“DOCTOR, HOW DO I LOSE WEIGHT?”
Hunger is the strongest drive—in humans and in all animals! Sex is the second strongest drive, but it only lasts from puberty to somewhere in old age, which varies genetically.
Hunger is there from birth to death. No species will survive if it doesn’t eat.
We start eating as soon as we are born, and we continue to the very last day. Very occasionally, when we are super sick, we will not eat, but we will drink. Another pause in our constant eating comes when we are depressed. Weight loss is a sure sign of depression or a very serious disease.
In the last decade people have been over-eating. Obesity has become the pandemic of the 21st. century. Medical scientists are totally stymied by this pandemic. Doctors ask each other: “Why am I getting fat?”
I, personally know. I struggle to keep my weight at 160 pounds, which is normal for my height. I look at my belly every morning. Is that round or is that flat? Did I eat too much? Drink too much? Were those things carbs or proteins?
I’ve got to got to the gym!
I have investigated every facet of nutrition and weight gain and wait loss. I am as perplexed as anybody at the “tubs” I see sitting in the restaurants and walking in the streets.
My latest theory is that it is the plastic. Every particle of food is wrapped in plastic. Whether packaged in the USA or in China or anywhere in the world, everything, but everything, from dried seaweed to fresh noodles is wrapped in plastic!
And, as we know, plastic is made of BPA’s, which is a molecule akin to the hormone estrogen.
BISPHENOL-A (BPA) attacks the thyroid and binds with thyroid hormones, making them less active. It also interferes with other hormones and is reputed to cause cancers.
In Japan it is banned. In other countries, particularly the USA, it is used like water. We know that money can kill entire societies.
If you can ( and you cannot) look or use foods not wrapped in plastic.
My second theory is that everybody (almost) on the planet is consuming sugar laden drinks. Drinking is easier than eating, and the food industry has zillions of bottles of High Fructose Corn Syrup in all the stores in all the countries of the planet.
PLEASE, DOCTOR!
Because of this pandemic of obesity I am getting special requests from patients: “Please, Doctor, can you help me lose weight?”
I used to get this request approximately once a week in the 1980’s. Recently, I get this request more than several times daily. I no longer can attend to these patients. Advising a patient on how to lose weight takes up to one hour weekly.
It was my practice in the 1980’s to have the patient keep a “food diary” daily. The patient must write down everything, solid and liquid, consumed daily. There was an ever-present tendency to “forget” foods or drinks.
The two of us would review the food diary, and I would make my suggestions and explain why. If the patient was faithful and highly motivated, that patient would lose weight. The others would not.
Today, because of the sheer volume of patients, I send them to a “Weight Loss Clinic.’ However, I have decided to review in this article, the fundamental principles of weight loss.
FUNDAMENTAL PRINCIPLES
1. NO MAGIC
There is absolutely no magic, no “trick” to losing weight. All those crazy ads that you see on the Internet are a means of stealing your money. Ignore them!
2. IT IS PURE PHYSICS
There is one equation that has never been refuted. Every scientist on this planet knows the equation and not one scientist will disagree with the equation. If he does, he is a charlatan. Avoid him!
3. THE EQUATION
CALORIES IN – CALORIES OUT = FAT.
IF CALORIES IN > CALORIES OUT, YOU GAIN FAT.
IF CALORIES IN < CALORIES OUT, YOU LOSE FAT.
Fat is a form of energy. Calories are units of energy. Your body is a scale.
Put more calories on the IN side of the scale than those you put on the OUT side of the scale and you add fat. Put more calories on the OUT side of the scale than you put on the IN side of the scale and you lose fat.
That is the simple mathematical description of what happens when any animal, including humans, consumes calories.
QUESTIONS
In order to incorporate the Calories Equation into an action plan to lose weight you need to ask and answer seven questions:
1. How many calories in a unit of fat?
2. How many units of fat do you want to lose? (IDEAL WEIGHT)
3. How much time will it take?
4. What is your Basal Metabolic Rate?
5. How many calories do you use daily. (Calories Out)
6. How many calories do you consume daily. (Calories In)
7. Are we motivated to reduce our weight?
QUESTION ONE: HOW MANY CALORIES IN A UNIT OF FAT?
Metric: there are 9,000 calories in a kilo (1000 grams) of fat.
English: there are 3,500 calories in a pound of fat.
QUESTION TWO: HOW MUCH FAT DO YOU WANT TO LOSE?
To answer this question take this link to your ideal weight: http://www.halls.md/ideal-weight/body.htm Subtract your ideal weight from your present weight. This is the amount of weight to lose to arrive at your ideal weight.
Please note: The “ideal weight’ is derived from a formula, it is not exact.
I always ask patients: “How much did you weigh when you graduated high school? Were you a normal weight?” A normal person at age 18 is almost always at a near perfect weight. As we age, the muscle in our bodies is reduced and therefore we should weigh less.
QUESTION THREE: HOW MUCH TIME WILL IT TAKE?
Most doctors believe that one pound per week is the best rate of weight loss.
This belief is based on two factors.
There will be no major change in the life style of the patient. Therefore, the patient will adhere to the program which will consist of a minimal increase in calories out (exercise) and a minimal decrease in calories in (food and drink consumption).
One pound of fat equals 3,500 calories or 500 calories daily. Reducing 250 calories of calories in and 250 calories of calories out is very doable.
THE HARD PART!
If we are quite obese; that is, over fifty pounds, we are suddenly talking about a life style change that will take years.
When I tell a patient that it will take two or three or four years to reach an ideal weight they show signs of sudden depression.
This is when we separate the men from the boys. A man or woman who is facing four years of self control in terms of food, and also needs to avoid lying on a couch and watching television will not like the prescription of eating less and exercising more.
At this point, I add a bit of information: “You can eat less and exercise more or die early. Take your pick!” This is not a cruel push. This is a realistic description, which any doctor must provide for his patient, to keep him or her healthy.
If the patient decides to accept the challenge, we go on to question four. Many patients say they “want to think about it” and they leave. Most never come back for advice about weight loss.
Those that accept the challenge move forward. These are the people that I like. I admire humans who are not afraid to face the vicissitudes of being alive on this planet. They remind me of my German Shepherd who is never afraid to face the enemy.
When we go on, we must develop our unique approach. Each man and woman is different and absolutely unique. Their eating likes and dislikes are based on their genetics and their family heritage and their social environment. Their ability to exercise also reflects their genes, their social education and their peculiar societal environment.
Italians eat pasta and Asians eat rice. Changing a lifetime of habits is almost impossible.
If we have decided to go forward we then need the exact method.
If we are driving to a distant city, we need to know the distance in miles or kilometers, so that we can calculate the gas to be used. We need to know our average speed to calculate our time of arrival.
The next question helps us determine our energy out so that we can calculate the limit of energy in.
QUESTION FOUR: WHAT IS OUR BASAL METABOLIC RATE?
Since we are living animals, we use energy constantly; whether asleep, awake, running or sitting. We use this energy as our heart pumps blood, our lungs pull air in and push air out, our gastro-intestinal tract propels food from our mouth to our colon, our arteries and veins and lymphatic vessels pulsate and push blood and fluids through our body, our muscles maintain “tone” so that they are ready to work instantly, and our nervous system processes sensations and thoughts and unconscious messages to our glands and our brains process thoughts and dreams.
All this energy is calculated in our “Basal Metabolic Rate.” We use this much energy constantly, as long as we are alive.
It is generally, amongst sedentary people, the largest component of “energy out.”
Our metabolic rate changes with gender, age and weight and height. Here is a link to your Basal Metabolic Rate (BMR): http://www.bmi-calculator.net/bmr-calculator/
Use this quantity to determine your total calories out. The next question will give you an approximation of total calories out.
QUESTION FIVE: HOW MANY CALORIES DO YOU USE (BURN) DAILY?
This is an extremely hard question to answer accurately.
Most of us are sedentary. We sit at desks throughout the day. We sit in a vehicle to go to our jobs or to go shopping. We may exercise one or two hours, but generally not every day.
Most data on the calories out or calories burned include the BMR or Basal metabolic Rate, and they use questions such as: “sedentary”
“light activity” “moderate activity” and “very active activity.”
The results are rough approximations, but they can be used.
Here is a link for “Calories Burned”: http://caloriecount.about.com/cc/calories-burned.php
In terms of exercise, unless you are active in a sport, such as tennis or running, the amount of calories burned is small: generally 200 for an hour of steady exercise. If you are active in a sport, you almost always do not need to lose weight.
Golf is not a sport.
QUESTION SIX: HOW MANY CALORIES DO YOU CONSUME DAILY?
“Consume” means whatever goes through your mouth and includes liquids and solids.
One of the unnatural forms of nutrition, being widely used throughout the world, is the consumption of sugary drinks. Wherever I go on this planet, and I have been to Asia, South America and Europe; and I live in the USA, I see people carrying bottles of fluid and sucking on these bottles constantly.
This is happening everywhere, including health clubs. The liquids are almost always water and sugar. This could be the could be the other explanation of the pandemic of obesity. You must quantify the number of calories consumed (solid and liquid) daily.
This is a complex job. The easiest way is to make a “food diary.” This can be done with a smartphone.
In the beginning enter exactly what you are consuming and its weight. Google the quantity of calories involved. Get a daily total. You will be shocked! Subtract “Calories Out” from “Calories In” and you will know your daily fat increase or decrease. This method must be used daily for one or two months to become accurate.
QUESTION SEVEN: ARE YOU MOTIVATED?
Here again, we have a problem. Being truly motivated to enter a project, which involves thought, sacrifice and changing a life style is rare.
We can look at the statistics of weight loss and they are grim. Almost everybody starts some form of weight loss program and then, like addicts or criminals, there is a high rate of recidivism (giving up and returning to the old habits.)
However, there is one ray of hope in the picture: If you repeat the process over and over, statistics show, that you will eventually win. Those that say “No” at the very thought of trying again have no hope.
For those who cannot conceive of giving up their daily intake of food or are horrified of exercising, they may not have to decide. I am convinced that mankind will soon face starvation because of a failing economy coupled with constant drought.
That may be your ray of hope.
OTHER TOOLS
As you proceed in your program, men, measure your waist and women, measure your buttocks. These two measurements are more indicative of weight loss than total body weight.
Use a glucometer, blood glucose device, to measure blood sugar after exercising. This is more accurate that measuring calories burned.
Let nothing but pure water and no more than one half liter of dry wine pass your lips. If you can eat Japanese diet without the rice, you will lose weight at twice the speed!
SUMMARY
From all we know about life expectancy, the only one method of living longer than the average, for any animal, including humans, is Caloric Restriction.
Eat less, live longer. That is the name of your short stay on Planet Earth.
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