WEIGHT LOSS PART THREE

 A Fool Proof Weight Loss TemplateThe United States of America contains over 220 million overweight citizens. That’s more than 2 out of every 3 people in this country. And, while there ARE a lot of low quality foods, and people DO have more sedentary lifestyles than they have had in the past, for many of these 220 million people, repeated efforts at reducing calories and increasing exercise hasn’t, and won’t, result in lasting weight loss. There is often more going on than simply “calories in versus calories out”. 

In our last two articles we looked first, at some surprisingly common imbalances in the fundamental systems of the body, imbalances that can occur as the result of exposure to environmental pollutants, hormones that have gradually gotten out of sync, or chronic, low-level inflammation. In our second article, we looked at simple steps you can take through diet, lifestyle and with some commonly available supplements, to address these obstacles to successful weight loss. In today’s article we present a simple template for successful weight loss. There are a few key concepts that you need to adhere to in order to make a weight loss program effective. Apply those, and modify the rest to make it fit your lifestyle and goals. For the majority of people, following these key principles will result in progress. If you haven’t had a chance to read the previous two articles, we suggest you go back and read them now as, this article assumes that you already understand the concepts covered in those articles, but also, the steps we suggest here should only be taken once you have already addressed those issues we discussed in the previous articles.


You have probably heard that losing weight is just a matter of “calories in versus calories out.” And, yes, of course, on paper that is exactly true. However, there is a lot that takes place in the mind and physiology of the human body that isn’t contained in that simple equation. A much better model has been researched, proposed, and well described by a researcher and neurobiologist from the University of Washington in Seattle, Wa. Stephan Guyenet proposes that weight gain and loss are determined by how a food influences two separate tracts of appetite regulation: the hedonic system, and the energy homeostasis system. 


The energy homeostasis system is akin to the thermostat in your house, only this one regulates fat. (Many refer to it as an adipostat (“adipo-” meaning fat), which is the term we will use.) The body has an ideal body weight that it strives to maintain. An interaction between the various metabolic hormones (leptin, ghrelin, insulin, glucagon, adiponectin, etc.) and appetite and satiety processing parts of the brain located in the hypothalamus all work together to maintain an ideal weight. It strikes a balance between having enough stored energy (in the form of fat) to make it through gaps in available resources, yet not so much that the ability to move efficiently and purposefully is hindered. The body has some surprisingly powerful mechanisms in place to maintain the body at the appropriate weight. One such mechanism is of course, the appetite. A hormone called leptin is produced in relation to the amount of fat stored on the body, with more fat resulting in more leptin circulating. This leptin in turn signals the appetite center in the hypothalamus to suppress appetite in order to reduce energy stores. Movement is also regulated by our adipostat. We are compelled to move more when we are carrying more than our body thinks is ideal, and we become lethargic when stores are low and need to be replenished. One quick look around any public place in America will tell you that the adiopostat system isn’t working, we still seem to have no problem accumulating more stored energy than is practical or ideal. This is where our conversation turns to the hedonic system of appetite. 


In our evolutionary history there were times when we were confronted with a food that is so full of calories and beneficial nutrients that our best interests would be served by eating more than what would simply fill us up. In other words, the hedonic value of the food would override the adiopostat regulation of appetite. These types of foods were rare in our evolutionary history, so there was little risk of overeating as a result, and from a survival standpoint, there was good reason to take in these energy dense and nutrient dense foods whenever possible. Unfortunately, the food industry has capitalized on this aspect of our physiology and actively engineers our food to trigger a hedonic effect. There are various cues in a food that triggers this override of our energy homeostatic system: rich flavors, combinations of sweet, salty and savory flavors as well as certain textures such as crunchy or juicy. Many of the foods at the grocery store are carefully designed and engineered to strike exactly the right balance between these flavors and impart a pleasing mouth feel in such a way that it is very hard to let appetite work as intended. In his book, “The End of Overeating” former FDA commissioner, David Kessler described this ongoing battle food manufacturers are waging over our mouths and our dollars. At one point he quotes a food industry scientist, saying “ For product developers, it is of interest to add elements to a food that make a food highly desired and liked, both initially and over repeated consumption.” He goes on to describe the lengths and research the food industry has gone to in order to create foods that hack our biology and create highly pleasurable food, from little chemical nuggets of artificial flavor, to seemingly endless refinement of recipes to get that perfect product. In short, the goal is food that is very difficult to say no to, food that entirely bypasses our adipostat. This brings us to our first principle of successful weight loss: “eat close to the ground”. Avoid processed foods because they don’t work with our physiology the way they should. Processed foods bypass our natural system for weight maintenance. An example from my own life is steak, I really enjoy a good steak. But I couldn’t sit down and eat six steaks. I could on the other had sit down and eat an entire bag of potato chips, no probelm. Steaks are not a novel food for my physiology. Humans have been eating red meat for a long time, and my adipostat knows what to do when steak comes in. Potato chips on the other had, are a carefully engineered food, one that strikes the perfect balance between salty, crunchy, and fat. If you eat those sorts of foods, maintaining a healthy weight, or losing weight will be difficult.


1. The first principle of successful weight loss is to avoid processed food of all kinds. 
Only shop the perimeter of the grocery store (the produce section, the frozen section, and the bulk section) avoid anything that has extra steps of processing, instead choose the foods that are as close to their natural form as possible, the foods that are “closer to the ground.”



The second principle, which is crucial for successful weight loss, is to restore insulin sensitivity. Everyone knows insulin as the hormone that relates to diabetes, where it is responsible for shuttling glucose into cells. A better way to think about insulin would be as a director that switches us to storage mode. When insulin is circulating, energy gets stored. This storage can take place in a few different ways. First, the glucose goes directly into cells where it can be converted in energy (in the form of ATP). When you are physically active, this glucose is used up and the system returns to a state of homeostasis. In a more sedentary state however, the cell’s need for glucose is met more quickly, but there is still glucose in the bloodstream that needs to be removed. In this case glucose moves into additional storage locations. First the glucose can be bound into starch chains called glycogen, which is then stored in muscles and in the liver (this is the goal of carb loading familiar to endurance athletes). Once these stores are filled, the remaining glucose is converted into free fatty acids, which are then stored in adipose cells, as fat. (for simplicity we paint this process as sequential, when in reality it is much more complex, with all three of these process happening at once, but the concept is accurate and sufficient for our purposes). The important part is: the more insulin is circulating, the more glucose is stored as fat. When the body becomes resistant to insulin, it takes more insulin to get the same effect. This accelerates the process of fat accumulation. In order to stop storing fuel as fat, you need to bring down the insulin levels. Fortunately, that can be easily done. Insulin is released with the consumption of carbohydrates mainly (but also to a lesser degree, with the consumption of protein.) The more carbohydrates in a food, typically, the higher the insulin response will be, however several other factors also influence how a food influences insulin levels. The more processed a food is, the more severe the insulin response will be. For instance, corn on the cob causes a rise in insulin, but not as much as cornmeal, which also doesn’t raise insulin nearly as much as corn flour, which in turn doesn’t raise insulin nearly as much as cornstarch. The more processed a carbohydrate, the more rapidly the glucose derived from it reaches the bloodstream and the more quickly the body needs to respond in order to maintain balance. Those severe spikes in insulin level are what drives insulin resistance, and increasing insulin levels. Improving your insulin sensitivity requires two steps: first avoiding process foods because they cause a more rapid spike, and second reducing your intake of carbohydrates. If your goal is weight loss, you should ideally be getting between 10-20% of your calories from carbohydrates. Protein and fat on the other hand are able to supply energy needs without damaging insulin sensitivity, so increasing your intake of those two classes of calories will actually result in weight loss. I know it can seem counter intuitive that eating fat can result in losing fat. If you just remember that it isn’t about fat, it’s about insulin, then it makes sense. In fact, this was borne out in a study in the prestigious Journal of the American Medical Association (JAMA) in 2007. This study, termed “The A to Z study” compared the effects of a several different diets including a high fat-low carbohydrate and a high carb-low fat diet, and found that the biggest reductions in weight and waist measurement happened with the high fat-low carbohydrate diet. Not only that, but the high fat diet also caused the greatest improvement in blood pressure, and cholesterol. The vilification of fat that has been a main talking point from the medical community for the last several decades is not in agreement with the most current research, and the best informed doctors are changing their recommendations on this issue. Having addressed that aside, by reducing one’s carbohydrate intake, the body’s response to insulin returns to normal and the body can function properly again. So the second step is:


2. Reduce your carbohydrate intake to 10%-20% of total calorie intake. 
First calculate the number of calories per day that is ideal for your target weight (here’s a great calculator). Next, multiply the total calories by 10%. There are 4 calories in each gram of carbohydrates, so to figure out how many grams of carbs you need per day, divide the number of calories from carbs by 4. This will yield the number of grams of carbs you should eat to reach 10% of calories from carbs. Repeat the process for 20% to get a range to stay within each day. For example in a 1,800 calorie diet, you should consume between 45 and 90 grams of carbohydrates per day.


The third crucial piece to a successful weight loss diet, is that unyielding fact of thermodynamics: calories in must be fewer than calories out in order to reduce energy stores in the body. The good news is that your body is very good at regulating this when you are eating the right foods. Once you cut the processed food out of your diet, you’ll find that it is much, much easier to only eat the calories you need. Not only that, but unprocessed food is much more dense with vitamins and minerals than processed food, so you’ll feel more satisfied, have more energy and likely other symptoms will improve as well. (Poor sleep, reduced energy, muscle aches, headaches, and many other symptoms can all relate to nutritional deficiencies.) Adhering to the calorie target you used above to calculate your total carbohydrates is a valuable part of a weight loss program. In my experience however, it isn’t as important than counting carbohydrates. In other words if you consistently go over on calories, but maintain within your goals on carbohydrates, you’ll do much better than the if you err in the reverse fashion. The impact on insulin is just too strong to ignore that of the equation. Keeping track of carbohydrate and calorie numbers is difficult at first. You’ll need to keep a journal of some kind and write down everything you’re eating and look them all up as you go (I like the site http://nutritiondata.self.com/) Once you have those numbers looked up, it becomes very easy. From one day to the next most people eat a lot of the same foods. Most of it is just copying and pasting. In time you’ll start to recognize what a plate of food should look like for your weight. That is a valuable lesson. The servings in America are way too big, a problem continuated by a largely cheap and processed food supply. Getting a sense of what is a realistic serving size is a valuable lesson and one that will help to make your weight loss a lifelong change rather than just one cycle of the yo-yo.


3. Stay within the target calories for your weight loss goal. 


So to review, the three key pieces of a weight loss program are: 
1. Eliminate Processed Food.
2. Reduce Carbohydrates to 10-20% of calories.
3. Reduce Calories to align with your target weight.

We hope you appreciate this information. This three part series is a basic skeleton of the dietary program we run in our office. With our program we add acupuncture to help reduce food cravings, and address the underlying obstacles to weight loss through herbal supplements, and dietary counseling. We’ve also partnered with a local gym to get you a discount on your exercise program. If you’re serious about weight loss, our program gives you the guidance and support that ensures success.