NPY suppressants, your body wants you to keep eating (which means that even low-fat foods can have extremely bad consequences, calorie- and appetite-wise). Americans have gone from eating no pounds of this stuff per person in 1960 to eating more than sixty-three pounds of it every year (that’s 128,000 calories). That’s a contributor to weight gain, since the fructose in HFCS doesn’t turn off your hunger signals. Foods with fructose—which may in fact be labeled as low-fat—make you both hungry and unable to shut off your appetite. They are also rich sources of calories: the perfect storm of weight gain. So you constantly get the signal that you’re hungry, even after you’ve jammed your gut with two baskets of calorie-laden, fructose-loaded biscuits.

YOU TIPS!

Get Over Sticker Shock. You should read food labels as actively as you read the stock ticker or the horoscopes. Don’t eat foods that have any of the following listed as one of the first five ingredients:

 Simple sugars

 Enriched, bleached, or refined flour (this means it’s stripped of its nutrients)

 HFCS (high-fructose corn syrup-a four-letter word).

Putting them into your body is like dunking your cell phone in a glass of water. It’ll cause your system to short out your hormones and send your body confusing messages about eating. Today’s yearly per capita consumption of sugar is 150 pounds, compared to 7.5 pounds consumed on average in the year 1700. That’s twenty times as much! When typical slightly overweight people eat sugar, they on average store 5 percent as ready energy to use later, metabolize 60 percent, and store a whopping 35 percent as fat that can be converted to energy later. Any guess as to where 50 percent of the sugar we consume comes from? HFCS in fat-free foods like salad dressings and regular soft drinks.

Choose Unsaturated over Saturated. Meals high in saturated fat (that’s one of the aging fats) produce lower levels of leptin than low-fat meals with the exact same calories. That indicates you can increase your satiety and decrease hunger levels by avoiding saturated fats found in such sources as high-fat meats (like sausage), baked goods, and whole-milk dairy products.

Don’t Confuse Thirst with Hunger. The reason some people eat is because their satiety centers are begging for attention. But sometimes, those appetite centers want things to quench thirst, not to fill the stomach. Thirst could be caused by hormones in the gut, or it could be a chemical response to eating; eating food increases the thickness of your blood, and your body senses the need to dilute it. A great way to counteract your hormonal reaction to food is to make sure that your response to thirst activation doesn’t contain unnecessary, empty calories-like the ones in soft drinks or alcohol. Your thirst center doesn’t care whether it’s getting zero-calorie water or a mega-calorie frap. YOU-reka! When you feel hungry, drink a glass or two of water first, to see if that’s really what your body wants.

Avoid the Alcohol Binge. For weight loss, avoid drinking excessive alcohol-not solely because of its own calories, but also because of the calories it inspires you to consume later. Alcohol lowers your inhibition, so you end up feeling like you can eat anything and everything you see. Limiting yourself to one alcoholic drink a day has a protective effect on your arteries but could still cost you pounds, since it inhibits leptin.

Watch Your Carbs. Eating a super-high-carb diet increases NPY, which makes you hungry, so you should ensure that less than 50 percent of your diet comes from carbohydrates. Make sure that most of your carbs are complex, such as whole grains and vegetables.

Stay-Va-Va-Va-Voom-Satisfied. In any waist management plan, you can stay satisfied. Not in the form of a dripping double cheeseburger but in the form of safe, healthy, monogamous sex. Sex and hunger are regulated through the brain chemical NPY. Some have observed that having healthy sex could help you control your food intake; by satisfying one appetite center, you seem to satisfy the other.

Manage Your Hormonal Surges. There will be times when you can’t always control your hormone levels; when ghrelin outslugs your leptin, and you feel hungrier than a lion on a bug-only diet. Develop a list of emergency foods to satisfy you when cravings get the best of you-things like V8 juice, a handful of nuts, pieces of fruit, cut-up vegetables, or even a little guacamole.

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