Doug's Diet Manifesto

Talking about weight loss can sometimes be worse than discussing religion or politics. Advocates in different camps are convinced they are right and everybody else is wrong.

Here is my current 100% completely honest no-holds-barred thinking on weight loss, which some of you will disagree with in parts and some might agree with in parts:

1. Everybody is different. There is no universal solution to obesity which suits everybody. It's not one size fits all. There are different body types, different genetic factors, different psychologies, different medical conditions, different tastes, different levels of obesity, different upbringings, different times of life when obesity set in... just too many different factors to say to everybody "this is the way and if you don't follow my way you will never lose weight." When somebody claims they have universal insight and have discovered the only best solution to weight loss they are ignoring all these differences and are, instead, claiming that one's own personal experience is universal, which seems rather like saying, "the whole world revolves around me." People are different in just about every aspect of their lives. Why not different in how they need to lose weight or prevent overweight too? We need to be more understanding of the differences between people.

2. Some people do seem to have success at losing and maintaining weight by following a low-carb high-fat diet. It doesn't work for me, but I don't deny that it seems to work for some people. For me, reducing carbs has the effect of reducing appetite to a certain extent, but every time I try it I typically lose weight the first week or two, and then weight loss stalls, and then weight starts creeping up again. This is even when rigorously counting all my carbs and keeping them within 20. I even count the 1.7 net carbs in a teaspoon of garlic powder. I have tried it multiple times and it plain doesn't work for me. I am irritated when people in the Atkins group say I must not be following the diet correctly. One person will say I'm having too much protein, so I cut back on protein and it doesn't help. If you look at the fine print at the Atkins site (I have links for reference) they say if you are not losing weight cut back on protein. If you are still not losing weight cut back on fat. If you are still not losing weight cut back on calories to about 1800 per day. Voila. You're back to where you started from - counting calories. I personally think the "science" of low-carbing is a hall of mirrors and the reason it works for some people is simply because the appetite suppressant aspect (which is real) helps bring down appetite sufficiently to reduce calorie intake enough to lose enough weight over time. But that doesn't happen for a lot of people and it doesn't happen for me. Being aware of carbs may be useful in making low calorie choices which are more filling, but for me that's about the total use of it.

3. Gary Taubes, the science writer for the New York Times, is supposedly well-regarded and not a crackpot. But he out-and-out claims that the single nutrient, carbohydrates, is the cause of obesity and severely limiting carbs is the way to lose weight. He can make your eyes glaze over with hours of slides showing this and that research over history and discussing some poor culture where people are overweight subsisting on carbs and some other richer culture where people are thinner with less carbs. But he makes what I consider a fatal flaw for an educated person of science. He simply ignores data which doesn't fit his thesis. Much like a creationist simply ignores data which supports evolution. Here is a fact: the obesity rate in Japan is about 3%. The obesity rate in the U.S. is over 30% (http://www.nationmaster.com/graph/hea_obe-health-obesity). Yet the basic Japanese diet is very very high carbohydrate, with multiple servings of white rice per day. Plus Japanese have about the highest lifespans in the world. Until Taubes and the low-carbers fit this into their overall diet theory I can't ignore the contradiction.

4. So I'm back to my first point - everybody is different. It could be that a certain percentage of people, perhaps due to upbringing, find that living on a high-carb, low-fat diet is really perfect for their health, physiologies, sense of satiety and so on.

5. I personally find that carbs - particularly high glycemic ones like white rice - while tasty aren't really satisfying. I'm left feeling hungry after eating them rather than full. So I'm in a difficult position that way. This is part of the reason I have trouble getting back on a diet.

6. I believe a calorie-is-a-calorie and also in basic conservation of energy. I believe if you eat more calories than your body expends through its natural metabolism and exercise the excess calories get stored as fat and you gain weight. If you reduce calorie intake and increase exercise enough so there is a deficit of calories then your body uses the stored fat for its energy needs and you lose weight. I have actually shown this to be true multiple times in my life, where I restricted calories for 2+ years and have lost 100+ lb each time. This is something I've never been able to do by reducing carbs, even to 20 carbs/day. I've ended up regaining my weight each time, but this is another part of the complicated obesity picture.

7. Reducing blood pressure and important blood sugar values, such as A1C, to normal levels, without medication, works just fine on a low-calorie, high-carb diet. I have evidence with my own monthly blood tests taken while dieting over a period of 6 months. Low carb advocates claim blood values are helped by low-carb diets. I have nothing to dispute that. But if low-carb advocates claim the same is also not true of high-carb, low-calorie dieting I have evidence to the contrary. I believe the important thing in getting blood sugar and other values under control is losing weight, not how you lose weight.

8. I have a problem with rebounds after losing weight. From all I've read in multiple reputable journals, I do believe there is more than just psychology at work. When growing up, if you are overweight (which I was as a young adult) your body apparently adds extra fat cells. But when you lose weight those fat cells do not go away. They just shrink. And fat cells are not just dead lumps of fat. They are active cells which secrete hormones and signal the brain that they are starving if they go below a certain point. This is a huge contributor to the regain problem the vast majority of overweight people experience. I don't know the answer to this problem. But I do know that saying, "simply push yourself away from the table while you are still hungry and that's all there is to it" shows a lack of understanding for the situation the repeated regainer is in, and trivializes the overall problem and trivializes the huge effort the obese person made in staying on a diet for multiple years and losing a great amount of weight. It's a non-helpful suggestion.

9. Exercise is good because (a) it helps you expend more calories; (b) certain kinds of exercise can help build muscle mass, which results in an overall higher metabolism, thus helping you expend more calories even when not resting and (c) it helps increase body flexibility and endurance. Sitting around all day causes overall health and endurance to deteriorate. And lying around all day is the worst of all because you can catch pneumonia that way.

10. There is absolutely nothing wrong with eating snacks or the word "snacks." If you want to lose weight, the only thing that really matters is that your total energy expenditure exceeds the energy in kilocalories you consume. It doesn't make one whit of difference if you like snacking, or what you snack on, as long as you keep your calorie limits under control. If snacking helps you keep within your calorie limit it is actually helpful. Of course there are certain kinds of snacks which are more satisfying than others. A small 30 gm bag of potato chips versus 2 hard-boiled eggs with fat-free dressing mixed in with some salad greens have about the same number of calories. So either are just fine as a between-meal snack, though I bet the potato chips will leave you wanting more while the egg salad will be more satisfying because of the protein and the larger volume. So some snacks help you stay on your diet and some snacks are unhelpful because they might trigger more hunger.

11. Similarly there is nothing wrong with eating less during the day and saving your calories to eat more in the evening. If you know you are busy with work during the day and so are less likely to think of food, but are bored or just generally more prone to think of food in the evening, there is absolutely nothing wrong with eating at night, even late at night. The only thing that matters is the total energy in versus out over the day. It's plain conservation of energy.

12. Going back to point (1) - that everybody is different - some people are somehow able to lose weight by just eating certain kinds of food and forcing themselves to stop eating when they are "almost full." This does not work for me. My sense of fullness is too out-of-kilter to make such a system work. I absolutely must journal and track everything I eat, every last calorie, or I simply have no idea if I am within my quota for the day or not. Again, everybody is different here. I don't condemn people who are able to get by without counting, but I hope such people can understand why their experience is not universal and why I must count my calories.

13. All diets are diets. It drives me crazy when proponents of this or that diet claim it's not really a diet it's a "way of life." What you eat is your diet. I don't care if people want to make themselves feel better by pretending they are not on a diet. Any dietary or psychological trick which helps is useful. But don't insist to me that a pattern of eating designed to lose and maintain weight isn't a diet.

14. One of my favorite Murphy's laws is, "For every complicated problem there is a simple, easy-to-understand, wrong answer." Dealing with obesity is a complicated problem. Everybody seems to have a "simple" answer. But there isn't one. If you think there is one you are just assuming everybody is the same. But everybody is different.

Doug Lerner