My Failure

I gained weight slowly, from an ideal BMI (body mass index) of 24 to becoming obese (BMI=30) over 30 years, and then back to a BMI of 22.6 in 2 years. I started my internship in medicine in the summer of 1972, thin and fit. The hard work and long hours of internship, residency, and private medical practice made me eat anything I could get. I worked, ate, slept, and was a couch potato during my waking hours. I gained weight slowly—even while eating junk food and a lot of simple carbohydrates, because medical practice was also hard work. I really gained weight after my retirement in 2000, and by 2003 my weight increased from 165 to 186 pounds. With my height of 5 feet 6 inches, that gave me a BMI of 30, bringing me into the obese category. After I retired, I started to play golf, but that didn't stop the weight gain. In 2003, I tried the Atkins diet and lost 21 pounds. About 1/3 of the weight I lost came back after a few months, then I tried the cabbage soup diet for a week, and my weight quickly returned once again to 165 pounds. Since then, I had been trying to control my weight using different means, without any success. My failure didn't surprise me since I didn't really understand the principles of weight loss. I found out later what went wrong.

Finally, in the summer of 2005 I found a balanced, healthier, and easier way to keep my weight down. I tried it in August 2005, and lost another 25 pounds, bringing me to 140. My waist size went from 36 to 29. With a new understanding of the main principles of dieting, I incorporated them with my own exercise program, which I did at home without purchasing any new expensive exercise equipment. Since 97% of all dieters failed in 5 years, I would like to let you know why I failed to lose weight in the beginning.

1. I tried to skip breakfast to reduce calorie intake.
Breakfast is the most important meal of the day, and should be taken after morning exercise or within one hour after getting up. It will ease your hunger, keep you from overeating afterwards, increase energy levels, increase metabolism—and trigger more calorie burning. Skipping breakfast in the morning causes your body to burn a little muscle as fuel, if you wait too long before your next snack or lunch. With a big lunch and/or dinner, your body then builds the excess energy back as fat. The worst thing you can do is to replace your breakfast with a midnight snack. You might have the same calorie intake, but you will end up with more fat than muscle. You might weigh the same, but your size will increase because fat takes up more space than muscle.

2. I tried to reduce portion size, but still ate many simple and refined carbohydrates.
If you maintain a high glycemic diet (starchy and sugary foods) while reducing your total calorie intake, then your portion sizes will have to be reduced. Eventually, you will be so hungry that you won't be able to sustain this diet too long. A low glycemic diet (high fiber foods) will sustain you much better, with slow and prolonged glucose absorption, and you can still have adequate portion sizes. To further satisfy your stomach, you should have beverages such as unsweetened drinks, tea, coffee, or soup with each meal or snack. I prefer soup with a lot of vegetables.

3. I didn’t like vegetables.
I thought only rice, bread, pasta and potatoes would satisfy my appetite. Actually, I was craving high glycemic foods to satisfy my sugar addiction, which was probably due to high insulin (a pancreatic hormone) and transient hypoglycemia (low blood sugar). Excess intake of starchy and sugary food leads to elevated blood glucose and increases insulin secretion. Too much insulin drastically drops the level of blood sugar and causes hypoglycemia and sugar craving. Leafy vegetables are super foods, and you can never eat too many of them. They make you feel full longer, and provide fiber, antioxidants, important phytonutrients, vitamins, calcium, and iron—but not too many calories.

4. I didn’t exercise because I didn’t think it was that important and didn’t have time due to my busy medical practice.
Actually, there was plenty of time to exercise, and I only needed 150 minutes a week. I could accumulate that much time just doing several short bursts of exercise on weekdays and longer ones on weekends. Without exercise, it will be much harder to lose weight by dieting alone. (The reverse is true: without dieting, exercise alone won’t help you lose weight, either.) The additional health benefits of exercise are as important as weight loss.

In a low glycemic state (during morning fasting before breakfast), dieting burns both fat and muscle, but exercise mainly burns fat as fuel. To lose weight by dieting might be faster initially, but exercise is healthier. By firming and building muscle, and burning more calories, exercise will sustain weight loss more effectively. Whenever you feel like your diet just won't be able to get rid of those last few pounds, adding a few more minutes of exercise every day will do the trick. Exercise may be especially helpful in reducing the size of fat cells around the waistline. Dieting alone showed no such change. This is important, because fat specifically in the abdomen has been linked to the risk of heart disease and diabetes.

Actually, dieting is a negative and restrictive concept, because you have to reduce your portion size and calorie intake. Instead, exercise is a positive activity because it makes you look better, feel better by releasing endorphins, and makes you want to do more, as well as making you fit. Exercise improves your physical and mental health. Exercise (and adequate sleep) also releases growth hormone, which promotes growth in children, increases calcium retention and bone density, increases muscle mass, promotes lipolysis (the breakdown of fat stored in fat cells) and reduces body fat, increases protein synthesis and stimulates the growth of all internal organs except the brain, and stimulates the immune system.

5. I didn’t really understand the concept of lifestyle modification, and went on yo-yo dieting.
“Lifestyle modification” means good eating choices and regular exercise. The right carbohydrates, lean meats, and good fats should be the main components of your diet, and they can be found in all major food groups. A low glycemic index (This index measures how much your blood glucose increases in the two or three hours after eating) and glycemic load carbohydrates (a ranking system for carbohydrate content in food portions based on their glycemic index and the portion size) will slowly replenish glucose and glycogen. Lean meats will supply amino acids to muscles and convert them to glucose if needed, esp. for the brain in a low glycemic state. Good fats include unsaturated fats and omega-3 fatty acids.

Having the right mix of food is very important. A small amount of high glycemic index food, mixed with vegetables, meats, or unsaturated fats, becomes low glycemic index food because the mix encourages slow glucose absorption. Different varieties of food also ensure that valuable nutrients are included in your diet. A lack of certain nutrients can make you hungry, even you already have adequate calorie intake.

If you try any diet program, don't ever lose and gain weight like a yo-yo. If you are not losing weight as you desire, find out what is the problem. Ask your doctor, nutritionist, expert or someone you know who has successfully lost weight. Never give up in the middle of your diet program, but do modify it. When you lose weight, up to 25% of this is muscle loss (which can be prevented by exercise), but when you gain weight back, almost all of it is fat. So even you go back to the same weight as before, your body size will increase because fat is much less dense than muscle. The fat takes up more space on your body.

6. I tried to starve myself into losing weight.
Actually, you should avoid excessive hunger, because it will trigger a “starvation protection mechanism” in your body and produce cortisol. It will also increase blood glucose by inhibiting tissue glucose uptake, store fat, and also increase appetite. A low glycemic diet and proper snacking will slowly replenish your supply of glucose and prevent hunger.

Snacks should consist of a small handful of nuts and seeds, skim milk, low-fat dairies and soy products, and/or vegetables. After the initial quick loss phase (first phase), you can add fruits as part of your snack and actually ease your craving for sweets. You shouldn’t have an empty stomach for more than 5 hours to avoid starvation protection, and you should resist having sweets between meals and snacks.

7. I usually ate more when I played golf or exercise and thought I needed it or could afford it.
Some people load up carbohydrates before, during or after golfing. They actually are taking in more calories than the exercise can burn. An avid golfer burns about 1000 calories in four hours by walking, but the percentage of overweight golfers is the same as the percentage in the general population. It is better to have normal meal, like a decent breakfast, before golfing, and a smaller snack or lunch afterwards.

8. I couldn't resist the craving for sweets and late night snack, which is usually a pretty large one.
If you have 3 meals and 2 snacks a day, you won't overeat due to excessive hunger. You should control craving with self-discipline, determination, and by devoting your attention to something else, such as exercise or listening to music. Craving will often go away if you can resist for 15 minutes. Actually, one of the best ways to lose weight in my experience is to go to bed earlier without late night snack, and have an early morning exercise.