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Don't Count Calories

Contestants on the television program The Biggest Loser dropped an average of 129 pounds, yet six years later, most have regained more than 70 percent of their lost weight, largely because dieting decreased their ability to burn calories. They now burn about 500 fewer calories each day than would be expected for a person of the same age and weight (Obesity, published online May 2, 2016).

We have known for many years that the commercial weight loss programs do not work. The $2.5 billion weight loss industry has a terrible one-year-weight-loss record and of the clients who have lost weight at one year, almost all have regained their lost weight three years later (Annals of Internal Medicine. April 2015;162(7):501-512).

In spite of all this discouraging news, I know that it IS possible to lose weight and keep it off. For at least thirty years, I have been telling my patients not to count calories or to eat so little food that they feel hungry all the time. Instead, I tell them to switch to eating lots of the foods from plants that fill you up so you do not ever need to feel hungry. If you do this, your body never turns down your metabolism in its effort to protect you from starving to death. Those of you who listened to my radio show or have read my books know that my mantra has always been "fruits, vegetables, whole grains and beans" -- and nuts and other seeds. Eating mostly these foods will cause you to lose weight without lowering your metabolism.

Why You Should Lose Excess Weight
Being overweight increases your risk for premature death from cancer, heart attacks, strokes, and diabetes. Each year obesity is associated with 481,000 new cancers worldwide (Lancet Oncology, Jan 2015;16(1):36–46), particularly those of the breast, colon, rectum, uterus, esophagus, stomach, pancreas, kidney, liver, gallbladder, ovary, aggressive prostate cancers, non-Hodgkin lymphoma, multiple myeloma, and cervix. See Being Overweight Increases Risk for Many Cancers

How to Lose Excess Weight and Keep It Off
What and when you eat now appear to be more important than how much you eat. Today, the three key messages for people who want to lose or control weight are:
• Eat mostly anti-inflammatory foods
• Eat the foods that favor growth of beneficial bacteria in your gut
• Use intermittent fasting to cut total calorie intake without lowering your metabolism

Anti-Inflammatory Foods: Right now the hottest topic in health research is inflammation. When your immunity stays overactive it attacks your own cells to cause diseases and shorten lives. Foods are now classified into harmful pro-inflammatory and healthful anti-inflammatory categories. Basically, this research tells us that you should eat lots of fruits, vegetables and seeds (nuts, beans, whole grains) and try to severely restrict sugar-added foods and drinks, red and processed meats, and fried foods. For a list of anti-inflammatory foods, see Belly Fat Predicts a Heart Attack

Beneficial Gut Bacteria: Fortunately, the anti-inflammatory foods are the ones that encourage the healthful types of bacteria to colonize in your gut. We do not yet fully understand how gut bacteria affect body weight and weight loss, but scientists agree that a high-plant diet fosters growth of the beneficial bacteria. See Gut Bacteria and Weight Gain

Intermittent Fasting: Any of the variations of intermittent fasting can significantly reduce your total intake of food without lowering your metabolism. You do not need to fast for long periods, which would be very difficult. Instead, you skip some of your regular meals on some days and snack on small amounts of healthful foods. For example, you can stop eating meals from 5 PM to the next morning, or skip meals for a certain number of days each week or month. When you "fast", you can snack on small amounts of anti-inflammatory foods such as nuts, vegetables or fruits. A few days each week, I eat oatmeal for breakfast and then snack on small amounts of nuts, fruits and vegetables throughout the day. Since we have no more will power than anyone else, we keep nothing else in the house. See Weight Loss with Intermittent Fasting

Exercise for Weight Loss
Most people are not capable of exercising long enough or hard enough to lose weight with exercise alone (no diet changes) because exercise does not increase 24-hour fat oxidation (Exerc Sport Sci Rev, April 2009; 37(2): 93–101). However, people who want to lose excess weight should exercise in addition to changing their eating patterns and choice of foods. Storing fat in the belly markedly increases your risk for diabetes and heart attacks, and exercise specifically reduces abdominal fat and improves health, even without weight loss (PLOS One, January 25, 2016). Because high blood sugar levels damage every cell in your body to shorten life and cause disease, a major benefit of exercise comes from the fact that contracting muscles draw very large amounts of sugar from the bloodstream and don't even require insulin to do so. (Resting muscles draw almost no sugar from the bloodstream and when they do, they require insulin). However, this benefit from exercise lasts no longer than 17 hours, so you need to exercise every day.

My Recommendations
I hope that you will ignore the "weight loss is hopeless" message in all of the news reports about The Biggest Loser. You CAN lose weight and keep it off, but you need to make permanent lifestyle changes. Temporary diets never work. To lose weight and then maintain your healthful weight for the rest of your life:
• eat a diet based primarily on fruits, vegetables, whole grains, beans, nuts and other seeds
• restrict sugar-added foods and drinks, processed foods and all sources of refined carbohydrates
• use short periods when you skip meals and just snack
• exercise every day 

Checked 6/3/17

May 15th, 2016
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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