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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
