Quiz

So what are the keys to happiness? In my experience, there are several keys that drive most people toward happiness. Loving and sharing in meaningful relationships is a big one. Having a purpose is very important. Being present-centered, living life here in the moment, is another. (Don't dwell in the past or constantly dream of the future.) Having autonomy and control over one's life is extremely important to happiness, as is being rewarded for effort.

All of these keys to happiness are relevant to weight loss. People who are in meaningful, supportive relationships are more likely to follow good health habits. People who feel that their actions have a purpose are more driven and motivated and stick with a plan. Those who live now, in the present, are more attuned to their bodies' needs. It's been shown that personalities that are more autonomous and independent, sometimes called "having an internal locus of control," are less likely to be obese. Finally, those who feel that they are getting positive feedback for their efforts are more likely to continue those efforts. That's why there is so much emphasis in some diet programs on the regularly scheduled weigh-ins.

Traditional diets fail eventually because we stop thinking about what we put in our mouths. The only way to modify the input permanently is to ingrain the new eating habits. But the bigger reason that traditional diets fail is that we hate restrictions and commands. When a human feels forced to do a behavior but doesn't learn to enjoy it, eventually the behavior stops.

Most weight-loss books are traditional diet books because they concentrate on the "diet component," that is, the food part of the equation for weight loss. Yes, food choices are important, but they're only a third of the formula. The biggest component of successful weight loss is the mind (behavior), not the food component. And just as big a component as food intake is the activity. An overemphasis on what to put in the mouth misses the truth about permanent and successful weight loss.

Some people are internally driven, that is, they use their own thoughts and emotions to assess and motivate themselves. But many people are externally motivated. They need others to tell them their accomplishments, tasks, and self-worth and to encourage motivation. This is an important point: those who are externally driven are more likely to be overweight, since so many cues to eat surround us in our modern existence.

If you are externally driven, you may undermine your ability to lose weight by blaming others for your own behavior. You may say that you can't lose weight because "my husband likes to eat out a lot" or "I have to keep junk food in the house for the kids." Nobody forces you to put food in your mouth, and nobody forces you to sit on the couch at night except yourself. (However, if people are tying you to the couch and force-feeding you potato chips, I suggest you put this book down and call 911.)

When it comes to being overweight, our genetic predispositions do matter, a little bit. Heredity is involved in taste preferences for food and for psychological coping responses, although often these are learned, as well. Genes also account for how well or how poorly we process our foods (for example, diabetics don't process sugars as well as others). It is said that genetics account for about 30 percent of our risk for obesity. The other 70 percent is the environment and our own behavior toward it. We can't change our heredity. We can change our environment and how we react to it.

Most of us who have struggled with a weight issue have learned to eat beyond when we are hungry. Cultures that are thinner don't do that. Bradley Willcox, MD, of the University of Hawaii, has published extensive research on Japanese longevity, weight, and health habits and compared them to those of the Western world. The people of Okinawa are some of the healthiest, longest-lived, and least overweight people on the planet. Traditionally, they practice the concept of hara hachi bu, which means "eat until you are 80 percent full." Never eat until stuffed or bursting, they tell their kids.

Social eating may make you automatically eat more when others are around, but heavy people who are self-conscious will sometimes eat less around others. If you are one of those, then make plans to eat more meals with others. Pick eating partners who will help you eat less by their own behavior if you have a choice in this. Obese people tend to pick other corpulent people to eat with, which encourages overeating. That's why fat couples get fatter together and have fat kids. Being overweight is contagious because of the behaviors that we encourage in those around us.

We surround ourselves with people who reinforce our social tendencies, including overfeeding and lack of exercise. Therefore, if you want to lose weight, you need to start choosing to spend more time with people with healthier attitudes and waistlines. But be careful—not all thin types are healthy. I don't know anyone who really enjoys being surrounded by skinny, crack-addicted smokers, unless you are an addiction counselor being paid by the hour. Hang out in places that encourage healthier behaviors. Meet a friend by the lake or in the park for a walk after work, rather than at the usual happy-hour bar or restaurant.

We eat more in groups than alone. This is as true in the lunchroom at work and at the Friday night card party at a neighbor's house as in a traditional restaurant. Just being aware that you are in a challenging situation is more than half the battle. Allow yourself the festive enjoyment of the social moment without the baggage of excess calories. Concentrate on your internal signals of hunger. Ignore the external signals of other peoples' hunger and eating patterns and you will accomplish a true defense against social overeating.

Dr. Barbara Rolls of Penn State estimates that obese people begin eating due to hunger only 20 percent of the time and finish eating a meal due to internal signals of satiety less than 40 percent of the time. If you are overweight, it is very likely that you eat beyond when your internal signals should have told you to stop. Relearning your body's own signals may be the most important step you ever take to permanent thinness. The nice thing about this approach to weight loss is that self-deprivation and starvation aren't necessary.

These foods are the most important food choices you can make at the beginning of every meal. For reasons explained in Chapter 6, each is nutritional and will significantly decrease your desire for calories. You will feel full after every meal and eat a whole lot less. You can drop weight without starving yourself. How awesome is that?

Some authors insist that meals should include a certain percentage of protein, carbohydrates, and fat to promote satiation. Complex carbohydrates, such as fruits and vegetables, are water-containing and so help with satiation because they are higher in volume. The stomach registers fullness not just according to the calories and the composition of the food (e.g., fats) but also by its volume. I'm not convinced, however, that those diet bars and foods that are supposedly "balanced" with the proper percentages of fats, protein, and carbohydrates are that useful. They are still missing the water content in the food itself and may not have easily absorbable nutrients, as do plain whole fruits and vegetables. The closer the food is to the soil, the less processed it is, the better it is for you. (Or, as my husband likes to say, the closer you eat to the ground, the shorter you are.)

Wherever you are, always have good food snacks handy so that you don't allow yourself to get too hungry and you aren't tempted by the availability of the not-so-good foods. This makes the vending machines, chips in the pantry, and the donut tray in the break room less inviting. It's okay to dive into your own personal snack bag when you need it; just make a habit of going there first, rather than in the direction of the not-so-good foods.

Our bodies want good nutrition. Often our bodies will tell us when we are not eating correctly or if we are lacking in a certain important mineral or vitamin. However, we might not know how to correct the problem. Strangely, though, in many cases our bodies might not even give us a hint. It is not uncommon for people, both children and adults, who are nutritionally deprived to eat nonfood items like paper or paint chips in the subconscious search for the nutrient their bodies are missing. Don't send your body down the wrong path looking for poor food substitutes because you haven't fed it the right foods. I believe a well-balanced nutritionally sound diet will help you avoid many cravings for junk foods, not just paint chips. If you judiciously spend your calories on proper food, your spouse won't need to restrain you from a late-night run to Dairy Queen or find you chowing down on the morning paper.

Listen to your body; it will often give you clues to nasty food and drink. If you are nauseous or have an upset stomach after eating something, that's an important hint. Perhaps the food was bad, as in old and stinky, or perhaps it wasn't meant to be ingested by you. Your body will feel better when it eats food that energizes it.

Speaking of nasty stuff, MSG (monosodium glutamate) is a "flavor enhancer" found in many products at home and commonly in restaurant food. It works to enhance flavor by screwing with your taste buds and, in some people, with brain chemistry. Personally, my brain chemistry can't take any more screwing up. I avoid it.

Other additives, like artificial sweeteners such as aspartame, acesulfame potassium, and saccharin, may be linked to cancers. How about artificial colorings? Many of them, from Blue 2 to Yellow 6, are known to increase cancer risk, but they are still on the shelves in your local supermarket. On the other hand, naturally colored foods from plants are cancer protective.

According to researchers at Harvard University, it's not unusual for teenagers to drink between 500 and 1,000 calories a day in sugar-containing beverages. They see this as a contributor to the obesity epidemic among children. They have also found a strong correlation between consumption of sugar-containing drinks and the development of obesity and diabetes in adults. The scientists at Harvard have gone so far as to declare the need to curb the consumption of soft drinks and other sweetened beverages to fight our national epidemic of obesity (and the resultant diabetes).

Milk alone can suppress appetite because it has protein in it and sits in the stomach longer than most other types of beverages. Use only skim milk. Anything more is not worth the excess fat.

Purdue University psychologists Drs. Susan Swithers and Terry Davidson found that rats exposed to diet sweeteners are more likely to consume excess calories than those who drink sugar-containing beverages! Their saccharine-fed rats gained more weight and put on more fat than those fed a simple sugar. Those fatter rats never cut back in their eating habits later. The researchers believe that the use of artificial sweeteners causes a break in the body's ability to regulate intake and metabolism. Since the substances are sweet, the body believes it's about to get a lot of calories; when it doesn't, it actually spurs feeding to get those calories it's anticipating. This would explain why other studies of artificial sweeteners have not conclusively demonstrated that they help in weight loss.

I strongly feel that most people who eat at night don't eat because they are hungry. Mental fatigue, stress, and sleep deprivation often lead to eating to decrease physical and mental discomfort. We try to get the bump of pleasure from the food when what we really need is rest and mental comfort. If you check your hunger level before eating every time, you will know whether it is appropriate to eat before bed.

I can't leave the discussion of nighttime snacking without mentioning gastroesophageal reflux disease (GERD). Overweight people suffer from GERD more than anyone else. When stomach or bile acids backwash up into your food pipe (the esophagus), they cause irritation, including heartburn, difficulty swallowing, asthma, and coughing. Everyone can have this happen on occasion, but when this happens more than twice a week, it's given the name of GERD. The funny thing about reflux disease is that the symptoms can make the sufferer eat more food, trying to alleviate the symptoms. It's one of those vicious cycles.

I've noticed that many overweight people get bogged down in their genetics. They spend too much time worrying about their family history of thick thighs and not enough time contemplating how to move those thighs. Yes, twin studies and adoption studies show that people are more likely to have a metabolic rate that is similar to those of their biologic parents than one like their adoptive parents'. So your quick or slow metabolism is somewhat determined by genes. However, this can be modified by nurture, by what you do to speed up your metabolism. Heredity is not destiny.

You can control your own metabolism, and you have a lot of power in this regard. Metabolism is affected by such things as starvation and eating cycles and also perhaps by ingested chemicals like artificial sweeteners. In addition, metabolism is affected by exercise, sedentary activities (like television watching), temperature, foods, hormones, medicines, and muscle and adipose tissue.

Americans are the most sleep-deprived people on earth and also the fattest. Columbia University presented research in 2004 showing a statistical relationship between the number of hours of sleep daily and the risk for obesity. Those who get less than four hours of sleep a night have a 73 percent greater risk of being severely overweight. Anyone who gets less than seven hours of sleep a night is at increased risk for becoming overweight, and there is a direct inverse relationship—the less sleep you get a night, the fatter you will become. Do you think you are the only one not getting enough sleep? Americans report an overall decrease in sleep by about two hours a night in just the last four decades.

Most aging-related changes in muscle result from inactivity, not true aging. The number of mitochondria, the individual powerhouses of cells, declines only in inactive muscle but can be increased if the subject exercises. This was demonstrated by an elegant study done more than a decade ago in the United Kingdom, at the University of Newcastle upon Tyne. The researchers compared muscle function in young and old, in sedentary and in active people, and were able to conclude that in those older folks who stayed active, the metabolic markers for "aging muscle" were absent.

I'm going to give it to you straight: it is nearly impossible to lose weight and keep it off long term without a daily exercise regimen, permanently. Yes, there are people who do it, and you may know them, but they are a very small minority of the successful normal weight individuals of the world. And, besides, just because they are normal weight doesn't mean they are healthy. My approach to weight loss is to do it for the sake of health, not just for the great-looking figure. The great-looking body is a wonderful side effect.

At least three-quarters of those who lose any weight permanently do so by exercising regularly at least three days a week for the rest of their lives. Walking is by far the most common exercise, and many do it daily to lose the weight and keep it off forever.

One hundred years ago, most people led very active lifestyles out of necessity. The vast majority of the world's population lived on farms. They exercised the equivalent of jogging up to 7 to 10 miles a day. Our bodies have evolved to want and need that much activity; we are not that far removed biologically from our animal brethren. When we are inactive, our bodies break down rapidly, both physically and emotionally.

I believe our medical establishment has overblown the necessity of "check with your doctor before beginning an exercise program." I've always been irritated by that statement when I see it in a magazine or hear it on TV. Given the fact that many people wait to see a physician until they are having a near-death experience (men more than women do this), telling people to "check with their doctor" throws a huge hurdle in front of couch potatoes. Those potatoes are more likely to stay on the couch; it gives them a great excuse to procrastinate.

What I'd love to see is blaring television ads and front-page headlines screaming, "Check with your doctor if you want to stay a couch potato." Believe me, in our modern culture, inactivity kills many more people than exercise.