I’ve been overweight all my life.  Before it was cool to be obese I was the fat kid.  I don’t remember scale weights and ages but I can tell from pictures that fat has been a part of my life since I was born.  I have lost and gained again for years.   For the past 10 years, I’ve been better at finding a workable balance and my weight has stayed fairly stable.  I’m never going to fit a pair of skinny jeans but I keep a close eye on moving my belt notch.

I’ve learned a number of concepts about weight gain and how to lose and maintain a healthy weight.  While working in the medical field, I saw the impact of obesity on a patients health. I watch physicians explain to patients that their obesity was the cause of health problems but learned that there were no real tools to help that patient shed the weight and get their health back in control.

As the eternal entrepreneur, I started a weight loss business, QMed Weight Loss. QMed was a service where a patient could be referred to by a physician to a department in their own practice.  The goal was to convert the success rate from 1 in 10 patients who actually lost weight when instructed by a physician to 1 out of 2. While building QMed I acted as a test subject.  I researched the latest fads, bought and reviewed over 1500 diet books.  I looked for patterns and narrowed down the theories that made sense and had scientific foundations.  I ran the program on over 150 patients and had the most advanced tools to measure success. I ended up building a program that worked for dozens of patients. This article is a summation of a lifetime of research, personal experience, and theories on weight loss.   If this helps you on your journey to lose weight and get healthy then I’ve done my part. Even knowing what I do, it’s still hard to stay disciplined, day in and day out, for a lifetime. (QMed patient video diary – HERE)

1. It’s ALL about what you eat!

   – I’ve spoken with personal trainers, nutritionists and done the research and the consensus is that 80-90% of weight loss or gain is what you eat and NOT exercise.  Calories in and calories burned isn’t the solution to weight loss and weight maintenance…..it’s all about what you eat.   That being said, High Interval-Intensity Training helps and major weight lifting and muscle mass can change your bodies set point for resting calories burned but the effort is great and the time to see results is long.  Watching what you eat is the most important factor in losing weight PERIOD. Here’s a video I made that breaks this down.

2. Sugar and High Fructose Corn Syrup absolutely has to be avoided to lose weight … and highly moderated to maintain weight.  There are dozens of studies on sugar and inflammation, cancers and dozens of other chronic ailments. Sugar is a rapid fuel that quickly moves into fat.  High Fructose Corn Syrup is actually much worse than pure cane sugar.  Fructose Corn Syrup is found in many everyday items. The human body didn’t evolve to metabolize the large doses of plant-based sweeteners.  Google the rise in obesity to the prevalence of High Fructose Corn Syrup and you’ll see the correlation.  Follow the money from corn growers to Congress and you can see how this epidemic was built and protected by powerful interests. If you want to reduce weight, I suggest removing ALL carbohydrates. To maintain, eat only whole grain carb based foods in moderation.  Carbs convert into sugars and spike the pancreas into creating insulin. Insulin that doesn’t get burned moves to fat. Shut down the pancreas, then shuts off insulin which forces the body to burn fat for energy.  Look for your body to move into ketosis for maximum fat burning. You can buy test strips to measure when you’ve gone into ketosis but typically you’ll notice pungent urine and bad breath.
   Some more research on sugar…looks like the industry may have taken a page out of the tobacco companies play book – HERE – For more on insulin and obesity, a friend of mine Dr. Maximov explains – HERE  and Cholesterol explained HERE
   

   My skinny bartending days.

3. Animal-based fats GOOD – plant-based fats BAD!

   Once again, we as a species evolved eating natural food items grown, foraged or hunted.  The switch from animal lard to vegetable-based cooking oils was the other point where obesity in advanced societies spiked.  Give a listen to Malcolm Gladwell’s interview on the flaws in the government study that showed the negative effects of linoleic acid, found naturally in vegetables but harmful in vegetable oils had on our societies health. Listen to the story, Basement Tapes – HERE.

4. Eat like the Cavemen Ate! 

   I’ve bought and read hundreds and hundreds of diet books.  I boiled down an entire library to about 20 books that actually made sense and that were easy to follow.  The hands-down winner for weight loss and weight maintenance is the Paleo or Caveman diet.  The theory lays out that we evolved into humans eating a certain type of food. The addition of refined and processed foods isn’t natural and our bodies are breaking down because of what we are eating.  Please watch  Gary Taubs and study his findings of looking at societies and what happened to them when the western diet was introduced.  Taubs does an amazing job looking at our societies anthropologically to explain the high incidence of chronic disease related to a diet that departed from how they evolved.

Those are the big ones.

Here’s some of the other things I learned and ideas you may want to incorporate into the big 4 items above:

1.  Notice I didn’t talk about calorie consumption. Restricting calories works really well for 30 days, slows from 30 to 60 and moves to a crawl from 60 to 90.  We put 100+ patients on the Dexa body scan and monitored their body composition and 30-day intervals. What we found, especially in patients with a Body Mass Index over 36 was major weight loss in the first month with virtually no muscle loss.  The second month saw slower weight loss and a bit more muscle loss (60-40% ratio) and the third month we saw much slower weight loss and larger muscle loss (40-60% fat to muscle). Losing muscle is a big negative because there are studies that show that the muscle loss slows down metabolism.  So what I learned is that you can trick the body with drastic weight loss (say 500-750 calories per day) for about 60 days before you body sees what’s going on and moves into hibernation mode.   So if you’re really ready to lose go drastically for 30 to 45 days then transition. There are calculators to determine how many calories you should burn a day to maintain or lose weight. Remember, calories alone aren’t the only thing to watch, keep away from sugars and plant-based cooking oils.  Animal-based proteins, like bacon, will have high calories but you can still lose weight enjoying those foods.
2. Calorie restriction SUCKS then it DOESN’T!  Of all the patients we ran through the Optifast 700 calorie program (including me), to a T the experience went something like this;  The first 1-5 days were fine and because we were committed financially and emotionally the shakes weren’t that bad. Usually, around day 6 or 7, the majority of patients really felt hunger. Every part of their mind and stomach was saying FEED ME! Once the 8th day hit, patients could cruise along indefinitely.  Typically the hardest times were family gatherings when the food and social interactions mixed.  Patients that did this program found more energy, better sleep, and better mental sharpness.  This has to do with the removal of sugars/carbs and the bodies movement into fat burning.
3. Hormones are something to consider.  When we brought patients into our program we asked about the onset of obesity…when it the pounds started creeping on. If the answer was during para menopause or menopause or in men, starting in the mid 40’s we looked for hormonal imbalances that may explain part of the weight gain problem. There is a lot of research on hormone therapy and it’s not for everyone. A good friend of mine, Dr. Dan Mihayi’s lecture on hormones – HERE
4. Intermittent Fasting – I’m not quite convinced on this but intuitively fasting makes sense.  Again, as we evolved, humans would go days without food.  There is a number of people that are seeing success in an 18 hour fast with 8 hours of eating per day.  Google this topic a bit and make your own decision. Try it. Popular Mechanics – HERE
5. Emotional Issues – In order to get to the WHY of obesity, we have to look at the WHY we eat.  Pick an emotion or state of mind and I’ll bet someone has a food trigger. Mad, Sad, Glad, Bored, Scared, Lonely are a few of the big ones. Deeper wounds from childhood or failed relationships can be triggers too.  I suggest that you find out your triggers and first identify them and second learn to control them if you’re serious about long-term weight.  For me, travel is a time that I put on pounds. I’m out of my routine and I make bad choices. At home and work, the routine makes losing and maintaining weight a breeze.
   

   Highest Weight Ever…15 years ago!

6. Some people can eat what you eat and not gain weight.  It sucks but it’s a fact.  I know that carbs are a killer for me.  I  searched and searched for a blood or saliva test that we could administer to a patient that would definitively tell them that they were ‘carb resistant’ but I couldn’t find one.  The large movement to gluten-free comes close but those symptoms are mostly gut related.
7. If you have full FAT cells that shrink…. they WANT to fill back up.  HBO did a great four-part series on obesity and the big take away for me was that in order to just MAINTAIN after weight loss a person needs to cut upwards of 20% from the food intake they would normally eat before the weight gain.   This simple fact shows why so many people lose than gain back all the weight and more.  Mix in aging, metabolism slows down, hormonal changes and declining muscle mass and the fact that 90% of people regain the weight starts making sense.  I lost and held at a new lower set point for 2 years but sadly the weight came back on.
8. Psyching Yourself Up For Weight Loss – A good friend of mine, Dr. Kevin Leman says the secret to losing weight is posting your goal and intentions on Facebook or on the company refrigerator. He pontificates that the public commitment is critical for success and stick with it.  Dieting with a partner is a big plus, having someone to keep you focused is an obviously good thing.  Have triggers that get you back on the ‘watch/lose weight train’.  For me, it’s a belt that I wear that gets tighter. For some, it’s a morning weigh in and once they go up 5 pounds they get back on the bandwagon.  For me, the scale doesn’t work. If it’s too high I feel defeated and if its a great weight loss weigh in, I feel like I can reward the efforts with a donut.
9. 

   The struggle continues, 10 years and holding!

   Mix in Probiotics – I’ve done a bunch of research on vitamins and herbs that boost the metabolism or promise to help you lose weight. NONE OF THEM WORK! What I did recommend is a good probiotic and a daily fiber supplement.  The probiotic helps re-establish the digestive properties in the lower intestine and the fiber helps move things through the digestive tract.  The American diet robs your digestive system of the good aspects needed for maximum nutrient uptake.  I recommend injective B12 and a B Complex if you can find and tolerate the weekly injections. This book and this great lecture HERE

10. Know Your Trigger Foods There are certain foods that you love and that you can’t live without.  Typically it’s not celery and carrots, for me, it’s bread, pasta, ice cream, and licorice.  Decide for yourself how or if these foods are part of your life while you’re trying to lose weight. For me, during a period that I’m trying to drop pounds, I completely avoid these foods and treat myself once per month.  Tim Ferris and a personal trainer friend of mine, Dirk Nelson speak about a cheat day. The cheat day is a day of gluttony where you can eat anything! Conceptually, the idea of jolting your body makes sense because I’ve seen how your body eventually gets wise to your restrictions and starts holding on to fat as part of a defense mechanism.  For me, this concept never seemed to work. 
11. 

    Burke, a friend of mine who died from apnea.

    Sleep and Obesity, Poor Health – One of the tests we ran on our weight loss patients was a week-long sleep analysis using a device that measured REM sleep.  The science surrounding poor sleep and the connection to obesity are pretty profound.  In some cases, even when you think you are getting 7 to 8 hours of sleep per night, the actual restorative quality of that sleep is lacking. If you aren’t experiencing high-quality REM sleep your health can be greatly affected.  On the extreme scale, sleep apnea can lead to death if not treated. The cycle of weight gain and sleep apnea is real and poor sleep must be addressed in a weight loss program.

12. Stress – Cortisol and Weight Gain – There is a link and it’s easy to say, ‘stop being stressed’ but good luck in mastering that problem. Exercise, meditation, nature are all things that work for me. Stress typically triggers food cravings so, stress can be a double whammy.
13. Carbs and Low Glycemic Index Foods – Carbs are everywhere! If you want to shut down your pancreas, stop or slow insulin production and move your body into fat burning mode (ketosis) then you have to eliminate sugar and high fructose corn syrup as listed above AND you have to cut out carbs.  If you think of white bread as a glycemic (sugar load) of 100 then broccoli and celery at a 15, you want to focus on eating only low glycemic index foods if you want to lose weight.  Of course, the low glycemic index foods aren’t as awesome as pasta, potatoes, and tortillas but if you don’t change what you’re eating then the weight won’t be coming off.
    More on glycemic index foods – HERE –  HERE and HERE –  HERE 
14. Videos That Reinforce My Theories – HERE

The Lectures Research That Helped Me:

Gary Taubes made the argument that CARBS are the reason for obesity and the rise of diabetes. He brings an anthropological analysis to his argument. I happen to agree with him;

These lectures are long and detailed. Taubes looks at various societies around the world and argues his hypothesis using real data. Spend the time and learn why Taubes theories match my ideas on obesity.

Why We Get Fat: The Diet/Weight Relationship, An Alternative Hypothesis –  HERE

Why We Get Fat: Adiposity 101 and an Alternative Hypothesis of Obesity  HERE

Why We Get Fat – Gary Taubes at OSUMC  HERE

Powerful Documentaries That Motivated Me!

Linoleic Acid and Vegetable Fats

Give a listen to Malcolm Gladwell’s podcast from season 2 – Revisionist History.  HERE

I listened to McDonald’s Broke My Heart first and found that interview just as interesting – HERE

The story revolves around a son’s responsibility to his father.  The central character in the episode is a box of files that turns out to be the life’s work of a son’s dead father. The focuses on a longitudinal study of fats in the American diet. The information is startling

A cardiologist in Minnesota searches through the basement of his childhood home for a missing box of data from a long-ago experiment. What he discovers changes our understanding of the modern American diet — but also teaches us something profound about what really matters when we honor our parents’ legacy.

Think back to the ‘low fat’ craze that swept America in the 1990’s. Everything was marketed as low fat. In hindsight, that may not have been the been the best thing for our health.

Dig Deeper Into Vegetable Oils vs Animal Fats

TIME Magazine – But in a study published in the BMJ, researchers re-analyzed data from older unpublished studies and found the link between vegetable oil and heart health may not hold. They revealed that it’s possible that too much vegetable oil could actually increase the risk of heart disease — rather than decrease it.

Vegetable based fats (High dose Linoleic Acid)

Between the years 1909 and 1999, the consumption of soybean oil increased more than a thousandfold and now supplies about 7% of calories in the U.S. diet (2). High consumption of Linoleic Acid is one of the major causes of the obesity epidemic in the developed world.  Back to the theory that we should be eating what we, as a species evolved to eat. Animal fats, fruits and vegetables from the source and moderate to limited consumption of sugars.

Healthline.com sums up my arguments against the high consumption of vegetable-based fats.

Vegetable Oil Consumption is Associated With Various Other Diseases

 

High Fructose Corn Syrup and Sugar

Dr. Axe.com – There are so many reasons why high fructose corn syrup should be banned from our food supply. Here are some of the most highly disturbing high fructose corn syrup facts:

• Americans consume an average of 50 grams of HFCS every day. (7)
• HFCS now represents more than 40 percent of caloric sweeteners added to foods and beverages and is the sole caloric sweetener in soft drinks in the U.S. (8)
• HFCS has been shown to increase the risk of developing high blood pressure, diabetes and heart disease.
• Consumption of HFCS increased more than 1,000 percent between 1970 and 1990, far exceeding the intake changes of any other food or food group, and is a main factor in our current obesity epidemic.
• HFCS can cause leaky gut syndrome.
• HFCS contains up to 570 micrograms of health-hazardous mercury per gram.
• HFCS has been shown to promote cancer.
• The average 20-ounce soda contains 15 teaspoons of sugar, all of it high fructose corn syrup.

The Science Behind Corn Syrup

Dr. Hyman.com  – The takeaway: Cane sugar and the industrially produced, euphemistically named “corn sugar” are not biochemically or physiologically the same.

Now back to biochemistry. Since there is there is no chemical bond between them, no digestion is required so they are more rapidly absorbed into your blood stream. Fructose goes right to the liver and triggers lipogenesis (the production of fats like triglycerides and cholesterol) this is why it is the major cause of liver damage in this country and causes a condition called “fatty liver” which affects 70 million people.The rapidly absorbed glucose triggers big spikes in insulin–our body’s major fat storage hormone. Both these features of HFCS lead to increased metabolic disturbances that drive increases in appetite, weight gain, diabetes, heart disease, cancer, dementia, and more.But there was one more thing I learned during lunch with Dr. Bruce Ames. Research done by his group at the Children’s Hospital Oakland Research Institute found that free fructose from HFCS requires more energy to be absorbed by the gut and soaks up two phosphorous molecules from ATP (our body’s energy source).

This depletes the energy fuel source, or ATP, in our gut required to maintain the integrity of our intestinal lining. Little “tight junctions” cement each intestinal cell together preventing food and bacteria from “leaking” across the intestinal membrane and triggering an immune reaction and body wide inflammation.

High doses of free fructose have been proven to literally punch holes in the intestinal lining allowing nasty byproducts of toxic gut bacteria and partially digested food proteins to enter your blood stream and trigger the inflammation that we know is at the root of obesity, diabetes, cancer, heart disease, dementia, and accelerated aging. Naturally occurring fructose in fruit is part of a complex of nutrients and fiber that doesn’t exhibit the same biological effects as the free high fructose doses found in “corn sugar”.

The real issues are only two.

• We are consuming HFCS and sugar in pharmacologic quantities never before experienced in human history–140 pounds a year versus 20 teaspoons a year 10,000 years ago.
• High fructose corn syrup is always found in very poor-quality foods that are nutritionally vacuous and filled with all sorts of other disease promoting compounds, fats, salt, chemicals, and even mercury.

6 Reasons High Fructose Corn Syrup Is Bad For You – HERE

Metabolic Danger of High Fructose Corn Syrup – HERE

Harvard Men’s Health Watch

The sweet danger of sugar

Too much added sugar can be one of the greatest threats to cardiovascular disease. Here’s how to curb your sweet habit.

“Basically, the higher the intake of added sugar, the higher the risk for heart disease,” says Dr. Hu.

How sugar actually affects heart health is not completely understood, but it appears to have several indirect connections. For instance, high amounts of sugar overload the liver. “Your liver metabolizes sugar the same way as alcohol, and converts dietary carbohydrates to fat,” says Dr. Hu. Over time, this can lead to a greater accumulation of fat, which may turn into fatty liver disease, a contributor to diabetes, which raises your risk for heart disease.

Consuming too much added sugar can raise blood pressure and increase chronic inflammation, both of which are pathological pathways to heart disease. Excess consumption of sugar, especially in sugary beverages, also contributes to weight gain by tricking your body into turning off its appetite-control system because liquid calories are not as satisfying as calories from solid foods. This is why it is easier for people to add more calories to their regular diet when consuming sugary beverages.

“The effects of added sugar intake — higher blood pressure, inflammation, weight gain, diabetes, and fatty liver disease — are all linked to an increased risk for heart attack and stroke,” says Dr. Hu.

Fructose: This Addictive Commonly Used Food Feeds Cancer Cells, Triggers Weight Gain, and Promotes Premature Aging – Mercola.com

• In 1700, the average person consumed about 4 pounds of sugar per year.
• In 1800, the average person consumed about 18 pounds of sugar per year.
• In 1900, individual consumption had risen to 90 pounds of sugar per year.
• In 2009, more than 50 percent of all Americans consume one-half pound of sugar PER DAY—translating to a whopping 180 pounds of sugar per year!

Sugar is loaded into your soft drinks, fruit juices, sports drinks, and hidden in almost all processed foods—from bologna to pretzels to Worcestershire sauce to cheese spread. And now most infant formula has the sugar equivalent of one can of Coca-Cola, so babies are being metabolically poisoned from day one of taking formula.

No wonder there is an obesity epidemic in this country.

Today, 32 percent of Americans are obese and an additional one-third is overweight. Compare that to 1890, when a survey of white males in their fifties revealed an obesity rate of just 3.4 percent. In 1975, the obesity rate in America had reached 15 percent, and since then it has doubled.

Carrying excess weight increases your risk for deadly conditions such as heart disease, kidney disease, and diabetes.

In 1893, there were fewer than three cases of diabetes per 100,000 people in the United States. Today, diabetes strikes almost 8,000 out of every 100,000 people.¹

You don’t have to be a physician or a scientist to notice America’s expanding waistline. All you have to do is stroll through a shopping mall or a schoolyard, or perhaps glance in the mirror.

Here some of the dangers of consuming sugar:

1. Feeds candida
2. Promotes wrinkling and aging skin²
3. Makes your blood acidic³
4. Can lead to osteoporosis.⁴
5. Rots your teeth⁵
6. Raises your blood sugar level⁶
7. Contributes to obesity⁷
8. Is addictive (almost as much as drugs) ⁸
9. Can create the urge to binge⁹
10. Provides ’empty calories’ with no nutritional value¹⁰
11. Contributes to diabetes¹¹
12. Robs your body of minerals.¹²
13. Robs you of energy¹³
14. Contributes to heart problems¹⁴
15. Can cause cancer¹⁵
16. Contributes to ulcers¹⁶
17. Can cause gallstones¹⁷
18. Contributes to adrenal fatigue
19. Can suppress your immune system¹⁸
20. Raises the level of neurotransmitters called serotonin¹⁹
21. Weakens eyesight
22. Sugar can cause hypoglycemia (low blood sugar levels).
23. Can cause aging²⁰
24. Can contribute to eczema²¹
25. Can cause arthritis²²

To learn more about the dangers of sugar and find out if you’re a ‘sugarholic’, read Lick The Sugar Habit, by Nancy Appelton, PhD.

Looking to HACK Your Body? 4 Hour Body by Tim Ferris

Tim’s – Slow Carb Diet is one of the key features of the book.  His research into insulin production and his use of cold ice baths to rev up the calorie burning is fascinating. Here’s some of the big areas of this program:

RULE 1: AVOID “WHITE” CARBOHYDRATES.

RULE 2: EAT THE SAME FEW MEALS OVER AND OVER AGAIN.

RULE 3: DON’T DRINK CALORIES.

RULE 4: DON’T EAT FRUIT.

RULE 5: TAKE ONE DAY OFF PER WEEK. ….This one makes me nervous….

I recommend Saturdays as your Dieters Gone Wild (DGW) day. I am allowed to eat whatever I want on Saturdays, and I go out of my way to eat ice cream, Snickers, Take 5, and all of my other vices in excess. If I drank beer, I’d have a few pints of Paulaner Hefe-Weizen.
I make myself a little sick each Saturday and don’t want to look at any junk for the rest of the week. Paradoxically, dramatically spiking caloric intake in this way once per week increases fat-loss by ensuring that your metabolic rate (thyroid function and conversion of T4 to T3, etc.) doesn’t downshift from extended caloric restriction.
That’s right: eating pure crap can help you lose fat. Welcome to Utopia. There are no limits or boundaries during this day of gluttonous enjoyment. There is absolutely no calorie counting on this diet, on this day or any other.
Start the diet at least five days before your designated cheat day. If you choose Saturday, for example, I would suggest starting your diet on a Monday.

 

 

TED Talks that I like:

HERE

 

 HERE