by Barbara Berkeley, MD
Imagine that you lived next door to a factory that was working on an automatic program and was spewing out toxic garbage.
Over time, your property had become covered with smelly, unsightly waste and each day, as you gazed out your window, you became more and more upset. Your beautiful home was ruined.
One day, you wake up with a great idea. You are going to clean up the toxic mess. You put on your gloves, mask and hip boots and you wade in-- expending many days and much sweat in the effort. Finally, you step back exhausted. Your property is clean, your house is gleaming and you are happy. You sigh and fall asleep contented.
But the next morning when you go to your window, what do you see? The factory has been spewing out toxic waste all night and your yard is a mess once again. Competely defeated, you resolve to just "live with it". And that's what you do. Until the next time.
What went wrong? You had a fundamental flaw in logic. Rather than wasting time and energy on a clean up, you needed to get a crowbar and break a window in the factory. You needed to use a flashlight to find that big switch marked "ON and OFF". And then you needed to shut the factory down.
Essentially, dieting for weight loss is nothing more than cleaning up a toxic dump. Your excess weight is the unwanted, stored stuff that your body's factory produced and couldn't get rid of. Cleaning it up is satisfying---for a moment---but doesn't do a single thing to solve the problem.
Sadly, America is obsessed with cleaning up the yard. Almost without exception, weight loss programs, books, products and remedies focus on losing pounds. That's a tragedy, because, other than giving you a fresh place to start, the clean up itself is meaningless.
Conventional wisdom (beware conventional wisdom!) says that we gain weight because we eat too much and exercise too little. But if you are looking for this switch, you are looking in the wrong place. Every overweight person knows some thin person who eats just as much as he or she does and sits on the couch all day--- yet that person never gains weight. If eating too much and moving too little is the problem, are we to say that it is only the heavy person who is gluttonous and lazy? This is the source of a great deal of the weight prejudice we experience (as in, "Why can't those fat people just push away from the table?").
Weight gain appears to be much more related to the specific ways in which our individual bodies dispose of (or store) the foods we eat. For a great many of us, the problem with excess storage runs through the insulin system and minimizing insulin production (to whatever degree we can) is the switch that stops the factory. If you have located another switching mechanism that works for you, use it. But for the majority of people I treat, disabling insulin production shuts down the problem.
To minimize insulin production, take sugars and starches out of your diet. Vastly curtail these foods: sugar, honey, syrup, molasses, high fructose corn syrup, grains and whole grains, flour, pasta, crackers, bagels, bread, cookes and cakes, chips, potatoes, hot and cold breakfast cereals, granola and anything made from corn, rice, or other grains.
If you are in the process of "cleaning up your yard", select a diet that lowers insulin. What works is any low carb diet that has total carbs of 100 grams or below per day. I recommend that your weight loss diet look very much like a diet you could follow permanently. My objection to the Atkins diet is that the very low carb requirement makes it tough to continue. In addition, I have not found that lowering carbs as much as Atkins recommends is necessary to get weight loss. Our patients do just fine on about 100 grams (or slightly more) per day. We achieve a continued low calorie count (necessary for the weight loss phase) by using liquid meal replacements and bars for part of the day. This approach is very successful, can be picked up again when weight creeps up in maintenance, or can be partially adopted as a permanent plan. Permanent maintenance diets should have lots of vegetables, some fruits and good quality animal proteins.
Whether you are contemplating weight loss, in the throes, or trying to maintain, remember that everything hinges on this: Don't assume that you have solved your problem once weight is lost. Seek the switch and pull firmly!