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Compassionate Weight Loss for Life PDF Print E-mail
Written by Frank Sabatino, D.C., Ph.D.   
Wednesday, 29 August 2007 18:00

Obesity has become a modern day global epidemic. Two out of three Americans are overweight, and close to one in three are obese. Globally, overweight people in the world have topped the one billion mark.1 What makes this even more devastating is the fact that since 1980 one of the most rapidly growing overweight segments of our population has been children under the age of 18. The U.S. has achieved the frightening distinction of having the fattest children in the history of the world!

Obesity has become a modern day global epidemic. Two out of three Americans are overweight, and close to one in three are obese. Globally, overweight people in the world have topped the one billion mark.1 What makes this even more devastating is the fact that since 1980 one of the most rapidly growing overweight segments of our population has been children under
the age of 18. The U.S. has achieved the frightening distinction of having the fattest children in the history of the world!

Excessive weight gain is clearly associated with an increased risk of developing heart disease, diabetes, and cancer. In fact, since fat cells produce reproductive hormones, an increase in fatness can exaggerate the amount of these hormones and promote hormone-induced cancers of the breast, uterus, ovaries and prostate. As a result, obesity has become one of the leading causes of cancer in our culture today.

Yet, as pervasive as this problem is, the approaches to solving it have been incredibly short sighted. Reducing weight and fat seems to constantly focus on the narrow minded debate of “calories in” vs. “calories out,” so that the burden of responsibility for weight gain is routinely focused solely on the dieting and exercise habits of individuals. As a result, a panorama of quick- fix fad diets and exercise programs are held out as the answer to the prayers of the overweight, even though the millions of people who religiously adopt these approaches typically meet with failure and, even worse, reactive long-term weight gains. With this in mind, it should be no mystery why the dieting industry in the U.S. is annually more than a $50 billion industry with a failure rate greater than 95 percent!

There is no argument that more discipline in our eating and exercise habits is necessary to reduce weight.  However, an extensive body of clinical practice and research data strongly suggest that it is imperative to consider the synergistic interaction of several key factors to solve the problem of obesity. These factors include the quantity, quality, and type of food we eat, the exercise and activity we maintain, how we handle daily and chronic stress, the emotional context of our food use,  the sleep we get, the drugs and stimulants we overuse, and the impact of industrial and environmental pollution and toxicity.

As human primates, we are designed to eat primarily a plant-based diet. Historically, the original food supply of our species was fruits and plants that grew readily around us. However, there was a time in our past when these original food supplies became scarce as a result of environmental pressures and changes, and we were driven to hunt and kill for food in a very arduous and threatening environment. In this scenario, food was no longer easy to come by, so there could be long gaps between when we ate and when we ate again.

As a result, a “starvation response” developed in response to periods of deprivation. Hormonal and chemical changes were established that could program an exaggeration of hunger signals and override satiety signals when food was available again, to encourage overeating and store calories for a future time of need. This same ancient starvation response still exists within each of us today, and is often triggered by the recurring use of extreme calorie restricted or fragmented fad diets. This becomes very problematic in modern times when there are no longer big gaps between the “kills,” as we are constantly overexposed to all the calorie dense meat and dairy products, and processed junk and refined foods that are so readily available today, and our calorie output is decreased by the remarkable reduction of physical activity in our modern society and school systems.

As a result of the hormonal and biochemical changes of this ingrained survival response, fad diets that promote restricted calories and food types — e.g., low-carb, high- protein animal-based diets — without regard for the quantity and synergy of key nutrients, typically promote long-term reactive weight gain.

Understanding and correcting certain hormonal and biochemical disturbances is essential to solving the problem of obesity. Perhaps the most common metabolic disturbance associated with weight gain is insulin resistance. Insulin is a hormone that carries sugar into cells by attaching to special proteins (receptors) on the surface of brain and muscle cells. These receptors act like doors in the membrane, or outer envelope, of cells. When insulin attaches to these doors, it acts like a key opening these doors so that sugar can enter the cell and be converted into energy. However, weight gain, high fat diets, excessive consumption of refined carbohydrates, yo-yo dieting, decreased physical activity, and sleep deficiency slam these insulin doors shut making them resistant to the attachment and action of insulin. As a result, sugar can’t enter cells, blood sugar rises, driving sugar into fat production and weight gain via the action of the fat making enzyme, lipoprotein lipase. It is important to note that the potential activity of this fat making enzyme is significantly increased during extreme dieting as a part of the starvation response so that this enzyme is poised and ready to promote dramatic, rapid weight and fat gain whenever fat and sugar intake is increased following periods of dieting and calorie restriction.

Since insulin is not attaching well in insulin resistance, the body begins to believe that there is an insulin deficiency, and overproduces insulin. This excessive insulin increases our craving for fat and sugar, reinforcing the cycle of sugar imbalance and weight gain.

Because of the disturbance of insulin function, eating in a way that produces excessive fat, or raises blood sugar quickly, can promote reactive weight gain. So the ideal eating plan is a plant-based diet. This eating plan is low in calorie density and fat, high in complex carbohydrates, high in plant-based proteins, high in fiber and water content, high in vitamins, minerals, phytonutrients and antioxidants, and low in glycemic index.  Glycemic index is just a measure of the impact any food has on blood sugar. High glycemic foods — e.g., all refined sugar and bakery products, and white flour products (white bread, white rice, refined pastas etc.) — which raise blood sugar quickly to a high degree should be avoided. These foods tend to promote reactive weight gain. The ideal plant-based approach contains low glycemic foods including all fresh vegetables, a variety of fresh fruits, (especially all berries, grapefruit, apples, kiwi, peaches, plums, cherries, and nectarines), complex starches like lentils, beans and whole grains that include brown rice, millet, barley, and quinoa. Overcooking and over processing fruits and vegetables tend to raise their glycemic index. Therefore, fruits and veggies, should be eaten as close to the raw state as possible, or lightly steamed or sautéed, not embalmed.
The diet should contain moderate amounts of nuts, soy proteins, and avocados, and a very modest use of both 100 percent whole grain, man-made starches like bread and pasta, and man-made bottled vegetables oils. Fresh juicy fruit should be used as a substitute for refined sugary desserts whenever possible. As a strategy to eliminate an addiction to refined sugar over the next 30 days, every time you want a dessert or something sweet, have a piece or two of juicy fruit. In addition, have some fat, a few almonds or a sliver of avocado and a few celery sticks, with the fruit. This will lower the glycemic impact, slow down sugar absorption, maintain better blood sugar stability, and decrease hunger and craving. In addition, avoid all sugar additives, artificial sweeteners, and sugar substitutes.

With the prevalence of high protein diets, it’s amazing to me how many people are freaked out about eating a piece of fruit. Juicy fresh fruits are ideal for healthy weight loss. In fact, I’m going to give you a guarantee. If you’re sitting out there with a weight problem or a weight concern, I can guarantee you one thing. Fruit is not your problem. In 30 years of counseling people about health, I have yet to have one person come in and say, “Doc, I have a weight problem, can you help me with this apple thing.” Also, in the next 30 days, in addition to fruit only for dessert, anytime you want anything grainy, make it brown rice, millet or quinoa instead of bread or pasta. After the 30 day period, incorporate breads and pastas moderately in your diet, perhaps a few times a week, and make sure they are 100 percent whole grain products.

There should be elimination, or at least, a dramatic decrease in all animal and dairy products. If you can’t commit to a complete vegan diet, try to limit your animal protein to less than 10 percent of all the protein you eat. This translates to about 5-10 ounces of animal protein a week. Once you realize that you can live on this small amount of animal protein, you’ll realize that you can live on no ounces a week.

Unfortunately, we have been sold the barbaric, erroneous, and unscientific notion that life, health, and weight loss can only be maintained by the consumption of animal products. It is imperative to realize that we can’t keep destroying other forms of animal life and the environment to promote the illusion of weight loss. Typically, since high protein animal-based diets eliminate carbohydrates that tend to promote water retention, some initial weight is lost due to dehydration. Some weight is lost due to significant calorie reduction, in the early stages of a high protein diet, resulting from the abrupt elimination of calorie dense refined carbohydrates. As a result, weight loss has very little to do with protein consumption per se, while people continue to overeat concentrated protein foods, and mistakenly attribute their weight loss to excessive protein intake. Unfortunately, high protein animal-based diets also have dangerous levels of fat, typically 40 percent or more of total calories.

Therefore, staying on this type of diet for more than 4-6 months can result in a significant increase in vascular blockage and decreased blood flow to the heart and brain, increasing the risk of stroke, and heart disease. In addition, high protein animal-based consumption significantly increases chronic constipation, migraine headaches, potential cardiac arrhythmias from mineral losses associated with the dehydration effect of high protein diets, and significant reactive weight gain over time. Animal and dairy products are too high in cholesterol, saturated fat, acidity and arachadonic acid (omega-6), that provoke systemic inflammation, weaken the immune system, and promote exaggerated hormonal changes which increase stress and reactive weight gain. While some fish may contain helpful omega-3 fatty acids (DHA), they can also contain high cholesterol, potential mercury contamination, and organochlorines, like PCB in farm raised salmon, which can disturb hormone and thyroid function to promote weight gain.

We eat too much meat and dairy products (liquid meat) in America. Annually, Americans consume more than 600 million Big Macs and 27 billion hot dogs, and are killing and eating 27 chickens a second.  It is a killing field out there. It is a holocaust of animal abuse, torment, and torture. There are no human primates that need to have their routine protein and weight loss requirements met by this pattern of torture and killing.

And if that’s not bad enough, poverty-stricken farmers and corporate ranchers in Central and South America are paid vast sums of money to engage in slash and burn agriculture to destroy valuable rainforest trees to grow one single crop: grass for cattle production. The U.S. imports more than 200 million pounds of meat a year from the small rainforest countries of Central America.2 As a result, we are losing approximately 40 million acres of rainforest a year to make a 99-cent hamburger available for the vulgar appetite of our fast food nation.3 Since 1990, that’s just 17 years now, we have lost close to 50 percent of the rainforest on planet earth!4 The loss of this tree life eliminates a valuable source of oxygen for our planet. Within a short period of time, a global crisis of oxygen deficiency may affect our future generations. Tell me how good that hamburger tastes when you or your children or your grandchildren are suffocating to death eating it!

Furthermore, burning this biomass of trees increases the presence of carbon dioxide in our atmosphere. Eliminating these trees also wipes out the potential of forests to capture carbon dioxide from the atmosphere and drive it into groundwater for long-term carbon storage. As a result, excessive carbon dioxide is maintained in the atmosphere, enhancing the greenhouse effect, and feeding the life-threatening problem of global warming. No good can come from this pattern of environmental abuse, lack of compassion, and vibration of violence!

Remember, in all the years of weight loss research, the most important parameter of any eating plan to support long term weight loss is calorie density. This is the amount of calories the diet contains per weight of food. A plant- based diet has the greatest amount of nutrients for the smallest amount of calories. A pound of salad greens is only 100 calories a pound! Eating a diet primarily composed of fruits and vegetables, provides a diet that has the lowest calorie density of any diet on planet earth, and is the most effective for long term weight loss. Furthermore, since this diet also contains the most water and fiber, it will also fill you up, provide a better sense of satiety, and eliminate craving and hunger.

Increase physical activity and aerobic exercise. Walking, 45-60 minutes, 4-5 times a week will lower body fat and body set point, and make you more calorie efficient so that you can burn, rather than store, calories more successfully throughout your day. The combination of aerobic exercise and weight training, 30 minutes 3 times a week, can improve insulin function, help resolve the problem of insulin resistance and lower levels of insulin release, thereby reducing food and sugar craving. Exercise can also enhance the production of serotonin, the neurotransmitter that promotes sleep, to improve the extent and quality of sleep, and reduce sleep deficiency related weight gain.

Stress management
We are all capable of creating an arousal stress response whenever we perceive the events and interactions of our lives to be traumatic, threatening or stressful. During the typical stress response, also called a fight or flight response, short term increases in muscle tension, blood pressure, heart rate and breathing are created to provide the drive and energy to fight or run away from the perceived challenge. These actions are promoted by the hormone cortisol, and other chemical transmitters released by the glands of stress, the adrenal glands, and also to some degree by the hormones and activity of the thyroid gland.

Ongoing, unresolved stress can increase cortisol release to raise blood sugar levels and increase the production and circulation of fat. In addition, visceral, omental fat in the abdominal region has a greater number of receptors for cortisol than fat in other areas of the body,5 so that when excessive cortisol is released in response to chronic stress, it can preferentially target fat cells in your stomach area and promote the production and buildup of belly fat. The localization and increase in abdominal body fat has been linked to an increased risk of heart attack, angina, stroke, and non-drug dependent diabetes.6 Stress, alcohol, smoking, and caffeine in all of its’ forms all increase cortisol levels, and can contribute to risky, long-term fat and weight gain.7

The stress response is an energy demanding process that has evolved as an essential survival tool. However, as the relentless pressures and demands of our hectic, modern lives drive us into a state of chronic stress, we can deplete energy reserves and move into a state of exhaustion, also exhausting the glands of metabolism, adrenals and thyroid, and interfere with our ability to lose weight. Unfortunately, instead of resolving the exhaustion with supportive stress management techniques and sleep, we often opt for stimulants like caffeine, nicotine refined sugar and other stimulant-based drugs, supplements, and drinks which only magnify the problem of exhaustion.

Whenever the body is stimulated chemically, stimulation is only the initial effect. As the stimulants are metabolized, you will eventually crash to the same extent that you have been stimulated. Whatever goes up has to come down with equal and opposite force! Therefore, consistent use of caffeine and other stimulants promotes long-term fatigue and depression, suppression of the thyroid and adrenal glands, and reactive weight gain. Since caffeine in sodas, chocolate, coffee, some dietary weight loss supplements, and some over the counter analgesic drugs (Excedrin) can directly stimulate excessive cortisol release, it can directly contribute to adrenal exhaustion and increased body fat and weight gain over time.

This strongly suggests that stress management techniques should be an essential part of any weight loss program. Yoga, tai-chi, chi-gung, breathing and relaxation techniques, meditation, etc., are all approaches that can provide you with an opportunity to step back from the chatter of your life, embrace some quiet moments of precious present, replenish your energy reserves, and support the weight loss process.

In addition, our emotional responses to the conditions of life are intimately tied to our perception of the events and information we encounter. With the exception of major catastrophic trauma, negative stress and emotional upset are typically not in the event, but rather in the perception of the event, so that perception feeds emotion and together shape the strategies, behaviors, and solutions we create to solve the problems at hand. For example, our emotional relationship with food can also provoke abnormal eating behavior, especially since so many of us have been entrained from childhood to use food for comfort and distraction whenever life gets difficult and overwhelming. Growing up in an Italian household as I did, the deepest rooted experiences of affection and love were associated with food and food preparation. So even as adults, we often attempt to satisfy our ongoing needs for pleasure, physical well-being, emotional nourishment, and spiritual comfort with devastating calorie-dense comfort foods (high fat and refined sugar), that give us the illusion of well-being, while only increasing obesity, dissatisfaction and even self-loathing.

Also, in our brains there is a finely tuned orchestration of neurotransmitters and neuropeptides that establish our sense of reward and pleasure. However, a variety of reasons, including poor nutrition, sleep deficiency, lack of physical movement, chronic stress, and genetic modifications, can cause an imbalance of this chemical reward system. As a result, a reward deficiency can develop that makes it difficult to experience pleasure and joy from the normal activities of life. This can manifest as restlessness, anxiety, lack of satisfaction, “emptiness,” and vague or specific cravings.8 This can lead to behaviors and substances of abuse to fill the emptiness and satisfy the cravings.  So take some time to incorporate lifestyle changes that improve body and brain balance to support your brain reward system. Take a closer more conscious look at yourself and evaluate what you are using food for. Try to understand the context of your food use as well as the content of what you are eating.

The work of sleep medicine suggests that sleep deficiency is one of the leading causes of weight gain. Adults need an average of 7-8 hours of sleep a night, while children need 9-10 hours. Sleep deficiency can be defined as less than 4-6 hours a night. Sleep deficiency promotes abnormal food craving, blood sugar instability, stress, and potential weight gain.

Sleep deficiency is perceived by the body as a major stressful event. As a result, cortisol levels are increased, thereby increasing the circulation and stores of body and belly fat. Sleep deficiency also worsens the problem of insulin resistance, provoking the overproduction of insulin, and increasing the craving for fat and refined sugar. In addition, sleep deficiency increases the amount of ghrelin, a natural appetite stimulant, and decreases the amount of lepten, a hormone produced by fat cells that signals the brain that we’ve had enough to eat. So sleep deficiency can interfere with satiety signals and promote overeating. And since insulin resistance is increased by sleep deficiency, the craving for fats and refined sugar will also be increased at the same time, promoting a greater tendency to overeat these foods and increase weight gain.

Create a ritual of sleep. Sleep time is the time to wind down. Too many of us are winding up at bed time. Try not to take the stress and worries of the day to bed with you at night. The bedroom should be for two things: sex and sleep! Take a warm bath at bedtime. Put on some soothing music. Do a gentle relaxation technique. Have some intimate time with your partner. Eliminate as many stimulants from your life as possible, especially caffeine, nicotine, and refined sugar. These stimulants can interfere with body and brain chemistry, and promote sleep disturbances.

Pollution and Toxicity
Research in England, Canada, and the United States suggests that the most overweight people are found in cities and areas with the greatest amount of industrial and environmental pollution.9 In the U.S., the 10 fattest states are in the industrial South of our nation.10 They are connected either to the Mississippi River, the most polluted river in the U.S., or in the case of West Virginia, Texas, Alabama, Louisiana, and Georgia are home to some of the top 20 mercury polluting power plants in the nation.  While these areas may foster lifestyles that support poor eating habits and sedentary behavior, it appears that the increased levels of industrial pollutants may be contributing to the epidemic of obesity independent of other factors.

Mines, refineries, and factories regularly release toxins into the environment. Some of these pollutants are capable of disrupting key biological hormones, affecting the fertility of mammals and invoking changes that may be involved in reactive weight gain. Organochlorines — e.g., the pesticides DDT, its’ breakdown product DDE, and PCB (found in farm-raised salmon) — can decrease the levels of thyroid hormones, slowing down the metabolic rate of the body, and interfering with weight loss. These pollutants act directly on the sympathetic nervous system to interfere with weight-regulating hormones, and the receptors on fat cells, that may be involved in reactive weight gain.11

Some industrial pollutants like bisphenal-A, an estrogen mimic used to make clear hard reusable plastic products, and flame retardants, can signal dormant pre-adipocytes (baby fat cells) to grow into mature fat cells.12 As fat cells grow, it is harder to keep weight down. This increase in weight urges the detoxifying systems of the body to slow down and simply store more and more toxins in the growing mass of available fat. As a result, the body becomes increasingly fatter and more toxic. In some cases, these chemicals may elicit inflammatory responses and toxic effects on brain, liver, and kidneys.13 This may eventually overwhelm the body’s detoxification pathways. Under this pressure, the body tries to dilute these toxins by making new fat cells in which to store them, since these chemicals are usually soluble in fat, thereby reinforcing an ongoing cycle of toxicity, fat, and weight gain.

Obesity is a major health problem with devastating consequences of disability, disease, and death. However, it is a problem that can be solved if we are willing as individuals to address a constellation of causative lifestyle factors. There is no simple quick-fix solution. Yet, while the solution requires disciplined lifestyle choices by the individual, it also requires that countries and governments shoulder some of the responsibility, and take action to address the toxic by-products of the industrialization and urbanization of modern society. It is imperative that we create more emotional and spiritual balance in our lives, and realize that we must stop digging our graves with our teeth. At the same time, businesses and corporations must also be more accountable for their actions, and legally pressured if necessary, to realize that they can’t keep poisoning people and the environment for profit.

1. Thomas P. A big fat problem. Ecologist 2006. November issue 9, vol. 36:33-43
2. Hartman T. The Last Hours of Ancient Sunlight. Northfield,VT. Mythical Books, 1998.
3. Hartman T. op cit.
4. Williams L. Environmental Science Demystified. New York, NY. McGraw-Hill, 2005.
5. Bjorntorp P, Brodoff  BN. Obesity. Philadelphia, PA. J.B. Lippincott Company,1992.
6. Bjorntorp P. op cit.
7. Bjorntorp P. op cit.
8. Miller M, Miller D. Staying Clean and Sober. Orem, Utah. Woodland Publishing, 2005.
9. Thomas P. A big fat problem. Ecologist 2006. November issue 9 vol. 36:33-43.
10. Thomas P. op cit.
11. Thomas P. op cit.
12. Thomas P. op cit.
13. Thomas P. op cit.


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