Mainstream Diets Often Similiar to Quitting Heroin

 

The sentinel change we seek to actually succeed and lose weight is a change to our body’s response to diet and exercise. To make a few comparisons, consider 1) the withdrawal of a heroin addict or 2) the power of the human sex drive. Both occur because of brain signaling disruption just like the one we feel when we start the diet and exercise duo of doom.

Heroin addicts cannot just quit heroin on Monday. Again, it’s not because they lack discipline or will power, it’s because their brains have restructured themselves to require the heroin molecule. This restructuring is a real thing, a real change in molecules in the brain that can be documented.  The syndrome that heroin addicts go through when withdrawing from the drug is predictable and reproducible, and it happens every time until the body restructures its molecules to survive on less (or no) heroin. Same with food.

 

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Likewise, imagine what would happen if I instituted a program to control the population, and the rules were that no one from 20-40 years old could have sex ever – starting Monday. What do you think the success rate would be? Do you think many humans could just shut that drive off, and forget about it? Could be happy and enjoy life the same way those do that have voluntarily shut it off? Like nuns or monks? Of course not.

These urges are biological and can only be contained for limited periods of time, against the current. The same is true with calorie restriction. No matter how many books come out about this diet and that diet, humans can’t just shut off the food consumption urge that is wired in for our survival and expect to be successful. However, just like the nuns or monks (or whomever) that have voluntarily deferred sexual relations, or recovered heroin addicts, the brain can be adapted to diminish those signals. Importantly, life without sex or without 4000 calories/day, in those that are successful, is not a struggle. On the other side of the catching point people no longer receive those signals, and as a result don’t feel that same urge to consume or reproduce – to survive – as the general population does on day 1 of a diet. So for them, it is easy!

This is how the beautiful people feel, which is why they are smiling all the time. Also this is why they have no idea how anyone could struggle with their programs because they don’t experience these same feelings. As a result, they conclude that we must be “weak, “or “lack will power,” and so on. But these negative labels are without meaning because we face a different challenge with which they are not familiar. Of course we don’t know how any of these folks would fare if they faced the same powerful signals to quit, but we aren’t looking to prove that they would struggle. We are looking to reverse and extinguish our own signals – and join them.

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Dynamic fitness scheduling opens new doors for chronic “diet quitters.” – J. David Prologo, MD

Consider Jane. Jane was my coworker for many years. Jane is a bit overweight and sedentary. She has never really exercised for any significant length of time in her life, which is to say that she has limited knowledge of exercise physiology.  I’ve watched her over the years come in on Monday after Monday declaring that, “this is day 1 of my diet!” I’d watch her unpack a salad with no dressing as a snack and describe her exercise program to the girls in the break room who listened intently. She’d say how she wasn’t going to eat after 6pm, how she planned to walk around the hospital with her pedometer at lunch, how her family would be “on their own,” with regard to dinner during her diet, how her aunt’s friend lost 80 lbs on this diet, and on and on.

One Monday it was someone’s birthday and a cookie basket was delivered in their honor. Jane was stricken. The girls were giggling and eating cookies and celebrating a birthday together in the afternoon and Jane looked like her dog had just died. I asked, “Why don’t you have one? It’s a special day” She didn’t want to have one, because it meant the end of her program. If she ate that cookie, and joined in that party, she would officially be “off her diet.” It meant giving up. It meant failure. It meant restarting.

Jane’s focus was restriction. She believed that the she could change her body by reducing calorie counts. I am here to announce to all of the Janes (and Dicks) in the world, that that way of thinking is absolutely, categorically, and unquestionably, FALSE. You have not reached the end of diet programs because that is not the way. I submit to every trainer, every nutritionist, every fitness expert in the world, that the changes people are looking for can only occur during rest, and that a different way of thinking (a way that allows for that variable intensity and an occasional cookie) is warranted to finally overcome this widespread history of repeated failures.

Three overreaching themes will prevail in any new way that leads to success: No dietary restrictions, no going backwards, and no perfection goals. Long term transformation hinges on dynamic scheduling, and piecemeal progress, not perfection.

 

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Hunger Hormone Management

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How many people do you know that have really lost weight? I know of a few: mostly people who have just gotten divorced or dumped, or some of those people on The Biggest Loser. But everyday people like us? Not many.

You already know this. You’ve known for years that you can’t lose weight or follow mainstream diet and exercise programs. It’s your thyroid, right? Or genetics. Stress? The devil?

It’s probably none of those things, but medical science has recently shown us (thanks to the gastric bypass era) that hunger hormones increase during the first few weeks of traditional diet and exercise programs. The old-fashioned combination of abrupt food restriction and exercise assault on the body flips us into survival mode and results in hellfire signals from our brain to quit it all.

No one ever failed a fitness schedule or diet because they ran out of workout options or low calorie recipes. People succumb to the body’s strategic, orchestrated response to what the brain thinks is a life threatening external stressor. Hormones called ghrelin, leptin, GLP-1, and others break your spirit during that first week or two – usually while you’re shopping for rice cakes on the way to fitness boot camp.

Expert trainers and fitness gurus also know this. They drone on about “no pain, no gain” and their superhero powers of discipline, dedication, and endurance. They profess how they overcome obstacles that crush the weak and are rewarded with beauty, slim bodies, and nice teeth. Really? Do those yoga pants women you see walking and laughing all the time look like they are in pain? Of course not. At some point they got over the hump, and now it’s fun.

Here is the good news. There is a point beyond which the brain gets on board, and stops sending out hormone mediated signals to eat everything in sight and quit exercising 3 days into a diet (these are the smiley, beautiful people that make you want to scream). What’s more, the concept of neuroplasticity allows us to navigate around that barrier that has been stopping us from really losing weight or getting in shape all these years – and join the folks on the other side.

So yes, it is possible to really lose weight. But not by trying to bull rush through with our heads down. You can overcome this motivation sap one of three ways: 1) gastric bypass surgery, 2) bariatric artery embolization, 3) or intentional transformation.

 

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References
1. Chandarana, K. and R.L. Batterham, Shedding pounds after going under the knife: metabolic insights from cutting the gut. Nat Med, 2012. 18(5): p. 668-9.
2. Weiss, C.R., et al., Bariatric Embolization of the Gastric Arteries for the Treatment of Obesity. J Vasc Interv Radiol, 2015.
3. de Araujo, I.E., et al., The gut-brain dopamine axis: a regulatory system for caloric intake. Physiol Behav, 2012. 106(3): p. 394-9.
4. Aristizabal, J.C., et al., Effect of resistance training on resting metabolic rate and its estimation by a dual-energy X-ray absorptiometry metabolic map. Eur J Clin Nutr, 2015. 69(7): p. 831-6.
5. Barrett, L.F. and W.K. Simmons, Interoceptive predictions in the brain. Nat Rev Neurosci, 2015. 16(7): p. 419-29.

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“Just burn more calories than you take in, right?” Not quite. . .

For years I have been a fan of the Cleveland based talk-radio show called Rover’s Morning Glory. The host, Rover, and I share many of the same opinions (which, I am sure, is why I like the show so much), from politics to relationships to work. However – I’ve argued with the radio on more than one occasion as he launches into his “A calorie is just a calorie’ speech. So I’ve decided to use this opportunity to finally set him straight. A Calorie is NOT a Calorie, and here’s why, Rover.

 
First, the response to the lost calorie.

A calorie foregone by Joe Fitness is not the same as a calorie foregone by Obese Andy – and this is why sedentary (out of shape) people cannot successfully follow the diet schedules of the beautiful people. I’m not saying the people are different (which of course they are), I am saying the calorie is different.

When Joe cuts 100 calories his body responds by efficiently burning fuel and reorganizing fat stores, so his abs get more chiseled. When Andy does the same, his body reacts by storing more fat and signaling him to eat. Why? Because Joe’s brain has lived under these conditions for a long time – conditions that aren’t a change from his baseline life so his body “is used to it” and doesn’t panic. Andy’s brain, on the other hand – interprets the calorie cut as a major, life threatening change to be dealt with by storing fat for survival and finding food.

But it’s worse than that. Joe’s body will further react by burning the food he does eat efficiently, while Andy’s body will slow down its metabolism. Andy’s brain will convert his body to a slower burning factory in an effort to conserve energy for survival – the sum result being 1) more fat stored, 2) more hunger hormone signals to eat, and 3) slower metabolism, at the end of which Andy end’s up eating cheeseburgers anyway!
This triple threat is why it is impossible for seriously overweight people to drop their calorie intake enough to lose weight. And what’s more, these foregone calories from diets serve to end people’s efforts toward losing weight, such that in the long run 100 calories missed by Andy means the end of a healthy program and/or lifestyle – sadness, sickness, and maybe even death.

 
Second, the effort to burn a calorie.

Overweight individuals cannot burn calories like in-shape people. Joe Fitness has 100 times the capacity to burn calories than the average person – which makes it different. A burned calorie to Joe is not the same as a burned calorie for Andy when trying to lose weight.

Calories are little amounts of energy. Energy we either use to live, or store as fat if we take in more than we need. A calorie burned by an “in-shape” person is worth more energy in the universe than a calorie foregone by an obese person – because the “in-shape” people can do more with less. Their bodies are much more efficient. As a result, sedentary, overweight person needs to abstain from many, many more calories than Joe Fitness to lose the same amount of weight, and this difference is even more pronounced the more obese the person.

 
Third, the value of a recovery calorie.

One hundred protein calories taken in by Joe Fitness equals maintenance. One hundred intentional, carefully selected protein/anti-oxidant/glycogen forming calories taken in by Andy after exercise equals transformation. On day one, Andy can burn 50 calories – maybe. But eat the right foods after exercise, and avoid the trap of food restriction, and he will transform over time to a calorie burning machine with efficient metabolism.

I’m sure you would agree that one dollar invested in Yahoo during the 1980’s isn’t the same as one dollar put in a shoebox during the same time. The first dollar is intentional and directed; the second useless and fairly random. In the same way, a calorie is not a calorie because complex human weight loss cannot be distilled to a mathematical equation translated as, “just burn more than you take in.”

Transformation is possible through hunger hormone management, intentional exercise, and selected foods. Gastric bypass surgery has taught us new things about the body’s response to diet and exercise, things we now know can be used to change the way we lose weight through fitness.

 

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Start a new diet – fail. Start a new diet – fail. Two new rules for getting over the hump next time.

 

No one who succeeds with any diet and exercise program does so through will power, discipline, and plain old fashioned grit. That just isn’t reality. People succeed because it’s easy for them. Their bodies are structured to succeed, to easily proceed with diet and exercise programs. They succeed because they start at a catching point, instead of in no man’s land, where most of you live (no offense). All you have to do to reverse your trend with diet and exercise, is get to the catching point first.

Listen, each morning I wake up early before my cases begin, and I work on this blog. My friend Jon presses snooze 4-5 times every morning and can barely get to work within 30 minutes of his start time. Jon and I are structured differently. I don’t feel like I can’t wake up. In fact, I wake up automatically before any alarm goes off because of the way I am built. I literally have no idea what Jon feels like in the morning because my brain and organs aren’t structured like his so I don’t feel what he feels. As a result, I may be tempted to say, “I wake up early because God has made me a supreme human being with will power, determination, and guts to succeed. I choose to work hard and resist the urge to sleep because I am strong.” Sure that would make me feel good, but really – I just wake up.

So the same applies to dieting and fitness. I know the smiley in shape people love to tell themselves (and everyone else who will listen) that they have been successful because they possess will power, strength, focus, and so on and on, but the truth is that they don’t resist the urge to eat or be lazy any more than I resist the urge to sleep in. Honestly, are we to believe that these people who go to the gym 6 times/week, drink smoothies, tan, surf, and smile feel miserable? They do not, because at some point in their lives they got over the hump, and now it’s fun. The point of The Catching Point Transformation program, actually, is to show you how to adjust your body so that diet and exercise will be as effortless for you as waking up early is for me. Here are a two tips to help you get to that trans-formative point.

 

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Don’t start over

Imagine that you are a collector of rare coins, and you hope to one day have a collection of all of a certain series of coins. They are hard to come by so you can’t just walk into a store and buy the whole set. What you would do, then, is always keep the idea of your collection in the back of your mind – and collect coins “in chunks” as the opportunities presented themselves. For example, if you had a vacation you might take a day to travel to a certain location that is known to have coins of your type and buy a few. Conversely, if you had two busy days at work you wouldn’t worry about the coins. BUT, you would keep the coins you have collected in a safe place, and continue to add to them. You would not say, “Well, I had two busy days at work and I couldn’t add to my coin collection, so I’m going to throw all my coins out and start over.” You would add to your collection in chunks, as your life allowed. Same thing here.

Invoke the “do nothing” clause

People who succeed at anything take a few lumps, have a few down days, take a few days off, and then they keep going. To be clear, though – I’m not saying push through it. I’m saying come back where you left off. This is where the “do nothing” clause comes in to play. Each time you start to feel that darkness creep in, vow to do nothing for 24 hours. Don’t make any decisions one way or the other, don’t workout, don’t recover, and don’t even think about your fitness program. Just literally stop in your tracks and do nothing. After 24 hours return to the program and decide what you want to do.
Remember, we are all human beings with the same anatomy and physiology. We are all capable of accomplishing our fitness goals. As has been so famously said, “Pursue progress, not perfection.”

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Eight days of functional exercise quiets the hunger hormone response and makes dieting easy.

Harvard researchers gave obese people chocolate cake for breakfast then tracked their hunger hormone levels and weight loss. They showed that those who ate lost more weight and had lower hunger hormone levels in the long run vs. a group that was fed a low carbohydrate breakfast. [1] Finland researchers showed that in genetically identical twins if one twin repeatedly tried fad diets, and one did not – the dieter gained more weight in the long run. [2]

Starting on the left, the figure depicts how traditional diet changes and calorie cuts send an alarming message to the brain: we’re starving! The brain then, following thousands of years of evolutionary learning, rains hell down on you until you stop it (this is the source of the feelings you have on day 3 or 4, traditionally). The catching point program aims to create happy links between the brain and clean eating by harnessing and facilitating the positive changes that occur in between workouts. New links mean new feelings and fewer struggles with diet and exercise, like Sally Yogapants on the right.

What is the point of these studies? Mind-body links will not allow you to starve. [3, 4] The hunger hormone response to calorie restriction diets is intense, and real – and strong enough to cause you to overeat in the name of survival. [1, 5, 6] It is not reasonable to try and “white knuckle” through calorie restriction and beat this response. You will end up gaining more weight in the long run. Hence, so many people repeatedly fail these diets and become convinced that they cannot lose weight.

The solution to this epidemic is well known to the obesity medicine community. Pioneer of obesity medicine and Yale Professor Lee Kaplan, MD, PhD, said, “Exercise alters food preferences toward healthy foods . . . and healthy muscle trains the fat to burn more calories.” Most people don’t get to that point though, because they quit the diet once they feel the hunger hormone response.

What does it take to get to that point? To reach that position where clean eating is easy and fun? Eight days of functional exercise. Eight intentional workouts spread out over as many days as necessary, while staying full and supplementing recovery. At that point, the body’s response to fitness is positive, kinetic – and you are on your way. So stay full, supplement wisely, and exercise deliberately for as long as it takes to get in those eight workouts. Then you can abandon the struggle.
1. Dieting? Have some cake. Could your favorite treat help you lose weight? Harv Health Lett, 2012. 37(8): p. 4.
2. Pietilainen, K.H., et al., Does dieting make you fat? A twin study. Int J Obes (Lond), 2012. 36(3): p. 456-64.
3. Schubert, M.M., et al., Acute exercise and hormones related appetite regulation: comparison of meta-analytical methods. Sports Med, 2014. 44(8): p. 1167-8.
4. Disse, E., et al., Systemic ghrelin and reward: effect of cholinergic blockade. Physiol Behav, 2011. 102(5): p. 481-4.
5. Sainz, N., et al., Leptin resistance and diet-induced obesity: central and peripheral actions of leptin. Metabolism, 2015. 64(1): p. 35-46.
6. Weiss, C.R., et al., Bariatric Embolization of the Gastric Arteries for the Treatment of Obesity. J Vasc Interv Radiol, 2015. 26(5): p. 613-624.

 

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